Respiratory System

CHAPTER 11
2
Respiratory System Overview
Responsibilities of respiratory system
Respiration = exchange of gases between
body and air
Provides oxygen to body cells for energy
Removes carbon dioxide from body cells
Production of sound
Assisting in bodys defense against foreign
materials

3
External respiration
Oxygen is inhaled into lungs
Passes through capillaries of the lungs into
the pulmonary bloodstream
Carbon dioxide passes from blood through
the same capillaries into the lungs and is
exhaled
Respiratory System Overview
4
Internal respiration
Inhaled oxygen circulates from pulmonary
bloodstream in the lungs, back through the
heart, to systemic bloodstream, to the body
cells
At cellular level, oxygen passes through capillaries
into tissue cells where it is used for energy
Carbon dioxide passes from tissue cells into
capillaries and travels through bloodstream for
removal from body via lungs
Respiratory System Overview
5
Respiratory System Structures
Nose
External portion composed of cartilage and
bone covered with skin
Entrance to nose = nostrils or nares
Air enters body through the nose and mouth
Nasal cavity
Divided into left and right chambers by
dividing wall called the septum
As air enters through nose, it passes into the nasal
cavity
6
Paranasal sinuses
Hollow areas or cavities within the skull
that communicate with the nasal cavity
Lighten the skull and enhance the sound of
the voice
Lined with mucous membranes
Help to warm and filter the air as it enters the
respiratory system
Cilia (hairlike projections on mucous
membranes) sweep dirt and foreign material
toward throat for elimination
Respiratory System Structures
7
Pharynx
Airway that connects the mouth and nose
to the larynx
Also known as the throat
Serves as a common passageway for both air
and food
Respiratory System Structures
8
Pharynx
Commonly divided into three sections
Nasopharynx
Contains the adenoids
Oropharynx
Contains the tonsils (palatine tonsils)
Laryngopharynx
Respiratory System Structures
9
Larynx
Connects pharynx with trachea
Also known as the voice box
Most prominent of supporting cartilages is
the thyroid cartilage at the front
Forms the Adams apple
Contains structures that make vocal sounds
possible the vocal cords
Vocal cords vibrate as air passes through the
space between them, producing sound
Respiratory System Structures
10
Trachea
Extends into the chest and serves as a
passageway for air to the bronchi
Commonly known as the windpipe
Bronchi
Trachea branches into two tubes called the
bronchi
Each bronchus leads to a separate lung
Divides and subdivides into progressively smaller
tubes called bronchioles
Respiratory System Structures
11
Bronchioles
Smallest branches of bronchi
Terminal ends known as alveoli
Air sacs
Have thin walls that allow for exchange of gases
between the lungs and the blood
Alveoli = pulmonary parenchyma
Respiratory System Structures
12
Lungs
Two cone-shaped, spongy organs consisting
of alveoli, blood vessels, elastic tissue, and
nerves
Left lung has two lobes and right lung has
three lobes
Apex = uppermost part of lung
Base = lower part of lung
Hilum = portion in midline region where blood
vessels, nerves, and bronchial tubes enter and
exit the lungs
Respiratory System Structures
13
Pleura
Double-folded membrane that surrounds the
lungs
Parietal pleura
Outer layer of the pleura which lines the thoracic
cavity
Visceral pleura
Inner layer of the pleura which covers the lungs
Respiratory System Structures
14
Pleura
Pleural space
Small space between the pleural membranes
Filled with lubricating fluid that prevents friction
when the two membranes slide against each other
during respiration

Respiratory System Structures
15
Breathing Process
Inhalation = inspiration
Diaphragm is stimulated by phrenic nerve
Diaphragm contracts and flattens (descends)
Chest cavity enlarges
Decrease in pressure within the thorax
