The Respiratory System By Kelly Hutchison R.N.

Respiratory system Consists of the lungs and air passages Responsible for taking in oxygen, a gas needed by all body cells, and removing carbon dioxide, a gas that is a metabolic waste product produced by the cells

Body has only a four to six minute supply of oxygen Therefore, respiratory system must work continuously or death will occur

Parts of the respiratory system include the nose, pharynx, larynx, trachea, bronchi,alveoli, and lungs

Your nose is not only for picking….. It’s actually a very improtant part of the respiratory system

Nose Has two nostrils (nares) or openings through which air enters Nasal septum: partition or wall of cartilage divides the nose into two hollow spaces called nasal cavities

Nasal cavities Lined with a mucous membrane Have a rich blood supply As air enters the cavities, it is warmed, filtered, and moistened Mucous, produced by the mucous membranes, also helps trap pathogens (germs) and dirt.

Cilia Tiny hair like structures in nasal cavity Also help trap dirt and pathogens as they enter nose so trapped particles can be pushed toward the esophagus and be swallowed

*Cilia act like tiny brooms to push the dirty mucus out of your lungs and into your throat. The cilia help prevent your lungs from getting sick from germs floating around in the air. Without the cilia in our lungs, we would be sick all the time!!

Olfactory receptors for the sense of smell are located in the nose Nasolacrimal ducts drain tears from the eye into the nose to provide additional moisture for the air

Sinuses Cavities in the skull around the nasal area Connected to the nasal cavity by short ducts Lined with mucous membrane that warms and moistens air Also provide resonance for the voice

Pharynx or throat Lies directly behind the nasal cavities As air leaves the nose it enters the pharynx Three sections Nasopharynx Oropharynx Laryngopharynx

Nasopharynx Upper portion behind the nasal cavities Pharyngeal tonsils or adenoids (lymphatic tissue) and the auditory (eustachian) tube openings located here

Oropharynx Middle section located behind the oral cavity Receives both air from the nasopharynx and food and air from the mouth

Laryngopharynx Bottom section of the pharynx Branches into the trachea, which carries air to and from the lungs, and the esophagus, the tube that carries food to the stomach

Larynx (Voice box) Lies between the pharynx and trachea Has a framework of cartilage commonly called the Adam's apple Contains two folds called vocal cords Opening between the vocal cords is called the glottis As air leaves the lungs, the vocal cords vibrate and produce sound Tongue and lips act on the sound to produce speech

Back of larynx photo below

Epiglottis Special piece of cartilage Leaf like structure that closes the Opening into the larynx during swallowing Prevents food and liquids from entering the respiratory tract

Trachea or windpipe Tube extending from the larynx to the center of the chest Carries air between the pharynx and bronchi Series of C-shaped cartilage, which are open on the dorsal or back surface, help keep the trachea open

Bronchi Two divisions of the trachea near the center of the chest Right bronchus and left bronchus Right bronchus is shorter, wider, and extends more vertically than the left bronchus Each bronchus enters a lung and carries air from the trachea to the lungs In the lungs, the bronchi continue to divide into smaller and smaller bronchi Smaller branches are called bronchioles Smallest bronchioles, called terminal bronchioles, end in air sacs called alveoli

to Alveoli Air sacs that resemble a bunch of grapes Adult lung contains approximately 500 million alveoli Made of one layer of squamous epithelium issue Contain a rich network of blood capillaries Capillaries allow oxygen and carbon dioxide to be exchanged between the blood and the lungs Inner surface of alveoli are covered with surfactant,a lipid or fatty substance.It helps prevent alveoli from collapsing.

Lungs Organs that contain divisions of the bronchi and alveoli Right lung has three sections or lobes: superior, middle, and inferior Left lung has only two lobes, the superior and inferior Left lung is smaller because tire heart lies more to the left side of the chest

Pleura : membrane or sac enclosing each lung Consists of two layers (1)Visceral pleura attached to surface of lung (2) Parietal pleura attached to chest wall Pleural space (1) Located between the two layers (2) Filled with a thin layer of pleural fluid that lubricates the membranes and prevents friction as the lungs expand during breathing

Both of the lungs, along with the heart and major blood vessels, are located in the thoracic cavity

Ventilation : process of breathing Two phases: inspiration and expiration Inspiration or inhalation 1.a. Process of breathing in air 2.b. Diaphragm (dome-shaped muscle between the thoracic and abdominal cavity)and the intercostal muscles (between the ribs) contract and enlarge the thoracic cavity 3. This creates a vacuum- air rushes into the tubes to the aveoli where gas exchange takes place.

