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RESPIRATORY SYSTEM Main Function = gas exchange from O2 CO2 Other functions: speech (sounds) regulation of pH of blood. 1. NOSE: This is made of cartilage. Nose jobs involve taking a mallet, breaking the nasal bone and shaving the cartilages. a. NASAL CAVITY: This is where the nostrils are. They have hairs which filter large particles in the respiratory tract. (insects, etc). The functions of the nasal cavity is for the air you breathe: 1. Warm (cold air can freeze lungs); warmed by superficial veins 2. Clean (dirty air can clog lungs); mucous is sticky, and cilia will move that dirt down the back of the throat, then it’s swallowed. 3. Humidify (dry lungs can crack). The fluid secreted by glands makes the moisture, even on windy days the air goes to 100% humidity by the time it gets to the lungs. When you have a cold and get extra fluid (edema) stuffed up or runny nose, and the pressure can cause sinus headaches. 2. PHARYNX is where the nasal passages join with the oral passages. The AUDITORY TUBE from the ears is located here. A. SOFT PALATE: move your tongue along the roof of your mouth, and going from the front to the back you’ll feel the hard part turning into a soft part on the roof of your mouth. B. UVULA: located at the end of the soft palate (seen in cartoons). The function of the soft palate and uvula is to move upward when swallowing, to prevent food from going into nasal cavities. When you vomit, they don’t close, and food and stomach acids go into nasal cavity and cause problems. Can also see tonsils (lymph nodes) and vocal cords. 3. LARYNX This is a very complex structure. Made up of cartilages It has two functions: 1. Produce sounds (vocal cords are located in the larynx) 2. Prevent food from entering lungs What is the Adam's apple and what does it do? It’s really a part of the larynx or voice box. When boys go through puberty, hormones cause the larynx to grow rapidly, deepening their voices and causing the bulge to form. Girls' voices also deepen with puberty, but since their larynxes don't tend to grow as much, they don't usually develop an "Eve's apple." The protrusion is actually composed of thyroid cartilage. Your larynx is surrounded by a skeleton of cartilage plates that prevents it from collapsing. Some folks undergo cosmetic surgery to make it less prominent. Definition of Adam's apple Adam's apple: A familiar anatomic feature in the front of the neck that is due to the forward protrusion of the thyroid cartilage, the largest and most prominent cartilage of the larynx. The thyroid cartilage tends to enlarge at adolescence, particularly in males. Enlargement of the Adam's apple is considered, like pubic hair growth, one of the secondary sexual characteristics. Origin of the term: It is usually said that Adam's apple takes its name from the biblical story about Adam, Eve. The serpent and the apple. A piece of the forbidden fruit stuck in Adam's throat and created the anatomic Adam's apple. So the story goes. However, it may be wrong. Adam's apple in Latin is "pomum Adami." This may have been a mistranslation of the Hebrew "tappuach ha adam" which also means male bump. Between Latin and English there's many a slip. Why does your voice sound funny after you inhale helium from a balloon? A healthy 13-year-old boy who suffered a cerebral gas embolism after inhaling helium from a pressurized tank at a party. A word to the wise: Pressurized, industrial tanks are not for human consumption! Repeated inhalation of helium can hinder your ability to breathe. Helium is an inert gas that is lighter than air. Sound is produced by vibration, the movement of air around our vocal chords. Because helium gas is lighter than the usual oxygen/nitrogen blend, it changes the resonant frequency of the human vocal tract, causing a faster vibration and a higher-pitched, cartoon-character sound. A. EPIGLOTTIS closes when you swallow so nothing will go into the trachea and lungs. When you get hiccoughs, it’s from a sudden movement of air into the lungs, so the epiglottis closes to prevent more air from going in. It’s unknown why you get hiccoughs. All the treatments you can try involve interrupting the normal breathing patterns. B. GLOTTIS is the opening. C. VOCAL CORDS Vocal cords are attached to cartilage. If these cartilages move, the vocal cords open. The type and pitch of sounds you make depend on how far apart the vocal cords are. Way open = no sound (like when breathing) Mostly closed = sounds Men: their thyroid cartilage is larger, so their vocal cords are longer = deeper voice. LARYNGITIS: inflamed vocal cords (↓ sound production). Singers can get scar tissue nodules, requires surgery. The number one sign that a person is lying is voice irregularities. 