1) Maacy Traning Module-PAH.pptx

PAH Medical Training Respiratory System Anatomy and Function Section Objective You need to know from this section • What is the respiratory system and what is it’s function • What is the Cardiac System and what is it’s function • What is the parts correlation between the lung and heart • How it...

PAH Medical Training Respiratory System Anatomy and Function Section Objective You need to know from this section • What is the respiratory system and what is it’s function • What is the Cardiac System and what is it’s function • What is the parts correlation between the lung and heart • How it works. FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. The Respiratory System  The main function of the Respiratory System is to supply the body with oxygen and dispose of the carbon dioxide.  To accomplish this function at least four processes, collectively called respiration, must happen:  Pulmonary Ventilation.  External Respiration.  Transport of the Respiratory Gases, i.e. Peripheral gas exchange. FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. Respiration • Pulmonary Ventilation is the movement of air into and out of the lungs so that the gases there are continuously changed and refreshed (commonly called breathing). • External Respiration is the movement of oxygen from the lungs to the blood and of carbon dioxide from the blood to the lungs. • Transport of Respiratory Gases is the transport of oxygen from the lungs to the tissue cells of the body, and of carbon dioxide from the tissue cells to the lungs. This is accomplished by the cardiovascular system using blood as the transporting fluid. FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. Respiratory Tract Upper Respiratory Tract The nasal cavity Epiglottis: Closes over the larynx to stop food going into the airways. Pharynx Larynx Trachea Lower Respiratory Tract Bronchi Bronchioles The Lungs. The Alveoli Alveoli are microscopic chambers at termini of bronchial tree; walls of simple squamous epithelium underlain by thin basement membrane, the external surface intimately associated surfacta with the pulmonary capillaries. They are covered with that keep them from nt collapsing. Functions of the Alveoli: • It is the main site for gas exchange (i.e. Internal Respiration). • The surfactant reduces surface tension and prevents the lungs from collapsing. The Alveoli The airway walls • Smooth muscle: lies beneath the submucosa, between the cartilaginous supports in the bronchus and bronchi and in the bronchioles. • These smooth muscle winds down the bronchi in a spiral or lattice. When stimulated they contract and become shorter forcing the surrounding airways to become folded and the lumen squashed (Contraction). • This contraction is termed bronchospasm. This reduces the airflow. • The tone of the smooth muscle is controlled by the autonomic nervous system. The Mechanics of BREATHING  Inspiration  During inspiration, the diaphragm contracts and flattens and the intercostal muscles attached to the ribs contract lifting the ribs upwards and outwards. Both these maneuvers enlarge the space within the chest thereby reducing resistance or pressure in the lungs so that they can fill with air. The Mechanics of BREATHING Expiration  In expiration the reverse happens. The intercostal muscles and the diaphragm naturally recoil (relax) and air is pushed out of the lungs. If necessary neck, shoulder and abdominal muscles can be used to help breathing. The Control of BREATHING • While breathing is essentially an involuntary action, many of the external muscles involved can be controlled voluntarily so that we can hold our breath when we want to, or breathe at a rate we decide. • However, there are no voluntary muscles within the lung itself, so we cannot control the diameter of the airway tubes themselves. The most important influence on the breathing and the airways is the autonomic nervous system. • The rate and depth of breathing is controlled by the respiratory center in the mid-brain, via the autonomic nervous system. The activity of this center is regulated by the chemistry and temperature of the blood. The Control of BREATHING • The respiratory center receives information from different types of chemoreceptors: Carotid receptors: These are sensitive to changes in carbon dioxide levels in the blood. Medullary receptors: These are sensitive to changes in blood PH. Cough/irritant receptors: cough/sneeze reflex. Sensitive to chemical and mechanical irritation and stimulate the The Control of BREATHING • The most important factor in regulation is the level of carbon dioxide in the blood. The Autonomic nervous system Sympathetic and Parasympathetic systems: • These two systems complement or counter balance each other. • In times of stress the sympathetic system prepares the body to fight or run by causing adrenaline to be released. • Adrenaline increases heart rate, dilates pupils, opens airways and increases blood supply to muscles. • The parasympathetic system has the opposite effect and ‘calms’ everything down. During sleep the parasympathetic system dominates. • Within the respiratory system the bronchial smooth muscle (in the airways) is controlled by both the sympathetic and parasympathetic nervous systems. The Autonomic nervous system • The receptors involved in the sympathetic nervous system are adrenergic receptors and are sited on the smooth muscle cells in the bronchioles. • There are two main types of adrenergic