RESPIRATORY SYSTEM

Achmad aminuddin

RESPIRATORY SYSTEM
 STRUCRURALLY UPPER RESPIRATORY SYSTEM the nose, pharynx, and associated structur LOWER RESPIRATORY SYSTEM the larynx, trachea, bronchi and lung  FUNCTIONALLY THE CONDUCTING ZONE the nose, pharynx, larynx, trachea, bronchi, bronchioles, and terminal bronchioles,. that filter, warm, and moisten air  THE RESPIRATORY ZONE the respiratory bronchioles, alveolar ducts, alveolar sacs and alveoli, the main sites of gas exchange.

NOSE
 THE NASAL CAVITIES
RIGHT N.C. LEFT N.C.

 THE FUNCTIONS OF THE NOSE AND NASAL CAVITIES

OLFACTION. RESPIRATION. FILTRATION OF DUST. HUMIDIFICATION OF INSPIRED AIR. RECEPTION AND ELIMINATION OF SECRETION FROM PARANASAL SINUSES AND NASOLACRIMAL DUCT.

THE BONY PART OF THE NOSE

 NASAL BONES.  FRONTAL PROCESSES OF THE MAXILLAE.  NASAL PART OF THE FRONTAL BONE AND ITS NASAL SPINE.  BONY PART OF THE NASAL SEPTUM.

THE CARTILAGINOUS PART

 TWO LATERAL CARTILAGES.  TWO ALAR CARTILAGES.  A SEPTAL CARTILAGE.

THE NASAL SEPTUM

 THE PERPENDICULAR PLATE OF THE ETHMOID.  THE VOMER.  THE SEPTAL CARTILAGE.  THE NASAL CREST OF THE MAXILLARY.  THE NASAL CREST OF THE PALATINE.

NASAL CAVITIES
 THE NARES.  THE CHOANAE.  MUCOSA LINES THE NASAL CAVITIES, EXCEPT THE NASAL VESTIBULE WHICH IS LINED WITH SKIN.  COMMUNICATE WITH :
THE NASOPHARYNX. THE PARANASAL SINUS. THE LACRIMAL SAC AND CONJUNCTIVA.

THE NASAL MUCOSA

 CONSIST OF
THE RESPIRATORY AREA - inferior 2/3 rd. THE OLFACTORY AREA - superior 1/3 rd.

 THE BOUNDARIES
THE ROOF. THE FLOOR. THE MEDIAL WALL. THE LATERAL WALL.

THE NASAL CAVITY

 ROOF
FRONTONASAL PART. ETHMOIDAL PART. SPHENOIDAL PART.

 FLOOR
THE PALATINE PROCESS OF THE MAXILLA. THE HORIZONTAL PLATE OF THE PALATINE BONE.

THE NASAL CAVITY

 THE MEDIAL WALL
THE NASAL SEPTUM.

 THE LATERAL WALL

NASAL CONCHAE
 SUPERIOR.  MIDDLE.  INFERIOR

THE NASAL CAVITY

     SPHENOETHMOIDAL RECESS. SUPERIOR MEATUS. MIDDLE MEATUS. INFERIOR MEATUS. COMMON NASAL MEATUS.

THE ARTERIAL SUPPLY OF THE MEDIAL AND LATERAL WALL OF THE NASAL CAVITY
     ANTERIOR ETHMOIDAL A. POSTERIOR ETHMOIDAL A. SPHENO PALATINE A. GREATER PALATINE A. SEPTAL BRANCH OF THE SUPERIOR LABIAL A. ( FROM THE FACIAL A. )

KIESSELBACH AREA
 ANTERIOR PART OF THE NASAL SEPTUM.  AN AREA RICH IN CAPILLARIES WHERE ALL FIVE ARTERIES SUPPLYING THE SEPTUM ANASTOMOSE.

THE VENOUS DRAINAGE

 RICH PLEXUS OF VEIN DEEP TO NASAL MUCOSA
SPHENOPALATINE V. FACIAL V. OPHTHALMIC V.

