The Respiratory System

Question 1

The Lungs 4 Functions

Answer 1

To extract O2 from the atmosphere and transfer it to the bloodstream in the lungs.
To excrete water vapour and CO2.
To maintain the normal acid-base balance of the blood.
To ventilate the lungs.

Question 2

the exchange of gas occurs in 2 places

Answer 2

External respiration - in the lungs

Internal respiration - in the body tissues

Question 3

process of gaseous exchange is called

Answer 3

diffusion - Movement from a high to low concentration.

Question 4

External Respiration

Answer 4

the process of breathing where:
oxygen from inhaled air is absorbed into the blood via the capillaries of the lung.
CO2 is released from the blood into the lungs and is exhaled.

Question 5

Internal Respiration

Answer 5

blood and the circulatory system carries O2 to the body cells. O2 is given off for use by the cells and CO2 is absorbed by the blood which is carried to the lungs.

Question 6

2 respiratory movements

Answer 6

Inspiration - breathing in or inhalation

expiration - breathing out or exhalation

Question 7

components of inspired air

Answer 7

O2 = 20%
Nitrogen = 79%
inert gas = 1%
CO2 = 0.04%
Water Vapour (variable)

Question 8

components of expired air

Answer 8

O2 = 16%
Nitrogen = 79%
CO2 = 0.4% (100% increase)
Water Vapour (to saturation/100% increase)

Question 9

17 components of the respiratory system

Answer 9

Nose
Mouth
Soft Palate
Pharynx
Epiglottis
Larynx
Trachea
Carina
Parietal Pleura
Serous Fluid
Visceral Pleura
right/left bronchus
Bronchi
Bronchioles
Alveolar Ducts
Alveoli
Diaphragm

Question 10

Structure of the Lungs

Answer 10

2 Spongy, Cone shaped Organs.
Right has 3 lobes.
Left has 2 Lobes.

Question 11

The Pleura

Answer 11

is a serous membrane that surrounds each lung.

it has 2 layers: Parietal and Visceral

Question 12

normal breathing rate for an adult

Answer 12

16 to 24 BPM

Question 13

normal breathing rate for infants and children

Answer 13

24 to 40 BPM dependant on age. younger = faster

Question 14

factors that can Increase breathing rates

Answer 14

Exercise
Fever
Clinical Shock
Conditions affecting the lungs (pneumonia, bronchitis)

Question 15

factors that can Decrease breathing rates

Answer 15

Conditions which affect the brain (CVA, head injury)
Certain drugs (Heroin, Methadone, Barbiturates)

Question 16

Control of respiration - involuntary

Answer 16

rate & depth automatically controlled by the respiratory centre & various other receptors

Question 17

Control of respiration - voluntary

Answer 17

concious control of breathing as in holding breath

Question 18

Chemoreceptors

Answer 18

in the brain and aorta monitor levels of CO2 in the blood.

increase in CO2 = increase in breathing rate & depth

Question 19

Dsypnoea

Answer 19

difficulty breathing

Question 20

Apnoea

Answer 20

absence of breathing

Question 21

Hypoxia

Answer 21

lack of O2 supplied to the tissues

Question 22

Hypercarbia

Answer 22

too much CO2 in the blood

Question 23

Obstructive Airways Diseases

Answer 23

Bronchitis
Emphysema
Asthma

Question 24

Bronchitis - what is it?

Answer 24

inflammatory condition affecting the airways caused by viruses or bacteria.

usually a short lived infection

Common in young children and the elderly

Question 25

Bronchitis - signs and Symptoms

Answer 25

``` Tachycardia (fast HR) Tachypnoea (fast breathing) Dyspnoea (Diff Breath) Cyanosis (blue bloater) Reduced O2 saturation (SpO2) BP normal or slightly raised Productive cough ```

Question 26

Bronchitis - signs and Symptoms

Answer 26

Use of accessory muscles Pupils may be dilated or slow to react If hypoxia is severe LOC may be reduced May be evidence of oedema (build up of fluid in tissue) Auscultation (listening) usually reveals Rhonci ( coarse rattling) and wheezes

Question 27

Emphysema - what is it?

Answer 27

distension of the alveoli & destructive changes in their membranes

Question 28

Emphysema - signs and symptoms

Answer 28

``` usually thin Tachycardia (fast HR) Tachypnoea (fast breathing) cardiac dysrhythmias (irregular heart beat) Dyspnoea (diff breath) skin colour usually normal (pink puffer) use of accessory muscles difficulty in exhaling pursed lips on expiration ```

Question 29

Emphysema - signs and symptoms

Answer 29

BP usually elevated Cyanosis may be evident in acute attack patient will appear to have have abnormally large chest (barrel chested) Wheezing and crackles may be heard on auscultation - mainly on inspiration possible evidence of oedema

Question 30

Asthma - what is it?

Answer 30

A narrowing of the medium to smaller air passages due to muscle spasm. Swelling and blockage by secretion of mucous from inflammatory cells.

Question 31

Asthma - signs and symptoms

Answer 31

``` Tachypnoea Dyspnoea, respiratory distress, cyanosis sitting up, leaning forward, anxious use of accessory muscles usually and expiratory wheeze difficulty exhaling low peak flow reading ```

Question 32

breathlessness/Dyspnoea

Answer 32

common symptom of respiratory disease including pneumonia, asthma and other COPDs also common in non-respiratory conditions (cardiac failure, hypovolaemic shock)

Question 33

breathlessness/Dyspnoea - management

Answer 33

Primary survey, provide O2 as appropriate Position patient for comfort (usually sitting upright) Evaluate whether any time critical features are present peak flow

Question 34

Hyperventilation - definition

Answer 34

A rate of ventilation higher than that required to maintain a normal level of plasma CO2

Question 35

Hyperventilation - management

Answer 35

maintain a calm approach and manner at all times. reassure the patient and try to remove the source of the patients anxiety if this is believed to be the cause of hyperventilation. coach the patients respirations whilst maintaining a calm environment.

Question 36

Hypoxic Drive

Answer 36

in patients with severe COPD the levels of CO2 in the blood is permanently raised. They also have low levels of O2 in the blood (hypoxia) due to poor respiratory function. As a result the respiratory centre in the brain utilises this hypoxia as the stimulus to breathe.