Lesson 3 Flashcards
The nurse is temporarily the consciousness of the unconscious, the love of life of the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the newborn, knowledge and confidence for the young mother, a voice for those too weak to speak, and so on
Virginia Henderson, RN
It is an intricate arrangement of spaces and passageways that conduct the air into the lungs
Respiratory System
The respiratory system is divided into 2 sections:
Upper Respiratory Tract
Lower Respiratory Tract
Upper Respiratory Tract:
Nostril
Nasal Cavities
Pharynx
Epiglottis
Larynx
Lower Respiratory Tract:
Trachea
Bronchia
Bronchioles
Lungs
What are the Phases of Respiration?
Pulmonary Ventilation
External Exchange of Gases
Internal Exchange of Gases
The exchange of air between the atmosphere and the air sacs (alveoli) of the lungs
Pulmonary Ventilation
This is normally accomplished by inhalation and exhalation of breathing
Pulmonary Ventilation
Occurs in the lungs when oxygen (O2) diffuses from the alveoli into the blood and carbon dioxide (CO2) diffuses out of the blood to be eliminated
External Exchange of Gases
Occurs in the tissues as O2 diffuses from the blood to the cells, CO2 passes from the cells into the blood
Internal Exchange of Gases
External portion produces from the face and supported by the nasal bones and cartilage
Nose ( External and Internal portions )
The external openings of the nasal cavity
Nostril or Nares
Internal Portion
Nasal Cavity
Each Nasal Cavity is divided into 3 passageways by the projection of the turbinates:
Turbinate Bones
Mucus
Paranasal Sinuses
It is also called conchae “ shell-like appearance”
Turbinate Bones
What are the three parts of turbinate Bones?
Inferior Turbinate
Middle turbinate
Superior turbinate
Secreted continuously by goblet cells, covers the surface of the nasal mucosa and is moved back to the nasopharynx by the action of the cilia (fine hairs)
Mucus
Are four pairs of bony cavities that are lined with nasal mucosa and ciliated pseudo stratified columnar epithelium
Paranasal Sinuses
Serve as a resonating chamber in speech (phonation)
Paranasal Sinuses
Sinuses are named by their location:
Frontal
Ethmoidal
Sphenoidal
Maxillary
is a funnel shaped tube that connects the nasal and oral cavities to the larynx
Pharynx
It is a common opening between the digestive and respiratory system
Pharynx
3 regions of the pharynx:
Nasopharynx
Oropharynx
Laryngopharynx
Located posterior to the nose and above the soft palate
Nasopharynx
Houses the faucial or palatine, tonsils
Oropharynx
Extends the hyoid bone to the cricoids cartilage
Laryngopharynx
Function:
Passageway for the respiratory and digestive tracts
Pharynx
Are found in the pharynx
Tonsils
3 types of tonsils
Pharyngeal tonsil or adenoid
Palatine tonsils
Lingual tonsils
Located high in the nasopharynx
Pharyngeal tonsil or adenoid
Located in the oropharynx at the end of the soft palate
Palatine tonsils
Located at the base of the tongue
Lingual tonsils
Function:
act as part of the immune system to help protect against infection
Tonsils
Is a cartilaginous epithelium- line structures that connects the pharynx and the trachea
Larynx
Structures of the larynx :
Epiglottis
Glottis
Thyroid cartilage
A valve flap of cartilage that covers the opening of the larynx during swallowing
Epiglottis
It is also referred to as “ guardian of the airways”
Epiglottis
A slitlike passageway or opening between the vocal cords in the larynx
Glottis
A largest of the cartilage structure; part of it forms the “ adams apple”
Thyroid cartilage
3 parts of thyroid cartilage:
Cricoid cartilage
Arytenoid cartilage
Vocal cords
The only complete cartilaginous ring in the larynx (located below the thyroid cartilage)
Cricoid cartilage
Used in vocal cord movement with the thyroid cartilage
Arytenoid cartilage
Ligaments controlled by muscular movements that produce sounds; located in the lumen of the larynx
Vocal cords
Referred to as a voice box
Vocalization
(windpipe) is composed of smooth muscle with C-shaped rings of cartilage at regular intervals
Trachea
Are paired elastic structures enclosed in the thoracic cage, which is an airtight chamber with distensible walls
Lungs
Narrow a superior portion of each lung located just deep to the clavicle
Appex
A broad lung area resting on the diaphragm
Base
Serous membranes that encloses the lungs
Pleura
2 types of pleura:
Visceral pleura
Parietal pleura
Directly cover the lungs
Visceral pleura
Lines the wall of the thoracic cavity
Parietal pleura
A potential space between the two pleurae
Pleural space
A slippery serous secretions produce by the pleural membranes which allows the lungs to slide easily over the thorax wall during breathing movements
