呼吸系统 Overview of the Respiratory System PDF

呼吸系统概述 - 功能 Overview of the Respiratory System – Functions  吸入氧气并排出二氧化碳 Takes in oxygen and removes carbon dioxide  温暖和湿润吸入的空气 Warms and moistens inhaled air  过滤吸入空气中的颗粒 Filters particles from inhaled air  提供嗅觉...

呼吸系统概述 - 功能 Overview of the Respiratory System – Functions  吸入氧气并排出二氧化碳 Takes in oxygen and removes carbon dioxide  温暖和湿润吸入的空气 Warms and moistens inhaled air  过滤吸入空气中的颗粒 Filters particles from inhaled air  提供嗅觉 Gives sense of smell  通过空气经过声带产生声音 Produces sound by moving air past the vocal cords 下呼吸道 Lower Respiratory Tract  鼻子 The Nose: o 开口于鼻孔，通向鼻腔 Opens at the nostrils/nares and leads into the nasal cavities o 鼻中的毛发和黏液过滤空气 Hairs and mucus in the nose filter the air o 鼻腔中有大量毛细血管，温暖和湿润空气 The nasal cavity has a lot of capillaries that warm and moisten the air o 特殊细胞作为气味受体（嗅觉感受器） Specialized cells act as odor receptors (olfactory sensory receptors) 下呼吸道（续） Lower Respiratory Tract (con’t.)  咽 The Pharynx: o 扁桃体在呼吸时提供淋巴防御，位于口腔和咽的交界处 Tonsils provide a lymphatic defense during breathing at the junction of the oral cavity and pharynx 下呼吸道（续） Lower Respiratory Tract (con’t.)  喉 The Larynx: o 喉是一个三角形的软骨结构，将空气从咽传递到气管 The larynx is a triangular, cartilaginous structure that passes air between the pharynx and trachea o 它被称为声盒，容纳声带 It is called the voice box and houses vocal cords o 有两片黏膜褶皱组成声带，中间有一个开口称为声门  There are 2 mucosal folds that make up the vocal cords with an opening in the middle called the glottis 声带 Vocal Cords  由声门分隔。呼气时声带振动产生声音。音高由声带的张力控制。 Separated by glottis. Sound produced by vibration of cords during exhalation. Pitch controlled by tension on cords. 下呼吸道 Lower Respiratory Tract  由以下部分组成： Made up of: o 气管 Trachea o 支气管树 Bronchial tree o 肺 Lungs 气管 The Trachea  一根管子，通常称为气管，连接喉和支气管 A tube, often called the windpipe, that connects the larynx with the bronchi  由结缔组织、平滑肌和软骨环组成——软骨环保持气道开放 Made of connective tissue, smooth muscle, and cartilaginous rings – the rings keep the airways open  内衬纤毛和黏液，帮助保持肺部清洁 Lined with cilia and mucus that help to keep the lungs clean 支气管树 The Bronchial Tree  从气管进入肺的两根主支气管开始 Starts with two main bronchi that lead from the trachea into the lungs  支气管继续分支，直到成为直径约 1 毫米的细支气管，壁较薄 The bronchi continue to branch until they are small bronchioles about 1mm in diameter with thinner walls  细支气管最终通向称为肺泡的 elongated sacs Bronchioles eventually lead to elongated sacs called alveoli 肺泡 The Alveoli  肺中有 3 亿个肺泡，大大增加了表面积 300 million in the lungs that greatly increase surface area   肺泡被毛细血管包裹 Alveoli are enveloped by blood capillaries  肺泡内衬有表面活性剂，作为薄膜保持肺泡开放 Alveoli are lined with surfactant that acts as a film to keep alveoli open 肺 The Lungs  