Respiratory System Physiology

RCP 350: Applied Anatomy and Physiology

Case Study: Respiratory System Physiology

A 79-year-old Caucasian male who is 6 foot tall and weighs 150 pounds presents to emergency room with complaints of a reoccurring cough, chest tightness, dyspnea, coughing up a lot of thick secretions, and fatigue during and exertion and at rest. He says he thinks he has a lower respiratory tract infection because he gets those several times a year. The patient reports that he has never smoked cigarettes or used other tobacco products. The patient reports that he is regularly seen by his internal medicine physician to manage a history recurring pleural effusions.

Assessment reveals that he has a fever of 101.6 F O. His respiratory rate is 30 breaths per minute, labored and shallow. Auscultation of his chest reveals that he has coarse crackles in the inferior lobe of his left lung and both the middle and inferior lobes of his right lung.

A chest X-ray is obtained and reveals diffuse patchy infiltrates with consolidation developing bilaterally in the lower lobes. A sputum sample is collected for culture. Analysis of the sputum culture reveals the presence of Haemophilus influenzae. A complete blood count (CBC) with a white blood cell (WBC) differential was drawn and analyzed. Results revealed a normal red blood cell (RBC) count, hemoglobin and hematocrit, normal platelet count, and elevated leukocytes with elevated neutrophils.

The ER physician makes a diagnosis of pneumonia and bronchiectasis.

Instructions:

Answer the following questions, ensuring that you:

• Type each question before each of your answers.
• Use complete sentences and paragraphs, when appropriate
• Cite the textbook name, textbook edition, textbook author, and page numbers for any resources that you use.
• Cite the URL for any web-based used as a reference

Case-Study Questions:

1. Describe how the airways would be specifically affected, as applicable to this patient’s diagnosis.
   • Consider the full scenario, describing each area, the impact, and why that would be evident.

1. Describe the relevance of this patient’s documented respiratory rate.
   • Ensure to include the following, as applicable to:
     1. the acceptable range in breaths per minute for this patient’s age
     2. factors that may be influencing the patient’s respiratory rate
     3. potential effects on patient’s alveolar ventilation

1. Explain the effects of the patient’s ventilation processes.
   • Ensure to include the following, as applicable:
     1. potential effects on patient’s alveolar ventilation
     2. ventilatory parameters that may be affected, as applicable to acceptable range for each parameter
     3. the clinical significance of abnormal parameters

1. Explain the impact on the processes of respiration.
   • Ensure to include the following, as applicable to the patient’s diagnosis:
     1. Effects on gas exchange
     2. Diffusion of gases across the alveolar-capillary membrane

1. Would this patient have more difficulty with inhaling or with exhaling? Ensure to provide the rationale for your answer.

1. Describe how the progression of this disease may affect each of the following:
   • lung compliance, as applicable to distention and recoil of lung tissue
   • airway resistance
   • work-of-breathing
   • alveolar inflation

1. Explain the thoracic skeletal muscles potential affected by this patient’s condition. Ensure to include specific examples.

1. Identify the pulmonary volumes and capacities that may be affected by this patient’s condition. Ensure to include how these volumes and capacities may be affected by the diagnosis given. Ensure to include:
   • the average value for each parameter
   • the predicted values for this patient for tidal volume and vital capacity
   • How would these results impact the patient’s pulmonary reserves volumes?
2. What would be expected impact on parameters that reflect the patient’s oxygenation status to include PaO2, SaO2, and/or SpO2, and why?

1. Describe how this patient’s condition may manifest, applicable to his nail beds. Ensure to include why this clinical manifestation may present.

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RCP 350: Respiratory System Case Study: Revised 10/2023

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