Expiration or exhalation Process where air leaves the lungs Diaphragm and intercostal muscles relax Air is forced out of the lungs and air passages

Process of respiration is controlled by the respiratory center in the medulla oblongata of the brain Decreased amount of oxygen as seen in certain diseases (asthma, congestive heart failure, or emphysema) or increased amount of carbon dioxide in the blood causes the center to increase the rate of respirations Process is usually involuntary, but a person can control the rate of breathing by breathing faster or slower

Two main stages of respiration : External respi ration Internal respiration

External respiration Exchange of oxygen and carbon dioxide between the lungs and bloodstream Oxygen, breathed in through the respiratory system, enters the alveoli (1) Concentration of oxygen in the alveoli is higher than the concentration in the blood capillaries (2) Oxygen leaves the alveoli and enters the capillaries or bloodstream.

Carbon dioxide, a metabolic waste product, is carried in the bloodstream (1) Concentration of carbon dioxide is higher in the capillaries (2) It leaves the capillaries and enters the alveoli (3) Alveoli expel it from the body during exhalation

Internal respiration Exchange of carbon dioxide and oxygen between the tissue cells and bloodstream Oxygen is carried to the tissue cells by the blood (1) Concentration of oxygen is higher in the blood than in the tissue cells (2) Oxygen leaves the blood capillaries and enters tissue cells

Tissue cells then use the oxygen and nutrients to produce energy, water, and carbon dioxide, a process called cellular respiration (1) Level of carbon dioxide is higher in cells (2) Carbon dioxide leaves the cells and enters the bloodstream to be transported back to the lungs where external respiration takes place

Diseases and abnormal conditions of the Respiratory System

Asthma Respiratory disorder usually caused by sensitivity to an allergen such as dust, pollen, animals, or foods Stress, overexertion, and infections can also cause an asthma attack sensitivity to an allergen such as dust, pollen, animals, or foods b. Stress, overexertion, and infections can also cause an asthma attack

Symptoms for asthma (1) Occur when bronchospasms narrow openings of bronchioles, mucus production increases, and edema develops in the mucosal lining (2) Dyspnea and wheezing (3) Coughing with expectoration of sputum (4) Tightness in the chest

Treatment for asthma ( 1) Bronchodilators to enlarge the bronchioles (2) Epinephrine and anti-inflammatory medications (3) Oxygen therapy (4) Identification and elimination of or desensitization to allergens causing the problem is important in preventing asthma attacks

Bronchitis Inflammation of the bronchi and bronchial tubes Acute bronchitis (1) Usually caused by an infection (2) Characterized by a productive cough, dyspnea, chest pain, and fever (3) Treated with antibiotics, expectorants to remove excessive mucus, rest, and drinking large amounts of water

Chronic bronchitis (1) Occurs after frequent attacks of acute bronchitis and long-term exposure to pollutants or smoking (2) Characterized by chronic inflammation, damaged cilia, and enlarged mucous glands

Symptoms for chronic bronchitis: Excessive mucus resulting in a productive cough Wheezing and dyspnea Chest pain Prolonged expiration of air Treatment but no cure Antibiotics and bronchodilators Respiratory treatments/ therapy.

Chronic obstructive pulmonary disease (COPD) Any chronic lung disease that results in obstruction of the airways Disorders such as chronic asthma,chronic bronchitis, emphysema, and tuberculosis lead to COPD Smoking is the primary cause, but allergies and chronic respiratory infections are also factors

Emphysema Noninfectious chronic respiratory condition Occurs when the walls of me alveoli deteriorate and lose their elasticity (1) Carbon dioxide remains trapped in the alveoli (2) Poor exchange of gases * Most common causes are heavy smoking and prolonged exposure to air pollutants

Symptoms of Emphysema Dyspnea and a feeling of suffocation Pain and a barrel chest Chronic cough Cyanosis Rapid respirations with prolonged expiration Eventual respiratory failure and death

Treatment but no cure for emphysema……. Treatment but no cure (1) Avoiding smoking (2) Bronchodilators (3) Prompt treatment of respiratory infections (4) Oxygen therapy and respiratory therapy

Below is a postmortem lung specimen of a chronic emphysema sufferer.

Epistaxis or nosebleed Occurs when capillaries in nose become congested and bleed Causes: Injury or blow to the nose Hypertension Chronic infections Anticoagulant drugs Blood diseases such as hemophilia or leukemia

Treatment of Epistaxis or nosebleed ….. Compress the nostrils toward the septum, elevate the head and tilt it slightly forward, and apply cold compresses At times it is necessary to insert nasal packs or cauterize (burn and destroy) the bleeding vessels (3) Eliminate an underlying cause such as hypertension

Influenza or flu Highly contagious viral infection of the upper respiratory system with a sudden onset Symptoms: 1.Chills and fever 2.Cough, sore throat, and runny nose Muscle pain and fatigue

Treatment for the flu………… (1) Bed rest and fluids (2) Analgesics for the pain and antipyretics for fever (3) Antibiotics not effective against viruses, but they are given at times to avoid secondary infections such as pneumonia

Immunization with a flu vaccine (1) Recommended for die elderly individuals with chronic diseases, pregnant women, and health care workers (2) Many different viruses cause influenza, so vaccines are developed each year to immunize against the most common viruses identified

