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Inspiration
- Requires muscel activity- Diaphragm and external intercostals
- Normal Relaxed breathing
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Expiration
- Relaxation phase, should be passive
- If forced will use abdominals & internal intercostals
- Coughing is done during the expiration phase and reuires forced expiration
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Define Tidal Volume
- Amount of air entering lungs with each normal breath
- 500ml
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Define Residual Volume
- Amount of air remaining in the lungsafter forced expiration
- 1200mL
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Define Inspiratory Reserve
- Maximal volume of air inspired in excess of normal tidal volume
- 3000mL
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Define Expiratory Reserve
- Maximal volume or air expired following a passive expiration
- 1200mL
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Vital Capacity
- maxiaml amount of air expired following a maximal inspiration
- 4600mL
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Total Lung Capacity
- Total volume or air in the lungs after maximal inspiration
- 6000mL
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Chemial Factors affecting repiration
What drives breathing
- Centeral chempreceptors in the medulla repsond to:
- slight elevation in PCO2 and Decreased cerebrospinal fluid pH
- Peripheral Chemorecptor in the heart are sensitve to decrease O2 levesl in arterial blood as well as low pH
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Factors that affect gas exchange
- accumulation of fluid in alveoli or interstital fluid
- adequate surface area for gas exchange to occur
- Need a balance of ventilation and perfusion
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Manifestations of poor gas exchange
- Inadequate O2 in circulation
- Decreased O2 for cell meatbolism
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Diagnostic Test for Respiratory
- Pulmonary Volumes
- Arterial blood gases
- Oximeters
- Exercise testing
- Radiography
- Bronchoscopy
- Culture and sensitivity tests
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Sputum
- Yellow green thick- bacteria
- Rusty Dark - pneumococcal pneumonia
- Large amounts, purulent sputum - Brocnchiectasis
- Thick tenacious - cystic fibrosis
- Blood Tinged - blood vessels rupture Tb Tumor
- Hemoptysis - blood tinged frothy sputum- pulmonary edema
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Define Eupnea
- Normal Rate and rhythm of breathing
- 10-18 per min
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Define Kussmaul Respirations
Deep Rapid
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Define Cheyne Stokes
- apnea, the increasing then decreasing depth of respiration
- happens with head injury
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Define Wheezing
whistling sound
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Define Striodr
High pitched crowing wound
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Define Dyspnea
Difficult breathing
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Define Orthopnea
Difficult breating in supine
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Define Paroxysmal Nocturnal dyspnea
sudden acute dyspnea and left side CHF
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Define Rales
- serous secretions
- light bubbly sounds
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Define Thonchi
- Thicker secretions
- deeper harsher sounds
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Pleural pain
- Inflammation or infection
- Pain increases with inspiration or coughing
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Common Treatment Measures
- Avoid allergens
- Humidify air - thinner secretions
- Exercise
- Breathing and coughing
- Cheast PT
- Oxygen
- Medications
- Surgery
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Define Infectious Rhinitis
- The common cold
- Caused by virus - can go on the develop secondary bacterial infection
- Treated according to symptoms
- Upper Respiratory Tract infection
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Define Sinusitis
- Bacterial infection in the upper tract
- Exudate builds up causes pain
- Treated for pain, decongestant, antibodies
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Croup
- Viral illness common in kids 1-2
- larynx and glottis are swollen inflamed
- S&S: hoarse barking cough inpiratory stridor resless
- Treatment: cold moisturized air
-
Influenza
- May affect both upper and lower respiratory tract
- S&S: sudden acute onset with fever fatigue and aching pains
- may be complicated by a secondary bacterial infection
- Treatment: anit-viratl meds in first 48 hours
-
RSV
- Bronchiolitis
- common in kids age 2-12months VERY CONTAGIOUS
- Causes inflammtion necrosis of bronchioles, increases secrestions, reflexive bronchospams, wheezing, dyspnea
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General Pneumonia facts
- classified by causative agent or lung area affects pathologial change or epideiologic data
- Process:
- Inflammation cause exudate of fluid in the lungs
- Fluid & Exudate gets into lungs and blocks gas exchange at alveoli level
- Fluid contains fibrin which overtime cause lung tissue to soldify
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Three Types of pneumonia
- Lobar pneumonia
- Bronchopeumonia
- Primary Atypical
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Lobar Pneumonia
- Caused by streptococcus pneumonia
- Localized to one or more lobes
- Sudden onset
- Signs: high fever chills ratles orgessing to no breath sounds productive cough RUSTY SPUTUM
- treatment: antibacterial, supportive care
-
Bronchopneumonia
- Diffuse pattern of infactions in both lungs more ofetn in the lower lobes
- Multiple bacteria
- Insidious onset
- Signs: mild fever, productive cough YELLOW GREEN SPUTUM, dyspnea
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Primary Atypial Pneumonia
- Caused by Mycoplasma pneumonis bacterium or an influenza virus
- Scattered small patch involves interstitial inflammtion
- Signs:
- variable fever headache, aching mucles non-productive baking cough milder more slef limiting
- Treatment: Erythopyocin or tetracycline
-
SARS
- Severe acute respirtory syndrome
- Coause by a coranacirus
- transmitted by repiratory droples during close contact
- S&S:
- Next: dry cough and marked dyspnea
- Chest X-ray spreading patchy area of interstitial congestions
- Mechanical Ventilation may be need in progesses to severe sometimes fatal respiratory disease
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TB
- Countaious lung infection mycobacterium tuberculosis
- causes: exposure to infected person
- S&S: low grade fever, nigh sweats, cough, anorexia, fatigue
- Diagnosis: skin test chest xray, seutum analysis
- Treatment: meds for 3-12 months
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Primary and Secondary TB infection
- Primary: if pt has adequate resistance bacilli become alled off form a tubercle
- Pt is infected but NO ACTIVE DISEASE
- Secondary: active form bacillus is not alled off
- destruction of lung tissue, erosion of bronchi blood vessels ACTIVE DIESEASE
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