THE NERVE SUPPLY OF THE NASAl MUCOSA

 POSTEROINFERIOR TO 2/3
THE MAXILLARY N. ( C.N. V2 ).- CHIEFLY. ). THE NASOPALATINE N. NASAL SEPTUM. POSTERIOR LATERAL BRANCHES OF THE GREATER PALATINE N. LATERAL WALL

 THE ANTEROSUPERIOR PART

THE ANTERIOR ETHMOIDAL N. BRANCHES OF THE NASOCILIARY N. ( C.N.V1 ).

PARANASAL SINUSES
 AIR-FILLED EXTENSION OF THE AIRRESPIRATORY PART OF THE NASAL CAVITY IN TO THE FOLLOWING CRANIAL BONES
FRONTAL BONE. SPHENOID BONE. ETHMOID BONE. MAXILLARY BONE.

FRONTAL SINUS
 POSTERIOR TO THE SUPERCILIARY ARCHES AND THE ROOT OF THE NOSE  EACH SINUS DRAINS FRONTO NASAL DUCT INFUNDIBULUM SEMILUNAR HIATUS OF THE MIDDLE MEATUS.  INNERVATED BY BRANCHES OF THE SUPRAORBITAL N. ( C.N. V1 ). V1

ETHMOIDAL SINUS
 LOCATED IN THE LATERAL MASS OF THE ETHMOID BETWEEN THE NASAL CAVITY AND ORBIT.  THE ANTERIOR ETHMOIDAL CELLS DRAINS DIRECTLY OR INDIRECTLY IN FUNDIBULUM MIDDLE MEATUS.  THE MIDDLE ETHMOIDAL CELLS OPEN DIRECTLY IN TO THE MIDDLE MEATUS.  THE POSTERIOR ETHMOIDAL CELLS OPEN DIRECTLY IN TO THE SUPERIOR MEATUS.  INNERVATED BY ANTERIOR AND POSTERIOR ETHMOIDAL BRANCHES OF THE NASOCILIARY N. ( C.N. V1). V1

SPHENOIDAL SINUS
 OCCUPY THE BODY OF THE SPHENOID, MAY EXTEND IN THE WING.  ONLY THIN PLATES OF BONE SEPARA YE THE SINUSES FROM SEVERAL IMPORTANT STRUCTURE; THE OPTIC N AND OPTIC CHIASM, THE PITUITARY GLAND, INTERNAL CAROTED A. AND CAVERNOUS SINUSES.  SEVERAL POSTERIOR ETHMOIDAL CELLS INVADE THE SPHENOID, GIVING RISE TO MUL TIPLE SPHENOIDAL SINUSES THAT OPEN SEPARATELY IN TO THE SPHENOIDAL RECESS.  THE POSTERIOR ETHMOIDAL A. AND N. SUPPLY SPHENOID SINUS.

THE MAXILLARY SINUSES

 THE APEX OF THE SINUS EXTENDS TOWARD AND OFTEN IN TO THE ZYGOMATIC BONE.  THE BASE OF THE SINUS FORM THE INFERIOR PART OF THE LATERAL WALL OF THE NASAL CAVITY.  THE ROOF IS FORMED BY THE FLOOR OF THE ORBIT.  THE FLOOR IS FORMED BY THE ALVEOLAR PART OF THE MAXILLA.  EACH SINUS DRAIN BY AN OPENING THE MAXILLARY OSTIUM IN TO MIDDLE MEATUS

THE MAXILLARY SINUS

 ARTERIAL SUPPLY
MAINLY FROM SUPERIOR ALVEOLAR BRANCHES OF THE MAXILLARY A. THE GREATER PALATINE A FLOOR.

 INNERVATION
THE ANTERIOR, MIDDLE AND POSTERIOR SUPERIOR ALVEOLAR N., BRANCHES OF THE MAXILLARY N. ( C.N. V2 ).

