bab 3-respiratory devices
TRANSCRIPT
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RESPIRATORYDEVICES
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INTRODUCTION
• The human respiratory system functions toallow gas exchange.
• Respiratory care is the medical field that
works with patients with breathingdisorders.
• These disorders can be malfunctioning
lungs, lack of proper oxygen in the arterialblood and cancers of the lungs or
respiratory tract.
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Pulmonary Volumes and Capacities Graph
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PULMONARY VOLUMES
• Tidal Volume (TV) – the volume of air inspired orexpired with each normal breath. (about 500ml averaged
over 12 to 15 normal breaths per minute)
• Inspiratory Reserve Volume (IRV) – is the
extra volume of air that can be inspired over the normaltidal volume. (about 3000 to 3500ml)
• Expiratory Reserve Volume (ERV) – is the
amount of air that can be expired after the end of the
normal tidal volume with the forced expiration. (1000ml
to 1200ml)
• Residual Volume (RV) – is the volume of air
still remaining in the lungs after the most forcefulexpiration. (about 1200ml)
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PULMONARY CAPACITIES
• Inspiratory Capacity (IC) – the amount equalto the sum of the tidal volume and the inspiratory reserve
volume. (IC = TV + IRV)
• Vital Capacity (VC) – when the person can
forcefully inspire to the maximum amount and then canexpel the air to the maximum by forceful expiration.
(VC = IRV + TV + ERV @ VC = IC + ERV)
• Total Lung Capacity (TLC) – is the maximum
volume to which lungs can be expended with themaximum inspiratory effort. (TLC = RV + VC)
• Functional Residual Capacity (FRC) – the amount of air remaining in the lungs from the end of
the normal expiration level. (FRC = RV + ERV)
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LUNG COMPLIANCE
• The elastic force of the lungs accepting a
volume of inspired air.
• Lungs with high compliance have low elastance,
lungs with low compliance have high elastance.Compliance = volume of the inspired air
Intrapleural pressure
• Elastance is the reciprocal of compliance and isthe natural ability to respond to force and return
to the original resting shape.
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RESPIRATORY ABNORMALITIES
• Eupnea (normal breathing)
• Tachypnea (rapid breathing)
• Bradypnea (slow breathing)• Hyperpnea (over-respiration)
• Hypopnea (under-respiration)
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Common Infectious Diseases
• Bronchitis
• Common cold
• Influenza• Pneumonia
• Tuberculosis
• Laryngitis• Pharyngitis
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SPIROMETER
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A modern portable
desktop spirometerwith digital turbine
and antibacterial filter
A modern
portablespirometer
Anincentive
spirometer
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Function of a spirometer
• A spirometer is a device used to measure
air volume when the patient inhales and
exhales through a mouthpiece.
• Spirometry is the measurement of a
person’s ability to inhale and exhale.
• This device then records the person’s
breathing capabilities and measures the
amount of air expelled and the rate at
which the air is expelled from the lungs.
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CONT…
• Spirometry indicates several parameters
of breathing such as Forced Vital Capacity
(FVC) and Forced Expiratory Volume
(FEV).
• The physician can diagnose asthma or
other lung diseases and also measure the
progression of respiratory diseases withthe spirometry test.
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CONT…
• If the patient has abnormal spirometer
measurements (values fall below 85% of
the normal values), then other lung tests
are recommended to diagnose lungdisease or airflow obstructions.
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Preparation of the patient for
spirometry • Many variables may affect the test - before
it, the patient should avoid:
– Smoking for 24 hours
– Drinking alcohol for at least four hours
– Vigorous exercise for at least 30 minutes.
– Wearing any tight clothing.
– Eating a large meal for at least two hours.
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Cont…
– Taking short-acting bronchodilators for four
hours.
– Taking long-acting beta-2-agonist inhalers for
12 hours – Taking slow-release medicines that affect
respiratory function, and theophylline-based
drugs for 24 hours
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Procedure to use a Spirometer
• The patient should be seated in a chair with
arms.
