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NURS 453

Pulmonary and Acid Base Pathophysiology

respiration is the cellular process that uses oxygen to make ATP
respiration rate in this class is equal to ventilation rate
the ventilation rate is the number of times gas is exchanged in a minute
ventilation is the movement of air in and out of the lungs
breathing allows absorption of oxygen and elimination of carbon dioxide
tissue respiration is gas exchange between blood and tissues
the five stages of pulmonary system development embryotic phase, pseudogladnular phase, canalicular phase, terminal sac phase, alveolar phase
the embryonic phase occurs from 3-7 weeks
the pseudogladular phase occurs from 7-16 weeks
the canalicular phase occurs from 16-24 weeks
the terminal sac phase occurs from 24-36 weeks
the alveolar phase occurs from 36 weeks to term/adult usually until 3 years
The diaphram is formed during the pseudoglandular phase around the 8th-10th week
During the embryonic phase the trachea divides into right and left
During the pseurogladular phase there is continued differentiation of bronchi and 25,000 terminal bronchioles start splitting into 23 parts, diaphram is formed and distal airways start to be formed in the later weeks
During the canalicular phase maturation of the pulmonary alveoli begins, pulmonary surfactant starts to be produced, blood flow begins
Terminal sac phase start to get grape like structures
Alveolar phase start to mature and and develop and differentiation of more mature alveoli takes place up to three years of life.
The pulmonary system develops in this direction caudaly
Pulmonary Surfactant is produced by Type II pneumocyte cells
Alveoli are made of Type I pneumocyte cells
The pulmonary system develops from this the primitive foregut endoderm
Gas exchange occurs in this the pulmonary acinus
The pulmonary acinus is made up of these four items bronchioles, alveolar ducts, alveolar sacs and alveoli
The pulmonary acinus allows this Oxygen to enter circulation and the carbon dioxide is diffused from circulation
Pulmonary Circulation does these four things facilitates gas exchange, delivers nutrients to lung tissues, acts as a reservoir for the LV, serves as a filter
The bronchial arteries do this provide a small amount of oxygenated blood to lung tissues
the pulmonary arteries do this provide deoxygenated blood
compared to systemic circulation, pulmonary circulation has lower pressures and lower amounts of resistance compared to systemic circulation
this many vessels are profused at a time one third
the pulmonary artery is exposed to this much pressure 1/5 the pressure in comparison to systemic vessels
the pulmonary artery has this amount of walls thinner walls compared to others in circulation
When the right ventricles output increases more blood is delivered to the lungs and become oxygenated
when excess fluid volume occurs or LV dysfunction occurs there is an increase in hydrostatic pressure which can allow for storage in the pulmonary vessels
if there is no room for storage in pulmonary vessels the fluid builds up in the interstitial spaces
The primary function of the pulmonary system is to exchange gases from environmental air to the blood stream
The exchange of gases from the environmental air to the bloodstream is done by ventilation, diffusion and perfusion
diffusion is the movement of gases between air spaces in lungs and blood stream
Perfusion is driven by cardiac output and is a primary role of the cardiovascular system.
breathing is inspiration and exhalation
4 brain centers control breathing brain stem, cerebral cortex, chemoreceptors and mechanoreceptors
the chemoreceptors are located in the peripheral arteries
mechanoreceptors can sense breathing patterns
the medullary respiratory center consists of the inspiratory center and the expiratory center
the inspiratory center is also known as the dorsal respiratory group
the inspiratory center or dorsal respiratory group controls basic rhythm of breathing
the inspiratory center receives input from cranial nerves 9 and 10 and the chemoreceptors
the inspiratory center sends output to the diaphram
the expiratory center is also known as the ventral respiratory group
the expiratory center is activated during this physical activity
normal expiration is a passive process
the regular normal breathing center is the inspiratory or dorsal group
The dorsal respiratory center receives afferent impulses from peripheral chemo receptors that are located in the carotid and aortic bodies
chemoreceptors can detect the CO and Oxygen levels
cranial nerves 9 and 10 are Glossopharangeal and vagus nerve
the pneumotaxic center is located in the upper pons
the function of the pneumotaxic center is that it turns off inspiration and limits bursts of action potentials in phrenic nerve
the pneumotaxic center does this to tidal volume and this to the respiratory rate limits tidal volume and increases respiratory rate
the pneumotaxic center antaganizes this center the apeneustic center
the apeneustic center is located in the lower pons
stimulation of apeneustic center excites the inspiratory center in the medulla
apeneustic center controls the intensity of breathing by prolonging action potentials of the phrenic nerve and prolonging the contraction of the diaphram
apneusis is an abnormal breathing pattern with prolonged inspiratory gasps and a brief expiratory movement
apnic individuals are those who have one of the following severe neurological damage, decerebrate posture, fixed or dialated pupils, coma, profound stupor, quadraparesis, absent corneal reflex, dolls eye, negative oculocephalic reflex
apnic individuals are those who have one of the following severe neurological damage, decerebrate posture, fixed or dialated pupils, coma, profound stupor, quadraparesis, absent corneal reflex, dolls eye, negative oculocephalic reflex
the cerebral cortex temporarily overrides automatic brain stem centers
automatic brain stem centers include limbic system and hypothalamus
the automatic brain stem centers help to regulate memory
hypothalamus regulates this part of memory psychosomatic and emotions associated with anxiety
hyperventilation increases the volume and frequency of breath
people who are hyperventilating are hypocapnic with low PaCO2
low PaCO2 correlates with respiratory alkalosis
chemoreceptors are located three places centrally, medulliarily and peripherally
central chemoreceptors are responsible for minute to minute control of breathing
central chemoreceptors are sensitive to changes in pH of the CSF
low pH is indicative of hyperventilation
high pH is indicative of hypoventilation
high PaCO2 is related to this pH low
peripheral chemoreceptors are located in aortic bodies in the aortic arch
Created by: jonquil