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Pendelluft
Pendelluft (Derived from the German words for pendulum and air.) refers to the movement of gas between two regions of the lung, usually between regions of differing Compliance (physiology), compliance or airway resistance. Pendelluft is an important physiological concept to take into account during mechanical ventilation, particularly in patients with an open thorax, severe bronchospasm (e.g. asthma or Copd, COPD), or with heterogeneous lung compliance (e.g. ARDS). It was first published as a physiological concept in 1956. Occurrence and consequences of pendelluft An extreme example of pendelluft is found in a spontaneously breathing patient with an Thoracic surgery, open hemithorax or large Flail chest, flail segment. During the inspiratory phase, the contralateral lung (with a closed / intact chest wall) will expand with most of the tidal volume, with the open plura or paradoxical chest wall movement preventing expansion of the ipsilateral lung. However, during the expiratory ph ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Compliance (physiology)
Compliance is the ability of a hollow organ (vessel) to distend and increase volume with increasing transmural pressure or the tendency of a hollow organ to resist recoil toward its original dimensions on application of a distending or compressing force. It is the reciprocal of "elastance", hence elastance is a measure of the tendency of a hollow organ to recoil toward its original dimensions upon removal of a distending or compressing force. Blood vessels The terms elastance and compliance are of particular significance in cardiovascular physiology and respiratory physiology. In compliance, an increase in volume occurs in a vessel when the pressure in that vessel is increased. The tendency of the arteries and veins to stretch in response to pressure has a large effect on perfusion and blood pressure. This physically means that blood vessels with a higher compliance deform easier than lower compliance blood vessels under the same pressure and volume conditions. Venous compl ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Airway Resistance
In respiratory physiology, airway resistance is the resistance of the respiratory tract to airflow during inhalation and exhalation. Airway resistance can be measured using plethysmography. Definition Analogously to Ohm's Law: :R_ = \frac Where: : = P_ - P_A So: :R_ = \frac Where: *R_ = Airway Resistance *P = Pressure Difference driving airflow *P_ = Atmospheric Pressure *P_A = Alveolar Pressure *\dot V = Volumetric Airflow (not minute ventilation which, confusingly, may be represented by the same symbol) N.B. PA and \dot V change constantly during the respiratory cycle. Determinants of airway resistance There are several important determinants of airway resistance including: *The diameter of the airways *Whether airflow is laminar or turbulent Hagen–Poiseuille equation In fluid dynamics, the Hagen–Poiseuille equation is a physical law that gives the pressure drop in a fluid flowing through a long cylindrical pipe. The assumptions of the equation are that the flow is ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Mechanical Ventilation
Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube. For non-invasive ventilation in people who are conscious, face or nasal ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bronchospasm
Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles. It is caused by the release ( degranulation) of substances from mast cells or basophils under the influence of anaphylatoxins. It causes difficulty in breathing which ranges from mild to severe. Bronchospasms occur in asthma, chronic bronchitis and anaphylaxis. Bronchospasms are a possible side effect of some drugs: pilocarpine, beta blockers (used to treat hypertension), a paradoxical result of using LABA drugs (to treat COPD), and other drugs. Bronchospasms can present as a sign of giardiasis. Some factors that contribute to bronchospasm include consuming certain foods, taking certain medicines, allergic responses to insects, and fluctuating hormone levels, particularly in women. Bronchospasms are one of several conditions associated with cold housing. The overactivity of the bronchioles' muscle is a result of exposure to a stimulus which under normal circumstances ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Copd
Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce mucus. COPD progressively worsens, with everyday activities such as walking or dressing becoming difficult. While COPD is incurable, it is preventable and treatable. The two most common conditions of COPD are emphysema and chronic bronchitis and they have been the two classic COPD phenotypes. Emphysema is defined as enlarged airspaces ( alveoli) whose walls have broken down resulting in permanent damage to the lung tissue. Chronic bronchitis is defined as a productive cough that is present for at least three months each year for two years. Both of these conditions can exist without airflow limitation when they are not classed as COPD. Emphysema is just one of the structural abnormalities that can limit airflow and can exist without ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
ARDS
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). For those who survive, a decreased quality of life is common. Causes may include sepsis, pancreatitis, trauma, pneumonia, and aspiration. The underlying mechanism involves diffuse injury to cells which form the barrier of the microscopic air sacs of the lungs, surfactant dysfunction, activation of the immune system, and dysfunction of the body's regulation of blood clotting. In effect, ARDS impairs the lungs' ability to exchange oxygen and carbon dioxide. Adult diagnosis is based on a PaO2/FiO2 ratio (ratio of partial pressure arterial oxygen and fraction of inspired oxygen) of less than 300 mm Hg despite a positive end-expiratory pressure (PEEP) of more than 5 cm H2O. Cardiogenic pulmonary edema, ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pressure Time Waveform
