Health Occupations

Health Occupations Respiratory System

Respiratory System • Consists of • Lungs • Air passages • Responsible for • Taking in oxygen needed by ALL body cells • Removing carbon dioxide & waste produced by cells • 4-6 minute supply of oxygen • System MUST work continuously

Parts of the Respiratory System • Nose A. Air enter via 2 nostrils B. Nasal septum – divides nose into 2 hollow nasal cavities C. Lined with mucous membranes with a rich blood supply D. Air enters cavity 1. Warmed 2. Filtered 3. Moistened

E. Mucous is produced by mucous membranes 1. Moistens air 2. Traps pathogens & dirt F. Cilia – helps to move mucous 1. Pushes trapped particles towards esophagus where it is swallowed G. Olfactory receptors – sense of smell H. Nasolacrimal ducts – drain tears from eyes to nose, provides extra moistures

2. Sinuses • Cavities in skull surrounding nasal area • Connected to nasal cavity by short ducts • Lined with mucous membranes to warm & moisten air • Provides resonance for voice

3. Pharynx • Throat, lies directly behind nasal cavities • Air leaves nose & enters pharynx • 3 sections • Nasopharynx • Upper portion, behind nasal cavities • Contains adenoids • Contains Eustachion tube (to middle ear)

2. Oropharynx a. Middle section, behind mouth b. Receives air from nasopharynx c. Receives food & air from mouth 3. Laryngopharynx a. Bottom section of pharynx b. Contains esophagus, carrying food to stomach c. Contains trachea, carrying air to & from the lungs

4. Larynx • Voice box, between pharynx & trachea • Nine layers of cartilage • Thyroid cartilage – Adam’s apple is largest • Vocal cords – 2 folds in larynx • Glottis – opening between the vocal cords • As air leaves lungs, vocal cords vibrate & produce sound. Tongue & lips act on sound to produce speech • Epiglottis – leaflike piece of cartilage that closes the opening of the larynx when swallowing to prevent food & liquid from entering the respiratory tract

5. Trachea • Windpipe, tube extending from larynx to the center of the chest • Carries air between pharynx & bronchi • C-shaped cartilage, in a series, open on the dorsal surface, to keep trachea open

6. Bronchi • Trachea divides into 2 of these near the center of the chest • Right bronchus – shorter, wider, more vertical • Left bronchus – longer, narrower, less vertical • Each enters a lung, carries air from trachea to lung • In lung, bronchi divide into smaller & smaller bronchi • Lined with cilia & sticky mucous (phlegm) to catch dust & germs • Produces 125 mL of mucous/day that is removed by cilia

7. Bronchioles • Very small bronchi • Terminal bronchioles – smallest • End in sacks called alveoli

8. Alveoli • Look like a bunch of grapes • Adult lung – 500 million alveolis • Consists of 1 layers of squamous epithelial tissue & has many capillaries • Capillaries allow oxygen & carbon dioxide exchange between blood & lung • Inner surface of alveoli are covered with a fatty substances (surfactant) that prevents them from collapsing

9. Lungs • Organs of respiratory system, contain the bronchi & alveoli • Right lung 1. 3 sections or lobes • Left lung 1. 2 lobes, smaller because of heart’s location • Pleura • Sac or membrane containing lungs • 2 layers • Visceral pleura – attaches to lung surface • Parietal pleura – attaches to chest wall

E. Pleura space 1. Located between 2 layers 2. Filled with pleural fluid 3. Lubricates the membranes, prevents friction as lungs expand during breathing F. Located in thoracic cavity along with heart & blood vessels G. Mediastinum – space separating the lungs & contains esophagus, heart, & bronchi

Ventilation • Process of breathing • 2 phases • Inspiration or Inhalation • Breathing in air • Diaphragm (dome shaped muscles between the thoracic & abdominal cavities) & intercostal muscles contract & enlarge the thoracic cavity to create a vacuum (moves downward) • Air rushes through airways to alveoli • Gas exchange takes place in alveoli • Process is called respiration

