Respiratory System

RespiratorySystem

HST I

Includes:

•Nasal cavity

•Sinuses

•Pharynx

•Larynx

•Epiglottis

•Trachea

•Bronchi

•Bronchioles

•Alveoli

•Lungs

•Pleura

•Mediastinum

Main organs involved in therespiratory system:

•Nose/mouth

•Pharynx

•Larynx

•Trachea

•Bronchi

•Alveoli (withinlungs)

•Lungs

Nasal Cavity

•Anterior Nares = nostrils

•Nasal Septum = cartilagewhich divides nasal cavitiesinto right and left sides

•Turbinates are bones thatprotrude into the nasalcavity – they increase thesurface area for filteringdust and dirt particles by themucous membranes

•Cilia – the hairs in the nose;trap larger dirt particles

Sinuses:

•Cavities in the skull,ducts connect them tothe nasal cavity, linedwith mucousmembranes to warm andmoisten air

–Frontal

–Maxillary

–Ethmoid

–Sphenoid

•Sinuses give resonanceto the voice.

Pharynx

•The throat

•Common passageway forair and food

•5” long

•Divided into:

–Nasopharynx

–Oropharynx

–Laryngopharynx

When food is swallowed, the epiglottiscloses over the opening to the larynx,preventing food from entering the lungs.

Larynx

•Voice box

•Triangularchamber belowthe pharynx

•Within thelarynx arevocal cords(glottis)

•Adam’s Apple

Trachea

•Windpipe

•4 ½” long

•Walls are alternate bands ofmembrane and C shaped ringsof hyaline cartilage – to keeptrachea open

•Lined with ciliated mucousmembranes

•Coughing and expectorationgets rid of dust-laden mucous

Bronchi and bronchioles

•Lower end of tracheadivides into R and Lbronchus

•As they enter lungs,subdivide into bronchialtubes and bronchioles

•Bronchi – similar totrachea with ciliatedmucous membrane andhyaline cartilage

•Bronchial tubes – cartilaginous plates(instead of C-shaped rings)

•Bronchioles – thinner walls of smoothmuscle, lined with ciliated epithelium

•At the end, alveolar ducts and cluster ofalveoli

Alveoli

•Composed of a single layerof epithelial tissue

•Inner surfaces covered withsurfactant – to keep alveolifrom collapsing

•Each alveolus surrounded bycapillaries

•O2 and CO2 exchange takesplace between the alveoli andcapillaries (diffusion)

Lungs

•Fill thoracic cavity

•Separated by mediastinum and heart

•Upper part = apex

•Lower part = base

•Base fits snugly over diaphragm

•Lung tissue porous and spongy – it floats

•R lung = larger and shorter (displaced bythe liver) and has 3 lobes

•L lung = smaller (displaced by heart) andhas 2 lobes

Diaphragm

•Large dome-shaped musclethat contractsrhythmically,continually, andmost of the time,involuntarily.

Pleura

•Thin, moist slippery membrane thatcovers the lungs

•Double-walled sac

•Space is pleural cavity – filled with pleuralfluid to prevent friction

Mediastinum

•Interpleural space

•Contains

–Thymus gland

–Heart (and aorta)

–Pulmonary arteries and veins

–Superior and inferior vena cava

–Esophagus

–Trachea

–Thoracic duct

–Lymph nodes and vessels

Functions of the Respiratory System

1.External, internal,and cellularrespiration

2.Production ofsound (vocal cords)

•Oxygen is the MOST critical substanceneeded by the body for survival.

–We can only live about 4-6 minutes withoutoxygen.

