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Viral Infection of Lungs in 70 year old Female (Upper Respiratory System,…
Viral Infection of Lungs in 70 year old Female
Patient age effecting illness
Preexisting lung conditions?
COPD?
Asthma?
Poor lung compliance?
Smoker?
Preexisting conditions?
Congestive Heart Failure?
Blood Clots?
High Blood Pressure?
Heart Attack?
Prescription Medications?
Location
High Altitude
Temperature
Humidity
Air Pollution
Viral Infection
Diagnoses of Virus vs Bacteria?
Immune System Response
Respiration
Four Processes of Respiration
Pulmonary ventilation(breathing)
Ventilation consists of inspiration and expiration
Inspiration moves air into lungs from atmosphere
Expiration moves air out of lungs into the atmosphere
External Respiration
O2 diffuses from the lungs to the blood
CO2 diffuses from the blood to the lungs
Transport of respiratory gases
Cardiovascular system uses blood to transport gases throughout body
O2 is transported from the lungs to the tissues of the body
CO2 is transported from the tissue cells to the lungs
Internal respiration
O2 diffuses from blood to tissue cells
CO2 diffuses from the tissue cells to blood
Tissue cells use O2 and produce CO2 during cellular respiration
Respiratory Volumes
Tidal Volume
amount of air inhaled or exhaled with each breath under resting conditions
Average value for male is 500ML
Inspiratory Reserve Volume
amount of air that can be forcefully inhaled after a normal tidal volume inspiration
Average value for male is 3100ML
Expiratory Reserve Volume
amount of air that can be forcefully exhaled after a normal tidal volume expiration
Average value for male is 1200ML
Residual Volume
amount of air remaining in the lungs after a forced expiration
average value for male is 1200ML
Respiratory Capacities
Total Lung Capacity
maximum amount of air contained in lungs after a maximum inspiratory effort : TLC= TV + IRV + ERV + RV
Average value for male is 6000ML
Vital Capacity
Maximum amount of air that cab be expired after a maximum inspiratory effort : VC = TV + IRV + ERV
Average value for male is 4800ML
Inspiratory Capacity
maximum amount of air that can be inspired after a normal tidal volume expiration : IC = TV + IRV
average value for male is 3600ML
Functional Residual Capacity
Volume of air remaining in the lungs after a normal tidal volume expiration : FRC = ERV + RV
Average value for male is 2400 ML
Upper Respiratory System
Nostril
provides airway for respiration
Nasal Cavity
moistens, warms, cleans, and filters inspired air
Oropharynx
connects nasal cavity and mouth, stratified squamous epithelium
Laryngopharynx
passageway for food and air, stratified squamous epithelium
Nasopharynx
air passageway
Lower Respiratory System
Larynx
Provide patent airway
Act as switching mechanism to route air and food into proper channels
Voice production
Trachea
elastic and flexible windpipe supported by C shaped rings of Hyaline cartilage
Right and Left Main (Primary) Bronchi
largest of bronchi
Lobar (Secondary) Bronchi
three on the right and two on the left, each supply one lung lobe
Segmental (Tertiary) Bronchi
bronchi continue to divide into smaller bronchi until smaller than 1 mm which then are termed bronchioles
Terminal Bronchioles
less than 0.5mm in diameter
Respiratory Bronchioles
smallest of bronchioles, connect to Alveolar Ducts
Alveolar Ducts
walls consist of diffusely arranged rings of smooth muscle cells, connective tissue fibers, and outpocketing alveoli
Alveolar Sacs/Saccules
clusters of Alveoli
Alveoli
individual alveola is where gas exchange occurs via diffusion
Type I alveolar cells
squamous epithelial cells that form the major part of alveolar walls
Type II alveolar cells
Cuboidal Epithelial Cells that are scattered among type I cells. Secrete Surfactant to keep alveoli from sticking and collapsing
Alveolar Macrophages
crawl freely along internal alveolar surfaces consuming bacteria, dust, and other debris
Lungs
Apex
narrow superior tip of the lung
Base
concave, inferior surface that rests on the diaphragm
Costal surface
anterior, lateral, and posterior lung surfaces in close contact with the ribs and form continuous curve
Right Lung
contains 3 lobes(superior, middle, and inferior)
Left Lung
contains 2 lobes (superior and inferior)
Pulmonary Arteries
deliver systemic venous blood that is to be oxygenated in the lungs
Pulmonary Veins
carry freshly oxygenated blood from the respiratory zone of the lungs to the heart
Bronchial Arteries
provide oxygenated systemic blood to lung tissue
