anatomy of respiratory system 11/1/20151mr.homood alharbi respiratory module
TRANSCRIPT
Anatomy of respiratory system
04/21/23 1Mr.Homood Alharbi Respiratory module
Function of respiratory system
Oxygen transport: exchange of O2 &CO2 “diffusion” , increase O2 sat
Ventilation: flow of air in &out of the lung, clear CO2, RR,TV
Mechanism of spontaneous breathing : diaphragm movement& atmospheric pressureInhalation (-ve pressure), exhalation (+ve pressure)
04/21/23 2Mr.Homood Alharbi Respiratory module
Airway resistance : any change on the airway diameter which effects airway flow to/ out the lung.
Compliance :elasticity, expandability of the lung. Effected by age, disease, surfectant, lung tissue (collagen, elastin)
Positioning &lung perfusion :
Upper right position : lower part perfused more due to low PAP
Lateral position: one side perfused more than other
04/21/23 3Mr.Homood Alharbi Respiratory module
Inhaled air consists of Nitrogen 78%Oxygen 21%CO2 .04%Vapor water .05%HeliumArgon Oxygen carried in form of:
Dissolved in the Plasma (PaO2) 70-80 mmhg
With hemoglobin in RBC (O2 sat) 90%
04/21/23 4Mr.Homood Alharbi Respiratory module
Control of ventilationCentralChemoreceptors in Medulla & Pons which are sensivitive
to PH, CO2, O2 controls rate &depth of ventilation through phrenic nerve.
Pripheral : in Aortic Arch, carotid arteries.
04/21/23 5Mr.Homood Alharbi Respiratory module
Assessment of respiratory systemDyspnea Difficult breathing, shortness of breathDue to decreased lung compliance, high
airway pressureEffect RV due to high resistanceSudden dyspea in a healthy person may
indicate pneumothorax, ARDS, respiratory obstruction
In immobilized person may indicate Pulmonary emboli
Orthopnea indicates heart disease.Rx: treat causes, O2 administer
04/21/23 6Mr.Homood Alharbi Respiratory module
Cough :Irritation of mucus membrane in respiratory tractFrom infection, airborne irritants (smoke, dust)Serve as natural protection Night cough due to Lt side heart failure, bronchial asthmaMorning cough due to brochitisSupine cough due to sunusitis
Sputums production: Thick, (yellow, green) indicates bacterial infectionThin indicates viral infectionPink indicates lung tumour Fouel smelling indicates lung abscessRx: if pt able to expactorate, hydation, inhalation of
aerosolized solutions (spray to humidify air)
04/21/23 7Mr.Homood Alharbi Respiratory module
Wheezing RT bronchoconstriction, narrowing airwaysRx: bronchodilators
Clubbing fingersRT hypoxia
04/21/23 8Mr.Homood Alharbi Respiratory module
ASTHMA WHEEZE.wav
Hemoptysis : blood in sputums, p.emboli, PA/PV diseases, heart disease
Cynosis: indicate hypoxia, can be central or peripheral
04/21/23 9Mr.Homood Alharbi Respiratory module
Physical assessment of respiratoryNose/ SinusesInspect nose for color, bleeding,
dischargesPalpate sinuses for tender
Phrynx/ Mouth:
Inspect mouth for color, symmetry, exudates, ulcerationUse tongue depression to inspect pharynx
04/21/23 10Mr.Homood Alharbi Respiratory module
Trachea Palpate and inspect for symetery or deviation (tension
pneumotharx)
Breathing patterns& respiratory ratesEupnea : normal breathing rate 12-18 bpmBradypnea: slow breathing, less than 12bpmTachypnea: fast breathing, more than 18bpmHypoventilation: shallow breathingHyperventilation: deep breathing, to correct acidosis,
athelets Apnea: cessation of breathing
04/21/23 11Mr.Homood Alharbi Respiratory module
Thoracic palpataionPalpate for tenderness
Respiratory excursionTo determine symmetryOf expirartion
Pulse oximeter To determine O2 sat
04/21/23 12Mr.Homood Alharbi Respiratory module
Thoracic auscultation
04/21/23 13Mr.Homood Alharbi Respiratory module
Adventitious Breath Sounds
Fine crackles (dry, high-pitched popping…COPD, CHF, pneumonia)
Coarse crackles (moist, low-pitched gurgling…pneumonia, edema, bronchitis)
Sonorous wheezes (low-pitched snoring…asthma, bronchitis, tumor)
Sibilant wheezes (high-pitched, musical … asthma, bronchitis, emphysema, tumor)
Pleural friction rub (creaking, grating… pleurisy, tuberculosis, abscess, pneumonia)
Stridor (crowing…croup, foreign body obstruction, large airway tumor).
