Respiration Part Duex

• [1] Flow-volume loops 
• [2] Pressure-volume 
• [3] Oscillometry
• [4] Arterial blood gas

• {a}FEV1/FVC- below normal
• {b}Maximal flow rates- below normal
• {c}RV- increased
• {d}FRC- increased
• {e}TLC- increased

• {a}FEV1/FVC- normal or above normal
• {b}Maximal flow rates- below normal
• {c}RV- decreased
• {d}FRC- decreased
• {e}TLC- decreased

• [a]
• Examines the lung elastic recoil or compliance (DV/DP)
• {1}Compliance
•      {a}COPD- lungs not stiff
•      {b}RLD- lungs stiff
• {2}TLC
•      {a}COPD- increased
•      {b}RLD- decreased

• [a] Effort-independent and noninvasive
• pulmonary function testing of airways resistance
• [b] Uses superimposed sound waves over normal
• breathing patterns to examine proximal and distal airway caliber
• [c] Detects early pathological changes of the small
• airways
• [d] Examines effect of drug in different lung
• regions

• {1}Partial pressure of oxygen (PaO2)
•     {a} Measures the pressure of dissolved O2 in the blood
•     {b} How well O2 moves from lung airspaces into the blood
• {2} Partial pressure of carbon dioxide (PaCO2)
•     {a}Measures the pressure of dissolved CO2 in the blood
•     {b} How well CO2 moves out of the body tissues into the blood
• {3} pH (acidity)
•     {a} Measures hydrogen ions (H+) in blood
• {4} Bicarbonate (HCO3-)
•     {a} HCO3- is a buffer that keeps the pH of blood from becoming too acidic or too basic
• {5} Oxygen content
•      {a}A measure of the amount of O2 in the blood
• {6} Oxygen saturation
•     {a} Measures how much of the hemoglobin in red blood cells is carrying O2

• {1} Check for severe breathing problems and lung diseases
•      {a}COPD -Asthma Chronic bronchitis Emphysema
•      {b} RLD - Cystic fibrosis, Idiopathic fibrosis
•      {c}Evaluate affect of treatment on lung disease
•      {d} Determine need for extra O2 or help with breathing (mechanical ventilation)
•      {e}Diagnose other non-pulmonary conditions which affect acid-base levels such as Heart failure, Kidney failure, Uncontrolled diabetes, Sleep disorders, Severe infections,  Drug overdose

• [a]To permit visualization of lungs and diaphragm during respiration
•     {1}Bronchoscopy
•     {2}Chest x-ray
•     {3}Computed tomography (CT) scan
•     {4} Fluoroscopy

<1> Checks for weakness of right and left diaphragms which can reduce the ventilatory capacity of the lungs

<2> During inspiration, downward movement of the diaphragm on the intact side increases intraabdominal pressure and decreases intrathoracic pressure, leading to an upward movement of the paralyzed side

• [1] Inflammation/irritation
•     [a] Sinuses
•     [b] Nose
•     [c] Throat

• [1] Upper respiratory tract infections
•     [a] Microorganisms -Bacterium, Fungus,Virus
• [2] Allergies
• [3] Nasal polyps 
• [4] Snoring
• [5]Obstructive sleep apnea

• [a] Noncancerous sac-like growths of inflamed
• tissue lining nasal mucosa or sinuses
• [b] Persons with polyps often complain about having
• a cold that has lasted for months or years
• [c] Large polyps can block the sinuses or nasal
• airways

• {1} Aspirin sensitivity
• {2} Asthma
• {3} Chronic sinus infections
• {4} Cystic fibrosis
• {5} Allergic rhinitis (hay fever)

• {1}Mouth breathing
• {2}Nasal obstruction
• {3} Reduced or complete loss of sense of smell
•  {4} Runny nose

• {1}Intranasal glucocorticosteroids
• {2} Oral glucocorticosteroids
• {3} Antibiotics
• {4} Surgical removal
•     {a} Reoccurrence of polyps may still recur

• [a]
• An exaggerated breathing sound

• {1} Causes include
•     {a}Nasal congestion
•     {b}Postnasal drip
•     {c} Inflamed sinuses

• [a] A condition in which a person has episodes of blocked breathing during sleep
• [b] It is the most common sleep disorder
• [c] A person with obstructive sleep apnea often is not aware of the apneic episodes during the night
• [d] Often, family members, especially spouses, witness the periods of apnea

• {1}Heavy snoring begins after falling to sleep
• {2}Airways collapse or secession of breathing (>10 seconds)
• {a} Apnea is followed by a sudden attempt to breathe and a change to a lighter stage of sleep
• {3} Sleep is fragmented or disrupted, not restful
• {4} Leads to daytime drowsiness
• {5} Pattern repeats frequently throughout the night

• {1}Polysomongraphy
• {2}Arterial blood gases
• {3}ECG
• {4}Echocardiogram
• {5} Thyroid function studies

• {1}Shape of the palate and jaw
• {2}Large tonsils and adenoids in children
• {3}Large neck or collar size
• {4}Large tongue
• {5}Nasal obstruction
• {6}Obesity
• {7}Alcohol and/or sedative usage

• {1} Abnormal daytime sleepiness including falling asleep at inappropriate times
• {2}Awakening unrefreshed in the morning

• {1}Depression
• {2}Memory difficulties
• {3}Morning headaches
• {4}Personality changes
• {5}Poor concentration
• {6}Restless and fitful sleep
• {7}Frequent awaking during the night to urinate
• {8}Insomnia

• {1}Lifestyle changes
•     {a}Avoid alcohol or sedatives at bedtime
•     {b}Avoid sleeping on back
•     {c}Lose weight
• {2}Surgical options
•     {a}Uvulopalatopharyngoplasty (UPPP)
•         <1>Removes excess tissue at the back of the throat
•     {b}Tracheostomy
•     {c}Endoscopic sinus surgery
•     {d}Somnoplasty
•         <1> Uses radiofrequency energy to shrink affected areas