Pulmonary System Anatomy and Physiology

RESPIRATORY SYSTEM MUST WORK CONTINOUSLY OR DEATH WILL OCCUR HOW MUCH O2 DO WE HAVE? FOUR TO SIX MINUTES SUPPLY

RESPIRATORY SYSTEM NOSE PHARYNX LARYNX TRACHEA BRONCHI ALVEOLI LUNGS DIAPHRAM

Nasal Cavity Nostrils also known as anterior nares Beginning of respiratory tract Warms the air Filters the air Moistens the air

NASAL SEPTUM PARTITION OR WALL CARTILAGE DIVIDES THE NOSE INTO HOLLOW SPACES

CILIA TINY HAIRLIKE STRUCTURES IN NASAL CAVITY TRAPS DIRT TRAPS PATHOGENS TRAPPED PARTICLES PUSHED TOWARD ESOPHAGUS SWALLOWED

Sinuses Hollow cavities Short ducts connect the sinuses to the nasal cavity Mucous membrane lines the sinuses to help warm and moisten the air Also give resonance to the voice

Pharynx Commonly known as the “throat” Subdivided Nasopharynx Oropharynx Laryngopharynx Both air AND food travel down the pharynx

Larynx Also know as the “voice box” Contain the vocal cords or folds Sound occurs when air leaves the lungs, passing through the vocal cords causing them to vibrate

Larynx Has 9 layers of cartilage The largest is called the thyroid cartilage or the Adam’s apple

Epiglottis Flap of cartilage lying behind the tongue and in front of the larynx At rest is upright and allows air to pass through the larynx to the lungs During swallowing it folds back over the larynx to prevent food and liquids from getting into the airway

Trachea Known as the “windpipe” Passes IN FRONT of the esophagus Continues down below the larynx Lined with cartilage rings to prevent it from collapsing

Cilia Also in trachea Smoking is a constant irritation Smoking kills the cilia Leads to frequent infection and inflammation Triggers cough reflex and results in what we call the “smoker’s cough”

LUNGS Porous, spongy tissue Right lung is larger and broader than the left lung It has three lobes This is because the heart lies to the left and needs room Left lung, therefore, only has two lobes

PLEURA Thin, moist, slippery membrane of tough tissue cells Two layers Visceral covers just the lung Parietal covers lungs and diaphragm and lines the thoracic cavity Pleural Fluid fills the space between the two pleural membranes

Bronchi Lower end of trachea separates into the left and right bronchus

Bronchioles Bronchi subdivide into the bronchioles

Alveoli About 500 million alveoli in the adult lung This is 3x the amount needed to sustain life Inner surface are covered with a lipid substance called SURFACTANT Prevents alveoli from collapsing

Alveoli Site of gas exchange Covered with a network of blood capillaries Oxygen brought into the lungs flows into the capillaries Carbon dioxide created in the body flows out of the capillaries and is exhaled

Process of Breathing VENTILATION Mechanical process known as “breathing” Two phases called Inspiration and Expiration

Ventilation Inspiration Diaphragm contracts (moves downward) Intercostal muscles contract (pull ribs outward) Creates positive pressure and therefore air rushes into the lungs

Ventilation Expiration Diaphragm and intercostal muscles relax (return to resting state) Returns to negative pressure state Air is forced out of the lungs

Fun Facts Hiccups Sneezing Yawning Caused by a spasm of the diaphragm believed to be the result of an irritation Sneezing Air rushes out of your nose at a rate of 100 miles per second Some people have a “photic reflex” which makes them sneeze in response to a sudden, bright light Yawning A deep, prolonged breath believed to be caused by the need to increase oxygen in the blood

Respiration Chemical process where oxygen (O2) and carbon dioxide (CO2) are exchanged There are three types External respiration Internal respiration Cellular respiration

Cellular Respiration Cells use Cells produce Oxygen (O2) Nutrients (glucose) Cells produce Energy (ATP) Water (H2O) Carbon dioxide (CO2)

External Respiration Occurs in the lungs Between the alveoli and the blood stream Exchange of oxygen (O2) and carbon dioxide (CO2)

Internal Respiration Occurs in the body Between the blood stream and tissue cells Exchange of oxygen (O2) and carbon dioxide (CO2)

Control of the Respiratory Center Medulla oblongata controls respirations Located in the brain (lowest portion of the brain stem) Increased respirations occur if these things are happen Decreased oxygen (O2) in the blood stream Increased carbon dioxide (CO2) in the blood stream

DISEASES OF THE RESPIRATORY SYSTEM ASTHMA

CAUSATIVE AGENTS SENSITIVITY TO AN ALLERGEN DUST POLLEN ANIMALS FOODS STRESS OVEREXERTION INFECTIONS

SYMPTOMS OCCUR BRONCHOSPASMS NARROW OPENING OF BRONCHIOLES MUCUS PRODUCTION INCREASES EDEMA DEVELOPS IN MUCOSAL LINING

SYMPTOMS DYSPNEA WHEEZING COUGHING WITH EXPECTORATION OF SPUTUM TIGHTNESS IN CHEST

Treatment Bronchodilators (via rescue inhaler or nebulizer) Anti-inflammatory medications (steroids) Epinephrine O2 Therapy

