The Respiratory System: Anatomy and Function

• The respiratory system facilitates gas exchange.
• It transports gases, produces voice, and creates resonance during voice production.
• It also helps moisturize air and maintain fluid and acid-base balance.
• Insensible water loss occurs through the skin (600-800 ml) and lungs (400-600 ml), totaling about 1 liter per day.
• Decreased respiratory rate can lead to hypoventilation and increased CO2, resulting in respiratory acidosis.
• Increased respiratory rate leads to hyperventilation and decreased CO2, causing respiratory alkalosis.
• The respiratory system is divided into the upper and lower respiratory systems.

Upper Respiratory System

• It includes the nose, nasal cavity, nasal sinuses, and pharynx.

Nose

• It is formed by bone and cartilage, with the upper one-third being bone and the lower two-thirds being cartilage.
• The external nose opens into nares.
• The nose internally has a nasal septum made of cartilage that separates the nostrils, often deviated slightly to the right.
• Ryle's tube is inserted first into the left nostril.
• It is lined by pseudostratified ciliated columnar epithelium.
• The mucosa of the nose contains goblet cells that produce mucous to trap microorganisms.
• There are also hair cells that filter air.
• Immunoglobulin A (IgA) is present in the mucous.
• The bony parts consist of three bones: the frontal bone (base of nose), the maxillary bone, and the nasal bone.
• Cartilaginous parts include lateral and septal cartilage, as well as alar cartilage formed by hyaline cartilage.
• The functions include air filtration, moisturizing and warming of air, and helping with voice production and resonance.

Nasal Cavity

• It acts as a bridge between the nose and the pharynx.
• Its main function is olfaction and respiration.
• It connects the nose to the pharynx.
• There are two internal nares that open into the pharynx.
• It's lined by pseudostratified ciliated columnar epithelium.
• The upper one-third is the olfactory region, and the lower two-thirds is the respiratory region.
• The respiratory region of the nasal cavity is divided into three parts: superior conchae, middle conchae, and inferior conchae.
• Heavy particles like H2O are unable to move out because of the zig-zag route, preventing fluid loss (insensible water loss).
• Humidification and moisturizing of the airway occurs here.

Nasal Sinuses

• A congenital blockage is known as choanal atresia.
• Paranasal sinuses can become blocked.
• They're comprised of bone and membranous blockage.
• Frontal, maxillary, sphenoid, and ethmoid sinuses make up the sinus cavities.
• The mandinular sinus is not a nasal one.
• Sphenoid and ethmoid sinuses may not be shown in an X-ray.
• They're formed by the articulation of facial bones and filled with air.
• The frontal sinus, maxillary sinus (largest), sphenoid sinus, and ethmoid sinus are the parts of the sinus.
• They aid in lightening the skull and creating resonance during voice production.

Sinusities

• It involves inflammation of the paranasal sinuses.
• It is marked by an air-filled cavity replaced with fluid, and sometimes mucormycosis (fungal sinusities.)
• Mucor-mycosis can be caused by industrial air contamination.
• DOC is Amphotericin B, an anti-fungal.

Pharynx

• Also known as the "house of tonsils".
• It usually measures between 12-14 cm.
• It is located between C1 and C6.
• The pharynx is divided into nasopharynx, oropharynx, and laryngopharynx.
• The nasopharynx relates to C1, oropharynx to C2-C3, and the laryngopharynx to C4-C6.
• Anteriorly, it relates to the nose, oral cavity, and larynx.
• Posteriorly, it relates to the cervical vertebra.
• Superiorly, it relates to the skull, and inferiorly to the esophagus.

Nasopharynx

• It has five openings.
• Of those is two internal nares (nasal cavity).
• The eustachian tube equalizes the pressure around the tympanic membrane.
• Contains one oropharynx.
• It consists of PCCE tissue.
• Health professionals advise repetitive "test air" for patients experiencing respiratory issues.

Tonsils

• Pharyngeal tonsils provide immunity up to 6 years of age due to the immature nervous system, and atrophy at age 20.

Oropharynx

• Located at C2-C3.
• Has adenoid tonsils are present in adults only.
• Contains lingual tonsils which are present on tongue only.
• The tissue consists of non-keratinized stratified squamous epithelium.

Laryngopharynx

• Located at C4-C6.
• The tissue consists of non-keratinized stratified squamous epithelium.
• You should advise repetitive active swallowing when pressure tests measure air.
• Act on swallowing to equalize pressure of the tympanic membrane.

