Respiratory Sg

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Respiratory Study Guide:

* Surfactant, role in ventilationDECREASES SURFACE TENSION, allowing the alveoli to open easily with each breath

* Definition of ventilationThe movement of air into the lungs & distributed to the alveoli for maintenance of oxygenation & removal of C02

* Gas transport (o2)1. VENTILATION of lungs
2. DIFFUSION of 02 from the alveoli into the capillary blood 3. PERFUSION of systemic capillaries with oxygenated blood
4.DIFFUSION of 02 from the systemic capillaries into the cells

* Alveolar functionprimary gas-exchange units

Definitions discussed in class and which disease process they go with (for example..) * PND with pulmonary edema
* Paroxysmal nocturnal dyspnea (PND): individuals with heart failure or lung disease wake up at night gasping for air & must sit up or stand to relieve the dyspnea * Pulmonary edema?

* Kussmaul’s vs. cheyne-stokese (what they are & when they happen) * Kussmauls respiration:
* Hyperpnea; characterized by a slightly increased ventilator rate, very large tidal volume & no expiratory pause * Induced by strenuous exercise or metabolic acidosis
* Cheyne-stokese:
* Characterized by alternating periods of deep and shallow breathing, apnea lasting 15-60 seconds followed by ventilations, decreasing to apnea (neuro impairment) * Result from any condition that slows the blood flow to the brainstem, which in turn slows impulses sending information to the respiratory centers of the brainstem

* Hypoxia and Hypoxemia (difference between)
* Hypoxia: Decrease in tissue cell oxygenation
* MAY BE CAUSED BY ALTERATIONS OF OTHER SYSTEMS
* Low cardiac output, cyanide poisoning

* Hypoxemia: Reduced 02 of arterial blood (reduced Pa02) * CAUSED BY RESPIRATORY ALTERATIONS ONLY
* Table 33-1 list common causes which include high altitude, oversedation, chest trauma, asthma, etc) * Most often associated with compensatory hyperventilation & resultant respiratory alkalosis * Clinical Manifestations:

* Not enough oxygen; Cyanosis (almost always a late finding), confusion, tachycardia, edema, and decreased between renal output

Restrictive lung disorders (1274)
* Characterized by decreased compliance of lung tissue
* Means it takes more effort to expand the lungs during inspiration, which increases the work of breathing * Complain of dyspnea, have increased RR, and decreased tidal volume * Common diseases are aspiration, atelectasis, bronchiectasis, bronchiolitis, pulmonary fibrosis, inhalational disorders, pulmonary edema, ARDS

Bronchiectasis vs. Bronchiolitis (Difference between the patho of each; S&S) I. Bronchiectasis:
* Often caused by recurrent inflammation or infection of the airways * Persistant abnormal dilation of the bronchi
* Usually occurs in conjunction with other respiratory conditions * CF causes 1/3 of cases
* Other causes include obstruction of an airway with mucous plugs, atelectasis, aspiration of foreign body, infection, TB * Large anastomoses develop b/n bronchial and pulmonary blood vessels, thought to cause hemoptysis * Pathophysiology

* Associated with recurrent inflammation of the bronchi walls which leads to persistent dilation of the bronchi & bronchioles * Inflammation causes destruction of the bronchial walls
* Destructive process leads to loss of ciliated epithelium * DIALATION INCREASED MUCUS PRONE TO INFECTION
* Clinical manifestations
* * Chronic, Productive cough
* *Purulent, foul-smelling, green or yellow sputum
* Fever, night sweats
* Hemoptosis
* Moist crackles, rhonchi
* Clubbing (infrequent)—caused by prolonged, decreased oxygenation * Hypoxemia

II. Bronchiolitis:
* Wide spread inflammation of the...
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