NCM 112-A: Medical-Surgical 1 Lecture

UNIT 1 LESSON 1: OVERVIEW OF THE RESPIRATORY SYSTEM

1st SEMESTER A.Y. 2022 - 2023 Prepared by: Puno, Jacqueline S., Batch 2024

THE RESPIRATORY SYSTEM

• Along with the cardiovascular system, the
respiratory system share responsibility for
supplying the body with oxygen and disposing
of carbon dioxide.
• The organs of the respiratory system include
the nose, pharynx, larynx, trachea, bronchi,
and their smaller branches, and the lungs,
which contain the alveoli, or terminal air sacs. ➢Auditory tubes (Eustachian tube), which
drain the middle ear, open into the
I. FUNCTIONAL ANATOMY OF UPPER RS nasopharynx. *equalizes pressure
➢ Tonsils – found also in the pharynx; the
pharyngeal tonsils (adenoid), palatine
tonsils, and lingual tonsils
D. LARYNX
➢ “Voice box”; routes air and food into the
proper channels and plays a role in
speech
➢ Thyroid cartilage – common called the
“Adam’s apple” is the largest hyaline
cartilage which protrudes anteriorly.
➢ Epiglottis – “guardian of the airways”;
protects superior opening of the larynx
➢ Vocal folds or true vocal cords – it
A. NOSE vibrates with expelled air which allows us
➢ Whether “button” or “hooked” in shape, to speak
is the only externally visible part of the ➢ Glottis – slit like passageway between
respiratory system. During breathing, air the vocal folds
enters the nose by passing through the E. TRACHEA
nostrils, or nares. (Marieb) ➢ Also called “windpipe”, has a length of
B. PARANASAL SINUSES 10-12 cm or about 4in, is lined with a
➢ They lighten the skull and act as ciliated mucosa.
resonance chambers for speech. ➢ Cilia of the trachea function to propel
➢ A ring that surrounds the nasal cavity. mucus. Loaded with dust particles and
(Marieb). other debris, away from the lungs to the
➢ Classifications: throat, where it can be swallowed or spat
1. Frontal out.
2. Sphenoid
3. Ethmoid II. FUNCTIONAL ANATOMY OF LOWER RS
4. Maxillary bones A. PRIMARY BRONCHI
➢ The right and left primary bronchi are
C. PHARYNX formed by the division of the trachea
➢ It serves as a passageway for food and air ➢ The right primary bronchus is wider,
➢ Subdivided into three portions: shorter, and straighter than the left, also
nasopharynx, oropharynx, and more to some lodging of foreign object
laryngopharynx

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 ➢ It warm, cleanse and humidify air that
enters the lungs
*w/o proper humidification, it would be
difficult for us to collect O2 and to be
transported easily to the airway tract
*O2 loves to attach to hydrogen ion (H2O)
B. LUNGS
➢ They occupy the entire thoracic cavity
except for the most central area –
mediastinum
➢ Apex – the narrow superior portion of
each lung, located just deep to the
clavicle
➢ Base – broad lung area resting on the
diaphragm
➢ Each lung is divided into lobes by fissures;
the left lung has 2 lobes, and the right
lung has 3 lobes
➢ Pleura (serous membrane) – visceral
serosa that covers the surface of each
lung; it has 2 forms: the parietal pleura
and the visceral pleura.
➢ Bronchioles – subdivisions of the
primary bronchi inside the lungs before it
terminates in alveoli
➢ Alveoli – air sacs; the ONLY site of gas
exchange
III. RESPIRATORY PHYSIOLOGY
A. 4 DISTINCT EVENTS DURING RESPIRATION
1. Pulmonary Ventilation - Air must move
into and out of the lungs so that the gases
in the alveoli of the lungs are continuously
refreshed. This process of pulmonary
ventilation is commonly called breathing
2. External Respiration - Gas exchange
(O2 loading and CO2 unloading) between
the pulmonary blood and alveoli must
take place. Remember that in external
respiration, gas exchanges are being
made between the blood and the body
exterior.
3. Respiratory Gas Transport – O2 and
CO2 must be transported to and from the
lungs and tissue cells of the body via the
bloodstream
4. Internal Respiration - At systemic
capillaries, gas exchange occurs
between the blood and cells inside the
body.
B. MECHANICS OF BREATHING
1. Inspiration
2. Expiration
3. Nonrespiratory Air Movements (other
than inhale & exhale; ex. Coughing,
hiccups, yawning, sneezing, crying,
laughing)
C. RESPIRATORY VOLUMES AND
CAPACITIES
1. Tidal Volume (VT) – the volume of air
inhaled and exhaled with normal quiet
breathing (500ml)
2. Inspiratory Reserve Volume (IRV) - the
maximum volume that can be inhaled
following a normal quiet inhalation (2100-
3200ml)
3. Expiratory Reserve Volume (ERV) - the
maximum volume that can be exhaled
following a normal quiet exhalation
(1200ml)
4. Residual Volume (RV) - the volume of air
that remains in the lungs after forceful
exhalation
5. Vital Capacity (VC) - the maximum
volume of air that can be exhaled after a
maximum inhalation; the sum of the TV,
IRV, and ERV (4800ml)
6. Inspiratory Capacity - total amount of air
that can be inhaled following normal quiet
exhalation; the sum of TV and IRV
(3,600ml)
7. Total Lung Capacity (TLC) - the total
volume of the lungs at maximum inflation;
sum of TV, IRV, ERV and RV (6,000ml)
D. RESPIRATORY SOUNDS
1. Bronchial sounds (Bronchi)
2. Vesicular breathing sounds (Alveoli)
E. FACTORS INFLUENCING RESPIRATORY
RATE AND DEPTH
1. Physical factors (ex. Running)
2. Volition (Conscious Control) (control of
breathing)
3. Emotional factors (ex. Anger→faster
breathing)
4. Chemical factors (respiratory gases)
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F. NEUROLOGIC CONTROL OF THE
RESPIRATORY SYSTEM
1. MEDULLA OBLONGATA – center for
respiration
2. PONS – control rate and depth of
respiration
3. PHRENIC NERVE – controls
diaphragmatic movement
4. PNEUMOTAXIC CENTER – controls
pattern of respiration (E.g., Kussmaul’s)
5. APNEUSTIC CENTER – stimulate
medulla to create prolonged and deep
respiration

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