Upper Airway

● Nose
– Nares/nostrils – opening of the nose
– Nasal septum – separates the right and left
sections of the nose
– Vibrissae – hair follicles that filters the inspired air
● Oral Cavity
– An alternative portal of entry for air into the respiratory tract.
– Main function: to move food from the mouth into the esophagus
in the process of swallowing.
– Vestibule – the outer portion of the oral cavity that consists of the
lips, gums and teeth.
– Hard and soft palate
– Tonsils – play a role in immune defense and protection from
foreign matter.
– Uvula – fleshy appendage that hangs down from the soft palate.
● Pharynx
– Nasopharynx
– Oropharynx
– Laryngopharynx
● Serves as a conduit to the lower airways
 Lower Airway and Lungs

● Lungs – cone-shaped, spongy structure with a

narrow end at the top and wide bases at the
bottom.
– Surface area: about the size of a tennis court
(approx. 70 – 100 m2)
● Larynx – also known as voice box
– Functions:
● Provide a pathway for airflow from the upper airways
into the lower airways
● To separate air from food or liquids preventing
aspiration
● Serve as a site for resonance of spoken voice
● Trachea – composed of C-shaped
cartilaginous rings that provide firm support.
● Bronchi – large, cartilage-containing airways
that serve as the central passageway to the
right and left lungs.
● Alveoli – tiny grapelike sacs
– serves as functional unit where gases are
exchanged.
– Alveolar capillary interspace – separates the
alveolus from the pulmonary capillary
– Pores of Kohn – small openings between the
alveoli
● Pleura– provide a cover for the lungs and line
the thoracic wall.
Composed of:
– Visceral pleurae – cover the lung parenchyma
– Parietal pleurae – cover the outside of the lungs
and are in contact with the thoracic cage
● Pleural space – contains serous fluids that
allows the layers to move easily and without
friction during normal ventilation
● Thoracic Cage –
– Maintain pressure and tension that are necessary
for normal ventilation
–
–
● Mediastinum – houses the trachea,
esophagus, heart, pulmonary lymphatics, great
blood vessels and thymus glands
 Substances important in
maintaining alveolar integrity
1. Surfactant
– acts to lower surface tension and prevent collapse
of the alveoli.
– Promotes expansion and stability of the alveoli.
– Protective, waterproof material that may prevent
the movement of fluid across the alveolar-capillary
membrane during the respiratory cycle.
2. Alpha 1- antitrypsin
– A glycoprotein produced by the liver that plays a
significant role in maintenance of the pulmonary
tissue
– Primary function: inhibit natural proteolytic
enzymes
 Respiratory Muscles

● Inspiratory Muscles
– Diaphragm– the major muscle in the act of
breathing
● Able to facilitate lung expansion by moving downward
during inspiration.
– External intercostal muscles – located between the
ribs
● Able to further enlarge the thorax during inspiration by
creating an upward and outward motion of the lower
ribs.
● Scalene and sternocleidomastoid muscles
– Used during labored breathing to raise the first two
ribs and sternum in an effort to increase the size of
the thoracic cavity.
Respiration
-provides the body with a means of gas exchange

can be divided into 3 parts:

a. Ventilation
b. Perfusion
c. Diffusion
Ventilation
-movement of air between the atmosphere and
respiratory portion of the lungs

Control of breathing:
1. Central Receptors
*medulla oblongata
*pons
2. Chemoreceptors
3. Lung Receptors
 Lung Receptors
a. Stretch receptors
-respond to changes in pressure in the walls of
the airways.
-location: smooth muscle layers

Inflation reflex
Hering-Breuer reflex – serves to regulate the
depth of breathing by limiting lung inflation.

b. Irritant receptors
Stimulation leads to airway constriction
Location: airway epithelial cells
c. Juxtacapillary or J receptors

-sense lung congestion

-responsible for rapid shallow breathing that
occur with pulmonary edema, pneumonia.
Location: alveolar wall
Perfusion

-the flow of the blood through the lungs

Diffusion

-transfer of gases between the air-filled spaces in

the lungs and the blood
Gas Exchange and Gas
Transport
Oxygen is transported in two forms:
1. chemical combination with hemoglobin

Hemoglobin
-serves as a transport vehicle for oxygen.
-it binds oxygen in the pulmonary capillaries and
release it in the tissue capillaries.
- 1gm of hemoglobin= 1.34ml of oxygen

2. dissolve state (1%)

Ratio of Oxygen dissolve:
*for every 1mmHg of PO2 present in the alveoli,
0.003ml of O2 becomes dissolved in 100ml of
plasma
Carbon dioxide Transport

CO2 is transported in 3 forms:

1. As dissolved CO2 (10%)

2. attached to hemoglobin (30%)
3. as bicarbonate (60%)
*lungs restore the oxygen content of the arterial blood and remove
carbon dioxide from the venous blood.
*The blood carries oxygen and carbon dioxide in a dissolve state and
combination with hemoglobin.
*Oxygen and carbon dioxide are dissolved in plasma.
 ALTERATIONS
in RESPIRATORY SYSTEM
and FUNCTION
Respiratory Tract Infection
 Common Cold
-viral infection of the upper respiratory tract
which is usually lasts for 7 days.

