Module A2: Upper Airway Anatomy & Physiology

Objectives

Classify epithelial tissue based on cell type and tissue layers. Identify location of tissue epithelium in the respiratory system. Describe the major structures and functions of the upper and lower airways. Contrast and compare mouth and nose breathing. Explain how placing an endotracheal tube in the airway will affect the humidification and filtering process.

The lung is for gas exchange.

John B. West Respiratory Physiology: The Essentials

Function of the Lungs/Heart

Provide

Ventilation Provide Respiration

Exchange

of Carbon Dioxide and Oxygen

Humidify

and Protect Pump oxygen to vital organs

Cellular

metabolism

Failure of the Lungs/Heart

Hypoxemia
Decreased

low oxygen level in the blood

PaO2

Hypoxia

- low oxygen level at the tissue

level
Decreased

oxygen at the cellular level can cause death of the tissue Presence of anaerobic respiration

Ventilation
Brain
Muscles Lungs Inability

of the lungs to remove carbon dioxide leads to hypercarbia, which is an elevated amount of carbon dioxide in the blood stream (PaCO2)

ARTIFICIAL AIRWAYS

INTUBATION

ARTIFICIAL AIRWAYS
Tracheotomy with tracheostomy tube: 1 - Vocal cords 2 - Thyroid cartilage 3 - Cricoid cartilage 4 - Tracheal cartilages 5 - Balloon cuff
INTUBATION

Intubation Insertion of an Endotracheal Tube Extubation Removal of the Endotracheal Tube

Anatomy of the Respiratory System

Tissue

Epithelium Upper Airway Lower Airway Site of Gas Exchange Pulmonary Vascular System

Neural
Lungs

Control

Mediastinum

Thorax
Muscles

of Ventilation

Four Tissue Types

Epithelial

Tissue Connective Tissue

Bone,

Cartilage, Blood, Fibrous

Muscle

Tissue Nervous Tissue

Neurons

conduct electrical impulses

Epithelial Tissue
Epithelium
Covers

and protects the body surface Lines body cavities Forms many glands Specializes in moving substances into and out of the blood

Epithelial Cell Type

Squamous

Cells Cuboidal Cells Columnar Cells

HISTOLOGY 101

Lots of Surface Area

Lots of Volume

Height is 2x Width Usually associated with secretion or absorption of material Very little diffusion

aka Pavement, Sunnyside up egg

Great for Diffusion of Gases

Volume = Cytoplasm
Cytoplasm means metabolism Less diffusion

Classification of Epithelium by Layers

Simple

Epithelium Single Layer

Simple

squamous Simple cuboidal Simple columnar

Epithelium Multiple Layers Pseudostratified Single Layer but appears stratified

Stratified
Pseudo

means false

Goblet Cells

Nose to Large Bronchioles

Secrete mucus

Stratified Squamous Epithelium

Associated

with PROTECTION Anterior portion of nasal cavity Oral cavity Oropharynx Laryngopharynx

Pseudostratified Columnar Epithelium

SECRETION

OF AND SWEEPING OF MUCUS Posterior 2/3 of nose Tracheobronchial tree Function of cilia

Simple Cuboidal Epithelium

PRIMARY

FUNCTION IS SECRETION, FILTRATION & ABSORPTION Bronchioles Clara Cells

Non-ciliated

cells that secrete surfaceactive agents which prevent collapse.

Simple

Cuboidal also found in alveoli (Type II cells that secrete surfactant)

Simple Squamous Epithelium

FUNCTION GAS EXCHANGE Alveoli (Type I pneumocytes) Pulmonary capillaries
PRIMARY

Upper Airway
Anatomy
Nose Oral

Cavity Pharynx
Throat

Upper Airway
Function

of the Upper Airway

Conduct

Air To prevent foreign materials from entering the lower airway Smell/Speech

Nose
Function
Heat, Smell Speech

Humidify and Filter the incoming gas

Anatomy of the Nose

Bone

and Cartilage Partition in the nose is called the nasal septum Air enters through the nostrils or nares Two nasal passages are called choanae Vibrissae filter the incoming gas
Whiskers

First

1/3 is stratified squamous epithelium (PROTECTION) Posterior 2/3 is pseudostratified ciliated columnar epithelium (MUCUS SECRETION)

Anatomy of the Nose

Mucous

secreting glands are found in the posterior 2/3 of nose Bony Protrusions on the lateral wall are called nasal turbinates or conchae
Separate

incoming gas into turbulent airstreams more contact

Extensive
Constrict

capillary network
or dilate to change blood flow

Nasal Conchae

Deviated Septum
The

nasal septum can be deviated to the right or left

More often to the left

Rhinitis: Inflammation of the nasal membrane

20% of Population

$5.3 Billion/Year

Physiology of the Nose

can filter particles down to 5 m (microns) in diameter Two factors which decrease the humidification and filtering ability of the nose is:
Nose
Mouth

Breathing Placement of an ET (endotracheal) tube

Paranasal Sinuses
Empty

air spaces found in the bones of the skull; Paired

Frontal

Ethmoid
Sphenoid Maxillary

They

contain mucous secreting goblet cells which drain into the nasal cavity

Nose and Nasal Cavities

Anatomy of the Oral Cavity

Roof

of the mouth is formed by the hard and soft palate

Bony portion Soft Fleshy portion
Hard

Uvula

is the soft fleshy structure Epithelium is stratified squamous epithelium which is non-ciliated. Palatine (faucial) tonsils are located on each side of the oral cavity.

TONSILS

Pharynx - Throat
Nasopharynx
Oropharynx Laryngopharynx

Nasopharynx
Located

posterior to nasal

cavity Pseudostratified ciliated columnar epithelium Includes pharyngeal tonsils or adenoids Eustachian Tubes (auditory tubes)
Connects

the middle ear and nasopharynx Middle ear infection is called otitis media

Complication of ET tubes

Oropharynx
Lies

behind the oral cavity Lingual tonsils lie at the root of the tongue Statified squamous epithelium

Laryngopharynx
Lies

between the base of the tongue and the entrance to the esophagus Lies posterior to the epiglottis Stratified squamous epithelium aka Hypopharynx