Respiratory System.

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Chapter 08

• Respiratory System.

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• The nose, nasal cavity, sinuses, pharynx, larynx,
  trachea, bronchi and structures within and
  associated with the lungs constitute the?
• ________________
• The passages conducting air and from respiratory
  surfaces plus the respiratory surfaces themselves
  make up the?
• _______________
• The cup-shaped air sacs in which processes of gas
  exchange take place are?
• ________________

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• Upper respiratory system

• Lower respiratory system

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• Respiratory System Functional Aspects/Anatomy
• Surfaces for gas exchange
• Passages and means of movement of air to exchange
  surfaces
• Mechanisms for protection of respiratory surfaces
  from dehydration/infection/temperature
• vocalizations
• Physiological regulation blood chemistry,
  pressure, volume

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• Nasal bones
• Lateral nasal cartilage
• Alar cartilages
• external nares

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Nose -- Internal Structures

• Large chamber within the skull
• Roof is made up of ethmoid and floor is hard
  palate
• Internal nares (choanae) are openings to pharynx
• Nasal septum is composed of bone cartilage
• Which bones?
• Bony swelling or conchae on lateral walls
• Each encloses a nasal meatus

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• Nasal Cavity
• Nasal vestibule
• External/internal nares (choanae)
• Nasal conchae
• Hard/soft palate
• Paranasal sinuses
• Olfactory region/cribiform plate

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• Nasal Structures Functional Aspects
• Olfactory epithelium for sense of smell
• Pseudostratified ciliated columnar with goblet
  cells lines nasal cavity
• warms air highly vascular
• mucous moistens air traps dust
• cilia move mucous towards pharynx
• Paranasal sinuses open into nasal cavity
• found in ethmoid, sphenoid, frontal maxillary
• lighten skull resonate voice

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Rhinoplasty
Rhino - Nose
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• Rhinoplasty
• Commonly called a nose job
• Surgical procedure done for cosmetic reasons /
  fracture or septal repair
• Procedure
• local and general anesthetic
• nasal cartilage is reshaped through nostrils
• bones fractured and repositioned
• internal packing splint while healing

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Paranasal Sinuses Frontal Ethmoid Sphenoid Maxill
ary Decrease mass Add resonance to voice
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• Pharynx
• 3 regions connects oral and nasal passages with
  esophagus/trachea
• Nasopharynx superior portion, behind internasal
  nares, above soft palate
• Oropharynx- soft palate to base of tongue
• Laryngopharynx hyoid bone to entrance of
  esophagus common passage for food and air

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• Nasopharynx
• Pharyngeal oriface auditory tube
• Pharyngeal tonsil
• uvula
• Oropharynx
• Palatoglossal Arch
• Palatine Tonsil
• Palatopharyngeal arch
• Laryngopharynx

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• Lower Respiratory - Larynx down
• Larynx 9 cartilages (details) -
• Trachea
• Mucus membrane, C-shaped cartilages
• Primary bronchi enter lungs
• Right/left
• Lungs left 2 lobes, right 3 lobes

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• Larynx Details
• Thyroid (Adams apple)
• Thyrohyoid membrane connects to hyoid
• Cricoid (inferior to thyroid) sits on top of
  trachea
• Cricothyroid ligament connects to thyroid cartil.
• Epiglottis covers thyroid
• 3 smaller paired cartilages
• Arytenoid
• Corniculate
• Cuneiform located in aryepiglottic fold

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• Laryngeal Ligaments and Vocal Cords
• Vocal ligaments and vestibular ligaments
• Extend between arytenoid and thyroid cartilage
• True vocal folds vocal cords vocal ligaments
  mucous membrane
• Cover rima glottidis (opening)
• Rima glottidis vocal folds glottis
• False vocal folds lateral to true vocal folds
• Mucous membrane vestibular ligaments
• Extend between

