Respiratory System 2015 jo slides.pdf - Respiratory System...

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Respiratory System Zoya Minasyan RN, MSN-Edu
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Respiratory System Review of system Normal Arterial Blood Gasses Upper respiratory problems Deviated septum & Nasal Fracture Epistaxis Rhinitis Influenza Sinusitis Pharyngitis Obstruction Tracheostomy Lower respiratory infections Bronchitis Pneumonia TB Lung Abscess Obstructive Pulmonary Diseases Asthma Chronic Obstructive Pulmonary Disease
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Structures and Functions of Respiratory System A, Pulmonary functional unit. B, Ciliated mucous membrane.
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Structures and Functions of Respiratory System A small portion of the respiratory membrane greatly magnified. An extremely thin interstitial layer of tissue separates the endothelial cell and basement membrane on the capillary side from the epithelial cell and surfactant layer on the alveolar side of the respiratory membrane. The total thickness of the respiratory membrane is less than 1⁄5000 of an inch.
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Normal Blood Gas Values Parameter Reference Interval pH 7.35-7.45 PaCO2 35-45 mm Hg Bicarbonate (HCO3−) 22-26 mEq/L (mmol/L) PaO2† 80-100 mm Hg SaO2 >95% Base excess ±2.0 mEq/L †Decreases above sea level and with increasing age. PaCO2, Partial pressure of CO2 in arterial blood; PaO2, partial pressure of O2 in arterial blood; SaO2, arterial O2 saturation.
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Assessment of Respiratory System Sequence for examination of the chest. A, Anterior sequence. B, Lateral sequence. C, Posterior sequence. For palpation, place the palms of the hands in the position designated as “1” on the right and left sides of the chest. Compare the intensity of vibrations. Continue for all positions in each sequence. For percussion, tap the chest at each designated position, moving downward from side to side. Compare percussion sounds at all positions. For auscultation, place the stethoscope at each position and listen to at least one complete inspiratory and expiratory cycle. Keep in mind that, with a female patient, the breast tissue will modify the completeness of the anterior examination.
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Estimation of thoracic expansion: A, Exhalation. B, Maximal inhalation.
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Diagram of percussion areas and sounds in the anterior side of the chest.
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Assessment of Respiratory System Diagram of percussion areas and sounds in the posterior side of the chest. Percussion proceeds from the lung apices to the lung bases, comparing sounds in opposite areas of the chest.
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Assessment of Respiratory System Normal auscultatory sounds
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Diagnostic Studies of Respiratory System Sputum Studies Endoscopic Examinations Bronchoscopy Fiberoptic bronchoscope. A, The transbronchoscopic balloon-tipped catheter and the flexible fiberoptic bronchoscope. B, The catheter is introduced into a small airway and the balloon inflated with 1.5 to 2 mL of air to occlude the airway. Bronchoalveolar lavage is performed by injecting and withdrawing 30-mL of sterile saline solution, gently aspirating after each instillation. Specimens are sent to the laboratory for analysis.
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  • Fall '17

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