Abnormal sounds and some conditions associatedwith them:
Fric_rub.wav
STDR MUTH.wav
FINE RALES.wav
MEDIUM RALES.wav
ASTHMA WHEEZE.wav
Upper respiratory tract RhinitisInflammation of nose by viral , obstructive ,allergic
reaction.Clinical manifestations1.Rhinorrhea “ excessive nasal drainage”2.Nasal congestion, Itching ,& sneezing3.Headache may occur
Medical Management1.Treatment of cause “antibiotics”2.Decongestant agents3.Antihistamine 4.In severe cases corticosteroids
04/21/23 15Mr.Homood Alharbi Respiratory module
common coldOften is used when referring to a symptoms of an
upper respiratory tract infection ch.ch.by nasal congestion ,sore throat , & cough
Cold referred to a febrile, infectious, acute inflammation,of the mucus membranes of the nasal cavity
Clinical manifestations1.Nasal congestion2.Scratchy or sore throat3.Sneezing & cough4.Headache & muscle ache5.Herpes simplex sore (cold sore )
common cold Medical Management (symptomatic
management)
Fluid intake ,rest ,prevention of chills. Aqueous decongestant,anti histamin, Vit. C. Expectorant as needed Analgesic for aches ,pain , & fever. Antimicrobial to reduce incidence of
complications
Nursing Management Patient teaching of self care & prevention
of infection & break chain of infection
Acute Sinusitis It is inflammation of sinuses , it is resolved
promptly if their opening into nasal cavity .
Clinical Manifestations Pressure , pain over the sinus area Tenderness Purulent nasal secretions
Medical Management Antimicrobial agent “Amoxicillin” Oral & Topical Decongestant Heated mist or Saline irrigation
Nursing management Teaching pt. to promote drainage “inhaling
steam, more intake, applying local heat” Teaching pt. about rebound effect of nasal
decongestant. Complications Meningitis &osteomylitis Brain abscess Ischemic infarction
04/21/23 19Mr.Homood Alharbi Respiratory module
Acute Pharyngitis It is a febrile inflammation of throat ,caused by virus about
70% , uncomplicated viral infection usually subsided promptly within 3-10 days
Clinical Manifestations Fiery red pharyngeal membrane& tonsils Lymphoid follicles that are swollen Enlarge tender cervical lymph node Fever & malaise Sore throat , hoarseness,& cough
Medical Management Supportive measures for viral infection Pharmacologic therapy antibiotics for 10
days “cephalosporin”analgesic for severe sore anti tussive medications
Nutritional therapy liquid or soft diet “If liquid can’t tolerated IV fluid administered “
Nursing Management (bed rest ,skin assessment, mouth care &normal saline gargle & self care teaching
04/21/23Mr.Homood Alharbi Respiratory module 21
Chronic Pharyngitis Common in adults who work or live in dusty
surrounding ,use the voice too excess , suffer from chronic cough , & habitually use alcohol & tobacco
Types of pharyngitis1. Hypertrophic :ch.ch.by general thickening&
congestion of pharyngeal mucus membrane2. Atrophic : probably late stage of first type 3. Chronic Granular : ch.ch.by numerous swollen
lymph follicles on the pharyngeal wall
Clinical Manifestations
Constant sense of irritation or fullness in throat
Mucus expelled by coughing Difficulty in swallowing
Medical Management Relieving symptoms Avoiding exposure to irritant Correct respiratory & cardiac conditions
04/21/23 23Mr.Homood Alharbi Respiratory module
Antihistamine drugs Decongestant Controlling malaise
Nursing Management Patient teaching of self care Avoid alcohol , tobacco , exposure to
cold Face mask to avoid pollutant Warm fluids,&warm saline gargle
04/21/23 24Mr.Homood Alharbi Respiratory module
TonsillitisThe tonsils are composed of lymphatic tissue & situated on
each side of the oropharynx ,they frequently are the site of acute infection (tonsillitis)
Clinical ManifestationsTonsils : sore throat, fever , snoring & difficulty of
swallowing Adenoids : ear ache , mouth breathing , drainage ear ,frequent
cold , bronchitis, noisy respiration, foul smelling breath &voice impairment
Medical Management For recurrent tonsillitis “tonsillectomy” Conservative or symptomatic therapy Antimicrobial therapy “penicillin” for 7 days
Nursing Management Provide post op. care :V/S ,hemorrhage , position head
turned to side,water or ice chips Teaching patient :S&S of hemorrhage Avoid too much talking or coughing Liquid or semi liquid diet for several days Alkaline mouth washing with warm saline
Laryngitis It is an inflammation of larynx ,often occur as a result
of voice abuse or exposure to dust , chemicals , smoke , & other pollutants
Common in winter & easily transmitted The cause of infection is almost virus
Clinical Manifestations Hoarseness or aphonia Severe cough
Medical Management
Resting voice & avoid smoking Inhale cool steam or an aerosol Conservative treatment Antibiotics for bacterial organisms
Nursing Management Rest voice Maintain a well humidified environment Daily fluid intake
Sleep apneaCan be obstructive, central, or mixed
Manifestations :Excessive daytime sleepiness, morning headache,
personality change, mentality changes, loud snoring, restless sleep
Need sleep test “cardiopulmonary status monitored during sleeping”
Cause hypoxia, hypoventilation, MI, HTN, dysrythmias
04/21/23 29Mr.Homood Alharbi Respiratory module
Medical treatment:+ve airway pressure with O2 nasal canulaOR to correct obstructionTracheostomy to be open during sleepTriptil at bed time to increase airway
diameter
Epistaxis Bleeding from the noseDue to rupture of tiny vesselsCaused by trauma, infections, some
medicationsTreatment: nasal packing, suctioning
04/21/23Mr.Homood Alharbi Respiratory module 30
Nursing process: pt with upper respiratory tract
Assessment
Diagnosis
Planning & goals Interventions
Evaluation
04/21/23 31Mr.Homood Alharbi Respiratory module
Conclusion
Any question
04/21/23 32Mr.Homood Alharbi Respiratory module