Presentation by-Dr.HIMANI MODERATOR- Dr. S.

Dam

INTRODUCTION
THE GOAL OF RESPIRATION ARE TO PROVIDE OXYGEN TO THE TISSUE & TO REMOVE CO2 FROM THE LUNGS.

Anatomy
Respiratory tract extends from mouth/nose to alveoli
Upper airway filters airborne particles, humidifies

and warms inspired gases Lower airway serves for gas exchange

Upper airway

Upper airway
The upper airway starts : At the nostrils, extends through the nasal conchae to the nasopharynx, hard and soft palates, to the hypo pharynx and larynx.

The Lower Airways

Respiratory anatomy
The respiratory system can be divided into 4 regions: Nasopharynx Region: the head region, including the nose, mouth, pharynx, and larynx. Tracheo bronchial Region: includes the trachea, bronchi, and bronchioles. Pulmonary (Alveolar) Region: comprising of alveoli. Chest cage including Muscles of respiration, diaphragm & accessory muscles of respiration.

THE NOSE
Nose is the natural pathway of breathing,mouth

breathing is acquired through learning. nose is divided into rt&lt nasal cavity by nasal septum,and each nasal cavity communicates with the exterior through nostril and with the nasopharynx through posterior nasal aperture. each nasal cavity consists of a skin lined portion the vestibule, and a mucosa lined portion the nasal cavity proper.

1.Nasal septum. 2.Lateral wall. 3.paranasal sinuses.

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Nasal septum
The nasal septum is made up of: perpendicular plate of ethmoid vomer maxilla septal cartilage

Major arteries of the septum

The septum and the nasal cavity,

in general is highly vascularized. One reason for this might be to warm the air before it reached the bronchi and lungs. The major arteries of the septum are: anterior ethmoidal (ophthalmic) posterior ethmoidal (ophthalmic) Sphenopalatine (maxillary) greater palatine (maxillary) branch of superior labial (facial)

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Sensory innervations to the nose

Sensory innervations to the

nose is also important in that it provides reflexes (such as the sneeze reflex) to keep foreign particles out of the respiratory system. The sensory nerves to the septum are: anterior ethmoidal (V1) (nasociliary) nasopalatine (V2) (maxillary)

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Lateral wall of the nasal cavity2.

sphenoethmoid recess

(arrow above 1) superior concha (1) superior meatus (tip of arrow) middle concha (2) middle meatus (tip of arrow) inferior concha (3) inferior meatus (tip of arrow)
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PARANASAL SINUSES
Sinuses are air filled cavities in certain bones of skull.they are 4 on each side. 1 frontal sinus 2 ethmoidalsinus 3 maxillary sinus 4 sphenoidalsinus Clinically sinuses have been divided into 2 groups ANTERIOR GROUP-this include maxillary,frontal and ant. Ethmoidalsinus.they all open in the middle meatus. POSTERIOR GROUP-this include posterior ethmoidal sinus which open in the superior meatus, and the sphenoidalsinuswhich open in sphenoethmoidal recess.

Relation of the Para nasal sinuses.

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FUNCTION OF NOSE
1 RESPIRATION
2 AIR CONDITIONING OF INSPIRED AIR 3 PROTECTION OF LOWER AIRWAY

4 VOCAL RASONANCE
5 OLFACTION

Structures in mouth.
Structures to identify: vestibule hard palate soft palate uvula palatoglossal arch palatine tonsil palatopharyngeal arch posterior wall of oropharynx pterygoid hamulus

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Tongue elevated. frenulum of tongue. ridge formed by deep lingual vein. sublingual fold. sublingual caruncle. opening of submandibular duct. The sublingual gland forms the sublingual fold and sends multiple small ducts into the mouth along the fold.

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Pharynx.

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NASOPHARYNX
It is the upper most part of the pharynx .it lies behind the nasal cavity and extends from base of skull to the level of the horizontal plane passing through the hard palate.

Oropharynx
1.Inferior to the uvula and superior to the epiglottis. 2. Lined by nonkeratinized stratified squamous epithelium b/c it is a common pathway for food and air. 3.The palatine tonsils are located near the opening of the oral cavity into the pharynx.

