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Factors necessary for respiration

Adequate O2 in the atmosphere

A functioning respiratory tract

Functioning thoracic muscles and nerves to control the thoracic cage

Blood to transport the gases

Capillaries in close proximity to the cells to allow the exchange of gases.

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Regulation of respiration

The automatic control is located in the respiratory centers of the brain stem.Reflex responses and chemical signals control these centers.Chemical control is usually reliant on the level of CO2 in the blood.We can voluntarily control respirations for a short time – speaking, swallowing .

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Factors affecting respiratory function Availability of O2 – usually 20% in airRegulating mechanisms –cerebral Oedema, medications.Passage of gases – accumulation of secretions, injury / disease to chestDiffusion of gases – COADTransport of gases – anaemia, CCFInfluences on characteristics of breathing-Pain, emotion , exercise.

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Breath sounds site

http://www.cvmbs.colostate.edu/clinsci/callan/breath_sounds.htm

http://www.med.ucla.edu/wilkes/inex.htm

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Characteristics of respiration

Rate;

Tachypnoea- increased respiratory rate (exercise , fever, pneumonia, COAD, lesions in the pons varolii).

Bradypnoea – decrease in respiratory rate ( opioids, brain tumours)

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Characteristics of respiration

Rhythm – evenly spacedHyperventilation- an increase in both the rate and depth of respirations (extreme exertion, fear / anxiety , fever, midbrain lesions, acid –base imbalance , blood gas concentration).Cheyne –stokes – periodic breathing with gradual increase in depth then apnoea.Biot’s respiration – interrupted breathing patterns like Cheyne – Stokes but depth remains the same (meningitis).

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Characteristics of respiration

Depth – should be constant and relaxedDyspnoea – undue breathlessness and an awareness of discomfort with breathingExhertional dyspnoea- exercise , CCfOrthopnoea – shortness of breath on lying down, relieved by sitting upright (LVF)Paroxsmal nocturnal dyspnoea – sudden breathlessness that occurs at nigh when patient is lying down (APO, LVF) .

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Characteristics of respiration

Sound – usually inaudible

Stertorous laboured breathing with a snoring sound (obstructed airway)

Wheezing – high pitched and squeaky (asthma)

Rales – bubbly or crackly (eg PO)

Ronchi – course and rattly (bronchitis)

Stridor – high pitched musical sound on inspiration (croup).

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Monitoring respirations

Patient has a respiratory condition

Evaluate their condition

Monitoring effectiveness of treatment

Postoperatively

Critically ill

Patient receiving o2 therapy

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