Air is drawn into the lungs
16
Breathing Process
Exhalation = expiration
Diaphragm relaxes and rises back into
thoracic cavity
Chest cavity decreases in size
Increase in pressure with the thorax
Air is forced out of lungs
17
Physical Exam Techniques
Inspection
Visual examination of the external surface of
the body as well as of its movements and
posture
Palpation
Process of examining by application of the
hands or fingers to the external surface of the
body to detect evidence of disease or
abnormalities in the various organs
18
Physical Exam Techniques
Auscultation
Process of listening for sounds within the
body, usually to sounds of thoracic or
abdominal viscera, to detect some abnormal
condition, or to detect fetal heart sounds
Performed with a stethoscope
19
Physical Exam Techniques
Percussion
Use of the fingertips to tap the body lightly
but sharply to determine position, size, and
consistency of an underlying structure and
the presence of fluid or pus in a cavity
Tapping over solid organ = dull flat sound
Tapping over air-filled structure = clear, hollow
sound
20
Common Signs and Symptoms
Apnea
Temporary cessation of breathing
Without breathing
Bradypnea
Abnormally slow breathing
Evidenced by respiratory rate slower than 12
respirations per minute
21
Cough
Forceful and sometimes violent expiratory
effort preceded by a preliminary inspiration
Glottis is partially closed, accessory muscles of
expiration brought into action, air is noisily
expelled
Due to irritation of the airways or infection
Irritants = dust, smoke, mucus
Common Signs and Symptoms
22
Cough
Nonproductive = unproductive
Not effective in bringing up sputum
Dry cough
Productive
Effective in bringing up sputum
Wet cough
Common Signs and Symptoms
23
Cyanosis
Slightly bluish, grayish, slatelike, or dark
purple discoloration of the skin due to
presence of abnormal amounts of reduced
hemoglobin in the blood
Dysphonia
Difficulty in speaking
Hoarseness
Common Signs and Symptoms
24
Dyspnea
Air hunger resulting in labored or difficult
breathing, sometimes accompanied by pain
Epistaxis
Hemorrhage from the nose; nosebleed
Common Signs and Symptoms
25
Expectoration
Act of spitting out saliva or coughing up
materials from the air passageways
leading to the lungs
Hemoptysis
Expectoration of blood arising from the oral
cavity, larynx, trachea, bronchi, or lungs

Common Signs and Symptoms
26
Hypercapnia
Increased amount of carbon dioxide in the
blood
Hypoxemia
Insufficient oxygenation of the blood
Hypoxia
Deficiency of oxygen
Common Signs and Symptoms
27
Kussmaul respirations
Very deep, gasping type of respiration
associated with severe diabetic acidosis
Orthopnea
Respiratory condition in which there is
discomfort in breathing in any but erect,
sitting, or standing position
Common Signs and Symptoms
28
Pleural rub
Friction rub caused by inflammation of the
pleural space
Rales
Abnormal sound heard on auscultation of the
chest, produced by passage of air through
bronchi that contain secretion or exudate or
that are constricted by spasm or a thickening
of their walls
Common Signs and Symptoms
29
Rhinorrhea
Thin, watery discharge from the nose
Rhonchi
Rales or rattlings in the throat, especially
when it resembles snoring
Common Signs and Symptoms
30
Sneeze
To expel air forcibly through the nose and
mouth by spasmodic contraction of muscles
of expiration due to irritation of nasal mucosa
Stridor
Harsh sound during respiration
High pitched and resembling the blowing of
wind, due to obstruction of air passages
Common Signs and Symptoms
31
Tachypnea
Abnormal rapidity of breathing
Wheeze
Whistling sound or sighing sound resulting
from narrowing of the lumen of a respiratory
passageway
Common Signs and Symptoms
PATHOLOGICAL CONDITIONS
Upper
Respiratory System
33
Coryza
Pronounced
(kor-RYE-zuh)
Defined
Inflammation of the respiratory mucous
membranes known as the common cold
Common cold usually refers to symptoms of an
