RESPIRATORY SYSTEM

What is the respiratory system?

Respiration is the release of energy from food. The process of respiration takes place in all living cells of animals, hence it is known as CELLULAR RESPIRATION. Cellular respiration is complex and it involves a series of small steps with each step releasing energy bit by bit. The chemical equation for respiration is C6 H12 06 + 6O2 6CO2 + 6H2O + energy

The primary function of the respiratory system is: To obtain oxygen for the use bodys cell and to eliminate carbon dioxide that cells produce. It has the airways leading in and out of the lungs It is the pathway of air ; nasal cavities

Breathing is an active process requiring the contraction of skeletal muscles. The primary muscles of respiration include the external intercostals muscles (located between the ribs) and the diaphragm (sheet of muscles between thoracic and abdominal cavities).

When we breathe in air is sucked into our lungs. The lungs are the main organs in the respiratory system. They are situated side by side in the thorax, which are bounded by ribs that is joins to the back and to the front of the sternum.

Landmarks The landmarks serve as reference points for internal structures of the respiratory system. The landmarks for assessment of the thorax include bony structures, horizontal and vertical lines and the division of the thorax. The 12 pairs of ribs from horizontal reference points.

The sternum, the first bony landmark, is the flat line in the midline of the thoracic cavity. The thorax is divided into anterior and posterior sections

Parts of the Respiratory System

The nose does the following: 1. Filters the air by the hairs and mucous in the nose 2. Moistens the air 3. Warms the air

The nose or nasal cavity

As air passes through the nasal cavities it is warmed and humidified, so that air that reaches the lungs is warmed and moist.

The Pharynx The pharynx is also called the throat. As we saw in the digestive system, the epiglottis closes off the trachea when we swallow. Below the epiglottis is the larynx or voice box. This contains 2 vocal cords, which vibrate when air passes by them. With our tongue and lips we convert these vibrations into speech

The trachea or Wind pipe

This is made of muscles and elastic fibers with rings of cartilage. The trachea is divided into bronchi and smaller bronchioles. The bronchioles branch off into the alveoli.
The lungs

The lungs are spongy structures where gas exchange takes place. Each lung is surrounded by a pair of pleural membranes. There are over 700,000,000 alveoli in the lungs.

The Larynx or Voice box This is a tube-shaped structure which sits at the entrance to the trachea. The functions of the larynx are: Breathing allows air breathed to reach the lungs Deglutition acts as a valve to prevent food and drink from entering the windpipe Phonation contains 2 vocal cords which vibrate when air passes between them.

The Diaphragm Is a thin muscle that separates the chest from the abdomen. It is the main muscle the body uses for breathing, when relaxed, domes upwards and when contracted it flattens downwards.

The bronchus This is the airways of the lungs. Each bronchus is divided into smaller part called bronchi.

Ventilation of the Lungs

Ventilation means air goes in and out of the lungs. For this to happen, there must be a difference in air pressure i.e. the air moves from a place of high pressure to one volume of low pressure. When we breathe the volume of the thorax changes, which alters the pressure inside it. This causes air to move in and out of the lung. The structures involved in ventilation are: rib cage, intercostal muscles and the diaphragm

Mechanics of Respiration

Gases flow from regions of high pressure to regions of low pressure. When the total gas pressure inside the alveoli is equal to the pressure of the surrounding atmosphere, no movement of gas is possible. For inhalation(breathing in or inspiration)to occur, the gas pressure in the alveoli must be less than that in the atmosphere. For exhalation(breathing out or expiration), the gas pressure in the alveoli must be greater than that in the atmosphere.

Inspiration occurs when the inspiratory muscle i.e. the diaphragm and the external intercostal muscles contract. Contraction of the diaphragm(the skeletal muscle below the lungs)causes an increase in the size of the thoracic cavity, while contraction of the external intercostal muscles elevates the ribs and sternum. Thus, both muscles causes the lungs to expand, increasing the volume of their internal air passages. In response, the air pressure inside the lungs decrease below that of air outside the body. Because gases move from regions of high pressure to low pressure, air rushes into the lungs.

