Review of lungs anatomy and physiology

Review of lungs anatomy and physiology

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  ANATOMIC AND PHYSIOLOGIC OVERVIEW OFRESPIRATION SWATILEKHA DAS ASST PROFESSOR BSN(RN & RM) MSN
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  INTRODUCTION The basic humanneed is to be able to maintain normal or desirable respiration. Anatomically respiratory system includes (top to bottom) nasal cavity, nasopharynx, larynx, trachea and bronchi. Physiologically respiratory system enables gaseous exchange and thus maintains acid base balance.
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  ANATOMY OF RESPIRATION The lungsare a pair of spongy, air-filled organs located on either side of the chest (thorax). The trachea (windpipe) conducts inhaled air into the lungs through its tubular branches, called bronchi. The bronchi then divide into smaller and smaller branches (bronchioles), finally becoming microscopic. 1. Upper respiratory tract 2. Lower respiratory tract
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  AIR MOVEMENT THROUGH LUNGS
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  PHYSIOLOGY OF RESPIRATION Howbreathing takes place is referred as mechanism of respiration. The air inhaled into the lungs by this mechanism of respiration is the source of supply of oxygen for the body tissues. There is a gaseous exchange that takes place between the blood capillaries and the alveoli within the lungs- referred as external respiration , and there is a gaseous exchange i.e. of oxygen and carbon dioxide at the tissue cellular level- referred as internal respiration.
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  ASSESSMENT OF RESPIRATORYFUNCTION Careful assessment and monitoring of respiratory status of a critically ill patient is of utmost importance for prompt decision making regarding necessary respiratory support e.g. endotracheal intubation , tracheostomy , initiation of mechanical ventilation or weaning from mechanical ventilation. 1. Health history 2. Physical assessment 3. Laboratory findings
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  1. Health history ❑Itis difficult to obtain complete health history from the critically ill patient on admission. ❑Some history may be obtained from relatives or from previous health records. ❑Complete health history includes the following- ▪History of present illness ▪Past respiratory history e.g. COPD, tuberculosis, pneumonia etc ▪Past surgical history related to lungs and thorax ▪History of medication
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  ▪Allergies ▪History of smoking ▪Familyhistory of respiratory problems ▪Chief respiratory symptoms e.g. ✓Breathlessness ✓Cough ✓Sputum production ✓Hemoptysis ✓Chest pain
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  PHYSICAL ASSESSMENT
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  1. Inspection GENERAL –level of consciousness , nutritional status, skin turgor, musculoskeletal development, position of the patient , ability to speak, hoarseness of voice EXTREMITIES – Edema, peripheral cyanosis, clubbing HEAD & NECK- Types of breathing rate, pattern of breathing, I & E ratio, central cyanosis, tracheal position, use of accessory muscles of shoulder and neck THORAX- Rate and pattern of breathing e.g. tachypnea, bradypnea, apnea, Cheyne-stroke, kussmauls etc
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  2. PALPATION ❑ Palpationof anterolateral and posterolateral chest is done to identify areas of tenderness, masses and inflammation. ❑Palpation of ribs and costal margin is undertaken for assessment of symmetry, motility , tenderness and vertebral position. ❑Neck area is palpated to assess position of trachea and presence of subcutaneous emphysema.
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  3. PERCUSSION ❑ Atechnique performed to evaluate the density of the lung tissue. ❑Undertaken to aid in determining whether the underlying tissues are air filled , fluid filled or solid.
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  4. AUSCULTATION It isthe art of listening to the sounds produced within the airway with the help of stethoscope. It is used to detect normal breath sounds e.g. bronchial , broncho-vesicular and vesicular and abnormal lung sounds.
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