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70 year old female recently moved from TX to CO and has developed a viral…
70 year old female recently moved from TX to CO and has developed a viral infection in her lungs. She has a shallow breathing and a wet wheezy cough pointing at pneumonia.
Age: respiratory muscle strength decreases with age and the aveolar physiologic dead space increases meaning there is less exchange of respiratory gases do to any possible lost alveoli.
Location: Colorado is at a higher altitude and a higher altitude "thins" our the air which exerts a lower atmospheric pressure.
Viral Infection is not related to the pressure gradient, however it does affect the lungs function.
Pneumonia is an infection of the lung, which results in the aveoli filling with fluid, exudate, or pus. It is most likely that the patient has developed pneumonia due to her viral infection in the lungs. Pneumonia also results in tissue sweling, accumulated fluid and leukocytes within the lungs, which increases the thickness of the respiratory membrane. Therefore the capacity for gas exchange is impaired, decreasing the difusion of O2 and CO2 between the aveoli and the blood withing the pulmonary capillaries.
Her cardiovascular system along with her circulatory system would also be affected by the lack of oxygen being carried by the blood to the organs of the body such as the heart.
Other complications include - Pleural effusion: this is when fluid builds up in the layers of tissue between the lungs and the wall of the chest making breathing very difficult. Bacteria in the bloodstream: this can occur when the pneumonia infection in the lungs spreads to the blood increasing the risk of the infection spreading to other organs in the body. Lung abscesses: can occur when pus collects in the lungs.
If pneumonia is left untreated it can lead to respiratory failure and and death.
Lung anatomy from cells to organs
Cells:
1)
Alveolar type I cell
(simple squamous epithelium tissue) is the most abundant and collectively form the alveolar epithelium of the respiratory membrane, and
type II cell
secrete pulmonary surfactant which prevents the collapse of alveoli. 2)
Alveolar macrophage or dust cell
, is a leukocyte that engulfs microorganisms and particulate material that reached the alveoli.
Structures of Lower Respiratory Tract:
1)
Alvioli
- small air sacs for gas exchange. 2)
Alveolar ducts
- small airways that branch off respiratory bronchioles; multiple alveoli found along walls of alveolar duct. 3)
respiratory brochioles
- first structure of respiratory zone. 4)
terminal bronchioles
are the last part of the conducting zone. 5)
bronchioles
- conducts air and can bronchoconstrict or bronchidialate. 6)
Bronchi
- largest airways of the bronchial tree. 7)
Trachea
- tubular organ connecting larynx to main bronchi. 8)
Larynx
- conducts air, prevents ingested material from entering the trachea, etc. 9)Lungs:
Structures of the Upper Respiratory Tract:
1)
Pharynx or commonly called the throat
- both air and food pass along its entire length. It has 3 regions the nasopharynx, the oropharynx, and laryngopharynx. 2)
Nasal Cavity
- primary function is to condition the air (warm, cleanse, and humidify the air). 3)
Nose
- first structure of the conducting passageway for inhaled air.
Conducting Zone includes
: nose, nasal cavity, pharynx, larynx, trachea, bronchus, bronchiole, and terminal brinchiole.
Respiratory Zone includes:
Respiratory brinchiole, alveolar duct, alveoli.
Respiratory physiology at the alveoli level/Alveolar gas exchange is external respiration.
A)
Po2 in the alveoli is 104 mm Hg, and the blood entering the pulmonary capillaries has a Po2 of 40 mm Hg. Due to the Po2 partial pressure gradient, O2 diffuses across the respiratory memebrane from the aveoli into the capillaries until Po2 in the blood is equal to that of the aveoli as it moves through = Po2 increased from 40 to 104 mm Hg.
B)
Simultaneously CO2 diffuses in the opposite direction. Pco2 in the aveoli is 40 mm Hg and the blood entering the pulmonary capillaries has 45 mm Hg. Also due to its partial pressure gradient CO2 diffusses from the blood into the aveoli until it is equal to 40 mm Hg. Pco2 decreases from 45 o 40 mm Hg.
Both the Po2 and Pco2 levels remain constant in the aveoli due to the continuous oxygen entering and carbon dioxide leaving the aveoli through the respiratory passageways.
The effects of inflammation on the respiratory system
Inflammation is the body’s response to infection, trauma, and hypersensitivity. The inflammatory response is complex and involves a variety of mechanisms to defend against pathogens and repair tissue. In the aveolar macrophages in the lungs that
Sinus infections and headaches occur when the mucosa of the ducts that drain from the paranasal sinuses into the nasal cavity become inflamed in response to a respiratory infection or allergy.
Laryngitis is an inflammation of the larynx that may extend to its surrounding structures. This can be caused by a viral or bacterial infection.
Bronchitis is an inflammation caused by a viral or bacterial infection or by inhaling irritants such as vaporized chemicals, particulate matter, or cigarette smoke.
Henry's Law
states that a given temperature, the solubility of a gas in a liquid is dependent upon the partial pressure of the gas in the air and the solubility coefficient of the gas in the liquid. The solubility coefficient is the volume of gas that dissolves in a specified volume of liquid at a given temperature and pressure.
Dalton's Law
states that the total pressure in a mixture of gases is equal to the sum of all of the individual partial pressures.
Boyle's Law
states that a constant temperature, the presure of a gas decreases if the volume of the container increases, and vise versa. Formula: P1V1=P2V2. The formula represents the inverse relationship that exists between gas pressure and volume.
Partial pressure is the pressure exerted by each gas within a mixture of gases and is measured in mm Hg. It is the driving force of a gas to move into a liquid. Atmospheric pressure is an example of total pressure and the gases such as nitrogen, oxygen, carbon dioxide, water vapor, and other minor gases each individual one represent a partial pressure. Equation:
Total pressure x % of gas = partial pressure of that gas
.
Partial pressure gradient
exists when the partial pressure for a specific gas is higher in one region than in another.
Altitude
changes the solubility of a gas when it increases or decreases. A higher altitude decreases the partial pressure and when under sea level the pressure is greater.