Gas Exchange and Respiratory Function
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Gas Exchange
Gas exchange Gas exchange occurs as a result of respiration, when carbon dioxide is excreted and oxygen taken up, and photosynthesis, when oxygen is excreted and carbon dioxide is taken up. The rate of gas exchange is affected by: • the area available for diffusion • the distance over which diffusion occurs • the concentration gradient across the gas exchange surface • the speed with which molecules diffuse through membranes. Efficient gas exchange systems must: • have a large surface area to volume ratio • be thin • have mechanisms for maintaining steep concentration gradients across themselves • be permeable to gases. Single-celled organisms are aquatic and their cell surface membrane has a sufficiently large surface area to volume ratio to act as an efficient gas exchange surface. In larger organisms, permeable, thin, flat structures have all the properties of efficient gas exchange surfaces but need water to prevent their dehydration and give them mechanical support. Since the solubility of oxygen in water is low, organisms that obtain their oxygen from water can maintain only a low metabolic rate. In small and thin organisms, the distance from gas exchange surface to the inside of the organism is short enough for diffusion of gases to be efficient. Diffusion gradients are maintained because gases are continually used up or produced. In larger organisms, simple diffusion is not an efficient way of transporting gases between cells in the body and the gas exchange surface. In many animals a blood circulatory system carries gases to and from the gas exchange surface. The gas-carrying capacity of the blood is increased by respiratory pigments, such as haemoglobin. -
Download Article
...& more SELF-TEST Respiratory system challenge Test your knowledge with this quick quiz. 1. Gas exchange takes place in the 8. Which continuous breath sounds are 14. Wheezes most commonly suggest a. pharynx. c. alveoli. relatively high pitched with a hissing a. secretions in large airways. b. larynx. d. trachea. or shrill quality? b. abnormal lung tissue. a. coarse crackles c. wheezes c. airless lung areas. 2. The area between the lungs is b. rhonchi d. fine crackles d. narrowed airways. known as the a. thoracic cage. c. pleura. 9. Normal breath sounds heard over 15. Which of the following indicates a b. mediastinum. d. hilum. most of both lungs are described as partial obstruction of the larynx or being trachea and demands immediate 3. Involuntary breathing is controlled by a. loud. c. very loud. attention? a. the pulmonary arterioles. b. intermediate. d. soft. a. rhonchi c. pleural rub b. the bronchioles. b. stridor d. mediastinal crunch c. the alveolar capillary network. 10. Bronchial breath sounds are d. neurons located in the medulla and normally heard 16. Which of the following would you pons. a. over most of both lungs. expect to find over the involved area b. between the scapulae. in a patient with lobar pneumonia? 4. The sternal angle is also known as c. over the manubrium. a. vesicular breath sounds the d. over the trachea in the neck. b. egophony a. suprasternal notch. c. scapula. c. decreased tactile fremitus b. xiphoid process. d. angle of Louis. 11. Which is correct about vesicular d. muffled and indistinct transmitted voice breath sounds? sounds 5. -
Respiratory Examination Cardiac Examination Is an Essential Part of the Respiratory Assessment and Vice Versa
Respiratory examination Cardiac examination is an essential part of the respiratory assessment and vice versa. # Subject steps Pictures Notes Preparation: Pre-exam Checklist: A Very important. WIPE Be the one. 1 Wash your hands. Wash your hands in Introduce yourself to the patient, confirm front of the examiner or bring a sanitizer with 2 patient’s ID, explain the examination & you. take consent. Positioning of the patient and his/her (Position the patient in a 3 1 2 Privacy. 90 degree sitting position) and uncover Exposure. full exposure of the trunk. his/her upper body. 4 (if you could not, tell the examiner from the beginning). 3 4 Examination: General appearance: B (ABC2DEVs) Appearance: young, middle aged, or old, Begin by observing the and looks generally ill or well. patient's general health from the end of the bed. Observe the patient's general appearance (age, Around the bed I can't state of health, nutritional status and any other see any medications, obvious signs e.g. jaundice, cyanosis, O2 mask, or chest dyspnea). 1 tube(look at the lateral sides of chest wall), metered dose inhalers, and the presence of a sputum mug. 2 Body built: normal, thin, or obese The patient looks comfortable and he doesn't appear short of breath and he doesn't obviously use accessory muscles or any heard Connections: such as nasal cannula wheezes. To determine this, check for: (mention the medications), nasogastric Dyspnea: Assess the rate, depth, and regularity of the patient's 3 tube, oxygen mask, canals or nebulizer, breathing by counting the respiratory rate, range (16–25 breaths Holter monitor, I.V. -
