Respiratory System

Upper Respiratory Tract- Helps to warm and filter the air.

            Nose and sinuses

            Pharynx

            Larynx

            Tonsils and adenoids

Lower Respiratory Tract- helps get the air where its needed most

            Trachea

            Mainstream Bronchi     

            Lobar Bronchi

            Bronchioles

            Alveolar ducts and alveoli

            Lung

Changes in Respiratory system with age

            Declines with age

            Increased potential for infections

            Risk for hypoxia increases

            Lung elasticity decreases

            More air is retained in the lungs

Chest wall becomes more rigid

Decreased muscle strength and endurance

Other factors affecting respiratory function

            Environment

            Lifestyle

            Health status

            Medications

            stress

Oxygen in Carbon dioxide out

Hemoglobin is the carrier of oxygen this is an important fact if you’re anemic

Three processes essential for cellular respiration

1. Ventilation- inspiration is the active phase the diaphragm contracts, the chest expands, the pressure in the lungs lower air flows in. Inspiration is controlled by the brain stem (important if you have a brain trauma
   1. Normal High Pco2 stimulates breathing
   2. In COPD low oxygen stimulates breathing

2. Diffusion- happens in the capillaries, process of gas exchange between alveolar air and the blood. All based on a pressure gradient( high oxygen level in the lung forces that oxygen into the blood, high level of co2 in blood causes it to go into the lungs to be exhaled
3. Perfusion- process of circulating oxygen and carbon dioxide between the lungs and tissue cells.
   1. Cardiac output, number of erythrocytes and hematocrite, exercise, competent vasculature, and pulmonary emboli can all effect perfusion

Hypoventilation results in respiratory acidosis

Hyperventilation results in alkalemia                  

Respiratory Assessment-

History, psychosocial, review of systems, (subjective information) don’t forget to ask about snoring.

Physical assessment of the Lungs and Thorax-

Inspection

            Skin and mucous membranes, clubbing, muscle development, physical endurance, scar lesions masses ect.

Palpation

            Crepitus- feel over lungs it’s a crackly feeling when air is in the tissues

Percussion

Auscultation

ARTERIAL BLOOD GAS

            Ph 7.35-7.45

            Pco2 35-45 mmHg

            HCO3 22-26mEq/l

            PO2 80-100mmHG

            SaO2 90-100%

Pulse oximetry- hemoglobin saturation- less accurate at lower values

Pulmonary function test, measures lung volume and capacity useful screen before pt has symptoms

Oxygen is a drug be extra careful with pt who has COPD

With a Tracheotomy, make sure they have hygiene, emotion care, body image support and tracheotomy care such as cleaning and suctioning and humidification and warming of the air

END of the Review INFORMATION

THIS was just HIGHLIGHTS

Upper Respiratory Disorders

Rhinitis- Inflammation and irritation of the Mucous membranes of the nose, blocks sinus opening

            Treatment depends on cause allergic, non allergic and viral or bacterial. IF VIRAL NO ANTIBIOTICS given

Sinusitis- inflammation /infection and or obstruction of the sinuses.

            Acute last less then 3 weeks. Treat with antibiotics

Chronic Sinusitis last longer then 3 weeks treat with antibiotics for longer period of time, possible surgery for structural deformities

*Complications OF BOTH IF  untreated MENINGITIS, brain abscess, ostomylitis, orbital cellulites     

Pharyngitis- inflammation/infection of the throat, can be viral or bacterial

            Can still get even if had tonsillectomy

            STREP THROAT- bacterial 

Chronic Pharyngitis- Constant sense of irritation/fullness in throat

Tonsillitis/Adenoiditis- Group a bata-strep is most common causing organism

            Note- enlargement is normal in children but size decreases with age

            Treatment- antibiotics, possible surgical removal

Laryngitis- inflammation of the larynx- hoarseness

            Treatment rest voice may use topical steroids by inhalation to reduce local inflammation.