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THE RESPIRATORY SYSTEM 1 Health Science 1 THE RESPIRATORY SYSTEM Objectives 30-1 Explain the functions of the respiratory system. 30-2 Explain the difference between internal and external respiration. 30-3 Describe how the larynx produces voice sounds. 30-4 List the structures contained within the lungs. 30-5 Describe the coverings of the lungs and chest cavity. 30-6 Describe the events that lead to the inspiration and expiration of air. 30-7 Explain how the brain controls breathing and how normal breathing patterns can be disrupted. 30-8 List and explain various respiratory volumes and tell how they are used to diagnose respiratory problems. 30-9 Describe how oxygen is transported from the lungs to body cells. 30-10 Describe how carbon dioxide is transported from body cells to the lungs. 2 30-11 Describe the signs, symptoms, causes, and treatments of various respiratory disorders and diseases. THE RESPIRATORY SYSTEM The major function of the respiratory system is ventilation (breathing). Deliver oxygen (O2) to the bloodstream and Remove carbon dioxide (CO2) from the bloodstream. Make speech possible O2 Exchange of oxygen and carbon dioxide O2 O2 CO2 CO2 3 CO2 ORGANS OF THE RESPIRATORY SYSTEM Organs of the respiratory system: Nose Pharynx Larynx Trachea Bronchial tree Lungs Alveoli Diaphragm 4 ORGANS OF THE RESPIRATORY SYSTEM (CONT.) The Nasal Cavity Nasal septum divides the cavity into right and left portions Mucous membrane warms and moistens the air and cilia helps eliminate particles The Paranasal Sinuses These are air-filled spaces within the skull bones Serve to reduce weight of the skull and give your voice a certain tone 5 ORGANS OF THE RESPIRATORY SYSTEM (CONT.) The Pharynx An organ of both the respiratory and digestive system The Larynx Larynx also called the “voice box” Moves air in and out of the trachea, and produces voice Composed of three cartilages: Thyroid cartilage Epiglottic cartilage Cricoid cartilage 6 ORGANS OF THE RESPIRATORY SYSTEM (CONT.) Vocal Cords Stretched between the thyroid cartilage and the cricoid cartilage Upper vocal cords are false cords and lower vocal cords are true vocal cords. The glottis is the opening between the vocal cords The more vocal cords are stretched, the higher the voice pitch. Posterior Portion of Tongue Glottis False Vocal Cords True Vocal Cords 7 ORGANS OF THE RESPIRATORY SYSTEM (CONT.) Trachea Trachea Referred to as the windpipe Tubular organ made of rings of cartilage and smooth muscle Lined with cells possessing cilia Extends from the larynx to the bronchi. Cilia moves mucus up to the throat where it is swallowed. Smoking destroys cilia. 8 ORGANS OF THE RESPIRATORY SYSTEM (CONT.) • Cone-shaped organs • Right lung has three lobes and the left lung has two lobes • The membranes surrounding the lungs is called the pleura The lungs contain connective tissue, the bronchial tree, nerves, lymphatic vessels and blood vessels. 9 APPLY YOUR KNOWLEDGE Which of the following sites would be the most lethal if obstructed by a foreign body? a. Right bronchus b. Left bronchiole c. Trachea 10 APPLY YOUR KNOWLEDGE - ANSWER Which of the following sites would be the most lethal if obstructed by a foreign body? a. Right bronchus b. Left bronchiole c. Trachea 11 SNORING Occurs due to vibration of soft tissues when muscles of the palate, tongue and throat relax. Affects approximately 50% of men and 25% of women over the age of 40. Causes daytime sleepiness and may be associated with sleep apnea. Common Causes • enlargement of tonsils or adenoids • being overweight • alcohol consumption • nasal congestion • deviated nasal septum 12 Continuous positive airway pressure therapy (CPAP) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway doesn't collapse when you breathe in. 13 SNORING (CONT.) Lifestyle Modifications to Reduce Snoring Lose weight Change sleeping position Avoid using alcohol or medications that induce sleep Use nasal strips to widen the nasal passages Use dental devices to keep airways open Some patients may require surgery to remove excess soft tissue or a portion of the soft palate. 14 SNORING (CONT.) Mayo Clinic’s Sleep Disorders Center rating of snoring: Heard from close proximity Heard from anywhere in the bedroom Heard from just outside the bedroom door with door open Heard outside the bedroom door with the door closed 15 Internal respiration refers to the exchange of gases between the blood capillaries and the tissues/cells of the body. External respiration, commonly known as breathing, is the exchange of oxygen and carbon dioxide between an animal and its environment Cellular respiration allows organisms to use (release) energy stored in the chemical bonds of glucose. The energy in glucose is used to produce ATP. Cells use ATP to supply their energy needs. Cellular respiration is therefore a process in which the energy in glucose is transferred to ATP 16 THE MECHANISMS OF BREATHING Inspiration • Air rich in O2 enters the lungs from the atmosphere • The diaphragm contracts or flattens • The intercostal muscles raise the ribs Expiration • Air rich in C0 2 exits the lungs • The diaphragm relaxes • The intercostal muscles lower the ribs Breathing or pulmonary ventilation, consist of inspiration (inhalation) and expiration (exhalation). The medulla oblongata controls the rhythm and depth of breathing and the pons controls the rate of breathing. 