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Airway consists of the following structures:
nose/mouth, pharynx, larynx, trachea, bronchi
Nasal passages
lined with ciliated cells to filter air, mucus membranes to moisten air, blood capillaries to warm air
What type breathing is preferred?
nasal breathing
Pharynx
region behind nose and mouth, common passage for food and air
What are the 3 sections of the pharynx?
Nasopharynx, Oropharynx, Laryngopharynx
Larynx
voice box below pharynx
What is the largest section in the larynx of the 9 cartilages?
thyroid cartilage (adams apple; suspended from hyoid bone)
What folds down and covers the larynx during swallowing?
epiglottis
Trachea
tube-like passageway for air from larynx to primary bronchi (consists of C-shaped rings of cartilage; located very interior in the neck but central in chest)
Primary (main stem) bronchi/bronchus
splitting of the trachea to allow air to reach both lungs (right & left)
Carina
splitting point of trachea
Secondary bronchi
division of the primary bronchi to allow air to reach the lobes of each lung
How many secondary bronchi are on the right side?
three
How many secondary bronchi are on the left side?
two
Bronchiole
small branches off secondary bronchi for distribution of air throughout each lung
Trachea and bronchi are covered with _____ to create and expel mucus
ciliated columnar epithelial cells
Alveoli
microscopic air sacs
Alveoli purpose:
o2 and CO2 are exchanged with the bloodstream (not radiographically visible)
Foreign bodies are more likely to enter the
right lung
Foreign objects enter the right lung because
right primary bronchus is more vertical and larger in diameter
Apex (apices)
most superior portion of the lungs
Hilum (hila)
slit in the medial aspect of the lungs where bronchi and blood vessels enter and leave the lungs
Base
most inferior portion of lungs that rests against the diaphragm muscle
Costophrenic angle
inferior corners of lung that lie lateral and posterior
Lobes (right)
superior, middle, inferior
Lobes (left)
superior and inferior
Fissures
separations between the lobes of a lung (not normally seen on chest radiographs, overlap front to back)
Upper lobe extends
inferior in front
Lower lobe extends
superior in back
Diaphragm
“dome-shaped” muscle under the lung bases that control breathing
The diaphragm separates what two cavities
thoracic and abdominal
Breathing in the diaphragm occurs from the
“top down”
The diaphragm attaches to ____ at the central tendon
lung bases
The three openings of the diaphragm are
esophagus, aorta, and inferior vena cava
Hemidiaphragm
one half of the diaphragm
The RIGHT hemidiaphragm is more superior than LEFT because of
the liver under the RIGHT hemidiaphragm
Mediastinum
space between lungs
Several important structures reside in the mediastinum such as:
trachea, esophagus, heart, aorta, inferior vena cava, thymus gland
Mediastinum shift
mediastinal structures being pushed or pulled to one side due to pathology
Pleura
double-walled epithelial membrane lining surrounding each lung
What is the purpose of the pleura?
to reduce friction during breathing
Parietal pleura
the outer lining of the lungs
Visceral pleura
the inner lining of the lungs
Bony thorax includes:
ribs (12 pairs), sternum, clavicle, scapula, thoracic vertebra (T1-T12), lower cervical vertebra (C4-C7)
Bony landmarks include:
larynx (C4-C6), thyroid cartilage (C5), apices (T1), trachea (C6-T4/T5)
Respiration
the process of taking air into the lungs (inspiration/inhalation) and exhaling air out of the lungs (expiration/exhalation)
During inspiration the diaphragm moves
down (creates a negative pressure with the outside atmosphere)
During expiration the diaphragm moves
up (creates excessive pressure in the thorax)
Vital capacity
total lung capacity
Tidal volume
average intake of air in normal respiration
Expiratory reserve
the amount of air that can be forced after tidal volume
Residual volume
the amount of air left in the lungs after forceful respiration
Normal breathing =
15 mph
Forced expiration =
100 mph
Sneeze=
600 mph
Alveolar exchange
the process of exchanging o2 and CO2 with bloodstream (based on the diffusion of molecules across the permeable alveolar wall)
Arterial blood
bright red (due to high o2 content)
Venous blood
very dark blood (high CO2 content)
Pulse oximeter
the non-invasive device that measures the % of oxygen saturation in skin
Oxygen saturation should be
95%
Oxygen should NOT fall below
95%
What percent of CO2 actually diffuses out of the blood into the lungs?
12%
Blood pH always needs to be at
~7.4
Hyperventilating will cause excessive CO2 to be
exhaled
Raising the blood pH can lead to
hypocapnia
Hypocapnia
breathing out too much CO2
Hyperventilation can be triggered by
pain
Pneumonia
inflammation of the lungs caused by viral or bacterial infection
Emphysema
long term destruction to the alveolar walls, preventing adequate gas exchange, and leaving air trapped in the lungs
Lung cancer
“mutated” cells that grow rapidly and engulf healthy cells
Asthma
allergic disorder characterized by thickening of the bronchial tree and excessive mucus production
Pneumothorax
“collapsed lung”
Atelectasis
incomplete expansion of the lung due to obstruction or other forces (sponge sticking together)