ALTERATIONS OF PULMONARY FUNCTION
respiration consists of two processes - ANS -- alveolar ventilation: movement of air into the
lungs (external respiration), distribution of oxygen and removal of CO2
- perfusion: pulmonary circulation, distribution of blood flow (movement of O2 and CO2
between the lungs and tissues)
internal respirations - ANS -oxygen utilization is the use of O2 by cells to release energy
factors affecting lung performance - ANS -gas exchange, work of breathing
surfactant - ANS -decreases alveoli surface tension
loss of surfactant - ANS -causes alveoli collapse, called atelectasis
airway resistance - ANS -relationship pressure and airflow
higher airway resistance with - ANS -smaller airway diameter
small changes in pediatric airways cause - ANS -large incremental increases in airway resistance
lung compliance - ANS -ability to stretch
relationship between lung volume and pressure
,compliance = - ANS -change in volume / change in pressure
forced vital capacity (FVC) - ANS -measurement of the amount of air that can be forcefully
exhaled from the lungs after the deepest inhalation
forced expiratory volume in 1 second (FEV1) - ANS -amount of air expelled from lungs in 1 sec
after a maximal inspiration
diagnostic criteria for asthma
FEV1/FVC ratio - ANS -low = obstructive disease
normal = restrictive disease
dyspnea - ANS -subjective sensation of uncomfortable breathing
orthopnea - ANS -difficulty breathing when lying down
paroxysmal nocturnal dyspnea (PND) - ANS -shortness of breath at night
cough - ANS -protective reflex that helps clear the airway
acute cough - ANS -resolves in 2-3 weeks
chronic cough - ANS -lasts longer than 3 weeks
abnormal sputum - ANS -changes in amount, consistency, color, and odor
,hemoptysis - ANS -coughing up blood
eupnea - ANS -normal breathing
kussmaul respirations - ANS -slightly increased ventilatory rate, very large tidal volume, and no
expiratory pause
labored breathing - ANS -increased work of breathing
restricted breathing - ANS -disorders that stiffen the lungs or chest wall and decrease
compliance
cheyne-stokes respirations - ANS -alternating periods of deep and shallow breathing; apnea
lasting 15-60 seconds, followed by ventilations that increase in volume until a peak is reached,
after which ventilation decreases again to apnea
hypoxemia - ANS -reduced oxygenation of arterial blood caused by respiratory alterations
hypoxia - ANS -reduced oxygenation at the tissue cellular level; not always a lung thing, could be
a perfusion thing like HReEF
ventilation-perfusion abnormalities - ANS -most common cause of hypoxemia, shunting,
alveolar dead space
shunting - ANS -perfusion without ventilation
alveolar dead space - ANS -alveoli are ventilated but not perfused
, acute respiratory failure - ANS -gas exchange is inadequate (hypoxemia)
Pao2 is ≤50 mmHg
hypercapnia occurs, during which partial pressure of carbon dioxide (PaCO2) is ≥50 mmHg
pH is ≤7.25
requires ventilatory support, oxygen, or both
chest wall restriction - ANS -chest wall is deformed, traumatized, immobilized, or made heavy by
fat; work of breathing is increases, and ventilation may be compromised because of a decrease
in tidal volume
impaired respiratory muscle function is caused by - ANS -neuromuscular disease
flail chest - ANS -the instability of a portion of the chest wall from rib or sternal fractures
causes paradoxical movement of the chest with breathing
pneumothorax - ANS -presence of air or gas in the pleural space
primary (spontaneous) pneumothorax - ANS -occurs unexpectedly in healthy individuals
secondary pneumothorax - ANS -is caused by chest trauma, rupture of bleb/bulla, or
mechanical ventilation
respiration consists of two processes - ANS -- alveolar ventilation: movement of air into the
lungs (external respiration), distribution of oxygen and removal of CO2
- perfusion: pulmonary circulation, distribution of blood flow (movement of O2 and CO2
between the lungs and tissues)
internal respirations - ANS -oxygen utilization is the use of O2 by cells to release energy
factors affecting lung performance - ANS -gas exchange, work of breathing
surfactant - ANS -decreases alveoli surface tension
loss of surfactant - ANS -causes alveoli collapse, called atelectasis
airway resistance - ANS -relationship pressure and airflow
higher airway resistance with - ANS -smaller airway diameter
small changes in pediatric airways cause - ANS -large incremental increases in airway resistance
lung compliance - ANS -ability to stretch
relationship between lung volume and pressure
,compliance = - ANS -change in volume / change in pressure
forced vital capacity (FVC) - ANS -measurement of the amount of air that can be forcefully
exhaled from the lungs after the deepest inhalation
forced expiratory volume in 1 second (FEV1) - ANS -amount of air expelled from lungs in 1 sec
after a maximal inspiration
diagnostic criteria for asthma
FEV1/FVC ratio - ANS -low = obstructive disease
normal = restrictive disease
dyspnea - ANS -subjective sensation of uncomfortable breathing
orthopnea - ANS -difficulty breathing when lying down
paroxysmal nocturnal dyspnea (PND) - ANS -shortness of breath at night
cough - ANS -protective reflex that helps clear the airway
acute cough - ANS -resolves in 2-3 weeks
chronic cough - ANS -lasts longer than 3 weeks
abnormal sputum - ANS -changes in amount, consistency, color, and odor
,hemoptysis - ANS -coughing up blood
eupnea - ANS -normal breathing
kussmaul respirations - ANS -slightly increased ventilatory rate, very large tidal volume, and no
expiratory pause
labored breathing - ANS -increased work of breathing
restricted breathing - ANS -disorders that stiffen the lungs or chest wall and decrease
compliance
cheyne-stokes respirations - ANS -alternating periods of deep and shallow breathing; apnea
lasting 15-60 seconds, followed by ventilations that increase in volume until a peak is reached,
after which ventilation decreases again to apnea
hypoxemia - ANS -reduced oxygenation of arterial blood caused by respiratory alterations
hypoxia - ANS -reduced oxygenation at the tissue cellular level; not always a lung thing, could be
a perfusion thing like HReEF
ventilation-perfusion abnormalities - ANS -most common cause of hypoxemia, shunting,
alveolar dead space
shunting - ANS -perfusion without ventilation
alveolar dead space - ANS -alveoli are ventilated but not perfused
, acute respiratory failure - ANS -gas exchange is inadequate (hypoxemia)
Pao2 is ≤50 mmHg
hypercapnia occurs, during which partial pressure of carbon dioxide (PaCO2) is ≥50 mmHg
pH is ≤7.25
requires ventilatory support, oxygen, or both
chest wall restriction - ANS -chest wall is deformed, traumatized, immobilized, or made heavy by
fat; work of breathing is increases, and ventilation may be compromised because of a decrease
in tidal volume
impaired respiratory muscle function is caused by - ANS -neuromuscular disease
flail chest - ANS -the instability of a portion of the chest wall from rib or sternal fractures
causes paradoxical movement of the chest with breathing
pneumothorax - ANS -presence of air or gas in the pleural space
primary (spontaneous) pneumothorax - ANS -occurs unexpectedly in healthy individuals
secondary pneumothorax - ANS -is caused by chest trauma, rupture of bleb/bulla, or
mechanical ventilation
