Respiration and Temperature PDF

## Respiration **External respiration:** - uptake of O₂ and excretion of CO₂ - O₂ diffuses from alveoli into lungs and passes through blood - O₂ diffuses from blood into alveoli for exhalation **Internal respiration:** - O₂ diffuses from blood...

## Respiration **External respiration:** - uptake of O₂ and excretion of CO₂ - O₂ diffuses from alveoli into lungs and passes through blood - O₂ diffuses from blood into alveoli for exhalation **Internal respiration:** - O₂ diffuses from blood to cells - CO₂ diffuses from cells through peripheral capillaries to the blood for exhalation Breathing is involuntary and is controlled by the brainstem. It includes inhalation (air enters lungs) and exhalation (expiration) (air leaves from lungs to atmosphere). ### Types of breathing: - **Thoracic breathing:** common in females - **Diaphragmatic (abdominal) breathing:** common in males ### Factors affecting breathing: - **Age:** decreases respiration rate - **Exercise:** it increases respiration rate and depth - **Acute pain:** alters rhythm and rate, breathing becomes shallow - **Stress:** increases rate - **Environment:** increases rate, high altitude, increases rate - **Medications:** supine position, smoking, sedentary job - **Lifestyle:** chronic smoking leads to increased rate at rest ## Respiration assessment: - **Respiratory rate/frequency:** - number of breaths per minute - **Eupnea (Normopnea):** 12-20 breaths per minute at rest - **Bradypnoea:** < 12 breaths/min - **Tachypnoea (Polypnoea):** > 20 breaths/min - **Apnoea:** absence of breathing (temporary/prolonged) - **Respiratory rate:** - **Infants:** 35-40 breaths/min - **Toddler:** 30-35 - **Pre-school:** 20-25 - **School:** 15-20 - **Adult:** 12-20 - **Respiratory depth:** - It can be assessed by watching the movement of chest and abdomen - It can be normal, deep or shallow - **Normal depth:** 500 ml of air inhalation (tidal volume) - **Deep & Hyperventilation (Hyperpnoea):** full expansion of lungs during exhalation with larger tidal volume and doesn't necessarily need rapid breathing. - **Shallow (Hypoventilation/Hypopnea):** small quantity of air passes through lungs, and breathing movement is difficult to observe - **Rapid breathing (Tachypnea)** can be shallow and may not ensure proper ventilation, leading to hypoventilation. - **Respiratory rhythm:** - Shows regularity of inhalation-exhalation - Can be regular or irregular - **Respiratory effort:** - Amount of work required to breath (should be effortless). ## Abnormal respiratory functions/patterns: - **Cheyne-Stokes:** - Tidal volume starts shallow and gets deeper, then again shallow followed by periods of apnoea which lasts up to 30 s or longer. - Can indicate severe heart failure, brain damage, strokes, respiratory damage. - **Biot's Respiration:** - Have no pattern, irregular breathing with various tidal volume (depth) and random apnoeas - Can indicate central nervous system disorders - **Kussmaul (Extreme air hunger):** - Abnormally deep, loud, rapid labored breathing - Indicates advanced kidney failure, metabolic disorders e.g. diabetic coma - **Dyspnoea:** - Sensation of shortness of breath and using chest and neck muscles to assist. - Indicated lung/heart diseases, spasmed dyspnoea (asthma) - **Shallow:** - Reduced chest movement - Indicates pain, lung inflammation, drug overdose, anesthesia - **Agonal:** - Present when body makes final attempts to recover itself, when for e.g. a patient dies - Gasping breaths which are ineffective in circulating air. ## Respiration measurement: - Watching chest/abdomen movement - Palpating chest - Listening to breath sounds - Monitoring respiration electronically. ## Body temperature: - Is the result of heat produced and lost from the body. - Their balance means stable body temperature, which is maintained by thermoregulation mechanisms (nervous - endocrine) and specifically, the thermoregulatory center in hypothalamus by releasing heat and breathing ### Factors affecting body temperature: - **Age:** - Infants and children have immature thermoregulation, making them sensitive to extreme temperature changes. - Elderly have a decreased thermoregulation system, increasing risk of hypothermia due to less fat, slower metabolism, decreased vasomotor control, inactivity. - **Daytime:** - **Morning (4-6 am):** lowest body temperature, also considered T minimum. - **Evening (4-6 pm):** highest BT. - **Throughout the day, BT fluctuates by 2°C** due to basal metabolism and activity. - **Physical activity:** increases metabolism, heat production and hence BT - **Hormones:** - **Progesterone in women slightly raises BT during ovulation** - **Thyroid and adrenal hormones increase metabolic rate and BT** - **Environment:** heat exposure increases BT - **Pathology:** - Inflammation, tumor increases BT - Major bleeding shock decreases BT ## Body temperature assessment: - **Normal BT:** 36°C - 36.9°C (afebrile person) - **36°C:** hypothermia, subnormal - **37-37.9°C:** Increased BT, subfebrile - **38-38.8°C:** Mild fever (pyrexia) - **38.9-39.9°C:** Central fever - **> 40°C:** High fever (hyperpyrexia) ## Phases of body temperature: - **Rise:** Smooth, slight fatigue (or sudden), strong chills, fever - **Duration:** Temperature remains elevated - **Fall:** - Can be critical (rapid decrease within hours) - Can be lytic (gradual decrease over time) ## Body temperature measurement: - **Axillary:** least accurate - **Oral:** 0.3°C higher than axillary - **Skin (forehead):** - **Tympanic:** - **Rectal:** 0.5°C higher than axillary, most accurate (not after surgery). - **Temporal (over temporal artery):** non-invasive - **Vaginal:** - **Oral and rectal measurements are higher because bulb of thermometer is in contact with mucous membrane.** - **Rectal is higher than oral because of the seal created by anal sphincter, which decreases contact with environmental air.** - **This value should be subtracted from taken temperature.** ## Types of thermometers: - **Digital electronic thermometers:** - Most commonly used today - Fast, accurate - Display temperature on an LED screen - Have batteries - **Digital tympanic thermometer:** - **Digital forehead contact/non-contact thermometer:** - **Digital temporary artery thermometer:** - **Chemical forehead thermometer:** - **Glass/plastic mercury thermometer:** - They have been eliminated from healthcare facilities due to the bizarre/environmental hazards of mercury.