PHARYNX
 THE PART OF THE ALIMENTARY CANAL POSTERIOR TO THE NASAL AND ORAL CAVITY.  EXTENDS FROM THE BASE OF THE CRANIUM TO THE INFERIOR BORDER OF THE CRICOID CARTILAGE ANTERIORLY AND THE INFERIOR BORDER OF V.C.6 POSTERIORLY. V.C.6  DIVIDED IN TO
NASOPHARYNX. OROPHARYNX. LARYNGOPHARYNX.

NASOPHARYNX
 HAS A RESPIRATORY FUNCTION.  LIES SUPERIOR TO THE SOFT PALATE AND IS THE POSTERIOR EXTENSION OF THE NASALCAVITY.  THE PHARYNGEAL TONSIL ( ADENOID )  ORIFICE OF THE PHARYNGOTYMPANIC TUBE.  TUBAL TONSIL.

OROPHARYNX
 DIGESTIVE FUNCTION  BOUNDARIES
ANTERIOR
 SOFT PALATE.  BASE OF THE TONGUE.

LATERAL
 PALATOGLOSSAL ARCH.  PALATOPHARYNGEAL ARCH.

 EXTENDS FROM THE LEVEL OF THE SOFT PALATE TO THE SUPERIOR BORDER OF THE EPIGLOTTIS.

THE PALATINE TONSILS

 COLLECTION OF LYMPHOID TISSUE ON EACH SIDE OF THE OROPHARYNX.  LIES IN THE TONSILAR BED, BETWEEN THE PALATOGLOSSAL AND PALATOPHARYNGEAL ARCHES.  THE BED IS FORMED BY THE SUPERIOR CONSTRICTOR OF THE PHARYNX AND THE PHARYNGOBASILAR FASCIA.

LARYNGOPHARYNX
 POSTERIOR TO THE LARYNGEAL INLET AND THE VESTIBULE AND VENTRICLE OF THE LARYNX.  EXTENDS FROM THE SUPERIOR BORDE OF THE EPIGLOTTIS TO THE ESOPHAGU AT THE LEVEL OF THE INFERIOR BORD DER OF THE CRICOID CARTILAGE.  POSTERIORLY IS RELATED TO THE BO DIES OF C4 THROUGH C6 VERTEBRAE. C4 C6  COMMUNICATES WITH THE LARYNX THROUGH THE LARYNGEAL INLET

THE NERVE SUPPLY TO THE PHARYNX

 PHARYNGEAL PLEXUS OF NERVE
MOST OF SENSORY AND MOTOR
 PHARYNGEAL BRCH OF THE C.N. X - MOTOR.  GLOSSOPHARYNGEAL ( C.N.) - SNSR.  SYMPATHETIC BRCH FROM THE SUPERIOR CERVICAL GANGLION.

PHARYNGEAL LYMPHOID RING

    PALATINE TONSIL. LINGUAL TONSIL. PHARYNGEAL TONSIL. TUBAL TONSIL.

RESPIRATORY LAYER OF THE CERVICAL VISCERA

 I.E
LARYNX. TRACHEA.

 MAIN FUNCTION
ROUTING AIR AND FOOD INTO THE RESPIRATORY TRACT AND ESOPHAGUS. PROVIDING A PATENT AIR WAY AND A MEANS OF SEALING IT OFF TEMPORARILY. PRODUCING VOICE.

LARYNX
 LIES IN THE ANTERIOR PART OF THE NECK AT THE LEVEL OF THE BODIES OF C3 THROUGH C6 VERTEBRAE. C6  COMPOSED OF 9 CARTILAGE.  CONTAINING THE VOCAL FOLD.  GUARD THE AIR PASSAGES, ESPECIALLY DURING SWALLOWING

THE LARYNGEAL SKELETON

 THREE CARTILAGE ARE SINGLE
THYROID CARTILAGE. CRICOID CARTILAGE. EPIGLOTTIC CARTILAGE.