Mechanisms of Pulmonary Gas Exchange Abnormalities During Experimental Group B Streptococcal Infusion
003 I -3998/85/1909-0922$02.00/0 PEDIATRIC RESEARCH Vol. 19, No. 9, I985 Copyright 0 1985 International Pediatric Research Foundation, Inc. Printed in (I.S. A. Mechanisms of Pulmonary Gas Exchange Abnormalities during Experimental Group B Streptococcal Infusion GREGORY K. SORENSEN, GREGORY J. REDDING, AND WILLIAM E. TRUOG ABSTRACT. Group B streptococcal sepsis in newborns obtained from GBS (5, 6). Arterial Poz fell by 9 torr in association produces pulmonary arterial hypertension and hypoxemia. with the increase in pulmonary arterial pressure (4). In contrast, The purpose of this study was to investigate the mecha- the neonatal piglet infused with GBS demonstrated both pul- nisms by which hypoxemia occurs. Ten anesthetized, ven- monary arterial hypertension and profound arterial hypoxemia tilated piglets were infused with 2 x lo9 colony forming (7). These results suggest that the neonatal pulmonary vascula- unitstkg of Group B streptococci over a 30-min period. ture may respond to bacteremia differently from that of adults. Pulmonary arterial pressure rose from 14 ? 2.8 to 38 ? The relationship between Ppa and the matching of alveolar 6.7 torr after 20 min of the bacterial infusion (p< 0.01). ventilation and pulmonary perfusion, a major determinant of During the same period, cardiac output fell from 295 to arterial oxygenation during room air breathing (8), has not been 184 ml/kg/min (p< 0.02). Arterial Po2 declined from 97 studied in newborns. The predictable rise in Ppa with an infusion 2 7 to 56 2 11 torr (p< 0.02) and mixed venous Po2 fell of group B streptococcus offers an opportunity to delineate the from 39.6 2 5 to 28 2 8 torr (p< 0.05). -
Visual Examination
Visual Examination • Consider the impact of chest shape on the respiratory condition of the patient – Barrel chest – Kyphosis – Scoliosis – Pectus excavatum (funnel chest) – Pectus carinatum Visual Assessment of Thorax • Thoracic scars from previous surgery • Chest symmetry • Use of accessory muscles • Bruising • In drawing of ribs • Flail segment www.nejm.org/doi/full/10.1056/NEJMicm0904437 • Paradoxical breathing /seesaw breathing • Pursed lip breathing • Nasal flaring Palpation • For vibration of secretion • Surgical emphysema • Symmetry of chest movement • Tactile vocal fremitus • Check for a tracheal tug • Palpate Nodes http://www.ncbi.nlm.nih.gov/books/NBK368/ https://m.youtube.com/watch?v=uzgdaJCf0Mk Auscultation • Is there any air entry? • Differentiate – Normal vesicular sounds – Bronchial breathing – Wheeze – Distinguish crackles • Fine • Coarse • During inspiration or expiration • Profuse or scanty – Absent sounds – Vocal resonance http://www.easyauscultation.com/lung-sounds.aspx Percussion • Tapping of the middle phalanx of the left middle finger with the right middle finger • Sounds should be resonant but may be – Hyper resonant – Dull – Stony Dull http://stanfordmedicine25.stanford.edu/the25/pulmonary.html Pathological Expansion Mediastinal Percussion Breath Further Process Displacement Note Sounds Examination Consolidation Reduced on None Dull Bronchial affected side breathing Vocal resonance Whispering pectoriloquy Collapse Reduced on Towards Dull Reduced None affected side affected side Pleural Reduced on Towards Stony dull Reduced/ Occasional rub effusion affected side opposite side Absent Empyema Asthma Reduced None Resonant Normal/ Wheeze throughout Reduced COPD Reduced None Resonant/ Normal/ Wheeze throughout Hyper-resonant Reduced Pulmonary Normal or None Normal Normal Bibasal crepitations Fibrosis reduced throughout Pneumothorax Reduced on Towards Hyper-resonant Reduced/ None affected side opposite side Absent http://www.cram.com/flashcards/test/lung-sounds-886428 sign up and test yourself.. -
THE DUBLIN MEDICAL SCHOOL and ITS INFLUENCE UPON MEDICINE in AMERICA1 by DAVID RIESMAN, M.D
THE DUBLIN MEDICAL SCHOOL AND ITS INFLUENCE UPON MEDICINE IN AMERICA1 By DAVID RIESMAN, M.D. PROFESSOR OF CLINICAL MEDICINE IN THE UNIVERSITY OF PENNSYLVANIA PHILADELPHIA, PA. HE Irish, a mixture of primitive universal genius like Robert Boyle, Ireland pre-Celtic peoples and of Goidelic did not produce a perpetuating body of Celts coming from the European learned men who made their influence felt T continent, developed in the early beyond the confines of the Green Island. Middle Ages, out of their own resources Of the history of Irish medicine in the and untouched in any marked degree by the Middle Ages, little is known and the all-pervading influence of Rome, a remark subject is largely an untilled field. Norman able indigenous culture. In particular they Moore (St. Barth. Hosp. Rep., 1875, it