1. Module A2: Upper Airway Anatomy & Physiology

2. Objectives
Classify epithelial tissue based on cell type and tissue layers.
Identify location of tissue epithelium in the respiratory system.
Describe the major structures and functions of the upper and lower airways.
Contrast and compare mouth and nose breathing.
Explain how placing an endotracheal tube in the airway will affect the humidification and filtering process.

3. The lung is for gas exchange.
John B. West
Respiratory Physiology: The Essentials

4. Function of the Lungs/Heart
Provide Ventilation
Provide Respiration
Exchange of Carbon Dioxide and Oxygen
Humidify and Protect
Pump oxygen to vital organs
Cellular metabolism

5. Failure of the Lungs/Heart
Hypoxemia – low oxygen level in the blood
Decreased PaO2
Hypoxia - low oxygen level at the tissue level
Decreased oxygen at the cellular level can cause death of the tissue
Presence of anaerobic respiration

6. Ventilation
Brain
Muscles
Lungs
Inability of the lungs to remove carbon dioxide leads to hypercarbia, which is an elevated amount of carbon dioxide in the blood stream (PaCO2)

7. ARTIFICIAL AIRWAYS INTUBATION
INTUBATION

8. ARTIFICIAL AIRWAYS
Tracheotomy with tracheostomy tube: 1 - Vocal cords 2 - Thyroid cartilage 3 - Cricoid cartilage 4 - Tracheal cartilages 5 - Balloon cuff
INTUBATION

9. Intubation – Insertion of an Endotracheal Tube Extubation – Removal of the Endotracheal Tube

10. Anatomy of the Respiratory System
Tissue Epithelium
Upper Airway
Lower Airway
Site of Gas Exchange
Pulmonary Vascular System
Neural Control
Lungs
Mediastinum
Thorax
Muscles of Ventilation

11. Four Tissue Types Epithelial Tissue Connective Tissue Muscle Tissue
Bone, Cartilage, Blood, Fibrous
Muscle Tissue
Nervous Tissue
Neurons conduct electrical impulses

12. Epithelial Tissue Epithelium Covers and protects the body surface
Lines body cavities
Forms many glands
Specializes in moving substances into and out of the blood

13. Epithelial Cell Type
Squamous Cells
Cuboidal Cells
Columnar Cells

14. HISTOLOGY 101 Lots of Surface Area aka Pavement, Sunny-side up egg
Lots of Surface Area
aka Pavement, Sunny-side up egg
Great for Diffusion of Gases
Lots of Volume
Volume = Cytoplasm
Cytoplasm means metabolism
Less diffusion
Height is 2x Width
Usually associated with secretion or absorption of material
Very little diffusion

15. Classification of Epithelium by Layers
Simple Epithelium – Single Layer
Simple squamous
Simple cuboidal
Simple columnar
Stratified Epithelium – Multiple Layers
Pseudostratified – Single Layer but appears stratified
Pseudo means “false”

17. Nose to Large Bronchioles
Goblet Cells
Nose to Large Bronchioles
Secrete mucus

18. Stratified Squamous Epithelium
Associated with PROTECTION
Anterior portion of nasal cavity
Oral cavity
Oropharynx
Laryngopharynx

19. Pseudostratified Columnar Epithelium
SECRETION OF AND SWEEPING OF MUCUS
Posterior 2/3 of nose
Tracheobronchial tree
Function of cilia

20. Simple Cuboidal Epithelium
PRIMARY FUNCTION IS SECRETION, FILTRATION & ABSORPTION
Bronchioles
Clara Cells
Non-ciliated cells that secrete “surface-active agents” which prevent collapse.
Simple Cuboidal also found in alveoli (Type II cells that secrete surfactant)

21. Simple Squamous Epithelium
PRIMARY FUNCTION – GAS EXCHANGE
Alveoli (Type I pneumocytes)
Pulmonary capillaries

22. Upper Airway
Anatomy
Nose
Oral Cavity
Pharynx
Throat

23. Upper Airway Function of the Upper Airway Conduct Air
To prevent foreign materials from entering the lower airway
Smell/Speech

24. Nose
Function
Heat, Humidify and Filter the incoming gas
Smell
Speech

25. Anatomy of the Nose Bone and Cartilage
Partition in the nose is called the nasal septum
Air enters through the nostrils or nares
Two nasal passages are called choanae
Vibrissae filter the incoming gas
Whiskers
First 1/3 is stratified squamous epithelium (PROTECTION)
Posterior 2/3 is pseudostratified ciliated columnar epithelium (MUCUS SECRETION)

26. Anatomy of the Nose
Mucous secreting glands are found in the posterior 2/3 of nose
Bony Protrusions on the lateral wall are called nasal turbinates or conchae
Separate incoming gas into turbulent airstreams – more contact
Extensive capillary network
Constrict or dilate to change blood flow

27. Nasal Conchae

28. Deviated Septum The nasal septum can be deviated to the right or left
More often to the left

29. PURPOSE: They serve a dual purpose; the mucus secreted keeps the nose form drying out and keeps the air we breathe in moist, and because they contain air, they make the voice we produce echo and resonate.

30. Rhinitis: Inflammation of the nasal membrane 20% of Population
NONE
Rhinitis: Inflammation of the nasal membrane
20% of Population
$5.3 Billion/Year

31. Physiology of the Nose
Nose can filter particles down to 5 m (microns) in diameter
Two factors which decrease the humidification and filtering ability of the nose is:
Mouth Breathing
Placement of an ET (endotracheal) tube

32. Paranasal Sinuses
Empty air spaces found in the bones of the skull; Paired
Frontal
Ethmoid
Sphenoid
Maxillary
They contain mucous secreting goblet cells which drain into the nasal cavity

33. NONE

34. Nose and Nasal Cavities

35. http://evolvels. elsevier. com/section/default. asp

36. Anatomy of the Oral Cavity
Roof of the mouth is formed by the hard and soft palate
Hard – Bony portion
Soft – Fleshy portion
Uvula is the soft fleshy structure
Epithelium is stratified squamous epithelium which is non-ciliated.
Palatine (faucial) tonsils are located on each side of the oral cavity.

37. TONSILS
NONE

39. Pharynx - Throat
Nasopharynx
Oropharynx
Laryngopharynx

40. Nasopharynx Located posterior to nasal cavity
Pseudostratified ciliated columnar epithelium
Includes pharyngeal tonsils or adenoids
Eustachian Tubes (auditory tubes)
Connects the middle ear and nasopharynx
Middle ear infection is called otitis media
Complication of ET tubes

41. Oropharynx Lies behind the oral cavity
Lingual tonsils lie at the root of the tongue
Statified squamous epithelium

42. Laryngopharynx
Lies between the base of the tongue and the entrance to the esophagus
Lies posterior to the epiglottis
Stratified squamous epithelium
aka Hypopharynx