4. TRACHEA This is a tube that carries air from the larynx to the lungs. (See model) It’s fairly rigid from about 16 rings of cartilage. The purpose of the cartilage rings is to keep the trachea open like a hollow tube. Otherwise, when you inhale, the trachea would collapse like when you suck hard on a straw. That’s why your vacuum cleaner has rings on the hose. The trachea is lined with epithelium interspaced with goblet cells, which are the cells that produce mucous to trap dirt. The epithelial cells also have little hairs on them called cilia which sweep dirt to larynx swallowed. In this way, the respiratory passage is filtered. Therefore, the cilia have several functions: they move the mucus, remove debris and harmful organisms, and circulate the air. The trachea branches out into smaller tubes called BRONCHI. Bronchi branch out into smaller tubes called BRONCHIOLES. Bronchioles branch out into smaller tubes that empty into a sack = ALVEOLI (overhead picture). This sac is like a balloon surrounded by a capillaries. The alveoli are where the gas exchange occurs: oxygen goes from the air in the lungs into the red blood cells passing by there, and carbon dioxide diffuses out of the cells and into the air in the lungs where it is exhaled. Therefore, inspired air (breathe in) contains oxygen, and expired air (breathe out) contains more carbon dioxide than oxygen. By the time these air tubes are this small, they don’t have any more cilia, so any particle that gets down that far has to be eaten by macrophages or just stay there. Therefore, within the alveoli are macrophages to eat the foreign object. A cough can be expelled at 60 mph. DIAPHRAGM is a muscle on the floor of the chest cavity. It is involved in breathing. Exactly what happens when you get the wind knocked out of you? It’s all about your diaphragm. This dome-shaped muscle sits below your lungs, and it helps your windbags inhale and exhale. When you get hit in the abdomen, this can cause a pressure difference that makes your diaphragm spasm for a few seconds. You can't catch your breath until the spasm stops. MYTH: Cover your head or catch a cold: Although 90% of the heat lost from the body is lost from the head, covering your head will not prevent this heat loss. The heat is lost from the warm air that you exhale. PROBLEMS WITH THE LUNGS In allergic conditions, bronchioles will constrict, blocking air flow to the lungs = ASTHMA. This can also be caused by irritants in the environment, especially by pollution in the city. SMOKING Smoking destroys cilia, and smoke of any kind is toxic. Particles in the lungs can’t clear. Cigarettes contain tar, which is the same kind of tar used to pave roads. When there is a thin lining of tar on the alveoli, there is no oxygen exchange to the lungs there. Large chunks of the lung become useless. Damage to the lungs shows up several ways. If a person smokes for 10 years and then stops, the damage will repair. If they have been smoking longer than 10 years, they may have some residual damage. It takes 7 years for lungs to repair. Smoking right after exercise is worse because you are breathing more deeply, so the particles go in deeper. Pollution in the air can also cause particles in the lungs, and the ozone can damage the lungs. Living in southern California is like smoking one pack a day. A mother who smokes during pregnancy will give birth to a baby with a lower birth weight. Smoking also is associated with heart disease, cancer of the lung, bladder, and pancreas. It also causes emphysema, pneumonia, and bronchitis. Some people try to quit smoking by smoking less, trying not to inhale, or switching to chewing tobacco, but there is no safe way to use tobacco. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) Number 5 killer in the USA. It is a combination of two conditions: 1. CHRONIC BRONCHITIS: inflammation of the bronchi, produces mucous, the openings become smaller = obstructed. 2. EMPHYSEMA: loss of elastic tissue on the bronchioles and alveoli, which collapse now during exhalation. Alveoli lose their shape and their surface area. When you see someone at the mall with an oxygen tank, they probably have emphysema, and need pure oxygen. LUNG CANCER There are many types of lung cancers. About 150,000 die each year from them. It is the #1 or #2 most deadly form of cancer. 