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physiology & pathophysiology of respiration, mvdr i
uhrikova phd
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physiology – what is essential for breathing?
1.pulmonary ventilation (athmosphere – alveoli)
2.diffusion (alveoli – blood)3.transport of gases (blood –
tissues)4.(regulation)
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what is essential for breathing
1. pulmonary ventilation (athmosphere – alveoli)– muscles – pressure in thoracic cavity – lung compliance– thorax compliance– pulmonary volume– alveolar ventilation
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impaired pulmonary ventilation
PLEURAL EFFUSION•normally 0.1-0.3 ml/kg of fluid•communication between left & right pleural space (?)
•inflammatory vs non-inflammatory effusion
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impaired pulmonary ventilation
PLEURAL EFFUSION•normally 0.1-0.3 ml/kg of fluid•communication between left & right pleural space (?)
•inflammatory vs non-inflammatory effusion
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impaired pulmonary ventilation
PLEURAL EFFUSION•normally 0.1-0.3 ml/kg of fluid•communication between left & right pleural space (?)
•inflammatory vs non-inflammatory effusion
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impaired pulmonary ventilation
PLEURAL EFFUSION•normally 0.1-0.3 ml/kg of fluid•communication between left & right pleural space (?)
•inflammatory vs non-inflammatory effusion
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impaired pulmonary ventilation
PLEURAL EFFUSION•normally 0.1-0.3 ml/kg of fluid•communication between left & right pleural space (?)
•inflammatory vs non-inflammatory effusion
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impaired pulmonary ventilation
PLEURAL EFFUSION•transudate•modified transudate
•hemorrhage•bile•chyle•septic exudate (pyothorax)•aseptic exudate (neoplasia, FIP)
¼ Hct
Bie>Bis
milky
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what is essential for breathing
2. diffusion (alveoli - blood)– composition of gases in alveoli– diffusion capacity of the alveolar
membrane– pressure of blood in the pulmonary
vessels– amount of the blood in systemic vs
pulmonary circulation– distribution of the blood according to
ventilation
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impaired diffusion
PULMONARY EMBOLISM
•fq of small emboli probably high•arise from deep vein thrombosis of the lower extremities
•mechanism in thrombi formation:– stasis of blood– alteration in coagulation– alteration of vessel wall
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impaired diffusion
PULMONARY EMBOLISM
•most commonly cardiomyopathy in cats•heartworm disease in dogs
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impaired diffusion
PULMONARY EMBOLISM
•pulmonary hemodynamics:thrombi + reflective vasoconstriction increase in pulmonary artery pressure
right-ventricle heart failure(pulmonary oedema) obstruction
of at least ½ of
pulmonary circulation
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impaired diffusion
PULMONARY EMBOLISM
•pulmonary mechanics:decreased alveolar pCO2
bronchoconstriction + alveolar duct constriciton
increase in pulmonary resistance
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impaired diffusion
PULMONARY EMBOLISM
•gas exchange:ventilation-perfusion inhomogeneity
increased dead space
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impaired diffusion
PULMONARY EDEMA
•accumulation of fluid in extravascular tissue•two phases
– interstitial edema– alveolar edema alveoli
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impaired diffusion
PULMONARY EDEMA
•interstitial edema increases alveolar-capillary thickness by 15-20 %
- fluid moves from gas-exchange site to perivascular site – remains unaffected unless- when interstitial space expands >50 % alveolar edema occurs
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impaired diffusion
PULMONARY EDEMA
•alveolar edema– leakage site: junction between alveoli &
small alveolar ducts OR epithelial tight junctions
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impaired diffusion
PULMONARY EDEMA
•decrease in lung compliance•decrease in pO2•further progress in lung compliance
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impaired diffusion
PULMONARY EDEMA
•most commonlyleft sided heart failure
( hydrostatic pressure)may be without alveolar edema due
to adjustment of the lymphatic drainage
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impaired diffusion
PULMONARY EDEMA
•most commonlyexcessive i.v. fluids, acute renal failure
( hydrostatic pressure permeability)
toxins (endotoxin, exotoxins)( permeability)
lymphatic drainage
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what is essential for breathing
3. transport (blood - tissues)– haemoglobin content
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what is essential for breathing
3. transport (blood - tissues)
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what is essential for breathing
4. regulation– respiratory center– peripheral receptors
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impaired regulation
IVERMECTIN TOXICOSIS•border collie, australian shepherd, collies, long-haired whipet, etc.•ivermectin cross hematoencephalic barrier•stimulate GABA release•ataxy, mydriasis, hypersalivation, vomiting, blindness, tremor, seizures, bradykardia, bradypnoe
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diagnostics• pulse oxymetry• arterial blood gases• capnography• plethysmograph
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thank you for attention
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referencesCohn LA, Reinero CR. Respiratory defense in health and disease. Vet Clin North Am Small Anim Pract 2007; 37: 845-860.Dunlop RH, Malbert CH. Veterinary patophysiology. Blackwell publishing 2004, Iowa, USA.Epstein SE. Exudative pleural disease in small animals. Vet Clin Small Anim 2014; 44:161-180.Guyton AC, Hall JE. Textbook of medical physiology. Elsevier 2006, Pennsylvania, USA.Hoffman A. Airway physiology and clinical testing. Vet Clin North Am Small Anim Pract 2007; 37: 829-843.