spa3101 chapter 3

Passive expiration

system is restored to resting position after respiration, driven by forces of elasticity and gravity

Active expiration

muscular effort enhances act of expiration, abdomen is compressed, muscles reduce size of thorax, rib cage pulled down, air pillow out of lungs, eliminates waste products

Two elements to measure in respiration

volume (cc) spirometer and pressure (cm/H20) manometer

Spirometer

measures volume of air that is displaced

Manometer

measures pressure, u shaped tube

Pumonic (alveolar) pressure

pressure within the lungs and specifically alveoli

Intrapleural (pleural-surface) pressure

pressure between visceral (lung) and costal (rib) pleurae

Subglottal pressure

pressure below level of vocal folds (trachea)

Glottis

area between vocal folds

Intraoral pressure (oral pressure)

pressure within mouth

Intraoral and subglottal are __ if vocal folds are open

same

atmospheric pressure

pressure arising from force of gravity on air molecules of atmosphere

Four basic processes of respiration and gas exchange

ventilation, distribution, perfusion, diffusion

Ventilation

actual movement of air in the conducting respiratory passageway

Inspiration is usually ___ where expiration is usually ___

active, passive

Distribution

air is distributed to 300 million alveoli

Perfusion

migration of fluid or gas through a barrier, oxygen-poor vascular supply is perfused to six billion capillaries that supply alveoli

Diffusion

gas exchange across alveolar-capillary membrane

Respiratory cycle

one inspiration and one expiration. Adults complete between 12 and 18 cycles per minute

Quiet tidal respiration

quiet flow of air into and out of lungs

Minute volume

air involved in one minute of respiration

Factors that affect respiration

exercise, age, muscle weakness, illness, body posture

Checking action

uses muscles to restrain expiration, can use accessory muscles of expiration and inspiration to produce syllable stress

External respiration

exchange of gasses between lungs and blood

Internal respiration

exchange of gasses between blood and body cells

Volume displacement requires an

open larynx and upper airway

Volume is divided into

lung volumes and lung capacities

Output variables of breathing

volume (lung), pressure (alveolar), shape (chest wall)

Tidal volume (TV)

the volume of air exchanged in one breathing cycle (resting tidal volume when resting)

Inspiratory reserve volume (IRV)

the maximum volume of air that can be inspired after tidal inspiration

Expiratory reserve volume (ERV)

the maximum volume of air that can be expired from tidal expiration

residual volume (RV)

the volume of air remaining at the end of maximum expiration, cannot be measured directly

Inspiratory capacity (IC)

the maximum volume of air that can be inspired from the tidal expiration

Vital capacity (VC)

maximum volume of air that can be inspired after a maximum expiration

Functional residual capacity (FRC)

volume of air at the end of passive exhalation

Total lung capacity (TLC)

the volume of air in the pulmonary apparatus after a maximum inspiration

Lung volume and alveolar pressure are

inversely related when the breathing apparatus is closed (Boyle’s Law)

Diseases affecting speech function

chronic obstructive pulmonary disease, asthma, bronchitis, lung cancer, pleurisy, pneumonia, sleep apnea, pulmonary fibrosis

Chronic obstructive pulmonary disease (COPD) two subtypes

chronic bronchitis, emphysema

Chronic bronchitis

most often caused by tobacco smoke, productive cough that lasts for 4 months or longer, twice in one year for 2 years

Cause of chronic bronchitis and results

caused by inflammation of bronchial passageway, excessive mucus, cough, wheezing, shortness of breath, poor lung function, reduced capacity

Treatments of chronic bronchitis

bronchodilators, steroids, long-term oxygen therapy, lung transplant

Effect of chronic bronchitis on speech

reduced vocal intensity, short phrasing, fatigue during speech

Emphysema

second type of COPD, results from loss of continuity of alveoli, surface declines

emphysema symptoms develop

between 40 and 60 years

Emphysema cause

tobacco smoke, environmental pollutants

Complications of emphysema

pneumothorax, heart problems

Physical changes of emphysema

barrel chest, paradoxical respiration, diaphragm can’t descent further

Emphysema and speech

short phrasing, limited phonatory ability, significant fatigue

Paradoxical respiration

thorax expands when alveoli collapse, diaphragm flattens at rest. Diaphragm contracts, pulling rib cage in, effectively expiration. Act of inspiration causes expiration.

Asthma physical changes

narrowing of bronchial passageway, extra mucus, inflammation of bronchi

Symptoms of asthma

chest pain, shortness of breath, coughing, sleep disturbance

Causes of asthma

exercise, occupational irritants, cold air, medication, emotional stress, reflux, allergy

Long term treatment for asthma

bronchial dilator (inhaler)

Asthma effects on speech

paradoxical vocal fold movement, involuntary adduction of vocal folds during inspiration, reduced vocal intensity, short phrasing, fatigue

Lung cancer is

leading cause of cancer deaths in the U.S.

Risk factor of lung cancer

longer you smoke, greater the risk, radon

Treatment of lung cancer

surgical, chemotherapy, radiation therapy

Lung cancer effects on speech

short phrasing, shortness of breath, fatigue

Pleurisy

pleural membrane becomes inflamed, painful and debilitating

symptoms of pleurisy

chest pain related to breathing, shortness of breath, coughing or fever, may have pleural effusion

Causes of pleurisy

viral infection, fungal infection, immune disorder, cancer, trauma

Pneumonia has

two classes (viral and bacterial), infection in the lungs

Symptoms of pneumonia

chest pain with breathing, coughing, fatigue, fever, sweating, chills, nausea, vomiting

Aspiration pneumonia

occurs as a result of dysphagia, bacterial, life threatening

Sleep apnea

sleep disorder, breathing stops and starts

Three types of sleep apnea

obstructive caused by flaccid pharynx, central neurological issue, complex combination

Symptoms of sleep apnea

loud snoring, episodes of stop breathing, gasping during sleep, awakening with dry mouth, excessive daytime sleepiness

Treatment of sleep apnea

continuous positive airway pressure

Pulmonary fibrosis

lung tissue is scarred and thickened, alveolar walls

Etiology of pulmonary fibrosis

some lung conditions, genetic diseases, idiopathic, occupational

Signs and symptoms of pulmonary fibrosis

shortness of breath, dry cough, fatigue, aching muscles and joints, widening and rounding of finger tips and toes

inspiratory capacity formula

tidal volume + inspiratory reserve volume

functional residual capacity formula

expiratory reserve volume + residual volume

total lung capacity formula

sum of tidal volume, inspiratory reserve volume, expiratory reserve volume and residual volume

vital capacity formula

tidal volume + inspiratory reserve volume + expiratory reserve volume