Chap 21

1
Chap 21 Respiratory System

• Learning Objectives (Part 1)
• Know the entire structures (and their associated
  functions) in the respiratory system.
• Be able to explain common diseases of the
  respiratory system including causes, symptoms,
  etc. (such as rhinitis, sinusitis, laryngitis,
  pneumonia, tuberculosis, lung cancer, etc.)

2
Brainstorming

• What are some of the deadliest lung diseases?

3
Lung Cancer Kills Dana Reeves Dead at 44

• 
  
  March 8, 2006 - 219PM
• Did years of singing in smoky nightclubs
  kill Dana Reeve, the widow of paralysed Superman
  actor Christopher Reeve? She died yesterday of
  lung cancer even though she was not a smoker.
• "Ten to 15 per cent of people who develop
  lung cancer are thought to be non-smokers. It was
  said that she had, in the course of being an
  entertainer, spent a lot of time in pubs, in
  nightclubs, in which there is a lot of cigarette
  smoke," said Dr James Mulshine from Rush
  University Medical Centre in Chicago.
• In the US more women die of lung cancer
  than breast cancer, and one in five American
  women diagnosed with the disease have never lit a
  cigarette. "We know that 90 per cent of lung
  cancer is linked to direct smoking, the other 10
  per cent is tied to occupational exposures, radon
  and secondhand smoke," said Pat McKone, a senior
  director of tobacco control with the American
  Lung Association.
• "Dana Reeve was not a smoker, but she did
  spend many years of her singing career in smoke
  filled nightclubs.
• Her death comes amid a worldwide debate on
  the danger of passive smoking and attempts to ban
  smoking from bars, clubs and eateries.

4
Lung Cancer

• Accounts for 1/3 of all cancer deaths in the U.S.
• 90 of all patients with lung cancer were smokers
• The three most common types are
• Squamous cell carcinoma (20-40 of cases) arises
  in bronchial epithelium
• Adenocarcinoma (25-35 of cases) originates in
  peripheral lung area
• Small cell carcinoma (20-25 of cases) contains
  lymphocyte-like cells that originate in the
  primary bronchi and subsequently metastasize

5
Tuberculosis

• Infectious disease caused by the bacterium
  Mycobacterium tuberculosis
• Symptoms include fever, night sweats, weight
  loss, a racking cough, and splitting headache
• Treatment entails a 12-month course of
  antibiotics
• For more on drug resistant TB http//www.cdc.gov/
  tb/pubs/tbfactsheets/mdrtb.htm

6
Pneumonia

• Lungs fill with watery mucous secretions from
  invasion of bacteria (or virus)
• Some strains of pneumonia are very serious and do
  not respond well to antibiotics

7
Chronic Obstructive Pulmonary Disease (COPD)

• Exemplified by chronic bronchitis and obstructive
  emphysema
• Patients have a history of
• Smoking
• Dyspnea, where labored breathing occurs and gets
  progressively worse
• Coughing and frequent pulmonary infections
• COPD victims develop respiratory failure
  accompanied by hypoxemia carbon dioxide
  retention

8
Introduction Functions of the Respiratory System

• Transport of O2 and CO2 between lungs tissues

To supply the body with oxygen and dispose of
carbon dioxide
Respiration four distinct processes must
happen Pulmonary ventilation moving air into
and out of the lungs External respiration gas
exchange between the lungs and the
blood Transport transport of oxygen and carbon
dioxide between the lungs and tissues Internal
respiration gas exchange between systemic blood
vessels and tissues
9
A Closer Look at the General Anatomy Major
Respiratory Organs
Label your practice diagram.
http//www.airwaycam.com/flash/fpsinterview.aspx
10
What Are The Structures of the Respiratory System
What Do They Do?

