Thank you Margie and the Norwalk
Hospital for letting me share this valuable information
with others. I know its help me tremendously.
The Respiratory System General Principles
The lungs are two cone-shaped organs located
within the chest. The main function of the lungs is
to supply oxygen to the body and to remove carbon dioxide
(used air) from the blood. This function is also known
as gas exchange. Every day the lungs move enough air
to fill an Olympic size swimming pool!
Oxygen (also known as O2) is a gas found in the air
we breath in (inhale). Your body requires oxygen to
do much of its work. In other words, oxygen is necessary
for survival. Carbon dioxide (also known as C)2) is
a gas produced in the body as a waste product of the
work it does and is found in the air we breath out (exhale).
How the process works
Air enters the body through the nose and
mouth. When we breath in through the nose, three things
happen:
- Tiny hairs that line the nose and
nasal cavity trap dirt and fine particles;
- Special mucus cells moisten or humidify
the air.
- Then air is warmed to body temperature.
All of these things happen before the
air ever enters the lungs. Then… from the nose,
air travels down the trachea (windpipe). The trachea
splits into two large airways known as bronchi –
each going into a lung. Each of these bronchi continue
to divide into smaller airways known as bronchioles.
Think of your lungs as an upside down tree of sorts
with smaller and smaller branches. There are over 700,000
branches in your lungs.
Then smallest airways are very small in
size and lead to tiny air sacs known as alveoli there
are about 300 million alveoli in a pair of healthy lungs.
The alveoli may be thought of as clusters of berries
at the end of the tree branches.
Now What?
Each air sac or alveolus is surrounded
by a group of blood vessels known as capillaries. There
are about 1 billion of these capillaries in the healthy
lung. To give you an idea of how large this area is:
if you were to flatten out the area of gas exchange
(where the alveoli and capillaries come in contact),
it would cover the size of a tennis court!
Back to gas exchange
Oxygen moves form the air sacs into the
capillaries and attaches to hemoglobin in the red blood
cells. A small amount dissolves in the liquid part of
the blood. From there it is sent to the heart and on
to the rest of the body. Oxygen is used by the cells
of the body in chemical reactions. These chemical reactions
produce energy-energy to eat, sleep, exercise, and so
on.
As this process is going on, carbon dioxide
is produced as a waste product of the chemical reactions.
It (carbon dioxide) attaches to the red blood cells
for transport back to the lungs. Carbon dioxide then
leaves the capillaries, goes to the air sacs or alveoli.
As we exhale it passes up through the bronchioles, bronchi,
trachea and finally out the nose or mouth.
Restrictive Lung Disease
Restrictive lung disease is actually a
group of conditions where there is a restriction to
breathing in The person with restrictive lung disease
has difficulty getting air into the lungs and usually
has to breathe more rapidly.
There are several conditions that contribute
to restrictive lung disease one of them is scarring,
fibrosis from known and unknown cases.
Diagnostic Tests
There are several tests the doctor may
order to obtain more information about your lungs. Two
of these tests are pulmonary function tests (also known
as PFTs) and arterial blood gases (also known as ABGs).
Pulmonary Function Tests
Pulmonary function tests (PFTs) are a
group of tests with measure several characteristics
and abilities of your pulmonary or respiratory system
(your lungs). The results of your tests are compared
to values that are considered normal for your height,
weight, age, gender and race. Your physician can use
this information to help determine what type of lung
problems you have, how were your problem is and whether
or not certain medications will helpful in treating
you.
Spirometry (one type of pulmonary functions
test or PFT)
Measures the about and rate at which you
can breath air, particularly the amount you can breathe
out. Most often, you’re asked to inhale or fill
up your lungs completely and then blow out into a mouthpiece
as hard, fast and completely as possible.
Another type of PFT that may be done
in the hospital or at home is the peak flow. Basically,
you blow as hard as you can into a tube like device
called a peak flow meter. This measures how fast you
can exhale and is sometimes helpful in evaluating you
response to inhaled medications. Many people with asthma
monitor their peak flow several times a day with a home
peak low meter. Other types of pulmonary function tests
may be done in the pulmonary function laboratory.
Arterial Blood Gas
An
arterial blood gas (ABG) is a measurement of how well
your lungs are exchanging gas, namely oxygen and carbon
dioxide. When a ABG is ordered by the doctor, a sample
of blood is drawn by puncturing one of you arteries
(usually in your wrist). The blood is analyzed using
a special machine. Information is then obtained on the
amount of oxygen and carbon dioxide found in your blood.
Additionally, oxygen saturated of the amount of oxygen
presently in the blood a s compared to how much oxygen
could be carried is also determined by an ABG.
Emphysema, chronic bronchitis or acute
asthmas can change the values normally found. Results
form an ABG are useful in giving information about the
functioning of the lungs and how much, if any, extra
oxygen to give you.
Pulse Oximetry
 When
only information on oxygen saturation is needed, it
may be obtained by a special device known as a pulse
oximeter. An ear, finger or forehead probe is placed
and measures your oxygen saturation my measuring light
waves. An added bonus-no arterial puncture is needed
(no pain!). If interested in one you can find them on
Ebay, their around $225.00
Additional tests
Other tests which may be done to determine
your medical and pulmonary (lung) condition include
chest x-rays, scans, EKG (electrocardiogram-to measure
how your heart is beating), special exercise tolerance
tests, bronchoscopy and sleep studies.
Breathing Retraining
I’ve been breathing all my life,
so why do I need to retrain? One reason for breathing
retraining is to combat some of the distressing and
disabling shortness of breath that occurs with chronic
lung disease – the shortness of breath that my
interfere with your ability to walk any distance, climb
stairs, take a shower.
Some Basics
Normally, your diaphragm does about 80%
of the work to get air into the lungs. The other breathing
muscles in between the ribs do less of the work. Finally,
muscles in the neck and shoulders can also be used to
pull air into the lungs. In the healthy person, these
muscles are only used under conditions of extreme physical
exertion (like, running the hundred-yard dash in record
time). Also, for the person with healthy lungs, exhalation
(breathing out) is considered passive-requiring very
little energy.
The person with COPD and other chronic
lung conditions may have several problems with using
the breathing muscles efficiently. The diaphragm may
not be as strong. The shape of the chest may change.
Air trapping may be a problem because of airway and
alveolar (air sac) changes. Additionally, the muscle
fibers themselves might not work as efficiently as they
one did. You start to rely more on the intercostals
and neck and shoulder muscles (also called the accessory
muscles) rather than the diaphragm. Exhalation becomes
more active-requiring more energy and more oxygen.
All of the changes combine to make breathing
more work. To put it in perspective: healthy people
without lung disease use about 5% of their energy for
breathing. People with lung disease may use 30% or more
of their energy just to breathe. With any increase in
activity, the energy needed to breathe increases even
more. The end result is increased shortness of breath
with exertion.
People with restrictive lung conditions
have difficulty getting air into the lungs.
So the goal of breathing retraining is to make your
breathing muscles work more efficiently and to help
remove trapped air form your lungs. The ultimate goal
is you’ll have more energy.
Breathing Exercises
Exercise
1: Pursed Lip Breathing:
Exercise
2: A Method Of Diaphragm Breathing
Exercise
3: Expanding your lower Chest
Additional Information
 Energy
Conservation Information
Emotional
Health Information
Physical
Reconditioning Information
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