Module 8 Section 2

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Module 8:

Section 2:

 

• The Upper Respiratory Tract
  • respiration
  • nasal septum
  • nasolacrimal duct
  • sinus cavities
  • pharynx
  • esophagus
  • epiglottis
  • larynx
• The Lower Respiratory Tract
  • trachea
  • bronchi
  • bronchioles
  • alveoli
  • pleura
  • diaphram
  • ventilation
• Common Respiratory Diseases
  • asthma
  • chronic obstructive pulmonary disease (COPD)
    • chronic bronchitis
    • emphysema
  • lung cancer
  • pneumonia
  • tuberculosis (TB)

 

Respiration is the process of taking oxygen from air and transporting it to the bloodstream, while taking carbon dioxide from the blood and transporting it to the air outside of the body. The respiratory system is usually divided into two tracks. The Upper Respiratory Tract An upper respiratory infection is a "head cold". The upper tract follows the pathway of air from the nose to the trachea (windpipe), which begins the lower tract and leads into the lungs. The nasal septum divides the nose into two parts. The septum is made of bone and cartilage and is the part of the nose that breaks when you run into a door with your face.  Mucus and hair line the inside of the nose, serving to filter out dust and dirt, and they also serve to provide some humidity to dry air. The nasolacrimal duct drains tears into the nose.  From there the tears drain down the throat, sometimes passing over the back of the tongue. That’s why some patients complain that they can taste the eye drops that they are given. You can use their observation to inform them that their tear drainage system is working well.
Air filled spaces called sinus cavities surround the nose. Sinuses affect the resonant quality of the voice and provide a convenient breeding ground for bacteria. The frontal sinuses are just above the eyes. The maxillary sinuses are just below the eyes. The ethmoid sinuses are to the sides of the nasal cavity, and the sphenoid sinuses are behind the nose. All but the sphenoid sinuses have openings into the nose. The sinuses sometimes affect the eyes in terms of pain. The facial pain caused by a sinus infection sometimes feels to the patient like it is originating in the eyes. This is called "referred" pain.
Air passes from the nasal cavity into a passageway called the pharynx which serves to direct air into the lower respiratory tract and food into the esophagus. Confusion in the pharynx sometimes results in food going into the lower respiratory tract, resulting in choking and the possible need for the Heimlich maneuver.  Usually, food is kept out of the windpipe by the epiglottis, which covers the windpipe (trachea) when swallowing. To avoid confusion, don’t try to breathe while food is passing down the pharynx (you should be swallowing). Before passing into the lower respiratory tract, air passes through the larynx (Adam’s apple, voice box).  Air passing through the vocal cords in the larynx vibrate and produce the sound of your voice.

 

 

The Lower Respiratory Tract A lower respiratory infection is a "chest cold".  The windpipe (trachea) brings air from the nose into the lungs. The trachea branches into the right lung via the right bronchus and into the left lung via the left bronchus. The bronchi branch several more times into small twigs called bronchioles which lead to alveoli.
The sac-like alveoli pass oxygen and carbon dioxide between nearby capillaries, to and from the blood stream. The right lungs is divided into three lobes. The left lung is divided into two lobes. Each lobe is supplied by a branch of the bronchi. The lungs and chest wall are lined with a tissue called the pleura, which can become inflamed (pleurisy) and cause pain when breathing. Ventilation of the lungs is caused by movement of the diaphragm and other muscles which cause the lungs to expand and contract. The effectiveness and efficiency of respiration depends upon proper ventilation (air supply to the lungs) and perfusion (blood supply to the lungs).  The body has sensors that monitor the level of oxygen and carbon dioxide in the blood . If the blood oxygen level decreases, or if the blood carbon dioxide increases, the body automatically increases the breathing rate. The normal adult breathing rate is about 12-15 times per minute and can be measured by observing the motion of the chest over a period of time (one minute, or 30 seconds x 2). In a Review of Systems (ROS) you might ask if the patient has breathing difficulty, shortness of breath, persistent cough, or chest pain. These are the most common symptoms of respiratory diseases.

 

Common Respiratory Diseases   Asthma: A constriction of the air passageways in the lungs from excess mucus production and swelling, making it difficult to breathe.  It is a chronic condition with periodic mild to severe attacks triggered by an irritant (e.g., cigarette smoke, dust, mold, colds).  Asthma is treated with oral or inhaled medications that reduce the swelling.  Prevalence: 17 million Americans. Chronic obstructive pulmonary disease (COPD): The term includes emphysema and chronic bronchitis, which many patients have concurrently. About 85 percent of cases are caused by smoking.  Many of these patients come into the office pulling an oxygen tank.  Prevalence: 16.5 million Americans, fourth leading cause of death. Chronic bronchitis: An inflammation and scarring of the lining of the bronchial tubes.  See "COPD". Emphysema:  Air sac walls lose the ability to stretch and recoil.  Air becomes trapped in the sacs and cannot exchange oxygen and carbon dioxide.  See "COPD". Obstructive pulmonary diseases can be treated with antibiotics (if indicated),  avoidance of irritants,  bronchodilator drugs,  and in severe cases, oxygen. Lung cancer: Cancerous tumor formation from abnormal cell growth usually secondary to an irritant such as cigarette smoking (80 percent of cases). There is a danger of metastasis (spreading) to other organs. Treatments include surgery, radiation, and chemotherapy. Pneumonia:  A serious infection or inflammation in the lungs resulting in the air sacs becoming filled with fluid.  The number one cause of death in the U.S. in 1936.  Modern antibiotics have reduced it to the number six cause of death in the U.S.   It can be caused by bacteria, viruses, fungi, or chemicals.  It most commonly develops in those who are not in good health, such as the elderly and patients with chronic illnesses. Tuberculosis (TB):  An infectious disease that most often affects the lungs.  TB spreads from person to person through the air, but it usually takes a long exposure time in a closed space.  Most people who become infected do not develop the disease because their body’s defense mechanisms protect them.  Prevalence: 10 million Americans infected, but only one million have the disease symptoms.  TB is a major problem in other countries, particularly Africa.  TB is treated with various medications.

 

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