RESPIRATORY SYSTEM

ANATOMY,PHYSIOLOGY,PATHOLOGY AND
SURGICAL PROCEDURES
The Respiratory System (Oxygen Delivery
System)

The respiratory system is the set

of organs that allows a person to
breathe and exchange oxygen
and carbon dioxide throughout the
body.
Functions
•Supplies the body with oxygen
and disposes of carbon dioxide
•Filter inspired air
•Produced sound
•Contains receptor for smell
•Removes excess of water and
heat
•Helps regulate blood PH.
 The organs of the “Respiratory Tract” can be divided into two groups
“STRUCTURALLY”

The Upper Respiratory Tract

• Nose
•Nasal Cavity
•Sinuses
•Pharynx
The Lower Respiratory Tract
•Larynx
•Trachea
•Bronchial Tree
•Alveoli
•Lungs
NOSE AND NASAL CAVITY
•Main route of air entry.
•Two cavities divided by a SEPTUM.
•Anteriorly consist hyaline cartilage.
•The roof is formed by ethmoid bone
•The floor is formed by roof of the mouth.
•The medial wall formed by the septum.
•The lateral wall formed by the maxilla

NOSE:
•The nose also called external nares.
•Divided into two halves by nasal septum.
•Contain cilia which is responsible for
filtering out foreign bodies.
External nares:- opening to exterior
Internal nares:- opening to pharynx
Nasal conchae:- folds in the mucouse
membrane that increase air turbance
and ensures that most air contacts the
mucous membrane.
NASAL CAVITIES:
•Two hollow spaces
•Lined with mucous to trap
pathogens(germs).
•Has rich blood supply.
•As air enters, the cavities, it is
warmed,filtered and moistened.

CILIA:
•Tiny hairlikes structures in nasal cavity.
•Trap dust and pathogens.
•The trapped particles are the pushed
towards esophagus and
swallowed.

SINUSES:
•Cavities in the skull
•Connected to nasal cavity by short ducts.
•Also lined with mucous membrane
•Provide Resonance for the voice.
PHARYNX
• The pharynx is the part of the
throat that is behind the mouth
and nasal cavity and above the
esophagus and the larynx.
•Length – 12-14cm (extends
from the base of the skull to the
level of 6th cervical vertebra).

Position

superiorly- Base of the skull.

Inferiorly –Continuous with the
oesophagus.
Anteriorly- Incomplete wall
because of the nose, mouth and
larynx opening.
Posteriorly- Areolar tissue &first
6 vertebra .
THREE SECTION OF PHARYNX
•Nasopharynx
cccontains the pharyngeal
tonsils(adenoids)which aid in the body’s immune
defence.
•Oropharynx
Back portion of the mouth that contain palatine
tonsils which aid in the body’s immune defense.
•Laryngopharynx
Bottom section of the pharynx where the
respiratory tract divides into the esophagus and
the larynx.

Function of pharynx
1. Common space used by both the respiratory
and digestive system
2. Commonly called throat.
3. Common pathway for both air and food
4. Walls are lined by a mucosa and contain
skeletal muscles that are primarily used for
swallowing
5.Taste:
There are olfactory nerve endings.
6.Hearing:
The auditory tube, extending from the nasopharynx to each middle ear.
7.Protection:
The lymphatic tissue of the pharyngeal tonsils produces antibodies.
8.Speech:
Acts as a resonating chamber for sounds ascending from the larynx
LARYNX:
• The larynx or voice box extends from
the root of the tongue.
•It lies in front of the laryngopharynx at the
level of 3rd ,4th , 5th, and 6th cervical
vertebra.
•Until the puberty there is little difference
in the size of the larynx between the
sexes.
•It grows larger in the males.

STRUCTURE
•The larynx is composed of several
irregularly shaped cartilage attached to
each other by ligaments and membranes.
• The main cartilages are:
1 thyroid cartilage
1 cricoid cartilage Hyaline cartilage
2 arytenoid cartilage
• 1 epiglottis - elastic fibrocartilage
•Thyroid cartilage
This is the most prominent& consists of 2 flat pieces of hyaline cartilage &
fused anteriorly forming the Adam’s apple.
• The Cricoid cartilage
This lies below the thyroid cartilage& composed of hyaline cartilage.
•The arytenoid cartilages
These are two roughly pyramid-shaped hyaline cartilage situated on top of
the broad part of the crocoid cartilage.
•The epigottis
The is a leaf-shaped fibroelastic cartilage attached to the inner surface of the
anterior wall of the thyroid cartilage.
Blood and nerve supply
•Superior and inferior laryngeal arteries.
•Thyroid veins.
•Superior laryngeal nerves.
Function
•Production of sound
•Speech
•Protection of the lower respiratory tract during swallowing the larynx moves
upwards and hinges epiglottis closes over the larynx.
TRACHEA
•The trachea or wind pipe is a
continuation of the larynx &extends
downward to about the level of T-5
where it divides into right and left
primary bronchi
•Length -10-11cm.