支气管、细支气管和肺泡组成肺 The bronchi, bronchioles, and alveoli beyond the bronchi make up the lungs  右肺有 3 个叶，左肺有 2 个叶，分为小叶 The right lung has 3 lobes while the left lung has 2 lobes that divide into lobules  每个肺被胸膜包裹 Each lung is enclosed by membranes called pleura 定义 Definitions  通气——空气进出肺的运动（呼吸） Ventilation – movement of air into and out of the lungs (breathing) o 吸气（吸入）——吸入空气 Inspiration (inhalation) – breathing in o 呼气（呼出）——呼出空气 Expiration (exhalation) – breathing out  呼吸——气体交换 Respiration – gas exchange  细胞呼吸——细胞利用氧气制造 ATP Cellular respiration – use of oxygen by cells to make ATP 呼吸/通气 Breathing/Ventilation  1. 吸气——将空气吸入肺的主动过程 2. Inspiration – an active process of inhalation that brings air into the lungs  2. 呼气——通常是将空气排出肺的被动过程 3. Expiration – usually a passive process of exhalation that expels air from the lungs 吸气/吸入 Inspiration/Inhalation  膈肌和肋间肌收缩 The diaphragm and intercostal muscles contract  膈肌变平，肋骨向上和向外移动 The diaphragm flattens and the rib cage moves upward and outward  胸腔和肺的容积增加 Volume of the thoracic cavity and lungs increase   肺内气压降低 The air pressure within the lungs decreases  空气流入肺 Air flows into the lungs 呼气/呼出 Expiration/Exhalation  膈肌和肋间肌放松 The diaphragm and intercostal muscles relax  膈肌向上移动并呈圆顶状 The diaphragm moves upward and becomes dome-shaped  肋骨向下和向内移动 The rib cage moves downward and inward  胸腔和肺的容积减少 Volume of the thoracic cavity and lungs decrease  肺内气压增加 The air pressure within the lungs increases  空气流出肺 Air flows out of the lungs 呼吸时的空气量 Volumes of Air During Breathing  潮气量——每次呼吸时通常进出肺的空气量 Tidal volume – the small amount of air that usually moves in and out with each breath o 约 500 毫升 Approx 500 mL  肺活量——一次呼吸中能吸入和呼出的最大空气量 Vital capacity – the maximum volume of air that can be moved in plus the maximum amount that can be moved out during one breath o 约 4800 毫升 Approx 4800 mL 呼吸调节 Regulation of Breathing  神经控制： Nervous control: o 大脑中的呼吸控制中心（延髓）发送神经冲动以收缩肌肉进行吸气 Respiratory control center in the brain (medulla oblongata) sends out nerve impulses to contract muscle for inspiration o 控制呼吸速率和深度 Controls breathing rate and depth o 我们为什么会打哈欠？ Why do we yawn? 化学控制 Chemical Control  化学控制： Chemical control: o 两组化学感受器感知血液 pH 的变化：一组在大脑中，另一组在循环系统中 2 sets of chemoreceptors sense changes in blood pH: one set is in the brain and the other in the circulatory system o 两者都对二氧化碳水平敏感，二氧化碳水平会因代谢而改变血液 pH Both are sensitive to carbon dioxide levels that change blood pH due to metabolism o 当血液 pH 下降——变得过酸——呼吸速率加快 When blood pH drops – becomes too acidic – breathing rate speeds up 上呼吸道感染 Upper Respiratory Tract Infections  鼻窦炎——鼻窦阻塞 Sinusitis – blockage of sinuses  中耳炎——耳部感染 Otitis media – infection of the ear  