TASK : ANATOMICAL PHYSIOLOGICAL PAPERS ON THE

RESPIRATORY SYSTEM

ARRANGED BY :

ADE AULIA MARETNA

201701049

CLASS IIB NURSING

PRODI S1 KEPERAWATAN

STIKES WIDYA NUSANTARA PALU

2019
 BAB I

PENDAHULUAN

A. Latar Belakang
Humans are living things that are always active. Human needs are very many
of which are human needs for air. Air is needed to carry waste that must be removed by
the human body. Waste is produced from absorption processes which are important and
then produce substances that are not useful to the human body. The entire process must
be carried out by certain organs. Therefore it takes organs that work as a tool to carry out
these activities.

B. Rumusan Masalah

1. Anatomy of upper and lower respiratory system physiology

2. Function of the respiratory organs
3. Factors that affect breathing

C. Tujuan
The purpose of making this paper is to fulfill the task of English language
courses.
 BAB II
TINJAUAN TEORI

A. Definition

Breathing (respiration is the event of breathing air from outside containing

oxygen and exhaling air which contains lots of carbon dioxide as a residue of oxidation
out of the body. This suction of air is called inspiration and exhaling is called expiration.
Respiration system plays a role in ensuring the availability of oxygen for the
continuity of metabolism of body cells and gas exchange. through the role of oxygen
respiration system taken from the atmosphere, transported into the lungs and there is an
exchange of oxygen gas with carbon dioxide in the alveoli, then oxygen will be diffused
into the blood capillaries to be utilized by cells in the process of metabolism.

B. Respiratory system organs

1. Upper respiratory tract
a. Nasal cavity
 The nose is the main organ of the respiratory tract that is directly related to
the outside world which functions as an airway in and out of breathing. besides
that the nose also serves to maintain and warm the incoming air, as a filter in
cleaning foreign objects that enter and play a role for sound resonance, as a place
of alfactic receptors

b. Pharynx

Pharynx consists of three main parts. The anterior part is the nasal pharynx
(nasopharynx), the back of the nasal cavity. The pharynx of the nose is connected
to the second area, the oral pharynx (oropharynx), with a path called the isthmus.
The oral pharynx starts at the back of the oral cavity and continues down the
throat to the epiglottis, a fold of tissue that covers the airways to the lungs and the
food canal to the esophagus.
c. Larynx
 Larynx is the respiratory tract located between the oropharynx and
trachea, the function of the larynx is the entry of air, clearing the entry of food
into the esophagus and as the production of sound
- Epiglottis: Cartilage valve leaves that cover the ostium towards the larynx
during swallowing
- glotis: ostium between the vocal cords in the larynx
2. Lower airway
a. Trachea

The trachea is a tube organ between the larynx and the top of the lung,
about ten to twelve cm long, 6-thoracic cervical height 5. also called the trachea
stem trunking ends into two bronchi called karina
b. Bronchus
 The bronchus is a branch of the windpipe located after the trachea and
before the lungs. After entering the lungs, the bronchi will branch out again into
bronchioles. The right bronchus will branch into 3 lobar bronchi, while the left
bronchi will branch into 2 lobar bronchi. The bronchus functions to bring air to
the lungs.
c. Lungs

The lungs are a body instrument mostly in the upper thoracic cavity, the
sides are limited by muscles and ribs and are lowered by a strong muscular
diaphragm. Is a cone-shaped elastic organ. Located in the thoracic or thoracic
cavity. Both lungs are separated by a central mediastinum which contains the
heart and several large blood vessels. Each lung has a larger apex and base of the
right lung and is divided into 3 lobes by the interlobar fissure. The left lung is
smaller and is divided into 2 lobes. The lobes are divided into several segments
according to the bronchial segment.
d. Alveolus
 The alveolus is the terminal part of the bronchial branches and is
responsible for the lung structure resembling a small open bag on one side and the
O2 and CO exchange site. There are around three hundred million, which if
united forms one sheet, covering an area of seventy m2.

