Anatomy & Physiology - Nursing Module #18 PDF

Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ S...

Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ Lesson title: RESPIRATORY SYSTEM (Part 1) Learning Targets: At the end of the module, students will be able to: 1. List the processes & functions of respiratory system; Materials: Book, pen and notebook 2. Describe the structural & functional anatomical components of respiratory system; 3. Differentiate the processes involved in inspiration and References: expiration in breathing; VanPutte, C., Regan, J., & Russo, A. 4. Describe the factors involved in airflow into & out of lungs and the lung recoil; and, (2019). Seeley’s essentials of anatomy & 5. Identify the processing measuring the various respiratory physiology (10th ed.). New York, NY: volumes and capacities. McGraw-Hill Education. A. LESSON PREVIEW / REVIEW Take a review from the previous chapter by responding to the statement posted based on your own understanding. Use the space provided. If not enough, you may write at the back portion of this page. Right after, you can proceed comparing your responses from the Main Lesson in the previous chapter. Enjoy! Explain the differences between innate and adaptive immunity. ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ B. MAIN LESSON You must read & study the concepts and refer to figures/tables in Chapter 15 of the book. Processes of Respiration: 1. ventilation / breathing, which is the movement of air into & out of lungs 2. exchange of O2 and CO2 between the air in lungs and blood 3. transport of O2 and CO2 in the blood 4. exchange of O2 and CO2 between the blood and tissues Functions of Respiratory System: 1. Regulation of blood pH 3. Olfaction 2. Voice production 4. Innate immunity Anatomy of Respiratory System has two divisions, the upper respiratory tract (nose, pharynx, & larynx) & lower respiratory tract (trachea, bronchi, & lungs) (See figure 15.1) Nose – consists of external nose (visible structure, composed mainly of hyaline cartilage) & nasal cavity (extends from nares to choanae). (See figure 15.2) Structure Description Nares / Nostrils external openings of nose Choanae openings into the pharynx Nasal Septum partition dividing nasal cavity into right & left parts Hard Palate floor of nasal cavity, separating it from oral cavity This document is the property of PHINMA EDUCATION 1 of 7  Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ bony ridges on each side of nasal cavity; increase the surface area of nasal cavity & Conchae cause air to churn to be cleansed, humidified, & warmed air-filled spaces within bone & open into nasal cavity; resonating chambers; reduce Paranasal Sinuses weight of skull, produce mucus, & influence the quality of voice Nasolacrimal Ducts carry tears from eyes & open into nasal cavity Processes in the Nose & Nasal Cavity: 1. Coarse hairs inside the nares & the mucus produced by goblet cells trap large particles. 2. Cilia sweep the debris-laden mucus towards the pharynx, where it is swallowed. 3. Air is warmed by blood vessels underlying the mucous epithelium & humidified by moisture. Sneeze Reflex: Foreign substances detected by sensory receptors in superior part of nasal cavity ▼ Action potentials conducted along trigeminal nerve (V) ▼ Sent to medulla oblongata ▼ Reflex is triggered ▼ Uvula & soft palate are depressed to allow the rapidly flowing air from lungs directly through nasal passages ▼ Foreign substances dislodged Photic Sneeze Reflex / ACHOO (Autosomal-Dominant-Compelling-Helio-Ophthalmic-Outburst) – stimulated by exposure to bright light; associated with complicated wiring to pupillary reflex (pupils constrict in response to bright light) Pharynx / Throat – common passageway for both respiratory and digestive systems; divided into three regions: ▪ Nasopharynx – lined with pseudostratified ciliated columnar epithelium continuous with nasal cavity; takes in air ▪ Oropharynx – lined with stratified squamous epithelium that extends from uvula to epiglottis where oral cavity opens; takes in food, drink, & air ▪ Laryngopharynx – lined with stratified squamous & ciliated columnar epithelium which passes posterior to larynx & extends from top of epiglottis to esophagus; food & drink pass through Larynx / Voice Box – located in anterior throat, extends from base of tongue to trachea; consists of 9 cartilage structures: ▪ Thyroid Cartilage / Adam’s Apple – largest; attached to hyoid bone; opens passageway for air movement ▪ Cricoid Cartilage – most inferior cartilage that forms the base of larynx; opens passageway for air movement ▪ Epiglottis – has elastic cartilage; protects airway by covering the glottis as larynx elevates during swallowing ▪ Cuneiform Cartilage – paired on top part ▪ Corniculate Cartilage – paired on middle part Form an attachment site