Oxygen reaches the body cells and carbon dioxide is removed from the cells through respiration. Respiration involves two processes which is the external respiration and the internal respiration. The External respiration is the movement of air between the environment and the lungs while internal respiration is the movement of oxygen between the hemoglobin and single cells.
External respiration involves the following interrelated processes:
- Ventilation. It is the mechanical movement of air to and from the lungs and the exchange of respiratory gases.
- Conduction. It is the movement of air through the airways of the lungs.
- Diffusion. It is the movement of oxygen and carbon dioxide between the alveoli and red blood cells.
- Perfusion. It is the distribution of blood through pulmonary capillaries.
Abnormal Respiratory Patterns
- Cheyne-stokes respiration – respiratory rhythm is irregular, characterized by alternating periods of apnea and hyperventilation. Respiratory cycle begins with slow, shallow breaths that gradually increase to abnormal depth and rigidity. Gradually, breathing slow and becomes shallower, climaxing in 10-20 second period of apnea before respiration resumes.
- Kussmaul’s respirations – respirations are abnormally deep but regular, similar to hyperventilation. Rate is increased.
- Biot’s respirations – condition of CNS causes shallow breathing interrupted by irregular periods of apnea.
- Orthopnea – a respiratory condition in which a person must sit or stand to breathe deeply or comfortably.
- Dyspnea – difficulty breathing.
Normal Respiratory Rates by Age
|Age Group||Respiratory Rate||Age Group||Respiratory Rate|
|Newborn||35 cpm*||10 years||19 cpm|
|1-11 months||30 cpm||12 years||19 cpm|
|2 years||25 cpm||14 years||18 cpm|
|4 years||23 cpm||16 years||17 cpm|
|6 years||21 cpm||18 years||16-18 cpm|
|8 years||20 cpm||Adult||12-20 cpm|
* cpm – cycles per minute
(From Fundamentals of Nursing by Potter and Perry)
Factors Affecting the Character of Respiration
- Exercise. This activity increases the rate and the depth of respiration to meet the body’s greater need for oxygen.
- Acute pain. When a person is in pain, the rate and the depth of respiration increases as a result of sympathetic stimulation.
- Anxiety. Anxiety increases the rate and the depth of respiration as a result of sympathetic stimulation.
- Smoking. Long-term smoking changes the lung’s airways which results to an in increase in respiratory rate.
- Body position. When a person is in straight and erect posture, full chest expansion is promoted. A stooped or slumped position impairs ventilatory movement.
- Medications. Narcotics and sedatives depress the rate and depth of respiration while amphetamines and cocaine increases the arte and depth.
- Brainstem injury. Injury to the brainstem impairs the respiratory center and inhibits respiratory rate and rhythm.