17 RESPIRATORY VOLUMES Tidal Volume Reflects the amount of air that moves in or out of the lungs during a normal breath Inspiratory Reserve Volume Amount of air that can be forcefully inhaled following a normal inhalation Expiratory Reserve Volume Amount of air that can be forcefully exhaled following a normal exhalation 18 RESPIRATORY VOLUMES Residual Volume Vital Capacity Total Lung Capacity Represents the volume of air that always remains in the lungs even after a forceful exhalation. Amount of air that can be forcefully exhaled after the deepest inhalation possible. This measure reflects the total amount of air the lungs can hold. 19 THE TRANSPORT OF OXYGEN AND CARBON DIOXIDE IN THE BLOOD Most of the body’s oxygen binds to hemoglobin in the red blood cells. This transport system is called oxyhemoglobin. When carbon dioxide gets into the bloodstream bicarbonate ions are formed and some carbon dioxide binds to hemoglobin. When bicarbonate ions reach the lungs, an enzyme changes them back into carbon dioxide and water. 20 APPLY YOUR KNOWLEDGE The medical assistant working for a general practitioner is taking the medical history of a new patient. The patient states “Even after sleeping 8 to 9 hours I still feel really tired.” The patient’s spouse states, “Well you sure snore loud, as if the sleep is so good.” Which of the following is a possible cause for the excessive fatigue? a. Periods of apnea b. Depression c. Tuberculosis 21 APPLY YOUR KNOWLEDGE - ANSWER The medical assistant working for a general practitioner is taking the medical history of a new patient. The patient states “Even after sleeping 89 hours I still feel really tired.” The patient’s spouse states, “Well you sure snore loud, as if the sleep is so good.” Which of the following is a possible cause for the excessive fatigue? a. Periods of apnea b. Depression c. Tuberculosis 22 COMMON RESPIRATORY CONDITIONS Asthma is a condition in which the bronchial tree becomes obstructed due to inflammation Causes includes allergens, cigarette smoke, pollutants, cold temperatures and exercise Signs and symptoms include difficulty breathing, wheezing, coughing, and a tight feeling in the chest Treatment include avoidance of allergens, steroid inhalers, bronchodilators and stopping smoking 23 COMMON RESPIRATORY CONDITIONS (CONT.) Bronchitis is inflammation of the bronchi May be caused by viruses, gastro-esophageal reflux, exposure to cigarette smoke, pollutants and fumes. Signs and symptoms includes chills, fever, difficulty breathing, coughing up yellow-gray or green mucus, chest tightness, wheezing and difficulty breathing Treatment with rest, fluids, cough medicines, humidifiers, inhalers and antibiotics for smokers Asthma. You're more likely to think about the specific symptoms of the condition: wheezing, coughing, shortness of breath, or the fear and anxiety that can accompany asthma attacks. While bronchitis symptoms such as wheezing and shortness of breath are similar to the symptoms of asthma, there are some important differences. The presence of a mild fever may be caused by virus, is often seen with bronchitis, for example, but not with asthma. And, bronchitis can cause people with asthma to have an asthma attack or make their asthma 24 symptoms worse. When the two conditions co-exist, the condition is called "bronchial asthma." 25 COMMON RESPIRATORY CONDITIONS (CONT.) Disease Causes Signs & Symptoms Treatments Chronic Obstructive Pulmonary Disease Cigarette smoke and air pollution Fatigue, difficulty breathing & frequent coughing Lifestyle changes, inhalers, stop smoking Emphysema Cigarette smoke, pollutants, dust Chronic cough, weight loss, fatigue, shortness of breath Stop smoking, vaccinations, antibiotics, oxygen, bronchodilators 26 • Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. • Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease (COPD). • Smoking is the leading cause of emphysema. • Emphysema damages the inner walls of the lungs' air sacs (alveoli), causing them to eventually rupture. This creates one larger air space instead of many small ones and reduces the surface area available for gas exchange. • When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage. 27 Emphysema, Gross The chest cavity is opened at autopsy to reveal numerous large bullae (air bubbles) apparent on the surface of the lungs in a patient dying with emphysema. Bullae are large dilated airspaces that bulge Out from beneath the pleura. Emphysema is characterized by a loss of lung parenchyma (bulk), destruction of alveoli