Take a deep breath and relax!
 This
is your lungs and air passage.
 gives O2 to blood and removes CO2 from
blood
 Respiratory=pulmunary=pneumatic=air!!!
 The
parts that make up respiratory system:
 Nose
 Pharynx
 Larynx
 Trachea
 Bronchi
 bronchioles
 Alveoli
 This
is the process of breathing- inspire,
expire. Most people are 16-18
breaths/minute.
 Inspired air follows the pathway to the lungs
and O2 exchange with CO2---happens
through the alveoli
 Expire-air is forced from the lungs
 Respiration is controlled by the medulla
oblongata- so if there is too much CO2- the
patient will increase respirations to blow it
off.
Boyles law
Boyles law states that the volume of gas is
inversely proportion to the pressure applied
to it.
Diaphragm goes down=air comes in.
Boyles law
 So
when the thoracic cavity expands, the pressure
of the air within the lungs drops below atmospheric
pressure; air will flow down the gradient from the
outside into the lungs in a process referred to as
inhalation. Exhalation results from the reduction of
thoracic cavity and lung volume, the increase in
intrapulmonary pressure, and the movement of air
down its gradient from inside the lungs to the
outside
Boyles law
 Translation???….
 Here
is an example:
 When you put a needle in a vein to draw a
blood sample, you pull back on the plunger.
This decreases the pressure in the syringe
and increases to volume. So, blood flows
into the syringe to compensate for the
change.
 Well….
 The
air passes in through the nasal cavity
where it is warmed and humidified by
vascular tissue.
 Guard hairs in the nasal cavity filter out
large particles, and goblet cells make the
mucous to trap smaller particles- known as
boogers!
 In
the uppermost portion of the nasal cavity
you will find the olfactory nerve. This is
your sniffer! It contains olfactory neurons
that can respond to odors (like your gym
shoes and flowers and puppy breath)
 Pharynx-
it is made up of 3 parts:
 A. Nasopharynx from the nasal cavity
 B. oropharynx from the oral cavity
 C. laryngopharynx leads to the esophagus
and trachea branches in front. Larynx goes to
the respiratory system and is covered by the
epiglottis –a fleshy leafy cap that covers the
larynx so you don’t choke when drinking.
 Okay,
the larynx(voice box) also has- La LA
LA- vocal cords.
 From the larynx the air enters the trachea.
 The esophagus is behind the trachea
 Both have ciliated epithelium- little hairs
that push the mucous toward the
larygopharynx = loogey!
 The
trachea branches into the right and left
primary bronchi. The trachea runs beside
what tube????
 This leads to the lungs.
 What keeps trachea open? 16-20 cartilage
rings
 So it branches from primary bronchi to
secondary bronchi to tertiary bronchi
 This branches to bronchioles
 These terminate into tiny alveoli- the little
grape clusters
 This
is where O2 and CO2 exchange.RBC
pickup oxygen and go away to tissues then
return with CO2=cellular respiration.
 All alveolar sacs are surrounded by loads of
tiny capillary beds. They have one cell layer
to allow gas to get through.
 That is where external respiration takes
place. Ext resp=lungs, internal resp =cells
 Alveolar cells secrete surfactant to keep
lungs moist and juicy. Neonatal problem..
 Gases dissolve into the surfactant
 Oxygen +glucose=energy for life
 Hypercapnic
acidosis(increased co2)- in
diseases like:
 Asthma
 CHF- congestive heart failure
 Emphysema
 COPD- chronic obstructive pulmonary disease
 Hypercapnic acidosis increases the CO2 levels
in the blood and a decreased ph balance of
the body
 Acid
range for the human body lies between
7.35 and 7.45. water is about pH 7.
 Acid= battery,lemon
 base=baking soda,bleach
 Below 7.35 becomes too acid
 Below 7.45 becomes too alkaline or basic
 Body’s
pH is too acidic – below 7.35, and
CO2 will be too high on labs.
 Patient will breath rapidly to try to blow off
CO2.
 If the respiratory system is unable to
compensate, the patient may stop breathing.
Too much CO2 decrease the need to breath,
can paralyze respiratory muscles.
 When
the alveoli of the lungs are damaged
by disease like emphysema from smoking,
they become stiff, and unable to dump off
CO2. this would lead to an acidotic state.
 Air in the room has 21% O2, nitrogen 78%,
1%other
 Respiratory
alkalosis- this happens when the
body rises above 7.45. usually an event
happens that causes the person to breath
rapidly or hyperventilate. As a result they
blow off too much CO2, and will usually pass
out at which time the body resumes normal
breathing.
