respiratory and phonatory systems

two parts of respiratory and phonatory systems

1. upper respiratory tract

2. lower respiratory tract

upper respiratory tract

a) nasal cavity

b) oropharynx

c) larynx

lower respiratory tract

a) trachea

b) bronchi

c) lungs

three main functions of the nasal cavity

1. filter

2. humidify

3. warm

components of the oropharynx

1. oral cavity to the level of the BOT

2. pharynx (naso, oro, hypo)

functions of the oropharynx

1. swallowing (oral prep & transit)

2. speech

3. breathe-respiration

oropharynx- oral cavity is separated from nasal cavity by:

1. hard palate

2. soft palate

oropharynx- oral cavity terminates at:

1. posteriorly

2. anteriorly

1. posteriorly- faucial arches (pillars)

2. anteriorly- lips

oropharynx- pharynx originates at:

posterior portion of the nasal cavity

oropharynx- pharynx extends to:

upper portion of the esophagus- upper digestive tract

oropharynx- pharynx consists of 3 segments:

1. nasopharynx

2. oropharynx

3. hypopharynx

larynx is attached inferiorly to:

trachea

larynx is suspended superiorly from:

hyoid bone

larynx is comprised of 2 paired cartilages:

1. thyroid cartilage

2. cricoid cartilage

1 paired cartilage of the larynx

arytenoid cartilage

The arytenoids are responsible for what movements of the vocal folds?

1. abduction (← →)

2. adduction (→ ←)

The first entrance to the larynx is the:

laryngeal vestibule (airspace above the VFs)

The 3 major regions of the larynx include:

1. supraglottis

2. glottic level

3. subglottic level

What are the 3 main components of the upper respiratory tract?

1. nasal cavity

2. oropharynx

3. larynx

the lower respiratory tract is housed within the ________ cavity

thoracic

the lower respiratory tract is formed by the:

1. 12 thoracic vertebrae

2. sternum

3. ribs

The left and right halves of the thoracic cavity are divided by: (which tract?)

mediastinum

lower respiratory

The mediastinum houses the:

1. heart

2. blood vessels

3. nerves

4. portion of the esophagus

The trachea is composed of semi-circular:

1. U-shaped

2. cartilaginous rings

This trachea extends from the ______ to the _________

larynx (at the cricoid cartilage) to the starting point of the upper thoracic cavity

The inferior end of the trachea divides into 2 branches called the:

1. ______

2. ______

1. main stem

2. primary bronchi

the inferior end of the trachea consists of both the:

• left bronchus

• right bronchus

The terminal bronchioles end at the _________

alveolar air sacs

Gas exchange with the bloodstream takes place in the ______

alveoli

The lungs are divided into segments called:

lobes

In total, there are 5 lobes which are split:

1. __ on the right

2. __ on the left

1. 3

2. 2 (heart)

What are the 3 main components of the lower respiratory tract?

1. trachea

2. bronchi

3. lungs

Where does gas exchange take place?

alveolli sacs

3 types of breathing

1. quiet

2. forced

3. speech

types of breathing chart for active and passive

Volume of air inhaled and exhaled during normal quiet breathing

Tidal Volume (TV)

Volume of air that can be inhaled beyond a normal tidal inspiration

Inspiratory Reserve Volume (IRV)

Volume of air that can be exhaled beyond a normal tidal expiration

Expiratory Reserve Volume (ERV)

Volume of air that remains in the lungs beyond a maximum forced expiration

Residual Volume (RV)

Volume of air that remains in the lungs beyond a normal tidal expiration

Functional Residual Capacity (FRC)

Volume of air maximally exhaled after a maximum inspiration.

Vital Capacity (VC)

Reflects inspiratory/expiratory muscle strength.

Vital Capacity (VC)

Amount of air that is inspired and expired per minute.

minute volume

4 lung volumes

1. tidal volume

2. inspiratory reserve

3. expiratory reserve

4. residual volume

3 lung capacities

1. total lung capacity

2. vital capacity

3. function residual capacity

which lung volume? quiet breathing

tidal volume

which lung volume? bigger breath beyond tidal

inspiratory reserve

which lung volume? bigger exhale beyond tidal

expiratory reserve

which lung capacity? sum of all volumes

total lung capacity

which lung capacity? tidal + inspiratory reserve + expiratory reserve

vital capacity

which lung capacity? expiratory reserve + residual volume

functional residual capacity

lung volumes and capacity measures are obtained during: ____ or ____ and tested via ___ or _____.

pulmonary function testing or PFT; spirometry or peak flow meter

What are the 3 main types of breathing patterns?

1. quiet (rest)

2. forced

3. speech

Which is the only type of breathing pattern that includes passive respiration?

quiet (expiration)

Which measure of lung capacity gives you information about inspiratory and expiratory muscle strength?

vital capacity

main muscle of inspiration for breathing

diaphragm

dome shaped muscle at the base of the rib cage

central pattern generator is located in the _______ (_______ & ______)

brainstem (pons & medulla)

Collection of specialized ___________________ that communicate information regarding the levels of ______ in the blood to the respiratory control center

nerve (sensory) cells, O2; chemoreceptors (stimulate)

Other types of cells which respond to events of the ____________________. They also contribute to cycles of ________________ by responding to the expansion and deflation of lungs and bronchi.

respiratory cycle, ventilation; stretch receptors (inhibit)

So then once inspiration is triggered, how does respiration take place?