elaborated a native type of Christianity 145) has resuscitated a few of the original which with characteristic energy and manuscripts in the Irish language. Most wandering spirit they carried to Scotland, of them are translations from the works of to Northern England—to Northumbria—to Bernard de Gordon, especially from his France, to Belgium, and to Switzerland. “Lilium Medicinae”; of John of Gaddes- St. Columba, of Iona, and St. Columbanus, den’s “Rosa Anglica”; of the works of of Luxeuil, stand forth as the great militant Avicenna, of A verroes, of Isaac, and of the missionaries of that first flowering period Salernitan School. Much space is given to of Irish civilization. Although they and their the writings of Isidorus. This Isidorus is successors had to succumb to the greater the famous Spanish churchman, bishop might of Latin Christianity,2 they left of Seville, who not only was a master of dotted over Europe a number of large theology but a writer upon every branch of monasteries which became active centers of knowledge of his day. -
Pleurisy Dry and Exudative: Symptoms and Syndromes Based on Clinical-Instrumental and Laboratory Methods of Study
Topic: Pleurisy dry and exudative: symptoms and syndromes based on clinical-instrumental and laboratory methods of study. Syndrome of fluid and air accumulation in the pleural cavity in pathology of the respiratory system Objective 1. Patient S. 25 years old, has complaints of severe pain in the left half of the chest, exacerbated by deep breath, lack of air. He first felt sick 3 days ago, noticed a one-time increase in body temperature to 37,5°C. On examination: rapid superficial breathing, the left half of the chest is slower in the act of breathing. Clear pulmonary sound is determined by percussion. During auscultation, there is a pleural friction sound to the left, it is louder in the armpit. The pain increases with inhalation, decreases with lying on the side of pain. In the general clinical blood test - moderate leukocytosis, ESR - 17 mm / h. Questions: 1. What is the diagnosis? 2. What (all) data will the doctor receive when auscultating the patient's lungs with this pathology? 3. How can you distinguish the pleural friction sound from the pericardial friction sound? 4. What is the normal respiratory rate? What is the respiratory rate of rapid breathing? 5. What are the possible causes of this disease. Task 2. Patient M., 33 years old, has complaints of chills, fever up to 38,5°C for 3 days, dry cough, pain in the right half of the chest. The pain is exacerbated by breathing and coughing. Objectively: the skin is pale, the lips are cyanotic, the respiratory rate is up to 30 per minute, the right half of the chest is enlarged in volume, the intercostal spaces are smoothed. -
Chest Pain and Non-Respiratory Symptoms in Acute Asthma
Postgrad Med J 2000;76:413–414 413 Chest pain and non-respiratory symptoms in Postgrad Med J: first published as 10.1136/pmj.76.897.413 on 1 July 2000. Downloaded from acute asthma W M Edmondstone Abstract textbooks. Occasionally the combination of The frequency and characteristics of chest dyspnoea and chest pain results in diagnostic pain and non-respiratory symptoms were confusion. This study was prompted by the investigated in patients admitted with observation that a number of patients admitted acute asthma. One hundred patients with with asthmatic chest pain had been suspected a mean admission peak flow rate of 38% of having cardiac ischaemia, pleurisy, pericardi- normal or predicted were interviewed tis, or pulmonary embolism. It had also been using a questionnaire. Chest pain oc- observed that many patients admitted with curred in 76% and was characteristically a asthma complained of a range of non- dull ache or sharp, stabbing pain in the respiratory symptoms, something which has sternal/parasternal or subcostal areas, been noted previously in children1 and in adult worsened by coughing, deep inspiration, asthmatics in outpatients.2 The aim of this or movement and improved by sitting study was to examine the frequency and char- upright. It was rated at or greater than acteristics of chest pain and other symptoms in 5/10 in severity by 67% of the patients. A patients admitted with acute asthma. wide variety of upper respiratory and sys- temic symptoms were described both Patients and methods before and during the attack. One hundred patients (66 females, mean (SD) Non-respiratory symptoms occur com- age 45.0 (19.7) years) admitted with acute monly in the prodrome before asthma asthma were studied. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
(Charity Hospital), As a Pathologic Rarity, One Or Two Dr
