Chronic Respiratory Disease

  1. Resistance
    • determined by the radius of the airway
    • (increased in asthma) smaller passage causes wheezes
  2. compliance
    • how easily lungs can be expanded
    • COPD lungs can not comply, no elasticity
  3. Diffusion
    • O2 and CO2 are exchanged at air-blood interface (capillary membranes)
    • high to low
  4. perfusion
    • movment of the blood through pulmonary circulation
    • is it going where it needs to go?
  5. Functions of the respiratory system?
    • oxidation, O2 transport, respiration, ventilation, gas exchange
    • O2 transported by diffusion into the capillary wall and CO2 diffuses out
  6. conditions that can narrow the airways:
    • bronchial diameter- airway resistance (asthma)
    • contraction of broncial smooth muscle
    • thickening of bronchial mucosa
    • airway obstruction
    • intubation
  7. Compliance?
    • measure of the elasticity, expandability and dispensability of the lungs and the thoracic cage
    • lungs lose elasticity-thorax becomes overdistended (emphysema)
    • stiff lungs= decreased compliance (pulm fibrosis)
    • pneumothorax, hemothorax, pleural effusion, pulmonary edema, atelectasis all decrease complaince
    volume inhaled and exhaled with each breath
    • max volume that can be inhaled after a normal inhalation
    • take a normal breath... and keep going
    • max volume that can be exhaled after normal exhalation
    • breath out.. keep going
    • air in the lungs after max exhalation
    • COPD increased residual
  12. vital capacity
    • max volume exhaled from max inspiration
    • most pts can exhale 80% of VC in 1 sec
  13. inspiratory capacity
    max volume inhaled after normal expiration
  14. functional reserve
    • volume of air remaining in the lungs after normal expiration
    • we all have this
  15. total lung capacity
    volume of air in the lungs after max inspiration
  16. ways to deliver O2?
    • NC
    • simple mask
    • Venti mask
    • non-rebreather mask
    • intubation
    • tracheostomy
  17. what is the FIO2 with a mask?
    • 5 L- 40%
    • 10 L- 60%
    • Vapotherm-Auquanox- high flow: blended delivery of O2 and medical air, last step before intubation
  18. normal ABGs:
    • pH: 7.35-7.45
    • PaO2: 80-95
    • PCO2: 35-45
    • HCO3: 22-26
    • O2: 95-100
  19. Low VQ:
    • shunt is when the blood bypass the alveoli without any gas exchange. NO gas EXCHANGE
    • pneumonia
    • atelectasis
    • tumor
    • mucus plug
  20. High VQ:
    • dead space is not enough blood to the alveoli
    • PE, cardiogenic shock
  21. Silent VQ:
    • silent unit as in area without perfusion or ventialtion
    • pneumothorax
  22. mismathcing VQ:
    shunting results prior to hypoxia
  23. S/S of VQ?
    • tachycardia
    • headache
    • flushing
    • diaphoresis
    • bounding pulse
    • increased BP and HR
  24. respiratory failure s/s?
    • restlessness, fatigue, h/a, dyspnea, tachycardia
    • confusion, lethargy
    • respiratory distress and arrest
  25. Oxy-hemoglobin curve
    • normal curve optimizes pickup of O2 at the lungs and drop off O2 at the tissue level
    • holds the o2 until ready to drop off (affinity)
  26. what 5 things can affect the oxy-hemoglobin curve?
    • H+
    • CO2
    • pH
    • temperature
    • 2-3 diphosphoglycerate
  27. a RISE in H+, CO2, Temp and 2-3 di leads to:
    • shift to RIGHT
    • MORE O2 is released to the tissues at the same PaCO2
    • H+ goes up, pH goes down
  28. a decrease in those factors will lead to:
    • shift LEFT
    • makes affinity STRONGER, less O2 given up by tissues at same PaO2

    O2 held for LONGER, MAKE PT COLD
  29. COPD
    • air flow obstruction by emphysema or bronchitis or btoh
    • 4th leading cause of death in US
    • caused by: SMOKING
  30. CM of COPD:
    • dyspnea, cough, increased workload of breathing, interfere with ADLs
    • weight loss
    • activity intolerance
    • increased incidence of resp infections
  31. stimulus for breathing in long standing COPD pt?
  32. pulmonary HTN?
    • systolic pulmonary artery pressure >30 mm Hg
    • found with R heart angiogram
  33. Cor Pulmonale:
    • R ventricle enlarges due to disease affecting the lung or its vasculature
    • heart workload increased as it pumps against high resistance into the lungs
    • peripheral edema
    • COPD, PE
  34. Occupational Lung Diseases:
    • Silicosis:chronic fibrotic pulm disease, nodular lesions
    • Asbestosis: pul fibrosis
    • coal workers Pneumoconiosis: black dots on x-ray
Card Set
Chronic Respiratory Disease
Exam #3