RespiratorySystem

Functions
Gasexchange
Smell
Filtersinspiredair
Soundproduction
Respiration
Theexchangeofgasesbetweenthe
atmosphere,bloodandcells.
Involvesthreeprocesses
Pulmonaryventilation inspirationand
expiration.
External repiration theexchangeofgas
betweenthelungsandblood.
Internalrespiration theexchangeofgases
betweenthebloodandcells.
UpperRespiratorySystem
Nose
Pharynx(throat)
LowerRespiratorySystem
larynx(voicebox)
Trachea(windpipe)
Bronchi
Lungs
StructuresoftheRespiratory
System
Functionally,therespiratorysystemconsistof
twoparts
Conductingportionaseriesof
interconnectedtubesandcavitiesthat
conductairtothelung.
Respiratoryportionwheregasexchange
occurs.
StructuresoftheRespiratory
System
Nose
Function
Warms,moistens,andfiltersincomingair
nasalhairs
superior,middle,andinferiornasalconchae(turbinates)lined
withmucusmembranescontaininggobletcellsandisvascular
(moistensandtrapsparticles).
Receivesolfactorystimulation
abovethesuperiornasalconchaeistheolfactoryepithelium
(olfactorybulb),whichreceivesolfactorystimuli.
Providesaresonatingchamberforspeechsounds
ethmoid,maxillary,sphenoid,andfrontalsinuses
Connectstheeyeswiththenoseviathe nasolacrimal duct.
NasalRespiratoryEpithelium
EthmoidSinuses
Paranasalsinus
anairfilledcavity
withinabone
connectedtothe
nasalcavity.
Perpendicularplate
ofethmoidbone
Maxillarysinus
Middlenasalconcha
Vomer
Cribriform plate
ofethmoidbone
InferiorNasalConchaescrolllikebonesthatprojectintothenasal
cavityinferiortothesuperiorandmiddlenasalconchaeoftheethmoid
bone.
Vomertriangularshapedbonethatformsthelowerandbackpartofthenasalseptum.Thenasal
septumiscomposedofthreestructures:perpendicularplateofthe ethmoidbone,vomer,andthe
septalcartilage.Adeviatedseptummaycausepartialorcompleteblockageofthenasalpassage
leadingtonasalcongestion,blockedparanasalsinuses,chronicsinusites,headaches,ornosebleeds.
Sinusitis
Sinusitisstartsasaresultofblockageofthe
drainagepathwayofthesinuses.Thisblockage
canoccurasaresultof
ananatomicalobstruction,
swellingduetoacoldorallergy,
orchronicrecurrentsinusinfections.
Whenthisoccurs,mucusthatnormallyisexpelled
fromthesinusbuildsupinthesinus.
causepressureorpain
mucusisanexcellentculturemediumforbacteria
Ifthemucusisnotclearedimmediately,a
bacterialinfectionexistsuntiltheblockageis
clearedandthesinusesdrainnormallyagain.
NormalSinusDrainage
BlockSinusDrainageResultingin
Sinusitis
NasalPolypObstructing
theSinuses
DeviatedSeptum
Obstructingthe
Sinuses
PostNasalDrip
Whenexcessmucous
producedinthesinuscavities
dripsdownthebackofthe
throat.
Excessmucous,oncesettled
onyournasalandthroat
lining,canirritate,causinga
sorethroat,andthebeliefthat
youmaybecomingdown
withacold.
Excessmucousproductionor
PostNasalDrip(PND)will
directlyaffectyourbreathasit
ishighinproteinsandisan
excellentfoodsourcefor
anaerobicbacteria.
Smallwhiteoryellowcrystals
lodgedinyourtonsils.
