The Panting Carpenter

1
The Panting Carpenter

• Kinsey, Kaija, Diana, Robyn

2
Problem

• 59-year old carpenter complaining of shortness of
  breath (SOB).
• Evaluation reveals his HR is 112, he has a BP of
  138/88, and a Respiration Rate of 35 breaths/min
  (rapid and shallow).
• Patients skin is ashen and nail beds are
  cyanotic.
• A sample of arterial blood was drawn for blood
  gas analysis.

3
Relevance to Class

• Respiratory system
• Chapter 18 Gas Exchange and Transport
• Chronic Obstructive Pulmonary Diseases (COPD)

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Hypoventilation

• Decreased alveolar ventilation
• Shallow breathing
• Asthma
• Obstructive lung diseases, such as COPDs.

5
COPD

• Defined as a disease that is characterized by
  airflow obstruction (problem of ventilation).
• COPDs are currently the fourth leading cause of
  death in the United States.
• Types of COPDs include chronic bronchitis and
  emphysema.

6
Parameters and Predictions
7
Further Results

• In addition to the previous table, laboratory
  tests revealed the following information about
  this patients oxygen carrying capacity.

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Length of problem?

• one year
• Due to the high Hb concentration and high
  hematocrit

9
Erythropoiesis
Normal O2 O2 O2 Red Bone
Marrow Kidneys Erythropoietin (EPO)
hypoxia
Fe B12) Intrinsic factor Folacin
(cytokine)
10
Analogy
? Under inflated tire (COPD) ? Air volume goes
down (Low O2 exchange) ? Contact area/friction
increases (CO2 increases) ? Friction increases
(bicarbonate increase) ? Bad gas mileage - more
work is required to move (panting to increase
gas exchange)