ANATOMY & PHSIOLOGY OF RESPIRATORY SYSTEM -------- COMMON HEALTH

PROBLEMS
Air conduction
Function of upper respiratory system
Gas exchange
Function of lower respiratory system
Nose
For airway, warming, moistening the air, filters air
Pharynx
Both for digestion and respiration
Larynx
Voicebox (composed of hyoid, thyroid & cricoid cartilage)
Glottis
Opening of the laryx
Glottis
Prevents aspiration of fluid & food of respiratory tract
Trachea
10-14cm, 4-5 in, 1.5-2.5 cm in dm
16-20
# of C-shaped cartilages of trachea
Bronchi
1 ml in dm
Bronchioles
Collection of terminal branches
Alveoli
Sac
Right & left
Parts of hylum in the lungs:
9,10
Number of segments of hylum in the lungs: Left:_ Right:_
Terminal bronchioles Divides respiratory bronchioles
Pleura
Thin translucent elastic tissue that covers the lungs
Parietal & visceral
Parts that covers the lungs
pleura
Effusion
Abnormal accumulation of fluid in the blood
BLOOD SUPPLY:
1. Comes from the pulmonary artery & receives blood from the RIGHT
VENTRICLE(deoxygenated)
2. Comes from the bronchial ateries & receives blood from the AORTA (oxygenated)
3. Coming from the aorta per se and this supplies blood to the bronchial artery,
bronchial arterioles & bronchial capillaries
PULMONARY CIRCULATION
Pulmonary vein
Left arterioles
Cilia
Covers surface of tracheobronchial epithelium
Cilia
Endowed w/ rhythmic movement to expel secretions w/c are undesirable
Neutrophils,
4 phagocytic cells that protects the lungs
macrophages, IgA,
IgG
Surfactant
Prevents collapse
Intrapulmonic
Maintained before & after respiration
pressure/intraalveol
ar pressure
Intrathoracic
Pressure maintained after deep inspiration & expiration
pressure
Lung vol and
Amount of O2 retained and expelled
capacity
Tidal volume
Fraction of lungs not inhaled/exhaled w/ each normal breath (500600cc)
IRV
Adtl vol of air that can be inhaled at the end of normal respiration
ERV
Amount of air that is forcefully exhaled/released after the normal
respiration
RV
Amnt of air that cant be expelled after forceful exhalation (12001300ml/cc)
Capacity
Combination of /more volumes
Inspiratory capacity
TV(500)+IRV(3000)=3500 cc
Functional residual
ERV(1500)+RV(1500)=3000 cc
capacity
Vital capacity
TV+IRV+ERV= 5000-6000cc
Vital capacity
Maximal amnt to be inhaled after maximal expiration
Total lung capacity
VC+RV= 6500-7000cc
Minute ventilation
TV x RR/min
External respiration
Exchanging of O2 & CO2 between atmosphere and blood
Ventilation, alveolar Types of external respiration
diffusion
Internal respiration
Transporting O2 from blood to cells
7 removal of CO2 of cells to the blood
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ANATOMY & PHSIOLOGY OF RESPIRATORY SYSTEM -------- COMMON HEALTH

PROBLEMS
External & internal
Types of respiration
Steps of respiration
1. Transport of O2 & CO2 via hemoglobin & plasma
2. Cellular diffusion
3. Oxidation reduction-reaction
Myocardium
Muscle of the heart
Myocardium
Supplies the left ventricle
Left ventricle
Has the strongest contraction
Kidneys
Tolerate 6-8 hrs of O2 lack
Acute renal failure
More than 6-8 hrs results to:
VENTILATION-PERFUSION PATCHES
Ventilation
Flow of gas in & out of the lungs
Perfusion
Distribution of blood all throughout the body
low-ventilation
3 VENTILATION-PERFUSION PATCHES:
perfusion ratio,
high-ventilation
perfusion ratio,
silent units
1. LowLow perfusion compared to ventilation
ventilation
perfusion
ratio
Low-ventilation
Lack of O2 to supply the lung tissue
perfusion ratio
Physiologic shunt
Ill effect of low-ventilation perfusion ratio
2. HighMore air than fluid distribution
ventilation
perfusion
ratio
High-ventilation
Lung tissue becomes physiologic dead space
perfusion ratio
Embolism,
Examples:
pulmonary
infarction,
thrombosis
3. Silent units
Complete absence of perfusion & ventilation exs: pneumothorax, ARDS
peripheral
At the aortic arc/carotid
chemoreceptors
When is the
1. When theres decreased partial O2/ increased in partial O2
2. When theres increased partial CO2/ decreased in partial CO2
peripheral
3. When there are PH changes in the blood
chemoreceptors
activated:
Hering Breuer reflex Active to prevent overdistention
Proprioceptors
In muscles & joints and is active during exercise
Phrenic nerve
Primary nerve involved in quiet breathing, C4
Intercostal nerve
Innervates intercostal muscles, from thoracic nerves 1-11
FACTORS OF _:
1. Atmospheric
Increased altitude, decreased atmospheric pressure
factor
Atmospheric factor
Decreased PaO2 , decreased atmospheric pressure
Atmospheric factor
Decreased altitude, increased diffusion of nitrogen in the blood
2. Pulmonary/lung
Patent airway, patent gas exchange
factor
3. Circulatory factor Composition of blood
4-7M
Normal lvl of RBC
5-8L
Normal blood vol in adults
150,000-450,000
Normal # of platelets
4. Normal pumping
capacity of the
heart
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ANATOMY & PHSIOLOGY OF RESPIRATORY SYSTEM -------- COMMON HEALTH

