Cari’s Story

Question A: How could an infection in Cari’s nasal passages and pharynx spread into her sinuses? The infection will spread into her sinuses because the pharynx, sinuses, larynx, and trachea are all connected and the infection is prone to spread to the surrounding areas if not treated in a timely manner. Question B: What is the cough reflex? Describe the process that Cari’s respiratory system is using to clear her lungs by coughing.

The cough reflex is a long and deep inhalation followed by the closing of the glottis, this causes a strong exhalation that pushes the glottis open and sends air through the respiratory passages. Stimulus for the reflex could be a foreign body in the larynx, trachea, or epiglottis. Cari’s body in is causing the cough reflex due to mucus and fluid buildup in her lungs. Question C: Which structures found in the terminal bronchioles and alveoli normally would protect Cari’s lungs from infectious pathogens and particulate matter?

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Alveolar macrophage protects Cari’s lungs by wondering around the alveoli spacing collecting dust particles and debris. Because Cari is a smoker this has caused the cilia in her respiratory passages to become paralyzed and secrete excess amounts of mucus, macrophages are being sent to her lungs continuously and is getting stuck in the mucus instead of fighting off the pathogens. Question D: How would the resistance of Cari’s airways be affected by excess mucus and fluid in her lung?

Cari is having issues with getting adequate oxygen by the pressure of fluid and mucus buildup in her lungs by not allowing her lungs to fully expand to get the quality of breath her body needs. Question E: How would Cari’s lung compliance (the effort required to expand the lungs) be altered as her alveoli fill with fluid due to pneumonia?

Cari would have to enforce more effort to get a full breath because the fluid buildup is causing pressure and is also blocking oxygen from dispersing to the appropriate areas. Question F: How would fluid in Cari’s lungs affect her total lung capacity?

Cari’s total lung capacity would be affected because the fluid buildup is not allowing the oxygen to get through the lungs. Question G: How does the elevation of Cari’s respiratory rate alter her minute ventilation?

Increasing her respiratory rate will increase the minute ventilation; this means Cari is taking in more breaths than needed causing her to hyperventilate (taking in more oxygen) and in turn cause hypocapnia (too little carbon dioxide). This will cause her blood gas levels to become unbalance and her body to become a hostile environment. Question H: Normal blood oxygen saturation levels are great than 94%; Cari’s blood oxygen saturation level was 90% at the time of her exam and an initial arterial blood gas analysis done when she was admitted to the hospital revealed her arterial PO2 was 54mm Hg. How do these clinical findings relate to the internal respiration in Cari’s body?

Because normal ranges of PO2 should be between 80-100 mm Hg and a normal O2 saturation level should be above 94% this means that the body is experiencing an unbalanced blood gas level and is becoming acidic. Internal respiration is the gas exchange between tissues in the body; this is not working properly causing the body to experience ketoacidosis. Question I: Which of the symptoms Cari’s has described are due to lack of oxygen and reduce oxygen exchange at her tissues?

Cari’s symptoms that are related to lack of oxygen are Shortness of breath, her chest feeling heavy and mucus build up with a cough. Question J: As Cari’s PCO2 rose, how was the oxygen-carrying capacity of hemoglobin affected?

Because the PCO2 levels are too high the body is not getting the adequate amount of oxygen. This means the oxygen-carrying hemoglobin is not working properly do to the excessive amounts carbon dioxide causing respiratory acidosis. Question K: How would you have expected Cari’s deceased Pco2 and alkaline blood pH to have affected her breathing?

The decrease in her PCO2 and pH will cause her central nervous system to slow down causing her breathing to slow down to try to give her body more carbon dioxide to level out the amount of oxygen/carbon dioxide ratio. Question L: How would administration of oxygen enhance Cari’s central drive to breathe?

Giving Cari proper steady flow oxygen will keep her body from working hard to get the amount of oxygen it needs. This will soon help level her out to get the proper oxygen/carbon dioxide ratio. Question M: Which anatomical structures in Cari’s respiratory system were initially involved?

The initial structures that were involved were the nasal passage, sinuses, throat, and pharynx. Question N: Why was Cari plagued with chronic smoker’s cough? Because Cari is a smoker this has caused the cilia in her respiratory passages to become paralyzed and secrete excess amounts of mucus that need to be expelled, leading to the smoker’s cough. Question O: Which damaging effects of tobacco smoke led to Cari’s impaired respiratory defense mechanisms?

Alveolar macrophage protects Cari’s lungs by wondering around the alveoli spacing collecting dust particles and debris. Because Cari is a smoker this has caused the cilia in her respiratory passages to become paralyzed and secrete excess amounts of mucus, macrophages are being sent to her lungs continuously and is getting stuck in the mucus instead of fighting off the pathogens. Question P: How did pneumonia affect Cari’s lung function?

Cari was having issues with getting adequate oxygen by the pressure of fluid and mucus buildup in her lungs by not allowing her lungs to fully expand to get the quality of breath her body needs.

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