receptors: and  : •  -receptors are subdivided into three sub-types: •  1 mainly found in heart muscle •  2 found in bronchial smooth muscle •  3 found in adipose tissue (fat). • Stimulation of the  2 receptors by adrenaline and nor-adrenaline causes the smooth muscles to relax so that the airways dilate. • In fight adrenalin stimulate adrenergic  2 receptors  dilate airways  2 receptor agonist/antagonist?? • The receptors in the parasympathetic system are called cholinergic receptors. They are sited on bronchial smooth muscle and are served by the vagus nerve. Transmitters • The process of controlling the bronchial smooth muscle via the sympathetic and parasympathetic systems involves complex interactions between receptors and chemical messengers known as transmitters. • In the parasympathetic nervous system the vagus nerve serves the smooth muscles of the airways. In the parasympathetic system the transmitter is called acetylcholine. • Stimulation of the cholinergic receptors by acetylcholine causes the smooth muscle to contract and the airways constrict. • In healthy people the vagus nerve is involved in a reflex response that causes narrowing of the airways. This bronchoconstriction is a normal defense response against inhalation of a foreign object or irritant, and is often accompanied by a bout of coughing. Functional Anatomy of the Respiratory System • The Respiratory System includes the nose and nasal cavity, pharynx, larynx, trachea, bronchi and their smaller branches, the lungs which contains the terminal air sacs. Pulmonary Circulation: Pulmonary Artery Pulmonary Vein • Pulmonary circulation involves transferring oxygen and carbon dioxide between the blood in the body and the air that's inhaled and exhaled in the lungs. • The role of the Pulmonary arteries is to carry blood that's low in oxygen and high in carbon dioxide waste to the pulmonary capillaries of the lungs, where the exchange takes place. • When the blood is enriched with oxygen and cleared of carbon dioxide waste, it flows back through the Pulmonary veins to the heart's left atrium. • Most arteries in the body carry oxygenated blood, but the pulmonary arteries carry deoxygenated blood. FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. Functional Anatomy of Pulmonary Artery • The pulmonary artery is big, relatively short, and wide. The left and right pulmonary arteries are each shaped like tubes with an opening called a lumen that blood can flow through. Pulmonary Artery Anatomy • • • • • • • The pulmonary artery is shaped like the capital letter " T.“ The pulmonary trunk makes up the lower portion and the left and right pulmonary arteries each form one of the two sides at the top. There is a valve between the right ventricle of the heart and the pulmonary artery. This valve has two cusps of connective tissue. The valve is set up to open when the heart pumps and the blood can flow from the right ventricle to the pulmonary trunk. When the heart muscle relaxes, the valves close to prevent blood from flowing backward. As with all arteries, the walls of the pulmonary arteries have several layers of muscle that allow them to widen ( dilate) and narrow (constrict). This is very different from the walls of veins, which are thinner and less muscular. Function • • • • • • • FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. The pulmonary arteries are key players in pulmonary circulation along with the pulmonary veins and pulmonary capillaries. Pulmonary circulation involves transferring oxygen and carbon dioxide between the blood in the body and the air that's inhaled and exhaled in the lungs. The role of the pulmonary arteries is to carry blood that's low in oxygen and high in carbon dioxide waste to the pulmonary capillaries of the lungs, where the exchange takes place. Most arteries in the body carry oxygenated blood, but the pulmonary arteries carry deoxygenated blood When the blood is enriched with oxygen and cleared of carbon dioxide waste, it flows back through the pulmonary veins to the heart's left atrium. From there, the blood travels to the left ventricle and finally disperses through the aorta to the arteries that carry the oxygenrich blood throughout the body. Each pulmonary artery will usually divide into three to seven branches. The most common anatomic variations of the pulmonary arteries are related to the number of arterial branches in the lungs. The Cardiac System The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, that consists of the heart and blood vessels. The function of the Cardiac System: 1. Provides adequate circulation of blood through the body. 2. Pulmonary circulation allows for the oxygenation of the blood, and systemic circulation provides for oxygenated blood and nutrients to reach the rest of the body. 3. Circulates OXYGEN and removes Carbon Dioxide. 4. Provides cells with nutrients and removes the waste products of metabolism to the excretory organs for disposal. 5. Protects the body against disease and infection. 6. Clotting stops bleeding after injury. The blood Circulation from Heart to Lung Superior and Inferior Vena Cava Right Atrium Pulmonary Artery Left Atrium Pulmonary Veins Left Ventricle Aorta FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. Right Ventricle Lungs Oxygenated blood to all Body tissues Non oxygenated Blood Non Oxygenated blood from All Body The blood Circulation from Heart to Lung FOR INTERNAL EDUCATION AND SALES TRAINING ONLY. NOT FOR EXTERNAL USE. Thank You