PROBLEMS
60-90 bpm
Normal HR in adults
5. Cellular factor
Normal utilization of O2 by the cells
6. Aging process
Middle age (40 y.o)
Theres decreased SA for exchange of O2 and CO2
50 up (age)
The alveoli loses elasticity
Aged
If theres decreased lung recoil, theres decreased lung capacity. If theres
increased lung vol, theres increased chest wall stiffness.
History taking
Includes the treatment modalities the patient employs
*Medication history
What to ask for history taking:
*previous respi
problems
*diet & fluid intake
*precipitating
activities
precipitating
Increased more of occurrence of conditions
activities
1. sudden dyspnea
s/sx of clients w/ aeration problems:
2. orthopnea
3. respiratory
wheezing
4.sterterus
breathing
5. expiratory and
inspiratory
wheezing
6. severe grade of
dyspnea
Laryngeochacitis
Hi pitched cough
Viral infection
Dry cough
Bronchiocarcinoma
Brassy cough
Severe changing
Brought by pleural/chest wall involvement
cough
Nocturnal cough
Onset of asthma/CHF
Bronchitis
Morning cough
Post nasal drip
Coughing in supine position
Aspiration
Coughing after food intake
Bacterial infection
Sputum is perfused(purulent) yellow/green color
Pneumonia
Rusty colored sputum, metallic taste
Viral infection
Thin and mucoid sputum
Chronic bronchitis,
Sputum increased overtime
bronchiectasis
Lung tumor
Pink tinged mucoid sputum
Pulmonary edema
Profusely pinkish, fruity
Lung abscess,
Malodorous sputum
bronchiectasis
Pneumonia,
Chest pain
pulmonary
embolism, lung
infarction
Bronchogenic
Pain at last, invasion of chest wall, mediastinum & spine
carcinoma
Pruritic chest pain
Stabbing of knife, pleuritic irritation
Nail clubbing
Last structure that receives O2
Hemoptysis
Coughing out of blood
Hemoptysis
Frothy, bright red, pinkish (rupture inside the lungs)
Cyanosis
Bluish discoloration of skin and mucus membranes
Cyanosis
Poor tissue perfusion
Cyanosis
Decreased perfusion, increased ventilation
Cyanosis
There are signs of hypoxia
Central cyanosis
Hemoglobin below 5 gms
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ANATOMY & PHSIOLOGY OF RESPIRATORY SYSTEM -------- COMMON HEALTH

