Question

This concept map asks you to organize the pathophysiology of ventilation and diffusion by mechanism of alteration. Your mapping should include each of the 7 model diseases from your chapter. Please include 1-2 examples of treatment for each disease.

Answer 1

Pathophysiology of Ventilation and Diffusion by mechanism of alteration:

  The Goals of Respiration are to Provide Oxygen to the Tissues and to remove carbon dioxide from them physiologically, to achieve this , respiration divided into four major functional events, they are

- Pulmonary ventilation, which means inflow and out flow of air between atmosphere and lung alveoli,

- Diffusion of O2 and CO2 between the alveoli and Blood,

- Transport of O2 and CO2 in the blood and body fluids to and from the cells,

- Regulation of Ventilation and other facets of Respiration,

Mechanics of Pulmonary ventilation:

1. Muscles helps for Lung expansion and Contraction,

2. Movement of Air in and Out of the lungs and the pressures that cause the movement,

3.Pleural pressures and its changes during respiration,,

4. Alveolar Pressure and Transmural pressure, all these mechanics helps for healthy respiration,

Pathophysiology of Ventilation:

The major aspects of ventilation are Mainly,

1. Disturbances of in Ventilatory function,

2. Disturbances of Pulmonary Corculation,

3. Disturbances in Gas exchange,

Distrubances of Ventilation:

The abnormal ventilation patterns are mainly two, as measured by static Lung volumes and Spirometry,

they are a) Restrictive and b) Obstructive patterns

In the Obstructive pattern, decrease in expiratory flow rates, the ratio FEV1/VC is decreased, TLC is normal or increased,

In the Restrictive pattern decrease in lung volumes primarily TLC and VC,

Disturbances of Pulmonary Circulation:

Assessment of Circulatory function depends on Pulmonary vasculature depends on pulmonary vascular pressures and Cardiac output,

PVR=80(PAP-PCW)/CO,

in pathological conditions Pulmonary arterial and arteriolar vasoconstriction is a prominent response to Hypoxia

Distrbances of Gas exchange:

The partial pressure of carbon dioxide in Paco2 is Directly proportional to the amount of carbon dioxide produced per minute,

Diffussion by Mechanisms of alteration:

Both Oxyzen and carbon dioxide down their respective concentration through the alveolar wall and pulmonary capillary endothelium, Under normal circumstances this above said process rapid and equilbration of both gases, Even in the disease diffusion of gases impaired unlikely to be severe enough, Consequently diffusion abnormality results in arterial hypoxemia.

The abnormality mainly causes ventilation - perfusion mismatch.

Disorders of Ventilation;

They are mainly categorised in to two,

1. Hypoventilation syndromes and

2.Hyperventilation Syndromes,

Hypoventilation Syndromes: They are Acute or Chronic,

The Acute syndromes are a) ARDS ( Acute respiratory Distress syndrome),

b) Hypoxemia and Hypercapnia may lead to diffused alveolar damage ex: Covid-19,

The chronic diseases are a)Asthma and copd,

Mechanism of Hypoventilation disorders: Impaired respiratory drive, Defective Neuro muscular system and impaired ventilatory apparatus.

Hyperventilation Syndromes:

1. Hypoxemia,

2.Pulmonary disorders,

3.Cardiovascular disorders

4.Metabolic Disorders,

5.Neurologic and psychological disorders,

6.Drug Induced,

7. Miscellaneous like fever,sepsis etc The above said 7 models are main disorders of ventilation.

Treatment for Hypoventilation: Identity the patient's particular disease,

- Correct the coexistent Metabolic alkalosis,

-Administration of supplemental oxygen,

-Pharmacological agents like progesterone and methyl xanthines are benefit for some patients,

- implanted phrenic electrode for Neuro system activation,

Treatment for Hyperventilation: a) appropriate treatment for underlying disease,

b)in some pts are having cerebral vasoconstriction,parasthesia,tetany or cardiac disturbances hence acute inhalation of low conc of CO2 is very beneficial,

c) Beta adrenergic antagonista