C. Factors That Affect Respiration

Respiratory frequency in humans is the intensity of inspiration and expiration of
respiratory air in humans which is carried out every minute. In normal circumstances the
inspiration and expiration process runs 15 to 18 times per minute. However, this situation
can change and be different for each person because there are factors that influence it.
The factors that influence a person's inspiration and expiration process include:
1. Physical factors such as age, gender, body temperature, body position, and body
activities
a. Age
the frequency of breathing performed in children is different from the
frequency of breathing performed by adults. Generally, the frequency of breathing
that occurs in more children. In adults, the frequency of breathing becomes slower
because the activity of cells in the body decreases. For more details, the following
normal frequencies based on age are as follows:
1) Newborn age, the frequency of breathing ranges from 35-50 times per
minute.
2) Age 2-12 years, the frequency of breathing ranges from 18-26 times per
minute.
3) Adult adults, the respiratory rate ranges from 16-20 times per minute.
4) Sex type
In general, under normal circumstances, the frequency of breathing in men is
greater than that of women. This happens because men tend to need more energy
than women so that the oxygen needed becomes more and more
b. Body Temperature
The temperature has a close relationship with breathing. The higher a person's
body temperature, he will need more energy so that the need for oxygen will
increase. Therefore, the frequency of breathing will be more often done.
 c. Body Position
The position of the body turns out to have a considerable influence on the
frequency of breathing. Someone who is standing, the frequency of breathing will
be more common than someone whose body position is lying down. When we
stand the muscle activity in the body will be more often contracted so that the
oxygen needed for the oxidation process in the body becomes more numerous,
this results in the frequency of inspiration and expiration becoming more frequent.
Meanwhile, when lying down, the muscles in the body tend to relax so that the
need for oxygen is not as much as when we stand.
d. Body Activity
Someone who has high body activity such as a farmer or athlete, the
frequency of breathing will be higher than a secretary who tends to do his work
activities by sitting. This is due to the energy needed by a farmer or athlete more
when compared to someone who is active in a way to sit.
From this description we can draw conclusions as follows:
1) The frequency of breathing can be reduced because of someone's age
2) The energy needed by people who are elderly is less than those who are
young so that the oxygen needed is reduced
3) Respiratory rate in men is higher than the frequency of breathing in a
woman
4) Respiratory frequency in children tends to be more compared to the
frequency of breathing in older people
5) Respiratory frequency in people who have higher physical activity tends to
be more frequent than people who have low physical activity.
2. Psychological factors such as emotions, mentality, feelings, energy and aura, and
spiritual stability.
a. Emotion
A person's emotions affect a person's high and low breathing. someone who is
emotional like anger, the frequency of breathing will tend to be high compared to
someone who has stable or normal emotional state.
b. Feelings
 Fear of someone will speed up the frequency of breathing, this is due to
increased heart rate activity so that the body needs more energy intake
c. Soul
Psychology is closely related to the nature or character of a person. Someone
who has a cheerful soul tends to have more active activities than someone who is
shy. Thus the respiratory frequency in jolly people tends to be higher than those
who are shy.
d. Spiritual stability
Someone who has a good understanding of the science of religion, his
spiritual condition tends to be better, their hearts will be filled with a sense of
calm and serenity so far from anxiety and excessive worry.
3. Volume of respiratory air in humans
Previously it was described that the frequency of breathing in each person could be
different. Similarly, the volume of breathing air. Respiratory air volume in humans is
affected by:
a. Lung size
Someone who has a large lung size will have a large volume of respiratory
air, and vice versa. This is caused by people whose large lungs will affect the
amount and extent of the alveoli in exchanging oxygen and carbon dioxide.
b. Strength of breathing
A diver tends to have more breathing power, this is supported by the capacity
of the air volume that can be accommodated in the lungs.
c. How to breathe
A good way to breathe is to breathe using the nose. Because in addition to
being able to filter the dust so that it does not enter it can also improve the
breathing rhythm. People who breathe using the nose tend to need relatively little
air volume than people who breathe using their mouths.
D. Pathophysiology, pharmacology and therapy
Several disorders and diseases of the human respiratory system include:
1. Asthma
Asthma is characterized by rigid contractions of the bronchioles which cause
difficulty breathing. Asthma is usually caused by hypersensitivity of the bronchioles
or bronchial asthma to foreign objects in the air.
The use of asthma medication inhaled through an inhaler or nebulizer is the
doctor's first choice for the treatment of long-term asthma rather than oral
medications. The reason, inhaled drugs work more effectively deliver drugs directly
to the respiratory tract tissue and are safer because of the minimal risk of side effects.
Examples of inhaled steroid drugs that are usually used in the treatment of
long-term asthma are omalizumab (anti-ige), long acting beta2 agonists, fluticasone
(flonase, flovent hfa), budesonide (pulmicort felxhaler, rhinocort), flunisolide
(aerospan hfa), ciclesonide (alvesco , omnaris, zetonna), beclomethasone (qnasl,
qvar), mometasone (asmanex), and fluticasone furoate (arnuity ellipta).
2. Tuberculosis
Tuberculosis is a specific disease caused by the bacterium mycobacterium
