Take a deep breath and relax!

This is your lungs and air passage. gives O2 to blood and removes CO2 from

blood Respiratory=pulmunary=pneumatic=air!!!

The parts that make up respiratory system: Nose Pharynx Larynx Trachea Bronchi bronchioles Alveoli

This is the process of breathing- inspire, expire

Inspired O2 follows a pathway to the lungs and O2 exchange with CO2---happens through the alveoli

Expire-air is forced from the lungs Respiration is controlled by the medulla

oblongata- so if there is too much CO2- the patient will increase respirations to blow it off.

Boyles law states that the volume of gas is inversely proportion to the pressure applied to it.

So when the thoracic cavity expands, the pressure of the air within the lungs drops below atmospheric pressure; air will flow down the gradient from the outside into the lungs in a process referred to as inhalation. Exhalation results from the reduction of thoracic cavity and lung volume, the increase in intrapulmonary pressure, and the movement of air down its gradient from inside the lungs to the outside

I know after the last slide you are thinking blarty blarty blar….

Here is an example: When you put a needle in a vein to draw a

blood sample, you pull back on the plunger. This decreases the pressure in the syringe and increases the volume. So, blood flows into the syringe to compensate for the change.

Well…. The air passes in through the nasal cavity

where it is warmed and humidified by vascular tissue.

Guard hairs in the nasal cavity filter out large particles, and goblet cells make the mucous to trap smaller particles- known as boogers!

In the uppermost portion of the nasal cavity you will find the olfactory nerve. This is your sniffer! It contains olfactory neurons that can respond to odors (like your gym shoes and flowers and puppy breath)

Pharynx- it is made up of 3 parts: A. Nasopharynx from the nasal cavity B. oropharynx from the oral cavity C. laryngopharynx leads to the esophagus

and trachea branches in front. Larynx goes to the respiratory system and is covered by the epiglottis –a fleshy cap that covers the larynx so you don’t choke when drinking.

Okay, the larynx also has- La LA LA- vocal cords.

From the larynx the air enters the trachea. The esophagus is behind the trachea ciliated epithelium--- little hairs that push

the mucous toward the laryngopharynx = loogey!

The trachea branches into the right and left primary bronchi

This leads to the lungs. So it branches from primary bronchi to

secondary bronchi to tertiary bronchi This branches to bronchioles These terminate into tiny alveoli- the little

grape clusters

This is where O2 and CO2 exchange All alveolar sacs are surrounded by loads of

tiny capillary beds. They have one cell layer to allow gas to get through.

That is where external respiration takes place

Alveolar cells secrete surfactant to keep lungs moist and juicy.

Gases dissolve into the surfactant

Hypercapnic acidosis--- in diseases like: Asthma CHF- congestive heart failure Emphysema COPD- chronic obstructive pulmonary disease Hypercapnic acidosis increases the CO2

levels in the blood and a decreased ph balance of the body

Acid range for the human body lies between 7.35 and 7.45. water is about pH 7.

Acid= battery,lemon base=baking soda,bleach

Below 7.35 becomes too acid Below 7.45 becomes too alkaline or basic

Body’s pH is too acidic – below 7.35, and CO2 will be too high on lab test.

Patient will breath rapidly to try to blow off CO2.

If the respiratory system is unable to compensate, the patient may stop breathing. Too much CO2 decrease the need to breath, can paralyze respiratory muscles.

When the alveoli of the lungs are damaged by disease like emphysema from smoking, they become stiff, and unable to dump off CO2. this would lead to an acidotic state.

Respiratory alkalosis- this happens when the body rises above 7.45. usually an event happens that causes the person to breath rapidly or hyperventilate. As a result they blow off too much CO2, and will usually pass out at which time the body resumes normal breathing.

ABG= arterial blood gas Ph- normal is 7.35 to 7.45 CO2- normal is 35-45meq/ml HCO3- 22-26 this is basic bicarbonate These can all be run on an ABG lab- arterial

blood gas- needs to be drawn by a respiratory therapist, and accesses an artery- OOOOuch!