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Laryngopharynx
1.Inferior to the epiglottis and superior to the split between the larynx and the esophagus. 2.Lined by nonkeratinized stratified squamous epithelium b/c it is a common pathway for food and air. 3.Continuous with the larynx inferiorly. 4. Lingual tonsils are located on the posterior surface of the tongue, which also places them near the opening of the oral cavity into the pharynx.

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The larynx
The larynx is a 5-7 cm long structure.

Its upper boundary starts at the tip of the epiglottis, opposite the 3rd to 4th,cervical vertebra. Its lower end is at the lower border of the cricoid cartilage. This lies opposite the 6th cervical vertebra.
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 Anatomically the larynx of an infant or children differs

from that of an adult in being smaller, funnel shaped and of a narrower lumen and little higher in position, cartilages are also softer and collapse easily. Infant larynx contain more submucosal tissue which make it more liable to become oedematous in response to trauma or inflammation.

Structure
i. Arrangement of 9 cartilages connected by membranes and ligaments and lined by respiratory epithelium. ii. Cartilages include unpaired thyroid, cricoid, epiglottis and 3 small paired cartilages. iii. All cartilages are hyaline with the exception of the epiglottis, which is elastic cartilage.

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The Larynx

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The Larynx : inlet.

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Major function of the larynx

the major function of the larynx is to keep the airway open. This means keeping the space between the vocal cords (rima glottidis) open. Phylogenetically it evolved as a valve to protect lower airway, voice production is sec. function If it isn't open, we don't breathe so the second function doesn't matter.

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Innervation of the Larynx

Motor innervation external laryngeal (X) recurrent laryngeal (X)

Sensory innervation internal laryngeal (X) sensory above the false vocal cords recurrent laryngeal (X) sensory below the false vocal cords

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Trachea.
The trachea is a cylindrical

tube that projects onto the spine from C6 to the level of T5. As it passes downwards, it follows the curvature of the spine, and courses slightly backward. Near the tracheal bifurcation, it deviates slightly to the right. The upper end is continous with the lower end of larynx

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Airway Cross Section

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Bronchioles.

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Lungs

Occupy the entire thoracic cavity except for the mediastinum. Each lung is cone-shaped and suspended within its own pleural cavity and connected to the mediastinum by bronchial and vascular attachments. Anterior, lateral, and posterior surfaces hug the ribs and form the costal surface. Deep to the clavicle is the apex, the narrow superior lung tip. Base the concave diaphragmatic surface of the lung. On the medial side of each lung is an indentation known as the hilus. Pulmonary vessels, nerves, and lymphatics enter/exit at this point.

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Lungs major function

Provide continuous gas exchange between inspired air

and blood in the pulmonary circulation

Blood Supply
Lungs have a double blood supply
Pulmonary circulation for gas exchange with the

alveoli (pulmonary artery with subdivisions) Bronchial arteries arising from descending aorta supplies lung parenchyma

Respiratory muscles
Inspiration is an active process During a period of relaxed and average respiration, the muscles associated with inspiration, or the process of inhaling, include the muscles of the diaphragm, the external intercostal muscles, and the interchondral region of the internal intercostal muscles.

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Respiratory muscles
The diaphragm is known to

contract downward, causing the necessary vertical increase in the thoracic dimensions. The muscles of the external intercostal muscles and the appropriate muscles of the internal intercostal muscles contract as well, in timed rhythm to the contraction of the diaphragm. This creates a simultaneous increase in the lateral thoracic dimensions

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Accessory muscles of inspiration

The sternocleidomastoid (elevated sternum) and the scalene

muscles (anterior, middle and posterior scalene) are typically considered accessory muscles of breathing .
The following muscles have also been observed contributing to the

breathing: serratus anterior, pectoralis major & minor, upper trapezius, latissimus dorsi, erector spinae (thoracic), iliocostalis lumborum, quadratus lumborum, serratus posterior superior and inferior, levatores costarum, transverses thoraces, subclavius. If a breathing pattern disorder exists, the accessory muscles of inspiration may become overused.

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Accessory Muscles of Inspiration

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