Lower Respiratory System

• Includes the larynx, trachea, bronchial tree, and respiratory muscles.

Larynx

• Also known as the "voice box."
• It is located between C4 and C6 with a length of 7-8 cms.
• Its superior relation is the Hyoid bone (oral cavity), and inferior to the Trachea.
• Its anterior relation is the neck muscle, and posterior is the pharynx.
• It is formed by nine cartilages.
• There are three paired (arytenoid, corniculate, and cuneiform) and three unpaired cartilages (thyroid, cricoid and epiglottis).

Unpaired Cartilage

• The thyroid cartilage consists of V-shaped cartilage, with two thyroid notches anteriorly fused to form the Adam's apple.
• The Adam's apple is responsible for secondary sexual characteristics in males including voice deepening and is more prominent in males.
• The thyroid cartilage is formed by hyaline cartilage, forming the anterior part of the larynx.
• The cricoid cartilage has a signet ring shape and is located posteriorly with lateral margins of the larynx with hyaline cartilage formation.
• The epiglottis cartilage contains a leaf shape formed by elastic cartilage.
• It is fused anteriorly with the thyroid to prevent food from entering the trachea.
• When food passes through the oropharynx, the epiglottis closes the trachea and therefore preventing food from entering.
• During swallowing, the epiglottis prevents food from entering the trachea.

The Paired Arytenoid Cartilage

• It is responsible for voice production.
• It helps the vocal cord to move and is a pyramid-shaped cartilage.
• Vocal cords are attached to it.
• True vocal cords are responsible for voice production.
• Closing false vocal cords increases pressure.
• Voice production involves contraction of the posterior cricoarytenoid muscles and abduction in vocal fibers, resulting in a clear larynx and vocal fiber release with a low pitch voice.
• Constriction on lateral cricoarytenoid muscles causes adduction in vocal fibers, resulting in a non-clear larynx and stress in vocal fibers with a high pitch voice.

Trachea

• Also known as the "wind pipe".
• It has a length of 10-12 cm and a diameter of 2.5 cm.
• It is located between C6 and T5.
• It bifurcates at the level of T5.
• The mucosa is lined by pseudostratified ciliated columnar epithelium.
• The adventitia is formed by areolar connective tissue.
• There is also a cartilaginous layer containing tracheal rings, 16 - 20 in count, that are C or U Shaped which allows them to shift.
• A submucosa blood vessels are also present with associated tracheal rings formed by hyaline cartilage.
• The trachealis muscle is located within the trachea.
• Supplied by the bronchial arteries.
• It is positioned between C6 and T5.
• The trachea bifurcates when it terminates.

Bronchial Tree

• The trachea divides at T5 into right and left main bronchi, with the right bronchus being shorter and wider than the left due to the heart.

• Primary bronchi divide into secondary (lobar) bronchi: three on the right and two on the left.

• Next Secondary bronchi divide into tertiary (segmental) bronchi: 10 on the right and 8 on the left side.

• Larger bronchioles consist of simple ciliated columnar epithelium.

• Smaller bronchioles consist of ciliated simple cuboidal epithelium.

• Terminal bronchioles are lined with non-ciliated simple cuboidal epithelium.

• The respiratory zone of the terminal bronchioles continues into alveoli.

• Respiratory bronchioles consist of simple squamous epithelium.

• It merges as alveolar ducts parenchyma of lungs (physiological part).

• Terminal bronchioles and the stroma of the lungs form the conductive zone.

• A respiratory bronchiole transforms to terminal alveoli from its zone.

• The trachea transforms to alveoli and create 25 branches present.

Alveoli

• At birth, approximately 29 million alveoli are present and by 8 years of age, this increases to about 300 million.

• Its has an area between 750-850 square feet in all.

• Consist of three types of cells which the release of a surface tension releaser, also known as a surfactant: pneumocytes I, pneumocytes 2, and dust cells.

• Pneumocytes I contribute 95% of structural organization and are non-regenerative.

• Pneumocytes II contribute 5% of structural organization and are regenerative.

• Surfactants consist of lecithin and sphingomyelin.

• Lecithin synthesis begins and matures in the last stages of gestation.

• A 1:1 ratio or 28 weeks of gestation,

• A 2:1 ratio occurs at normal 34 weeks.

• m/c cause of death in premature baby is RDS [releasing surfactant]

• Doc to for Releasing surfactant is "corticosteroids".

• Alvoli are simple squamos and are 5um in diameter.

