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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Objectives
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiratory Mucosa
• Structure
– Nasal septum separates interior of nose
into two cavities
– Mucous membrane lines nose
– Nasal polyp–noncancerous growths that
project from nasal mucosa (associated with
chronic hay fever)
– Frontal, maxillary, sphenoidal, and
ethmoidal sinuses drain into nose
10
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
11
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Nose
• Functions
– Warms and moistens inhaled air
– Contains sense organs of smell
12
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Pharynx
• Structure
– Pharynx (throat) about 12.5 cm (5 inches)
long
– Divided into nasopharynx, oropharynx, and
laryngopharynx
– Two nasal cavities, mouth, esophagus,
larynx, and auditory tubes all have
openings into pharynx
13
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Pharynx
• Structure
– Pharyngeal tonsils and openings of
auditory tubes open into nasopharynx;
other tonsils found in oropharynx
– Mucous membrane lines pharynx
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Pharynx
• Functions
– Passageway for food and liquids
– Air distribution; passageway for air
– Tonsils—masses of lymphoid tissue
embedded in pharynx provide immune
protection
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Larynx
• Structure
– Located just below pharynx; also referred
to as the voice box
– Several pieces of cartilage form framework
• Thyroid cartilage (Adam’s apple) is largest
• Epiglottis partially covers opening into larynx
– Mucous lining
– Vocal cords stretch across interior of
larynx; space between cords is the glottis
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Larynx
• Functions
– Air distribution; passageway for air to move
to and from lungs
– Voice production
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Larynx
• Laryngeal cancer
– Incidence increases with age and alcohol
abuse
– Occurs most often in men over age 50
– If larynx removed, “esophageal speech” or
electric artificial larynx needed for speech
20
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Upper Respiratory Tract
21
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Upper Respiratory Tract
22
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Upper Respiratory Tract
• Anatomical disorders
– Deviated septum—septum that is
abnormally far from the midsagittal plane
(congenital or acquired)
– Epistaxis (bloody nose) can result from
mechanical injuries to the nose,
hypertension, or other factors
23
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Trachea
• Structure
– Tube (windpipe) about 11 cm (4½ inches)
long that extends from larynx into the thoracic
cavity
– Mucous lining
– C-shaped rings of cartilage hold trachea open
• Function—passageway for air to move to
and from lungs
24
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Trachea
• Obstruction
– Blockage of trachea occludes the airway and if
complete causes death in minutes
– Causes more than 4000 deaths annually in the
United States
– Abdominal thrust maneuver is a lifesaving
technique used to free the trachea of obstructions;
also called abdominal thrusts
– Tracheostomy—surgical procedure in which a
tube is inserted into an incision in the trachea so
that a person with a blocked airway can breathe
26
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Bronchi,
Bronchioles, and Alveoli
• Structure
– Trachea branches into right and left bronchi
• Right primary bronchus more vertical than left
• Aspirated objects most often lodge in right primary bronchus
or right lung
– Each bronchus branches into smaller and smaller
tubes (secondary bronchi), eventually leading to
bronchioles
– Bronchioles end in clusters of microscopic alveolar
sacs, whose walls are made of alveoli
27
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
28
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Bronchi,
Bronchioles, and Alveoli
• Function
– Bronchi and bronchioles—air distribution;
passageway for air to move to and from
alveoli
– Alveoli—exchange of gases between air
and blood
29
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Bronchi,
Bronchioles, and Alveoli
• Structure
– Size—large enough to fill the chest cavity,
except for middle space occupied by heart
and large blood vessels
– Apex—narrow upper part of each lung,
under collarbone
– Base—broad lower part of each lung; rests
on diaphragm
31
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
32
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Lungs and Pleura
• Structure
– Pleura—moist, smooth, slippery membrane
that lines chest cavity and covers outer
surface of lungs; reduces friction between
the lungs and chest wall during breathing
33
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Lungs and Pleura
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiration
• Mechanics of breathing
– Pulmonary ventilation includes two phases called
inspiration (movement of air into lungs) and
expiration (movement of air out of lungs)
– Changes in size and shape of thorax cause
changes in air pressure within that cavity and in
the lungs because as volume changes, pressure
changes in the opposite direction
– Air moves into or out of lungs because of pressure
differences (pressure gradient); air moves from
high air pressure toward low air pressure
37
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiration
• Inspiration
– Active process—muscles increase volume of
thorax, decreasing lung pressure, which causes
air to move from atmosphere into lungs (down the
pressure gradient)
– Inspiratory muscles include diaphragm and
external intercostals
• Diaphragm flattens during inspiration—increases top-to-
bottom length of thorax
• External intercostals—contraction elevates the ribs and
increases the size of the thorax from front to back and
from side to side
39
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiration
• Expiration
– Reduction in the size of the thoracic cavity
decreases its volume and thus increases its
pressure, so air moves down the pressure
gradient and leaves the lungs
– Quiet expiration ordinarily a passive process
– During expiration, thorax returns to its resting
size and shape
– Elastic recoil of lung tissues aids in expiration
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiration
• Expiration
– Internal intercostals and abdominal
muscles— expiratory muscles used in
forceful expiration
• Internal intercostals—contraction depresses the
rib cage and decreases the size of the thorax
from front to back
• Abdominal muscles—contraction elevates the
diaphragm, thus decreasing size of the thoracic
cavity from top to bottom
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiration
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Respiration
• Transport of oxygen
– Only small amounts of oxygen can be dissolved in
blood
– Most oxygen combines with hemoglobin to form
oxyhemoglobin to be carried in blood
• Transport of carbon dioxide
– Dissolved carbon dioxide—10%
– Carbaminohemoglobin—20%
– Bicarbonate ions—70%
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Blood Transportation of Gases
48
Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Regulation of Respiration
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Regulation of Respiration
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Regulation of Respiration
• Eupnea—normal breathing
• Hyperventilation—rapid, deep
respirations
• Hypoventilation—slow, shallow
respirations
• Dyspnea—labored or difficult respirations
• Orthopnea—dyspnea relieved by moving
into an upright or sitting position
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Types of Breathing
• Apnea—stopped respiration
• Cheyne-Stokes respiration (CSR)—
cycles of alternating apnea and
hyperventilation associated with critical
conditions
• Respiratory arrest—failure to resume
breathing after a period of apnea
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Lower Respiratory Tract
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Lower Respiratory Tract
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Lower Respiratory Tract
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.
Disorders of the
Lower Respiratory Tract
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Mosby items and derived items © 2010, 2006, 2002, 1997, 1992 by Mosby, Inc., an affiliate of Elsevier Inc.