Respiratory System

Front 1

Primary purpose of Respiratory System

Back 1

Gas exchange, which involves the transfer of oxygen and carbon dioxide between the atmosphere and the blood

Front 2

2 parts of respiratory system

Back 2

Upper and Lower Respiratory Tract

Front 3

Upper Respiratory Tract includes

Back 3

Nose, Pharynx, adenoids, tonsils, epiglottis, larynx, & trachea

Front 4

Lower Respiratory Tract includes

Back 4

Bronchi, bronchioles, alveolar ducts, & alveoli

Front 5

Breathing thru upper resp. tract protects...

Back 5

the lower airway

Front 6

Purpose of nose

Back 6

is lined with mucous membranes and small hairs. Air entering the nose is warmed to near body temp., humidified to water saturation, and filtered of particles (dust, bacteria)

Front 7

The main- stem bronchi, pulmonary vessels, and nerves enter the lungs through a slit called

Back 7

Hilius

Front 8

difference btwn right and left mainstem bronchi

Back 8

right main-stem bronchi is shorter, wider, and straighter than the left.

therefore aspiration is more likely in the right lung.

Front 9

what are bronchioles?

Back 9

Smooth muscle that constrict and dilate in response to various stimuli.

Front 10

Bronchoconstriction vs. Bronchodilation

Back 10

Bronchoconstriction is a ddecrease in the diameter of the airway

Bronchodilation is an increase in the diameter of the airway

BOTH caused by the relaxation/contraction of the bronchioles.

Front 11

When does the exchange of oxygen or carbon dioxide take place?

Back 11

when the air enters the respiratory bronchioles.

Front 12

What are alveoli?

Back 12

Small sacs that form the functional unit of the lungs

they are inconnected by pores of Kohn, which allow movement of air from alveolus to alveolus.

bacteria can also move thru these pores causeing infection.

Front 13

what is surfactant?

Back 13

A lipoprotein that lowers the surfact tension of the alveoli. So that it doesn't collapse. (atelectasis)

Front 14

Who is at risk for atelectasis?

Back 14

the postop patient... because of effects of anesthesia and restricted breathing with pain.

Front 15

Two Circulation types for lungs & what they do

Back 15

Pulmonary - provides lungs with blood for gas exchange

Bronchial - provides oxygen to the bronchi and other pulmonary tissues

Front 16

Major muscle of respiration?

Back 16

Diaphragm

Front 17

What does ventilation involve?

Back 17

Inspiration & expiration

gas flows from an area of higher pressure to one of lower pressure.

Front 18

What is elastic recoil

Back 18

the tendency for the lungs to recoil after being expanded (streched).

Front 19

Compliance of the lungs?

Back 19

it is a measure of the elasticity of the lungs and thorax.

when compliance is decreased the lungs are more difficult to inflate.

Front 20

Where does the carbon dioxide and oxygen move back and forth across what by diffusion?

Back 20

Alveolar capillary membrane

Front 21

Oxygen is carried in the blood by what two forms?

Back 21

Dissolved oxygen (SaO2)

Hemoglobin-bound oxygen (PaO2)

Front 22

ABG?

Back 22

Arterial Blood Gas

used to measure oxygenation statue and acid-base balance.

Front 23

Respiratory Defense Mechanisms

Back 23

Filtration of air - nasal hairs

Mucociliary clearance system - Continuously secretes mucous,& forms a mucus blanket that protects agains bacteria and viruse.

Cough reflex - clears the airways if it is a productive cough. high velocity of air

Reflex bronchoconstriction - When there is an inhilation of large amounts of irritation substances the bronchi constrict in an effort to prevent the entry of the irritants.

Alvelar macrophages - eat inhaled foreign particles.

Front 24

SUBJECTIVE DATA
Assessment of Respiratory System

Back 24

Past Heath History - freq. of upper resp. problems & if they are seasonal or chronic. What causes the problems and what are the characteristic of the prob (sneeze, runny nose). NOTE any asthma, COPD, pneumonia, TB.

Medications - Prescription of OTC used to manage resp. problems. (cough, bronchodilators)

Surgery or other treatments - hospitalized for resp. problem?

Front 25

Functional Health Pattern

give example of a question you would ask for each category.

