Poly Cardia Pharm Respiratory System (Final)


Poly Cardia Pharm  Respiratory System (Final)
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Ventilation (Respiration)
 
movement of air in and out of lungs (respiratory system)
external (respiration)
 
gas exchange between air in lungs and blood
transport of oxygen (respiration)
 
transport of oxygen and CO2 Carbon dioxide in blood
internal (respiration)
 
gas exchange between the blood and tissue
gas exchange (Respiratory system functions)
 
oxygen enters blood and carbon dioxide (CO2) leaves
regulation of blood pH (RS function)
 
altered by changing blood carbon dioxide levels
voice production (RS functions)
 
movement of air past vocal folds makes sound and speech
olfaction (RS functions)
 
smell occurs when airborne molecules are drawn into nasal cavity
protection (RS functions)
 
against micro organisms by preventing entry and removing them from respiratory
upper tract (RS Divisions)
 
Nose
pharynx
associated structures
lower tract (RS Division)
 
larynx
trachea
bronchi
lungs
tubing within the lungs
vestibule
(Nose and Nasal Cavities-nasal)
(cavity from nares to conchae)
 
Just inside the nares
Hard palate
(Nose and Nasal Cavities-nasal)
(cavity from nares to conchae)
 
Floor of nasal cavity
Nasal Septum
(Nose and Nasal Cavities-nasal)
(cavity from nares to conchae)
 
Partition diving cavity.
Anterior cartilage: Posterior vomer and perpendicular plate of ethmoid
Conchae
(Nose and Nasal Cavities-nasal)
(cavity from nares to conchae)
 
Bony ridges on lateral walls with meatuses between openings to paranasal sinuses and to nasolacrimal duct.
Functions of the Nasal Cavity
 
Passageway for air
Cleans the air
Humidifies, Warms air
Smell
Along with Paranasal sinuses are resonating chambers for speech
Pharynx
 
Common opening for digestive and respiratory systems
Pharynx (Three regions )
1.) Nasopharynx
 
Mucous and debris is swallowed,
Openings of Eustachian (auditory) tubes
Floor is soft palate
Uvula is posterior extension of soft palate
Pharynx (Three regions )
2.) Oropharynx
 
Shared with digestive system

Pharynx (Three regions )
3.) Laryngopharynx
 
Epiglottis to esophagus
Epiglottis to esophagus is called? Pharynx (Three regions )
 
Laryngopharynx
Vocal folds are? (Function of Larynx)
 
True chords

True Chords are? (Function of Larynx)
 
Vocal folds
Vestibular folds are? (Function of Larynx)
 
False Chords

False Chords are? (Function of Larynx)
 
Vestibular folds
Functions of Larynx
 
-Maintain an open passageway for air movement; thyroid and cricoid cartilages
-Epiglottis and vestibular folds prevent swallowed material from moving into larynx
-Vocal folds are primary source of sound production
-greater the amplitude of vibration, louder the sound
-frequency of vibration determines pitch
-arytenoids cartilages and skeletal muscles determine length of vocal folds
-abduct the folds when not speaking to pull them out of the making glottis larger
Trachea is?
 
Dense regular tissue and smooth muscle;
Supported by 15-20 hyaline cartilage
C-shaped rings open posteriorly (back).
Contracts during Coughing.
Inner Lining (of Trachea)
 
Mucus traps debris
Cilia push it superiorly toward larynx and pharynx
Carina (of Trachea)
 
Membrane of Carina especially sensitive to irritation and inhaled objects initiate the cough reflex
Trachea ( Divides to Form)
 
Left and Right Primary Bronchi

Bronchopulmonary Segments is?
 
Tertiary Bronchi

Defined by tertiary bronchi
 
Bronchopulmonary segments
This membrane especially sensitive to irritation and inhaled objects initiate the cough reflex.
 
Carina (of Trachea)
List the Order in which the Tracheobronchial Tree flows & Conducting Zone
 
-Trachea --divides into 2 Primary Bronchi
-Primary Bronchi --divides into Secondary Bronchi (one/lobe)
-Secondary Bronchi --Divides into Tertiary Bronchi
-Tertiary Bronchi --further subdivide into smaller and smaller bronchi
-Smaller Bronchi --then turn into Bronchioles (less than 1mm in diameter)
- Bronchioles --finally divide into Terminal Bronchioles

Cartilage
(Tracheobronchial Tree flows & Conducting Zone
 
Holds tube system open; smooth muscle controls tube diameter. As tubes become smaller, smaller , amount of cartilage decreases, amount of smooth muscle increases.
What holds the tube system open: smooth muscle controls tube diameter.
 