PREVENTING ASTHMA ATTACKS IDENTIFY ALLERGEN ELIMINATE ALLERGEN DESENSITIZATION TO ALLERGENS

BRONCHITIS INFLAMMATION BRONCHI BRONCHIAL TUBES

ACUTE BRONCHITIS CAUSED BY INFECTION SYMPTOMS PRODUCTIVE COUGH DYSPNEA CHEST PAIN FEVER

TREATMENT ANTIBIOTICS EXPECTORANTS TO REMOVE EXCESSIVE MUCOUS

CHRONIC BRONCHITIS OCCURS AFTER FREQUENT ATTACKS OF ACUTE BRONCHITIS LONG-TERM EXPOSURE TO POLLUTANTS OR SMOKING CHARACTERIZED BY CHRONIC INFLAMMATION DAMAGED CILIA ENLARGED MUCOUS GLANDS

SYMPTOMS EXCESSIVE MUCUS PRODUCTIVE COUGH WHEEZING & DYSPNEA CHEST PAIN PROLONGED EXPIRATION OF AIR

TREATMENT NO CURE ANTIBIOTICS BRONCHODILATORS RESPIRATORY THERAPY

LARYNGITIS INFLAMMATION LARYNX VOCAL CORDS MAY OCCUR WITH RESPIRATORY INFECTIONS

SYMPTOMS HOARSENESS LOSS OF VOICE SORE THROAT DYSPHAGIA: DIFFICULTY IN SWALLOWING

TREATMENT REST FLUIDS LIMITED USE OF THE VOICE MEDICATIONS INFECTION IF PRESENT

INFLUENZA (FLU) CONTAGIOUS VIRAL INFECTION UPPER RESPIRATORY SYSTEM SUDDEN ONSET Influenza is a viral infection of the respiratory tract that causes coughing, breathing difficulty, fever, headache, muscle aches and weakness. The virus is spread from person to person by inhaling infected droplets from the air.

SYMPTOMS CHILLS HIGH FEVER COUGH SORE THROAT RUNNY NOSE MUSCLE PAIN FATIGUE Sometimes people confuse cold and flu, which share some of the same symptoms and typically occur at the same time of the year. However, the two diseases are very different. Most people get a cold several times each year, and the flu only once every several years. People often use the term "stomach flu" to describe a viral illness where vomiting or diarrhea are the main symptoms. This is incorrect, as the stomach symptoms are not caused by the flu virus. Flu infections are primarily respiratory infections.

TREATMENT BED REST FLUIDS ANALGESICS PAIN FEVER ANTIBIOTICS NOT EFFECTIVE AGAINST VIRUSES GIVEN TO AVOID SECONDARY INFECTIONS PNEUMONIA

EPISTAXIS NOSEBLEED CAPILLARIES IN NOSE BECOME CONGESTED AND BLEED

CAUSES INJURY OR BLOW TO NOSE HYPERTENSION CHRONIC INFECTIONS ANTICOAGULANT DRUGS BLOOD DISEASES HEMOPHILIA LEUKEMIA A nosebleed may be caused by trauma, irritation or dryness of the lining of the nose, allergic rhinitis, colds, or sinusitis. Other causes can include nasal obstruction such as a deviated septum, or foreign objects in the nose. Most nosebleeds begin on the septum, the midline, vertical cartilage that separates the nasal chambers and is lined with fragile blood vessels. This form of nosebleed is not serious and is usually easy to stop. Seek medical help if the bleeding persists after 15 to 20 minutes of treatment, nosebleeds recur, blood persistently drains down the throat, or a neck or serious head injury is suspected. The nose is a very vascular area of the body that contains many arterioles (tiny blood vessels) that can bleed easily. Nosebleeds occur more frequently in the winter when heated indoor air can dry the membranes of the nose. Also, air moving through the nose can also dry out the membranes and can form crusts. These crusts bleed when irritated by rubbing, picking, or blowing the nose. Occasionally, nosebleeds may indicate other disorders such as bleeding disorders, high blood pressure, or hardening of the arteries.

