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Respiratory Anatomy and Physiology

Respiratory Anatomy and Physiology. THORACIC CAVITY. 3 sections Mediastinum 2 Lung Chambers * because each lung is in a separate chamber the unaffected lung will remain expanded Right lung has ___ lobes Left lung has ___ lobes

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Respiratory Anatomy and Physiology

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  1. Respiratory Anatomy and Physiology

  2. THORACIC CAVITY 3 sections • Mediastinum • 2 Lung Chambers * because each lung is in a separate chamber the unaffected lung will remain expanded • Right lung has ___ lobes • Left lung has ___ lobes • Lower lobes or bases are positioned ___________. (Riddell, 2000)

  3. Surfactant • Functions of surfactant • Keeps surface tension lower • Allows for Alveolar expansion • Prevents collapse of alveoli (Riddell, 2000)

  4. Processes of Respiration • Gas exchange occurs in 4 steps: • Ventilation • Diffusion • Perfusion • Diffusion (Riddell, 2000)

  5. Ventilation • The respiratory control center is located in the ____and ____ of the brain stem (respiratory center). Autonomic regulation -controlled by ____________ -there are 2 groups of chemoreceptors • Central chemoreceptors -sense changes in _________ 2. Peripheral chemoreceptors - sense changes in ________ (Riddell, 2000)

  6. Hypoxia Causes: • Hypoxemic hypoxia • Stagnant or ischemic hypoxia • Anemic hypoxia • Histotoxic hypoxia (Riddell, 2000)

  7. Signs and Symptoms of Hypoxia Acute Hypoxia • Increase in ventilation (Chemoreceptor mediated) • Decreases in judgement and motor proficiency • Dyspnea, fatigue, headache, nausea, vomiting, decreased visual acuity • Cyanosis of lips and nail beds if adequate hemoglobin • Insomnia and cheyne stokes breathing • Disorientation, hallucinations, convulsions with extreme hypoxia Chronic Hypoxia • Dyspnea, fatigue, cyanosis • Pulmonary hypertension (d/t alveolar hypoxia and vasoconstriction) and polycythemia • Body adapts to hypoxia with increased ventilation, pulmonary vasoconstriction, and increased production of RBC’s (Riddell, 2000)

  8. Adventitious Sounds • additional breath sounds superimposed on normal sounds • indicate changes in the tracheobronchial tree • vary in pitch, intensity, duration, and the phase of the respiratory cycle Examples: crackle, wheeze, rhonchus, pleural friction rub (Ignativicius & workman, 2002)

  9. Voice Sounds • -vocal resonance is increasedwhen the sound must travel through a ________________ (i.e. consolidated area of the lung, pneumonia, atelectasis, pleural effusion, tumor, or abscess) • Bronchophony - assess by having client repeat the __________ while auscultating • Whispered Pectoriloquy -perceived by having the client whisper ____________ • Egophony - assess by having client repeat the letter __-listen for an _______ (Ignatavicius & Workman, 2002)

  10. Abnormal Rates and Rhythms • Bradypnea • Tachypnea • Hypoventilation • Hyperventilation • Cheyne Stokes • Ataxic Sighing • Obstructive (Riddell, 2000)

  11. Arterial Blood Gases Normal • pH • pO2 • pCO2 • HCO3 • Base excess 0 (+2 alkalosis, -2 acidosis) • SaO2 Respiratory Acidosis (pH<7.35, pCO2>50mmHg) Respiratory Alkalosis (pH>7.45, pCO2<35mmHg) Metabolic Acidosis Metabolic Alkalosis (Riddell, 2000)

  12. Interpreting ABGs Ask yourself these questions… • pH—acidotic or alkalotic? • PaCO2—low or high?-respiratory • Normal & HCO3 low or high with a normal PaCO2?--metabollic • pH is low (acidosis) • pH is normal or high (alkalosis) • PaCO2 is low (alveolar hyperventilation) • PaCO2 is normal or high (alveolar hypoventilation) • pH is low and PaCO2 is normal-consider metabolic causes—low pH and HCO3 less than 22-metabolic acidosis • pH is high and PaCO2 is normal-consider metabolic causes • high pH and HCO3 greater than 26-metabolic alkalosis (Riddell, 2000)

  13. References Ignatavicius, D. D. & Workman, M. L. (2002). Medical-surgical nursing: Critical thinking for collaborative care. Saunders: PA Riddell, K. (2000). Windsor Regional Hospital.

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