3. Sign: Loss of Shape and Elasticity (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 3. The changes in the bronchial tubes and the alveoli.

    00:06 Now, you might be wondering what that blob is up there? Well, it's actually this.

    00:10 Gum.

    00:11 Yeah.

    00:12 Now, we want to use this as another analogy for you to understand kind of how the airways work.

    00:17 But think about when you're chewing gum, not when you just took it all the package, and the stick is still kind of tough.

    00:23 But after you've chewed it up a little while, think about the characteristics of gum.

    00:29 Right, so I can change it.

    00:31 Right? It's elastic, I can stretch it.

    00:36 Now, if I took it out of my mouth, which I'm not going to do, because my mother would be so proud.

    00:42 I could stretch it and there would be no problem, right? But if I took that gum out of my mouth and I set it on a counter overnight, which would make me the worst roommate ever.

    00:54 But if I took it on my mouth and I set it on the counter overnight, I got up the next morning, what difference would you see in that gum? Could I pull it in shape it like I could before? Not likely.

    01:07 Because it lost its elasticity.

    01:09 It's stiffer now so it's not as easy to stretch it.

    01:13 Now, our lungs are not made of gum, it's the same concept.

    01:19 We need airways to keep their shape but yet be elastic, right? Be able to move and change.

    01:25 This is the same thing that happens in our airways when they become stiff, they no longer function as well.

    01:31 So this happens in the functional components of our respiratory system, both the bronchial tubes and the alveoli.

    01:38 When we say they become stiffer, this is what we want you to think about.

    01:42 Instead of being able to fill with air and expand, they don't move as much they lost their shape, and their ability to be elastic or to change.

    01:52 Now, the bronchial tubes increase in size as they become stretched and weakened.

    01:56 So kind of stiff and big and so they're kind of over and enlarged.

    02:00 Think of like a piece of elastic.

    02:02 You know, if I took an elastic band and I stretched it and over stretched it, it isn't as useful when it's all stretched out, right? We need it to be able to move.

    02:12 When those airways become overstretched and weakened, they can't contract again.

    02:19 Now this can start to happen as early as age 40 which again why is exercise and movement and being active is so important.

    02:29 Now, let's break it down even more about the alveoli.

    02:33 Look at our picture of an alveoli there.

    02:35 We're going to talk about the changes that happen on that level.

    02:38 You know that the alveolar wall is usually one cell thick, right? So is the capillary wall, they're both super thin like that, so that gas can pass between them the CO2 and the O2 exchange.

    02:50 In this case, your airway walls, the alveolar walls begin to become thickened.

    02:57 Now also you have less surfactant available.

    03:00 This is going to make the alveoli less effective because what you need for good gas exchange is an intact alveoli with plenty of surfactant to help keep that alveoli open.

    03:13 So the alveoli become flatter, they lose their shape and they lose their elasticity.

    03:18 Now, aging alveoli have less surface area for gas exchange.

    03:23 Why? Because remember what we just talked about, you have less surfactant, those walls become thicker, they become flatter, therefore you have less surface area for gas exchange.

    03:34 So overall, as we age the breathing process becomes less efficient.

    03:38 We have lost those elastic fibers in the airways.

    03:41 And so I might even have alveoli that collapse and trap air in my lungs.

    03:46 So I have less alveolar surface area, I have less vascularization, less surfactant, and therefore I have less gas exchange or a decrease in the efficiency of the gas exchange.

    04:00 So all these changes end up in less oxygen may make it into the bloodstream.

    04:06 So now what's the difference between Jose and Enrique here? Well, it's simple.

    04:11 Think of Jose as the gum that we never stopped chewing or playing with.

    04:16 We stretch it, we get it back to its original shape over and over again.

    04:19 Now it will stiffen with time.

    04:22 But since we're constantly using it, it's going to take longer for it to lose its elasticity completely.

    04:28 But how does Jose do this? How does he achieve this in real life? Well, the answer is simple.

    04:34 It's activity and exercising.

    04:36 Since Jose has been a runner all of his life.

    04:39 He hasn't stopped stretching his alveoli in his lungs, and so they haven't become as stiff as Enrique's.

    About the Lecture

    The lecture 3. Sign: Loss of Shape and Elasticity (Nursing) by Rhonda Lawes, PhD, RN is from the course Assessment of the Geriatric Patient: Respiratory System (Nursing).

    Included Quiz Questions

    1. A loss of elasticity can occur as early as age 40.
    2. The bronchial tubes decrease in size with age.
    3. The bronchial tubes become longer and increase in strength.
    4. They are the only part of the respiratory system unaffected by normal aging.
    1. Alveolar surfactant supply decreases
    2. Alveoli flatten out
    3. Alveoli can collapse, trapping air in the lungs
    4. Alveolar wall thins out
    5. Alveoli increase surface area for gas exchange

    Author of lecture 3. Sign: Loss of Shape and Elasticity (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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