85% of lung cancer is caused from smoking. The problem is that it starts as a hard nodule deep in the spongy tissue of the lung, where it has no symptoms until it presses against a structure. By then, it has also METASTASIZED (bits of it break off and travel to another location in the body, lodge there, and start multiplying). Surgery on the lung cancer of a smoker won’t work because the lungs are too weak, and they can’t do without the lung tissue. There are no good screening procedures for lung cancer. SURFACTANT is a slippery agent that is made by the alveoli, which coats it and keeps the walls of the alveoli from sticking together when they collapse during exhalation. If you have two wet pieces of paper and stick them together, they are hard to pull apart without ripping. Put soapy water between them, and you can pull them apart. The reason this is important is because surfactant is not produced in a fetus until the ninth month, so premature babies don’t have enough surfactant RESPIRATORY DISTRESS SYNDROME, which is the #1 cause of death in premature babies. You know how hard it is to blow up a brand new balloon? Imagine a baby having to do that with every single breath. You get tired. The treatment is to spray artificial surfactant into the lungs, and put them on a respirator to push air in. The more distal regions are still collapsed, so there are still problems. PNEUMONIA is when there is fluid in the lungs, usually from a viral or bacteria infection of the bronchi and alveoli. Blood plasma leaks out and fills the lungs, making it difficult to breathe. Needs hospitalization with iv antibiotics. TUBERCULOSIS is an infection of a really bad bacteria that get in the lungs and make themselves a capsule to hide in, where antibiotics can’t reach. They set up shop in the lungs and reproduce. Soon, the lungs fill up with these hard nodes and make it difficult to breathe. It causes extreme coughing, and then lots of these bacteria break off and get spewed into the air, where someone else can inhale them. It is extremely contagious and very deadly. If a person gets TB, the State Health Department has to be notified. They will show up at your house every morning for six months and stand there and watch you take your pills. If you don’t accept this, they have the right to haul you away to a lock-up facility and force the medicine in you for six months. There are only a few diseases where the State Health Department will step in like this: anthrax, typhoid fever, and bubonic plague are other diseases where you don’t get a choice; you are forced into isolation. Diseases like TB and the plague have almost wiped out Europe! A TB test will be positive if you have been exposed to the organism at any point in your life. Then you’ll have to go in for an xray to see if it is an active case of TB or not. Once you recover from TB you will always have a positive TB test, so tell the nurse that in advance. You may have to provide documentation that you have been treated for it already. Most employers require TB tests before hiring. I had to take one to work here. URINARY SYSTEM This system consists of the KIDNEYS, URETERS, URETHRA, and BLADDER. Not many structures, but very important. Functions: 1. Regulate electrolytes (K, Na, etc) in body 2. Regulate pH in blood 3. Regulate blood pressure 4. Regulate blood volume 5. Removing metabolic wastes (chemicals produces by chemical reactions in the body are excreted). This is the least important of the kidney’s functions. You can survive for a few weeks without excreting waste products in the urine, but hour by hour, the other functions are more important. LOCATION OF THE KIDNEYS They are toward the back side of the body, partly protected by the lower border of the ribcage. STRUCTURES WITHIN THE KIDNEY The kidney is surrounded by a capsule and some loose connective tissue which anchors the kidney to the abdominal wall. Not very strong. Jumping up and down can cause tearing. The term “renal” refers to the kidney. MICROSCOPIC ANATOMY OF THE KIDNEY You can’t understand how the kidney works until you understand how blood flows in the kidney. A large artery supplies the kidney, and it continues to get smaller and smaller until its branches become capillaries that end in a structure called the nephron. Just like the unit of function of the liver is the lobule, the unit of function of the kidney (forms the