• Instructions Working individually, match
  the structure with the function. Write the letter
  of the answer. Refer to page 736.
• Alveoli a. connects trachea to alveoli
• Trachea b. vital organs that house smallest
  passageways
• Larynx c. site of gas exchange
• Pleurae d. cleans, warms, and moistens incoming
  air
• Nose e. passageway for air food
• Lungs f. area of voice production
• Pharynx g. houses smell receptors
• Bronchial h. produce lubricating fluid
  compartmentalize lungs
• tree

11
Functions of the Nose

• The only externally visible part of the
  respiratory system that functions by
• Providing an airway for respiration
• Moistening and warming the entering air
• Filtering inspired air and cleaning it of foreign
  matter
• Serving as a resonating chamber for speech
• Housing the olfactory receptors

12
Nose continued

• The nose is divided into two regions
• The external nose, including the root, bridge,
  dorsum nasi, and apex
• The internal nasal cavity
• Philtrum a shallow vertical groove inferior to
  the apex
• The external nares (nostrils) are bounded
  laterally by the alae

13
External Nose
Students You dont have to know this anatomy.
Just reference.
14
Nasal Cavity

• Lies in and posterior to the external nose
• Is divided by a midline nasal septum
• Opens posteriorly into the nasal pharynx via
  internal nares
• The ethmoid and sphenoid bones form the roof
• The floor is formed by the hard and soft palates

15
Nasal Cavity continued

• Respiratory mucosa
• Lines the balance of the nasal cavity
• Glands secrete mucus containing lysozyme and
  defensins to help destroy bacteria
• Vestibule nasal cavity superior to the nares
• Vibrissae hairs that filter coarse particles
  from inspired air
• Olfactory mucosa
• Lines the superior nasal cavity
• Contains smell receptors

16
Nasal Cavity continued
Label your practice diagram.
17
Nasal Cavity continued
Label your practice diagram.
18
Part II Respiratory System

• Learning Objectives (part II)
• 3. Discuss the 3 regions of the pharynx.
• 4. Explain the 3 layers of the trachea as well as
  the other major anatomical features.
• 5. Explain the special anatomy (types of hyaline
  cartilage) as well as other featured of the
  larynx.
• 6. Be able to identify describe vocal cord
  anatomy function.

19
Pharynx

• Funnel-shaped tube of skeletal muscle that
  connects to the
• Nasal cavity and mouth superiorly
• Larynx and esophagus inferiorly
• Extends from the base of the skull to the level
  of the sixth cervical vertebra
• It is divided into three regions
• Nasopharynx strictly an air passageway closes
  during swallowing to prevent food from entering
  the nasal cavity
• Oropharynx - Extends inferiorly from the level of
  the soft palate to the epiglottis common
  passageway for food and air
• Laryngopharynx - Serves as a common passageway
  for food and air lies posterior to the upright
  epiglottis extends to the larynx, where the
  respiratory and digestive pathways diverge

20
Trachea

• Flexible and mobile tube extending from the
  larynx into the mediastinum
• Composed of three layers
• Mucosa made up of goblet cells and ciliated
  epithelium
• Submucosa connective tissue deep to the mucosa
• Adventitia outermost layer made of C-shaped
  rings of hyaline cartilage

21
Trachea continued
Label your practice diagram.
22
Larynx (Voice Box)

• Attaches to the hyoid bone and opens into the
  laryngopharynx superiorly
• Continuous with the trachea posteriorly
• The three functions of the larynx are
• To provide a patent airway
• To act as a switching mechanism to route air and
  food into the proper channels
• To function in voice production

23
Larynx continued

• Cartilages (hyaline) of the larynx
• Shield-shaped anterosuperior thyroid cartilage
  with a midline laryngeal prominence (Adams
  apple)
• Signet ringshaped anteroinferior cricoid
  cartilage
• Three pairs of small arytenoid, cuneiform, and
  corniculate cartilages
• Epiglottis elastic cartilage that covers the
  laryngeal inlet during swallowing

24
Framework of the Larynx
Label your practice diagram.
25
Vocal Cords

• http//www.voicedoctor.net/media/video/index.html

26
Diagnosis Laryngitis

• We know the familiar symptoms hoarseness, loss
  of vocal abilities, etc.
• Maybe you talked too much or screamed for your
  favorite team
• What is really going on?