环境管理体系肺讲座-英文课件

Pathophysiology
• Coagulopathies
– – – – Hemophilia Thrombocytopenia Anticoagulants Thrombolytics
Clinical Features
• History
– – – – – – – – – Fever Sputum Weight loss Night sweats Vitals NasalCavity and oropharynx Murmurs Clubbing Rales vs Rhonchi
EMS Pulmonary Lecture
Mike MD, MPH
Outline
• • • • • Anatomy Physiology Airway Management Medical Management Trauma Management
Epidemiology
• • • • • • 25% Infectious 5% Tb 28 % Neoplasia 13 % Multiple or miscellaneous 28 % Undetermined Risk Factors – Marlboro Man +/- horse
• • • • • • Airway Cardiac Lung Thoracic Cavity Vascular Neuromuscular
Respiratory Distress
• O2
– Hypoxia – Hypoxemia – Relative Hypoxemia
• CO2
– Acute – Chronic
Infections
• Bronchitis • Pneumonia • Tuberculosis
Hemoptysis
• Dual Blood Supply • Mechanisms
– Intravascular – Inflammatory – Coagulation
Pathophysiology
Respiratory Tract Anatomy
Respiratory Mechanics
Pressure and Volume PV=nRT PV=1
As pressure increases, volume decreases As volume increases, pressure decreases
• Physical Examination
Diagnostic Approach
• Confirm Location
– Pseudo, GI or pulmonary
• Urgent Bronchoscopy • CXR
– Neoplasia – 20-30% normal
• Chest CT
– Neoplasia vs bronchiectasis
• Intravascular
– LV CHF – Mitral Valve Stenosis – Rheumatic Heart Disease
Pathophysiology
• Inflammatory
– – – – – – – – – Bronchitis Bronchiectasis Mycetoma FB PE Pneumonia Neoplasia TB Vasculitidies
Respiratory Mechanics
• Surface Tension
Respiratory Mechanics
• Compliance
Respiratory Mechanics
• Gas Exchange • Oxygen TranspoБайду номын сангаасt
– Dissolved – Bound
• pH • O2 • Temperature
Respiratory Mechanics
• • • • • • Pressure Volume Adhesion Compliance Surface Tension Gas Exchange
Respiratory Mechanics
• Adhesion
– Parietal – Visceral – Pleural Fluid
Treatment
• • • • Identify history of Tb or COPD Decubitus Position Intubation with large ETT Mainstem Bronchus intubation
Asthma in Adults
Airway Resistance
• R=8nL/R 4 • Cross-sectional Area • Dynamic
Respiratory Cycle
Respiratory Control
• Mechanoreceptors
– Inflation – Deflation
• Chemoreceptors
– pH – PCO2 – PO2
Respiratory Distress
• • • • Dyspnea Orthopnea PND Cyanosis
– Central – Peripheral
• Lung Sounds PT 630 - Breath Sounds
Respiratory Distress
Functions of Respiratory System
• • • • Moves Air Communication Non-specific Immunity Acid/Base
Respiratory Tract Anatomy
• Conducting
– – – – Nose/Mouth Nasopharynx/Oropharnyx Laryngopharynx Trachea
Respiratory Tract Anatomy
• Conducting
– – – – Trachea Bronchus Bronchiole Terminal Bronchiole
Respiratory Tract Anatomy
• Respiration
– Alveolar ducts – Alveoli