Chapter 27 - Chapter 27: Pulmonology Pulmonology- study of...

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Chapter 27 : Pulmonology Pulmonology - study of the respiratory system. COPD (Chronic Obstructive Pulmonary Disease)- a disease characterized by a decreased ability of the lungs to perform the function of ventilation. Process of Gas Exchange Ventilation - the mechanical process of moving air in and out of the lungs. Diffusion - the movement of molecules through a membrane from an area of greater concentration to an area of lesser concentration. Perfusion - the circulation of blood through the capillaries. o Lung perfusion is dependent on 3 conditions Adequate blood volume Intact pulmonary capillaries Efficient pumping of blood by the heart Hemoglobin (Hb) - the transport protein that carries O2 in the blood. Oxygen dissociation curve- as fully oxygen-bound hemoglobin begins to release oxygen, it more readily sheds additional oxygen. Basically, the more Hb the more O2 can be transported. Changes in body temperature, blood pH, and the PCO2 can all alter the Oxygen dissociation curve. Bohr effect- phenomenon in which a decrease in PCO2/acidity causes an increase in the quantity of O2 that binds w/ the hemoglobin and, conversely, an increase in PCO2/acidity causes the hemoglobin to give up a greater quantity of O2. CO2 is transported from the cells to the lungs in one of three ways. 1. as bicarbonate ion- is predominantly what CO2 is converted to 2. bound to the globin portion of the hemoglobin molecule 3. dissolved in plasma (measured as PCO2) Respiration - the exchange of gases between a living organism and its environment. Pathophysiology Disruption in Ventilation o Upper and Lower Respiratory Tract Obstruction o Pneumothorax - a collection of air in the pleural space, causing a loss of the negative-pressure that binds the lung to the chest wall. Hemothorax - a collection of blood in the pleural space. Flail chest - one or more ribs fractured in two or more places, creating an unattached rib segment. o Nervous System- certain abnormal respiratory patterns are produced by specific brain injury or illness. Kussmaul’s respirations - deep, slow or rapid, gasping breathing. Associated w/ diabetic ketoacidosis Cheyne-Stokes respirations - progressively deeper, faster breathing alternating gradually w/shallow, slower breathing, indicating brain stem injury.
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Biot’s respirations - irregular pattern of rate and depth w/ sudden, periodic episodes of apnea, indicating increased ICP. Central neurogenic hyperventilation
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Chapter 27 - Chapter 27: Pulmonology Pulmonology- study of...

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