Patho Exam #3

protective structures of the pulmonary system

• hairs

  • trap & remove foreign particles from the air

role of the mucosal lining

lines the airways & warms & humidifies the air

irritant receptors

in the nose and airway

• recognize harmful agents

• respond through sneeze or a cough reflex

  • expels foreign particles

immune protections

coating in the respiratory tract

• ingest & remove bacteria through phagocytosis

inspiration

in air

expiration

out Co2

Ventilation impairments

• diaphragm not working

Airway blockage/narrowing

• anaphylaxis

• ex. food blockage

Reduced Lung Compliance

• Stiff Lungs

• decreased expansion

• pneumonia

• rib fracture

Disrupted Nerve Signals (Brain/Nerve damage)

• brain not signaling for expansion

• pons, medulla = controlled breathing rate

• chemoreceptors

ventilation compliance

distensibility (expandability) of the lung tissue and chest wall

ventilation resistance

the velocity & viscosity of the gas moving through the inner lumen of the airway

• narrowing

• mucous in the airway

adequate ventilation

appropriate lung compliance

measurement of ventilation

pulmonary function test

that measure lung volume, capacity, and air flow to diagnose conditions like asthma or COPD

• tidal volume (TV)

• vital capacity (VC)

• forced vital capacity (FVC)

• Forced expiratory volume in 1 second (FEV1)

• Residual volume (RV)

• Total lung capacity (TLC)

  • sum of VC & RV

tidal volume (TV)

• an aspect of a pulmonary function test

• vital capacity (VC)

diffusion

Gas exchange at alveolar capillary junctions

• O2 in, CO2 out

• Two major process

  • oxygen trying to get to all the cells

  • carbon dioxide is trying to escape

diffusion process: O2 moves in

• enters lungs through inhalation

• travels down to the alveoli

• crosses into the blood via tiny capillaries

• hemoglobin in the RBC picks up the O2 and carries it to the tissues

diffusion process": CO2 moves out

• Co2 = waste product from metabolism

• travels back through the blood to the lungs

• Co2 cross from the blood into the alveoli & is exhaled

factors impacting diffusion

Pulmonary edema

• fluid in the lungs

• slows gas exchange

Emphysema

• damaged alveoli

  • collapsed airway

  • collapsed alveoli

• reduced surface area for diffusion

Anemia

• low hemoglobin

• not enough oxygen transport

Pneumonia

COPD

ARDS

Pulmonary fibrosis

Affect gas exchange

oxygen saturation (SaO2)

The percentage of hemoglobin that is carrying O2

• Iron needed for O2 to bind

  • like a magnet

impaired diffusion

restricted transfer of O2 or CO2 across the alveolar capillary junction

Impaired ventilation (shunt)

inadequate oxygen coming into the lungs

• Two major mechanisms

  • airway problems

  • neural problem

impaired perfusion (dead space)

inadequate blood flow to the lungs

• PE

• Low BP

• Severe blood loss (hypovolemic shock)

impaired ventilation-perfusion (V/Q) mismatch

• lungs are ventilated, but not perfused (dead space)

  • ex. PE

• lungs are perfused, but not ventilated (shunt)

  • ex. pneumonia, atelectasis

hypoxemia

decreased oxygen in the arterial blood

hypoxia

oxygen deprivation in cells

• prolonged hypoxia leads to cellular death

• development of metabolic acidosis

hypercapnia

increased carbon dioxide in the blood

• air trapping

  • retention of CO2

  • COPD

  • respiratory acidosis

crackles

fluid in the lungs

• alveoli or small airways collapse during exhalation

wheezing

narrowed airways

• airways are narrowed by swelling, mucus, or muscle construction

• air has to squeeze through tight passages

orthopnea

SOB when lying flat, relieved when sitting up

dyspnea

difficulty breathing, sensation of not getting enough air

mechanisms of altered elimintation

1. Altered patency

   1. Bowel obstruction

1. Altered motility

   1. increased or decreased peristalsis

2. Altered neuromuscular

   1. Spinal cord injury

3. Altered perfusion