•Superiorly the larynx

•Inferiorly the right&left bronchi

•Anteriorly upper part-the thyroid

gland

•Posteriorly the oesophagus

•Laterally the lungs
Structure
•Composed of 3 layers of tissue
(i) fibrous& elastic tissue
(ii)smooth muscle
(iii) ciliated columnar epithelium
Held open by between 16 -20
incomplete cartilage rings(c –
rings

Blood supply
Inferior thyroid artery
Bronchial artery

Nerve supply
Laryngeal nerve
•Nerve supply
Vagus nerve

Functions
•External respiration

•Defence againts
microbes

•Exchange of gases
LUNGS
There are two lungs, one lying on each side.
•Shape-cone
•Length -20-24cm
•Weight-600-700gms
•Color-pinkish

•Surface –Apex
A base
costal surface
medial surface
•Apex- rounded and rises into the root of the neck.
•A Base- this is concave & semilinar in shape,lies on the thoracic surface
of the diaphragm.
•Costal surface-this surface is convex
•Medial surface-this surface concave & has a roughly triangular-shaped
area, called the hilum.
•Lobes of lungs –three lobes in the right lung

two lobes in the left lung

•lobes are separate by the fissures

•The area between the lungs is the mediastinum.

PLEURA
•The pleura consists of a closed sac of
serous membrane, one for each lung which
contains small amount of serous fluid.
•The lung is invaginates or pushed into this
sac.
•It forms two layers:
(i) visceral pleura
(ii)parietal pleura

The pleural cavity

•The two layers of pleura are separated by a
thin flim of serous fluid which allows them to
glide over each other.
•Preventing friction between them during
breathing
•The serous fluid is secreted by the epithelial
cells of the membrane
Types of respiration
•External respiration
•Internal respiration
Respiration is the process in which
organisms exchange gases
between their body cells and the
environment.
First, respiration may refer to
external respiration or the process
of breathing (inhalation and
exhalation), also called
ventilation. Secondly, respiration
may refer to internal respiration,
which is the diffusion of gases
between body fluids (blood and
interstitial fluid) and tissues.
Gaseous exchange

Gas exchange is the delivery

of oxygen from the lungs to the
bloodstream, and the elimination
of carbon dioxide from the
bloodstream to the lungs. It
occurs in the lungs between the
alveoli and a network of tiny blood
vessels called capillaries, which are
located in the walls of the alveoli.
 MUSCLES OF RESPIRATION

1. Diaphragm
The diaphragm is a thin
skeletal muscle that sits
at the base of the chest
and separates the
abdomen from the
chest.
2. Intercostal muscles
Intercostal muscles are
several groups of
muscles that run
between the ribs, and
help form and move the
chest wall.
Diaphragm and
intercostal muscles When you exhale, the
contracts and flattens diaphragm and intercostal
when you inhale. This muscles relaxes and the air
creates a vacuum effect is pushed out of lungs.
that pulls air into the
lungs.
REGULATION OF RESPIRATION

