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70 year old retired female develops viral pneumonia (Admitted to ER…
70 year old retired female develops viral pneumonia
Admitted to ER
increase risk of pulmonary stress
70 year old woman
Retired from long term job in Fort Worth
Moves to Denver Colorado
increase risk of pulmonary stress
higher elevation
Respiratory Anatomy and Physiology
Respiratory Anatomy
Pharynx (stratified squamous epithelial)
nasopharynx
oropharynx
laryngopharynx
passageway for air
Glottis
Opening covered by epiglottis when swallowing
Larynx (hyaline cartilage)
voice box
Trachea (ciliated pseudostratified columnar epithelial and hyaline cartilage)
wind pipe
Bronchial Tree
Trachea Splints into L & R lungs
Primary Bronchi
Secondary bronchi
Tertiary Bronchi
Bronchioli
Paranasal sinuses (mucosa, bone and cartilage cells)
mucosa-lined, air filled cavities
moistens and warms incoming air
Nostrils (stratified squamos epithelial)
nasal cavity -produces mucus
also warms and moistens incoming air
external nose- supported by bone and cartilage
Alveoli (simple squamous)
chambers at termini of bronchial tree
external surfaces intimately associated with pulmonary capillaries
Alveolar cells produce surfactant- reduce surface tension
Lungs
houses respiratory passages smaller than main bronchi
type 1 epithelial cells
type 2 epithelial cells
Pleurae
Serous membrane
Parietal pluera- lines thoracic cavity
visceral pleura - covers external lung surface
Respiratory physiology
Pressure relationships in the thoracic cavity
Intrapulmonary pressure
pressure within alveoli
760mm HG atmospheric pressure
As intrapulmonary pressure drops, air rushes into the lungs until the intrapulmonary and atmospheric pressures are equalized
pressure increasesduringinspiration
Intraplueral pressure
pressure within pleural cavity
Normally 4mm hg less than intrapulmonary
Gas Laws, Partial Pressure, and Gas Exchange by Diffusion
Dalton's Law
pressure exerted by each gas- its partial pressure- is directly proportional to the percentage of that gas in the gas mixture
in high altitude, partial pressures decline in direct proportion to the decrease in atmospheric pressure
Henry's Law
amount of gas that will dissolve in a liquid is proportional to the partial pressure of that gas
when PCO2 in the pulmonary capillaries is higher than in the lungs, CO2 diffuses out of the blood and enters the air in the alveoli.
important factors
solubility of gas in theliquid
temperature of the liquid
Boyle's law
at constant temperature, the pressure of a gas varies inversely with its volume
as thoracic cavity volume increases, intrapulmonary pressure decreases
as thoracic cavity volume decreases, intrapulmonary pressure increases
External Respiration (alveolar gas exchange)
Oxygen enters pulmonary capillaries
carbon dioxide leaves the blood and enters the alveoli
factors that influence external respiration
partial pressure gradients and gas solubilities
thickness and surface area of respiratory membrane
ventilation-perfusion coupling
Internal respiration (systemic gas exchange)
oxygen leaves the blood and enters tissue
carbon dioxide diffuses out of cells into the blood
Inflammation
undermines adequate ventilation
fast breathing
shallow breathing
shortness of breath
wheezing
Acute respiratory distress syndrome
fluid leaks into lungs
pneumonia
alveoli fills up with fluid or pus
asthma
airways swell due to excess mucus
chronic obstructive pulmonary disease
chronic bronchitis
emphysema
pneumonia
inflammed and fuild filled alveoli
coughing mucus
fast, shallow breathing with wet and wheezing cough
chest pain, fever and chills
age risk of developing pneumonia
high altitude exposure pulmonary responses
hyper ventilation
increased heart rate
both functions aim to achieve adequate oxygen supply to body and tissues
effects on other systems
cardiovascular
Higher heart rate
Arrythmias
vascular- low blood pressure (decreased O2)
Muscular
fatigue
aches
central
headaches
loss of appetite
immune system
age increases risk of cardiovascular complications
longer time for recovery
weakened immune system
Viral pneumonia
can lead to a secondary bacterial pneumonia
if left untreated
bacteremia
septic shock
dangerously low blood pressure
all forms of pneumonia can lead to an inadequate supply of oxygen into the tissues