Professional Documents
Culture Documents
I. FUNCTION
• To supply the body with oxygen and dispose carbon dioxide
• It involves at least 3 distinct process:
1. Pulmonary Ventilation
Inflow and outflow of air between the atmosphere and
alveoli of the lungs
2. External Respiration
Diffusion of oxygen and carbon dioxide between the alveoli
and pulmonary capillaries
3. Internal Respiration
Transport of oxygen and carbon dioxide via the blood to
and from the tissue
II. FUNCTIONAL ANATOMY OF THE RESPIRATORY SYSTEM
A. Conducting Zone
• Also called as “dead space” because there is no gas exchange
in these zones
• Respiratory passages extending from nose to the terminal
bronchioles
B. Respiratory Zone
• Actual site of gas exchange
• Composed of the respiratory bronchioles, alveolar ducts, and
alveoli
i. Conducting Zone Structures
a. Nose
b. Pharynx
c. Larynx
d. Trachea
e. Bronchi
1
Right bronchus Left bronchus
Diameter Wider Narrower
Length Shorter Longer
Direction More vertical Oblique
2
A. Lungs
Right Lung Left Lung
• Lobes 3 2
• Fissures 1 horizontal 1 oblique
1 oblique
• Cardiac notch (- ) (+)
• Lingula (- ) (+)
B. Pleura
IV. MUSCULAR CONTROL OF BREATHING
A. Inspiration
• Diaphragm contracts moves inferiorly and flattens out
increase height of the thoracic cavity
• Contraction of the external intercostals muscles elevates the
rib cage and thrust the sternum forward expand the diameter
of the thorax
B. Expiration
• Inspiratory muscles relax rib cage descends and lungs recoil
V. AIRWAY RESISTANCE AND COMPLIANCE
A. Airway resistance
• Determined chiefly by radium or size of the airway
• Changes in bronchial diameter alters the rate of air flow for
a given pressure gradient during respiration
• ↑ resistance – greater than normal respiratory effort is
required
B. Compliance
• A measure of the elasticity, expandability, and distensibility of
the lungs and thoracic structures
• Normal compliance lungs and thorax easily stretch and
distend when pressure is applied
3
• High or ↑ compliance lungs have lost elasticity and the
thorax is overdistended ? (example)
• Low or ↓compliance lungs and thorax are stiff ?
(example)
VI. GAS EXCHANGE IN THE BODY
VII. CONTROL OF RESPIRATION
A. Medullary Respiratory Centers
a. Dorsal respiratory group or inspiratory center
b. Ventral respiratory group or expiratory center
B. Pons Respiratory Centers
a. . Pneumotaxic Center rhythm and prevents over inflation of
the lungs
b. Apneustic Center inspiratory drive
C. Chemical Control of Respiration
a. Central chemoreceptor
i. Located bilaterally in the medulla
ii. Sensitive to small changes in blood CO2 and pH
iii. Hypercapnia / ↑ CO2 the most powerful respiratory
stimulant
iv. Release of H ions in the CSF reflexive increase in the
rate and depth of breathing
b. Peripheral chemoreceptor
i. Found within vessels of the neck (carotid and aortic
bodies)
ii. Sensitive to arterial oxygen levels
iii. ↓ arterial pressure of oxygen (below 60 mmHg)
becomes the major stimulus for respiration ↑ ventilation
ASSESSMENT
Major Signs and Symptoms of Respiratory Diseases
4
a. Dyspnea
How much exertion triggers SOB?
Is there an associated cough?
Is dyspnea related to the symptoms?
At what time of day or night does the dyspnea occur?
Is the SOB worse when the patient is flat in bed?
Does the SOB occur at rest? With exercise? Running? Climbing
stairs?
Is the SOB worse while walking?
Management: Identify and correcting its cause, rest, positioning,
oxygen administration
b. Sputum production
Purulent with change in color – bacterial infection
Profuse, frothy, pink material – pulmonary edema
Foul smelling associated with bad breath – lung abscess,
bronchiectasis
Management: ↑ OFI, inhalation of aerosolized solutions, chest
physiotherapy
c. Chest Pain
Sharp, stabbing, and intermittent – pulmonary problem
Dull, aching, and persistent
Management: Analgesics
d. Wheezing
Bronchoconstriction or airway narrowing
Management: Bronchodilators
e. Hemoptysis
Most common causes: pulmonary infection, lung Ca, heart or
blood vessel abnormalities, pulmonary artery or vein abnormalities,
pulmonary emboli and infarction
5
Determine the source and treat the underlying cause of
bleeding
f. Cyanosis
A very late indicator of hypoxia
Nor a reliable sign of hypoxia
g. Clubbing of the Fingers
Found in patients with chronic hypoxic conditions, chronic lung
infections, lung Ca