PROBLEMS
Peripheral cyanosis
Hemoglobin less than 9 gms
Peripheral cyanosis
Due to decreased blood flow to certain areas of the body
RR, HR, BP, TEMP
Vital signs
1. Inspection
4 modalities of physical exam:
2. Auscultation
3. Percussion
4. Palpation
Hypoxia
Inadequate cellular oxygenation
*insufficient O2
Causes of hypoxia
intake
*insufficient
perfusion of O2 in
pulmonary
system(decreased
intravascular vol)
Hypoventilation
Insufficient ventilation to meet bodys metabolic needs; leads to
metabolic acidosis
Hyperventilation
Ventilation that exceeds bodys metabolic needs; leads to respiratory
alkalosis
Grade 1 dyspnea
Mild exertion
Grade 2
SOB while walking
Grade 3
SOB of daily living
Grade 4
SOB at rest
Grade 5
SOB at supine position
TB DIAGNOSTIC
*Tuberculin test
TESTS:
*Mantoux test
*PPD
*Xray
*Sputum study
*Psytologic exam
*Sputum culture
*Lung scan
*Bronchosopy-visualization of brochi, laynx, trachea & alveoli
Purposes of
*Identify obstructions
bronchoscopy:
*Remove foreign body
*Idnetify surgical preparation
Brochography
Xray of the chest
Thoracentesis
Aspiration of sample/ fluid from particular cavity (pleural space)
Paracentesis
Removal/aspiration of fluid from parital pleura
PFT(Pulmonary
Measures lung capacity and vol
function test)
TREATMENT MODALITIES
1. Transtracheal
Aspiration of trachea by inspiratory needle
aspiration
Transtracheal
Employed to promote coughing w/ patient w/ absent cough reflex
aspiration
2. Thoracostomy
tube
3. O2 Administration
O2 therapy
For clients w/ hypoxia/hypoxemia
O2 therapy
Dry, tasteless, odorless
Colon
Dirtiest part of the body
How to maintain a patent airway:
1. Positioning
2.Oropharyngeal
suctioning
3. Nasopharyngeal
suctioning
4. Tracheostomy
suctioning
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ANATOMY & PHSIOLOGY OF RESPIRATORY SYSTEM -------- COMMON HEALTH

PROBLEMS
5. Endotracheal
suctioning
6. Incentive
Mechanical device for patients to achieve maximum inspiration,
spirometry
preventing lung collapse
*Decreased partial
Indications of mechanical ventilation:
O2
*Continuous of
PaCO2
*Persistent acidosis
4 CLASSES OF DISORDERS:
1. Restrictive
Limit lung expansion & restrict chest wall movement throughout
diseases
respiratory cycle
Restrictive diseases Decrease lung volume, pulmonary compliance
Atelectasis,
Examples of restrictive diseases
pneumothorax,
pleural effusion,
pneumonia,
neuromuscular
alteration,
neuromuscular
disorders
*kyphosis
Examples of neuromuscular disorders
*fractured ribs
*muscular
dystrophy
*myasthenia gravis
*Guillen barre
syndrome
*abdominal
distention
*pain/tight
application of
bondage
*occupational
Risk factors of restrictive diseases:
hazards
*Trauma to chest(rib
fracture)
*past & present
history of
musculoskeletal
disorders
2. Obstructive
Something in tracheobronchial tat impedes the airflow
diseases
Acute/chronic
Obstructive diseases can be :
CHRONIC OBSTRUCTIVE DISEASES:
*Asthma
Constriction of tracheobronchial tree
*Bronchitis
Inflammation of bronchi/bronchioles
*Emphysema
Enlarged alveoli
*Edema
*Mucus ciliary
transport caused by
chemical damage
. Respiratory Tract
Exs: TB & pneumonia
infection
*exposure to
Risk factors of respiratory tract infection
infected person
*stress
. Pulmonary related Disorders of pulmonary system, exs: corpulmonary and pulmonary
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ANATOMY & PHSIOLOGY OF RESPIRATORY SYSTEM -------- COMMON HEALTH

PROBLEMS
cardiac disease
embolism
5 CARDINAL SIGNS OF INFLAMMATION:
1. Transient
Neural reflex
vasoconstriction
32. Vasodilation
Redness at site of injury(rubor)
Vasodilation
Sudden gush of blood at the site of injury
3. Warm(pallor)
4. Exudation
5. Pain-loss of
function
Rhinitis
Caused by allergic/ non-allergic agents/ infections
Sinusitis
Can be acute/chronic
Pharyngitis
Can be acute/chronic
*Rhinorrhea
Manifestations of rhinitis:
*Nasal congestion
*Nasal itchiness
*sneezing
*headache
*facial pain
Manifestations of sinusitis:
*tenderness of
paranasal sinuses
*purulent nasal
discharge
*ear pain
*dental pain
*Decreased sense of
smell
*fiery red
Manifestations of pharyngitis:
pharyngeal
membrane
*white purple flexed
exudates
*enlarged lymph
nodes
*fever
*malaise
*sore throat
*diff of swallowing
*cough may be
absent
Interventions of
1. Maintain patent airway
rhinitis, sinusitis,
2. Administer medications to relieve nasal congestions
pharyngitis:
3. Increase oral fluids
4. Vaporizer
5. Promote comfort

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