 THREE CARTILAGE ARE PAIRED

ARYTENOID CARTILAGE. CORNICULATE CARTILAGE. CUNEIFORM CARTILAGE.

THE LARYNGEAL CAVITY

 EXTEND FROM THE LARYNGEAL INLET TO THE LEVEL OF THE INFERIOR BORDER OF THE CRICOID CARTILAGE.  DIVIDE INTO 3 PART
LARYNGEAL VESTIBULE
 BETWEEN THE LARTNGEAL INLET AND THE VESTIBULAR FOLD.

MIDDLE PART OF THE LARYNGEAL CAVITY

 THE CENTRAL CAVITY BETWEEN THE VESTIBULAR AND AND VOCAL FOLDS.

LARYNGEAL VENTRICLE
 RECESSES EXTENDING LATERALLY FROM THE NIDDLE PART OF THE LARYNGEAL CAVITY BETWEEN FESTIBULAR AND VC FOLD

INFRA GLOTTIC CAVITY

 FROM THE FOCAL FOLDS TO THE INFERIOR BORDER TO THE CRICOID CARTILAGE.

THE VOCAL FOLD

 EACH VOCAL FOLD INCLUDES
A VOCAL LIGAMENT A VOCAL MUSCLES

 THE SOURCE OF SOUND THAT COME FROM THE LARYNX  AS THE MAIN SPHINCTER OF THE RESPIRATORY TRACT

MUSCLES OF THE LARYNX

 THE EXTRINSIC LARYNGEAL MUSCLES
MOVE THE LARYNX AS A WHOLE. DEPRESSOR
 INFRAHYOID M.

ELEVATOR
 SUPRAHYOID M.  STYLOPHARYNGEUS M.

 THE INTRINSIC LARYNGEAL MUSCLES

MOVE THE LARYNGEAL PARTS. MAKING THE ALTERATIONS IN THE LENGTH AND TENSION OF THE VOCAL FOLD ANDS AND IN THE SIZE AND SHAPE OF THE RIMA GLOTTIDIS

VESSELS OF LARYNX
 ARTERIAL SUPPLY
THE INFERIOR LARYNGEAL A. THE SUPERIOR LARYNGEAL A.

 LARYNGEAL VEINS
THE INFERIOR LARYNGEAL V. THE SUPERIOR LARYNGEAL V.

 LYMPHATICS DRAINAGE
SUPERIOR TO THE VOCAL FOLD
 ACCOMPANY THE SUPERIOR LARYNGEAL A. SRAINS INTO THE SUPERIOR DEEP CERVICAL L.N.

INFERIOR TO THE VOCAL FOLD

 DRAIN INTO THE PRE TRACHEAL OR PARATRACHEAL L.N. AND THEN TO INFERIOR DEEP CERVICAL L.N.

NERVES OF THE LARYNX

 THE SUPERIOR LARYNGEAL N.
ARISES FROM THE INFERIOR VAGAL GANGLION
 THE INTERNAL LARYNGEAL N.  THE EXTERNAL LARYNGEAL N.

 THE INFERIOR LARYNGEAL N.

THE CONTINUATION OF THE RECURRENT LARYNGEAL N ( A BRANCH OF C.N. X ).
 THE ANTERIOR BRANCH.  THE POSTERIOR BRANCH.

TRACHEA
 A FIBROCARTILAGINOUS TUBE, IS SUPPORTED BY INCOMPLETE CARTILA GINOUS TRACHEAL RING, THE POSTER IOR GAP IS SPANNED BY THE INVOLUNTARY TRACHEALIS MUSCLE.  EXTENDS FROM THE LEVEL OF THE V.C 6 THROUGH THE STERNAL ANGLE ( THE T4-T5 IV DISC )

