Oxygen and carbon dioxide move between the alveoli and blood by what process?
Upper Respiratory Tract Consist of:
Lower Respiratory Trach Consist of:
- Lobar Bronchi
- Segmental Bronchi
The gas exchange portion of the lung is made up of millions of tiny sacs called
How do lungs move?
The mechanical process of ventilation is the result of:
Volume and pressure changes in the chest cavity.
During inspiration what muscles do what?
Diaphragm and external intercostal muscles contract.
During exhalation what muscles do what?
Diaphragm and intercostal muscles relax
When lungs expand what happens?
pressure drops in the airways.
Blood transports oxygen to tissues in two forms. What are they?
- Small amounts are dissolved in plasma.
- Most is attached to hemoglobin molecules on red blood cells.
Blood carries carbon dioxide in what forms?
- Dissolved state.
- Combine with some amino acides in form of carbamino compounds.
- Most important is in its dissociated form.
The average adult moves how much air?
About 1/2 a L of air per breath
When do fetus' have enought functional Aveoli?
- 24-25 weeks.
- 34-35 weeks fully functional.
What is surfactant?
- Decreases surface tention and permits alveolar expansion.
- It is produced in late gestation.
What are Chemical mediator sthat cause an inflammatory response?
What is the Mucociliary Elevator?
Protects airway by constantly sweeping potentially harmful material out of lungs by ciliated cells.
What is the purpose of the bicarbonate buffer system?
Maintains the body's acid-base balance.
Process of ventilation is regulated how?
Through neural pathways.
Factors of perfectly healthy lungs that do not expand fully are:
- Pain from surgical incision.
- high abdominal incision.
- Sever obesity.
- Chest or abdominal binders.
- Admoinal Distention.
- medicaitons or anesthesia
- Rib Injuries.
- Musculoskeletal Chest deformities.
- Severe weakness/neuromuscular disorders.
What is important when a cough produces sputum?
- Establish source of sputum.
- Assess color.
- Assess Volume
- Assess Consistency
- Assess noteworthy characteristics.
Primary components of the bicarbonate buffer system is:
- Carbon Dioxide.
- In water carbon dioxide dissolciates into bicarbonate ions.
Which receptors are sensitive to circulating blood levels of Carbon dioxide & Hydrogen Ions?
- Peripheral and Central Chemoceptors in aortic arch.
- Carotid arteries (Peripheral Receptors)
- Medulla (Central Receptors)
- Decrease in the partial pressure of O2 in Arterial Blood (PaO2) stimulated Peripheral Receptors)
What plays primary role in deteriming the Frequency & Depth of ventilation?
5 Levels of Dyspnea are:
- I-Pt can walk 1 mile at own pace before SOB.
- II-Pt becomes SOB after walking 100 yards.
- III-Pt becomes SOB while performing ADL.
- IV-PT is SOB during periods of No Activity.
- Orthopena: SOB lying down.
What are Crackles (fine)?
- Fine Rales.
- Discontinuous sounds
- Late inspiration assosicated with pnuemonia & CHF.
- Sound like hair rolling between fingers.
What are Coarse Crackles (Coarse Rales)?
- Coarse Rales.
- Bubling moist sounds.
- Early inspiration to early expiration.
- Periperal airways.
What is wheeze (sonorous)?
- Ronchi (gurgles).
- low pitched snoring or moaning sounds.
- Large airways.
- Bronchitis or single bronchus obstruction.
What is wheeze (sibilant)?
- High-pitched musical sound.
- Expiration (may be inspiration)
- Large or small airways.
- Acute asthma or chronic emphysema.
What is Pleural friction rub?
- Low pitched dry grating sound.
- Both inspiration and expiration.
Respiratory Objective Data includes:
- Observe rate and pattern of respiration.
- Observe effort of respiration.
- Pt color
- Chest deformities, wounds, masses.
- Chest contour.
Respiratory Palpations Objective Data:
- Swelling or tenderness.
- Extent or pattern of expansion.
- Position of the trachea.
- Fremitus (99)
Breath sound classifications include:
What is stridor?
- inspiratory wheeze.
- croup or epiglottitis.
Sputum Assessment includes:
- Normal Color - clear or white.
- Normal Odor - none.
- Normal Consistancy - medium.
- Asthmatic - thickened egg white look.
- Pulmonary edema - frothy pick secretions.
- Infection - Yellow or green
- Infection Odor - Musty, putrid
What does an AGB look at?
What is Blood's acid-base balance Alkalosis?
pH above 7.45
What is Blood's acid-base balance acidosis?
Arterial pH below 7.35
Types of Coughs include:
- Deep Cough-inspire deeply, close glottis, expell air when opening glottis,
- Stacked Coughs-release several short blasts of air.
- Low-flow (huff)-COPD use inhale deeply, say huff 3-4 times.
- Quad Cough- nueromusclaur disease-inhale then hemelich.
What is the purpose of pursed lip breathing?
pushing air against the small orifice made by pursed lips the client builds pressure backward throught the airways which prevents airway collapse.
What is the purpose of chest physiotherapy?
- Percussion, vibration and postural drainage are techniques used for COPD, systic fibrosis, and pneumonia pt.
- Striking of pt chest wall with cupped hand.
- Compress hands on pt chest while pt exhales.
- Place pt in various gravitational positions-Trendelenburg