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The Respiratory System Dean Handimulya, MD Dean Handimulya UIEU 2005 Introduction • The primary function of the respiratory system is to provide oxygen to, and remove carbon dioxide from, the bloodstream. • The respiratory system can be devided into three main portion : – the upper airway – the lower airway – the terminal alveoli Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 Upper Airway • • • • • Nasal cavities Sinuses Pharynx Tonsils Larynx Dean Handimulya UIEU 2005 Lower Airway • • • • Trachea Bronchi Bronchioles Alveoli Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 • The lungs are the major organs of respiration, providing gas exchange and thereby supplying the blood and body tissues with oxygen and disposing of waste carbon dioxide Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 Sign & Symptoms of Pulmonary Disease • Pulmonary disease is often classified as acute or chronic, obstructive or restrictive, infectious or noninfectious, and is associated with many common signs & symptoms. The most common is cough & dyspnea • Other manifastation include chest pain, abnormal sputum, hemoptysis, cyanosis, digital clubbing & altered breathing patterns Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 Cough • Cough as physiologic response occurs frequently in healthy people, but a persistent dry cough is commonly caused by a tumor, congestion or hypersensitive airways (allergies) • A productive cough with purulent sputum may indicate infection, whereas a productive cough with nonpurulent sputum is nonspesific and just indicates irritation Dean Handimulya UIEU 2005 • Hemoptysis indicates pathology : infection, inflamation, abscess, tumor or infarction • Dyspnea, or shortness of breath (SOB), usually indicates adequate ventilation (i.e.,hyperventilation with anxiety) insufficient amounts of oxygen in circulating blood Dean Handimulya UIEU 2005 • Dyspnea is usually caused by diffuse and extensive rather in focal pulmonary disease, pulmonary embolism being the aception • Factors contributing to the sansation of dyspnea include increase work of breathing, respiratory muscle false, decreased breathing reserve, and strong emotions, particularly anxiety & anger Dean Handimulya UIEU 2005 • Dyspnea when the person is lying down is called orthopnea and is caused by redistribution of body water Dean Handimulya UIEU 2005 • Chest pain originates in the pleurae, airway or the chest wall and is caused by pulmonary disorder, including pleurisy, pneumonia, pulmonary infark, tumor and spontaneous pneumothorax • Pulmonary pain patterns are usually localized in the substernal or chest region over involved lung fields which may include the anterior chest, side or back Dean Handimulya UIEU 2005 • Cyanosis, a bluish discoloration of the skin and mucous membranes, may be central, that is caused by decreased oxygen saturation of haemoglobin in arterial blood or peripheral, with slow blood circulation in fingers and toes • Central cyanosis is best observed in buccal (cheek) mucous membranes and lips Dean Handimulya UIEU 2005 • Peripheral cyanosis is observed in nail beds • Cyanosis can be caused by decreased arterial oxygenation, pulmonary or cardiac right to left shunts, decreased cardiac output, cold external temperature or anxiety Dean Handimulya UIEU 2005 • Clubbing, thickening & widening of the terminal phalnges of the fingers & toes, results in a painless clublike appearance recognized by the loss of the angle between the nail & the nail bed Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 • Altered breathing patterns, including changes in the rate, depth, regularity and effort of breathing, occur in response to any condition affecting the pulmonary system • Breathing pattern can vary depending on the neuromuscular or neurologic disease or trauma or disease present Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005 Dean Handimulya UIEU 2005