1. What physical findings might be indicative of a patient with emphysema? Extended expiration’s are always a finding in patients with emphysema, along with dyspnea on exertion (McCance & Heuther, 2014). Patients often present with a “barrel” chested appearance and seen leaning forward with arms resting on knees, this increases lung capacity for these types of patients (McCance & Heuther, 2014). Patients with emphysema do not often present with wheezing or cyanosis (McCance & Heuther, 2014). A productive cough may be exhibited in patients with emphysema in the later stages if there is infection present (McCance & Heuther, 2014).
2. What is the purpose and interpretations of the pulmonary function test? The purpose of a pulmonary function test is to see how well the lungs are working. The test is a non-invasive procedure that is performed using a spirometer or inside an airtight box called plethysmography (“Pulmonary Function,” n.d.). Pulmonary function tests measure the following: Tidal volume (TV)-the amount of air inhaled or exhaled during normal breathing; Minute volume (MV)-the total amount of air exhaled per minute; Vital capacity (VC)-the total volume of air that can be exhaled after inhaling as much as you can; Functional residual capacity (FRC)-the amount of air left in lungs after exhaling normally; Residual volume-the amount of air left in the lungs after exhaling as much as you can; Total lung capacity-the total volume of the lungs when filled with as much air as possible; Forced vital capacity (FVC)-the amount of air exhaled forcefully and quickly after inhaling as much as you can; Forced expiratory volume (FEV)-the amount of air expired during the first, second, and third seconds of the FVC test; Forced expiratory flow (FEF)-the average rate of flow during the middle half of the FVC test; Peak expiratory flow rate (PEFR)-the fastest rate that you can force air out of your lungs (“Pulmonary Function,” n.d.).
3. What are the pathophysiological findings specifying emphysema? The alveoli of the lungs become weakened or rupture which traps the air needing exhaled into larger air sacs, making it difficult to have effective gas exchange (McCance & Heuther, 2014). Hypoventilation and hypercapnia are results of air trapping (McCance & Heuther, 2014).
4. What are the three functions of the respiratory center located in the brain stem? The Dorsal Respiratory Group-sends outward impulses to the diaphragm and inspiratory muscles (McCance & Heuther, 2014, p. 1233). The Ventral Respiratory Group-contains neurons that become active when increased respiratory activity is required (McCance & Heuther, 2014, p. 1233). The Pneumotaxic Center & the Apneustic Center-modify the depth along with the rate and can be influenced by emotion and disease (McCance & Heuther, 2014, p. 1233).
5. Please provide a description of the oxyhemoglobin dissociation curve? The oxyhemoglobin dissociation curve refers to when the hemoglobin saturation and desaturation are plotted on a graph it shows a curve (McCance & Heuther, 2014). Hemoglobin molecules that bind with oxygen are called oxyhemoglobin, this bind occurs in the lungs and is referred to as saturation (McCance & Heuther, 2014). When oxygen is released from the hemoglobin, this is called desaturation and occurs at the cellular level (McCance & Heuther, 2014, p. 1242).
6. What are the pathophysiological findings specifying bronchitis? Bronchitis is an inflammation of the airways or bronchi (McCance & Heuther, 2014). There are two categories of bronchitis: acute and chronic. Acute bronchitis is caused by a virus / bacterium (McCance & Heuther, 2014). Acute bronchitis has a non-productive cough and the outbreak is usually aggravated by cold, dry or dusty air (McCance & Heuther, 2014, p.1275). Chronic bronchitis is defined as hypersecretion of mucus and chronic productive cough that continues for three months out of a year, for two consecutive years (McCance & Heuther, 2014, p. 1267). Inhaled irritants cause inflammation in the airway. The inflammation causes edema and mucous globs in the airway epithelium which are very thick and cannot be cleared because of damaged ciliary function (McCance & Heuther, 2014).