In an asthma “attack” the bronchioles spasm The inner lining of the lungs swells or has

edema This causes mucous production. This causes dyspnea- difficult breathing

Signs and symptoms: High pitched wheeze Dry or wet cough Chest pain If severe enough cyanosis

What can I do? If patient has a rescue inhaler, administer 2

puffs. Puffs can be given up to 2 puffs three times 15 minutes apart

If this does not help, go to the hospital If the patient is too hot, loosen clothing,

hydrate, put cold towel on the back of the neck

If the attack is due to an allergy, like to cats, remove them from the area. If they can have a Benadryl administer 1 tab.

COPD- chronic obstructive pulmonary disease=this is a catch-all for any chronic lung disease that results in obstruction of the airway. Pursed lip breathing—lips are tight and small when breathing. Also tripod position---hands on knees, bend over breathing

This includes: Asthma Emphysema Chronic bronchitis tuberculosis

Smoking is usually the main cause, but constant irritants, allergies, infection, and recurring chronic respiratory infections can be the root of COPD

This is considered COPD, but is not infectious.

The alveoli lose there elasticity CO2 stays trapped in the alveoli so O2 does

not have room to enter. These people will be hypercapnic- too acid.

Signs and symptoms- Dyspnea Feels like suffocating Chest pain Barrel chest Chronic cough Rapid breathing- to get the CO2 out Cyanosis Can lead to respiratory collapse- acute

respiratory failure ARF

So what can I do? There is no cure, but bronchodilators,

treatment of infections, O2 therapy, and try to not smoke

Three types: Small cell(oat cell) Squamous cell adenocarcinoma

Small cell carcinoma of the lung is very malignant

Treatment must begin quickly of life span is limited.

Smoking is a main cause for this type of cancer

Squamous cell carcinoma-usually will start in the epithelial cells of the bronchi branches. This may result after years of cell damage from smoking- happens more in men and women.

Once it becomes cancerous, it usually causes cancer in that area called in situ- not metastatic. It can become metastatic throughout the years if not treated, but not as much as small cell.

Adenocarcinoma- this is the most common type of lung cancer among people under age 45. this cancer starts in the outer part of the lungs.

One type in increasing among women- it is thought that the addition of filters to cigarettes has allowed people to inhale smoke more deeply, and adenocarcinoma starts in the outer part of the lungs.

Treatment- if the cancer is in situ, surgery may be required to remove the portion of the lung that is affected.

Bronchoscope- a small tube run in through the nose or mouth through the airway. If the obstruction is small enough, in can be removed.

If the cancer is metastatic, chemotherapy or radiation treatments may be required.

This is an inherited disease of the lungs and digestive system

A defective gene and it’s protein product produces unusually thick sticky mucous that:

a. Clogs the lungs and leads to life-threatening infections

b. Clogs the pancreas and keeps the body’s natural enzymes that break down food.

Children who had CF in the 1950’s did not usually live to elementary school age.

Now people live to 30-40 sometimes beyond. It depends on where they are most effected,

lungs or digestive system.

very salty-tasting skin; persistent coughing, at times with phlegm; frequent lung infections; wheezing or shortness of breath; poor growth/weight loss in spite of a good

appetite; and frequent greasy, bulky stools or difficulty in

bowel movements

There is no cure Therapy consists of initiating a strong cough

to clear the mucous from the lungs and airway.

Nutritional support and enzymes taken for the digestive system

Insulin for pancreatic function Bronchodilators to open airway

Videos now--- Sounds---http://www.easyauscultation.com/ Asthma--https://www.youtube.com/watch?

v=4aK76DoxKGk

COPD---https://www.youtube.com/watch?v=2nBPqSiLg5E

CF stories—https://www.youtube.com/watch?feature=player_detailpage&v=FMAOEOmLoUE

https://www.youtube.com/watch?v=r1Hg-NtqdQ4