for vocal folds ▪ Arytenoid Cartilage – paired on bottom part This document is the property of PHINMA EDUCATION 2 of 7  Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ Main Functions of Larynx: 1. Maintains an open airway 3. Produces the voice 2. Protects the airway during swallowing Vocal Folds / Vocal Cords – inferior set of ligaments (true vocal cords); primary source of voice production; air moves past, causes them to vibrate & producing sounds; superior set of ligaments forms vestibular folds (false vocal cords) ✔ force of air controls the loudness & the tension of folds controls the pitch of voice Trachea / Windpipe – allows air to flow into the lungs; consists of 16-20 C-shaped pieces of hyaline cartilage; projects through mediastinum & divides into the right & left primary bronchi at level of 5th thoracic vertebra. Cough Reflex: Foreign substances detected by sensory receptors ▼ Action potentials conducted along vagus nerve (X) ▼ Sent to medulla oblongata; Reflex is triggered ▼ Smooth muscle of trachea contracts (decreasing trachea’s diameter) ▼ Air moves rapidly through the trachea expelling mucus & foreign substances Main Bronchi / Primary Bronchi – each connected to left & right lung & lined with cilia Left Main Bronchus Right Main Bronchus more horizontal due to displacement from wider, shorter, more vertical heart’s location more in direct line with trachea Lungs – principal organs in respiration; cone-shaped with its base resting on diaphragm & apex extending superiorly to a point about 2.5 cm above the clavicle; right lung has 3 lobes while left lung has 2 lobes Bronchopulmonary Segments – division of each lobe which separated from one another by connective tissue septa; not visible as surface fissures; right lung has 10 segments while left lung has 9. Tracheobronchial Tree: Main Bronchi ► Lobar Bronchi / Secondary Bronchi (2 in left lung; 3 in right lung) ► Segmental Bronchi / Tertiary Bronchi (lead to bronchopulmonary segments of lung) ► Bronchioles ► Terminal Bronchioles ► Respiratory Bronchioles ► Alveolar Ducts ► Alveoli Alveoli – small air-filled chambers where the air & blood come into close contact with each other; surrounded by elastic fibers that allow them to expand during inspiration & recoil during expiration Respiratory Membrane – formed by walls of alveoli & capillaries where gas exchange takes place; consists of two layers of simple squamous, including alveolar fluid, & separating spaces; layers of this membrane include: ▪ Thin layer of alveolar fluid ▪ Thin interstitial space ▪ Alveolar epithelium (simple squamous) ▪ Basement membrane of capillary endothelium ▪ Basement membrane of alveolar epithelium ▪ Capillary endothelium (simple squamous) Pleural Cavities – spaces around each lung; lined with a serous membrane called pleura that consists of parietal pleura (lines thoracic cavity) & visceral pleura (covers lung’s surface); contains pleural fluid that performs two functions: This document is the property of PHINMA EDUCATION 3 of 7  Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ ✔ acts as lubricant, allowing the parietal & visceral pleura to slide past each other as lungs & thorax change shape during respiration ✔ helps hold the pleural membranes together Ventilation / Breathing – process of moving air into and out of lungs; regulated by changes in thoracic volume, which produce changes in air pressure within lungs (See figure 15.10) Structure Inspiration / Inhalation Expiration / Exhalation Thoracic Cavity Volume Increases Decreases Atmospheric Pressure Higher Lower Alveolar Pressure Lower Higher Contracts to move inferiorly to expand the rib Diaphragm Relaxes in quiet expiration cage External Intercostals Contracts to elevate ribs & sternum Relaxes Contracts in forceful exhalation Internal Intercostals Relaxes to depress ribs & sternum Physical Principles in Airflow into & out of Lungs: (See Process figure 15.11) 1. Changes in volume results in changes in pressure. As the thoracic cavity volume increases, the pressure decreases. 2. Air flows from an area of higher pressure to an area of lower pressure. The greater the pressure difference, the greater the rate of airflow Lung Recoil – tendency for an expanded lung to decrease in size during quiet expiration; due to elastic fibers and thin film of fluid lining alveoli Factors that Keep the Lungs from Collapsing: 1. Surfactant – mixture of lipoprotein molecules produced by secretory cells of alveolar epithelium that reduces the surface tension 2. Pleural Pressure – pressure in pleural cavity; normally less than alveolar pressure to expand alveoli which is caused by fluid removal by lymphatic system & by lung recoil Spirometry – process of measuring volumes of air that move into & out of respiratory systems. Spirometer – the device that measures these respiratory volumes (measures of the amount of air movement during different portions of ventilation). Four Respiratory Volumes: (See figure 15.12) ▪ Tidal Volume – air inspired / expired with each breath; about 500 mL at rest. ▪ Inspiratory Reserve Volume – air inspired forcefully; about 3L. ▪ Expiratory Reserve Volume – air expired forcefully; about 1.1L. ▪ Residual Volume – remaining air after maximum expiration; about 1.2L. Respiratory Capacities – sums of two or more respiratory volumes; total volume of air contained ranges from 4 to 6 L. ▪ Functional Residual Capacity = expiratory reserve volume + residual volume ▪ Inspiratory Capacity = tidal volume + inspiratory reserve volume ▪ Vital Capacity = tidal volume + inspiratory & expiratory reserve volume ▪ Total Lung Capacity = tidal + residual + inspiratory reserve + expiratory reserve volumes Forced Expiratory Vital Capacity – rate at which lung volume changes during direct measurement of vital capacity. This document is the property of PHINMA EDUCATION 4 of 7  Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ CHECK FOR UNDERSTANDING You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in your answer/ratio is not allowed. You are given 20 minutes for this activity. Multiple Choice 1. The site of respiration inside the lungs are _________. a. Alveoli d. Bronchioles b. Diaphragm e. Lungs c. Bronchi ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 2. What is the function of trachea? a. Filters air we breathe c. Carries air to lungs b. Releases air out of the body d. Exchange of gas ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 3. Which of the following is the primary function of hyaline cartilage? a. protect thyroid c. support trachea b. increase the surface area d. connect conchae ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 4. The result of the process of inspiration is: a. increased alveolar volume causes increased alveolar pressure. b. increased alveolar volume causes decreased alveolar pressure. c. decreased alveolar volume causes increased alveolar pressure. d. decreased alveolar volume causes decreased alveolar pressure. e. increased alveolar pressure caused decreased alveolar volume. ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 5. Arrange the following structures in the order air passes through them during inhalation: (1) alveolar ducts (3) respiratory bronchiole (2) alveolus (4) terminal bronchiole a. 1, 2, 3, 4 d. 3, 2, 1, 4 b. 2, 1, 3, 4 e. 4, 3, 2, 1 c. 4, 3, 1, 2 This document is the property of PHINMA EDUCATION 5 of 7  Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 6. What is the deep inspiration maximum expiration of lungs is called? a. Vital capacity c. Inspiratory capacity b. Total lung capacity d. Functional residual capacity ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 7. Pulmonary ventilation movements are due to __________. a. Costal muscles and diaphragm c. Wall of lungs b. Diaphragm d. Costal muscles ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 8. Expiration during quiet breathing: a. is an active process. d. occurs when the diaphragm and external b. requires more muscle contractions than intercostal muscles relax. inspiration. e. is not affected by the elastic properties of the c. is due to contraction of the diaphragm and lungs. elevation of the ribs. ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ 9. The vital capacity of the lungs is ____________. a. the sum of tidal volume, inspiratory reserve volume, and expiratory reserve volume. b. the sum of tidal volume, inspiratory reserve volume and residual volume. c. the sum of tidal volume and expiratory reserve volume. d. the sum of inspiratory reserve volume and expiratory reserve volume. ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ This document is the property of PHINMA EDUCATION 6 of 7  Anatomy & Physiology – Lecture (Nursing) Module #18 Student Activity Sheet Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ 10. Pepper has been reviewing the values of respiratory capacities prior to her exposure in the Respiratory Ward. She knows that the total lung capacity is the sum of the inspiratory and expiratory reserves and the tidal and residual volumes. Its normal volume is ________. a. 5000-6000ml c. 4000-5500ml b. 2500-5000ml d. 3000-6000ml ANSWER: ________ RATIO:______________________________________________________________________________ ____________________________________________________________________________________ __________________________ C. LESSON WRAP-UP AL Activity: CAT: MUDDIEST POINT This technique will help you determine which key points were missed in the main lesson. You will respond to only one question: In today’s session, what was least clear to you? ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ This document is the property of PHINMA EDUCATION 7 of 7