1. Nervous control

2. Chemical control
NEURAL MECHANISM
1. Medulla blongata
Medulla oblongata
has inspiratory and
expiratory center.

2. Pons
Pons has
pneumotaxic and
apneustic center
 CHEMICAL CONTROL
● Central chemoreceptors

● Peripheral chemoreceptors

● Stretch receptors
 Respiratory volumes and capacity
Lung Volumes
The lung volume can be described by the following terms:
Tidal Volume
The tidal volume is the total amount of air inhaled or exhaled during regular respiration or relaxed
breathing. Approximately 500 ml of air is utilized during normal respiration in a healthy man.
Inspiratory Reserve Volume
An inspiratory reserve volume is a supplementary volume, approximately ranging between 2500 to
3100 ml of air which could be effectively inhaled after the inspiration of a standard tidal volume.
Expiratory Reserve Volume
An expiratory reserve volume refers to the additional capacity of air which is about 1200 ml are that
could be forcibly exhaled out after the expiration of a standard tidal volume.
Residual Volume/Reserve Volume
The residual volume is about the total volume of air around 1100 ml to 1200 ml residing in the lungs
after the reserve volume is emitted or breathed out.
Lung Capacities
The lung capacities can be explained by the following terms:
Total Lung Capacity
The total lung capacity applies to the total volume of air-filled in the lungs after a forced inspiration.
The lung capacity of a healthy man is estimated to be 6000 ml.
Vital Capacity
The vital capacity is the total volume of air that can be expired after a maximum inhalation or
maximum air that a person can breathe in after forced expiration.
SIGNS AND SYMPTOMS OF RESPIRATORY DISEASES
Disease conditions:
Asthma
it is a common longterm inflammatory
disease of the airways of the lungs.
The mucous membrane&muscle layers
of the bronchi become thickened.

Bronchiectasis is a disease in
which there is permanent enlargement
of parts of the airways of the lung.
Symptoms typically include a chronic
cough with mucus production. Other
symptoms include shortness of breath,
coughing up blood, and chest pain.
Causes: Infections, cystic fibrosis,
other genetic causes.
 Bronchitis is an inflammation of the lining of bronchial tubes, which carry
air to and from your lungs

Tuberculosis:

A highly contagious infection caused

by the bacterium called
Mycobacterium tuberculosis.
Abbreviated TB.

Lung Abscess

Lung abscess is type of

liquefactive necrosis of the lung
tissue and formation of cavaties
containing necrotic debris or fluid
caused by microbial infection.
Pleurisy is a condition in which the
pleura — two large, thin layers of
tissue that separate your lungs from
your chest wall — becomes inflamed.
Also called pleuritis, pleurisy causes
sharp chest pain (pleuritic pain) that
worsens during breathing

Pleural effusion, sometimes

referred to as “water on the lungs,” is
the build-up of excess fluid between
the layers of the pleura outside the
lungs
Pulmonary edema
It is a condition caused by excess fluid
in the lungs. This fluid collects in the
numerous air sacs in the lungs,
making it difficult to breathe. In most
cases, heart problems
cause pulmonary edema.

Hydrothorax
It is a type of pleural effusion in which
transudate accumulates in the pleural
cavity. This condition is most likely to
.develop secondary to congestive heart
failure, following an increase in
hydrostatic pressure within the lungs.

.
.
Pneumothorax
It is a collapsed lung.
A pneumothorax occurs when air leaks into the space between your lung and
chest wall. This air pushes on the outside of your lung and makes it
collapse. Pneumothorax can be a complete lung collapse or a collapse of only
a portion of the lung

Croup:
An infection of the larynx, trachea, and
bronchial
tubes(laryngotracheobronchitis) that
occurs mainly in children. It is usually
caused by viruses but sometimes by
bacteria. Symptoms include a cough
that sounds like a seal's bark and a
harsh crowing sound during inhalation.
A low-grade fever is common.
Pneumonia
It is an infection in one or both lungs.
Bacteria, viruses, and fungi cause it.
The infection causes inflammation in
the air sacs in your lungs, which are
called alveoli. The alveoli fill with fluid or
pus, making it difficult to breathe.

Atelectasis
It is the collapse or closure of a lung
resulting in reduced or absent gas
exchange. It is usually unilateral,
affecting part or all of one lung. It is a
condition where the alveoli are
deflated down to little or no volume, as
distinct from pulmonary consolidation,
in which they are filled with liquid.
Emphysema: is a lung condition featuring an abnormal
accumulation of air due to enlargement and destruction of the lung's
many tiny air sacs resulting in the formation of scar
tissue. ... Emphysema is strongly associated with smoking cigarettes.
The best response to the early warning signs of emphysema is to stop
smoking.
Asbestosis is long term inflammation and scarring of the lungs
due to asbestos fibres. Symptoms may include shortness of breath,
cough, wheezing, and chest tightness.

SARS It is a fatal respiratory illness caused by a coronavirus.

SARS is a virus transmitted through droplets that enter the air when
someone with the disease coughs, sneezes .
Fever, dry cough, headache, muscle aches and difficulty breathing are
symptoms.
No treatment exists except supportive care
Respiratory Failure
Types of respiratory failure
Surgical procedures
Thoracentesis is a procedure in
which a needle is inserted into the
pleural space between the lungs and
the chest wall. This procedure is done
to remove excess fluid, known as a
pleural effusion, from the pleural space
to help you breathe easier.