• Alveolar endothelium has three functions to consider: alveolar, capillary, and dust cell function.

• They are the same: Endothelial cells contain Basement membranes to membrane.

• Alveolar macrophages are phagocytic.

• Kohl's powder is present in the alveoli.

• As a result, gasses exchange nutrients and combat infections.

Lung

• At about 1.3 kg.
• The lungs consists of a right and L left side.
• The right lung is upper is slightly upper than the left due to the livers position.
• The right lung consist of three lobes.
• The lobes of the three lungs is separated by horizontal-fissures and oblique fissure.
• The left consist of two lobes
• The left lungs consist of lobar and has an the long oblique fissure.
• Each lung consist of a custom surface.
• Costal Hilum Apex base can be located within the lung/cavity Total lung capacity in females measures at 4200 ml and in males at 6000 ml.
• It's considered vital when the lung capacity in females equal to 3.2 ml, 3.6 to total to 35 ml.
• A.O.D is what is the measure in early samples with hypoxia.

Pleura/Pleural Cavity

• It has an Alveolar viseral layer.
• Parietal contains the Visceral layers with a surface that consists with a pressure of (IIAP).
• As with Alveolars pressures (IAP) should consist of 25-30ml, and needs to exist for "Expanded Lungs=IAP>IAP" situation.

Respiratory Muscle

• Includes the diaphragm, intercostal muscles, sternocleidomastoid, scalene pectoralis, and several other sternal muscles.
• Suppress by all nerves and is important for (shaped - dome breathing).
• A contraction displaces downward for inspiration.
• A displaced or replaced muscle will relaxed into " Women to normal Expiration rate".
• External + internal muscles should Downward and a arrangement.
• The external muscles move from top to down during inspiration.
• Internal can't move, but are used to arrange the chest.

Assessment and Physiology of the Respiratory System

• The respiratory system functions in gas exchange.
• Pulmonary ventilation is the exchange of air between the environment and the lungs with two separate processes, being inspiration and expiration.
• With each respiration, air passes through the Alveoli. An external respiration system must consist of:
• Blood
• Arteries
• Tisuue
• The respiratory system in order works like this: Environment Pressure -> 790 mmHG or 1 atmosphetic preassure.
• N can pass because of the blood being lower is preassure compared to it's outside Atmosphetic preassure.
• Henry Foys is key in calculating the preasure of blood -> PV+ART = Pal / V Nitrogen Narcosis
• N2 will not disolve if the preasure.
• BUT! Sea will is N2. This headache.
• The headache that some experince from it will result in Dyspnea. INSYPERATION
• In short this 2sec process involes -> Activer-Constraction -> diaphragm
• As in result with the low volument this may reduce the 790->500

Expiration

• 761 hugh -> 758 mmHG for the Lungs to Penu Expriation Complete 3 sec.
• If Both Both Expriation +inspitation 5 sec on note. 1 cvcle Ideal Respiration Expiratory 12 Breath/min.

Alveolar Ventilation O 14.2 CO is best amount.

• less o2 and more c02 is key to good results (4.87 as well) In CPR precess, mouth to mouth is at 17 which helps the other Recuse.
• Exhange with the Alveoli blood is needed for this to exsit -> PPO2 equals +4 mmHG p-Co2 All is need to exist: Venous -> HA02 AND HMO2 both should have -36 Then 40mm

PH level Arterial - should consist of g5 mm Hg -

• In Internal is: CO2 transports by: Dissolves for Cabmines Bricatonees- this the marimum level -> Co2 transport

Systemies capillary

C00 and CA-forms - > which also can result in H+ or HIGH instability

• In the systemic capillaries the Association is that they have to be: HHb/002 = H+KIAL = BHCR Effect
• The halidate Effect

The 000 the Hb = and the DISSODATION is the Hl+ ion from the KIAL -Haladane CO0: Artisel blood =95% venous biood 7.6.6- 02 transport! 1 molecule to 4 molecule then + 1gmb of 40 is :1.36 m

• The co2 with the Hb binding is 20 greater The the of CCO Is : 200 normal preassure respiratiry In the inspriaty = 7 meladula is Obangesta !

Overview of the respiratory system, including gas exchange, voice production, and fluid balance. Covers the upper respiratory system (nose, nasal cavity, pharynx) and insensible water loss through the skin and lungs. Discusses the impact of respiratory rate on CO2 levels and acid-base balance, leading to conditions like respiratory acidosis and alkalosis.