3. Expiration or exhalation • Diaphragm & intercostal muscles relax • Air is forced out of lungs & air passages

4. Respiration controlled • Respiratory center in the medulla oblongata of brain • Respirations increase due to • Increased CO2 in blood • Decreased O2 in blood (asthma, COPD, CHF) • Mostly involuntary, but person can control rate

Stages of respiration • External respiration – exchange of O2 & CO2 between LUNGS & BLOODSTREAM • Oxygen enters alveoli • Oxygen concentration in alveoli is higher than concentration in blood capillaries • Oxygen leaves alveoli to enter capillaries • CO2 goes the reverse way, leaving the capillaries to enter the alveoli (because CO2 is higher in the capillaries than the alveoli) • CO2 expelled during exhalation

2. Internal respiration • Exchange of CO2 & O2 between BLOOD & TISSUE CELLS • O2 carried to tissue cells by blood • Concentration of O2 is higher in blood, so it leaves blood for tissues • Cells use O2 & nutrients to produce energy, water, & CO2 • CO2 concentration is higher in tissues than blood, so CO2 leaves tissues to enter blood

3. Cellular respiration • Tied in with internal respiration • Cells use O2 & nutrients • This process produces energy, water, & CO2 Once CO2 is transported back to bloodstream (internal respiration) it enters the lungs & is expelled by exhalation (external respiration)

Assessment • Rate • Breaths per minute • Varies with age, posture, exercise, temperature, etc • Children have faster rate than adults • Normal adult 14 – 20 per minute • Eupnea – normal respiration • Dyspnea – difficult or labored respiration • Tachypnea – respirations > 24 per minute • Bradypnea – respirations < 10 per minute

2. Character • Rhythm of respiration • Should have regular rhythm • Apnea – absence of respirations • Cheyne-Stokes respirations – abnormal pattern of respiration, labored, followed by apnea • May be dry, normal, wet, or shallow

3. Sounds • Breath sounds – heard with stethescope • All should be clear & dry • Wheezing – high pitched • Rales – like hair rubbing together • Rhonchi – wet bubbly noises

4. Lung volumes • Respiratory capacity – amount of air that can be brought into lungs • Measured with a spirometer • Depends on age & physical condition • Lung volume – measure of respiratory capacity • Tidal volume – amount of air normally exchanged with each inspiration & expiration • Inspiratory reserve volume – additional amount of air that can be inhaled with a conscious effort

Expiratory reserve volume – additional amount of air that can be exhaled with a conscious effort • Vital capacity = TV + IR + ER • Residual volume – amount of air always in lungs to maintain shape • TLC (Total lung capacity) = TV + IR + ER + RV

TOTAL LUNG Capacity VITAL CAPCITY Tidal volume Inspiratory Reserve Volume Expiratory Reserve Volume Residual Volume

5. Blood gases • Measure amount of gases in blood and blood pH • Accurate assessment • Hypoxia – not enough oxygen in blood

Abnormal conditions • Asthma – respiratory disorder usually caused by sensitivity to allergen, dust, pollen, animal, or food. Can be caused by stress, overexertion, & infection • Bronchospasms narrow opening of bronchioles • Mucous production increases • Edema develops in mucosal lining • Symptoms – dyspnea, wheezing, coughing, sputum, chest tightness • Treatment – bronchodilators, anti-inflammatory, epinephrine, O2, eliminate allergens

2. Bronchitis • Inflammation of bronchi & bronchioles • Acute bronchitis – caused by infection • Symptoms – productive cough, dyspnea, chest pain, fever • Treatment – antibiotics, expectorants, rest, FF • Chronic bronchitis – results from frequent attacks of acute bronchitis & long term exposure to smoking or pollutants • Chronic inflammation, damaged cilia, enlarged mucous glands • Symptoms –excessive mucous with productive cough, wheezing, dyspnea, CP, prolonged air expiration • No cure, may use antibiotics, bronchodilators, respiratory therapy

