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70 year old female pt with pneumonia (downstream (bacteria or virus enters…
70 year old female pt with pneumonia
Background
Lung
Partietal Pleura
outer membrane which is attached to the inner surfaced of thoracic cavity
cushion lungs and reduce friction
divided by pleural cavity
Visceral Pleura
delicate membrane that covers the surface of each lung
cushion lungs and reduce friction
divided by pleural fluid
Lobes
superior lobe of right/left lung
middle lobe of the right lung
inferior lobe of right/left lung
Alveoli
small air sacs
simple squamous epithelium
gas exchange
Pulmonary Artery
carries deoxygenated blood from the right ventricle to the lungs
pulmonary vein
attached to posterior of heart
4 main pulmonary veins attached to lungs
transfer oxygenated blood from lungs to the heart
drains from lungs to left atrium
Bronchi
largest airways of bronchial tree
incomplete rings and irregular plates of cartilage (smooth muscle)
pseudostratified ciliated columnar epithelium and by ciliated columnar epithelium
conduct air
bronchioles
smaller conducting airways of bronchial tree
no cartilage mostly smooth muscle in walls
simple ciliated columnar epithelium to simple cubiodal epithelium
conduct air
Alveolar ducts
small airways that branch off respiratory bronchioles
multiple alveoli found along walls of alveolar duct
simple cuboidal epithelium
gas exhange
trachea
organ connecting larynx to main bronchi
c-shaped cartilage rings keep trachea open
pseudostratified ciliated columnar epithelium
conducts air
larynx
cylindrical structure between pharynx and trachea
non keratinized stratified squamous & pseudostratified ciliated columnar epithelium
Respiratory physiology at alveoli level
pulmonary ventilation or breathing is the movement of air between the atmosphere and the alveoli
inspiration or inhaling air into the lungs
Expiration or forces air out of the lungs
Oxygen diffuses across the respiratory membrane from the alveoli into the capillaries
carbon dioxide diffuses across respiratory membrane from capillaries into the alveoli
lower respiratory tract includes the larynx, trachea, bronchi, bronchioles, alveolar ducts and alveoli
gas exchange with the blood
blood capillaries surround each alveolus for gas exchange
two types of cell
alveolar type I moist and prone to collapse due to high surface tension (simple squamous)
alveolar II cells secrete pulmonary surfactant, prevents the collapse of alveoli
Laws :
Dalton's Law
the sum of all partial pressures is equal to the total atomospheric pressure
Henry's Law
a given temperature, the solubility of a gas in a liquid is dependent upon the partial pressure of the gas
Boyle's law
states that a constant temperature, the pressure of a gas decreases if the volume of the container increases
Partial Pressure
exists when the partial pressure for a gas is higher in one region of the respiratory system than in another
Po2 in alveoli is 13.7% < atmosphere
Pco2 is 5.2% in alveoli > atmosphere
Po2 in the systemic cells is lower than in the alveoli opposite with Pco2
pressure exerted by each gas within a mixture of gases and is measured in mm Hg
Po2 and Pco2 in the blood are constantly fluctuating
under higher pressure,nitrogen is forced into the blood
Inflammation in Respiratory System
Laryngitis
inflammation of the larynx
caused by viral infection, bacterial infection, or overuse of the voice
swelling of the epligottis may lead to sudden airway obstruction in children
Bronchitis
inflammation of the bronchi
caused by viral infection, bacterial infection, inhalation of irritants or cigarette smoke
large of amounts of mucus and cough lasting three continuous months
Asthma
Episodes of bronchoconstriction coupled with wheezing, coughing, shortness of breath, and excess pulmonary mucus
inhaled steroids to reduce inflammatory reaction
airway pathway wall is inflammed
Upstream
Pt age - the older you get the weaker the immune system gets
Traveling and especially if in higher altitudes which decrease partial pressure of atmosphere oxygen so when you inhale less oxygen goes in
downstream
mental confusion
fever/chills
coughing mucus
difficulty breathing
heart failure
Nausea and vomiting
organ failure
chest pain
fatigue
low body temperature
bacteria or virus enters the body through an airway
infection gets into the lungs, inflammation causes air sacs called alveoli to fill up with fluid or pus
leads to trouble breathing, coughing, and coughing up mucus