Human Respiratory Anatomy and Function

Upper Respiratory Tract Anatomy & Function

• Components: Nose, pharynx, larynx
• Air Pathway: Enters through nostrils or mouth → nasal cavities → pharynx
• Pharynx Divisions: Nasopharynx (behind nasal cavity), Oropharynx (behind mouth), Laryngeal pharynx (leads to larynx)
• Larynx: Contains vocal cords; above trachea. Protected by epiglottis during swallowing.
• Function: Filters, warms, and humidifies air. Ciliated mucous membranes trap foreign materials. Tonsils (palatine, lingual, adenoids) aid in bacterial filtering.

Lower Respiratory Tract Anatomy & Function

• Components: Trachea, bronchi, lungs
• Trachea to Lungs: Trachea connects larynx to lungs → splits into right/left main bronchi → smaller bronchi and bronchioles → alveoli for gas exchange.
• Lung Lobes: Right lung (three lobes), left lung (two lobes)
• Pleurae: Two-layered membranes surrounding lungs, ensure stability and facilitate gas diffusion.
• Function: Conducts air to alveoli for oxygen-carbon dioxide exchange. The alveolar walls and adjacent capillaries facilitate this process.

Differences Between Children and Adults (Respiratory)

• Premature infants lack sufficient surfactant, increasing the risk of Respiratory Distress Syndrome (RDS).
• Smaller, less developed airways make children more prone to obstruction from mucus, swelling, and foreign bodies.
• Neonates have a significantly smaller airway size, a more compliant chest wall, and weaker respiratory muscles.
• Children have a higher respiratory rate and increased oxygen needs due to a higher metabolic rate
• Alveoli number increases significantly by age 3, with lung growth continuing into adolescence.
• Anatomical features in children (e.g., horizontally oriented Eustachian tubes, larger tonsillar tissue) can contribute to risk factors
• Children rely on abdominal muscles for inhalation until about age 5 or 6.

Nursing Interventions for Impaired Gas Exchange

• Assess Respiratory Status: Check respiratory rate and look for distress signs (e.g., grunting, nasal flaring).
• Oxygenation: Administer prescribed oxygen therapy and monitor saturation levels.
• Airway Management: Perform gentle suctioning as needed and encourage position changes for secretion clearance.
• Support Effective Breathing: Keep the environment smoke-free and promote deep breathing exercises for older children.
• Nutrition and Hydration: Ensure adequate fluid intake and coordinate nutritional support.
• Medication Administration: Provide prescribed medications (e.g., bronchodilators) and monitor for side effects.
• Educate Parents/Caregivers: Teach signs of respiratory distress and proper medication/oxygen use at home.
• Positioning: Use upright or semi-Fowler's position to facilitate easier breathing.
• Infection Control: Implement strict hand hygiene and reduce exposure to infections.
• Provide Emotional Support: Offer support to the child and family, addressing any concerns.

Signs of Respiratory Distress in Infants/Children

• Increased Respiratory Rate: Breathing faster than normal for their age.
• Nasal Flaring: Widening of nostrils with each breath.
• Retractions: Indrawing of the chest wall, especially around the ribs and sternum, during breathing.
• Grunting: A grunting sound at the end of each breath.
• Cyanosis: A bluish color of the skin, indicating low oxygen levels.
• Wheezing or Stridor: High-pitched whistling or harsh sounds when breathing.

RSV (Respiratory Syncytial Virus)

• RSV is a common respiratory virus, causing mild, cold-like symptoms in most people, but leading to serious lung infections, especially in infants and young children.
• Nursing Interventions: Monitor respiratory status, support oxygenation, ensure hydration, maintain clear airways, positioning, infection control, symptom management, educate caregivers, nutritional support, and emotional support.
• Teaching Parents/Caregivers: Recognize signs of respiratory distress, practice good hand hygiene, keep the child hydrated, use a cool-mist humidifier, manage fever, avoid smoke exposure, understand nasal saline drops and suctioning, know when to seek medical attention, isolate the child from people with colds or crowds, encourage rest and provide a comfortable sleeping position.

Cystic Fibrosis (CF)

• CF is a lethal genetic disorder characterized by thick, sticky mucus obstructing organs like bronchioles, small intestine, and pancreatic/bile ducts.
• CF stems from mutations in the CFTR gene, impacting chloride channels in epithelial cells and altering mucus production.
• Transmission: Autosomal recessive disorder; both parents need to be carriers for the child to be affected (25% chance per pregnancy).
• Incidence: Approximately 1 in 3,500 live births (in White children).

Pancreatic Enzymes

• Aid digestion (necessary when pancreas isn't performing optimally)
• Administer with meals/snacks.
• Specific instructions vary for dosage, route, and timing depending on the drug; follow doctor's instructions carefully.

Other Respiratory Conditions (Otitis Media, Asthma, etc.)

• Detailed information on specific conditions like Otitis Media (ear infections), asthma, immune or resp deficiencies, and related interventions/education/prevention, with consideration for respective patient needs.