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40 Cards in this Set
- Front
- Back
Primary purpose of Respiratory System
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Gas exchange, which involves the transfer of oxygen and carbon dioxide between the atmosphere and the blood
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2 parts of respiratory system
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Upper and Lower Respiratory Tract
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Upper Respiratory Tract includes
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Nose, Pharynx, adenoids, tonsils, epiglottis, larynx, & trachea
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Lower Respiratory Tract includes
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Bronchi, bronchioles, alveolar ducts, & alveoli
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Breathing thru upper resp. tract protects...
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the lower airway
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Purpose of nose
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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)
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The main- stem bronchi, pulmonary vessels, and nerves enter the lungs through a slit called
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Hilius
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difference btwn right and left mainstem bronchi
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right main-stem bronchi is shorter, wider, and straighter than the left.
therefore aspiration is more likely in the right lung. |
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what are bronchioles?
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Smooth muscle that constrict and dilate in response to various stimuli.
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Bronchoconstriction vs. Bronchodilation
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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. |
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When does the exchange of oxygen or carbon dioxide take place?
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when the air enters the respiratory bronchioles.
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What are alveoli?
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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. |
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what is surfactant?
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A lipoprotein that lowers the surfact tension of the alveoli. So that it doesn't collapse. (atelectasis)
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Who is at risk for atelectasis?
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the postop patient... because of effects of anesthesia and restricted breathing with pain.
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Two Circulation types for lungs & what they do
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Pulmonary - provides lungs with blood for gas exchange
Bronchial - provides oxygen to the bronchi and other pulmonary tissues |
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Major muscle of respiration?
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Diaphragm
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What does ventilation involve?
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Inspiration & expiration
gas flows from an area of higher pressure to one of lower pressure. |
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What is elastic recoil
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the tendency for the lungs to recoil after being expanded (streched).
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Compliance of the lungs?
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it is a measure of the elasticity of the lungs and thorax.
when compliance is decreased the lungs are more difficult to inflate. |
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Where does the carbon dioxide and oxygen move back and forth across what by diffusion?
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Alveolar capillary membrane
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Oxygen is carried in the blood by what two forms?
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Dissolved oxygen (SaO2)
Hemoglobin-bound oxygen (PaO2) |
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ABG?
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Arterial Blood Gas
used to measure oxygenation statue and acid-base balance. |
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Respiratory Defense Mechanisms
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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. |
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SUBJECTIVE DATA
Assessment of Respiratory System |
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? |
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Functional Health Pattern
give example of a question you would ask for each category. |
Health-Perception
Nutritional-Metabolic Elimination Patter Activity-Exercise Sleep-Rest Cognitive-Perceptual Self-Perception Role-relationship Sexually-Reproductive Coping-Stress Value-Belief |
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OBJECTIVE DATA
What do you assess for a physical examination? |
FIRST***Vitals (T,P,R,& BP)
look at nose, mouth & pharynx, neck, Thorax & lungs |
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OBJECTIVE DATA
what should be assessed in the nose? |
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. |
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OBJECTIVE DATA
what should be assessed in the mouth and pharynx? |
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. |
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OBJECTIVE DATA
what should be assessed in the neck? |
symmetry and presence of tender or swollen areas. Tender, hard, or fixed nodes indicate disease.
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OBJECTIVE DATA
How should you assess the thorax and lungs? |
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. |
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What is Fremitus?
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vibration of chest wall produced by vocalization
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What are the three normal breath sounds?
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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. |
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What are adventitious sounds?
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extra breath sounds that are abnormal.
includes crackles, rhonchi, wheezes, and pleural friction rub. |
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Rhonchi
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gurgling, harsh, louder sounds with a moaning or groaning quality.
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Friction rub
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grating or creaking sounds. not relieved by coughing.
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Wheeze
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continuous high-pitched squeaky musical sounds
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Abnormal breathing patterns
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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. |
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Five landmark lines of the chest wall
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Right midclavicular line
Right anterior axillary line Midsternal line Vertebral line Scapular line |
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Common blood studies to assess the Respiratory System
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Hemoglobin
Hematocrit ABG (arterial blood gases) |
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Gerontologic Considerations concerning Respiratory System
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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. |