Respiration
General Objectives:-
At the end of this lecture the student should be able to demonstrate basic
knowledge related to Respiration and Oxygen Saturation.
Specific Objectives:-
At the end of this lecture the student should be able to:
Identify Respiration.
Mention Purpose of Assessing Respiration.
Discuss Characteristics of Respiration.
List Factors affecting Respiration.
Describe Alternations of Respiration.
Discuss Guidelines when taking Respiration.
Identify Oxygen Saturation.
Outlines:
Definition of Respiration.
Purpose of Assessing Respiration.
Characteristics of Respiration.
Factors affecting Respiration.
Alternations of Respiration.
Guidelines when taking Respiration.
Oxygen Saturation.
Definition:
It‘s an action or process of inhaling and exhaling process, breathing
also called ventilation.
Phases of Respiration:
Two phases of respiration:
1. Inhalation and exhalation:
During inhalation or inspiration, the diaphragm descends and
the lungs expand, causing air containing oxygen to move
from the atmosphere into the lungs.
2. Exhalation, or expiration:
It involves the removal of carbon dioxide from the body.
The diaphragm ascends, and the lungs return to their original
state so that air containing carbon dioxide is expelled.
One complete respiration is composed of one inhalation and
one exhalation.
Mechanism of Respiration:
1. The medulla oblongata, located in the brain, is the control center
for involuntary respiration.
2. A buildup of carbon dioxide in the blood sends a message to the
medulla, which triggers respiration to occur automatically.
3. To a certain extent, respiration is also under voluntary control.
4. An individual can control respiration during activities such as
singing, laughing, talking, eating, and crying.
5. Voluntary respiration:
Is ultimately under the control of the medulla oblongata.
Breath can be held for only a certain length of time, after
which carbon dioxide begins to build up in the body,
resulting in a stimulus to the medulla that causes respiration
to occur involuntarily.
Assessment of Respiration:
Respiratory Rate:
Respiratory rate of the normal healthy adult is ranging from 12 to
20 respirations per minute.
Tachypnea:
An abnormal increase in the respiratory rate of more than 20
respirations per minute.
Bradypnea:
An abnormal decrease in the respiratory rate of less than 12
respirations per minute.
Factors Affecting Respirations:
Factors increase the rate:
1. Increase metabolism. 2. Exercise.
3. Lowered oxygen concentration. 4. Stress.
5. Increased environmental temperature.
Factors decrease respiration rate:
1. Decreased environmental temperature.
2. Certain medications such as narcotics.
3. Increased intra cranial pressure.
Rhythm of Respiration:
Normally the rhythm should be even and regular, and the pauses
between inhalation and exhalation should be equal.
Respiration depth: is generally described asnormal, deep, or shallow.
Deep respiration: large volume of air is inhaled and exhaled, inflated
most of the lungs.
Shallow breathing:involves the exchange of a small volume of air and
often the minimal use of a lung tissue.
Hyperventilation: refers to very deep, rapid respiration.
Hypoventilation: refers to very shallow respirations
Hypopnea: is a condition in which a patient‘s respiration, decrease in
the rate and depth.
Apnea: is a temporary absence of respirations. Apnea can be a serious
condition if the individual‘s breathing ceases for more than 4
to 6 minutes because brain damage or death could occur.
47
Abnormal Respiration:
Dyspnea: It means the patient who is having difficulty breathing or
shortness of breath. Dyspnea may occur normally during
vigorous physical exertion and abnormally in patients with
asthma and emphysema.
Orthopnea: A patient who is having difficulty breathing or shortness of
breath in lying position,occurs with disorders of the heart and
lungs, such as asthma, emphysema, pneumonia, and
congestive heart failure.
Cheyne-stokes:Is the term for cycles of breathing characterized by
deep, rapid breaths for about 30 seconds, followed by
absence of respirations for 10 to 30 seconds.
Cheyne-Stokes respirations constitute a serious symptom
and usually precedes death in cerebral hemorrhage, uremia,
or heart disease.
Kussmaul breathing: Increased rate and depth of respiration above
20bpm.
Abnormal Breathing Sounds:
Stridor:Harsh sound heard during inspirationwith laryngeal obstruction
Stertor:Snoring respiration usually due to a partial obstruction of the
upper airway.
Wheeze:Continuous, high pitched musical sound occurring on
expiration when air moves through narrowed or partially
obstructed air way.
Secretions and Coughing:
Hemoptysis: The presence of blood in the sputum
Productive cough: Cough accompanied by expectorated secretions
Nonproductive cough: A dry, harsh cough without secretions