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Respiratory

Respiratory. Anatomy & physiology. Nasal Cavity. Location Btw mouth & cranium Function Remove foreign bodies Warm Moisten Olfactory. Nasal Cavity. Nasal Septum Separates Cartilage Nostrils (nares) Entrance Mucous membrane Turbinates (Conchae) h surface area. Nasal Cavity.

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Respiratory

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  1. Respiratory Anatomy & physiology

  2. Nasal Cavity • Location • Btw mouth & cranium • Function • Remove foreign bodies • Warm • Moisten • Olfactory

  3. Nasal Cavity • Nasal Septum • Separates • Cartilage • Nostrils (nares) • Entrance • Mucous membrane • Turbinates (Conchae) • h surface area

  4. Nasal Cavity • Cilia • Hair-like • Wave-like movement • Moves towards pharynx • i with age • Sensitive nerve endings: • Olfactory • Instigate sneeze

  5. Para-Nasal Sinuses • Description • 4 pairs • Facial area • Continuous w/ nasal cavity • Function: • Resonating chamber • Speech

  6. Para-Nasal Sinuses • Frontal • Forehead • Ethmoid • Behind nasal bone • Sphenoid • Behind ethmoid • Maxillary • Sides of nose

  7. Which is the largest sinus and the most likely to get infected? A. Frontal B. Ethmoid C. Sphenoid D. Maxillary

  8. Pharynx (throat) • Passageway • Food & liquids  • Digestive tract • Air  • Respiratory tract

  9. Pharynx (throat) • Divided into 3 regions • Nasopharynx • Upper portion • Behind nasal cavity • Adenoids • Lymph system • Eustachian tubes • Middle ear

  10. Pharynx (throat) • Oropharynx • Middle • Behind mouth • Tonsils • Lymph chain • Laryngeal pharynx • Lowest portion • Opens into 2 space

  11. Larynx (voice box) • Location • Btw pharynx & trachea • Function • Vocalization • Protect Lower RT • Facilitates cough/sneeze

  12. Larynx (voice box) • Glottis • Epiglottis • Epi = upon • Gateway / trap door • Flap of elastic cartilage • Thyroid cartilage • Adam’s apple • Male

  13. Larynx (voice box) • Vocal cords • Cord like • Vibration • Controlled by muscles

  14. Trachea (Windpipe): • Location • Btw larynx & bronchi • Description • 4-5 inches long • Palpate • Above sternal notch • Normal = midline

  15. Trachea (Windpipe): • Function • Conduct air • C-shaped rings of cartilage • Carina • Bifurcation • Very sensitive • When stim  cough & bronchospasm

  16. Bronchi (pl)/Bronchus (sngl) • Location • Below trachea • Center of chest • Behind the heart • Branches into 2 tubes • Rt • h diameter • More vertical • Shorter in length

  17. Question? Mr. Henderson had a CVA 5 days ago and is having some difficulty swallowing. There is some question that he may have aspirated some food and developed pneumonia. What side pneumonia would you except him to have? A. Right sided B. Left sided

  18. Lungs • Location • Thoracic cage • Airtight • Mult. Air sacs • Description • Rt • 3 lobes • Upper, middle, lower • Lf • 2 lobes • Upper • Lower

  19. Lungs • Hilum (sngl)/ Hilus (pl) • URT • LRT • Bronchi • Bronchial tree • Bronchioles • No cartilage • Patency d/t • elastic recoil of the smooth muscles • alveolar pressure

  20. Lungs • Cilia • Alveolar ducts • Smallest tubes • Alveoli • Functional unit • Air sacs • Gas exchange • Surrounded by pulm. Capillaries

  21. Lungs • Alveoli • Thin membrane • Tendency to collapse • Alveolar Pressure • Secreted surfactant

  22. Lungs • Surfactant • Soft • Open • i surface tension • Prevents collapse • Allows exchange • Stretch/sigh • i surfactant • Stiff & Collapse • Atelectasis

  23. Pleural membrane • Location • Surrounds surface of lung & interior wall of thorax • Function • Protects • Neg. pressure • Allows movement (i friction)

  24. Pleural membrane • Parietal pleura • Line chest cavity • Visceral pleura • Covers lungs • Pleural space/cavity • Btw • Contains fluid • h fluid = pleural effusion

  25. Mediastinum • Location • Space btw lungs • Contains • Heart • Large blood vessels • Esophagus • Trachea • Bronchi

  26. Diaphragm • Location • Muscle btw lungs & abd. Cavity • Aids in resp • CNS • C-3 - C-5 • h size of cavity  • i pressure • Air flows from area of higher pressure to lower pressure