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Trachea

• 5 in. long 1in. diameter
• Extends from larynx to T5 anterior to the
  esophagus and then splits into bronchi
• Layers
• mucosa pseudostratified columnar with cilia
  goblet
• submucosa loose connective tissue seromucous
  glands
• hyaline cartilage 16 to 20 incomplete rings
• open side facing esophagus contains trachealis m.
  (smooth)
• internal ridge on last ring called carina
• adventitia binds it to other organs

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• Histology of Trachea
• Mucosa mucous membrane
• Respiratory epithelium
• continuous with lower larynx
• Pseudostratified, ciliated columnar
• Goblet cells
• Mucus catches debris
• Cilia sweep outwards
• Lamina propria
• Submucosa
• Cartilages - C shaped
• Elastic ligament trachialis closes
• Subject to autonomic nervous control
• Joined by annular ligaments

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• Ciliated pseudostratified columnar epithelium
  with goblet cells produce a moving mass of mucus.

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• Larynx to Lungs
• Trachea ? 2 primary bronchi (enter lungs)
• Carina internal ridge associated with cough
  reflex
• Extrapulmonary bronchi primary bronchi outside
  lungs
• Histology same as trachea
• Entering lungs at hilus depression on medial
  surface
• Complex of structures entering lung root
• primary bronchi
• Nerves
• blood vessels
• Lymphatic vessels
• anchoring connective

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• Lungs
• Lobes
• Right 3 Left 2
• Right Superior/middle/inferior
• Left superior/middle
• Fissures
• Right horizontal and oblique
• Left oblique

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• Surfaces
• Costal anterior against ribs
• Mediastinal medial
• root of lung and hilus
• Base
• apex

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• Divisions of Lung Tissue
• Trabeculae divide parenchyma
• Elastic connective tissue/smooth muscle
• Form partitions
• Lobule smallest self contained bronchio-
  pulmonary segment of lung
• Contains own
• Arteriole
• Venule
• lymphatic vessel
• Division of tertiary bronchiole
• 10 right
• 8-10 left

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• Bronchial Tree Branching of
• Intrapulmonary bronchi within the lungs
• Primary bronchi divide
• ? Secondary bronchi ( lobular bronchi) to each
  lobe
• How many in the right lung? In the left?
• ?Tertiary bronchi ( segmental bronchi) to each
  bronchiopulmonary segment 10/lung
• ?Bronchioles
• ?terminal bronchioles
• ?respiratory bronchioles (microscopic)
• ? alveolar ducts
• ?alveolar sacs (contain several alveoli)

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• Changes in Histology of Bronchial Tree
• Deeper in Lungs
• Pseudostratified ciliated columnar to nonciliated
  simple cuboidal to simple squamous
• Incomplete rings of cartilage replaced by rings
  of smooth muscle then connective tissue
• sympathetic NS adrenal gland release
  epinephrine that relaxes smooth muscle dilates
  airways
• asthma attack or allergic reactions constrict
  distal bronchiole smooth muscle
• nebulization therapy inhale mist with chemicals
  that relax muscle reduce thickness of mucus

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• Alveoli site of gas exchange
• Blind ended (cup shaped outpouching) contained
  in alveolar sac
• Membrane simple squamous elastic basement
  membrane
• Cells
• Type I form continuous lining
• Type II (Spetal cells)
• Produce alveolar fluid, contains surfactant
  prevents collapse of alveoli
• Alveolar macrophages (dust cells)
• Capillaries surround

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• Details of the respiratory membrane

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• Two Blood Circulation Patterns in Lungs
• Pulmonary Circuit
• Oxygen poor/Carbon dioxide rich blood from heart
  via pulmonary artery to lungs
• Gas exchange takes place in lungs to supply
  oxygen to body
• Blood returns to heart via pulmonary veins
• Bronchial arteries
• Branch from aorta
• Supply nutrient and oxygen rich blood to tissues
  of lungs
• Drainage via bronchial veins and pulmonary veins

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Pulmonary Circulation
Systemic Circulation
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Mechanism of breathing (ventilation)