Pulmonary Plexus
lungs innervated by parasympathetic and sympathetic nerve fibers
Sympathetic fibers
Dilate air tubes
Parasympathetic fibers
Constrict air tubes
Pressure Relationships in Thoracic Cavity
Atmospheric pressure
pressure exerted by air (gases) surrounding the body
atmospheric pressure = 760 mm Hg = 1 atm
Intrapulmonary Pressure
pressure in the alveoli, rises and falls with phases of breathing but always equalizes with atmospheric pressure eventually
Intrapleural Pressure
pressure in the pleural cavity, always about 4mm Hg less than Intrapulmonary pressure
Transpulmonary Pressure
Difference between intrapulmonary and intrapleural pressures (this is what keeps lungs from collpasing)
Gas Laws of Respiratory System
Boyles Law
at constant temperature, the pressure of a gas varies inversely with its volume
as volume decreases, pressure increases/ as volume increases, pressure decreases
Boyles law relates to ventilation
Daltons Law
states the total pressure exerted by a mixture of gases is the sum of the pressures exerted independently by each gas in the mixture
pressure exerted by each gas, its
partial pressure
, is directly proportional to the percentage of that gas in the gas mixture
Daltons law relates to how gas moves from the atmosphere to our body and vice versa
Henrys Law
states when a gas is in contact with a liquid, the gas will dissolve in the liquid in proportion to its partial pressure
Henrys law relates to how gas
diffuses
from the atmosphere into our body and vice versa
How elevation affects partial pressure??
dissolved gases always diffuse down their partial pressure gradients
As elevation
increases
, atmospheric pressure
decreases
so as elevation increases the partial pressure gradient decreases, making
diffusion
less effective
at high elevation the partial pressure of Oxygen is almost equal to the partial pressure of Oxygen in your blood, making it extremely difficult for gas exchange to occur
Inflammation of the Lungs
Increased mucous production
Causes constriction of smooth muscles surrounding the bronchioles
increased capillary permeability can lead to further fluid overload in alveoli
swelling and irritation of tissue in chest cavity
Preexisting conditions/Age
Asthma
pneumonia could trigger an asthma attack
COPD/Smoking
destruction of alveolar walls
loss of lung elasticity
air trapping
breakdown of elastin in connective tissue of lungs
excess mucus production
Prescription medications
is patient taking any medications that could interfere with her treatment of pneumonia??
Heart Attack
does patient have weakened cardiac output due to prior heart attack?
previous heart attack could have affect on pulmonary circulation
High Blood Pressure
high blood pressure could lead to stroke
high blood pressure could further complicate her systemic perfusion
Congestive Heart Failure
Right sided heart failure would complicate her respiratory system ever further due to fluid backup of her pulmonary artery
Left sided heart failure would decrease her systemic perfusion and add stress to her heart which could further add stress on her respiratory system
Blood Clot
blood clot could become lodged in her lungs
Immune System
does patient have any prior conditions that would weaken her immune system?
HIV?
removal of lymph nodes?
Location
Temperature
temperature could have direct effect on her circulation and gas exchange
Humidity
increased altitude could have low humidity putting further stress on her respiratory system due to dry air
Pollution
air pollution could increase her chance of staying ill and decrease her ability to breath in pure O2
Altitude
decreases the partial pressure of O2 and makes diffusion less effective in exchanging O2 and CO2 in her body
Pneumonia
Fluid in the lungs
fluid in the lungs increases the distance between the alveola and the capillary membrane and makes it more difficult for gas to travel across the fluid to be exchanged
wheezing
wheezing is caused by constriction of the bronchioles due to inflammation and constriction of the smooth muscles around the bronchioles
fast breathing
due to poor gas exchange from her fluid buildup in the lung she is retaining more CO2 and her body is attempting to blow off the CO2 by increasing her respiratory rate
shallow breathing
patient could be breathing shallow due to poor compliance or she could be getting fatigued due to constantly breathing fast
Cause of illness?
what is exactly causing patients illness?
bacteria?
virus?
other infection?
what test have been run to prove it is viral?