Bab 3-Respiratory Devices

8/13/2019 Bab 3-Respiratory Devices

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RESPIRATORYDEVICES

INTRODUCTION

• The human respiratory system functions toallow gas exchange.

• Respiratory care is the medical field that

works with patients with breathingdisorders.

• These disorders can be malfunctioning

lungs, lack of proper oxygen in the arterialblood and cancers of the lungs or

respiratory tract.

Pulmonary Volumes and Capacities Graph

PULMONARY VOLUMES

• Tidal Volume (TV) – the volume of air inspired orexpired with each normal breath. (about 500ml averaged

over 12 to 15 normal breaths per minute)

• Inspiratory Reserve Volume (IRV) – is the

extra volume of air that can be inspired over the normaltidal volume. (about 3000 to 3500ml)

• Expiratory Reserve Volume (ERV) – is the

amount of air that can be expired after the end of the

normal tidal volume with the forced expiration. (1000ml

to 1200ml)

• Residual Volume (RV) – is the volume of air

still remaining in the lungs after the most forcefulexpiration. (about 1200ml)

PULMONARY CAPACITIES

• Inspiratory Capacity (IC) – the amount equalto the sum of the tidal volume and the inspiratory reserve

volume. (IC = TV + IRV)

• Vital Capacity (VC) – when the person can

forcefully inspire to the maximum amount and then canexpel the air to the maximum by forceful expiration.

(VC = IRV + TV + ERV @ VC = IC + ERV)

• Total Lung Capacity (TLC) – is the maximum

volume to which lungs can be expended with themaximum inspiratory effort. (TLC = RV + VC)

• Functional Residual Capacity (FRC) – the amount of air remaining in the lungs from the end of

the normal expiration level. (FRC = RV + ERV)

LUNG COMPLIANCE

• The elastic force of the lungs accepting a

volume of inspired air.

• Lungs with high compliance have low elastance,

lungs with low compliance have high elastance.Compliance = volume of the inspired air

Intrapleural pressure

• Elastance is the reciprocal of compliance and isthe natural ability to respond to force and return

to the original resting shape.

RESPIRATORY ABNORMALITIES

• Eupnea (normal breathing)

• Tachypnea (rapid breathing)

• Bradypnea (slow breathing)• Hyperpnea (over-respiration)

• Hypopnea (under-respiration)

Common Infectious Diseases

• Bronchitis

• Common cold

• Influenza• Pneumonia

• Tuberculosis

• Laryngitis• Pharyngitis

SPIROMETER

A modern portable

desktop spirometerwith digital turbine

and antibacterial filter

A modern

portablespirometer

Anincentive

spirometer

Function of a spirometer

• A spirometer is a device used to measure

air volume when the patient inhales and

exhales through a mouthpiece.

• Spirometry is the measurement of a

person’s ability to inhale and exhale.

• This device then records the person’s

breathing capabilities and measures the

amount of air expelled and the rate at

which the air is expelled from the lungs.

CONT…

• Spirometry indicates several parameters

of breathing such as Forced Vital Capacity

(FVC) and Forced Expiratory Volume

(FEV).

• The physician can diagnose asthma or

other lung diseases and also measure the

progression of respiratory diseases withthe spirometry test.

CONT…

• If the patient has abnormal spirometer

measurements (values fall below 85% of

the normal values), then other lung tests

are recommended to diagnose lungdisease or airflow obstructions.

Preparation of the patient for

spirometry • Many variables may affect the test - before

it, the patient should avoid:

– Smoking for 24 hours

– Drinking alcohol for at least four hours

– Vigorous exercise for at least 30 minutes.

– Wearing any tight clothing.

– Eating a large meal for at least two hours.

Cont…

– Taking short-acting bronchodilators for four

hours.

– Taking long-acting beta-2-agonist inhalers for

12 hours – Taking slow-release medicines that affect

respiratory function, and theophylline-based

drugs for 24 hours

Procedure to use a Spirometer

• The patient should be seated in a chair with

• Two relaxed measurements of vital capacity

should be performed first, (the patient shoulduse nose clips for this procedure to prevent air

leakage from the nose), followed by three forced

vital capacity measurements.