upper respiratory tract infection
34
Croup
Pronounced
(KROOP)
Defined
Childhood disease characterized by a barking
cough, suffocative and difficult breathing,
stridor, and laryngeal spasm
35
Diphtheria
Pronounced
(diff-THEER-ree-uh)
Defined
Serious infectious disease affecting the nose,
pharynx, or larynx, usually resulting in sore
throat, dysphonia, and fever
Caused by bacterium Corynebacterium
diphtheriae which forms a white coating over the
affected airways as it multiplies
36
Laryngitis
Pronounced
(lair-in-JYE-tis)
Defined
Inflammation of the larynx, usually resulting in
hoarseness, cough, and difficulty swallowing
Causes: abuse of the voice, upper respiratory tract
infection, chronic bronchitis, chronic sinusitis
37
Pertussis
Pronounced
(per-TUH-sis)
Defined
Acute upper respiratory infectious disease,
caused by the bacterium Bordetello pertussis
Also known as whooping cough
38
Pharyngitis
Pronounced
(fair-in-JYE-tis)
Defined
Inflammation of the pharynx, usually resulting
in sore throat
Usually caused by a virus
39
Rhinitis
Pronounced
(rye-NYE-tis)
Defined
Inflammation of the mucous membranes of
the nose
Usually resulting in obstruction of the nasal
passages, rhinorrhea, sneezing, and facial
pressure or pain
40
Sinusitis
Pronounced
(sigh-nus-EYE-tis)
Defined
Inflammation of a sinus, especially a
paranasal sinus
Usually results in pain and a feeling of pressure in
the affected sinuses
41
Tonsillitis
Pronounced
(ton-sill-EYE-tis)
Defined
Inflammation of the palatine tonsils: tonsils
appear enlarged and red with yellowish
exudate
Symptoms:
Sore throat, fever, snoring, difficulty swallowing
PATHOLOGICAL CONDITIONS
Lower
Respiratory System
43
Asthma
Pronounced
(AZ-mah)
Defined
Paroxysmal dyspnea accompanied by
wheezing caused by a spasm of the bronchial
tubes or by swelling of their mucous
membrane
Occurs most frequently in childhood or early
adulthood
44
Bronchiectasis
Pronounced
(brong-key-EK-tah-sis)
Defined
Chronic dilatation of a bronchus or bronchi,
with secondary infection that usually involves
the lower portion of the lung
45
Pronounced
(brong-KIGH-tis)
Defined
Inflammation of the mucous membrane of the
bronchial tubes
Infection is often preceded by the common cold
Patient may experience productive cough,
accompanied by wheezing, dyspnea, and chest
pain
Bronchitis
46
Acute Bronchitis
Causes are viral infection, bacterial infection,
and airborne irritants
Chronic Bronchitis
Primarily associated with cigarette smoking or
exposure to pollution
Smoke irritates airways, resulting in inflammation
and hypersecretion of mucus
Productive cough is present for at least three
months of two consecutive years
Bronchitis
47
Bronchogenic Carcinoma
Pronounced
(brong-koh-JEN-ic car-sin-OH-mah)
Defined
Malignant lung tumor that originates in the
bronchi
Lung cancer
48
Emphysema
Pronounced
(em-fih-SEE-mah)
Defined
Chronic pulmonary disease characterized by
increase beyond the normal in the size of air
spaces distal to the terminal bronchiole, either
from dilation of the alveoli or from destruction
of their walls
49
Empyema
Pronounced
(em-pye-EE-mah)
Defined
Pus in a body cavity, especially in the pleural
cavity
Usually the result of a primary infection in the lungs
50
Hyaline Membrane Disease
Pronounced
(HIGH-ah-lighn membrane dih-ZEEZ)
Defined
Severe impairment of respiration in
premature newborn
Also known as respiratory distress syndrome
(RSD)
51
Influenza
Pronounced
(in-floo-IN-zah)
Defined
Highly contagious viral infection of the
respiratory tract transmitted by airborne
droplet infection
Also known as the flu
Symptoms include sore throat, cough, fever,
muscular pains, and generalized weakness
52
Lung Abscess
Pronounced
(lung AB-sess)
Defined
Localized collection of pus formed by the
destruction of lung tissue and
microorganisms by white blood cells that
have migrated to the area to fight infection
53
Pleural Effusion
Pronounced
(PLOO-ral eh-FYOO-zhun)
