RESPIRATORY SYSTEM ANATOMY AND PHYSIOLOGY

 

LARYNX

TRACHEA

BIFURCATION TO 2 BRONCHI

RIGHT LUNG (3 LOBES)

LEFT LUNG (2 LOBES)

BRONCHIOLES

ALVEOLI-

·        External respiration - exchange of gases between alveolus and lung capillaries (erythrocytes transport O₂ and CO₂)

 

·        Internal respiration (cellular) - exchange of gases between blood and tissue cells

 

RESPIRATORY SYSTEM PATHOLOGY AND PROCEDURES

 

 

·        AUSCULTATION - LISTENING TO SOUNDS WITHIN THE BODY

 

 

·        PERCUSSION - TAPPING ON SURFACE OF BODY TO DETERMINE THE STATUS OF AN UNDERLYING STRUCTURE (I.E., HOLLOW STRUCTURE FILLED WITH FLUID)

 

 

·        RALES/RHONCHI - SOUNDS HEARD DURING INSPIRATION/EXPIRATION

 

 

·        SPUTUM - MATERIAL EXPELLED FROM THE CHEST, PURULENT IF INFECTION

 

 

·        STRIDOR - HIGH-PITCHED SOUND HEARD DURING INSPIRATION WHEN LARYNX IS OBSTRUCTED, I.E., CROUP (CAUSED BY INFECTION, ALLERGY, FOREIGN BODY)

 

 

UPPER RESPIRATORY DISORDERS

 

 

·        DIPHTHERIA/PERTUSSIS - ACUTE, SERIOUS UPPER RESPIRATORY INFECTIONS; DPT vaccine to prevent these diseases and tetanus

 

 

·        EPISTAXIS - NOSEBLEED

 

 

BRONCHIAL DISORDERS

 

 

·        ASTHMA (PANTING) - BRONCHIAL SPASMS CAUSING OBSTRUCTION WITH RECURRING EPISODES OF DYSPNEA, WHEEZING, COUGHING; ETIOLOGY INCLUDES INHALATION OF ALLERGENS, INFECTION, PHYSICAL EXERTION, EMOTIONAL STRESS 

 

 

·        BRONCHOGENIC CARCINOMA - LUNG CANCER ARISING FROM MALIGNANT TUMORS IN THE BRONCHI; SYMPTOMS INCLUDE COUGHING, FATIGUE, CHEST TIGHTNESS, BLOODY SPUTUM LATE IN THE DISEASE.  OFTEN FAR ADVANCED AND INOPERABLE WHEN DIAGNOSED

 

 

·        CHRONIC BRONCHITIS/COPD  - Chronic Obstructive Pulmonary Disease, ASTHMA, EMPHYSEMA

 

 

·        CYSTIC FIBROSIS - HEREDITARY GENETIC DEFECT OF CYSTIC FIBROSIS TRANSMEMBRANE RECEPTOR (CFTR) THAT FUNCTIONS AS A CHLORIDE CHANNEL; ALLOWS BUILD-UP OF THICK MUCUS IN PANCREAS, LUNGS AND GI AND GU TRACT. 

 

 

LUNG DISORDERS

 

·        ATELECTASIS - COLLAPSED LUNG PREVENTING RESPIRATORY EXCHANGE OF GASES; ETIOLOGY INCLUDES OBSTRUCTION OF AIRWAYS BY FLUID OR TUMOR

 

 

·        EMPHYSEMA - OVER-INFLATION AND DESTRUCTIVE CHANGES IN THE ALVEOLAR WALLS CAUSING LOSS OF LUNG ELASTICITY AND DECREASED EXCHANGE OF GASES

 

 

·        PNEUMOCONIOSIS - DUST IN THE LUNGS (SEE BOOK FOR DIFFERENT KINDS)

 

 

·        PNEUMONIA - ACUTE INFLAMMATION OF THE ALVEOLI DUE MAINLY TO BACTERIAL INFECTION;  SYMPTOMS INCLUDE FEVER, CEPHALGIA, COUGH, +/-BLOOD-TINGED SPUTUM.

 

 

·        PULMONARY ABSCESS - PUS IN THE LUNGS

 

 

·        PULMONARY EDEMA - ACCUMULATION OF FLUID IN LUNG TISSUE AND ALVEOLI (EDEMA); USUALLY CAUSED BY CONGESTIVE HEART FAILURE.

 

 

·        PULMONARY EMBOLISM - FLOATING CLOT TRAVELING FROM A DISTANT VEIN (LEG MOST COMMON, POSTPARTUM PELVIS) AND LODGING IN BLOOD VESSELS IN THE LUNG; HIGH FATALITY RATE

 

 

·        TUBERCULOSIS - INFECTIOUS DISEASE AFFECTING LUNGS MOST COMMONLY

 

 

PLEURAL DISORDERS

 

 

·        PLEURAL EFFUSION - ESCAPE OF FLUID OR AIR INTO THE PLEURAL CAVITY, E.G., PYOTHORAX (EMPYEMA), HYDROTHORAX, HEMOTHORAX, PNEUMOTHORAX

 

 

·        PLEURITIS (PLEURISY) - INFLAMMATION OF THE PLEURA COMMONLY CAUSED BY LUNG CANCER, LUNG OR CHEST WALL ABSCESSES, PNEUMONIA, TB

 

·        PNEUMOTHORAX - GAS OR AIR IN THE PLEURAL CAVITY DUE TO DISEASE, TRAUMA, PERFORATION, ETC.

 

CLINICAL PROCEDURES

 

·        CHEST X-RAY - FRONTAL/CORONAL OR (ANTERIOR/POSTERIOR) VIEWS

 

 

·        BRONCHOSCOPY - PASS LIGHTED, FLEXIBLE FIBEROPTIC TUBE THROUGH NOSE TO BRONCHI.  OBTAIN SPECIMENS FOR:

1.      CYTOLOGICAL AND BACTERIOLOGICAL STUDIES BY ASPIRATING BRONCHIAL SECRETIONS OR BRONCHIAL WASHES.

2.      PERFORM BIOPSIES USING FORCEPS OR BRONCHIAL BRUSHING.

 

 

·        ENDOTRACHEAL INTUBATION - CREATE AN AIRWAY BY PASSING A TUBE THROUGH THE NOSE OR MOUTH

 

·        PULMONARY FUNCTION TESTS - USE SPIROMETER TO MEASURE BREATHING MECHANICS UNDER NORMAL CONDITIONS AND UNDER RESISTANCE.

 

·        THORACENTESIS - PERCUTANEOUS INSERTION OF A NEEDLE INTO THE PLEURAL CAVITY TO:

1.      REMOVE FLUID FOR ANALYSIS

2.      DRAIN PLEURAL EFFUSIONS

3.      RE-EXPAND A COLLAPSED LUNG

 

·        TRACHEOSTOMY - CREATION OF AN OPENING INTO THE TRACHEA AND INSERTION OF A TUBE TO FACILITATE AIR PASSAGE OR REMOVAL OF SECRETIONS.