–Arterial blood = 21% O2

–Venous blood = 16% (5% loss per cycle)

•Clinical death –the momentbreathing andheartbeat stop

Biological death –when brain cellsdie, irreversibleafter 6 – 10minutes

•Constant removalof carbon dioxideis just asimportant forsurvival –maintainshomeostasis

Pulmonary Ventilation (Breathing)

•Inspiration

–Intercostal muscles lift ribs outward,sternum rises and the diaphragmcontracts and moves downward – thisincreases the volume of the lungs andair rushes in

•Expiration

–Opposite action takes place

–Exhalation is a passive process

Respiratory Movements

•1 inspiration + 1 expiration = 1 respiration

•Normal adult = 14 – 20 respirations / min

•Age dependent - newborn = 40 – 60 / min

•Increases with exercise, bodytemperature, certain diseases

•Sleep = respirations ↓

•Emotion can ↑ or ↓

Lung Capacity and Volume

•Spirometer – device that measures lungcapacity

•Tidal Volume – amount of air that movesin and out of lungs with each breath.

–Normal = 500 mL

•Residual Volume – amount of air left inlungs that cannot be voluntarily expelled

•Hyperventilation –

–Rapid breathing causes body to lose CO2 tooquickly, blood CO2 decreases which leads toalkalosis

–Symptoms – dizziness and possible fainting

–Rx – have person breathe into a paper bag

Maintaining Transmission-Based IsolationPrecautions

•A communicabledisease iscaused by apathogenicorganism thatcan be easilytransmitted toothers

•An epidemic occurswhen thecommunicabledisease spreadsrapidly from personto person andaffects a largenumber of people atthe same time

•A pandemic existswhen the outbreakof disease occursover a widegeographic areaand affects a highproportion of thepopulation

Maintaining Transmission-Based IsolationPrecautions

•Transmission-based isolation precautions aremethods or techniques of caring for patientswho have communicable diseases

–Examples of communicable diseasesinclude:

•Tuberculosis

•Wound infections

•Pertussis (whooping cough)

Transmission-Based Isolation Precautions

•The type of transmission-based isolationdepends on the causative organism of thedisease, the way the organism istransmitted and whether the pathogen isantibiotic resistant.

•Personal protective equipment (PPE) isused to provide protection from thepathogen.

–Some transmission-based isolation requirethe use of gowns, gloves, face shields andmasks, while others only require the use of amask.

What’s the difference between standardprecautions and isolation precautions?

•Standard precautions are used on allpatients, while transmission-basedisolation techniques are used to provideextra protection against specific diseasesor pathogens to prevent their spread Vs.

Airborne Precautions

•Used for patients known or suspected tobe infected with pathogens transmittedby airborne droplet nuclei, where thedroplets contain microorganisms andremain suspended in the air.

•Examples of diseases requiring isolationinclude rubella (measles), varicella(chicken pox), and tuberculosis.

Airborne Precautions (cont.)

•The patient must be placed in a private room,and the door must be kept closed.

•Air in the room must be discharged to outdoorair or filtered before being circulated to otherareas.

•Each person must wear a mask that containsspecial filter to prevent the entrance of smallairborne pathogens.

•If at all possible, the patient should not bemoved from the room. If transport is essential,the patient should wear a surgical mask duringtransport to minimize the release of dropletsinto the air.

Droplet Precautions

•Must be followed for a patient known orsuspected to be infected with pathogenstransmitted by large droplets expelledduring coughing, sneezing, talking orlaughing.

•Examples of diseases requiring theseisolation precautions include diphtheria,pertussis, adenovirus, mumps and severecases of viral influenza, meningitis andpneumonia.

Droplet Precautions (cont.)

•The patient should be placed in a privateroom. If a private room is not available,the patient can be placed in a room withanother patient who has the sameinfection at least 3 feet away from otherpatients or visitors.

•Masks must be worn when working within3 feet of the patient.

•If the patients has to be transported, theymust wear a surgical mask.

Contact Precautions

•Must be followed for any patients known orsuspected to be infected with epidemiologicallymicroorganisms that can be transmitted byeither direct or indirect contact.

•Examples of diseases requiring this type ofisolation include any gastrointestinal,respiratory, skin, or wound infections causedby multidrug-resistant organisms; any highlycontagious skin infection; and viral orhemorrhagic conjunctivitis or fevers.

Contact Precautions (cont.)

•The patient should be placed in a private room.

•Gloves must be worn when entering the room.

•Gloves must be changed after having contact withmaterial that may contain high concentrations of themicroorganisms, such as wound drainage or fecalmaterial.