扁桃体炎——扁桃体炎症 Tonsillitis – inflammation of the tonsils  喉炎——喉部感染，导致失声 Laryngitis – infection of the larynx that leads to loss of voice 下呼吸道疾病 Lower Respiratory Disorders  肺炎——肺部感染，伴有黏稠的液体积聚 Pneumonia – infection of the lungs with thick, fluid build-up  结核病——细菌感染，导致结核结节（胶囊） Tuberculosis – bacterial infection that leads to tubercles (capsules)  肺纤维化——由于吸入颗粒物，肺失去弹性，纤维结缔组织在肺中积聚 Pulmonary fibrosis – lungs lose elasticity because fibrous connective tissue builds up in the lungs usually because of inhaled particles 下呼吸道疾病（续） Lower Respiratory Disorders (con’t.)  囊性纤维化——一种遗传性疾病，导致肺部、胰腺和其他器官形成增厚的黏液。在 肺部，这种黏液阻塞气道，导致肺损伤，使呼吸困难 Cystic Fibrosis - an inherited disease that causes thickened mucus to form in the lungs, pancreas, and other organs. In the lungs, this mucus blocks the airways, causing damage to the lungs, making it hard to breathe  哮喘——支气管树受到刺激，导致呼吸困难、喘息和咳嗽 Asthma – bronchial tree becomes irritated causing breathlessness, wheezing, and coughing 哮喘 Asthma  哮喘是一种以间歇性发作为特征的疾病，发作时气道平滑肌强烈收缩，显著增加气 道阻力 Asthma is a disease characterized by intermittent episodes in which airway smooth muscle contracts strongly, markedly increasing airway resistance  哮喘的基本缺陷是气道慢性炎症，其原因因人而异，包括过敏、病毒感染和对环境 因素的敏感性 The basic defect in asthma is chronic inflammation of the airways, the causes of which vary from person to person and include, among others, allergy, viral infections, and sensitivity to environmental factors 慢性阻塞性肺疾病（COPD） Chronic Obstructive Pulmonary Disease (COPD)  以慢性支气管炎和肺气肿为典型 Exemplified by chronic bronchitis and emphysema  是北美地区死亡和残疾的主要原因 Major causes of death and disability in North America 慢性阻塞性肺疾病（续） Chronic Obstructive Pulmonary Disease (con’t.)  肺气肿——由小气道的破坏和塌陷以及呼气弹性能力丧失引起；常见桶状胸 Emphysema is caused by destruction and collapse of the smaller airways and loss of elastic ability to exhale; barrel chest is common  慢性支气管炎——以支气管中黏液过多和小气道慢性炎症变化为特征。阻塞的原因 是气道中黏液积聚和气道壁增厚 Chronic bronchitis is characterized by excessive mucus production in the bronchi and chronic inflammatory changes in the small airways. The cause of obstruction is an accumulation of mucus in the airways and thickening of the inflamed airways  蓝肿者和粉红喘息者 Blue bloaters and pink puffers 慢性阻塞性肺疾病（续） Chronic Obstructive Pulmonary Disease (con’t.)  具有肺气肿和慢性支气管炎的特征 Features of both emphysema and chronic bronchitis o 患者几乎都有吸烟史 Patients almost always have a history of smoking o 呼吸困难（呼吸急促）逐渐加重 Labored breathing (dyspnea) becomes progressively more severe o 咳嗽和频繁的肺部感染常见 Coughing and frequent pulmonary infections are common o 大多数患者缺氧，保留二氧化碳，并有呼吸性酸中毒  Most victims are hypoxic, retain carbon dioxide, and have respiratory acidosis o 这些疾病不仅导致通气困难，还导致血液氧合困难 These diseases cause severe difficulties not only in ventilation but also in oxygenation of the blood o 感染者最终会发展为呼吸衰竭 Those infected will ultimately develop respiratory failure 肺癌 Lung Cancer  占美国所有癌症死亡的三分之一 Accounts for one-third of all cancer deaths in the United States  发病率增加与吸烟有关 Increased incidence is associated with smoking  两种主要类型： Two major types: 1. 