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Take a Deep Breath – Focus on the air- Where is it going?

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Presentation on theme: "Take a Deep Breath – Focus on the air- Where is it going?"— Presentation transcript:

1 Take a Deep Breath – Focus on the air- Where is it going? How does it move? What purpose does it serve?

2 Airway Defenses: Nose: Mucociliary clearance: Cough:
Reflexive bronchoconstriction: Alveolar macrophages:

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4 Ventilation Inhalation Exhalation

5 Rate and volume control:
Respiratory control center in the brain stem Responds to chemoreceptors CO2, pH, O2 – all trigger responses Which would cause what?

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7 Work of Breathing Lung Compliance:
Ability of lung tissue and chest wall to expand Surfactant – key facilitator Chest injuries? What would they causes?

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9 Work of Breathing Elastic recoil – Promotes expiration
Elastin fibers are present around the alveoli which act just like an elastic Elastin fibers are damaged in patients with emphysema – leads to air trapping. What does this do for ventilation? Diffusion?

10 Work of Breathing Increased Airway Resistance:
Asthma – results in bronchoconstriction, airway hyperreactivity, edema COPD – (emphysema) Most common cause is smoking – chronic inflammation leads to loss of elastic recoil. Cystic fibrosis – genetic – results in massive mucus production What impact do these have on ventilation?

11 Measuring ventilation
Tidal volume Vital capacity Forced vital capacity Forced expiratory volume – 1 sec Residual volume Total lung capacity

12 Impaired ventilation Something interferes with the movement of air
What might cause a narrowing or compression of the airways – anywhere along the way? What about neuronal stimuli – how might it be a cause of problems?

13 Diffusion Where alveoli interact with vascular – one cell thick!
Diffusion – down the concentration gradient

14 Diffusion

15 Diffusion Enhanced by: Pressure – concentration gradient
Solubility of gases: CO2 more soluble = diffuses more easily Distance from alveoli to capillary = super short Surface area What impact does accumulation of fluids have on the ability of gases to diffuse? What condition result in fluid accumulations?

16 PaCO2 – PaO2 – HbO2/saO2 Gases consist of particles – when they get in the serum they move about – this creates a pressure. How is this lab reported? The body can use this oxygen – it diffuses – Oxyhemoglobin = oxygen bound to hemoglobin The body cannot use this oxygen – Until it comes off the hemoglobin Hemoglobin is the delivery truck

17 Impaired diffusion Pressure/Solubility: O2 pressure Increases w/
Increased barometric pressures Temperature increases So – when would this decrease? High elevations Hypothermia Inadequate supply Membranes: Fluid or exudate = increased diffusion distance Decrease in surface area Fibrosis/thickening of either/both membranes

18 V/Q mismatch Either ventilation (V) or Perfusion (Q) is not adequate to facilitate gas exchange. No oxygen – but perfusion is present No perfusion – but oxygen is present

19 Results of decrease vent/diffusion
Hypoxemia/hypoxia What is the end result? Brain is super sensitive – what will you see? Hypercapnia What PaCO2 values will you see? What type of acid/base imbalance do you have? What are some results of this?

20 Manifestation of impaired ventilation/diffusion
Cough Excess mucus production Hemoptysis Dyspnea – subjective “patient reports…..” Accessory muscles use - objective Chest pain Barrel chest Adventitious breath sounds - objective

21 Systemic manifestations
Cyanosis – late sign! ABG values What does ____________ tell you? PaCO2 PaO2 SaO2 Mental status – restless, irritable…..lethargy Finger clubbing

22 Pneumonia What does this do for: Ventilation? Diffusion? Red vs gray
hepatization

23 COPD diseases Asthma, emphysema, chronic bronchitis

24 COPD diseases Asthma, emphysema, chronic bronchitis

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26 COPD diseases Asthma, emphysema, chronic bronchitis

27 Acute respiratory distress syndrome

28 How does this impact ventilation/diffusion?
Chest trauma Pneumothorax How does this impact ventilation/diffusion?

29 How does this impact ventilation?
Chest trauma Flail chest How does this impact ventilation?

30 Next Week Matters of the Heart


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