TREATMENT COMPRESS NOSTRILS ELEVATE HEAD TILT FORWARD SLIGHTLY APPLY COLD COMPRESSES NASAL PACKS CAUTERIZE THE BLEEDING VESSEL ELIMINATE UNDERLYING CAUSE

PNEUMONIA INFLAMMATION INFECTION OF LUNGS BUILD UP OF EXUDATE IN ALVEOLI CAUSED BY BACTERIA, VIRUS, OR CHEMICALS

SYMPTOMS CHILLS FEVER CHEST PAIN PRODUCTIVE COUGH DYSPNEA FATIGUE

TREATMENT BEDREST FLUIDS ANTIBIOTICS IF INDICATED RESPIRATORY THERAPY PAIN MEDICATION

RHINITIS (URI) INFLAMMATION OF NASAL MUCOUS MEMBRANE RUNNY NOSE SORENESS CONGESTION

COMMON CAUSES INFECTIONS ALLERGENS

TREATMENT FLUIDS MEDICATION TO RELIEVE CONGESTION

SINUSITIS (URI) INFLAMMATION OF MUCOUS MEMBRANE LINING SINUSES CAUSED BY BACTERIA OR VIRUS

SYMPTOMS HEADACHE PRESSURE THICK NASAL DISCHARGE CONGESTION LOSS OF RESONANCE IN VOICE

TREATMENT ANALGESICS MEDICATIONS TO LOOSEN SECRETIONS MOIST INHALATIONS SURGERY CHRONIC SINUSITIS OPENS CAVITIES ENCOURAGE DRAINAGE

TREATMENT ADMINISTRATION OF DRUGS DESTROY BACTERIA GOOD NUTRITION REST

TB TUBERCULOSIS INFECTIOUS DISEASE OF THE LUNGS CAUSED BY BACTERIA MYCOBACTERUIM TUBERCULOSIS

WHITE BLOOD CELLS MAY SURROUND INVADING TB ORGAMISMS WALL OFF CREATING A NODULE CALLED TUBERCLE ORGANISMS REMAIN DORMANT IN THE TUBERCLE CAN CAUSE ACTIVE CASE OF TB LATER IF BODY REISITANCE IS LOW

SYMPTOMS OF ACTIVE TB FATIGUE CHEST PAIN FEVER NIGHT SWEATS WEIGHT LOSS HEMOPTYSIS COUGHING UP BLOOD TINGED SPUTUM

Treatment Medications for one or more years to destroy the bacteria Good nutrition Rest * In recent years a new strain of the TB bacteria that is resistant to drug therapy has emerged causing concern that it will become a widespread infectious disease

EMPHYSEMA NONINFECTIOUS CHRONIC RESPIRATORY CONDITION WALLS OF THE ALVEOLI DETERIORATE LOSE ELASTICITY CARBON DIOXIDE REMAINS TRAPPED IN THE ALVEOLI POOR EXCHANGE OF GASES

CAUSE HEAVY SMOKING PROLONGED EXPOSURE TO AIR POLLUTANTS

TREATMENT NO CURE AVOID SMOKING BRONCHODILATORS PROMPT TREATMENT OF RESPIRATORY INFECTIONS OXYGEN THERAPY RESPIRATORY THERAPY

COPD INCLUDE DISORDERS SUCH AS ASTHMA CHRONIC BRONCHITIS EMPHYSEMA TB

CAUSES SMOKING IS THE PRIMARY CAUSE OTHER FACTORS INCLUDE ALLERGIES CHRONIC RESPIRATORY INFECTIONS

SYMPTOMS DYSPNEA FEELING OF SUFFOCATION PAIN BARREL CHEST CHRONIC COUGH CYANOSIS RAPID RESPIRATIONS WITH PROLONGED EXPIRATION RESPIRATORY FALURE ……….DEATH

LUNG CANCER DIAGNOSIS- XRAY BRONCHOSCOPY (flexible tube passed through mouth or nose into bronchi and lungs) TREATMENT SURGERY CHEMOTHERAPY RADIATION

CAUSED BY USUALLY SMOKING

LUNG CANCER XRAYS ON LEFT This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side of the picture) at the level of the second rib. The light spot has irregular and poorly defined borders and is not uniform in density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and malignant or benign tumors. ON RIGHT A CXR in a patient with central cancer of the right lung. Notice the white mass in the middle portion of the right lung (seen on the left side of the picture).

Diagnostic Tests Pulmonary Function Testing (PFT) Bronchoscopy

Pulmonary Function Tests Check how well your lungs work Determine how much air your lungs can hold Determine how quickly you can move air in and out of your lungs Determine how well your lungs put oxygen into and remove carbon dioxide from your blood The tests can diagnose lung diseases, measure the severity of lung problems, and check to see how well treatment for a lung disease is working. Spirometry is the first and most commonly done lung function test. It measures how much and how quickly you can move air out of your lungs. For this test, you breathe into a mouthpiece attached to a recording device (spirometer). The information collected by the spirometer may be printed out on a chart called a spirogram.

Bronchoscopy Procedure that looks inside the lungs' airways A thin, flexible tube called a bronchoscope is inserted into the nose or mouth. The tube is passed down the throat into the airways Medicine is given for relaxation during the procedure. The bronchoscope has a light and small camera that allows the doctor to see the windpipe and airways and take pictures. If there is bleeding in the lungs or a large object stuck in the throat, a bronchoscope with a rigid tube would be used. The rigid tube, which is passed through the mouth, is wider. This allows the doctor to see inside it more easily, treat bleeding, and remove stuck objects. A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia

Bronchoscopy