Function of the Respiratory System Exchange CO2 (on expiration) for O2 (on inspiration)
Upper Respiratory Tract Includes: Nose Mouth Pharynx Larynx Function: Warms and humidifies the inspired air Filters the air, keeping foreign matter out of the lower respiratory tract
Lower Respiratory Tract Includes: Trachea Bronchi, mainstem and secondary Lobules Bronchioles Alveolar ducts Alveolar sacs Function: Cough reflex, mucociliary system, and immune response protects against any foreign matter
http://www.youtube.com/watch?v=su_8jud3yzq
Mechanism Air moves in an out of the respiratory tract by the contraction and relaxation of the respiratory muscles: Sternocleidomastoid muscle Intercostal muscles Diaphragm For there to be effective exchange of O2 for CO2, ventilation and perfusion at the alveolar level must be matched http://www.youtube.com/watch?v=a-iglpuhvju
QW: Describe the respiratory system
Cyanosis Bluish discoloration, of the oral mucosa, lips, fingers, nail beds
Cyanosis Causes: Decreased cardiac output Anxiety Cold environment Polycythemia (cyanotic, but there is adequate oxygenation)
Allergic Rhinitis A reaction to inhaled allergens, which cause rhinitis and conjunctivitis, seasonally or year-round
Allergic Rhinitis - Pathophysiology Exposure to an allergen T-cells instruct B-cells to create antibodies against the allergen B-cells create antibodies called IgE IgE antibodies attach themselves to mast cells (release histamine) Mast cell-ige complex remain in the body for years, ready to react with the same allergen
Allergic Rhinitis Signs and Symptoms Paroxysmal sneezing Pale, cyanotic, edematous (boggy) nasal mucosa Profuse watery rhinorrhea Nasal congestion sinus pain and headache Pruritis of the nose, throat and eyes Red, edematous eyelids and conjunctivae
Allergic Rhinitis - Management Avoid allergens Antihistamines Inhaled intranasal steroids Cromolyn Leukotriene inhibitors Desensitization
Allergic Rhinitis http://www.youtube.com/watch?v=segas-35nsu http://www.youtube.com/watch?v=y3bogdvv- _M&feature=related
QW: Describe what you learned about Allergic Rhinitis?
Asthma A chronic inflammatory airway disorder, characterized by airflow obstruction and airway hyperresponsiveness to certain stimuli, extrinsic or intrinsic triggers.
Extrinsic triggers Animal dander Secretions from cockroaches Dust mites Pollen Mold Viral infections Feather pillows Cigarette smoke Cold air Temperature or humidity variations Food additives Certain foods: Shellfish, peanuts Asthma Intrinsic triggers Anxiety Emotional stress Strenuous exercise Gastroesophageal Reflux Disease (GERD) Coughing Laughing Fatigue Endocrine changes
Asthma includes the following mechanisms: Bronchospasms Edema of the airway mucosa Increased mucus secretion http://www.merckmanuals.com/home/sec04/ch044/ch044a.html
Asthma Signs and Symptoms Sudden: Dyspnea Wheezing Tightness in the chest Productive cough Rapid respiration Rapid pulse Use of accessory respiratory muscles http://www.youtube.com/watch?v=va9c_a CH7F0&feature=related
Asthma Four levels of severity Mild intermittent: (<2 times/week), normal between exacerbations, nighttime symptoms < 2 times/ month, FEV1 ~ 80% of normal Mild persistent: (>2 times/week), nighttime symptoms > 2 times/month, FEV1 ~ 80% of normal Moderate persistent: Symptoms occur daily, exacerbations occur more than two times per week, bronchodilator therapy is used daily, nighttime symptoms occur more than once per week, FEV1 60 80% of normal Severe persistent: Symptoms occur continuously, exacerbations occur frequently and limit physical activity, nighttime symptoms are frequent, FEV1 <60%
Asthma - Treatment Avoid triggers Desensitize to triggers Yoga Develop Cardiopulmonary endurance Hydration Monitor FEV1 Bronchodilator Corticosteroid Mast cell stabilizer Leukotriene modifier CAUTION: Do not take Aspirin, or other non-steroidal anti-inflammatory drugs, and do not take beta-blockers
Normal adults without airflow limitation have an FEV1 > 80% predicted. http://www.youtube.com/watch?v=fgcblhhq5wm&feature=related
Green Zone: 80 to 100 percent of your usual or "normal" peak flow rate signals all clear. A reading in this zone means that your asthma is under reasonably good control. It would be advisable to continue your prescribed program of management. Yellow Zone: 50 to 80 percent of your usual or "normal" peak flow rate signals caution. It is a time for decisions. Your airways are narrowing and may require extra treatment. Your symptoms can get better or worse depending on what you do, or how and when you use your prescribed medication. You and your healthcare provider should have a plan for yellow zone readings. Red Zone: Less than 50 percent of your usual or "normal" peak flow rate signals a Medical Alert. Immediate decisions and actions need to be taken. Severe airway narrowing may be occurring. Take your rescue medications right away. Call 911 or get a ride to the emergency room.
How to Use a Metered-Dose Inhaler Shake the inhaler after removing the cap. Breathe out for 1 or 2 seconds. Put the inhaler in your mouth or 1 to 2 inches from it and start to breathe in slowly, like sipping hot soup. While starting to breathe in, press the top of the inhaler. Breathe in slowly until your lungs are full. (This should take about 5 or 6 seconds.) Hold your breath for 4 to 6 seconds. Breathe out and repeat the procedure. If this method is difficult, a spacer can be used.
http://www.youtube.com/watch?v=7edo9puyvpe&nr=1 http://www.youtube.com/watch?v=agdi5ti5vtk
QW: Describe what you learned about asthma.
Chronic Obstructive Pulmonary Disease (COPD) http://www.youtube.com/watch?v=u775bgjjazm&feat ure=related Chronic Bronchitis and Emphysema Main cause is smoking
Chronic Bronchitis Inflammation of the bronchi caused by: Cigarette smoking Respiratory tract infection Prolonged exposure to irritants, noxious gases, organic or inorganic dusts
Chronic Bronchitis Results in: Hypersecretion of mucus Chronic productive cough for at least 3 months, and occurring at least two years in a row. Rhonchi http://www.youtube.com/watch?v=qpbzoohj2a0&feature=r elated
The permanent destruction of the alveolar walls. Emphysema
Emphysema Signs and Symptoms: Exertional dyspnea Tachypnea Barrel-shaped chest Use of accessory muscles for inspiration and abdominal muscles for expiration Clubbed fingers
Emphysema http://www.youtube.com/watch?v=aus9v_unbii
QW: Describe what you learned about Chronic Bronchitis and Emphysema.
Pulmonary Embolism Obstruction of a pulmonary artery by a dislodged thrombus, usually from a deep vein in the leg. This is the most common pulmonary complication in a hospitalized patient. S & S: Sudden severe dyspnea Tachycardia Blood-tinged sputum Anxiety
Breath sounds http://www.youtube.com/watch?v=nnuahgw1cwu