Laryngitis Inflammation of the larynx and vocal cords Frequently occurs with other respiratory infections Symptoms: (1) Hoarseness or loss of voice (2) Sore throat (3) Dysphagia or difficulty in swallowing

Treatment for laryngitis Rest and fluids Limited use of the voice Medications if an infection is present

Lung cancer Leading cause of cancer death in both men and women It is a preventable disease, because the main cause is exposure to carcinogens in tobacco, either through smoking or through exposure to "second hand” smoke

Three common types of lung cancer: Small cell Squamous cell Adenocarcinoma

Symptoms for lung cancer None in the early stages Chronic cough Hemoptysis: coughing up blood tinged sputum Dyspnea and chest pain Fatigue and weight loss Prognosis is poor since the disease is usually advanced before it is diagnosed

Treatment for lung cancer…. Treatment: surgical removal of the cancerous sections of the lung, radiation,and/or chemotherapy

Pleurisy Inflammation of pleura or membranes of the lungs Usually occurs with pneumonia or other infections Symptoms (1) Sharp stabbing pain while breathing (2) Crepitation or grating sounds in the lungs (3) Dyspnea and fever

Treatment for pleurisy Rest Medications to relieve the pain and inflammation If fluid collects in the pleural space, a thoracentesis (withdrawal of fluid through a needle) is done to remove fluid and prevent compression of the lungs

Pneumonia Inflammation or infection of the lungs with a buildup of fluid or exudate in the alveoli Usually caused by a bacteria, virus, or chemicals Symptoms: chills, fever, chest pain, productive cough,dyspnea, and fatigue Treatment: bedrest, Quids, antibiotics if indicated, respiratory therapy, and pain medication

Rhinitis Inflammation of nasal mucous membrane resulting in a runny nose, soreness, and congestion Common causes are infections and allergens Treatment: fluids and medications to relieve congestion

Sinusitis Inflammation of mucous membrane lining the sinuses Usually caused by a bacteria or virus Symptoms for Sinusitis: (1) Headache or pressure (2) Thick nasal discharge and congestion (3) Loss of resonance in the voice

Treatment for Sinusitis : Antibiotics if indicated Analgesics for pain Decongestants to loosen secretions Moist inhalations Surgery in chronic sinusitis to open the cavities and encourage drainage

Tuberculosis (TB)  Infectious disease of the lungs caused by the bacterium Mycobacterium tuberculosis  At times, white blood cells surround invading TB organisms (1) Wall them off, creating a nodule called a tubercle (2) Organisms remain dormant in the tubercle (3) Can cause an active case of tuberculosis later if body resistance is lowered

Symptoms of an active case of TB: Fatigue and chest pain Fever and night sweats Weightless Hemoptysis or coughing up blood tinged sputum

Treatment for TB……….. (1) Administration of drugs for one or more years to destroy the bacteria (2) Good nutrition and rest. In recent years, a new strain of the TB bacterium that is resistant to drug therapy has created a concern that tuberculosis will become a widespread infectious disease

Upper respiratory infection (URI) or common cold Inflammation of mucous membrane lining upper respiratory tract Caused by viruses and highly contagious Symptoms: fever, runny nose, watery eyes, congestion, sore throat, and hacking cough No cure and minimal treatment (1) Symptoms usually last about a week (2) Analgesics for pain and antipyretics for fever (3) Rest and increased fluid intake (4) Antihistamines to relieve congestion VI. APPLICATION

Treatment for a URI No cure and minimal treatment (1) Symptoms usually last about a week (2) Analgesics for pain and antipyretics for fever (3) Rest and increased fluid intake (4) Antihistamines to relieve congestion

REVIEW QUESTIONS

What is the nasal septum? Partition or wall of cartilage divides the nose into two hollow spaces called nasal cavities

Name five functions of the nasal cavity. Lined with a mucous membrane Have a rich blood supply As air enters the cavities, it is warmed, filtered, and moistened Mucous, produced by the mucous membranes, also helps trap pathogens (germs) and dirt

What are cilia? What is their function? Tiny hair like structures in nasal cavity Also help trap dirt and pathogens as they enter nose so trapped particles can be pushed toward the esophagus and be swallowed

What prevents food and liquids from entering the respiratory tract? Epiglottis

What are the smallest branches of the bronchi called? Bronchioles

What is the function of the capillaries in the alveoli? Capillaries allow oxygen and carbon dioxide to be exchanged between the blood and the lungs

This is a Respiratory disorder usually caused by sensitivity to an allergen such as dust, pollen, animals, or foods Asthma

Inflammation of the bronchi and bronchial tubes Bronchitis

Any chronic lung disease that results in obstruction of the airways Disorders such as chronic asthma,chronic bronchitis, emphysema, and tuberculosis lead to _________________. Chronic Obstructive Pulmonary Disease

Noninfectious chronic respiratory condition. Occurs when the walls of me alveoli deteriorate and lose their elasticity Emphysema