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Otorhinolaryngology - branch of medicine that deals with the ears, nose and throat Pulmonologist – specialist in the diagnosis and treatment of lung disease
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1. Respiration -exchange of gases within the body: O 2 & CO 2 2. Regulates blood pH 3. Contains receptors for smell 4. Filters inspired air 5. Sound production
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Pulmonary Ventilation (breathing) › Gas exchange between atmosphere and the lungs External Respiration › Gas exchange between lungs & pulmonary capillaries (pulmonary capillary blood gains O 2, loses CO 2 ) Internal Respiration › Gas exchange between systemic capillaries & body tissue cells (systemic capillary blood gains CO 2, loses O 2 )
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1. The Nose › Warms, moistens & filters air › Detects odors › Modifies speech vibrations › Conchae & meatuses Increase surface area Trap exhaled water droplets during exhalation Prevents dehydration
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Goblet cells secrete mucus › Moistens air › Traps debris Cilia- tiny hairs that trap debris Blood capillaries – warm inhaled air
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Stimulus irritates nasal mucosa Spasmodic contraction of respiratory muscles occurs Air focefully expelled out of nose & mouth Sneezes can travel up to 200 mph Sputum can be spread 2-3 meters
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2. The Pharynx › Part of both GI Tract & Respiratory Tract › Passageway for both food and air › Resonating chamber for speech sounds › Houses the tonsils › 3 Regions of Pharynx Nasopharynx – 5 openings (internal nares, eustacian tubes and into oropharynx) Oropharynx – respiratory & digestive function Laryngopharynx – contains the epiglottis, which is a flap of cartilage that covers the glottis during swallowing. Glottis – opening to the larynx/trachea
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3. The Larynx › “Voice box” › Connects laryngopharynx with the trachea › Lies anterior to C 4 – C 6 Vertebrae › Composed of cartilage › Air passing across vocal folds & vibration of folds creates sound › Pharynx, mouth, nasal cavity: act as resonating chambers to give sound human quality › Muscles of face, mouth & tongue allow for enunciation
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Pitch of voice is controlled by tension on the vocal cords › More tension = higher pitch › Less tension = lower pitch Men have longer, thicker vocal cords that vibrate more slowly which creates a lower pitch › This is due to testosterone
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4. The Trachea › Windpipe › 12 cm in length; 2.5 cm in diameter › Anterior to the esophagus › Contains 16-20 arcs (rings) of cartilage – helps to prevent collapse during breathing › Divides at carina (T-5) into right and left primary bronchi
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Nose Nasal Cavity Pharynx Primary Bronchi Secondary Bronchi LungsTertiary Bronchi Bronchioles Terminal Bronchioles Respiratory Bronchioles Alveolar Ducts Alveoli
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Right lung: 3 lobes Left lung: 2 lobes Pleural membrane - (2 layers) covers each lung Pleural cavity - space between layers; contains lubricating fluid Hilus - region where primary bronchi, blood and lymph vessels, and nerves enter or exit the lung
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Tiny air sacs 300 million Very thin tissue: 0.5 μm Diffusion of gases occurs here (exchange of CO 2 and O 2 between lungs & blood) Contains macrophages, which are cells that remove dust/debris Alveoli secrete fluid for moisture › Contains surfactant – lowers the surface tension of alveolar fluid to prevent alveolar collapse
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Lungs receive blood from two sets of arteries › Pulmonary Arteries – bring deoxygenated blood (O 2 poor blood) to the lungs from the body › Bronchial Arteries – (branch from the aorta) bring oxygenated blood (O 2 rich blood) to the lungs from the heart Pulmonary Veins – bring O 2 rich blood to the heart from the lungs
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Gases are exchanged between atmosphere & lung alveoli O 2 in or CO 2 out Due to differences in pressure when respiratory muscles contract & relax Inspiration – breathing in Expiration – breathing out Boyle’s Law explains how this occurs
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The pressure of a gas varies inversely with the volume › If pressure goes up, volume goes down › If pressure goes down, volume goes up
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Diaphragm contracts (flattens), lungs expand Volume of lungs increases Pressure of lungs decreases Air moves into lungs Inhalation is an ACTIVE process: it requires muscle contraction & ATP
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Diaphragm relaxes – returns to “dome” shape Pressure in lungs increases Air moves out of lungs (volume of lungs decrease) Exhalation is a PASSIVE process: it does not require muscle contraction & ATP
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Exchange of O 2 and CO 2 between alveoli and blood in pulmonary capillaries Occurs by passive diffusion Controlled by two gas laws: › Dalton’s Law › Henry’s Law
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Each gas in a mixture of gases exerts its own pressure as if all the other gases were not present This is its partial pressure (P x ) › Ex.; Atmospheric air is made up of N 2, O 2, H 2 O, CO 2 and other gases › P N 2 + P O 2 + P H 2 O + P CO 2 + P other = P total › P total = 760 mm Hg
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The gases will diffuse from the area of higher pressure to the area of lower pressure › Ex.; if O 2 is high in alveoli & low in blood, O 2 will diffuse across the alveoli and into the blood › **it determines the movement of O 2 between: Atmosphere & lungs Lungs & blood Blood & body cells
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the quantity of a gas that will dissolve in a liquid is proportional to the partial pressure of the gas and its solubility coefficient If a gas has high partial pressure, and a high solubility coefficient = high gas content in solution
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Oxygen crosses into blood because: › P O 2 (alveolar air) = 105 mm Hg › P O 2 (deoxygenated blood in pulmonary capillaries) = 40 mm Hg › …so O 2 moves from alveoli to blood Carbon dioxide crosses into alveoli because: › P CO 2 (deoxygenated blood in pulmonary capillaries) = 45 mm Hg › P CO 2 (alveolar air) = 40 mm Hg › …so CO 2 moves from blood to alveoli
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Rate of gas exchange depends on › 1. partial pressure difference of gases › 2. surface area for gas exchange Bigger the area, the higher the rate of exchange › 3. diffusion distance Smaller the distance, the higher the rate of exchange
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Exchange of gases at the cellular level (Dalton’s Law applies) O 2 leaves blood and diffuses into cell CO 2 leaves cells and diffuses into blood
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O 2 does not dissolve well in water Transportation requires hemoglobin Hemoglobin – an iron-rich protein that turns bright red when combined with O 2 Oxyhemoglobin – 1 hemoglobin + 4 O 2
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Dissolves well in water Most found in blood as bicarbonate ions Blood detects this & transports it to lungs to be exhaled Controls rate of breathing: › High ion level – high respiratory rate › Low ion level – low respiratory rate Medulla oblongata – part of brain that controls the respiratory rate
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Adult – 12 breaths/min Tidal volume – volume of one breath ~ 500ml Spirometer – device used to measure volume of respiration Residual volume – air that remains in lungs after maximum exhalation (~1200 ml) › Prevents lung collapse › Can’t be measured with spirometer
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