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70yr old female presents viral infection of lungs. Pneumonia? Altitude…
70yr old female presents viral infection of lungs. Pneumonia? Altitude change?
Lung anatomy
Cells
Alveolar type I & II form the alveolar wall, alveolar macrophages, goblet cells
Organs and structures
Bronchioles, alveoli, alveolar ducts
Respiratory physiology
Gas laws
Henry's Law
at a given temperature, the solubility of a gas in a liquid is dependent upon PP of the gas in the air and solubility of coefficient of the gas in the liquid
Dalton's Law
the total pressure in a mixture of gases is equal to the sum of all individual PPs
Partial pressure & Elevation
PP is the pressure exerted by each gas within a mixture of gases
The percentage of oxygen remains constant at different altitudes, however the fall of atmospheric pressure at higher altitudes decreases PP of inspired O2
Increases pressure for gas exchange in the lungs
Atmospheric pressure
the total pressure all gases collectively exert in the environment
Inflammation
Bronchitis
inflammation of the bronchi caused by a viral or bacteria infection
Acute
Develops rapidly either during or after an infection; pain upon inhalation, fever, coughing and sneezing
Chronic
Long-term exposure to irritants; production of large amounts of mucus, associated with a cough lasting 3 continuous months
if exposure to irritant persists, permanent changes to the bronchi occur, increasing the likelihood of future bacterial infections within the respiratory tract
Laryngitis
Inflammation of the larynx that may extend to nearby structures
Number 1 cause: viral or bacterial infection
Severe cases can produce inflammation and swelling of the epiglottis which may lead to sudden obstruction of airway
Alveolar gas exchange
Occurs when respiratory gases are exchanged between the alveoli into the blood of the pulmonary capillaries
O2 diffuses from the alveoli into blood of pulmonary capillaries while CO2 diffuses in the opposite direction
If untreated
the viral infection could spread throughout the body and possibly cause breathing to stop as fluid builds up in the lungs
Effect on other body systems
Immune system tries to fight against viral infection and pneumonia, and as the patient is an elderly woman her immune system is not as highly functioning
Circulatory system
If the respiratory system is unable to provide oxygen to the body, blood vessels will have no oxygen-rich blood to supply tissues and cells of the body
Cardiovascular
Lungs are unable to provide oxygen to the rest of the body, hemoglobin also unable to provide oxygen to the tissues
the heart must work harder to pump blood throughout, leading to tissue strain and death
Direct cause
The combination of the presence of a viral infection that was possibly left untreated leaving her susceptible to further illness, and altitude change
She could have inhaled or come into contact with a bacteria that lead to the pneumonia, causing her bronchioles and arterioles to work much harder, straining her lungs, circulatory and cardiovascular system
Relevant factors
Age
With age, the lungs, as well as the immune system, lose strength
More susceptible to infections
Location
At higher altitudes the supply of oxygen in the air decreases
It becomes much harder to get oxygen to the blood
Presence of viral infection
The body is fighting against the infection
Bacteria can readily enter the lungs, leading to the development of pneumonia
Each of these factors are interrelated and played a significant role in the condition of the patient
Effects of symptoms on respiration
Wet, wheezy cough
Pneumonia causes bronchi to produce and expel sputum, causing a wet and wheezy sounding cough
Fluid in lungs
Alveoli fill with excess fluid secreted from blood vessels in the lungs instead of air, resulting in difficulty breathing and poor oxygenation of blood
Shallow breathing (hypopnea)
results in smaller PP gradients between the alveoli and blood for O2 and CO2, and potentially respiratory acidosis, cyanotic tissues, polycythemia, lethargy