Clinical Notes (11, 13, 15)

Clinical note - Tracheal Blockage… what is it called?

• Aspiration = breathing in foreign objects (usually can be coughed out)

Clinical note - Tracheal Blockage… How to remove/stop this?

If normal coughing doesn’t work…

• Heimlich Maneuver/Abdominal Thrusts - forcefully pushes object out (allows airflow)

• Intubation

• Tracheostomy

What is intubation?

• when epiglottis (tissue around the glottis) swells

  • insert a curved tube through the pharynx and glottis (allows airflow)

What is Tracheostomy?

• Incision through the anterior tracheal wall

• Tube insterted, bypasses the larynx = airflow directly to the trachea

Clinical note - What is artificial Repiration?

A technique to provide air to peeps with unworkable respiratory muscles

• Mouth-mouth

• An Endotrecheal tube = tube into the glottis and trachea

  • Attached to this = Mechanical Ventilators

• CPR (Cardiopulmonary resuscitation) - if cadiovascular system does not work

Clinical Note - What are Pulmonary fuction tests?

• it monitors vairous respiratory functions

  • ** very simple but delivers very credible/useful results

• Spirometer = measures parameters (vital capacity, expiratory reserve volume, inspiratory reserve volume)

• Peak flow meter = measurs max rate of forced expiration (exhale)

Clinical note - What is Decompression Sickness?

Aka “THE BENDS”

• very painful : from a sudden drop in atmospheric pressure (NITROGEN BUBBLES FORM)

Nitrogen affects joint/blood stream/cerebrospinal fluid

Clinical note - What is Carbon Monoxide Poisoning?

• Whecn CO binds with hemoglobin and O2 can bond with the heme anymore

  • the hemoglobin/RBC is useless for respiratory fuctions now

  • ** very likely to die if medical assistance happens

Treatment

1. prevent more CO exposure

2. Administer pure O2 (bump out CO on Hemoglobin)

3. Transfusion of RBC

Clinical note - What is Emphysema?

• A Chronic progressive condition

  • Produces shortness of breath and th einability to tolerate physical exhertion

• Form the eleimation of bronchioles/alveoli

Clinical note - What is Lung Cancer?

• An agressive class of malignancies originating inthe bronchial passageways/alveoli

• Affects epithelia cells that lines conduting passageways, mucoous glands, alveoli

• Most common cancer to get

Treatment

• surgery, radiation therapy, chemotherapy

Clinical note - What is Hypercapnia?

• Increase of Pco2 in arterial blood

  • stimulates chemoreceptors in the carotid and aortic bodies and chemoreceptive neurons of the medulla obongata

• Stimulates Hyperventilation = increased rate of respiration (rapid breathing)

  • Co2 diffusion increases

• Hyperventilation leads to Hypocapnia = abnormally low Pco2

  • leads to hypoventilation = till Pco2 reaches og amount

Clinical note - What is Sudden Infant death syndrome (SIDS)?

• child just stops breathing

• usual ocurances…

  • midnight to 9AM

  • Late fall/winter

  • infant (2-4 months old)

Risk factors

• sleeping on belly

• genetic factor (controversial)

proposed cause

• respiratory process problem that disrupts the relfexive respiratory pattern

• ** people say that the age this commonly happens correlates to when the respi. centers are going through a period of connecting with the brain

What is Cystic Fibrosis?

• A defect of respiratory muscosa (inherited) = makes it more dense/viscous

• mucus transport stops and blocks small respiratory passageways

• Normal respi. defences stop = more bacteiral infections

  • leads to a lot of deaths

• Could lead to heart failure

** defected Chromosome 7 gene

What is Respiratory Distress Syndrome?

• when it is hard ot open the alveoli/inhaling is hard

• peopel die exhuasted, trying to keep lungs inflated

Clinical Note- What is Pneumonia?

• the inflammtion of the pulmonary lobules

• usually from infection (when respiratory defenses are down)

  • restricts airways/fluid leak into alveoli

Clinical notes - What is Pneumocystis carnii?

• a Fungus (escaped from the alveoli)

• Common Pneumonia in peeps with AIDS

Clinical Notes - What is Tuberculosis?

chp 15… pg 514…

Chap 11… What are two best known inherited disorders that comes from th eproduction of Abnormal Hemoglobin

1. Thalassemia

2. Sickle Cell Anemia (SCA)

Chap 11… What is Thalassemia?

• An inherited disease which is from the inadequate production of the globular protiens compotnents of hemoglobin

  • RBC production slows

  • Matured RBC are fragile and short lived

  • Scare number of healthy RBC = reduces O2 carrying capacity of the blood + leads to growth and developement problems

TREATMENT

• transfusions = administraction of blood components to Maintain RBC #s normal count

Chap 11… What is Sickle Cell Anemia (SCA)?

• A mutation that effects the amino acid sqeuence of one pair of the globular protiens of hemoglobin

  • when blood has an abundance of O2 = doesn’t show problem

  • when defective hemogloobin gives up a lot of stored O2 = surrounding hemoglobin molecules interact

    • RBC change shape + turn stiff + curves = “Sickle shaped”

    • Doesn’t affect O2 carrying

    • **makes RBC more fragile and easily damaged

    • **gets stuck in capillaries (can’t fold very well)

Chap 11… What is Hemolytic Anemia?

• the untimely breakdown of “sickled” RBC as a result of Sickle cell anemia

Chapter 11… What is the Hemolytic Disease of the Newborn (HDN)?

AKA Erythroblastosis Fetalis

• During pregnancy (fetal and mom’s circulaitory systems are closelt intertwined) = Antibodies from the mom cross the placenta and destroy the fetal’s RBC

• Usually during delivery : Rh(-) mom and Rh(+) baby’s antigens = mom’s antibodies (anti Rh) are produced

  • the amount doesn’t effect the 1st child a lot (usually)

  • massive amounts of anti-Rh antibodies ar eproduced for the 2nd child

    • hemolyzes the fetal’s RBC = procduces anemia

    • fetal demand for RBC increases = RBC leave the bone marrow and into circulation before maturing fully

Chapter 11… What is HDN in shorter terms? Why is it also called Erythroblastosis Fetalis?

• When the Hemolytic disease of the Newborn infleunces the mom’s anti Rh antibodies to destroy the fetal’s RBC = fetal needs more RBC

  • the fetal RBC leave the bone marrow before fully developing

It’s also called Erythroblastosis Fetalis ….

• immature RBC are called erythroblasts

Chapter 11… Testing for blood compatibility : what are the two steps?

1. Determining the blood type of the recipient

2. doing a cross match test

Chapter 11… How to test/determine a recpipiant’s blood type?

Chapter 11… What happens during Cross-match testing?

Chapter 11…Abnormal Hemostasis

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