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PARASCI_L5
Respiratory Complaints
| Question | Answer |
|---|---|
| lines pulmonary cavities & adheres to thoracic wall, mediastinum and diaphragm | parietal layer |
| covers lung and adheres to all its surfaces | visceral layer |
| pumping action of heart, blood vessels, blood volume | factors of perfusion |
| 99-98% of O2 | bound to haemoglobin |
| 1-2% of O2 | dissolved in plasma |
| responsible for slightly constricted smooth muscle tone of resting lung | parasympathetic stimulation |
| causes airway relaxation, blood vessel constriction & inhibition of glandular secretion | sympathetic stimulation |
| monitor blood levels of O2, CO2, and pH | chemoreceptors |
| monitor breathing patterns and lung function | lung receptors |
| diffusion of oxygen from lungs to blood | oxygenation |
| 760mmHg (sea level) | atmospheric pressure |
| gas exchange in the respiratory system | ventilation |
| total exchange of gases between atmosphere and lungs | pulmonary ventilation |
| adequate blood circulation through pulmonary vessela | perfusion |
| pressure inside the airways and alveoli of the lungs = atmospheric pressure | intrapulmonary pressure |
| pressure within the pleural cavity < atmospheric pressure | intrapleural pressure |
| difference between intrapleular and intrapulmonary pressure | transpulmonary pressure |
| pressure within thoracic cavity = intrapleural pressure | intrathoracic pressure |
| ventilation | V |
| perfusion | Q |
| occurs in alectasis, COPD, pneumonia, pneumothorax, where SA of lungs reduced impairing ventilation potential | low V/Q |
| occurs in shock, pulmonary embolism, cor pulmonale, where perfusion is impaired | high V/Q |
| Failure of respiratory system in oxygenation of veinous blood or CO2 elimination | Acute Respiratory Failure |
| Failure of gas exchange function | Hypoxemic respiratory failure |
| Failure to ventilate | Hypercapnic/hypoxemic respiratory failure |
| carbon dioxide retention causing increased RR | VQ mismatch |
| gas exchange between alveolar air and pulmonary blood impeded | severe hypoxemia but no hypercapnia, as CO2 crosses more freely |
| drug OD or injury causing CNS depression, Guillain-Barre syndrome, spinal cord injury, muscular dystrophy, COPD, thoracic cage disorders | causes of hypercapnic/hypoxemic respiratory failure |
| increased RR and depth to eliminate CO2 | Acidaemia |
| decreased RR and depth to eliminate O2 | Alkalaemia |
| Rapid, shallow breaths, drowsiness, dizziness, disorientation, muscle weakness, hyperflexia, dysrhythnmias, pH<7.35, pCO2>45mmHg, low BP | Respiratory acidosis |
| Deep rapid breathing, seizures, tachycardia, low BP, Hypokalemia, numbness & tingling of extremeties, lethargy and confusion, light headedness, nausea, vomiting, | Respiratory alkalosis |
| chronic and recurrent obstruction of pulmonary airways | CORD |
| associated with destruction of tissues and alveoli, causing enlarged airspaces and leading to gas trapping | emphysema |
| smoking, inherited deficiency of alpha antitrypsin | causes of emphysema |
| loss of lung elasticity, abnormal enlargement of airspaces, alveolar wall destruction, capillary bed destruction. | characteristics of emphysema |
| protease inhibitor, protects lung, | alpha-antitrypsin |
| incomplete expansion of lung or portion of lung causing decreased lung volume | atelectasis |
| mucus hypersecretion, associated with hypertrophy of submucosal glands in trachea and bronchi | bronchitis in large airways |
| obstructed, increased goblet cell numbers, mucus plugging of lumen, inflammation, fibrosis of bronchial wall | bronchitis in small airways |
| permanent dilated bronchi and bronchioles, supporting muscle & elastic tissue destroyed with chronic infection & inflammation, | bronchiectasis |
| blood borne substance lodges in a pulmonary artery branch, mechanically obstructing flow | pulmonary embolism |
| pulmonary hypertension and right heart failure may develop with massive vasoconstriction | large embolus |
| nose, oropharynx and larynx | upper respiratory tract |
| trachea, primary bronchi and lungs | lower respiratory tract |
| caused mostly by viruses, can damage bronchial epithelium, obstruct airways and lead to secondary bacterial infections | respiratory tract infection |
| inflammation of parenchymal structures of the lung | pneumonia |
| portion of lung involved in gas transfer, alveoli, alveolar ducts, respiratory bronchioles. | parenchymal |
| bacterial infection, multiple extracellularly in alveoli, cause inflammation and exudation of fluid into alveoli | typical pneumonias |
| viral and septum and interstitium of lung infected | atypical pneumonia |
| protect against aspiration to tracheobronchial tree | glottic & cough relfex |
| removes secretions, microorganisms and particles from the respiratory tract | mucociliary blanket |
| removes microorganisms and foreign particles from the lungs | phagocytic and bacteriocidal action of alveolar macrophages |
| alveoli filled with fluid containing multiple organisms causing capillary congestion | Oedema (pneumonia) |
| massive outpour of leukocytes and red blood cells | Red hepatisation |
| arrival of macrophages, phagocytose fragmented bacterial cells, RBCs and cellular debris | Grey hepatisation |
| alveolar exudate removed, lung slowly returns to normal | Resolution (pneumonia) |
| inflammation of pleura, common in infectious processes, especially pneumonia | pleurisy, pleuritis |
| abnormal collection of fluid in the pleural cavity, excess rate of formation or decreased lymphatic clearance | Pleural effusion |
| extravascular fluid | transudate |
| intravascular fluid | exudate |
| accumulation of serous transudate in pleural cavity | hydrothorax |
| lymph effusion from GI tract | chylothorax |
| presence of air in pleural space | pneumothorax |
| occur in healthy people, tall boys aged 10-30yrs, smoking family history of pneumothorax | primary spontaneous pneumothorax |
| occur in people with lung disease, associated with conditions causing gas trapping & lung tissue destruciton, life threatening due to underlying issue and poor compensatory mechanism | secondary spontaneous pneumothorax |
| occurence associated with menstrual cycle, usually reccurrent, unknown cause, women 30-40yrs with endometriosis, develops within 72h of menses onset, often R lung | catamenial pneumothorax |
| pneumothorax via penetrating/ non penetrating injuries | traumatic pneumothorax |
| life-threatening intrapleural pressure exceeds atmospheric pressure, causes compression atelectasis of unaffected lung | tension pneumothorax |
| venous return to the heart is impaired due to compression of superior and inferior vena cava, decreasing CO, heart migrates in cavity | mediastinal shift |
| accumulation of blood in pleural cavity | haemothorax |
| fills 1/3 of pleural space | moderate haemothorax |
| fills 2/3 of pleural space and must be drained asap | large haemothorax |
| chronic cough, SoB, wheezing, haemoptysis, pleuritic chest pain | lung cancer |
| upper airway constriction characterised by snoring, disturbed sleep, excessive daytime sleepiness | sleep apnoea |
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