Chemical reaction only takes place in the presence of oxygen

The main waste product of these chemical reactions is CO2

The resporatory system is the route of exrection for CO2

Physiology of the Respiratory System

Functions as a gas exchange system

10,000 L of air exchange daily

Wastes, including CO2 is excreted from the body via the respiratory system.

Thoracic Vertebrae

12 ribs

Intercostal Muscles

Sternum

Diaphragm

Lungs

(The lungs are attached to the heart bu pulmonary arteries and veins, Separated by mediastinum and its contents)

Plural Cavity

pariel & visceraol: Potential Space

Chest wall

Intrapleural Space

Pleural Space

Intrapleural Space is always negative (less than atmospheric)

There is a tight coupling of the lungsn to the thoracic wall in this closed cavity.

Loss of negative pressure results in lung collapse

As Pressure Increases

Volume Decreases

Control of breathing is loc in Medulla Oblongata

Peripheral chemorecptors in aoratic arch & carotid artery are sensitive to decreased oxygen levels.

Breathing Control

Sentitive to the levels of CO2, PH

Chemorecptors in the medulla repond quickly to the evevations in PCO2 or to a decrease in pH of the CSF

Oxygen bounded to hemoglobin (hgb) is oxygen saturation

Each Hbg molecule can carry 4 molecules of qxygen

Oxygen dissolved in plasma is the partial pressure of the gas oxygen (PO2)

PO2 of 80-100mmHg=Oxygen Sat near 100%

PO2 of 60=90% of Hbg is Sat

Oxyhemoglobin Dissocial Curve.

Important tool for understanding how our blood carries & releases oxygen

In the lungs, the partial pressure of oxygen is typically high, & the oxygen binds readily to hemoglobin that is present. As blood circulates throughout the body in which the partial pressure of oxygen is less, the hemoglobin releases the oxygen into tissue because hemoglobin cannot maintain full capacity of oxygen in the presence of lower oxygen partial pressure.

Incrased oxygen consumption

More oxygen is released at the tissue level

pH (Acidosis)

Fever

Increased Metabolism

Decreased Oxygen consumption

Less oxygen is released at the tissue level

pH (Alkalosis)

Temperature decrease

Metabolism decrease

Alveoli

thin respiratory membrane

interstitial space

capillary bed

Needed for adequate ventilation

-Central Neurological control initiate ventilation

-Neves between the brainstem & spinal nerves able to stimulate the muscles of respiration (C3,4,5)

-Functional diaphragm & intercostal muscles

-a patent upper airway

-a functional lower airway

-Alveoli that are functional & non-collapsed

-Atelectasis

-Upper / lower airway obstruction

-Foreign body, epiglottitis , asthma, obstrucive lung disease, airway edema

Problems in neurological control

-Stroke, drugs

-CNS depression, trauma, neuromuscular disease

-Ensure that both the upper and lower airways are open & unobstructed

-Provide asst ventilations

Partial obstruction to air flow by soft tissue-usually caused by the tongue

- Noise caused by the presence of liquids in the upper airway

A high-pitched crowing sound produced by a partial obstruction at the larynx, (Laryngospasm, or airway obstruction)

Short, sharp crackles created when there is fluid down in the alveoli & terminal bronchiole.

Heard in patients w/ bronchitis, asthma, emphysema, pneumonia and pulmonary edema.

Heard when air moves through a very narrow passage.

 Doesn't clear through coughing. Heard in patients w/ asthma, bronchitis, allergic reactions, pulmonary edema. Usually heard on expiration

Bluish discoloration occurs as a result of lack of oxygen in the hemoglobin.

Assess nail beds & arround the lips

Pulse

Tachycardia

Bradycardia

Tachycardia can be a sigh of hypoxemia

Bradycardia is an ominous sign of severe hypoxemia & warns of cardiac arrest

-hypoxemia: insufficent oxygen of arterial blood

(hypo:low)

Hypertension

-Anxiety

-Chronic condition

Respiratory rates

-Eupnea: 12-24

-Bradypnea: less than 12

-Tachycardia: more than 24

-Apnea Resp rate 0

Agonal respirations

A pattern of very slow, shallow respirations. Usually indicative of onset of respiratory arrest.

Respiratory Pattern

Cheyne Stokes

Shallow resps, then deep, than shallow, & then a period of apnea

Seen in stroke patients and those near death

Deep sighing respirations. Patient is breathing deeply & looks to be blowing air out.

Seen in diabedics who are in DKA

slow, shallow respirations

Narcotic or sedative overdose

Rapid rate & deep respiration

Increase volume of air exchange

anxiety atk, acidosis, hypoxic

Loss of elasticity of the lungs or narrowing of air passages makes it difficult to push air out

COPD or patients experienceing bronchospasms

Sigh of R heart failure

tension pneumothorax

cardiac tamponade

Increased production suggests infection, allergy or inflammation

Pink frothy sputum is associated w/ severe pulmonary edema

pulmonary edema: condition where fluid accumulates in the lungs, usually due to the hearts L venticle does not pump adequately

May be associated w/ hypocapnia (decreased CO2) resulting from deep, rapid respiration (hyperventilation)

Hypocapnia: a state of reduced Co2 in the blood

'pnea: in the breath