 ABG=
arterial blood gas
 Ph- normal is 7.35 to 7.45
 CO2- normal is 35-45 mm Hg
 HCO3- 23-30mEq/this is basic bicarbonate
 These can all be run on an ABG lab- arterial
blood gas- needs to be drawn by a
respiratory therapist, from an arteryOOOOuch!
 In
an asthma “attack” the bronchioles spasm
 The inner lining of the lungs swells or has
edema
 This causes mucous production.
 This causes dyspnea- difficult breathing
 Signs
and symptoms:
 High pitched wheeze
 Dry or wet cough
 Chest pain
 If severe enough cyanosis
 What
can I do?
 If patient has a rescue inhaler, administer 2
puffs. Puffs can be given up to 2 puffs three
times 15 minutes apart
 If this does not help, go to the hospital
 If the patient is too hot, loosen clothing,
hydrate, put cold towel on the back of the
neck
 If the attack is due to an allergy, like to cats,
remove them from the area. If they can
have a Benadryl administer 1 tab.
 COPD-
chronic obstructive pulmonary
disease=this is a catch-all for any chronic
lung disease that results in obstruction of the
airway.
 This includes:
 Asthma
 Emphysema
 Chronic bronchitis
 tuberculosis
Tripod position
 Smoking
is usually the main cause, but
constant irritants, allergies, infection, and
recurring chronic respiratory infections can
be the root of COPD
 This
is considered COPD, but is not
infectious.
 The alveoli lose there elasticity
 CO2 stays trapped in the alveoli so O2 does
not have room to move. These people will
be hypercapnic- too acid.
 Signs
and symptoms Dyspnea
 Feels like suffocating
 Chest pain
 Barrel chest
 Chronic cough
 Rapid breathing- to get the CO2 out
 Cyanosis
 Can lead to respiratory collapse- acute
respiratory failure ARF
 So
what can I do?
 There is no cure, but bronchodilators,
treatment of infections, O2 therapy, and try
to not smoke
 Three
types:
 Small cell
 Squamous cell
 adenocarcinoma
 Small
cell =‘oat cell’ carcinoma of the lung
is very malignant. starts in bronchi.
 Treatment must begin quickly life span is
limited.
 Smoking is a main cause for this type of
cancer
 Squamous
cell carcinoma-usually will start in
the epithelial cells of the bronchi branches.
This may result after years of cell damage
from smoking- happens more in men and
women.
 Once it becomes cancerous, it usually in-situ.
It can become metastatic throughout the
years if not treated, but not as much as small
cell.
 Adenocarcinoma-
this is the most common
type of lung cancer among people under age
45. this cancer starts in the outer part of
the lungs.
 One type in increasing among women- it is
thought that the addition of filters to
cigarettes has allowed people to inhale
smoke more deeply, and adenocarcinoma
starts in the outer part of the lungs.
 Treatment-
if the cancer is in situ—’precancer’, surgery may be required to remove
the portion of the lung that is affected.
 Bronchoscope- a small tube run in through
the nose or mouth through the airway. If the
obstruction is small enough, in can be
removed.
 If the cancer is metastatic, chemotherapy of
radiation treatments may be required.
 This
is an inherited disease of the lungs and
digestive system
 A defective gene and it’s protein product
produces unusually thick sticky mucous that:
a. Clogs the lungs and leads to lifethreatening infections
b. Clogs the pancreas and keeps the
body’s natural enzymes that break down
food.
 Children
who had CF in the 1950’s did not
usually live to elementary school age.
 Now people live to 30-40 sometimes beyond.
 It depends on where they are most effected,
lungs or digestive system.
 very
salty-tasting skin;
 persistent coughing, at times with phlegm;
 frequent lung infections;
 wheezing or shortness of breath;
 poor growth/weight loss in spite of a good
appetite; and
 frequent greasy, bulky stools or difficulty in
bowel movements
 There
is no cure
 Therapy consists of initiating a strong cough
to clear the mucous from the lungs and
airway.
 Vibration vest
 Nutritional support and enzymes taken for
the digestive system
 Insulin for pancreatic function
 Bronchodilators to open airway
 Videos
now-- Sounds---http://www.easyauscultation.com/
Asthma-- https://youtu.be/4aK76DoxKGk
 COPD---https://youtu.be/2nBPqSiLg5E
 CF stories— https://youtu.be/FMAOEOmLoUE
 https://youtu.be/Twjg7v-pTO4