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Respiratory System (Respiratory Physiology (Pressure Relationships in…

- - - - Pressure exerted by air surrounding the body
    - - Pressure in alveoli; fluctuates with breathing
    - - Pressure in pleural cavity; always a negative pressure
    - - the difference between the intrapulmonary and intrapleural pressures (P pul- P ip)
      - keeps the air spaces of the lungs open or from collapsing
      - the greater the transpulmonary pressure, the larger the lungs
  - - - lung collapse
      - a bronchiole becomes plugged
      - can also occur when air enters the pleural cavity either through a chest wound or a rupture of the visceral pleura
    - - presence of air in the pleural cavity
  - - - Inspiratory Muscles
        
        Diaphragm
        
        Dome Shaped
        
        when contracts through inspiration, it moves inferiorly and flattens
        
        external intercostal muscles
        
        when contracts, it lifts the rib cage up and pulls sternum superiorly
      - Forced Inspiration
        
        occurs during vigorous exercises and in chronic obstructive pulmonary diseases
    - - quiet expiration is usually a passive process
      - Inspiratory muscles relax, thoracic cavity volume decreases,
        and lungs recoil
      - Forced Expiration is an active process
    - - the relationship between the pressure and volume of a gas
  - - - normal quiet breathing
    - - The amount of air that can be inspired forcibly beyond the tidal volume
    - - the amount of air that can be expelled from the lungs after a normal tidal volume expiration
    - - air that remains in the lungs which helps to keep the alveoli open and prevent lung collapse
  - - - the total amount of air that can be inspired after a normal tidal volume expiration
    - - the amount of air remaining in the lungs after a normal tidal volume expiration
    - - the total amount of exchangeable air
    - - the sum of all lung volumes
- - - - actual site of gas exchange
        
        simple diffusion across respiratory membrane
        
        Oxygen passes from alveoli to blood while Carbon Dioxide leaves the blood to enter the alveoli
      - Its Structures
        
        Alveoli
        
        Thin-walled air sacs
        
        Has 3 major type of cells within
        
        Type I Alveolar Cells
        
        Squamous epithelial cells that form the major part of the alveolar walls
        
        Type II Alveolar Cells
        
        secrete surfactant that coats the gas-exposed alveolar surfaces
        
        secrete antimicrobial proteins that are important of innate immunity
        
        Alveolar Macrophages
        
        crawl along internal surface of alveoli consuming bacteria, dust, etc
        
        Alveolar Pores
        
        connects adjacent alveoli allowing air pressure throughout the lung to be equalized
        
        Provides alternate air routes
        
        "dead ends"
        
        aged and dead macrophages are prevented from accumulating by getting swept up by ciliary current to pharynx
        
        Respiratory Bronchioles
        
        Alveolar Ducts
      - Begins as terminal bronchioles feed into the respiratory bronchioles
      - Respiratory membrane
        
        Walls of alveoli
        
        type I alveolar cells
        
        External Surface of alveoli
        
        covered with "cobweb" pulmonary capillaries
    - - all respiratory passageways from nose to bronchioles
      - organs humidify ,cleanses, and warm incoming air as it reaches to the lungs
      - Its Structures
        
        Primary Bronchi
        
        Branches from the trachea
        
        Right primary bronchi
        
        Wider, shorter, and more vertical
        
        More common for inhaled foreign objects to get stuck
        
        Left Primary Bronchi
        
        Secondary (Lobar) Bronchi
        
        3 on Right Lung
        
        2 on Left Lung
        
        Each supplies one lung lobe
        
        Begins branching from primary bronchi
        
        Tertiary (Segmental) Bronchi
        
        Divides repeatedly into smaller bronchi
        
        Begins branching from secondary bronchi
        
        Bronchioles
        
        Passages smaller than 1mm
        
        Terminal bronchioles
        
        Smallest of all bronchi
        
        Less than 0.5 mm
      - Structural Changes
        
        Support Structure
        
        Plates of Cartilage replace cartilage rings
        
        Bronchioles contain elastic cartilage rather than supportive cartilage
        
        Epithelium
        
        mucosal epithelium changes from pseudostratified columnar to simple columnar and then to simple cuboidal in the terminal bronchioles
        
        Amount of Smooth Muscle
        
        Amount increases as passageways become smaller
  - - - Provides open airway
      - Acts as switching mechanism to route air or food into proper channels
      - Voice Production (houses vocal cords)
    - - Thyroid Cartilage
        
        Anterior midline is the Laryngeal prominence (Adam's Apple)
        
        Typically larger in males due to sex hormones
      - Cricoid Cartilage
      - 3 pairs of small cartilages
        
        arytenoid
        
        cuneiform
        
        corniculate
      - Epiglottis
        
        consists of elastic cartilage (all other cartilages of larynx is hyaline)
        
        Covers laryngeal inlet during swallowing
    - - True Focal Cords
      - Glottis
      - Vocal Ligaments
        
        Forms core of vocal folds
        
        composed of elastic fibers
        
        lack blood vessels, thus appears white
      - Pathophysiology
        
        Laryngitis
        
        inflammation of vocal cords
        
        interferes with vocal cords vibrations
        
        Can be caused by infections, overuse of voice, dry air, or irritants
      - Vestibular Folds
        