so that there is permanent 28 dilation of airspaces. COMMON RESPIRATORY CONDITIONS (CONT.) Disease Causes Signs and Symptoms Treatment Influenza (Flu) Numerous viruses Runny nose, sore throat, sneezing, fever, chills, diarrhea, loss of appetite Bed rest, fluids, antiviral medications Laryngitis Viruses, bacteria, excessive talking, allergies, smoking, frequent use of alcohol Hoarse voice, sore throat, dry cough and throat Antibiotics, avoidance of cigarettes and alcohol 29 COMMON RESPIRATORY CONDITIONS (CONT.) Disease Causes Signs and Symptoms Treatment Legionnaire’s Disease Bacteria that grows in air conditioning systems Fever, fatigue, difficulty breathing, chest pain, headache Antibiotics, respiratory therapy and supportive therapy Lung Cancer Smoking, exposure to radon, asbestos and industrial carcinogens Cough, hemoptysis, difficulty breathing, weight loss, chronic hoarseness, wheezing Depends on type of cancer and stage but chemotherapy and radiation are common 30 treatments COMMON RESPIRATORY CONDITIONS (CONT.) Disease Causes Signs and Symptoms Treatment Pleuritis Viruses, pneumonia, autoimmune diseases such as lupus, chest trauma Fever or chills, dry cough, shortness of breath, chest pain during breathing Pain medications, antibiotics, antiinflammatory drugs, removal of fluid around the lungs Pneumonia Bacteria, viruses, fungi, parasites, foreign matter entering the lungs Fever or chills, headache, fatigue, coughing up rustcolored, green or yellow mucus Rest, fluids, antibiotics, overthe-counter pain medications 31 COMMON RESPIRATORY CONDITIONS (CONT.) Disease Causes Signs and Symptoms Treatment Pneumothorax Chest trauma, and unknown causes Tightness in the chest, sharp chest pain, rapid heart rate, shortness of breath Chest tube, surgery Pulmonary Edema Congestive heart failure, heart attack, cardiomyopathy, heart valve disorders, lung infections, chest injuries and many others Shortness of breath, wheezing, weight gain, pink mucus, pale skin, sweating Oxygen therapy, diuretics, morphine 32 PNEUMOTHORAX HEALTHY LUNG Pneumothorax 33 COMMON RESPIRATORY CONDITIONS (CONT.) Disease Causes Signs and Symptoms Treatment Pulmonary Embolism Heart attacks, fractured hips, cancer, long periods of inactivity Fainting, sudden shortness of breath, hemoptysis, wheezing, tachycardia, chest pain Support stockings, clotdissolving medications, anticoagulants, surgical filter insertion Severe Acute Respiratory Syndrome Viruses Fever, chills, headache, dry cough, muscle aches Rest, anti-viral medications 34 PULMONARY EMBOLISM (1) 35 COMMON RESPIRATORY CONDITIONS (CONT.) Diseases Causes Signs and Symptoms Treatment Sinusitis Bacteria, blockage Fever, cough, Nasal decongestants, of sinus openings sore throat, nasal steroid sprays, facial pain, nasal antibiotics decongestion Tuberculosis Bacterium Mycobacterium tuberculosis Cough lasting >3 TB testing, Drug weeks, fever or therapy chills, weight loss, night sweats, pain when breathing 36 • Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. • The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. • Not everyone infected with TB bacteria becomes sick. As a result, two TBrelated conditions exist: latent TB infection and TB disease. • The bacteria can live in the body without making you sick, you are not infectious and cannot spread TB bacteria to others. • If TB bacteria become active in the body and multiply, will go from having latent TB infection to being sick with TB disease • TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected. 37 Cystic fibrosis is an inherited chronic disease that affects the lungs and digestive system of about 30,000 children and adults in the United States (70,000 worldwide). A defective gene and its protein product cause the body to produce unusually thick, sticky mucus that clogs the lungs and leads to life-threatening lung infections; and obstructs the pancreas and stops natural enzymes from helping the body break down and absorb food. 38 Chest Physiotherapy positions The Vest 39 COMMON RESPIRATORY CONDITIONS (CONT.) Sudden infant death syndrome has no specific signs or symptoms and no known causes. Risk Factors • More common in male infants • Babies between the ages of 2 weeks and 6 months are most susceptible • Premature or low birth weight babies are at risk • Babies with a sibling that died of SIDS • African American and Native American babies are at highest risk • Babies who were prenatally exposed to cocaine, heroine, or nicotine • Babies who sleep on their stomachs are three times more likely to die from SIDS 40 APPLY YOUR KNOWLEDGE Which of the following diseases must all health care workers be screened for annually? a. Pneumonia b. Tuberculosis c. Legionnaire’s disease 41 APPLY YOUR KNOWLEDGE - ANSWER Which of the following diseases must all health care workers be screened for annually? a. Pneumonia b. Tuberculosis c. Legionnaire’s disease 42 END OF PRESENTATION Got to: http://www.airinfonow.org/html/lungattack/lungplay.htm 43