.Ifyouhaveexcessmucousthiswillcauseanincreaseofanaerobicbacteria.Thesebacteriafeedonthemucous
asitishighinprotein.TheythenmakecondensedsulphurgranulescalledTONSILLOLITHSwhicharelaiddown
inthebackofthethroat.Everytimeyourtonguetouchesthebackofthethroatwhenyouswallow,itwillcarry
theseTonsillolithsintothecryptsorfoldsofthetonsils.IfyouhaveeverpickedtheseoutwithaQtipyouwill
noticethefoulsmellthattheyhave.Tonsillolithsarenotonlyasignofpostnasalproblems,butalsoasignof bad
breath.
SignsofPostNasalDrip
BadBreath
Needingtoclearyourthroat
Constantlyswallowingorfeelthatyouhavesomethingtrappedin the
backofyourthroat.
Continualsorethroatsthatdonotdevelopintoillness.
Smallwhiteoryellowcrystalslodgedinyourtonsils.
NasalandSinusCongestion
CausesofPND
InhaledIrritants swellingofthenasalandsinuslinings
DairyProducts causemucoustothickendramatically.Thiscanthen
inhibitproperdrainage.
Allergiestofoods Thesewillonceagainthickenmucous,andinhibit
properdrainage.
Illnesses asflu,colds,bronchitis,earinfectionsandtonsillitisarethe
mainculpritsinpostnasaldripandexcessmucous
Asthma excessmucous
FunctionalEndoscopicSinus
Surgery(FESS)
Straighteningtheseptum(theboneand
cartilageseparatingthetwosidesofyour
nose),
Removingtissuefrominsidethenose
Makinganopeningintothesinus(es)on
eithersideofthenosesothatdrainagecan
occurmoreeffectively,and
Removesomeoftheliningofthesinuses
forbiopsyifindicated..
Pharynx(Throat)
Atubethatstartsattheinternalnaresand
extendspartwaydowntheneck.
Itswallsarelinedwithskeletalmuscleand
linedwithmucousmembrane.
Functions
passagewayforairandfood
resonatingchamberforspeechsounds
PartsofthePharynx
Nasopharynx
connectswith
thetwointernalnares
Eustachiantubestwoopeningsthatleadintotheear
Thesingleopeningintotheoropharynx
Theposteriorwallcontainsthepharyngealtonsil
Itislinedwithpseudostratifiedciliatedcolumnar
epithelium,and
theciliamovesthedustladenmucoustowardthemouth.
Exchangesasmallamountofairwiththeauditorycanalto
equalizeairpressurebetweenthepharynxandmiddleear.
Haveyounoticedthathearingisworsejustbeforeyourearspop?Thisisbecauseoftheproperty
calledcompliance.Iftheairpressureisnotequalonbothsidesoftheeardrum,theeardrumwillnot
moveorvibrateefficiently(reducedcompliance).Theeustachian tubemaintainstheoptimal
compliancebykeepingtheairpressureoutsidetheearthesameasairpressureinsidetheear.The
endresultisthattheeustachian tubepreservesandmaintainsoptimalhearing.
Whennewairisunabletoentertheeustachian tube,thebodywillabsorbtheremainingairinthemiddleearcreatingavacuum
(negativepressure).ThisisthesametypeofpressurethatkeepsalidonaMasonJar.Whenthispressureismild,thebodysenses
thisasstuffinessorpressureintheear.However,whenthenegativepressureisseverethebodysensesthisaspain.Ifthenegative
pressureremainsforanextendedperiodoftimethenthebodywillreplacethevacuumwithfluid.
Thefluidbehindtheeardrumcanleadtoproblemswithhearinglossandearinfection ( otitis).Treatmentformiddleearfluid
consistsofwaystogettheairpressurebehindtheeardrumequaltopressureoutsidetheeardrum.Thesetreatmentsincludeinflation
ofthemiddleearviatheeustachian tubeorifunsuccessfulthroughtheeardrum(seeplacementofpressureequalizationtubes)
Apressureequalizationtubeisplacedtoallowairpressurein themiddleeartoequalairpressureintheoutside
world.Inhealthyears,theeustachain tubeprovidesthefunctionofpressureequalization.Withoutpressure
equalization,eardiseasescandevelop.Theseproblemsrangefrommildhearinglosstolifethreatening
disorders.