tuberculosae. This bacterium can attack all organs of the body, but most often are the
lungs and bones. This disease causes diffusion of oxygen which is disrupted due to
the presence of small spots on the alveolar wall.
Oral drug therapy recommended by doctors is isoniazid, rifampicin,
ethambutol, pyrazinamide and streptomycin for 6 months. Usually this type of
injectable tb drug is given if you have experienced tb for the second time or have not
recovered with drinking medication.
3. Phaaryngitis
Pharyngitis is inflammation of the pharynx so that pain arises when
swallowing food or the esophagus feels dry. This disorder is caused by a bacterial or
viral infection and can also be caused by too much smoking. The bacteria that usually
attacks this disease is streptococcus pharyngitis.
Treatment of pharyngitis is based on the cause. If this condition is caused by a
virus, then self-handling can be done at home to restore the condition to the body's
immune system to conquer the infection. For example by:
 1. Take freely available pain relievers, such as paracetamol and ibuprofen, to relieve
sore throats.
2. Get plenty of rest.
3. Drink plenty of fluids to prevent dehydration.
4. Using air humidifier in the room.
5. Eat warm broth or cold drinks.
6. Gargle with warm salt water.
7. Eat throat lozenges to relieve sore throat
4. Brochitis
Bronchitis due to inflammation of the bronchi or ducts that carry air to the lungs. It
can be caused by germ, virus, or bacteria infection. Other causes are cigarette smoke,
dust or air pollutants.
In some cases, the doctor will prescribe medicines such as:
a. Antibiotics: Bronchitis is usually caused by a viral infection, so antibiotic use is
not very effective. However, if the cause is a bacterial infection, the doctor will
give antibiotics. If you have a chronic lung disorder or you are a smoker, then the
use of antibiotics can reduce the occurrence of secondary infections.
b. Treatment for coughing: Coughing will help remove dirt from the lungs. If a
cough occurs during sleep, then you should take drugs to treat a simple cough to
help you sleep, but this drug is not very effective for removing coughs. If a cough
occurs that prevents you from sleeping, your doctor will provide a more effective
cough medicine.
c. Other medicines: If you have asthma or chronic obstructive pulmonary disease
(COPD), your doctor will recommend you use inhalers and take other treatments
that can reduce inflammation and open the narrowed respiratory tract
5. Pneumonia
Pneumonia is inflammation of the lungs where the alveoli is usually infected
by fluid and excessive erythrocytes. The infection is caused by bacteria from one
alveolus to another alveolus so that it can expand throughout the entire lobe
throughout the lungs.
 Treatment of pneumonia aims to cure infections that occur, and prevent
complications caused. Treatment is carried out according to the causes and severity
experienced. For mild pneumonia, patients will be given drugs in the form of:
a. Painkillers. This medicine is given to relieve fever and discomfort. An example
of this drug is ibuprofen or paracetamol.
b. Cough medicine. This medicine can relieve coughing so that patients can rest.
Giving this drug should be done in low doses. In addition to relieving cough,
there are types of cough medicines that function to thin the phlegm.
c. Antibiotics. This drug is used to treat bacterial pneumonia. Most pneumonia
sufferers respond well to antibiotics within 1-3 days
6. Pulmonary emphysema
Pulmonary emphysema is caused by loss of alveolar elasticity. In people with
emphysema, the lung volume is greater than that of healthy people because the
carbon dioxide that is supposed to be released from the lungs is trapped inside.
Cigarette smoke and lack of the alpha-i-antiripsin enzyme are causes of loss of
elasticity in the lungs.
There is no cure for emphysema. However, the following treatments can help
avoid symptoms that worsen your condition:
a. If you are a smoker, you should immediately stop smoking. Drugs such as
bronchodilators, steroids, or antibiotics can be given by doctors to reduce
coughing, relieve shortness of breath and prevent bacterial infections.
b. Therapy: lung rehabilitation, nutritional therapy or oxygen supplements can
correct breathing problems and help you regulate your weight, where you may
experience sudden changes in your weight.
c. Surgery: lung volume reduction surgery is a procedure wherein the doctor
removes damaged lung tissue to help the lungs work more effectively and relieve
shortness of breath. 4. Lung transplantation may be needed if the condition is
serious.
d. You may be asked to get influenza and pneumococcal vaccines to protect against
respiratory infections.
7. Diphtheria
 Diphtheria is a disease caused by bacteria that can cause blockages in the
pharyngeal cavity or pharyngitis and larynx or laryngitis by mucus produced by these
bacteria
The doctor will immediately deal with this disease, because diphtheria is a
very serious condition. First, the doctor will give an injection of antitoxin, to fight
poisons produced by bacteria. If you are allergic to antitoxin, you need to tell your
doctor so the doctor can adjust the treatment.
In patients with allergies, doctors will usually give a low dose of antitoxin and
increase the level gradually. After that, the doctor will give antibiotics to help deal
with the infection. After the medication is given, the doctor can recommend the
driving dose of diphtheria vaccine after being healthy, to build a defense against
diphtheria bacteria
8. Asfiction
Asfiction is a disorder in transporting oxygen to tissues caused by disruption
of lung function, blood vessels and body tissues.
Handling of neonatal asphyxia varies depending on the cause. But in general,
infants who experience neonatal asphyxia will receive oxygen supplementation at
birth and need to undergo intensive treatment at the hospital.
If neonatal asphyxia is caused by a hyaline membrane disorder, the baby will
generally be fitted with CPAP (continuous positive airway pressure). This is a tool to
help baby's breathing by inserting positive pressure into the lungs so that the lungs
expand. In addition, surfactants (substances to develop lungs) can also be given.