Pleural fluid
Located in the middle of the thorax, between the pleural sacs that contain the two lungs
Mediastinum
Each lung is divided into lobes by fissures
Lobes
Divided into two lobes by fissures:
Right lung
Left lung
3 lobes (upper, middle, lower lobes)
Right lung
2 lobes (upper and lower lobes)
Left lung
The right and left primary bronchi are formed by the division of the trachea
Bronchi and bronchioles
Space in the tracheobronchial tree which contains 150ml of air does not participate in gas exchange
Physiologic dead space
Lung is made up of about 300 million alveoli, which are arranged in cluster of 15 to 20 which resemble bunches of grapes and they make up the bulk of the lungs
Alveoli
Also called “air-blood barriers” is composed of alveolar epithelium, fused basement membranes, and capillary endothelium where gas exchange takes place
Respiratory Membrane
Mechanics of breathing:
Inspiration (inhalation)
Expiration (exhalation)
Intrapleural pressure
Lung volume and capacities:
Tidal volume
Residual volume
Inspiratory reserve volume
Expiratory reserve volume
Vital capacity
Functional residual capacity
Total lung capacity
The amount of air moved into or out of the lungs in quiet, relaxed breathing
Tidal volume
Average value: 500 ml
Tidal volume
The volume of air that remains in the lungs after the maximum exhalation
Residual volume
Average value: 1200 ml
Residual volume
The additional amount that can be breathed in by force after a normal inhalation
Inspiratory reserve volume
Average value: 2600 ml
Inspiratory reserve volume
The additional amount that can be breathed out by force after a normal exhalation
Expiratory reserve volume
Average value: 900ml
Expiratory reserve volume
The volume of air that be epelled from the lungs by maximum exhalation after maximum inhalation
Vital capacity
The amount of air remaining in the lungs after normal exhalation
Functional residual capacity
Average value: 2100 ml
Functional residual capacity
The total volume of air that can be contained in the lungs after maximum inhalation
Total lung capacity
Average value: 5200 ml
Total lung capacity
Regulation of respiration:
Nervous control
Chemical control
Central chemoreceptors
Peripheral chemoreceptors
Depends primarily on a respiratory control center located partly in the medulla oblongata and partly in the pins of the brain stem
Nervous control
Chemoreceptors are sensitive to chemical dissolved in the body fluids
Chemical control
Responds to CO2, level jn the circulating blood
Central Chemoreceptors
Found in carotid and aortic bodies
Peripheral chemoreceptors
Abnormal Ventilation:
Hyperventilation
Hypoventilation
An increased amount of air enters the alveoli
Hyperventilation
An insufficient amount of air enters the alveoli
Hypoventilation
Possible causes of hypoventilation
Respiratory obstruction
Lung disease
Injury to the respiratory center
Depression of the respiratory center
Chest deformity
Breathing Patterns
Normal rates of Adults:
12-20cpm
Breathing Patterns
Normal rates of Adults:
12-20cpm
Breathing Patterns
Normal rates of Children:
20-40cpm
Breathing Patterns
Normal rates of Infant:
> 40cpm
What are the Altered Breathing Patterns:
Hyperpnea
Hypopnea
Tachypnea
Apnea
Dyspnea
Orthopnea
Kussmaul respiration
Cheyne stoke respiration
An abdominal increase in the depth and rate of respiration
Hyperpnea
A decrease in depth and rate of respiration
Hypopnea
An excessive rate of breathing that may be normal, as in exercise
Tachypnea
A temporary cessation of breathing
Apnea
A temporary cessation of breathing
Apnea
A subjective feeling of difficult or labored breathing
Dyspnea
A difficulty in breathing that is relieved by sitting in an upright position, either against 2 pillows in bed or chair
Orthopnea
Deep, rapid respiration characteristics of acidosis as seen in uncontrolled diabetes
Kussmaul respiration
A rhythmic variation in the depth respiratory movements alternating with periods of apnea
Cheyne-Stoke respiration
A rhythmic variation in the depth respiratory movements alternating with periods of apnea
Cheyne-Stoke respiration
Results of inadequate breathing:
Cyanosis
Hypoxia
Anoxia
Hypoxemia
Suffocation
A bluish discoloration of the skin and mucous membranes caused by an insufficient amount of oxygen in the blood
Cyanosis
A lower than normal oxygen level in the tissues
Hypoxia
A total lack of oxygen in the tissues
Anoxia
A lower than normal oxygen concentration in arterial blood
Hypoxemia
The cessation of respiration, often a result of mechanical blockage of the respiratory passages
Suffocation
