Respiratory Disorders

lungs, airways, chest wall, and pulmonary circulation

gas exchange

the mechanical movement of gas/air into and out of lungs

the movement of gases between air spaces in the lungs and bloodstream (capillaries)

the movement of blood into and out of the capillary beds of the lungs to body organs/tissues

lined with ciliated mucosa, warms, humidifies, and fiilters inspired air

connects upper and lower airways

connects larynx to bronchi, bifurcates into right and lft main stem bronchi

Main airways that enter the lungs at the hila (roots of the lungs), right bronchi straighter allignment

respiratory bronchioles, alveolar ducts, alveoli

• the primary gas exchange units
• Type I this promotes gas exchange and provides structure
• Type II secretes surfactant to decrease surface tension and stabilize alveoli

permit some air to pass through the septa from alveolus to alveolus promoting collateral ventilation and even distribution of air among the alveoli

Vt : the amount of air normally inspired with each breath (500 mL)

VC: the maximum amount of air an individual can expire after maximum inspiration

Forced Expiratory Volume in 1 second: the maximum amount of air an individual can forcefully expire in one second (healthy is 80-100%0

active diaphragm, external intercostals, sternocleidomastoid

• Passive, alveolar surface tension causes alveoli to return to non expanded state, elastic recoil
• active internal intercostal muscles, abdominal (coughing)

• two layers of tissue surrounding lungs, creating pleural space with negative pressure
• Parietal pleura: outermost layer
• visceral pleura: innermost layer

the collapse of all or part of a lung that occurs when air enters the pleural cavity. can enter from parietal or visceral pleura

• the presence of fluid in the pleural space
• Transudative: watery
• Exudative: WBC's, plasma proteins
• Blood: hemothorax
• Chyle: Chylothorax

Pus in pleural space, infected pleural effusion

diseases where more force is required to expire a given volume of air, or emptying of lungs is slowed or both. dyspnea and weezing

genetic dysfunction resulting in thick dehydrated mucus, inability to clear airways, frequent infections, and bacterial colonization

Hypersensitivity of the airways causing chronic inflammation with intermittent bronchoconstriction (type 1 hypersensitivities rx). Constriction, wheezing on exp, non productive cough, prolonged exp, tachycardia, tachypnea

Increased mucus secretion secondary to viral or bacterial infection, up to 6 weeks

Hypersecretion of mucus and chronic productive cough at least 3 months per year for 2 years. Decreased alveolar ventilation: hypoxemia, hypercapnea, clubbing, cyanosis, bolycythemia, cor pulmonale (right ventricle failure)

abnormal, permanent enlargement of acini, destruction of alveolar walls, destruction of elastin resulting in coalescence of alveoli into blebs, change in lung tissues. Dypsneic, not cyanotic. Hypoventilation, polycythemia, and cor pulmonale late in course

• Chronic Obstructive Pulmonary Disease: syndrom includes pathologic lung changes consistent with emphysema or chronic bronchitis and even asthma
• 4th most common cause of death in us
• s&s: dyspnea on exertion, chronic hypoventilation, over expanded lungs (barrell chest), expiratory effort (pursed lips), diminished muscle mass on thighs and legs
• drive to breathe form low O2 not high CO2

• there is decreased compliance of lung tissue, increased work for breathing (RDS), Results from changes in airways
• s&s: dyspnea, increased resp rate, decreased tidal volume

• neonates: immature type II cells 50-70% survive, CLD common
• Adult: secondary to lung injury, decreased surfactant production and release of inflammatory mediators
• S&S: dyspnea, rapid shallow breathing, inspiratory crackles, respiratory alkalosis, hypoxemia

• any changes in the lungs caused by inhalation of inorganic dust particles. chronic inflammation with scarring, accumulation of debris at bifurcations of bronchi
• s&s: cough, chronic sputum production, decreased lung volumes, dyspnea, weight loss, rapid shallow breathing

Fluid in alveoli (pneumonia)high levels of hydrostatic pressure increase capillary permeability fluid leaks into interstitial space and alveoli, provides better growth medium for bacteria and poor gas exchange.

• Ventilation: air moving into and out of lungs
• perfusion: blood passing through the pulmonary circulation to be oxygenated
• normal ratio 0.8
• apex v>q, base v<q middle v=q

• infection of lower resp tract
• s&s: fever chills cough malaise pleural pain (sometimes dyspnea or hemoptysis) inspiratory crackles, dullness to percussion, egophony, xray

• occlusion of the pulmonary vasculature by an embolus
• s&s: vary from chest pain tachycardia, tachypnea, anxiety to death

• fewer than 20% survive 5 years
• fromt he epithelium of the respiratory tract
• s&s: cough chest pain hemoptysis, dyspnea, localized wheezing