•Gloves must be removed before leaving the room, andthe hands must be wash with an antimicrobial agent.

•A gown must be worn in the room if there is any chanceof contact with the patient, environmental surfaces oritems in the room. The gown must be removed beforeleaving the room and care must be taken to ensure thatclothing is not contaminated after gown removal.

Contact Precautions (cont.)

•Movement and transport of the patient from theroom should be for essential purposes only.

•The room and items in it must receive dailycleaning and disinfection as needed.

•If possible, patient-care equipment (bedsidecommode, stethoscope, thermometer) shouldbe left in the room and used only for thispatient. If not, all equipment must be cleanedand disinfected before being used on anotherpatient.

Reverse Isolation Precautions

•Used to protect patients from organismspresent in the environment.

•Examples of patients requiring thisisolation include patients whose immunesystems have been depressed prior toreceiving transplants, severely burnedpatients, patients receiving chemotherapyor radiation treatments, or patients whoseimmune systems have failed.

Diseases and Abnormal Conditions

•Asthma- arespiratorydisorder usuallycaused by asensitivity to anallergen such asdust, pollen, ananimal,medications or atype of food

Diseases and Abnormal Conditions

•Bronchitis- aninflammation ofthe bronchi andbronchial tubes

Diseases and Abnormal Conditions

•ChronicObstructivePulmonary Disease(COPD)- anychronic lungdisease that resultsin obstruction ofthe airways

copd-chronic-obstructive-pulmonary-disorder-picture

Diseases and Abnormal Conditions

•Emphysema- anoninfectious,chronic respiratorycondition thatoccurs when thewalls of the alveolideteriorate and losetheir elasticity.

Diseases and Abnormal Conditions

•Epistaxis- alsoknown as anosebleed, occurswhen capillaries inthe nose becomecongested andbleed

Nasal Alar Necrosis from Placemnt of a Posterior Pack

Diseases and Abnormal Conditions

•Influenza (flu)- ahighly contagiousviral infection ofthe upperrespiratory system

Diseases and Abnormal Conditions

•Laryngitis- aninflammation ofthe larynx andvocal cords

Diseases and Abnormal Conditions

• Lung Cancer- is theleading cause ofcancer death in bothmen and women.

–It is a preventabledisease because themain cause is exposureto carcinogens intobacco, either throughsmoking or throughexposure to “second-hand” smoke

Diseases and Abnormal Conditions

•Pleurisy- aninflammation of thepleura, ormembranes, of thelungs

–Usually occurs withpneumonia or otherlung infections

Diseases and Abnormal Conditions

•Pneumonia- aninflammation orinfection of thelungs characterizedby exudate ( abuildup of fluid) inthe alveoli.

Diseases and Abnormal Conditions

•Rhinitis- an inflammation of the nasalmucous membrane, resulting in a runnynose, watery eyes, sneezing, sorenessand congestion.

Diseases and Abnormal Conditions

•Sinusitis- an inflammation of the mucousmembrane lining the sinuses

Diseases and Abnormal Conditions

•Sleep Apnea- a condition in which anindividual stops breathing while asleep,causing a measurable decrease in bloodoxygen levels

–Two types of Sleep Apnea

•Obstructive Sleep Apnea

•Central Sleep Apnea

Diseases and Abnormal Conditions

•Tuberculosis (TB)- an infectious lungdisease caused by the bacteriumMycobacterium tuberculosis

Diseases and Abnormal Conditions

•Upper Respiratory Infection (URI)- orcommon cold, is an inflammation of themucous membrane lining the upperrespiratory tract

Related Health Careers

•Internist

•Otolaryngologist

•Perfusionist

•Pulmonologist

•Respiratory Therapist

•Respiratory Therapy Technician

•Thoracic Surgeon

Medical Terminology

•Root Word(s):

–Rhin(o)- denotes the nose

•Rhinodynia- pain in the nose

•Rhinolith- stone or rock in the nose

•Rhinorrhagia- excessive discharge of blood in the nose

•Rhinitis- inflammation of the nose

•Rhinomycosis- disease condition of fungus in the nose

Medical Terminology

•Root Word(s):

