RESPIRATORY SYSTEM

ANATOMY AND PHYSIOLOGY

 PYRAMID POINTS

• Functions of each part of the respiratory system

• Alterations that occur in the various parts of the
respiratory system
• The effect on the respiratory system when a
disorder occurs
• The function of the alveoli and the respiratory
process
• The effect of treatments and procedures on the
respiratory process
 RESPIRATORY SYSTEM

• PRIMARY FUNCTIONS
– Provides oxygen for metabolism in the tissues
– Removes carbon dioxide, the waste product of
metabolism
• SECONDARY FUNCTIONS
– Facilitates sense of smell
– Produces speech
– Maintains acid-base balance
– Maintains body water levels
– Maintains heat balance
 UPPER RESPIRATORY TRACT

• Nose
• Sinuses
• Pharynx
• Larynx
• Epiglottis
 UPPER RESPIRATORY TRACT

From Monahan, F. & Neighbors, M. (1998). Medical-surgical nursing: Foundations for

clinical practice, ed 2, Philadelphia: W.B. Saunders.
 UPPER RESPIRATORY TRACT

• NOSE
– Humidifies, warms, and filters inspired air
• SINUSES
– Air-filled cavities within the hollow bones that
surround the nasal passages
– Provide resonance during speech
 UPPER RESPIRATORY TRACT

• PHARYNX
– Located behind the oral and nasal cavities
– Divided into the nasopharynx, oropharynx, and
laryngopharynx
– Passageway for both the respiratory and
digestive tracts
 UPPER RESPIRATORY TRACT

• LARYNX
– Located above the trachea and just below the
pharynx at the root of the tongue
– Commonly called the voice box
– Contains two pairs of vocal cords, the false
and true cords
– The opening between the true vocal cords is
the glottis
– The glottis plays an important role in
coughing, which is the most fundamental
defense mechanism of the lungs
 UPPER RESPIRATORY TRACT

• EPIGLOTTIS
– Leaf-shape elastic structure that is attached
along one end to the top of the larynx
– It prevents food from entering the
tracheobronchial tree by closing over the
glottis during swallowing
 LOWER RESPIRATORY TRACT

• Trachea
• Mainstem bronchi
• Bronchioles
• Alveolar ducts and alveoli
• Lungs
 LOWER RESPIRATORY TRACT

From Monahan, F. & Neighbors, M. (1998). Medical-surgical nursing: Foundations for

clinical practice, ed 2, Philadelphia: W.B. Saunders.
 LOWER RESPIRATORY TRACT

• TRACHEA
– Located in front of the esophagus
– Branches into the right and left mainstem
bronchi at the carina
 TRACHEA

From Wilson SF, Giddens JF: Health Assessment for Nursing Practice, ed. 2, St. Louis, 2001, Mosby.
 LOWER RESPIRATORY TRACT

• MAIN STEM BRONCHI

– Begins at the carina
– The right bronchus is slightly wider, shorter,
and more vertical than the left bronchus
– The mainstem bronchi divide into five
secondary or lobar bronchi that enter each of
the five lobes of the lung
– The bronchi are lined with cilia, which propel
mucus up and away from the lower airway to
the trachea where it can be expectorated or
swallowed
 LOWER RESPIRATORY TRACT

• BRONCHIOLES
– Branch from the secondary bronchi and
subdivide into the small terminal and
respiratory bronchioles
– They contain no cartilage and depend on the
elastic recoil of the lung for patency
– The terminal bronchioles contain no cilia and
do not participate in gas exchange
 BRONCHIOLE

From Monahan, F. & Neighbors, M. (1998). Medical-surgical nursing: Foundations for

clinical practice, ed 2, Philadelphia: W.B. Saunders.
 LOWER RESPIRATORY TRACT

• ALVEOLAR DUCTS AND ALVEOLI

– Alveolar ducts branch from the respiratory
bronchioles
– Alveolar sacs, which arise from the ducts,
contain clusters of alveoli, which are the basic
units of gas exchange
– Cells in the walls of the alveoli secrete
surfactant, a phospholipid protein that reduces
the surface tension in the alveoli; without
surfactant, the alveoli would collapse
 ALVEOLI

From Thibodeau GA, Patton KT: Anatomy and Physiology, ed. 4, St. Louis,
1999, Mosby. Courtesy of Network Graphics.
 LOWER RESPIRATORY TRACT

• LUNGS
– Located in the pleural cavity in the thorax
– Extend from just above the clavicles to the
diaphragm, the major muscle of inspiration
– The right lung, which is larger than the left, is
divided into three lobes: the upper, middle, and
lower lobe
– The left lung, which is somewhat narrower
than the right lung to accommodate the heart,
is divided into two lobes
 LOWER RESPIRATORY TRACT

• LUNGS
– Innervation of the respiratory structures is
accomplished by the phrenic nerve, vagus
nerve, and thoracic nerves
– The parietal pleura lines the inside of the
thoracic cavity, including the upper surface of
the diaphragm
– The visceral pleura covers the pulmonary
surfaces
 LOWER RESPIRATORY TRACT

• LUNGS
– A thin fluid layer which is produced by the
cells lining the pleura, lubricates the visceral
and parietal pleura, allowing them to glide
smoothly and painlessly during respiration
– Blood flow through the lungs occurs via the
pulmonary system and the bronchial system
 ACCESSORY MUSCLES OF RESPIRATION

• SCALENE MUSCLES
– Elevate the first two ribs
• STERNOCLEIDOMASTOID MUSCLES
– Raise the sternum
• TRAPEZIUS AND PECTORALIS MUSCLES
– Fix the shoulders
 THE RESPIRATORY PROCESS

• The diaphragm descends into the abdominal

cavity during inspiration, causing negative
pressure in the lungs
• The negative pressure draws air from the area of
greater pressure, the atmosphere, into the area of
lesser pressure, the lungs
• In the lungs, air passes through the terminal
bronchioles into the alveoli to oxygenate the
body tissues
 THE RESPIRATORY PROCESS

• At the end of inspiration, the diaphragm and

intercostal muscles relax and the lungs recoil
• As the lungs recoil, pressure within the lungs
becomes greater than atmospheric pressure,
causing the air, which now contains the cellular
waste products of carbon dioxide and water, to
move from the alveoli in the lungs to the
atmosphere
• Expiration is a passive process
 DIAPHRAGM

From Herlihy B, Maebius NK: The human body in health and illness, Philadelphia, 2000, W.B. Saunders.
 INSPIRATION AND EXPIRATION

From Monahan, F. & Neighbors, M. (1998). Medical-surgical nursing: Foundations for clinical practice,
ed 2, Philadelphia: W.B. Saunders.