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70 year old
Female
Diagnose: Viral Pneumonia (Lungs
Located:…
- 70 year old
- Female
- Diagnose: Viral Pneumonia
Lungs
- Located: thoracic cavity lateral to the mediastinum
- Anatomy:
1) Right lung: a) Larger and wider of the two. b) Three lobes subdivdided by two fissures.
c) Superior, middle and inferior lobe.
d) 10 bronchopulmonary segments
2)Left lung: a) Smaller than the left lung
b)Two lobes; superior and inferior lobe
c) Lingula= projection of the superior lobe which is homologous to the middle lobe of the right lung
d) Two surface indentations to accomodate the heart= cardiac impression on the medial surface and cardiac notch at the anterior surface
e) 8-10 bronchopulmonary segments
3) Bronchopulmonary segments= Autonomous unit encapsulated within connective tissue and supplied by its own segmental bronchus, artery, vein and lymph vessel.
4-) Lobules: a-) Each lung is organized with marble sized ones.
b-) Surrounded by a connective tissue supplied by a terminal bronchiole, an arteriole and a lymph vessel.
5-) Main Bronchus Right and Left
Circulation and Innervation of the Lungs
- Pulmonary circulation= transports blood to and from the heart to pick up oxygen and get rid of carbon dioxide
- Bronchial circulation =transports oxygenated blood to the tissues of the lungs.
- Bronchial arteries = branch from anterior wall of the descending thoracic aorta
- Bronchial veins= collects venous blood from the capillary beds in the lungs
- Lymph nodes and vessels= located within the connective tissue of the lung around the bronchi and in the pleura
- Sympathetic Innervation = originates from the T1-T5 segments of the spinal cord -> Bronchiodilation.
- Parasympathetic Innervation = Vagus nerves (CN X) -> Bronchocontraction
Pleural Membranes and Cavity
- Visceral Pleura = Simple squamous epithelium.
=Tightly adheres to the lung surface
- Parietal Pleura = Simple squamous epithelium.
= Lines the internal thoracic walls, the lateral surfaces of the mediastinum, superior surface of the diaphragm
- Pleural Cavity= oily serous fluid produced by serous membrane and released into the pleural cavity
= Act as lubricant
= Located between the parietal and visceral membrane
- Partial Pressure => It is the pressure exerted
within a mixture of gases, and it is measured in mm Hg.
=>It is written with a P and the symbol of the gas.
- Partial Pressure Gradient => Partial pressure of one specific gas is higher in one region than in another region.
- AS PO2 increases ,
hemoglobin saturation increases.
- As PO2 decreases, hemoglobin saturation decreases.
- High Altitudes (Denver) = Large environmental PO2 = large decrease in alveolar PO2= large decrease in hemoglobin saturation= affecting the oxygen delivery = ALTITUDE SICKNESS
Gas Laws
- Dalton's Law = Total pressure in a mixture of gases=
the sum of all the individual partial pressures.
- Henry's Law = At a given temperature the solubility of a gas in a liquid depends on 1) the partial pressure of gas in the air and 2) the solubility coefficient of the gas in the liquid.
- Boyle's Law = At a constant temperature the pressure of a gas decreases if the volume of the container increases.
- Viral Infection = Exudate and Build up Fluid
- Wet Cough =
Thickness of respiratory membrane =
Lower gas exchange.
- Gas Exchange = Decreased diffusion
of O2 and CO2
between alveolus and
pulmonary cappilaries.
- If Untreated = Lungs will not be able to do gas exchange= STOP breathing = Death
Alveolar Gas Exchange
- Occurs when respiratory gases are exchanged between the alveoli and the pulmonary cappilaries accross the respiratory membrane.
1) O2 diffuses from the alveoli into the blood of pulmonary cappilaries.
2) CO2 diffuses from blood in the pulmonary cappilaries into alveoli
-
- Bronchioles Dilate or Constrict = Changes in CO2 in air whithin bronchioles.
- Pulmonary Arterioles Dilate or Constrict = Changes in blood PO2 or PCO2
Pneumonia
- Infection of the lung which results in the alveolus filling with fluid, exudate and pus.
- Result of a bacterial or viral infection.
Inflammatory Response
- Exudate = movement of additional fluid from blood through infected area and then into the lymph.
= Increased fluid, immune cells and protein leave the cappilaries and then enter the interstial space of the tissue.
= Delivers immune cells and substances needed to eliminate injurious agent and promote healing.
- Pus= exudate that contains destroyed pathogens, dead neutrophils, macrophages and cellular debris.
Virus x Bacteria
- Virus = Much smaller than a bacterial cell
= composed of DNA or RNA within a protein capsid or shell
= Intracellular parasites
= Reproduction includes directing the infected cell to make copies of its DNA or RNA and it's protein capsid.
= Immune response to virus = kills cells that are iinvaded by it
- Bacteria= microscopic, single-celled organism composed of prokaryotic cell.
- Denver = High altitude = Higher Atmospheric Pressure= Lower Alveolar PO2= Decreased Oxygen Delivery
- Thickness of respiratory membrane =
Lower gas exchange
- Decreased diffusion of O2 and CO2
between alveoli and pulmonary capillaries
-
- Produces Exudate and Liquid in the Lungs
-
- Trachea = Breathing Pathway =
narrowed by mucus
- Mucus= Inflamation in
air sacs
-
- Nose
- Larynx
- Trachea
- Main Bronchi
- Secondary Bronchis
- Tertiary Bronchis
- Bronchiloles
- Alveolar Ducts
- Alveoli
Cells and Tissues
- Trachea = 1) Mucosa = Pseudostratified Ciliated Columnar Epithelium and Goblet Cells
2) Submucosa = Areolar Connective Tissue
3) Tracheal Cartilage= Hyaline Cartilage Connective Tissue
4) Advetia= Elastic Connective Tissue
- Bronchi = 1) Ciliated Pseudostratified Columnar Epithelial
2) Smooth Muscle
3) Plates of Hyaline Cartilage
- Bronchioles = 1) Simple Ciliated Columnar epithelial
- Respiratory Bronchioles = Simple Ciliated Cuboidal Epithelia
- Alveolar Ducts and Alveoli = 1) Simple Squamous Epithelium
2) Alveolar Type 1 Cell = Simple Squamous Cell forms alveolar epithelium of each alveolus
3) Alveolar Type 2 Cells = Simple Cuboidal - produces surfactant
4) Alveolar Macrophage = leukocyte fixed within the connective tissue of the alveolar wall.
- Lungs - Simple Squamous Epithelium
- Lack of Elasticity of the Lungs
-
- Fast, Shallow Breathing =
Hypoventilation
- Age = Lower Elasticity of the Lungs
-
- Immune System = Fighting off Infection
-
- Due to Hypoventilation= Heart Overworking=
- Kidneys = Increase Release of EPO
- Bone Marrow = Increase Production of
Red Blood Cells
-
- Infection spread through
blood stream
Treatment
- Antiviral
- Expectorant
- O2 supplement therapy
- EPO shot
- Lot of Liquids
- Rest
Suplemental Treatment
- Take Patient to sea level so
O2 levels can Increase