• Process of moving air in and out of lungs
• Respiratory volume
• Involves
• Diaphragm and other muscles
• Pleural membranes
• Neural and sensory control

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• Visceral pleura covers lungs
• parietal pleura lines ribcage covers upper
  surface of diaphragm
• Pleural cavity is potential space between ribs
  lungs

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• Pneumothorax air fills pleural cavity
• Hemothorax blood fills pleural cavity
• ? collapse of lung (all or part) ? atelectasis
• Treatment drain/evacuate, lung normally
  reinflates

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Lung Volumes and Capacities

• Tidal volume amount air moved during quiet
  breathing
• Reserve volumes ---- amount you can breathe
  either in or out above that amount of tidal
  volume
• Residual volume 1200 mL permanently trapped air
  in system
• Vital capacity total lung capacity are sums of
  the other volumes

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• Pulmonary Ventilation
• Process of moving air in and out of bronchial
  tree
• increase decrease in volume of thoracic cavity
• Muscles Involved
• Diaphragm
• External and Internal intercostals

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• Primary Muscles Involved
• Inspiration (thorax increases in volume and air
  enters lungs)
• Diaphragm flattens
• External intercostals elevate ribs
• Expiration
• Diaphragm relaxes
• Internal intercostals depress ribs, reduce width
  of thoracic cavity

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• Shallow Breathing only intercostals involved
• At rest
• During pregnancy (abdominal volume decreases)
• Deep Breathing (Diaphragmatic) contraction of
  diaphragm

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• Accessory Muscles
• Assist in elevating ribs during inspiration
• Sternocleidomastoid
• Serratus anterior
• Pectoralis minor
• Scalenes
• Assist in decreasing thoracic volume during
  expiration by compressing abdomen
• Transversus thoracis
• Obliques and Rectus abdominis

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What factors affect breathing? Respiratory
control centers are sensitive to carbon dioxide
and hydrogen levels If those rise (in blood),
breathing rate increases Low blood oxygen can
also be detected Hyperventilation lowers blood
carbon dioxide levels can lead to blood
alkalosis (slows breathing rate)
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• Neural Control of Breathing
• paired centers in Brain Stem
• Medulla
• Ventral Respiratory Group (VRG) sets basic
  rhythm
• Dorsal Respiratory Group (DRG) integrates
  sensory and input from other regions of brain ?
  alters activity of VRG
• Pontine Centers
• Prev. Pneumotaxic Respiratory Group, others
• Adjust frequency depth alters activity of
  ventral group in medulla
• Responds to sensory input largely increase in
  H ion concentration

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• Newer information modifies role of DRG
  understanding modified by more recent research

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• ARDS Acute Respiratory Distress
• Various causes conditions lead to hypoxia
• Build-up of fluids in lung tissue
• Diagnosis observation of cyanosis, listen
  (auscultation) breathing sounds
• Treatment intensive care involving mechanical
  ventilation, treatment of underlying cause

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• Tuberculosis TB
• Cause bacteria Mycobacterium tuberculosis
• Spread primarily airborne aerosol
• Multiple antibiotic resistant strains have become
  a problem
• May occur as latent of active infection
• Attacks various tissues, most often lungs

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• Emphysema
• Various causes/risk factors
• Decreased lung function loss in alveolar
  function (capacity) ? decreased vital capacity
• Loss in alveolar elasticity

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• Asthma
• Inflammation of airways tightening of bronchial
  muscles
• Causes vary, immune issues
• Treatment
• Avoid trigger substance
• Long term and short term medications steroids,
  bronchodilators

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• Pneumonia
• Causes vary, bacterial (Streptococcus pneumoniae
  common), viral (as flu, others), certain fungi,
  protista
• Treatment varies with cause

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Aging the Respiratory System

• Respiratory tissues chest wall become more
  rigid
• Vital capacity decreases to 35 by age 70.
• Decreases in macrophage activity
• Diminished action of cilia
• Decrease in blood levels of O2
• Result is an age-related susceptibility to
  pneumonia or bronchitis

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The End.