Eartube(MyringotomyTubes)
Pressureequalizing
tubes allowairtoget
intotheearspacebehind
theeardrum. Airis
neededinthis spaceto
allowtheeardrumto
move.
PartsofthePharynx
Oropharynx
themiddleportionofthepharynxcontaing
theopeningfromthemouthcalledthe
fauces.
Servesasacommonpassagewayforair,
food,anddrink.
Linedwithnonkeratinizedsquamous
epitheliumthatsmoresuitableforabrasion
fromthecoarsefoodparticles.
ContainstheLingualandPalatinetonsils
LingualTonsils
PalatineTonsil
PharyngealTonsil
PartsofthePharynx
Laryngopharynx
Extendsdownwardfromthehyoidboneand
connectswiththeesophagus(foodtube)in
backandthelarynx(voicebox)infront.
Linedwithnonkeratinizedsquamous
epithelium.
Hasbothrespiratoryanddigestivefunction.
Pharyngitis
Beefyrednessofposteriorpharynx,whichistheresultof
infection.
PalateEdemaDueToPharyngitis
Larynx(Voicebox)
Ashortpassagewaythatconnectsthe
pharynxwiththetrachea.
Anatomy
Thewallsarecomposedofninepiecesof
cartilage
threesingle
thyroid,epiglottis,andcricoidcartilage
Threepaired(1pairisthemostimportant)
arytenoid cartilage
LaryngealCartilages
Thyroidcartilage(Adamsapple)
consistofhyaline catilage andformsthefront
ofthelarynxandgivesititstriangularshape.
Epiglottis
largeleafshapedpieceofelasticcartilage
coveredbyepitheliumlyingoverthetopofthe
larnyx.
Duringswallowing,theepiglottiscoversthe
glottis(thepassagewayleadingtothetrueand
falsevocalcords)sothatfooddoesnotenter
thelungs,therebyroutingittotheesophagus.
LaryngealCartilages(cont)
Cricoidcartilage
isaringofhyalinecartilageattachedtothefirst
ringofcartilageofthetrachea.
Arytenoidcartilage
mostlyhyalinecartilagelocatedabovethe
cricoid cartilage
attachthetruevocalcordsandpharyngeal
musclesandfunctioninvoiceproduction.
Falsevocalcordsfunctiontoholdthebreathagainstpressureinthethoraxsuchasmightoccur
whenstrainingtoliftaheavyobject.
Truevocalcordsproducesound.Theycontainelasticligamentsstretchedbetweenpiecesof
rigidcartilageviamuscle.Themuscletightensandrelaxesthecordcausingtensionvariations.
Laryngitisinflammationofthelarynxcausingswellingofthecordsanda henderanceto
vibration(hoarseness).
VoiceProduction
Trachea
Extendsformthelarynxtotheupperpartofthefifth
vertebra,whereitdividesintorightandleftprimary
bronchi.
Thewallislinedbypseudostratifiedciliated
columnarepitheliumwithgobletandbasalcells.
WallshaveCshapedcartilagenousringsthat
providesrigidsupporttopreventcollapse.
Tracheostomyemergencyairwaythroughthe
trachea
Intubationtheinsertionofatubethroughthemouth
ornosedownthroughthelarnyxandtreachea.
Tracheostomy
BronchialTree
Trachea
PrimaryBronchirightmore
straight,objectcaughthere.
SecondaryBronchi
TertiaryBronchi
Bronchioles
TerminalBronchioles
StructuralChangesofBronchioles
nocartilageatbronchioles
increaseofsmoothmuscleatbronchioles
epitheliumchangestocuboidalnonciliatedand
thentosimplesquamousinterminalbronchioles.
