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This document is about the anatomy and physiology of the respiratory system. It covers topics such as learning outcomes, respiration, respiratory tract, inhalation antibiotic therapy in detail. The document appears to be part of lecture notes.

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NFNF3613 Farmakoterapi Gangguan Kardiovaskular dan Respiratori Syaratul Dalina Yusoff (ext:7085) [email protected] © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system LEARNING OUTCOMES At the end of this chap...

NFNF3613 Farmakoterapi Gangguan Kardiovaskular dan Respiratori Syaratul Dalina Yusoff (ext:7085) [email protected] © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system LEARNING OUTCOMES At the end of this chapter, students will be able to: 1. Describe the anatomical structure of the respiratory system. 2. Explain the various functions of the respiratory system. 3. Explain the process of gas exchange and transport. 4. Describe the factors that can affect breathing. © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system RESPIRATORY SYSTEM © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system c. Respiratory centres on the brain © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Autonomic innervation of airway tract © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Major functions of the respiratory system To provide oxygen to cells and tissues and removing carbon dioxide from the body. Respiration: There are four distinct processes must happen – Pulmonary ventilation – gas exchange between lungs and the atmosphere – External respiration – gas exchange between the lungs and the blood – Transport – transport of oxygen and carbon dioxide in the circulation – Internal respiration – gas exchange between systemic blood vessels and tissues © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Respiration The exchange of gases between body cells and the environment. Regulated by the respiratory centers. Involves 2 main processes: – Pulmonary ventilation (breathing) – Respiration (External and internal) © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Respiratory tract © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Inhalation antibiotic therapy mainly targets the conductive zone where sputum is located, whereas systemic antibiotic therapy mainly targets the respiratory zones with no sputum © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system There are a range of conditions that compromises respiratory functions: – Inflammation (asthma, allergies) – Infections (pneumonia, bronchitis, colds, flu) – Diseases (lung cancer, emphysema) © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Epithelial lining The nasal vestibule in the upper respiratory tract is lined by: 1. stratified squamous epithelium. 2. It transitions into a pseudostratified columnar epithelial mucosa with ciliated and goblet cells lying on a basement membrane. 3. The narrower bronchioles are lined by simple, cuboidal epithelium with less ciliated and more club cells. 4. The alveoli are composed of type I and type II alveolar cells © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Nose and nasal cavity © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Lined with ciliated columnar epithelium to remove contaminated mucus. Goblet cells secrete mucus (~1L per day!) containing lysozyme and defensins to help destroy bacteria. Fine hairs ining the epithelial are coated with mucus able to trap dusts, pollens and bacteria forming clumps of boogers. Sensitive mucosa triggers sneezing when stimulated by irritating particles. Rhinitis is a condition that includes a runny nose, sneezing, and nasal stuffiness. Can be due to allergy or non-allergy trigger. © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Sinuses Sinusitis: swollen or inflamed lining and excess mucus due to infection. © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Pharynx Also known as throat. Funnel-shaped tube of skeletal muscle that connects to the: – Nasal cavity and mouth superiorly – Larynx and esophagus inferiorly Lined with ciliated pseudostratified columnar epithelium. Is divided into 3 regions: – Nasopharynx – Oropharynx – Laryngopharynx © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Larynx Attaches to the hyoid bone and opens into the laryngopharynx superiorly. Continuous with the trachea posteriorly. Hyoid Bone: the only bone in the body that floats Thyroid cartilage - the "adam's apple" on men Thyroid gland? © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Tonsils © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Functions: Helps air circulate to be warmed and moist Act as echo chambers that helps amplify voice. Mucus from this area drains into nasal cavity. © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Functions: Providing an airway for respiration Moistening and warming the inspired air Filtering inspired air and cleaning it of foreign matter Serving as a resonating chamber for speech Housing the olfactory receptors © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Functions: To act as a valve to prevent air from escaping the lungs, eg. Weightlifting To prevent foreign substances from entering the lungs, trachea To forcefully expel foreign substances which threaten the trachea, eg. Coughing Involves in the production of sound – Ligaments that vibrate to produce sounds as air rushes up from the lungs – Becomes longer and thicker in male when reach puberty © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Functions: Eustachian tubes open into its lateral walls. Serves as common passageway for air and food. Conducts air through trachea and into the lungs. Permits passage of food into eosophagus. Closes during swallowing to prevent food from entering the nasal cavity. © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Trachea Composed of 3 layers: – Inner layer – lined with ciliated columnar epithelium and mucus-secreting goblet cells – Middle layer – C-shaped cartilage and smooth muscle – Outer layer – fibrous and elastic tissue that encloses the cartilage © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Adventitia = connective tissue © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Trachea Functions Support and patency – Cartilage avoid obstruction of the airway when head and neck move. Ciliated cells push mucus with adherent particles upwards towards larynx where it is either swallowed or coughed up. – Smoking destroys cilia. Without cilia, it becomes difficult to sweep the mucus up and out of the trachea. The individual coughs violently. Cough reflex – Irritation in the region stimulate nerve endings in the larynx to send impulse to respiratory center in the brain stem. The reflex motor response is to cough. Warming, humidifying and filtering of air © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Trachea Smooth muscle layer is innervated by neurons from autonomic nervous system. – Sympathetic verves: “Fight-or-Flight” mode B2-adrenergic receptors – dilate airways, allows more air in – Parasympathetic nerves: “Rest-and-Digest” mode Muscarinic receptors – decrease in airway’s diameter Thus, bronchodilators can be B2-agonist or anticholinergic type. © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Bronchus Bronchi (singular bronchus) The last tracheal cartilage marks the end of trachea and the beginning of the right and left bronchi. Air reaching the bronchi: – Warm and cleansed of impurities – Saturated with water vapor Tissue walls slightly similar to trachea but not as many goblet cells. – Cartilage support structures changes – Amount of smooth muscle increases © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Chronic bronchitis Increased thickness of mucus gland layer of bronchus, airway inflammation, productive cough © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Bronchioles © Copyright Faculty of Pharmacy UKM Anatomy and physiology of the respiratory system Bronchioles Diameter

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