Expiration occurs when the diaphragm and external intercostal muscles relax. In response, the elastic fibers in lung tissue cause the lungs to recoil to their original volume. The pressure of the air inside the lungs then increases above the air pressure outside the body and air rushes out. During high rates of ventilation, expiration is facilitated by contraction of the expiratory muscles(the intercostal muscles and the abdominal muscles).

Contraction of external intercostals muscles > elevation of ribs & sternum > increased front- toback dimension of thoracic cavity > lowers air pressure in lungs > air moves into lungs Contraction of diaphragm > diaphragm moves downward > increases vertical dimension of thoracic cavity > lowers air pressure in lungs > air moves into lungs:

Normal quiet breathing is an involuntary process in that a person does not have to think about it for it to happen. Sometimes, what is known as forced respiration occurs, where a person takes voluntary control of breathing e.g. when playing a wind instrument, or taking vigorous exercises. Here, the breathing mechanism is slightly different and extra muscle is brought into action, including some from the neck and abdomen.

Respiratory Muscles

Movement of the diaphragm account for 75% of the change in intrathoracic volume during quiet inspiration. Attached around the bottom of the thoracic cage, this muscle arches over the liver and moves downwards like a piston when it contracts. The other important inspiratory muscles are the external intercostals muscles, which run obliquely downward and forward from rib to rib. The ribs pivot as if hinged at the back, so that when the external intercostals contract they elevate the lower ribs. This pushes the sternum outward and increases the anteroposterior diameter of the chest.

The transverse diameter also increases, but to a lesser degree. Either the diaphragm or the external intercostal muscles alone can maintain adequate ventilation at rest. The scalene and sternocleidomastoid muscles in the neck are accessory inspiratory muscles that help to elevate the thoracic cage during deep labored respiration. A decrease in intrathoracic volume and forced expiration result when the expiratory muscles contract. The internal intercostals have this action because they pass obliquely downward and posteriorly from rib to rib and therefore pull the

rib cage downward when they contract. Contractions of the muscles of the anterior abdominal wall also aid expiration by pulling the ribcage downward and inward and by increasing the intra-abdominal pressure, which pushes the diaphragm upward.

Pulmonary circulation: Its all in the Lungs

Pulmonary circulation is the movement of blood from the heat, to the lungs and back to the heart again. The veins bring waste rich blood back to the heart, entering the right atrium throughout two large veins called vena cava. The right atrium fills with the waste rich blood and then contracts, pushing the blood through a one way valve into the right ventricle. The right ventricle fills and then contracts, pushing the blood into the pulmonary artery which leads to the lungs. In the lung capillaries, the exchange of carbon

dioxide and oxygen takes place. The fresh oxygen rich blood enters the pulmonary veins and then returns to the heart re-entering through the left atrium. The oxygen rich blood then pass through a one way valve into the left ventricle where it will exit the heart through the main artery called the aorta. The left ventricles contraction forces the blood into the aorta and the blood begins its journey throughout the body.

Pulmonary Circulation

Gas Exchange Gas exchange is the process by which oxygen gets into cells and carbon dioxide is removed. It takes place in the alveoli. Oxygen from the inhaled air diffuses through the walls of the alveoli and adjacent capillaries into the red blood cells. Once oxygen has diffused from the alveoli into the pulmonary blood, it is transported to the peripheral tissue capillaries almost entirely

In combination with haemoglobin. The presence of haemoglobin in the red blood cells allows the blood to transport 30 to 100 times as much oxygen as could be transported in the form of dissolved oxygen in the water of the blood. Carbon dioxide produced by the bodys metabolism returns to the lungs via the blood. It then diffuses across the capillary and alveolar into the air to be removed from the body with expiration. Carbon dioxide, like oxygen, also combines with chemical substances in the blood that increase carbon dioxide transport 15 to 20 folds. The alveoli have a structure specialized for efficient gaseous exchange.

