The Respiratory system

Case Study-Respiratory System After a routine workout at your health club, you decide to soak in the hot tub. A young man in the tub tells you how he just finished a heavy weightlifting routine that lasted 2 hrs. He says that he soaks in the hot tub for 20 minutes to ward off muscle cramping. The man does this routine 7 days a week. The next day at the gym, you hear that he was hospitalized that morning with the following symptoms; chills, coughing, fatigue, fever, SOB, and tightness in his chest.

He appeared healthy until that incident He appeared healthy until that incident. A friend of his who also works out at the club said he had no history of heart disease or respiratory ailments. However, lately he was losing weight because of the heavy workout. People at the health club are speculating what could have caused the illness. What do you think?

How much of a supply of oxygen do you have? 4-6 minutes

Therefore, the respiratory system must work continuously or death will occur.

What is the purpose of the respiratory system? To take in oxygen, which all body cells need, and remove carbon dioxide, a waste product produced by cells when cells convert food into energy.

Organs and structures: RESPIRATORY SYSTEM Nose- has two openings call nostrils or nares through which air enters. Nasal Septum- a wall of cartilage, divides the nose into two hollow spaces called the nasal cavities. Nasal cavities- lined with a mucous membrane and have a rich blood supply. Warms, filters, and moistens air as it enters.

Organs and structures: RESPIRATORY SYSTEM Cilia- tiny, hair-like structures that filter inhaled air to trap dust and other particles. The cilia then helps move the mucous towards the esophagus where it can be swallowed. Sinuses- Cavities in the skull that surround the nasal area.

Organs and structures: RESPIRATORY SYSTEM Pharynx- (throat), lies directly behind the nasal cavities. As air leaves the nose, it enters the pharynx Nasopharynx-upper portion and includes the pharyngeal tonsils, adenoids, and eustachian tube. Oropharynx-middle section. This section receives both food and air from the mouth. Larynogopharynx- bottom section. The esophagus and trachea branch off from here.

Organs and structures: RESPIRATORY SYSTEM Larynx- (voice box) lies between the pharynx and trachea. It has 9 layers of cartilage including the Adam’s apple. The larynx also contains the vocal cords. As air leaves the lungs, the vocal cords vibrate and produce sound. Epiglottis- leaflike cartilage that closes the opening into the larynx during swallowing. This prevents food and liquids from entering the respiratory tract.

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

Organs and structures: RESPIRATORY SYSTEM Bronchi- Two divisions of trachea near center of the chest. Carries air from the trachea to the lungs. Right bronchus Left bronchus Right bronchus is shorter, wider, and extends more vertically than left bronchus

Organs and structures: RESPIRATORY SYSTEM Lungs- The organ of respiration Organs that contain divisions of bronchi and alveoli Right lung has three sections, or lobes; superior, middle, and inferior Left lung has only two lobes, superior and inferior

Organs and structures: RESPIRATORY SYSTEM Why is the left lung smaller then the right? The heart lies to the left side of the chest!

Organs and structures: RESPIRATORY SYSTEM Alveoli Air sacs that resemble a bunch of grapes Adult lung contains approximately 500 million alveoli Made of one layer of squamous epithelium tissue Contains a rich network of blood capillaries Capillaries allow oxygen and carbon dioxide to be exchanged between blood and lungs

ALVEOLI Microscopic View

Organs and structures: RESPIRATORY SYSTEM Pleura- membrane or sac enclosing each lung Consists of two layers of serous membranes Visceral pleura is attached to surface of lung Parietal pleura is attached to chest wall Pleural space is located between the two layers and is filled with thin layer of pleural fluid that lubricates membranes and prevents friction as lungs expand during breathing.

The Process of Breathing VENTILATION The Process of Breathing

Two phases of ventilation: Inspiration Expiration

Inspiration Inspiration- (is also referred to inhalation.) RESPIRATORY SYSTEM Inspiration- (is also referred to inhalation.) The process of breathing in air Diaphragm- a dome shaped muscle between thoracic and abdominal cavities. The diaphragm contracts allowing more room for the lungs to expand allowing exchange of oxygen and carbon dioxide.

Expiration Expiration is also known as exhalation. RESPIRATORY SYSTEM Expiration is also known as exhalation. The diaphragm relaxes forces air out of the lungs and air passages.

The process of inspiration and expiration is one completion respiration.

Respiration is controlled by the respiratory center in the medulla oblongata. .