of the great deal of gas and distress, crying most ANOMALIES OF TUBERCULOSIS IN THE and six stools a day, passing green, irritating day HIGHLANDS OF COLOMBIA which, under the microscope, were seen to contain con¬ siderable fat. The mother had considerable gas in the A NEW DIAGNOSTIC SIGN IN INCIPIENT CASES bowels. The analysis showed: fat, 1.4 per cent.; lactose, 8 per cent., and protein, 1.07 per cent. JORGE VARGAS S., M.D. Although no single component was excessively high, Professor of the General Pathologic Clinic, National University of the relative proportions of the fat, lactose and protein Colombia were abnormal. In this instance after weaning, the NEW YORK a of cow's baby straightened out on simple formula of the of observed milk. Physicians early part this century a curious evolution of tuberculosis in the Colom- In another instance a was being fed by a wet- great baby bian These have an elevation of nurse who also gave her own baby the breast after Highlands. highlands about 11,800 feet above sea level, and are inhabited the foster-baby received what it needed. It was by noticed that the wetnurse's an Indo-Spanish race which numbers very few Indians although baby gained and descendants of the it was uncomfortable and a good part of the many pure conquerors. rapidly, The an of time had stools. As time went on the highlands have average temperature undigested from 14 to 16 C. 57.2 to 60.8 with an inex- fosterbaby did not receive enough milk and was given (or F.), all of the wetnurse's milk. -
Part Two Physical Processes in Oceanography
Part Two Physical Processes in Oceanography 8 8.1 Introduction Small-Scale Forty years ago, the detailed physical mechanisms re- Mixing Processes sponsible for the mixing of heat, salt, and other prop- erties in the ocean had hardly been considered. Using profiles obtained from water-bottle measurements, and J. S. Turner their variations in time and space, it was deduced that mixing must be taking place at rates much greater than could be accounted for by molecular diffusion. It was taken for granted that the ocean (because of its large scale) must be everywhere turbulent, and this was sup- ported by the observation that the major constituents are reasonably well mixed. It seemed a natural step to define eddy viscosities and eddy conductivities, or mix- ing coefficients, to relate the deduced fluxes of mo- mentum or heat (or salt) to the mean smoothed gra- dients of corresponding properties. Extensive tables of these mixing coefficients, KM for momentum, KH for heat, and Ks for salinity, and their variation with po- sition and other parameters, were published about that time [see, e.g., Sverdrup, Johnson, and Fleming (1942, p. 482)]. Much mathematical modeling of oceanic flows on various scales was (and still is) based on simple assumptions about the eddy viscosity, which is often taken to have a constant value, chosen to give the best agreement with the observations. This approach to the theory is well summarized in Proudman (1953), and more recent extensions of the method are described in the conference proceedings edited by Nihoul 1975). Though the preoccupation with finding numerical values of these parameters was not in retrospect always helpful, certain features of those results contained the seeds of many later developments in this subject. -
Gas-Liquid Hollow Fiber Membrane Contactors for Different Applications
Review Gas-Liquid Hollow Fiber Membrane Contactors for Different Applications Stepan D. Bazhenov 1,*, Alexandr V. Bildyukevich 2 and Alexey V. Volkov 1 1 A.V. Topchiev Institute of Petrochemical Synthesis, Russian Academy of Sciences, Moscow 119991, Russia; [email protected] 2 Institute of Physical Organic Chemistry, National Academy of Sciences of Belarus, Minsk 220072, Belarus; [email protected] * Correspondence: [email protected]; Tel.: +7-495-647-5927 (ext. 202) Received: 14 September 2018; Accepted: 2 October 2018; Published: 10 October 2018 Abstract: Gas-liquid membrane contactors that were based on hollow fiber membranes are the example of highly effective hybrid separation processes in the field of membrane technology. Membranes provide a fixed and well-determined interface for gas/liquid mass transfer without dispensing one phase into another while their structure (hollow fiber) offers very large surface area per apparatus volume resulted in the compactness and modularity of separation equipment. In many cases, stated benefits are complemented with high separation selectivity typical for absorption technology. Since hollow fiber membrane contactors are agreed to be one of the most perspective methods for CO2 capture technologies, the major reviews are devoted to research activities within this field. This review is focused on the research works carried out so far on the applications of membrane contactors for other gas-liquid separation tasks, such as water deoxygenation/ozonation, air humidity control, ethylene/ethane separation, etc. A wide range of materials, membranes, and liquid solvents for membrane contactor processes are considered. Special attention is given to current studies on the capture of acid gases (H2S, SO2) from different mixtures.