Walls are extremely thin They have a large surface area in relation to volume They are fluid lined enabling gases to dissolve They are surrounded by numerous capillaries

Gas Exchange in the alveoli

THE SUBCLAVIAN SYSTEM

The Left Clavicle and Manubrium are removed to expose the arteries coming off the Arch of the Aorta.

Green:1. Left Subclavian 2. Left Common Caroted Artery, 3.Brachial Cephalic Trunk (Right Common Caroted and Right Subclavian Artery)

1st Landmark is- Lateral Border of First Rib

To the Lower Border of Teres Major Muscle

AXILLARY ARTERY (Armpit)

Brachial Artery (Arm)

Forearm Lateral Branch Radial Artery Medial Branch Ulnar Artery

Cephalic Vein (Radial) Basilic Vein (Ulnar)

Axillary Vein Brachial Vein

Right Subclavian Superior Vena Cava

Clinical Implication
Lung diseases are some of the most common medical conditions worldwide. Tens of millions of people suffer from lung disease in the U.S. Smoking, infections, and genetics are responsible for most lung diseases.

Lung Diseases Affecting the Airways The trachea (windpipe) branches into tubes called bronchi, which in turn branch to become progressively smaller tubes throughout the lungs. Diseases that affect the airways include: Asthma: The airways are persistently inflamed, and may occasionally spasm, causing wheezing and shortness of breath.Allergies, infections, or pollution can trigger asthma's symptoms. Chronic obstructive pulmonary disease (COPD): Lung conditions defined by an inability to exhale normally, which causes difficulty breathing. Chronic bronchitis: A form of COPD characterized by a chronic productivecough. Emphysema: Lung damage allows air to be trapped in the lungs in this form of COPD. Difficulty blowing air out is its hallmark. Acute bronchitis: A sudden infection of the airways, usually by a virus. Cystic fibrosis: A genetic condition causing poor clearance of mucus from the bronchi. The accumulated mucus results in repeated lung infections.

Lung Diseases Affecting the Air Sacs (Alveoli) The airways eventually branch into tiny tubes (bronchioles) that dead-end into clusters of air sacs called alveoli. These air sacs make up most of the lung tissue. Lung diseases affecting the alveoli include: Pneumonia: An infection of the alveoli, usually by bacteria. Tuberculosis: A slowly progressive pneumonia caused by the bacteriaMycobacterium tuberculosis. Emphysema results from damage to the fragile connections between alveoli. Smoking is the usual cause. (Emphysema also limits airflow, affecting the airways as well.) Pulmonary edema: Fluid leaks out of the small blood vessels of the lung into the air sacs and the surrounding area. One form is caused by heart failure and back pressure in the lungs' blood vessels; in another form, direct injury to the lung causes the leak of fluid. Lung cancer has many forms, and may develop in any part of the lungs. Most often this is in the main part of the lung, in or near the air sacs. The type, location, and spread of lung cancer determines the treatment options. Acute respiratory distress syndrome (ARDS): Severe, sudden injury to the lungs caused by a serious illness. Life support with mechanical ventilation is usually needed to survive until the lungs recover. Pneumoconiosis: A category of conditions caused by the inhalation of a substance that injures the lungs. Examples include black lung disease from inhaled coal dust and asbestosis from inhaled asbestos dust.

Lung Diseases Affecting the Interstitium The interstitium is the microscopically thin, delicate lining between the lungs' air sacs (alveoli). Tiny blood vessels run through the interstitium and allow gas exchange between the alveoli and the blood. Various lung diseases affect the interstitium: Interstitial lung disease (ILD): A broad collection of lung conditions affecting the interstitium. Sarcoidosis, idiopathic pulmonary fibrosis, and autoimmune diseaseare among the many types of ILD. Pneumonias and pulmonary edemas can also affect the interstitium.

References
http://www.youtube.com/watch?v=9iAlaAVcDmA http://www.youtube.com/watch?v=vv7m0WgeoZU http://www.webmd.com/lung/lung-diseases-overview http://www.youtube.com/watch?v=ByB7cK9iTKA&NR=1&feature =endscreen Gangongs Review of Medical Physiology Longmans Biology for CXC http://www.biology.com