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Respiratory

Respiratory. Medical – Surgical Nursing P10B. Nasal Cavity. Location Btw mouth & cranium Function Remove foreign bodies Warm Moisten Olfactory. Nasal Cavity. Contains Cilia Hair-like Sensitive nerve endings: Sneeze. Para-Nasal Sinuses. Description 4 pairs Facial area

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Respiratory

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  1. Respiratory Medical – Surgical Nursing P10B

  2. Nasal Cavity • Location • Btw mouth & cranium • Function • Remove foreign bodies • Warm • Moisten • Olfactory

  3. Nasal Cavity • Contains • Cilia • Hair-like • Sensitive nerve endings: • Sneeze

  4. Para-Nasal Sinuses • Description • 4 pairs • Facial area • Continuous w/ nasal cavity • Function: • Speech

  5. Pharynx (throat) • Passageway • Food & liquids  • Digestive tract • Air  • Respiratory tract • Lowest portion • Opens into 2 space

  6. Pharynx (throat) • Location • Behind nasal cavity • Contains • Adenoids • Tonsils • Lymph system • Eustachian tubes

  7. Larynx (voice box) • Location • Btw pharynx & trachea • Function • Vocalization • Facilitates cough/sneeze

  8. Larynx (voice box) • Epiglottis • Gateway / trap door • Flap of elastic cartilage • Thyroid cartilage • Adam’s apple

  9. Larynx (voice box) • Vocal cords • Speech

  10. Trachea (Windpipe): • Location • Btw larynx & bronchi • Description • 4-5 inches long • Palpate • Above sternal notch • C-shaped rings of cartilage

  11. Trachea (Windpipe): • Function • Conduct air

  12. Bronchi • Location • Below trachea • Center of chest • Behind the heart • Branches into 2 tubes • Rt • h diameter • More vertical • Shorter in length

  13. Question? Mr. Henderson had a CVA 5 days ago and is having some difficulty swallowing. There is some question that he may have aspirated some food and developed pneumonia. What side pneumonia would you except him to have? A. Right sided B. Left sided

  14. Lungs • Location • Thoracic cage • Description • Airtight • Mult. Air sacs • Rt • 3 lobes • Lf • 2 lobes

  15. Lungs • Bronchi • Bronchial tree • Bronchioles • No cilia • No cartilage • Patency d/t • elastic recoil of the smooth muscles • alveolar pressure

  16. Lungs • Alveolar ducts • Smallest tubes • Alveoli • Functional unit • Air sacs • Gas exchange • Surrounded by pulm. Capillaries

  17. Lungs • Alveoli • Thin membrane • Tendency to collapse • Alveolar Pressure • surfactant

  18. Pleural membrane • Location • Surrounds surface of lung & interior wall of thorax • Function • Protects • Neg. pressure • Allows movement (i friction)

  19. Pleural membrane • Pleural space/cavity • Btw • Contains fluid

  20. Mediastinum • Location • Space btw lungs • Contains • Heart • Large blood vessels • Esophagus • Trachea • Bronchi

  21. Diaphragm • Location • Muscle btw lungs & abd. Cavity • Aids in resp

  22. Skeletal System • Ribs • 12 pairs • Thoracic cage • Sternum

  23. Pulmonary circulation • Main function of resp. system is to deviler O2 to the blood & remove CO2 from it. • Pulm. Art. • CO2 / deoxygenated • Pulm vein • O2 / oxygenated

  24. Blood flow: heart and lungs • Inf/sup vena cave • Rt atrium • Tricuspid • Rt ventricle • Pulm • Pulm art • Pulm cap • Pulm vein • Lt atrium • Bicuspid / mitral • Left venticle • Aorta

  25. Small Group Questions • Name the structures that air flows past on its way to the lungs • What is the function of the epiglottis? • What are the supporting structures of the trachea? • Where in the circulation of blood do you find deoxygenated blood?

  26. How many lobes do the rt and lf lungs each have? • What is the purpose of the serous fluid btw the pleural membranes?

  27. Processes of respirations Ventilation • Movement of air in & out of the the tracheobronchial tree. Delivering O2 to the alveoli & removing CO2 Perfusion • Blood flow in the capillary bed in the lungs Diffusion • Movement of gases (O2 & CO2) across the alveoli membrane • Flows from area of greater concentration to lesser concentration

  28. Patient airway • Choking

  29. Changes assoc. with aging • Cartilage hardens • Muscles weaker • i cough reflex • i elasticity

  30. Assessment: Subjective • Nasal Congestion • Sore throat • Change in voice • Difficulty breathing • Orthopnea • Pain • Cough • Sputum • Affect on ADL’s

  31. History • Physical problems • Function problems • Life style • Smoking • Family Hx • Occupation hx • Allergens / environment • Anxiety

  32. Inspection • Normal chest • 2x as wide as deep • Anterior/posterior diameter • 1:2

  33. Inspection • Barrel chest • D/t over inflation of lungs • anterior-posterior diameter • 2:2

  34. Inspection • Kyphosis • AKA • Hunchback • Abnormal curvature of the thoracic spine

  35. Inspection • Lordosis • AKA • Sway-back • Abnormal curvature of the lumbar spine

  36. Inspection • Uniform expansion of the chest • Intercostal spaces

  37. Inspection • Shoulder rise • Accessory muscles • Posture

  38. Inspection: • Trachea • midline • Color • LOC • Emotional state

  39. Inspection: Breathing patterns Rate • Eupnea • Normal • 12-20 / min • Tachypnea • h rate • Bradypnea • i rate

  40. Inspection: Breathing patterns Depth • Hyperventilation • h depth & rate • Hypoventilation • i depth & rate

  41. Auscultation Purpose • Asses air flow through bronchial tree Procedure • Diaphragm of stethoscope • Superior  inferior • Compare rt to lf

  42. Auscultation: Results Normal • Vesicular • Lung field • Soft and low • Bronchial • Trachea & bronchi • Hollow

  43. Auscultation: Results Adventitious • Crackles • air  bronchi with secretions • Fine crackles • Air  suddenly reinflated • Course Crackles • Moist

  44. Auscultation: Results • Wheezes • Sonorous wheezes • Deep low pitched • Snoring • Caused by air  narrowed passages • D/t h secretions • Sibilant Wheezes • High pitched • Whistle-like • Caused by air  narrowed passages • D/t constriction • Asthma

  45. Early & late signs of hypoxia • Anxiety • Bradycardia • Cyanosis • Depressed respirations • Diaphoresis • Disorientation • Dyspnea • Restlessness • Headache • Agitation • Poor judgment • Retraction • Tachycardia • Tachypnea

  46. Dyspnea • Definition • SOB • SOB, flat affect, BS x 4

  47. Dyspnea • Significance • Common with cardiac & resp. disease

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