NSB231 Lecture Notes - Lecture 4: Pulsus Paradoxus, Pulmonary Function Testing, Arterial Blood Gas
Week 4: Respiratory Management Lecture
Respiratory System
• 300 million alveoli
What happens when you breathe?
• Air through nose, down trachea, into smaller airways called bronchi. These bronchi branch into
smaller passages called bronchioles and finally into the small, thin and fragile sacs called
alveoli
What happens during inspiration?
• Alveoli fill with air. Here oxygen is exchanges for carbon dioxide. Blood cells absorb oxygen
form capillaries as carbon dioxide is released back into the lungs from the veins. Diaphragm
contracts (moves down)
What happens during expiration?
• Carbon dioxide is expelled from the body, oxygen-risk blood travels to the heart so it can
pump back to the body where it is needed. Diaphragm relaxes (moves up)
Risk factors for chronic respiratory diseases
• Tobacco smoke
• Second hand tobacco smoke
• Air pollutants
• Allergens
• Occupational agents
Respiratory Focussed Assessment
• Cough? Deep or shallow? Due to a medication? Time of coughing
• Sputum & nasal secretion? Is it clear? Clogged with green stuff? Inflamed?
• Dyspnoea? Difficult breathing?
• Pain?
• Sleep/rest? Breathing disrupting sleep?
• Environment? Effecting breathing?
• Inspection, palpation, percussion, auscultation
• Vital signs- T, P, RR, BP
• Preparatory pattern
• Accessory muscle use
• SpO2
• Arterial blood gas (ABG)- how much carbon dioxide is in the blood?
• Pulsus paradoxus- pulse drops when breathing
• Chest x-ray
• CT
• MRI
• Pulmonary angiogram
• Ventilation/perfusion scan- see how much perfusion is compared to ventilation ratio.
• Pulmonary function test
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Document Summary
What happens when you breathe: air through nose, down trachea, into smaller airways called bronchi. These bronchi branch into smaller passages called bronchioles and finally into the small, thin and fragile sacs called alveoli. What happens during inspiration: alveoli fill with air. Blood cells absorb oxygen form capillaries as carbon dioxide is released back into the lungs from the veins. What happens during expiration: carbon dioxide is expelled from the body, oxygen-risk blood travels to the heart so it can pump back to the body where it is needed. Second hand tobacco smoke: tobacco smoke, air pollutants, allergens, occupational agents. Effecting breathing: vital signs- t, p, rr, bp. Breathing disrupting sleep: preparatory pattern, accessory muscle use. Asthma vs. copd: asthma can turn into copd, 20% of copd aren"t smokers. Inflammatory cells and cellular elements: chronic inflammatory condition of the airways, recurrent episodes wheezing, breathlessness, chest tightness and coughing, variable reversible airflow obstruction, bronchial hyperresponsiveness.