  27. Inspiration • Contracts • Lowers • Pressure  • i • Expiration • Relax • Raises • Pressure  • h

  28. Skeletal System • Ribs • 12 pairs • Thoracic cage • Sternum • Manubruim • Body • Xiphoid process

  29. Pulmonary circulation • Main function of resp. system is to deviler O2 to the blood & remove CO2 from it. • Pulm. Art. • CO2 / deoxygenated • Pulm vein • O2 / oxygenated

  30. Blood flow: heart and lungs • Inf/sup vena cave • Rt atrium • Tricuspid • Rt ventricle • Pulm • Pulm art • Pulm cap • Pulm vein • Lt atrium • Bicuspid / mitral • Left venticle • Aorta

  31. Small Group Questions • Name the structures that air flows past on its way to the lungs • What is the primary function of the sinuses • How is speech produced? • What is the function of the epiglottis? • What are the supporting structures of the trachea?

  32. What are the hilus and the carina? Where are they located? • How many lobes do the rt and lf lungs each have? • Describe the movement of the diaphragm during inspiration and expiration. • What is the function of surfactant? What stimulates its release? • What is the purpose of the serous fluid btw the pleural membranes?

  33. Processes of respirations Ventilation • Movement of air in & out of the the tracheobronchial tree. Delivering O2 to the alveoli & removing CO2 Perfusion • Blood flow in the capillary bed in the lungs Diffusion • Movement of gases (O2 & CO2) across the alveoli membrane • Flows from area of greater concentration to lesser concentration

  34. Ventilation: Mechanics • Air pressure • Air moves from h pressure i pressure • How to you i pressure? • h size • How do you h pressure? • i size

  35. Ventilation: Mechanics Airway resistance • SIZE • Anything that i diameter of resp. tube  • h resistance  • i ventilation • Asthma, bronchitis, obstruction

  36. Ventilation: Mechanics Lung Compliance • compliance • Elasticity of lungs • Factors • Surface tension • Connective tissue • h compliance • Over distended

  37. Ventilation: Lung Function Measures ventilation • Lung Volume • Tidal Volume* • Norm I – Norm E • IRV • Norm I – Max I • ERV • Norm E – Max E • Residual volume* • Left over after expiration

  38. Ventilation: Lung Function Measures ventilation • Lung Capacity • Vital capacity* • Max E – Max I • TV+IRV+ERV • IC

  39. Ventilation: Lung Function Measures ventilation • Lung Capacity • FC • TLC* • All vol. together • TV+IRV+ERV+RV

  40. Question? Given the following values, what is the patients Vital capacity? Total lung capacity? TV – 500 ml IRV – 2000 ERV – 1000 RV – 1500

  41. Answer! TV – 500 ml IRV – 2000 ERV – 1000 RV - 1500 • Vital capacity • TV + IRV + ERV • 500+2000+1000 = • 3500ml • TLC • TV+IRV+ERV+RV • 500+2000+1000+1500 • 5000ml

  42. Perfusion • Blood flow through the pulm circulation • Rt vent. • Pulm art divides into rt & lf • Shunted blood • no ventilation • “shunted” • receives no oxygenation

  43. Perfusion • Low pressure system • 20-30/5-15 • Alveolar pressure • h alveolar pressure  • capillaries squeezes • i perfusion

  44. Diffusion • Process where O2 & CO2 are exchanged at the air-blood interface

  45. Control of Respiration • Autonomic (some voluntary control) • Resp. control center • Brain stem • Pons • Rhythm • Medulla oblongata* • Rate • Normal rate • 12-20 /min

  46. Control of Respiration • Center is controlled by: • CO2 tension, • O2 tension • acidity (pH) of arterial blood

  47. Control of Respiration • Chemo receptors • Monitor • CO2 • O2 • pH • Normal Values • PaCO2: 35-45 torr • PaO2: 80-100 torr • pH: 7.35-7.45

  48. pH review • Blood concentration of Hydrogen ions • pH h • Alkaline / alkalosis • Base • pH i • Acidic / acidosis • Acid

  49. Control of Respiration • Primary stimulant for respiration • PaCO2 level • h PaCO2  • h resp. rate

  50. Control of Respiration • O2 carried in the blood • Hgb / RBC • CO2 carried in blood • CO2+ H2O = H2CO3 • Carbonic acid • CO2 = Acid

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