Pressure (symbol: ''p'' or ''P'') is the force applied perpendicular to the surface of an object per unit area over which that force is distributed. Gauge pressure (also spelled ''gage'' pressure)The preferred spelling varies by country and even by industry. Further, both spellings are often used ''within'' a particular industry or country. Industries in British English-speaking countries typically use the "gauge" spelling. is the pressure relative to the ambient pressure. Various units are used to express pressure. Some of these derive from a unit of force divided by a unit of area; the SI unit of pressure, the pascal (Pa), for example, is one newton per square metre (N/m2); similarly, the pound-force per square inch (psi) is the traditional unit of pressure in the imperial and U.S. customary systems. Pressure may also be expressed in terms of standard atmospheric pressure; the atmosphere (atm) is equal to this pressure, and the torr is defined as of this. Manometric unit ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thoracic Surgery
Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart (heart disease), lungs (lung disease), and other pleural or mediastinal structures. In most countries, cardiothoracic surgery is further subspecialized into cardiac surgery (involving the heart and the great vessels) and thoracic surgery (involving the lungs, esophagus, thymus, etc.); the exceptions are the United States, Australia, New Zealand, the United Kingdom, and some European Union countries such as Portugal. Training A cardiac surgery residency typically comprises anywhere from four to six years (or longer) of training to become a fully qualified surgeon. Cardiac surgery training may be combined with thoracic surgery and / or vascular surgery and called cardiovascular (CV) / cardiothoracic (CT) / cardiovascular thoracic (CVT) surgery. Cardiac surgeons may enter a cardiac surgery residency directly from ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Flail Chest
Flail chest is a life-threatening medical condition that occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall. Two of the symptoms of flail chest are chest pain and shortness of breath. It occurs when multiple adjacent ribs are broken in multiple places, separating a segment, so a part of the chest wall moves independently. The number of ribs that must be broken varies by differing definitions: some sources say at least two adjacent ribs are broken in at least two places, some require three or more ribs in two or more places. The flail segment moves in the opposite direction to the rest of the chest wall: because of the ambient pressure in comparison to the pressure inside the lungs, it goes in while the rest of the chest is moving out, and vice versa. This so-called "paradoxical breathing" is painful and increases the work involved in breathing. Flail chest is usually accompanied by a pulmonary contusion, a bruise of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Plura
The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes, and also to create a pressure gradient. The serous membrane that covers the surface of the lung is the visceral pleura and is separated from the outer membrane the parietal pleura by just the film of pleural fluid in the pleural cavity. The visceral pleura follows the fissures of the lung and the root of the lung structures. The parietal pleura is attached to the mediastinum, the upper surface of the diaphragm, and to the inside of the ribcage. Structure In humans, the left and right lungs are completely separated by the mediastinum, and there is no communication between their pleural cavities. Therefore, in cases of a unilateral pneumothorax, the contralateral lung will remain functioning normally unless there is a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pulmonary Alveolus
A pulmonary alveolus (plural: alveoli, from Latin ''alveolus'', "little cavity"), also known as an air sac or air space, is one of millions of hollow, distensible cup-shaped cavities in the lungs where oxygen Molecular diffusion#Biology, is exchanged for carbon dioxide. Alveoli make up the functional tissue of the mammalian lungs known as the lung parenchyma, which takes up 90 percent of the total lung volume. Alveoli are first located in the respiratory bronchioles that mark the beginning of the respiratory zone. They are located sparsely in these bronchioles, line the walls of the alveolar ducts, and are more numerous in the blind-ended alveolar sacs. The Pulmonary acinus, acini are the basic units of respiration, with gas exchange taking place in all the alveoli present. The alveolar membrane is the gas exchange surface, surrounded by a network of capillary, capillaries. Across the membrane oxygen is Diffusion#Diffusion vs. bulk flow, diffused into the capillaries and carbon ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Ventilation/perfusion Ratio
In respiratory physiology, the ventilation/perfusion ratio (V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching of two variables: * V – ventilation – the air that reaches the alveoli * Q – perfusion – the blood that reaches the alveoli via the capillaries The V/Q ratio can therefore be defined as the ratio of the amount of air reaching the alveoli per minute to the amount of blood reaching the alveoli per minute—a ratio of volumetric flow rates. These two variables, V and Q, constitute the main determinants of the blood oxygen (O2) and carbon dioxide (CO2) concentration. The V/Q ratio can be measured with a ventilation/perfusion scan. A V/Q mismatch can cause Type 1 respiratory failure. Physiology Ideally, the oxygen provided via ventilation would be just enough to saturate the blood fully. In the typical adult, 1 litre of blood can hold about 200 mL of oxygen; 1 litre of dry air has about 210 mL of oxygen. Therefore, under these conditio ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