9. Lung cancer
This disease is uncontrolled cancer cell growth in lung tissue. This cancer
affects the exchange of gas in the lungs and spreads throughout the body. Smoking is
the main cause, other causes that trigger this disease are sufferers breathing in
asbestos dust, chromium, petroleum products, and ionizing radiation.
Surgical removal of cancer can be done if the cancer is only on one side of the
lung and has not spread. In addition, the health condition of patients with lung cancer
 needs to be examined whether it is possible to do the surgery. Surgical removal of the
cancer will usually be continued with chemotherapy to eliminate the remaining
cancer cells.
For cancer that has spread, only radiotherapy and / or chemotherapy can be
done. In addition, biological therapy is also available as an alternative to
chemotherapy. Biological therapy aims to control and suppress the development of
cancer.
E. Assessment Of Breathing Systems
Physical examination is done after collecting a medical history. Use inspection, palpation
and auscultation techniques.
1. INSPECTION
Pay attention to current respiratory distress: comfortable position,
tachypnea, floats, cyanosis, open mouth, expansive nose lobes, dipsnea, facial and
lip skin color, and use of the respiratory system muscles. Pay attention to the risk
of inspiration and expiration, because the duration of expiration is twice the
normal length of inspiration, then the risk of normal expiration: expiration 2: 1.
Observe speech patterns.
Observe the client's general appearance, frequency and pattern of
breathing, and thoracic configuration.
2. PALPASI
The chest is palpated to evaluate the skin and walls of the chest. Palpation
of the chest and spinal cord is a general screening technique to identify
abnormalities such as inflammation. Chest wall palpation, assess for crepitus (air
in subcutaneous tissue), chest wall defects or tenderness, muscle tone, tactile
edema and fremitus or vibrations of air movement through the chest when the
client is talking.
3. PERCUSION
Tapping the chest wall between ribs produces a variety of sounds that are
described according to their acoustic properties - resonant, hyperventural, deaf,
flat or tympanic. The resonant sound is heard through the normal lung tissue. A
hyperresponsive sound is heard in the presence of increased air in the lungs or
 pleural specimens, commonly found in emphysema and pneumothorax patients.
Shaky sounds occur over dense lung tissue, such as in tumors or lung tissue
consolidation, usually heard by heart and liver bags. Flat sounds will be heard
when percussion is done on tissues that do not contain air. The tympanic sound is
usually heard above the stomach, the large intestine. Percussion was also carried
out to assess the excretion of the diaphragm.
4. AUSKULTASI
Able to assess the character of breath sounds through the mouth, there are
additional breath sounds, and sound characters that are spoken or whispered.
Normal breath sounds are called vascular, bronchial, and bronchovascular.
Changes in breath sounds that might indicate a state of pathology.
Including decreased or inaudible breath sounds, increased breath sounds, and
breath sounds overtaking each other or what is known as adventitic sounds.
Increased breath sounds will be heard if conditions such as atelectasis and
pneumonia increase desistas (immune) lung tissue. Decreasing or not audible
breath occurs when the transmission of sound waves that pass through the lung
tissue or chest wall decreases.