Cartilage
Site for gas Exchange
 
Respiratory Zone
Principal organs of respiration.
 
Two Lungs
Space enclosed by thoracic wall and diaphragm.
 
Thoracic cavity
Dome shaped with base of dome attached to inner circumference of inferior thoracic cage.
 
Diaphragm
Respiratory Zone: Respiratory Bronchi-oles to Alveoli
Respiratory Zone: site for gas exchange
 
-Respiratory bronchi-oles-- branch form terminal bronchi-oles
-Respiratory Bronchioles --have very few alveoli
-Alveolar ducts-- which have more alveoli
Alveolar ducts-- end as alveolar sacs at base of lung
No Cilia
Quiet Respiration
 
-Accounts for 2/3 of increase in size of thoracic Volume.
-Inferior movement of Central tendon flattens the diaphragm abdominal muscles relax.
Accounts for 2/3 of increase in size of thoracic Volume.
-Inferior movement of Central tendon flattens the diaphragm abdominal muscles relax.
 
Quiet Respiration
Quiet Expiration
 
-Relaxation of diaphragm and
-External intercoastals with contraction of abdominal muscles
Relaxation of diaphragm and external intercoastals with contraction of abdominal muscles
 
Quiet Expiration
A measure of the ease with which lungs and thorax expand.
 
Compliance
Amount of air inspired expired with each breath. AT rest: 500ml
 
Tidal Volume
Compliance
 
A measure of the ease with which lungs and thorax expand.
Deposition of inelastic fibers in lung (emphysema)
 
Pulmonary fibrosis


Measures volume of air that move into and of respiration system?
 
Spirometry
Tool used in Spirometry
 
Spirometer



Amount of air inspired or expired with each breath. At rest 500ml

 
Tidal Volume
Amount of air that can be inspired forcefully after inspiration of the tidal volume (3000 mL at rest)
 
Inspiratory reserve Volume
Volume still remaining in respiratory passages and lungs after most forceful expiration (1200mL)
 
Residual volume

Amount that can be forcefully expired after expiration of the tidal volume(100mL at rest)
 
Expiratory reserve Volume


Tidal volume + Inspiratory reserve volume
 
Inspiratory Capacity (IC)
Expiratory reserve volume + residual volume.
 
Functional residual capacity (FRC)
Inspiratory reserve volume + tidal volume + expiratory reserve volume.
 
Vital Capacity (VC)
Inspiratory reserve volume +tidal volume + expiratory reserve volume + residual volume.
 
Total lung Capacity (TLC)
Minute ventilation (measured in Lpm)
 
Total air moved into and out of (Lung) respiratory system each minute (TV x RR) (total Volume x Resp Rate)
Respiratory Rate
 
Number of breaths taken per minute
Formed by
Nasal Cavity
Pharynx
Larynx
Trachea
Bronchi
Bronchioles
Terminal Brochioles
 
Anatomic Dead Space
Anatomic dead space plus the Volume of any Alveoli in which gas exchange is less than normal
 
Physiological Dead Space
Volume of air available for gas exchange/minute
 
Alveolar Ventilation (Va)
Tool used to show relationship between SaO2 and PaO2
 
oxyhemoglobin Dissociation Curve
Cessation of breathing
 
Apnea
Causes decrease in blood PaCo2 levels.
Peripheral vasodilation causes decrease in BP
 
Hyperventalation
Too much CO2
 
Hypercapnia
Lower than Normal CO2
 
Hypocapnia
Specialized neurons that respond to changes in chemicals in solution.
 
Chemoreceptors
This detects level of CO2 and tells you when to breathe. (Primary)
 
Central chemoreceptors
Responds to changes in PaCO2
 
Carotid
This detects level of O2 changes and tells you when to breathe (Secondary)
 
Peripheral chemo-receptors
Responds to changes in Pa O2
 
Aortic bodies
Small change in carbon dioxide in blood triggers a large increase in rate and depth of respiration
 
Effect of Carbon Dioxide CO2
Greater than normal amount of carbon dioxide
 
Hypercapnia
Lower than normal amount of oxygen
 
Hypocapnia
Chronic disease caused by increased reactivity of the tracheobronchial tree to various stimuli
 
Asthma
This is used to treat Asthma in children and is a broncholdilator; however, this use is not a labeled indication for the drug
 
Isoproterenol
Agents that widen the diameter of brochial tubes.
 