Defined
Accumulation of fluid in the pleural space,
resulting in compression of the underlying
portion of the lung, with resultant dyspnea
Usually secondary to some other disease
54
Pleuritis (Pleurisy)
Pronounced
(ploor-EYE-tis)
(PLOOR-ih-see)
Defined
Inflammation of both the visceral and parietal
pleura
55
Pneumonia
Pronounced
(new-MOH-nee-ah)
Defined
Inflammation of the lungs caused primarily by
bacteria, viruses, and chemical irritants
56
Pneumothorax
Pronounced
(new-moh-THOH-racks)
Defined
Collection of air or gas in the pleural cavity
Air enters as the result of a perforation through the
chest wall or the pleura covering the lung
57
Pulmonary Edema
Pronounced
(PULL-mon-air-ree eh-DEE-mah)
Defined
Swelling of the lungs caused by an abnormal
accumulation of fluid in the lungs, either in the
alveoli or the interstitial spaces
58
Pronounced
(PULL-mon-air-ree heart dih-ZEEZ)
(cor pull-mon-ALL-ee)
Defined
Hypertrophy of the right ventricle of the heart
(with or without failure) resulting from
disorders of the lungs, pulmonary vessels, or
chest wall

Pulmonary Heart Disease
(Cor Pulmonale)
59
Sudden Infant Death Syndrome
Pronounced
(sudden infant death SIN-drohm)
Defined
Unexpected and unexplained death of an
apparently well, or virtually well infant
Also known as crib death or SIDS
60
Pronounced
(too-ber-kyoo-LOH-sis)
Defined
Infectious disease caused by the tubercle
bacillus, Mycobacterium tuberculosis
Inflammatory infiltrations, formation of
tubercles, and caseous (cheeselike) necrosis
in the tissues of the lungs
Tuberculosis
PATHOLOGICAL CONDITIONS
Work-Related
62
Anthracosis
Pronounced
(an-thrah-KOH-sis)
Defined
Accumulation of carbon deposits in the lungs
due to breathing smoke or coal dust
Also known as black lung disease or coal
workers pneumonoconiosis
63
Asbestosis
Pronounced
(as-beh-STOH-sis)
Defined
Lung disease resulting from inhalation of
asbestos particles
64
Byssinosis
Pronounced
(bis-ih-NOH-sis)
Defined
Lung disease resulting from inhalation of
cotton, flax, and hemp
Also known as brown lung disease
65
Silicosis
Pronounced
(sill-ih-KOH-sis)
Defined
Lung disease resulting from inhalation of silica
(quartz) dust, characterized by formation of
small nodules
DIAGNOSTIC
TECHNIQUES, TREATMENTS
AND PROCEDURES
Respiratory System
67
Bronchoscopy
Examination of interior of bronchi using a
lighted, flexible bronchoscope (or endoscope)
Chest X-ray
High-energy electromagnetic waves passing
through the body onto a photographic film
Produces a picture of the internal structures of
the body for diagnosis and therapy
Diagnostic Techniques,
Treatments, and Procedures
68
Laryngoscopy
Examination of interior of the larynx using a
lighted, flexible tube known as a laryngoscope
(or endoscope)
Lung scan
Visual imaging of the distribution or ventilation
or blood flow in the lungs by scanning the
lungs after the patient has been injected with
or has inhaled radioactive material
Diagnostic Techniques,
Treatments, and Procedures
69
Pulmonary function tests
Variety of tests performed to assess
respiratory function
Sputum specimen
Specimen of material expectorated from the
mouth
If produced after a cough, it may contain, in
addition to saliva, material from the throat and
bronchi
Diagnostic Techniques,
Treatments, and Procedures
70
Thoracentesis
Procedure that involves the use of a needle
to collect pleural fluid for laboratory analysis,
or to remove excess pleural fluid or air from
the pleural space
Diagnostic Techniques,
Treatments, and Procedures
71
Diagnostic Techniques,
Treatments, and Procedures
Tonsillectomy
Surgical removal of the palatine tonsils
Usually combined with an adenoidectomy (surgical
removal of adenoids)
Tuberculin skin test (TST)
Determines past or present tuberculosis
infection present in the body
Based on positive skin reaction to the introduction
of a purified protein derivative (PPS) of the
tubercula bacilli into the skin