* A decreased amount of oxygen or an increased amount of carbon dioxide in blood causes the medulla oblongata to increase rate of respirations. *Process is usually involuntary, but a person can control rate of breathing by breathing faster or slower.

Diseases and abnormal conditions of the respiratory system

ASTHMA

What is an asthma attack? An asthma attack occurs when bronchospasms narrow openings of bronchioles, mucus production increase, and edema (swelling) develops in mucosal lining.

What causes asthma? Usually caused by sensitivity to an allergen such as dust, pollen, animals, medications, or foods. Stress, overexertion, and infections can also cause an asthma attack.

Symptoms: Dyspnea Wheezing Coughing with expectoration of sputum Tightness in the chest

Treatment: Bronchodilators to enlarge the bronchioles Epinephrine and anti- inflammatory medications Oxygen therapy

Asthma Treatments

Identification and elimination of allergens causing the problem is important in preventing asthma attacks.

Bronchitis

What is bronchitis? Inflammation of the bronchi and bronchial tubes.

Two types of bronchitis: Acute bronchitis Chronic bronchitis

Acute Bronchitis: Acute Bronchitis is usually caused by an infection. Characterized by a productive cough, dyspnea, rales (bubbly or noisy breath sounds), chest pain, and fever Treatment: Treated with antibiotics, expectorants to remove excessive mucus, rest, and drinking large amounts of water http://www.stethographics.com/main/physiology_ls_co arse.html

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

Chronic Bronchitis: Symptoms: Treatment: Excessive mucus resulting in a productive cough Wheezing and dyspnea Chest pain Prolonged expiration of air There is treatment, but no cure Antibiotics Bronchodilators Respiratory Therapy

Chronic Obstructive Pulmonary Disease COPD Chronic Obstructive Pulmonary Disease

Any CHRONIC lung disease that results in obstruction of the airways What is COPD? Any CHRONIC lung disease that results in obstruction of the airways

What lung disorders can lead to COPD? Chronic asthma Chronic bronchitis Emphysema Tuberculosis

Smoking is the #1 cause of COPD, but allergens and chronic respiratory infections are also factors.

Treatment: Bronchodilators Mucolytics (loosens mucus secretions) Cough medicines Oxygen

Prognosis: Prognosis is poor because damage to the lungs causes a deterioration of pulmonary function leading to respiratory failure and death.

Emphysema

A noninfectious chronic respiratory condition What is emphysema? A noninfectious chronic respiratory condition

Emphysema Emphysema occurs when walls of the alveoli deteriorate and lose their elasticity Carbon dioxide remains trapped in the alveoli

Prolonged exposure to air pollutants Causes of Emphysema: Smoking Prolonged exposure to air pollutants

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

Barrel Chest

Cyanosis

Clubbing of Nails

Treatment: There are treatments but NO CURE: Avoiding smoking Bronchodilators Breathing exercises Prompt treatment of respiratory infections Oxygen therapy and respiratory therapy

Epistaxis

Occurs when capillaries in nose become congested and bleed. EPISTAXIS Occurs when capillaries in nose become congested and bleed.

Causes of Epistaxis: Injury or blow to the nose Hypertension Chronic infections Anticoagulant drugs Blood diseases such as hemophilia or leukemia

Treatment of Epistaxis: Compress nostrils toward the septum, elevate the head and tilt it slightly forward, and apply cold compresses. At times, it is necessary to insert nasal packing or to cauterize the bleeding vessels Eliminate the underlying cause, such as hypertension, etc.

INFLUENZA OR FLU Highly contagious viral infection of the upper respiratory system with a sudden onset

Symptoms: Chills Fever Cough Sore throat Runny nose Muscle pain Fatigue

Treatment: Bed rest and fluids Analgesics for pain and antipyretics for fever Antibiotics are not effective against viruses, but are often given to avoid secondary infections such as pneumonia

Prevention is the BEST treatment

Immunizations with a flu vaccine: Recommended for the elderly, children, individuals with chronic diseases, pregnant women, and health care workers Many different viruses cause influenza, so vaccines are developed each year to immunize against the most common viruses identified

What is the best way to sneeze? http://www.youtube.com/watch?v=3vw0hIs2LEg

LARYNGITIS Inflammation of the larynx and vocal cords Frequently occurs with other respiratory infections

Hoarseness or loss of voice Sore throat Symptoms: Hoarseness or loss of voice Sore throat Dysphagia, or difficulty swallowing

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

LUNG CANCER Malignancy of the lungs Leading cause of cancer death in men and women

CAN BE A PREVENTABLE DISEASE BECAUSE THE MAIN CAUSE IS EXPOSURE TO CARCINOGENS IN TOBACCO THROUGH SMOKING OR THROUGH EXPOSURE TO SECONDHAND SMOKE

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

Sx: Unfortunately, none in the early stages Chronic cough Hemoptysis: coughing up blood- tinged sputum Dyspnea and chest pain Fatigue and weight loss

Lung Cancer Prognosis is very poor since the disease is usually advanced before it is diagnosed.