–Pneumon(o); pneum(ato); pneum(a)- denotesthe lung

•Pneumonitis- inflammation in the lung

•Pneumonography- to record the lung

•Pneumoconiosis- disease condition of dust in the lung

•Pneumothorax- chest cavity in the lung

•Pneumocentesis- surgical puncture in the lung

Medical Terminology

•Root Word(s):

–Trache(o)- denotes the trachea

•Tracheotomy- surgical removal of the trachea

•Tracheoplasty- surgical repair of the trachea

•Tracheopathy- disease condition in the trachea

•Tracheorrhaphy- to suture the trachea

•Tracheitis- inflammation in the trachea

Medical Terminology

•Root Word(s):

–Laryng(o)- denotes larynx

•Laryngitis- inflammation of the larynx

•Laryngeal- pertaining to the larynx

•Laryngostenosis- abnormal hardening of the larynx

•Laryngoscope- visual examination of the larynx

•Laryngocentesis- surgical puncture of the larynx

Medical Terminology

•Root Word(s):

–Thorac(o)- denotes the thorax

•Thoracodynia- pain in the thorax

•Thoracentesis- surgical puncture of the thorax

•Thoracoscopy- visual examination of the thorax

•Thoracoplasty- surgical repair of the thorax

•Thoracotomy- surgical removal of the thorax

Medical Terminology

•Root Word(s):

–pnea- denotes breathing

•Eupnea- normal breathing

•Dyspnea- difficult breathing

•Orthopnea- straight breathing

•Hyperpnea- excessive/above breathing

•Tachypnea- fast breathing

•Apnea- without breathing

Medical Terminology

•Root Word(s):

–Bronch(o)- denotes bronchi

•Bronchiectasis- dilation of the bronchi

•Bronchitis- inflammation in the bronchi

•Bronchoscopy- visual examination of the bronchi

•Bronchoplegia- paralysis of the bronchi

•Bronchopneumonitis- inflammation of the lung and bronchi

Medical Terminology

•Root Word(s):

–Pleur(o)- denotes the membrane lining the chest cavityand covering the lungs

•Pleuralgia- pain in the membrane lining the chest cavity and covering the lungs

•Pleuroclysis- washing out in the membrane lining the chest cavity and covering the lungs

•Pleuritis- inflammation in the membrane lining the chest cavity and covering the lungs

•Pleurotomy- surgical incision in the membrane lining the chest cavity and covering the lungs

•Pleurocentesis- surgical puncture of the membrane lining the chest cavity and covering the lungs

Medical Terminology

•Root Word(s):

–Pharyng(o)- denotes the pharynx

•Pharyngonasal- pertaining to the nose of the pharynx

•Pharyngitis- inflammation of the pharynx

•Pharyngoscope- visual examination of the pharynx

•Pharyngostenosis- abnormal hardening of the pharynx

•Pharyngoxerosis- dry condition of the pharynx

Abbreviations (G-H)

•GA

•gal

•GB

•GC

•GI

•Gm

•gr

•GTT

•Gyn

•Gastric Analysis

•Gallon

•Gallbladder

•Gonorrhea

•Gastrointestinal

•Gram

•Grain

•Glucose Tolerance Test

•Gynecology

Abbreviations (G-H)

•H

•H2O

•H2O2

•HBV

•HCI

•hct

•HDL

•Hg

•Hgb

•HHA

•Hydrogen

•Water

•Peroxide

•Hepatitis B Virus

•Hydrochloric Acid

•Hemacrit

•High Density

•Mercury

•Hemoglobin

•Home Health Assistant

Abbreviations (G-H)

•HMO

•HOB

•HOH

•Hr, hr, hrs

•Ht

•Hx

•hypo

•hyper

•hyst

•Health Maintenance Organization

•Head of Bed

•Hard of Hearing

•Hour, hours

•Height

•History

•Hypodermic, or under

•Above, high

•hysterectomy