Thoracotomy
It is a surgery to open your chest. During
this procedure, a surgeon makes an
incision in the chest wall between your ribs,
usually to operate on your lungs. Through
this incision, the surgeon can remove part
or all of a lung.
Laryngectomy is the surgical
removal of the larynx. The larynx is the
portion of your throat that houses your
vocal cords, which allow you to produce
sound. The larynx connects your nose and
mouth to your lungs

Pneumonectomy (or
pneumectomy) is a surgical procedure to
remove a lung. Removal of just one lobe of
the lung is specifically referred to as a
lobectomy, and that of a segment of the
lung as a wedge resection (or
segmentectomy).

Lobectomy of the lung is a surgical

operation where a lobe of the lung is
removed. It is done to remove a portion of
diseased lung, such as early stage lung
cancer
Segmentectomy Surgery to remove part of an organ or gland. It
may also be used to remove a tumor and normal tissue around it. In lung
cancer surgery, segmentectomy refers to removing a section of a lobe of
the lung. Also called segmental resection.
Tracheostomy is a medical
procedure — either temporary or
permanent — that involves creating an
opening in the neck in order to place a tube
into a person's windpipe. The tube is
inserted through a cut in the neck below
the vocal cords. This allows air to enter the
lungs.

Bronchoscopy is a procedure that lets doctors

look at your lungs and air passages. It's usually
performed by a doctor who specializes in lung
disorders (a pulmonologist). During bronchoscopy,
a thin tube (bronchoscope) is passed through your
nose or mouth, down your throat and into your lungs.

Spirometry is a common office test used

to assess how well your lungs work by
measuring how much air you inhale, how
much you exhale and how quickly you
exhale.
SPIROMETRY TEST PROCEDURE
PREFIX
•An-,a- without, absent
•Endo- within
•Inter- between
•Intra- within

SUFFIX
-ar, -ary pertaining to
-capnia carbon dioxide
-centesis surgical puncture with needle to aspirate fluid
-ectasis streching or expansion
-gram record
-graphy process of recording
-itis inflammation
-osmia smell
-ostomy artificial opening
-oxia oxygen
-pnea breathing
-scope to view
-scopy visual examination
-sphyxia pulse
-stenosis narrowing or constricting
-thorax chest
ROOT WORDS
1. adenoid/o adenoids
2. Alveol/o alveolus , air sac
3. Atel/o imperfect, incomplete
4. Pharyng/o throat
5. Pector/o chest
6. Bronch/o bronchus
7. Bronchi/o bronchial tube
8. Capn/o carbon dioxide
9. Coni/o dust
10. Cyan/o blue
11. Epiglott/o epiglottis
12. Laryng/o larynx(voice box)
13. Mediastin/o mediastinum
14. Nas/o, rhin/o nose
15. Ox/o .ox/i oxygen
16. Phren/o diaphragm
17. Pleur/o pleura
18. Pneum/o lung, air
19. Pulmon/o lung
20. Py/o pus
21. Spir/o to breath
22. Thorac/o tonsil
23. Trache/o trachea(windpipe)
ABBREVIATIONS
ABG Artrial Blood gases
ARDS Adult or acute Respiratory Distress Syndrome
COPD Chronic Obstructive Pulmonoary Disease
CPR Cardio Pulmonary Resuction
C&S culture and sensitivity
CTA Clear to auscultation
CXA Chest X-ray
DOE Dyspnea on Exertion
Dpt Dipthria, pertusis, tetanus injection
ENT Ear, Nose, and Throat
ERV Expiratory Reserve Volume
FRC Functional Residual Capacity
HMD Hyaline membrane Disease
IC Inspiratory Capacity
IPPB Intermittent positive pressure breathing
IRDS Infant Respiratory Distress Syndrome
LLL Left lower lobe
LUL Left Upper lobe
MDI Metered dose inhaler
PCP Pneumocystic pneumonia
PFT Pulmonary Function Test
PPD Purified Protein Derivative
R Respiration
RA Room Air
RLL Right lower lobe
RML Right Middle lobe
RRT Registered Respiratory Therapist
RV Reserve Volume
RUL Right Upper lobe
SARS Severe Acute Respiratory
Syndrome
SIDS sudden Infant death syndrome
SOB shortness of breath
TB Tuberculosis
TLC Total Lung Capacity
TPR Temperature, pulse, and respiration
TV Tidal volume
URI Upper Respiratory Infection
VC Vital capacity
 BY
Blessy Jasmine. J
Trainer L2
VF-TMF