非小细胞癌 Non-Small cell carcinoma 2. 小细胞癌 Small cell carcinoma 复习主题 Topics to Review  上呼吸道和下呼吸道的部分和功能是什么？ What are the parts and functions of the upper and lower respiratory system?  呼气和吸气的机制是什么？ What is the mechanism for expiration and inspiration?  呼吸如何通过神经系统和化学物质控制？ How is breathing controlled by the nervous system and through chemicals?  气体交换在哪里以及如何完成？ Where and how is exchange of gases accomplished?  一些常见的呼吸道感染和疾病有哪些？ What are some common respiratory infections and disorders? 1. 上呼吸道和下呼吸道的部分和功能是什么？ What are the parts and functions of the upper and lower respiratory system? 上呼吸道（Upper Respiratory Tract）  部分： o 鼻（Nose） o 咽（Pharynx） o 喉（Larynx）  功能： o 过滤、温暖和湿润吸入的空气 Filters, warms, and moistens inhaled air o 提供嗅觉  Provides sense of smell o 产生声音（通过喉和声带） Produces sound (via larynx and vocal cords) 下呼吸道（Lower Respiratory Tract）  部分： o 气管（Trachea） o 支气管树（Bronchial Tree） o 肺（Lungs，包括肺泡 Alveoli）  功能： o 将空气输送到肺泡 Transports air to the alveoli o 在肺泡中进行气体交换（氧气和二氧化碳） Facilitates gas exchange (oxygen and carbon dioxide) in the alveoli 2. 呼气和吸气的机制是什么？ What is the mechanism for expiration and inspiration? 吸气（Inspiration/Inhalation）  过程： o 膈肌和肋间肌收缩 The diaphragm and intercostal muscles contract o 膈肌变平，肋骨向上和向外移动 The diaphragm flattens, and the rib cage moves upward and outward o 胸腔和肺的容积增加 Volume of the thoracic cavity and lungs increases o 肺内气压降低，空气流入肺 Air pressure within the lungs decreases, and air flows into the lungs 呼气（Expiration/Exhalation）  过程： o 膈肌和肋间肌放松 The diaphragm and intercostal muscles relax o 膈肌向上移动并呈圆顶状，肋骨向下和向内移动 The diaphragm moves upward and becomes dome-shaped, and the rib cage moves downward and inward o 胸腔和肺的容积减少 Volume of the thoracic cavity and lungs decreases o 肺内气压增加，空气流出肺 Air pressure within the lungs increases, and air flows out of the lungs 3. 呼吸如何通过神经系统和化学物质控制？ How is breathing controlled by the nervous system and through chemicals? 神经系统控制（Nervous Control）  呼吸控制中心位于延髓（Medulla Oblongata） The respiratory control center is located in the medulla oblongata  延髓发送神经冲动以控制呼吸肌的收缩和放松  The medulla sends nerve impulses to control the contraction and relaxation of respiratory muscles  调节呼吸速率和深度 Regulates breathing rate and depth 化学控制（Chemical Control）  化学感受器感知血液中的二氧化碳水平和 pH 值 Chemoreceptors sense carbon dioxide levels and pH in the blood o 中枢化学感受器位于延髓 Central chemoreceptors are located in the medulla o 外周化学感受器位于颈动脉和主动脉 Peripheral chemoreceptors are located in the carotid and aortic bodies  当二氧化碳水平升高或 pH 值下降（酸性增加）时，呼吸速率加快 When carbon dioxide levels rise or pH drops (increased acidity), breathing rate increases 4. 