• Two relaxed measurements of vital capacity
should be performed first, (the patient shoulduse nose clips for this procedure to prevent air
leakage from the nose), followed by three forced
vital capacity measurements.
• A large breath to full inspiration is taken through
mouth.
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Cont…
• The mouthpiece is placed into the patient’s
mouth and the patient is asked to place his
or her lips and teeth around the
mouthpiece to form a tight seal.
• For the relaxed VC, the patient breathes
out at a comfortable speed, but for the
FVC the patient should breathe out hardand quickly until all air is expelled.
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Cont…
• The FVC should take 6s, but in some
patients with obstructive breathing
patterns it can take up to 15s.
• At least 30s should be left between blows
(exhalations using the spirometer) to
enable the patient to recover.
• A minimum of three and a maximum of
eight blows should be attempted at any
one time.
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Technique of spirometer test
1. FORCED VITAL CAPACITY (FVC)
2. SLOW VITAL CAPACITY (SVC)
3. MAXIMAL VOLUNTARY VENTILATION(MVV)
4. MINUTE VOLUME (MV)
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FORCED VITAL CAPACITY
(FVC)• FORCED VITAL CAPACITY (FVC) which
is a vital capacity and measurements are
taken as quickly as possible.
• FVC is the total amount of air that can
forcibly be expired as quickly as possible
after taking the deepest possible breath.
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SLOW VITAL CAPACITY (SVC)
• This test resembles the FVC.
• The difference is that the expiration in the
spirometer is done slowly.
• The patient inspires fully and than slowly
expires all the air in his lungs (Inspiratory
Vital Capacity) or the other way around:
the patient expires fully and inspires slowly
to a maximum (Expiratory Vital Capacity).
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VENTILATION (MVV)
• MVV is a measure of the maximum
amount of air that can be breathed in and
blown out over a sustained interval, such
as 15 or 20 seconds.
• This is no longer a very common test as it
can be dangerous for some people.
• Sometimes the MVV is still done in
athletes.
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Volume graph of spirometer
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Graph FVC
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Graph SVC
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Graph MVV
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Interpretation of volume graph
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NORMAL SPIROMETRY
A normal flow-volume loop
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A normal volume-time loop
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• A normal Flow-Volume loop begins on the X-axis
(Volume axis): at the start of the test both flow and
volume are equal to zero. After the starting point the
curve rapidly mounts to a peak: Peak (Expiratory) Flow.• After the PEF the curve descends (=the flow diminishes)
as more air is expired. A normal, non-pathological F/V
loop will descend in a straight or a convex line from top
(PEF) to bottom (FVC).• The forced inspiration that follows the forced expiration
has roughly the same morphology, but the PIF (Peak
Inspiratory Flow) is not as distinct as PEF.
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Obstructive Lung Disease
Flow-volume in obstructive lung disease:
is concave, FEF25-75 too low, FVC normal
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• In patients with obstructive lung disease,
the small airways are partially obstructed
by a pathological condition. The most
common forms are asthma and COPD.
• A patient with obstructive lung disease
typically has a concave F/V loop.
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Pneumotach Sensors
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Explain the function of a
Pneumotachograph
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State the types of
Pneumotachograph.
xp a n e a r ow
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xp a n e a r owmeasurement of a
Pneumotachograph
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A man undergoing whole body
plethysmography
E l i h f i f
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Explain the function of a
Plethysmograph
St t th t f
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State the types of
Pleythysmograph
E l i th d t
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Explain the procedure to use a
Plethysmograph.
D ib th t f l
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Describe the types of lung
capacity
D ib th t ’ l l
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Describe the type’s lung volume
in the respiratory diagnosis.
St t th f t ff ti th
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State the factors affecting the
measurement of respiratory
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• Explain the function of respiratory
equipment.
• a. Ventilator
• b. Nebulizer
• c. Ambu Bag
• d. Oxygen concentrator• e. Oxygen Flow meter
• f. Apnea alarm
• g. Humidifier
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