Recall that:

• Gas exchange occurs within the bloodstream

• This takes place in the alveoli

A small vessel which transports three things to the organs and body systems (what is it and what 3 things?)

capillaries

1. blood

2. nutrients

3. oxygen

arteries role = Carry blood ______ the heart

away from

veins role = Carry blood ______ the heart

to

The primary function of the capillaries is to…

exchange materials between the blood and tissue cells

central pattern generator→control center for breathing

chemoreceptors→ stimulator +

stretch receptors→ inhibitors -

define respiration

exchange of gas (oxygen or carbon dioxide)

once oxygen comes in:

• where does it go?

• via what vessel?

heart→ artery → body

CO2 goes out:

• where does this come from?

veins

So, what is the difference between respiration and ventilation??

Respiration:

• Gas exchange for oxygenation

• The actual movement of gas across a membrane

• A ventilator cannot do this for you

Ventilation:

• The act of breathing and/or moving air (physical process)

• A ventilator pushes air into the lungs to quite literally ventilate them

Respiration is gas exchange for _______________

oxygenation

Ventilation is the act of ____________ and/or ______________

breathing and/or moving air

the route of ventilation

Mouth and nasal passages → pharynx → vocal folds → trachea → carina → bronchi → bronchioles → alveoli

ventilation is only functional IF what structures are functional?

brainstem, cranial and peripheral nerves, diaphragm, intercostal musculature, and lungs

carried out by the lungs

ventilation vs respiration

ventilation

occurs in alveoli and the walls of blood capillaries

ventilation vs respiration

respiration

ventilation vs respiration

voluntary or involuntary

ventilation: voluntary

respiration: involuntary

Diseases & Conditions Impacting the Respiratory System

1. Chronic Obstructive Pulmonary Disease (COPD)

2. Restrictive lung disorders

3. Neuromuscular diseases and conditions

4. Cardiopulmonary conditions

5. Sepsis

6. Acute respiratory distress syndrome (ARDS)

dyspnea

shortness of breath

Chronic Obstructive Pulmonary Disease (COPD)

Represents a group of diseases due to irreversible destruction of lung tissue

two causes of Chronic Obstructive Pulmonary Disease (COPD)

a) chronic bronchitis

b) emphysema

chronic bronchitis

caused by excessive mucus and narrowing of small airways due to edema

emphysema

caused by deterioration of the alveolar walls

restrictive lung disorders are caused by any of the following:

• respiratory muscle weakness

• paralysis

• reduced elasticity of the lungs and chest wall

_____________________ = elasticity of lungs and chest wall

compliance

2 main contributors to restrictive lung disorders

1. connective tissue disorders

2. pneumonia

connective tissue disorders

affect lung compliance by both loss of lung tissue and fibrotic changes in the lungs (ex: scleroderma, lupus)

pneumonia

acute infection and inflammation in alveoli and capillaries

neuromuscular conditions

• Amyotrophic Lateral Sclerosis (ALS)

• Multiple Sclerosis (MS)

• Muscular Dystrophy (MD)

• Guillain-Barré Syndrome (GBS)

• Stroke

• Poliomyelitis

• Spinal Cord Injury

Amyotrophic Lateral Sclerosis (ALS)

Degenerative disease that causes motor neurons of brain and spinal cord to deteriorate. Respiratory system progressively declines.

Multiple Sclerosis (MS)

Demyelinating disease of the white matter of the central nervous system. Respiratory complications arise due to plaque development in the cervical spinal cord.

Muscular Dystrophy (MD)

Progressive, hereditary disease which impacts striated muscle (such as diaphragm and heart) resulting in respiratory muscle weakness.

Guillain-Barré Syndrome (GBS)

Acute, demyelinating disease that causes rapid deterioration of extremity muscle function. Often impairs respiratory function- requiring rapid intubation/mechanical ventilation.

Brainstem stroke affects the stroke affects the

Cortical stroke…

central control system for respiration

have a peripheral effect on respiration (impacts abdominal and thoracic muscle tone and body posture, and consequently lung expansion)

Poliomyelitis

Viral disease that causes severe muscle weakness with associated respiratory failure requiring mechanical ventilation

Spinal Cord Injury

Injury above 4th vertebrae results in nonfunctional respiratory system from nerve damage to the diaphragm (the primary muscle of inspiration, innervated by phrenic nerve)

Cardiopulmonary Disorders:

• the purpose of the lungs is to accomplish what?

• successful gas exchange depends on adequate what?

• what are interdependent on each other for stable O2 and CO2 levels?

• gas exchange

• circulation of the blood to the alveoli

• heart and lungs

congestive heart failure (CHF)

• Heart cannot pump out a sufficient amount of blood

• Heart contracts less over time, this limits its ability to fill with blood

• Heart cannot keep up with the body’s demand for oxygen rich blood

sepsis

A systemic inflammatory response to an infectious source

Inflammation affects the organ systems and may cause them to go into organ failure. This includes the respiratory system.

Acute Respiratory Distress Syndrome (ARDS)

• Occurs secondary to various acute medical conditions

• Damage to area of oxygen transfer (alveolar-capillary membrane) resulting in severe impairment in gas exchange in the lungs

  • Fluid leaks into alveoli

  • Loss of surfactant (coating of alveoli which keeps them inflated)

  • Collapse of alveoli (atelectasis)

= loss of oxygen in arterial blood

hypoxemia