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70-year old female patient, now lives in Denver and is experiencing…

- - - - Higher Altitude
        
        Decreased atmospheric pressure
        
        Decreased partial pressure of oxygen
        
        Decreased pressure of carbon dioxide and oxygen
        
        Below average hemoglobin saturation
    - - Influenza
        
        Virus attacks respiratory tract structures
        
        Symptoms
        
        Runny nose
        
        Phlegm build up
      - Common Cold
        
        Caused by a rhinovirus
        
        Pathway of entry
        
        Nose, mouth, or eyes
        
        Symptoms
        
        Congestion
        
        Runny Nose
        
        watery secretions from from nose
        
        Could advance to pneumonia if..
        
        infection goes into respiratory conducting zones
      - Pneumonia
        
        Viral infection that inflames alveoli
        
        Due to bacteria, virus, fungi
        
        Causes accumulation of fluid in alveolar sac
        
        Affects gas diffusion between respiratory membrane and blood
    - - Weakening of respiratory muscles
        
        Sternocleidomastoid muscle
        
        Diaphragm
        
        External Intercostal muscle
        
        Scalenes muscle
        
        Transverse Abdominus
        
        Oblique muscles
        
        Reduce ability to clear respiratory tract
        
        From mucus and foreign agents
        
        Increase in alveolar dead space
        
        Reducing arterial oxygen inspiration
        
        Increase carbon dioxide buildup
      - Reduced Thoracic Wall Compliance
        
        Rib cage can not move easily superiorly/inferiorly
        
        Due to ossification of costal cartialges
        
        Ribs that connect to sternum do not move as easily
      - Reduced Immune System Function
        
        Organ/Structures/Tissues are more susceptible to infection
        
        Can not defend against bacteria/foreign agents as efficiently
  - - - Causes decreased effectiveness
        
        Immune system
        
        Muscular system
        
        Lymphatic system
    - - Due to age/acclimatization
        
        Kidney's cannot efficiently perform erthropoiesis
      - Reduce atmospheric pressure
        
        Reduction in partial pressures of gases (O2)
- - - - Exchange of gases/nutrients
        
        Alveolar Macrophages
        
        Destroy remaining infectious organism
        
        Gas exchange occurs due to
        
        Simple diffusion across capillaries along respiratory membrane
        
        Carbon dioxide leaves blood
        
        Enters gas-filled alveolus
        
        To be later exhaled
        
        Oxygen passes from alveolus into blood
        
        Alveolar Type II Cells
        
        Secrete surfactant
        
        Prevents a possible collapse of lung
        
        Helps increase lung/thoracic wall compliance
        
        Reduces surface tension within repsiratory membrane
      - Respiratory Membrane
        
        Composed of three surfaces
        
        Basement membrane
        
        Pulmonary Capillaries
        
        Primarily simple squamous epithelium
  - - - A gas in contact with a liquid will
        
        Dissolve in liquid depending on partial pressure of gas
        
        Ex. Higher CO2 pressure in pulmonary capillaries
        
        Causes CO2 diffusion out from blood
        
        Then CO2 enters alveoli
      - Gas law that describes diffusion of gasses
  - - - Pharynx
        
        Larynx
        
        Trachea
        
        Glottis (opening)
        
        Primary Bronchi
        
        Secondary Bronchi
        
        2 more items...
        
        Bronchi greater than 1mm in diameter
        
        Epiglottis: covers glottis
        
        Controls passage way for food/air
      - Pharynx subdivided into
        
        Nasopharynx
        
        Serves as air way only
        
        Oropharynx
        
        passageway for food and air
        
        Laryngopharynx
        
        passageway for air and food
    - - Nasal Concha (3)
        
        Helps warm/humidify/trap particles with aid of mucus
  - - - Total pressure = sum of partial pressure of mixtures of gases
        
        Sum of pressures = atmospheric pressure 760 mmHg
    - - Oxygen Gas (20.9% = 159 mmHg)
      - Carbon Dioxide Gas (0.04% = 0.03 mmHg)
      - Nitrogen Gas (78.6% = 597 mmHg)
      - Water Vapor (0.46% = 3.7 mmHg_
    - - Reduced atmospheric pressure causes
        
        Reduced partial pressure of gases
        
        Causing reduction in oxygen content
        
        Thus harder ventilation process
  - - - Chronic Bronchitis
      - Chronic Obstructive Pulmonary Disease
      - Pleurisy
      - Asthma
    - - Ventilation is affected
        
        Causing reduced oxygen and carbon dioxide exchange
        
        Tissues and structures do not receive proper nutrients/energy
        
        Hypo/Hyperventilation to compensate
        
        Lungs can not move properly in thoracic cavity
        
        Reduced inspiration/expiration volumes
        
        Rib cage can not move adequately
- - - - Fluid/bacteria build up can enter the pulmonary veins
        
        Enter systemic circulation (cardiovascular system)
        
        Widespread effect to all organ systems
        
        Skeletal system
        
        Urinary system
        
        Muscular System
        
        Recycling of bacteria/fluid
        
        Reduced removal/draining (lymphatic system)
      - Fluid build up in alveolar sacs (pulmonary edema)
        
        Affects gas exchange
        
        Gasses cannot reach respiratory membrane due to fluid blockage
        
        Blocks exposure to alveolar pores
        
        Blocks type I alveolar cells
  - - - Body is not fully acclimated to elevation/change of environment
        
        Decreased in partial pressure of O2
        
        Less oxygen content to uptake to lungs
        
        Causing increased effort of ventilation
        
        Decrease removal of carbon dioxide
        
        Resulting in fast shallow breathing
        
        Change of environment
        
        Denver, CO
        
        5,130 - 5,690 feet above sea level
        
        Typically colder weather
        
        Induced hypothermia
        
        Increased risk of upper/lower respiratory infections
        
        Cold temperatures/age reduce immune system potency
        
        2 more items...
        
        Fort Worth, TX
        
        653 feet above sea level
        
        Typical sunny weather
        
        Ideal to promote proper body temperature
        
        Normal functioning of enzymes
        
        Kidney's cannot perform erythropoiesis to meet demands
        
        Insufficient #of red blood cells
        
        Reduction in hemoglobin
  - - - Reduced ability to ventilate
        
        Achieve sufficient oxygen perfusion and CO2 removal
      - Reduced ability to expel particles trapped in mucus
        
        Causing infection to occur
        
        Infection can move down to certain respiratory pathways
        
        Conducting Zones
        
        Leading to upper respiratory diseases
        
        Influenza
        
        Common cold
        
        If not cleared by expelling (coughing)/stomach digestion
        
        1 more item...
    - - Due to ossification of costal cartilages