        False Vocal Cords
        
        Helps glottis close up
    - - pseudostratified ciliated columnar
        
        Cilia filters dust upward towards pharynx to continuously move mucus away from lungs ("clearing our throat")
      - Stratified squamous epithelium
        
        Lines superior portion of larynx; are subject to food contact
    - - vocal folds act as sphincter to prevent air passage
      - Valsalva maneuver
        
        Glottis closes to prevent exhalation and abdominal muscles contract
        
        Help empty rectum and also stabalize body trunk while heavy lifting
  - - - Mucosa
        
        Innermost layer
      - Submucosa
        
        Supported by C-shaped rings of hyaline cartilage
      - Adventita
        
        Outermost layer; encases C-shaped hyaline cartilage rings
      - Pathophysiology
        
        Smoking inhibits and destroys cilia in mucosa
        
        coughing is the only way to prevent mucus from accumulating in the lungs
        
        When someone stops smoking, ciliary function usually recovers
    - - Procedure in which air in the victim’s lungs is used to “pop out,” or expel, an obstructing piece of food
  - - - site for entry/exit of blood
        vessels, bronchi, lymphatic vessels, and nerves
      - On the mediastinal surface of each lung
    - - 3 Lobes ;superior, middle, inferior
        
        Lobes are divided by horizontal and oblique fissure
    - - 2 Lobes; superior, inferior
        
        Lobes are divided by oblique fissure
      - Smaller than right lung because of where heart is positioned
      - Cardiac Notch
        
        concavity for heart to fit into
    - - double-layered serosa
        
        Parietal Pleura
        
        lines the thoracic cavity
        
        Visceral Pleura
        
        cover external lung surface; dips into and lines the fissures
      - Pleural Cavity
        
        filled with pleural fluid produced by the pleurae
        
        Provides lubrication and surface tension that assists in expansion
        and recoil of lungs
      - Pleurisy
        
        inflammation of the pleurae
        
        often results from pneumonia
        
        Pleurae may produce excessive amounts of fluid, which
        may exert pressure on lungs, hindering breathing
      - Pleural Effusion
        
        fluid accumulation in the pleural cavity
        
        blood and blood filtrate can accumulate within the cavity
- - - - Functions of the Nose
        
        provides airway for respiration
        
        moistens and warms entering air
        
        filters and cleans inspired air
        
        serves as resonating chamber for speech
        
        houses olfactory (smell) receptors
      - Surface Features of the Nose
        
        Root (area between eyebrows
        
        bridge
        
        dorsum nasi
        
        apex (tip of nose)
        
        nares (nostrils)
        
        alae
      - The only externally visible part of the respiratory system
    - - Superior
      - middle
      - inferior
      - Nasal Meatuses
        
        groove inferior in each concha
      - minimizes amount of moisture and heat lost form body through breathing
    - - lined with skin containing sebaceous and sweat glands
      - Vibrissae
        
        numerous hair follicles
        
        filters coarse particles (dust, pollen)
    - - Hard Palate
      - Soft Palate
      - separates nasal and oral cavity
    - - Olfactory Mucosa
        
        contains smell receptors
      - Respiratory Mucosa
        
        pseudostratified ciliated columnar epithelium
        
        contains goblet cells
        
        Seromucous Nasal Glands
        
        secretes lysozymes
        
        attacks and chemically destroys trapped bacteria
        
        epithelial cells
        
        secrete defensins
        
        natural antibiotics that help kill invading microbes
        
        ciliated cells create a gentle current to move contaminated mucus towards throat where it is swallowed and digested
    - - richly supplied with nerve endings
        
        contact with irritating particles which triggers a sneeze
        
        Pathophysiology
        
        Streptococcal bacteria
        
        inflammation of nasal mucosa
        
        excessive mucus production
        
        nasal congestion
        
        postnasal drip
        
        Can lead to sinusitis (inflamed sinuses) and sinus headache
    - - located in the frontal, sphenoid, ethmoid, and maxillary bones
      - lighten the skull
      - help warm and moisten the air
  - - - Nasopharynx
        
        posterior to nasal cavity, superior to soft palate, inferior to sphenoid bone
        
        serves only as air passageway
        
        Soft palate and uvula moves superiorly during swallowing to prevent food entering into nasal cavity
        
        Pharyngeal Tonsils (adenoids)
        
        traps and destroys pathogens entering into nasopharynx
        
        Pathophysiology
        
        Infected and swollen adenoids block air passage in the nasopharynx
        
        air is not properly moistened, warmed, or filtered before reaching the lungs
        
        speech and sleep is disturbed when chronically enlarged
        
        Pharyngotympanic (auditory) tubes
        
        drain the middle ear cavities and allow middle ear pressure to equalize with atmospheric pressure
        
        tubal tonsil
        
        protect the middle ear against infections
      - Oropharynx
        
        posterior to oral cavity
        
        archway called isthmus of fauces
        
        Both food and air is passed through
        
        Palatine Tonsils
        
        Lingual tonsils
        
        covers posterior surface of tongue
      - Laryngopharynx
        
        lies directly posterior to the larynx
        
        where the respiratory and digestive pathways diverge