3. COPD • Chronic lung disease resulting in obstruction of airways • Caused by chronic asthma, chronic bronchitis, emphysema, TB, smoking, allergies, & chronic respiratory infections • See symptoms of chronic bronchitis

4. Emphysema • Noninfectious chronic respiratory condition occurring when walls of alveoli deteriorate & lose elasticity • CO2 remains trapped in alveoli & there is poor gas exchange • Causes – heavy smoking, exposure to pollutants • Symptoms – dyspnea, feeling of suffocation, pain, barrel chest, chronic cough, cyanosis, rapid respirations with prolonged expiration, eventual respiratory failure & death • No cure, treat with bronchodilators, prompt tx of respiratory infections, O2, resp tx, avoid smoking

5. Epistaxis • Nosebleeds • Occur when capillaries in nose become congested & bleed • Causes – nose injury, HTN, chronic infection, anticoagulants, blood diseases (hemophilia, leukemia) • Treatment – pinch nostrils towards septum, tilt head slightly forward, cold compresses. Sometimes necessary to insert nasal packs or cauterize

6. Influenza • Flu • Highly contagious, viral infection of upper respiratory system • Sudden onset, chills, fever, cough, sore throat, runny nose, muscle pain, fatigue • Treatment – bedrest, fluids, analgesics, Tylenol • Immunizations recommended for elderly, people with chronic disease, pregnant, health care workers, children

7. Laryngitis • Inflammation of larynx & vocal cords • Frequently occurs with other respiratory infections • Symptoms – hoarseness, loss of voice, sore throat, dysphagia • Treatment – rest, limited voice use, fluids, meds if infection

8. Lung cancer • Leading cause of cancer deaths • Preventable disease – main cause is tobacco exposure • 3 types of lung CA – Squamous cell, small cell, adenocarcinoma • Early stages – no symptoms • Later stages – chronic cough, hemoptysis, dyspnea, fatigue, weight loss, CP • Prognosis poor because of late dx • Treatment – surgical removal of cancerous part of lung, radiation, chemo

9. Pleurisy • Inflammation of pleura • Usually in conjunction with other infections • Symptoms – sharp stabbing pain when breathing, crepitus, dyspnea, fever • Treatment – rest, meds to relieve pain & inflammation, serious cases - thoracentesis

10. Pneumonia • Inflammation or infection of lungs with exudates in alveoli (fluid) • Usually caused by bacteria, viruses, or chemicals • Symptoms – chills, fever, CP, productive cough, dyspnea, fatigue • Treatment – bedrest, fluids, antibiotics, resp tx, pain meds

11. Rhinitis • Inflammation of nasal mucous membrane • Symptoms – runny nose, soreness, congestion • Causes – infections, allergens • Treatment – fluids, meds to relieve congestion

12. Sinusitis • Inflammation of mucous membranes in sinuses • May involve 1 or more sinuses • Usually caused by virus or bacteria • Symptoms – HA or pressure, thick nasal discharge, congestion, loss of voice resonance • Treatment – analgesics, antibiotics, decongestants, moist inhalations, sometimes surgery if sinusitis is chronic

13. Tuberculosis • Infectious lung disease caused by mycobacterium tuberculosis • WBC surround invading TB organisms & wall them off in nodules called tubercules in lungs • TB organisms can remain dormant in tubercules but can become active TB later if resistance is lowered • Symptoms of active TB – fatigue, fever, night sweats, weight loss, hemoptysis, CP • Treatment – drugs for 1or more years, good nutrition, rest • New strain of TB is drug resistant

14. Upper respiratory infection • URI, common cold • Inflammation of mucous membranes lining upper respiratory tract • Caused by viruses, very contagious • Symptoms – runny nose, fever, watery eyes, congestion, sore throat, hacking cough • No cure, symptoms last about 1 week • Treatment – analgesics, Tylenol, rest, FF, antihistamines to relieve symptoms

15. Cystic fibrosis • Genetic disease of exocrine glands in which the mucous in respiratory system becomes thick • Excessive salt also forms on skin • Also have digestive difficulties • Need to give intensive pulmonary care • Outlook is better now

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