-period of communicability: first 3 days after the

onset of symptom

S/S:
a. headache
b. generalized malaise
c. fever
d. exhaustion
 Sinusitis
-inflammation of paranasal sinuses
-classified as:
a. acute- lasts from 1day to 3weeks
b. sub acute- 3weeks to 3 months
c. chronic- 3 months and beyond

S/S:
a. facial pain
b. headache
c. purulent nasal discharges
d. fever
e. decrease sense of smell
 Influenza
-viral (influenza A and B) infection that can affect both the
upper and lower respiratory tracts.
-incubation period: 1-4days; 2 days being the average
-period of communicability: 1st day to 5th day of illness

S/S:
a. abrupt onset of fever and chills
b. malaise and muscle aching
c.headache
d. profuse,watery nasal discharges
e. non productive cough
f. sore throat
Pneumonia
-inflammation of parenchymal structure of the lung, such
as the alveoli and bronchioles
-can be atypical (viral) and typical (bacterial)
-classified as: CAP and HAP

S/S:
a. chills
b. fever
c. severe malaise
d. purulent sputum
e. elevated WBC
f. patchy or lobar infiltrates
 Tuberculosis
-infectious disease caused by the M. Tuberculosis
a. M. Tuberculosis hominis (human
tuberculosis)
b. M. Tuberculosis Bovis (bovine tuberculosis)
-acquired by drinking milk from infected
cows.
S/S:
a. low grade fever
b. night sweats
c. dyspnea/orthopnea
d. easy fatigability
e. f. weight loss
g. cough initially dry
but later become productive
with purulent/blood tinged
Disorders of Lung
Inflation
 Pleural Effusion
-abnormal collection of fluid in the pleural cavity
-the fluid may be a transudate (hydrothorax), exudate,
purulent drainage, blood (hemothorax), emphyema (pus).
*normally, only a thin layer (<10ml-20ml) of serous fluid
separates the visceral and parietal layers of the pleural
cavity.
 S/S of Pleural Effusion:

a. dullness, flatness during percussion

b. diminished breath sounds
c. dyspnea
d. pleuritic pain
e. mild hypoxemia
 Pneumothorax

-air enters the pleural cavity

-may be classified as:

a. Spontaneous Pneumothorax
-occurs when an air-filled bleb
or blister in the lung surface
b. Traumatic Pneumothorax

-may be caused by penetrating or nonpenetrating

injuries (fracture and dislocation)

c. Tension Pneumothorax

-occurs when the intrapleural pressure exceeds

atmospheric pressure (atelectasis)
 S/S of pneumothorax:

a. chest pain
b. increase RR
c. dyspnea
d. increase HR
e. asymmetry of the chest
f. hyprresonant sound
g. hypoxemia
 Atelectasis
-refers to the incomplete expansion of the lung or portion
of a lung.

Manifestations:
a. tachypnea
b. tachycardia
c. dyspnea
d. cyanosis
e. hypoxemia
f. diminished chest expansion
Obstructive airway
Disorders
 Bronchial Asthma

-chronic inflammatory airway disease

-caused by allergens, RTI, emotional upsets,
chemical, etc.

S/S: airway obstruction characterized by:

a. wheezing
b. breathlessness
c. chest tightness
d. cough
 COPD

-denotes a group of respiratory disorders

characterized by chronic and recurrent obstruction
of air flow in the pulmonary airway.
1. Emphysema (pink puffers)

-characterized by lung elasticity and abnormal

enlargements of air spaces distant to the terminal
bronchioles with destruction of the alveolar walls and
capillary beds.

-Causes: smoking
Antitrypsin deficiency
2. chronic Bronchitis (blue bloaters)

-obstruction caused by inflammation of the major

and small airway.
 Pink Puffer

S/S:

a. dyspnea
b. increased ventilatory effort
c. barrel chest
d. pursed lip breathing noted
e. weight loss
 Blue Bloaters

S/S:
a. hypoxemia
b. cyanosis
c. shortness of breath
d. prolonged expiratory respiration
e. pulmonary hypertension
f. cor pulmonale
g. clubbing of fingers
3. Bronchiectasis
-abnormal dilation of the large bronchial associated with
infection and destruction of the bronchial walls.

4. Cystic Fibrosis

- an autosomal recessive disorder involving secretion

in the exocrine glands, and epithelial lining of the
respiratory, GI and reproductive tract.
S/S:

a. chronic respiratory disease

b. pancreatic exocrine
deficiency (pancreatitis)
c. elevation of sodium chloride
in the sweat
d. nasal polyps
e. accumulation of viscid
mucus in the bronchi
 THANK you for listening

Enjoy the rest of the nyt=).....be safe..god

bless

Ms. Obenza