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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 Hypoxia – low oxygen level in the blood PaO2 - 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 Control Lungs 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 • aka Pavement, Sunnyside up egg • Great for Diffusion of Gases • Lots of Volume • Height is 2x Width • Volume = Cytoplasm • Cytoplasm means metabolism • Usually associated with secretion or absorption of material • Less diffusion • Very little 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 cells that secrete “surfaceactive agents” which prevent collapse. Non-ciliated 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, Humidify and Filter the incoming gas Smell Speech 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