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Oxygenation 2

Terms

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Primary Function of Pulmonary System
Gas Exchange
Upper Airways consist of
Sinuses, Nose, Mouth, Pharyn, Larynx, Epiglotis
Purpose of Upper Airways
To warm filter & humidify inhaled air
Epiglotis
protects us from aspirating food & fluid in lower airway
Lower Airways consist of
Trachea , Lungs, Bronchi
tracheobronchial tree, bronchiole, alviolar duct, alveoli
What are the lungs lined with
Visceral plearal (mucus)
What happens in Upper Airways
*Air enters nostrils

small hairs act as filters to clean air of dust and foreign particles

the nose warms and humidify the air

mucus layers trap fine foreign particles

cilia line the membranes to help mobilize mucus
What happens in Lower Airways

(THE LUNGS)
-the principle organ of respiration
-among the largest of all body organs
-rest on diaphragm (the principle Muscle of respiration)
-right lung (3 lobes)
-left lung (2 lobes)
-each lung surrounded by pleural cavity
Function of Respiratory System
*Gas exchange
*Oxygen transport
*Tissue Perfusion
*Acid balance
*Immune defence
Lower Airways
*pleural cavity filled with pleural fluid which acts as lubricant

*lower respiratory tract where gas exchange occurs

*Respiratory tract lined w/ mucus membran

*Constant movement of mucus by ciliary action cleanses and carrie foreing matter upward where mucus is expectorated or swallowed
The three stages of Respiration
Ventilation, Diffusion, Perfusion
Ventilation (infusion)
inflow and outflow of air between the atmosphere and alveoli
Diffusion
Exchange or oxygen and carbon dioxide between the alveoli and blood
Perfusion
Transportation of oxygen and carbon dioxide in the blood to and from the cells of the body
Definition of Ventilation
The physical process of moving air into and out of the lungs
Ventilation
-the result of volume and pressure changes in the chest cavity (thorax)
What happens during INSPIRATION
The diaphragm contracts, which enlarges the volume of the thorax (chest cavity) and DECREASES intra-thoracic pressure
What happens when the thoracic cavity enlarges
The lung pulled outward, Decreasing pressure in the airways to that BELOW atmospheric pressure, causing air to enter the lungs
What happens during EXPIRATION
The diaphragm and intercostal muscles relax, thoracic size decreases, pressure in the chest INCREASES, causing air to flow out of the lungs
What are the four things that adequate ventilation depend on
1. Availability of adquate oxygen
2. Clear air passages

3. Adequate pulmonary compliance and recoil (stretch ability)

4. Regulation of respiration (control by neural pathways, ie. medulla)
Medulla
respiratory center iniatiates each breath by sending messages via the PHRENIC Nerve to the pulmonary muscle
What happens during Diffusion
O2 and CO2 move between alvioli & blood.

*Movement occurs from area of greater concentration to area of lower concentration

The alveoli are primary units of gas exchange -exchange occurs through alveolar capillary membrane
What happens during Perfusion
Arterial blood transports O2
- 97% transported thru the bllood attached to hemoglobin molecules on RBC's
-3% physicall dissolved in the plasma

Hemoglobin bound with O2 to its fullest extent is considered 100% saturated, which makes normal arterial blood bright red

CO2 is mostly tansported in its disassociated form.

When chemically combined w/ water CO2 dissociates into bicarbonate ions, which is the primary component of buffer system. Plays a major role in acid base balance
Perfusion (Cyanosis)
Desaturate hemoglobin (hemoglobin not bound to fullest extent with O2)is purple and gives a bluish tone to the skin and mucus membranes.
Normal Breathing patterns
-vary with age
-pattern is smooth and even in depth, regular in rhythm
-appears effortless
-respiratory rate in resting adult 12-20
Factors Affecting Respiration
Body Position
-upright posture makes easier for diaphragm to move up and down w/o organs pressing on it

Exercise
-increases demand for O2 & increase CO2 production, increases rate and depth of respiration

Age
-lung become stiffer w/age

Pregnancy

Body weight
-obesity increase O2 demand due to extra work of carrying excess weight

Environment
-lower patial pressure of O2 at high altitudes means less available O2 for diffusion
-weather condition
-pollutants

Lifestyle habits
-smoking: slows muco-cialiary moverment and increase mucus production causing airway obstruction & promotes bacterial growth
-stress: increases O2 demand
-Nutrition: poor nutrition can inhibit production of hemoglobin
-Narcotic use: depress the rspiratory center in brain
Impact of Pulmonary dysfuncition on ADL(activities of daily living)
-activity tolerance decreases as disease progressees
-activity increases demand for O2 when walking, bathing etc.
-may require supplemental O2 at home
-impact onf family: caregiver burden and strain
Manifestations of Altered Respiratory Function
Cough: reflexive response to an irritant. helps clear offending substances from airway

Sputum production: -protetive feature to cleanse irritants from airway. source may be nose lungs or throat (IMPORTANT to note amount, color, consistency, odor)

Shortness of breath: : "dyspnea"

Chest pain

Abnormal breath sounds

Clubbing: fingertips become elnlarged and rounded, caused by chronic hypoxia

Accessory muscle use: - foward leaning posture, straining neck muscles, shoulder lifting and retractions

Cyanosis: bluish discoloration of skin and mucus membrane. Seriouse sign of poor oxygenation

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