PFT and COPD

Bell work What is the average NORMAL range of breaths per minute? How do you count breaths per minute?

Bell Work Answers 12-24 BPM Rise and fall of chest , 30 seconds x 2

Standard 10) Review the gross and cellular anatomy and physiology of the respiratory system and explain the ventilation process. Develop an exercise program and a rehabilitation plan for a patient/client who has chronic obstructive pulmonary disease (COPD) and one who is training for a marathon, based on their respective respiratory needs. Compare and contrast these plans to justify the components included.

Objectives By the end of class students will: Understand spirometer measurement Respiratory Diseases

How long do you think your body could exist without Oxygen?

FUN FACTS We need oxygen to survive. After about 4 minutes without oxygen, brain cells begin dying which can lead to brain damage and ultimately death Disorders of the respiratory system are usually treated by a pulmonologist and respiratory therapist.

Respiratory Sounds Sounds are monitored with a stethoscope Bronchial sounds – produced by air rushing through trachea and bronchi Vesicular breathing sounds – soft sounds of air filling alveoli Slide 13.31 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Neural Regulation of Respiration Activity of respiratory muscles is transmitted to the brain by the phrenic and intercostal nerves Neural centers that control rate and depth are located in the medulla The pons appears to smooth out respiratory rate Normal respiratory rate is 12–24 respirations per minute Slide 13.36 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Neural Regulation of Respiration Figure 13.12 Slide 13.37 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Key Terms Eupnea - normal quiet breathing, 12-24 breaths per minute. Tachypnea: Fast/Shallow breathing, Build up CO2 in lungs and blood stream Ex. asthma, lung dz., pulmonary embolism (blood clot in lungs) choking, heart failure, heat stroke Hyperpnea: Fast/Deep breathing Increased depth to meet metabolic demands of body tissues Ex. During exercise, lack of O2 (high altitude), anemia (low Hg. O2 in blood. Hyperventilation – increase minute volume of pulmonary ventilation in excess of the need for oxygen. CO 2 decreases. Someone hysterical Breathe into exertion paper bag.

Key Terms Hypoventilation - breathing at an abnormally slow rate, resulting in an increased amount of carbon dioxide in the blood. Apnea - temporary cessation of breathing at the end of normal expiration. Dyspnea – Difficult Breathing

What are non-respiratory air movements?

Nonrespiratory Air Movements Can be caused by reflexes or voluntary actions Examples Cough and sneeze – clears lungs of debris Laughing Crying Yawn Hiccup Slide 13.25 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Factors Influencing Respiratory Rate and Depth 1. Physical factors Increased body temperature Exercise Talking Coughing 2. Volition (conscious control) 3. Emotional factors Slide 13.38 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Factors Influencing Respiratory Rate and Depth 4. Chemical factors Carbon dioxide levels Level of carbon dioxide in the blood is the main regulatory chemical for respiration Increased carbon dioxide increases respiration Changes in carbon dioxide act directly on the medulla oblongata Slide 13.39a Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Factors Influencing Respiratory Rate and Depth Chemical factors (continued) Oxygen levels Changes in oxygen concentration in the blood are detected by chemoreceptors in the aorta and carotid artery Information is sent to the medulla oblongata Slide 13.39b Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Respiratory Volumes and Capacities Normal breathing moves about 500 ml of air with each breath (tidal volume [TV]) Many factors that affect respiratory capacity A person’s size Sex Age Physical condition Residual volume of air – after exhalation, about 1200 ml of air remains in the lungs Slide 13.26 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Respiratory Capacities Figure 13.9 Slide 13.30 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Respiratory Volumes and Capacities Inspiratory reserve volume (IRV) Amount of air that can be taken in forcibly over the tidal volume Usually between 2100 and 3200 ml Expiratory reserve volume (ERV) Amount of air that can be forcibly exhaled Approximately 1200 ml Slide 13.27a Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Respiratory Volumes and Capacities Vital capacity The total amount of exchangeable air Vital capacity = TV + IRV + ERV Total lung capacity= TV+ IRV + ERV+RV Slide 13.28 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Respiratory Volumes and Capacities Respiratory capacities are measured with a spirometer Slide 13.29 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Pulmonary Function Test (PFT) group of tests that measure how well your lungs work. includes how well you’re able to breathe and how effective your lungs are able to bring oxygen to the rest of your body.

Incentive Spirometer practice taking deep breaths opens your airways prevent fluid or mucus from building up in your lungs make it easier for you to breathe.

Malfunctions & Diseases of the Respiratory System asthma A severe allergic reaction characterized by the constriction of bronchioles  bronchitis Inflammation of the lining of the bronchioles emphysema A condition in which the alveoli deteriorate, causing the lungs to lose their elasticity pneumonia Caused by the bacteria, pneumococcus. A condition in which the alveoli become filled with fluid, preventing the exchange of gases lung cancer An irregular & uncontrolled growth of tumors in the lung tissue

Measurement of Lung Capacity Figure 10.10A

COPD chronic obstructive pulmonary disease a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time. COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness, and other symptoms.

COPD Exemplified by chronic bronchitis and emphysema Major causes of death and disability in the United States Slide 13.40a Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

COPD Features of these diseases Most victims retain carbon dioxide, are hypoxic and have respiratory acidosis Do not give these patients too much O2 Giving too much oxygen removes this stimulus to breathe, and thus reduces the removal of CO2 from the lungs Those infected will ultimately develop respiratory failure Slide 13.40c Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

COPD Features of these diseases Patients almost always have a history of smoking Labored breathing (dyspnea) becomes progressively more severe Coughing and frequent pulmonary infections are common Slide 13.40b Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

What is COPD? https://www.youtube.com/watch?v=nUGK8hKDpEg

COPD Causes Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease

Cost of smoking Research the cost of smoking ½, 1, 2 packs per day (PPD) for 20 years (research the info you need - # of cigarettes in a box, cost per box, etc) Research the amount of years taken off of your life if every cigarette takes 7-11 minutes off of your life (find the range)