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- - - - the amount of air that enters and leaves the alveoli.
    - - the amount of blood that flows to the alveolar capillaries.
    - - normal=1
      - high
        
        because of more ventilation or less perfusion
      - low
        
        because of less ventilation or more perfusion
  - - - is
        
        The total volume of fresh air entering the alveoli per minute
        
        Alveolar ventilation= [Tidal volume − Dead space ] × Respiratory rate
    - - an area with ventilation but no perfusion
      - normally it equals 150 ml, but may be larger in patients with lung disease
  - - - Body
      - Xiphoid process
      - Manubrium
    - - True ribs (1-7)
      - False ribs (8-10)
      - Floating ribs (11,12)
      - atypical: 1-2, (10-9)
      - typical (3-9)
    - - inspiration
        
        External intercostal muscles
        
        Diaphragm
      - forced expiration
        
        internal oblique
        
        external oblique
        
        Rectus abdominus
        
        transversus thoracic
        
        internal intecostal muscles
      - forced inspiration
        
        scalene muscles
        
        serretus anterior muscles
        
        sternocleidomastoid
        
        pectoralis minor
- - - - Associate with
        
        Chronic bronchitis
    - - are
        
        • Blood/ABG
        
        • Respiratory failure is indicated by
        
        – PaO2 < 8.0 kPa (60 mm Hg)
        – with or without PaCO2 > 6.0 kPa
        
        • Radiology
        
        will show
        
        – Hyperinflated lungs
        
        – Low placed and flat diaphragm
        
        – Tubular heart
        
        – Decrease vascular marking
        
        • Pulmonary Function test
        
        is
        
        a simple test used to help diagnose and monitor certain lung conditions by measuring how much air you can breathe out in one forced breath.
        
        used to
        
        diagnose asthma, chronic obstructive pulmonary disease (COPD)
        
        Forced Vital Capacity (FVC)
        
        The maximum volume of air (L) that can be exhaled forcefully and rapidly after a maximal inspiration.
        
        Forced expiratory volume in the first second (FEV1)
        
        The volume of air (L) that can be forcibly exhaled during the first second from the beginning of a FVC maneuver.
        
        Spirometry test of COPD
        
        Forced vital capacity (FVC) is normal or slightly decreased.
        
        (↓ ↓ FEV1) →→ ↓ FEV1: FVC ratio.
        
        Total lung capacity (TLC) is usually increased due to air trapping.
- - - - Two and three
        
        Patients will have a reduced lifespan, by approximately five to seven years.
      - Three or four
        
        Failure of the cardiovascular and respiratory systems reduced the oxygen capacity
      - Stage zero to stage one
        
        Patients will tend to have a normal lifespan
  - - - Narrow air passages
        
        Swelling in air tubes and destroy air sacs
        
        COPD
  - - - People with COPD are more likely to catch colds, the flu and pneumonia.
    - - Hyper-inflated lungs
        
        Low placed and flat diaphragm
        
        Tubular heart
        
        Decrease vascular marking
        
        Complications like Pneumothorax or infection
  - - - Stopping smoking
      - Inhalers and tablets
      - Pulmonary rehabilitation
      - Surgery or a lung transplant
    - - When we give a high amount of oxygen
        
        Acidosis will worsen
        
        NO breathing
        
        Respiratory failure
- - - - Long-term inflammation of the bronchi
    - - Destruction of air sacs (alveoli)
- - - - Neutrophils & Immune cells produce Neutrophile Elastase
        
        Break down Alveoli Elastic fibers
        
        Causing
        
        Loss of Elasticity & enlargement
    - - Alpha 1-Antitrypsin inhibits Elastase & is anti-inflammatory
        
        Meaning that
        
        It's deficiency would increase the risk for emphysema
        
        Can also lead to
        
        Liver Cirrhosis
  - - - Which is caused by Smoking & AATD? Upper/Lower Lobe?
- - - - by causing
        
        lung cancer
        
        More mucus & infections
        
        Fewer cilia
        
        Less airflow
    - - COPD
      - Productive or wet cough (mucus/sputum)
  - - - accessory muscles
        
        Transversus abdominis
        
        external & internal oblique
        
        Rectus abdominis
        
        Internal intercostal
      - primary muscles
        
        External intercostal
        
        diaphragm
    - - accessory muscles
        
        Sternocleidomastoid
        
        Latissimus dorsi
        
        Serratus anterior
        
        Pectoralis major & minor
        
        Scalenes
      - primary muscles
        
        diaphragm
        
        External intercostal
- - - - Prevent disease progression
        
        By
        
        Vaccination and healthy lifestyle
        
        Stop smoking
        
        Rehabilitation
        
        Breathing practice
  - - - Anti-cholinergic drugs
        
        Like
        
        Ipratropium
        
        MOA
        
        Inhibit the effects of acetylcholine thereby increasing bronchodilation
      - Beta 2 agonists
        
        Like
        
        Albuterol
        
        MOA
        
        Enhances the effects of norepinephrine which is increasing Camp and causing bronchodilation
    - - Inhaled
        
        Decreases inflammation over time (anti-inflammatory)
        
        Not used for acute attacks
        
        Minimal side effects
        
        Cough
        
        Sore throat
        
        Oral fungus infection
      - Systemic
        
        Oral or injectable
        
        Immediate anti-inflammatory response
        
        Used for acute attacks
        
        Side effects
        
        Blurred vision
        
        Weight gain
        
        Edema
        
        Onset of diabetes and hypertension
    - - Aims to eliminate the bacterial infections thereby reducing symptoms
      - In mild exacerbations
        
        Use of
        
        Doxycycline
        
        Azithromycin
      - In severe exacerbations
        
        Ceftriaxone
        
        Levofloxacin
- - - - Includes
        
        Having low oxygen but normal or decreased carbon dioxide
    - - Includes
        
        Having low oxygen and increased carbon dioxide
  - - - Right side heart failure condition that results from pulmonary hypertension
    - - Autoimmune diseases that damage the lungs, such as scleroderma
      - Chronic obstructive pulmonary disease
      - Chronic blood clots in the lungs
      - Cystic fibrosis
      - Severe bronchiectasis
      - Severe left-sided heart failure
    - - Swelling of feet, ankles and legs
      - Cyanosis
      - Jugular Vein Distention
      - Shortness of Breath