Brochodilators
What is PaO2 value?
 
90-100 mmHg
What is PaCO2 value?
 
35-45 mmHG
What is pH Value?
 
7.35 - 7.45 pH Normal Range
What is HCO3
 
22-26 mEq/L
What is O2 saturation value?
 
90% -100%
What are Three Clinical goals of Oxygen Therapy?
 
1 Treat hypoxemia
2 Decrease work of breathing
3 Decrease myocardial work
What are the TWO types of systems for oxygen administration?
 
High flow systems such as ventilators and T-pieces for Tracheostomy
-Low flow systems such as nasal cannula and CPAP
Are there any contraindications for Oxygen?
 
--NO
What are 3 precautions with oxygen?
 
1 -CO2 retainers
2- Fire Hazard is increased
3- Risk of bacterial contamination associated with a humidifier
What are 2 Complication with Oxygen?
 
-Nasal Dryness
-Respiratory depression
What are 3 oxygen titration techniques?
 
1- Based on sleep lab policy
2-Begin titrating .5-1 liter per minute (lpm)
3- Keep SpO2 greater equal 90%
What chronic disease is classified according to its allergy, exercised induced, or infections of respiratory tract?
 
Asthma
What are 2 sub classes of brochodilators?
 
-Xanthines
-Theophylline
What are 2 uses for Beta 2 Adrenergic Agonist?
 
-Relieve bronchospsm of Asthma
-Treat brochitis
What 2 Advers Effects of Bet 2 - Adrenergic Agonist?
 
_Nausea
-Vomiting
What are 4 effects of Beta 2 Adrenergic Agonist on Sleep Architecture?
 
SOL - increase
SE - Decrease
TRT - Decrease
TST - Decrease
Drugs chemically related to caffeine that dilate bronchioles by relaxing smooth muscles are?
 
Xanthines
Name 1 main USE for Xanthines
 
Prevent Asthma
What are 2 Adverse Effects of Xanthines?
 
-Nausea
-Vomiting
What are 4 effects of Xanthines on Sleep Architecture?
 
SOL - increase
SE - Decrease
TRT - Decrease
TST - Decrease
What are 4 effects of Theophylline on Sleep Architecture?
 
SOL - increase
SE - Decrease
TRT - Decrease
TST - Decrease
What are uses for Corticosteroids?
 
-Treat Allergic conditions
-Treat respiratory conditions
What are 2 Adverse effect of Corticosteroids?
 
-Nausea
-Vomiting
What are 1 Uses of Mat Cell Stabilizers?
 
Prevents Asthama

What are 4 Effects of Mast Cell Stabilizers on Sleep Architecture?
 
SOL - increase
SE - Decrease
TRT - Decrease
TST - Decrease
Name 1 Uses for Antitussives?
 
To suppress non productive cough
What are 2 Adverse Effects of Antitussives?
 
-Nausea
-Dizziness
What are 2 Uses for Expectorants and Mucolytics?
 
-Treat Brochopulmonary disease
-Treat Cystic Fibrosis
Name 1 Use for Decongestants
 
-Relieve Nasal Congestion
What are 2 Adverse Effects of Decongestants?
 
-Headache
-Dizziness
What are 4 Effects of Decongestants on Sleep Architecture?
 
SOL - increase
SE - Decrease
TRT - Decrease
TST - Decrease
Any condition resulting in hypoventilation can cause what?
 
-Respiratory Acidosis
Which has the faster response :
Renal Buffer or Respiratory Buffer?
 
Respiratory Buffer
(Kidneys slow to the party)
Any condition resulting in hyperventilation can cause what?
 
Respiratory Acidosis
How do you correct respiratory acidosis?
 
By increasing ventilation
What is treatment for respiratory alkalosis?
 
Resolve the underlying problem
Examples of Metabolic Acidosis are?
 
-Diarrhea
-Renal Failure
-Diabetic Ketoacidosis
Examples of Metabolic Alkalosis are?
 
-Vomiting
-Gastric Suctioning
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