TRACHEOSTOMY
 TRANSVERSE INCISSION OF THE SKIN  THE INFRAHYOID MUSCLES ARE RETRACTED LATERALLY  THE ISTHMUS OF THE THYROID GLAND IS EITHER DEVIDED OR RETRACTED SUPERIORLY  AN OPENING IS MADE BETWEEN THE FIRST AND SECOND TRACHEAL RING OR THE SECOND THROUGH 4TH RING  A TRACHEOSTOMY TUBE IS THEN INSERTED INTO THE TRACHEA AND SECURED

THE TRACHEA AND BRONCHI

 THE TRACHEA BIFURCATES AT THE LEVEL OF THE TRANSVERSE THORACIC PLANE INTO
RIGH MAIN ( PRIMARY ) BRONCHUS
 THREE LOBAR ( SECONDARY ) BRONCHI
SEGMENTAL ( TERTIARY ) BRONCHI  BRONCHOPULMONARY SEGMEN.

LEFT MAIN ( PRIMARY ) BRONCHUS

 TWO LOBAR ( SECONDARY ) BRONCHI
SEGMENTAL ( TERTIARY ) BRONCHI  BRONCHOPULMONARY SEGMEN.

TRACHEOBRONCHIAL TREE

SEVERAL CHANGES IN THE BRONCHIAL TREE

 THE MUCOUS MEMBRANE - PSEUDOSTRATIFIED CILIATED COLUMNAR EPITHELIUM - primary bronchus - secondary bronchus - tertiary bronchus - CILIATED SIMPLE COLUMNAR EPITHEEPITHELIUM WITH SOME GOBLET CELLS - large bronchioles - MOSTLY CILIATED SIMPLE CUBOIDAL EPITHELIUM WTH NO GOBLET CELLS - smaller bronchioles. - MOSTLY NON CILIATED SIMPLE CUBOIDAL EPITHELIUM - termial bronchioles

SEVERAL CHANGES IN THE BRONCHIAL TREE

 PLATES OF CARTILAGE GRADUALLY REPLACE - INCOMPLETE RING OF CARTILAGE - primary bronchus - DISAPPEAR - distal bronchioles  THE AMOUNT OF CARTILAGE DECREASES, THE AMOUNT OF SMOOTH MUSCLE INCREASES. SMOOTH MUSCLE ENCIRCLES THE LUMEN IN SPIRAL BANDS

BRONCHOPULMONARY SEGMEN

BRONCHOPULMONARY SEGMEN
 PYRAMIDAL-SHAPE SEGMEN OF THE LUNG. PYRAMIDAL THE LARGEST SUBDIVISION OF THE LUNG.  SEPARATED FROM ADJACENT SEGMEN TS BY CONNECTIVE TISSUE SEPTA.  SUPPLIED INDEPENDENTLY BY A SEGM ENTAL BRONCHUS AND A TERTIARY BRANCH OF THE PULMONARY ARTERY.  NAMED ACCORDING TO THE SEGMENTAL BRONCHI SUPPLYING THEM.  DRAINED BY INTERSEGMENTAL PARTS OF THE PULMONARY VEINS  SURGICALLY RESECTABLE.  USUALLY 10 IN THE RIGHT LUNG , 8 10 IN THE LEFT LUNG.

ALVEOLI
 THE WALLOF ALVEOLI - TWO TYPES OF ALVEOLAR EPITHELIAL CELLS - TYPE I ALVEOLAR CELLS - simple squmous epithelial - the main sites of gas exchange - TYPE II ALVEOLAR CELLS - between type I cells - containing microvilli - secrete alveolar fluid . Surfactans - keep the surface between cells and the air moist * ALVEOLAR MACROPHAGE ( DUST CELLS ) - ELASTIC BASEMENT MEMBRANE

THE RESPIRATORY MEMBRANE

 THE ALVEOLAR WALL - type I alveolar cells. - type II alveolar cells. - alveolar macrophages  AN EPITHELIAL BASEMENT MEMBRANE - underlying the alveolar wall.  A CAPILLARY BASEMENT MEMBRANE - often fused to the epithelial basement membrane  THE CAPILLARY ENDOTHELIUM