气体交换在哪里以及如何完成？ Where and how is exchange of gases accomplished? 位置（Location）  肺泡（Alveoli）是气体交换的主要场所 The alveoli are the primary site of gas exchange 过程（Process）  氧气从肺泡进入毛细血管中的血液 Oxygen moves from the alveoli into the blood in the capillaries  二氧化碳从血液进入肺泡，随后被呼出 Carbon dioxide moves from the blood into the alveoli and is then exhaled  气体交换通过扩散（Diffusion）完成，依赖于氧气和二氧化碳的分压差 Gas exchange occurs through diffusion, driven by the partial pressure differences of oxygen and carbon dioxide 5. 一些常见的呼吸道感染和疾病有哪些？ What are some common respiratory infections and disorders? 上呼吸道感染（Upper Respiratory Tract Infections）  鼻窦炎（Sinusitis）：鼻窦阻塞 Sinusitis – blockage of sinuses  中耳炎（Otitis Media）：耳部感染 Otitis media – infection of the ear  扁桃体炎（Tonsillitis）：扁桃体炎症 Tonsillitis – inflammation of the tonsils  喉炎（Laryngitis）：喉部感染，导致失声 Laryngitis – infection of the larynx that leads to loss of voice 下呼吸道疾病（Lower Respiratory Disorders）  肺炎（Pneumonia）：肺部感染，伴有液体积聚 Pneumonia – infection of the lungs with fluid build-up  结核病（Tuberculosis）：细菌感染，导致结核结节 Tuberculosis – bacterial infection that leads to tubercles   肺纤维化（Pulmonary Fibrosis）：肺失去弹性，纤维组织积聚 Pulmonary fibrosis – lungs lose elasticity due to fibrous tissue build-up  哮喘（Asthma）：气道炎症和收缩，导致呼吸困难 Asthma – inflammation and constriction of airways, causing breathlessness  慢性阻塞性肺疾病（COPD）：包括慢性支气管炎和肺气肿 Chronic Obstructive Pulmonary Disease (COPD) – includes chronic bronchitis and emphysema  肺癌（Lung Cancer）：与吸烟密切相关 Lung Cancer – strongly associated with smoking 主要内容： 呼吸系统功能概述 吸入氧气与排出二氧化碳：呼吸系统的基本功能是吸入氧气并将其输送到血液中，同时排 出二氧化碳。 温暖和湿润吸入空气：通过鼻腔中的毛细血管，空气被温暖和湿润，以适应肺部的生理需 求。 过滤吸入空气中的颗粒：鼻腔中的毛发和黏液能够过滤掉空气中的颗粒物。 提供嗅觉：鼻腔中的特殊细胞作为气味受体，负责嗅觉功能。 产生声音：通过空气经过声带产生声音，声带的张力控制音高。 下呼吸道结构 鼻子：作为呼吸系统的开口，鼻腔不仅过滤空气，还温暖和湿润空气。 咽：扁桃体位于口腔和咽的交界处，提供淋巴防御。 喉：喉是空气从咽传递到气管的结构，内有声带，负责发声。 气管：气管连接喉和支气管，由软骨环保持开放，内衬纤毛和黏液。 支气管树：从气管延伸至肺部的支气管树，最终分支成细支气管，通向肺泡。 肺泡：肺泡是气体交换的场所，被毛细血管包裹，内衬有表面活性剂。 肺：由支气管、细支气管和肺泡组成，分为左右两肺，右肺有三个叶，左肺有两个叶。 呼吸过程 通气：描述了空气进出肺的运动，包括吸气和呼气两个过程。 吸气/吸入：通过膈肌和肋间肌的收缩，胸腔和肺的容积增加，导致肺内气压降低，空气流 入肺部。 呼气/呼出：膈肌和肋间肌放松，胸腔和肺的容积减少，肺内气压增加，空气流出肺部。 呼吸时的空气量：介绍了潮气量和肺活量的概念及其数值。 呼吸调节：包括神经控制和化学控制，解释了大脑呼吸控制中心的作用和化学感受器对血 液 pH 变化的感知。 呼吸系统疾病 上呼吸道感染：包括鼻窦炎、中耳炎、扁桃体炎和喉炎等。 下呼吸道疾病：如肺炎、结核病、肺纤维化和囊性纤维化等。 哮喘：描述了哮喘的特征、基本缺陷和慢性炎症的原因。 慢性阻塞性肺疾病（COPD）：介绍了 COPD 的特征、类型（肺气肿和慢性支气管炎）以 及患者特征。 肺癌：概述了肺癌的发病率、类型和与吸烟的关系。 复习主题 上呼吸道和下呼吸道的功能：总结了上呼吸道和下呼吸道的组成部分及其功能。 呼吸机制：回顾了吸气和呼气的机制。 呼吸控制：复习了呼吸如何通过神经系统和化学物质进行控制。 气体交换：概述了气体交换的位置和过程。 常见疾病：列举了常见的呼吸道感染和疾病。