Treatment: Surgical removal of the cancerous sections of the lung, radiation, and/or chemotherapy.

Normal Lung X-Ray

Smokers Lungs

http://www.youtube.com/watch?v=dVLtNgAhPRg&feature=related

PNEUMONIA

Inflammation or infection of the lungs with a buildup of fluid or exudate in the alveoli Usually caused by a bacteria, a virus, a protozoa, or chemicals

Symptoms Chills Fever Chest pain Productive cough Dyspnea Fatigue

Treatment Bedrest Oxygen Fluids Antibiotics if needed Respiratory therapy Pain medication

Rhinitis Inflammation of nasal mucous membranes resulting in a runny nose, watery eyes, sneezing, soreness, and congestion Causes: infections and allergens Treatment: fluids and medication to relieve congestion

Sinusitis Inflammation of the mucous membrane lining the sinuses Usually caused by a bacteria of virus

Symptoms: Headache, pressure, or dizziness Thick nasal discharge and congestion Loss of resonance in the voice

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

SLEEP APNEA Condition in which an individual stops breathing while asleep, causing a measurable decrease in blood oxygen levels.

Two main kinds of sleep apnea: Obstructive Central

Obstructive sleep apnea: Caused by blockage in air passage that occurs when muscles that keep airway open relax and allow tongue and palate to block the airway.

Caused by a disorder in the brain’s respiratory control center. Central sleep apnea: Caused by a disorder in the brain’s respiratory control center.

Facts about sleep apnea: More common in men Obesity increases risk Hypertension increases risk Smoking increases risk Alcohol ingestion increases risk Use of sedatives may increase severity

Diagnosis: Diagnosed when more than five periods of apnea lasting at least 10 seconds each occur during an hour of sleep.

What does sleep apnea do? Periods of apnea lower the blood oxygen level. Causes the brain to awaken the individual, who then gasps for air and snores loudly Interruption of the sleep cycle leads to excessive tiredness and drowsiness during the day. https://www.youtube.com/watch?v=mjQdAf9cQBo

Treatment: Weight loss Abstaining from alcohol, smoking and sedatives Sleeping on side or stomach In more severe cases a Continuous Positive Airway Pressure or CPAP is used to deliver pressure to the airway to keep it open while the individual sleeps.

CPAP CPAP consists of a mask that fits securely against the face Tubing connects the mask with a blower device that can be adjusted to deliver air at different levels of pressure

http://www.youtube.com/watch?v=thTwA9GVJpI

Tuberculosis Infectious disease of the lungs caused by the bacterium Mycobacterium tuberculosis

Symptoms of active TB: Fatigue Chest pain Fever Night sweats Weight loss Hemoptysis (coughing up blood tinged sputum)

Administration of drugs for one or more years to destroy the bacteria Treatment: Administration of drugs for one or more years to destroy the bacteria Good nutrition and rest

Ancient treatment for TB: Electric Shock Therapy IV injections of goats blood

Just a Note: a new strain of TB that is resistant to drug therapy has created a concern that tb will become a widespread infectious disease

Upper Respiratory Infection: URI Another name for the common cold. It is an inflammation of mucous membrane lining of the upper respiratory tract Caused by viruses and is highly contagious

Symptoms: Fever, runny nose, watery eyes, congestion, sore throat, and hacking cough Treatment: No cure. Symptoms usually last a week. Give analgesics for pain and antipyretics for fever.

Cystic Fibrosis (CF)

Cystic fibrosis is an inherited chronic disease that affects the lungs and digestive system. A defective gene and its protein product cause the body to produce unusually thick, sticky mucus that: clogs the lungs and leads to life-threatening lung infections; and obstructs the pancreas and stops natural enzymes from helping the body break down and absorb food.

The predicted median age of survival for a person with CF is in the mid-30s. http://www.youtube.com/watch?v=abi7M6C4gNM&f eature=related http://www.youtube.com/watch?v=Twjg7v-pTO4

Lung Auscultation Incentive Spirometer Ventilator