Muscularcontractioncontrolledbytheautonomic
nervoussystemandvariouschemical(inhaled
irritantsandchemicalsfrominflammatorycells)
Asthmasmoothmusclespasmthatclosesoffthe
bronchioles
Bronchoscopythevisualexaminationofthe
bronchithroughabronchoscope.
Cartilagering
Cilliated
ColumnarEpithelium
Thesmooth,glisteningpleuralsurfaceofalungisshownhere.Thispatienthad
markedpulmonaryedema,whichincreasedthefluidinthelymphaticsthatrun
betweenlunglobules.Thus,thelunglobulesareoutlinedinwhite.
Toeachlung
Toeachlunglobe
Toeachlobule
Bronchopulmonary
segment
Respiratory
bronchioles
Alvolarducts
Alveolusaepitheliallinedsacwheregas
exchangeoccurs.
Alveolarsacstwoormorealveolithat
shareacommonopening.
AlvolarDucts
AlvolarSacs
&Alveoli
1storder
2ndorder
3rdorder
Respiratory
Bronchioles
Alveolus
Elasticfibers
Smoothmuscle
Terminalbronchiole
Lobule
SecretesSurfactant
AlveolarCapillaryMembrane
Thisisnormallungmicroscopically.Thealveolarwallsarethin anddelicate.
Thealveoliarewellaeratedandcontainonlyanoccasionalpulmonary
macrophage(typeIIpneumonocyte).
ExternalRespiration
HemothoraxChestDrainage
Pneumothorax
DynamicsofBreathing
Diaphragm
VitalCapaciatymaximal
volumethatcanbeinhaled
orexhale
Alveolarpressurethe
pressureinsidethelungs
CollapsedLung
Thepressureinthepleural
cavityissubatmospheric
inordertokeepthealveoli
slightlyinflatedafterthe
endofexpiration.
Thisnegativepressure
overcomestherecoilforce
fromtheelasticbands
aroundthealveoli.
Acollapsedlungmaybe
causedbyairenteringthe
pleuralspacefroma
surgicalincisionorachest
wound,airwayobstruction,
orlackofsurfactant.
Surfactanta phospholipid
producedbythe septal cells
thatpreventsthealveolar
wallsfromsticking
together(surfacetension)
LungCapacities
Spirogram
Anatomicdeadspace aprox 30%ofinhaledair
Minutevolumeofrespiration totalairtakeninduring1min.
Theefficiencyofexternalrespiration
dependsonseveralfactors
altitude
highaltitudesickness(shortnessofbreath,
nausea,dizziness)
surfaceareaavailableforO2CO2exchange
minutevolumerespiration
drugs,suchasmorphine,slowdownthe
respiratoryrate
theamountofO2thatreachesthealveoli
(pluggedpassages)
CO
2
+H
2
CO
3
HCO3

+H
+
ThereleaseofO2from
hemoglobindependson
differenceinpO2betweenblood
andtissue
pHincreaserelease
temperatureincreaserelease
Carbonmonoxidepoisoning
COhasastrongeraffinityfor
hemoglobinthanoxygen.
Hypoxiadificiency ofO2atthe
tissues.
LowpO2inarterialblood
highaltitude
toolittlefunctioning
hemoglobin(anemia)
inefficientbloodtransportas
inheartfailure
inabilityoftissuetouseO2
properlyasincyanide
poisoning
carbaminohemoglobin
Lobe
bronchopulmonary segment(supplied
bytertiarybronchi
lobuleseachcontainingarteriole,venule,
andlymphaticvesselandabranchfroma
terminalbronchiole,wrappedinelastic
connectivetissue.
Respiratorybronchioles
Alveolarducts
Alveolarsactwoormorealveoli,
sharingacommonopening
Alveoli
Bronchus
Bronchiole
RespiratoryBronchiole
RespiratoryBronchiole
RespiratoryBronchiole
RespiratoryBronchioleAlveolarDuct
RespiratoryBronchioleAlveolus
DoubleBloodSupply
FromPulmonary
arteries
Fromtheaortavia
bronchialarteries