Back 25

Health-Perception
Nutritional-Metabolic
Elimination Patter
Activity-Exercise
Sleep-Rest
Cognitive-Perceptual
Self-Perception
Role-relationship
Sexually-Reproductive
Coping-Stress
Value-Belief

Front 26

OBJECTIVE DATA
What do you assess for a physical examination?

Back 26

FIRST***Vitals (T,P,R,& BP)
look at nose, mouth & pharynx, neck, Thorax & lungs

Front 27

OBJECTIVE DATA

what should be assessed in the nose?

Back 27

Look for patency, inflammation, deformity, symmetry, and discharge.

tilt the patients head back and push tip of nose upward to look for polyps in upper nasal cavity.

Front 28

OBJECTIVE DATA

what should be assessed in the mouth and pharynx?

Back 28

Use a good light source and inspect for color, lesions, masses, gum retraction, bleeding, & poor dentition.

Inspect the tongue for symmetry and presence of lesions.

Check larynx for gag reflex. If they can gag than CN 9 & 10 are working and that the airway is protected.

Front 29

OBJECTIVE DATA

what should be assessed in the neck?

Back 29

symmetry and presence of tender or swollen areas. Tender, hard, or fixed nodes indicate disease.

Front 30

OBJECTIVE DATA

How should you assess the thorax and lungs?

Back 30

Inspection - have patient sit upright and observe chest for the presence of resp. distress such as tachypnea. Make sure the chest is symmetric and the proper shape. look at skin color (cyanosis = hypoxemia)

Palpation - Check the tracheal position with your pointers just above the suprasternal notch. Should be MIDLINE. assess chest expansion and the extent of movement at the level of the diaphragm. (The nurse places the hands over the lower anterior chest wall along the costal margin and moves them inward until the thumbs meet at midline. The patient is asked to breathe deeply, and the nurse observes the movement of the thumbs away from each other. Normal chest movement is equal.)

Percussion - is done to assess density or aeration of the lungs.

Auscultation - patient should breathe slowly and deeply through the mouth.

Front 31

What is Fremitus?

Back 31

vibration of chest wall produced by vocalization

Front 32

What are the three normal breath sounds?

Back 32

1. Vesicular - are relatively soft, low-pitched, gentle, rustling sounds. They are heard over lesser bronchi and lobes.

2. Bronchovesicular - medium pitch and intensity. heard over main stem bronchi

3. Bronchial - louder & higher pitched & resemble air blowing thru a hollow pipe. Can be heard over trachea.

Front 33

What are adventitious sounds?

Back 33

extra breath sounds that are abnormal.

includes crackles, rhonchi, wheezes, and pleural friction rub.

Front 34

Rhonchi

Back 34

gurgling, harsh, louder sounds with a moaning or groaning quality.

Front 35

Friction rub

Back 35

grating or creaking sounds. not relieved by coughing.

Front 36

Wheeze

Back 36

continuous high-pitched squeaky musical sounds

Front 37

Abnormal breathing patterns

Back 37

Kussmaul - rapid, deep breathing (pursed lips)

Cheyne-Stokes - pattern of resp. characterized by periods of apnea and deep rapid breathing.

Biot's - irregular breathing with apnea ever four to five cycles.

Front 38

Five landmark lines of the chest wall

Back 38

Right midclavicular line
Right anterior axillary line
Midsternal line

Vertebral line
Scapular line

Front 39

Common blood studies to assess the Respiratory System

Back 39

Hemoglobin
Hematocrit
ABG (arterial blood gases)

Front 40

Gerontologic Considerations concerning Respiratory System

Back 40

decrease in elastic recoil of lung, decrease in chest wall compliance, and a stiffening of the chest wall. Coastal cartilage hardens with age and interfere with chest expansion. - curvature of the spine occurs especially with osteoporosis. - they lose subQ fat and you can see their bones.

The amount of functional alveoli in the lung is decreased and they become less elastic - have less tolerance for exertion. dyspnea can occur if activity exceeds their normal excercise.

Respiratory defense mechanisms are less efective. Less productive cough. drier mucous membranes. retained mucus predisposes them to infections.

swallowing is slower - reduced sensation in the pharynx. WATCH FOR ASPIRATION

history of smoking, obesity, & diagnosed with chronic illness is more at risk.