• A large breath to full inspiration is taken through

mouth.

Cont…

• The mouthpiece is placed into the patient’s

mouth and the patient is asked to place his

or her lips and teeth around the

mouthpiece to form a tight seal.

• For the relaxed VC, the patient breathes

out at a comfortable speed, but for the

FVC the patient should breathe out hardand quickly until all air is expelled.

Cont…

• The FVC should take 6s, but in some

patients with obstructive breathing

patterns it can take up to 15s.

• At least 30s should be left between blows

(exhalations using the spirometer) to

enable the patient to recover.

• A minimum of three and a maximum of

eight blows should be attempted at any

one time.

Technique of spirometer test

1. FORCED VITAL CAPACITY (FVC)

2. SLOW VITAL CAPACITY (SVC)

3. MAXIMAL VOLUNTARY VENTILATION(MVV)

4. MINUTE VOLUME (MV)

FORCED VITAL CAPACITY

(FVC)• FORCED VITAL CAPACITY (FVC) which

is a vital capacity and measurements are

taken as quickly as possible.

• FVC is the total amount of air that can

forcibly be expired as quickly as possible

after taking the deepest possible breath.

SLOW VITAL CAPACITY (SVC)

• This test resembles the FVC.

• The difference is that the expiration in the

spirometer is done slowly.

• The patient inspires fully and than slowly

expires all the air in his lungs (Inspiratory

Vital Capacity) or the other way around:

the patient expires fully and inspires slowly

to a maximum (Expiratory Vital Capacity).

VENTILATION (MVV)

• MVV is a measure of the maximum

amount of air that can be breathed in and

blown out over a sustained interval, such

as 15 or 20 seconds.

• This is no longer a very common test as it

can be dangerous for some people.

• Sometimes the MVV is still done in

athletes.

Volume graph of spirometer

Graph FVC

Graph SVC

Graph MVV

Interpretation of volume graph

NORMAL SPIROMETRY

A normal flow-volume loop

A normal volume-time loop

• A normal Flow-Volume loop begins on the X-axis

(Volume axis): at the start of the test both flow and

volume are equal to zero. After the starting point the

curve rapidly mounts to a peak: Peak (Expiratory) Flow.• After the PEF the curve descends (=the flow diminishes)

as more air is expired. A normal, non-pathological F/V

loop will descend in a straight or a convex line from top

(PEF) to bottom (FVC).• The forced inspiration that follows the forced expiration

has roughly the same morphology, but the PIF (Peak

Inspiratory Flow) is not as distinct as PEF.

Obstructive Lung Disease

Flow-volume in obstructive lung disease:

is concave, FEF25-75 too low, FVC normal

• In patients with obstructive lung disease,

the small airways are partially obstructed

by a pathological condition. The most

common forms are asthma and COPD.

• A patient with obstructive lung disease

typically has a concave F/V loop.

Pneumotach Sensors

Explain the function of a

Pneumotachograph

State the types of

Pneumotachograph.

xp a n e a r ow

xp a n e a r owmeasurement of a

Pneumotachograph

A man undergoing whole body

plethysmography

E l i h f i f

Explain the function of a

Plethysmograph

St t th t f

State the types of

Pleythysmograph

E l i th d t

Explain the procedure to use a

Plethysmograph.

D ib th t f l

Describe the types of lung

capacity

D ib th t ’ l l

Describe the type’s lung volume

in the respiratory diagnosis.

St t th f t ff ti th

State the factors affecting the

measurement of respiratory

• Explain the function of respiratory

equipment.

• a. Ventilator

• b. Nebulizer

• c. Ambu Bag

• d. Oxygen concentrator• e. Oxygen Flow meter

• f. Apnea alarm

• g. Humidifier

Bab 3-Respiratory Devices

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