urine) is the NEPHRON. Each kidney as about 100,000 nephrons. They carry out all of the various functions of the kidneys. GLOMERULUS-CONVOLUTED TUBULES-LOOP OF HENLE-COLLECTING DUCT FUNCTION OF THE NEPHRON Blood comes into the capillary bed, and plasma leaks out and enters the glomerulus. The plasma contains good stuff like nutrients, and bad stuff like waste products. As the plasma moves through the convoluted tubules and Loop of Henle, all of the nutrients, and most of the water, are absorbed back into the blood. Everything that is not reabsorbed (the waste products) goes into the collecting duct and is excreted as urine. This is also how the water-salt balance is maintained, as well as the acid-base balance. Diuretics are medicines that increase the amount of urine that is produced. People who have high blood pressure might be prescribed diuretics to decrease the blood volume. Alcohol is a diuretic and this is what contributes to the symptoms of a hangover. Caffeine is also a diuretic, so coffee and regular Coca-cola are diuretics. UREA Urea is a waste product of amino acid metabolism. Remember, proteins are made of amino acids, so when you break down proteins, you break down amino acids, and the waste product left over is urea. This is the main waste product in urine. COLOR OF URINE When you urinate, it should be mostly clear with almost no yellow color. The more yellow the urine is, the more dehydrated you are. If the urine is very dark yellow, you are burning too much protein (as in food deprivation). URETERS These are long tubes that transport urine from the kidney to the urinary bladder. It comes in at the base of the urinary bladder, not the top. As the bladder fills, it presses down on the ureters to prevent urine from backing up into the kidneys. URINARY BLADDER The function is to store urine to permit controlled urination. The structure has folds = RUGAE which allow for expansion. You can hold up to one liter of urine, although at 500ml, you’ll be dancing. The function of the urinary bladder is just to store urine. There is a sphincter that keeps the urine in, and it’s made of skeletal muscle, so it is under voluntary control. The URETHRA connects the urinary bladder to the outside of the body. Don’t get urethra and ureters mixed up! The length differs from males to females: Females: 4cm Males 20 cm (varies with mood) Because females have a much shorter urethra, they are more susceptible to bladder infections. PROBLEMS WITH THE URINARY TRACT UTI (urinary tract infection) needs to be treated, or infection can reach the kidney. Prevent UTI by drinking water, cranberry, or blueberry juice. URETHRITIS = infection of the urethra CYSTITIS = infection of the urinary bladder. PROBLEMS WITH THE KIDNEY Things can happen to the kidney: infection, excess proteins, pH change, blood pressure drops, and can lead to kidney failure. Treatment is DIALYSIS, which removes blood, sends it through a filter, and returns it without the wastes. Done three times a week. Ideally, need a kidney transplant because the kidney has other functions as well. The brain, heart, and kidney are the only three organs in the body that have to get oxygen to sustain life. KIDNEY STONES These develop for unknown reasons. Stones are made out of a variety of things: uric acid, calcium, etc. They keep growing. They can block the urethra, causing the kidney to enlarge. As the kidney stretches, it causes excruciating pain in cycles of hours. As pressure builds up around the stone, urine can pass, and the kidney stone moves down the urethra slowly. Symptomatic kidney stones are pea sized or larger (up to 1 ½ inches). Treatment is ULTRASOUND: Put a powerful speaker on the outside of the kidney, sends a shock wave which the tissues absorb, but the stones shatter so the pieces can pass easier. To help prevent kidney stones, drink enough fluid so your urine stays clear and light colored. URINARY TRACT FUN DISCUSSION QUESTIONS Can you drink your own urine? Although urine is pretty clean, the exit tube (urethra) is not, so as it comes out, it gets contaminated like a garden hose with mud on the tip. Is it more sanitary to be spit on or peed on? If you are stranded on a desert island, should you drink seawater or your own urine? Why do I have to go to the bathroom immediately after a cup of coffee? Why do you have to pee when you hear water dripping? If you stick a sleeping person's hand in warm water, will he or she wet the bed? Does cranberry juice cure urinary tract infections?