I.

General Respiratory Anatomy and Physiology A. The respiratory system is comprised of the upper airway and lower airway structures. B. The upper respiratory system filters, moistens and warms air during inspiration. C. The lower respiratory system enables the exchange of gases to regulate serum PaO2, PaCO2 and Ph.

II.

Upper Respiratory A. Nose and sinuses 1. Filters, warms and humidifies air 2. First defense against foreign particles 3. Inhalation for deep breathing is to be done via nose 4. Exhalation is done through the mouth B. Pharynx 1. Behind oral and nasal cavities 2. Nasopharynx a. behind nose b. soft palate, adenoids and eustachian tube 3. Oropharynx a. from soft palate to base of tongue b. palatine tonsils 4. Laryngopharynx a. base of tongue to esophagus b. where food and fluids are separated from air c. bifurcation of larynx and esophagus C. Larynx 1. Between trachea and pharynx 2. Commonly called the voice box 3. Thyroid cartilage - Adam's apple 4. Cricoid cartilage a. contains vocal cords b. the only complete ring in the airway 5. Glottis - opening between vocal cords 6. Epiglottis - covers airway during swallowing

III.

Lower Respiratory and Other Structures A. Trachea 1. Anterior neck in front of esophagus 2. Carries air to lungs B. Mainstem bronchi 1. Right and left

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E.

Right is more vertical, so right middle lobe is more likely to receive aspirate into it with the result of aspiraton pneumonia, which is more commonly found in elderly populations Conducting airways 1. Lobar bronchi a. surrounded by blood vessels, lymphatics, nerves b. lined with ciliated, columnar epithelial cell c. cilia move mucus or foreign substances up to larger airways 2. Bronchioles a. no cartilage; collapse more easily b. no cilia c. do not participate in gas exchange Alveolar ducts and alveoli 1. Lungs contain approximately 300 million alveoli 2. Alveoli surrounded by capillary network 3. Gas exchange area (blood takes O2, gives off CO2) 4. Gas exchange happens at alveolar-capillary membrane (al-cap memb) 5. Held open by surfactant which decreases surface tension to minimize alveolar collapse Accessory muscles of respiration 1. Scalene muscles - elevate first two ribs 2. Sternocleidomastoid - raise sternum 3. Trapezius and pectoralis - stabilize shoulders 4. Abdominal muscles - puts power into cough and used most often with chronic respiratory problems and acute severe respiratory distress

2.

IV.

Physiology A. Basic gas-exchange unit of the respiratory system is the alveoli. B. Alveolar stretch receptors respond to inspiration by sending signals to inhibit inspiratory neurons in the brain stem to prevent lung over distention. C. During expiration stretch receptors stop sending signals to inspiratory neurons and inspiration is ready to start again. D. Oxygen and carbon dioxide are exchanged across the alveolar capillary membrane by process of diffusion. E. Neural control of respirations is located in the medulla. The respiratory center in the medulla is stimulated by the concentration of carbon dioxide in the blood. F. Chemoreceptors, a secondary feedback sysem, located in the carotid arteries and aortic arch respond to hypoxemia. These chemoreceptors also stimulate the medulla.