RESPIRATORY SYSTEM

RESPIRATORY SYSTEM

is the network of organs and tissues that help you breathe. It includes your airways, lungs and blood vessels.

Allows you to talk and to smell.

Warms air to match your body temperature and moisturizes it.

Delivers oxygen to the cells in your body.

Removes waste gases, including carbon dioxide, from the body.

Protects your airways from harmful substances and irritants.

Functions of Respiratory System

SMOKING

is the most significant risk factor for respiratory diseases and older adults have a higher rate of smoking, about 20%, compared to the national average of 18% (Bowler, Hansel, Jacobson, et al., 2017).

respiratory system

composed of the upper and lower respiratory tracts

upper respiratory tract

warms and filters inspired air so that the lower respiratory tract (the lungs) can accomplish gas exchange or diffusion.

Gas exchange

involves delivering oxygen to the tissues through the bloodstream and expelling waste gases, such as carbon dioxide, during expiration

nose; paranasal sinuses; pharynx, tonsils, and adenoids; larynx; and trachea

Upper Respiratory Tract

Mouth and Nose

serves as a passageway for air to pass to and from the lungs.

It filters impurities and humidifies and warms the air as it is inhaled

Paranasal Sinuses

include four pairs of bony cavities that are lined with nasal mucosa and ciliated pseudostratified columnar epithelium.

serve as a resonating chamber in speech. The sinuses are a common site of infection.

frontal, ethmoid, sphenoid, and maxillary

Paranasal Sinuses

pharynx

tubelike structure that connects the nasal and oral cavities to the larynx. It is divided into three regions: nasal, oral, and laryngeal.

tube that delivers air from nose to your trachea

functions as a passageway for the respiratory and digestive tracts.

nasopharynx

is located posterior to the nose and above the soft palate

oropharynx

houses the faucial, or palatine, tonsils

laryngopharynx

extends from the hyoid bone to the cricoid cartilage.

epiglottis

forms the entrance to the larynx.

larynx

voice box, is a cartilaginous epithelium-lined organ that connects the pharynx and the trachea

protects the lower airway from foreign substances and facilitates coughing; it is, therefore, sometimes referred to as the “watchdog of the lungs”

watchdog of the lungs

larynx is called

Epiglottis

: a valve flap of cartilage that covers the opening to the larynx during swallowing

Vocal chords

: ligaments controlled by muscular movements that produce sounds; located in the lumen of the larynx

Thyroid cartilage

: the largest of the cartilage structures; part of it forms the Adam’s apple

Cricoid cartilage

: the only complete cartilaginous ring in the larynx (located below the thyroid cartilage)

trachea

or windpipe, is composed of smooth muscle with C-shaped rings of cartilage at regular intervals.

serves as the passage between the larynx and the right and left main stem bronchi, which enter the lungs through an opening called the hilus.

the lungs

Lower Respiratory Tract

Lungs

are paired elastic structures enclosed in the thoracic cage, which is an airtight chamber with distensible walls

organ that removes oxygen from air and transport it to blood vessels

pleura

lungs and wall of the thoracic cavity are lined with a serous membrane called the

visceral pleura

covers the lungs;

parietal pleura

lines the thoracic cavity, lateral wall of the mediastinum, diaphragm, and inner aspects of the ribs.

Diaphragm

a muscle that helps move the air that you inhale

Ribs

bones that protects your lung and heart

ALVEOLI

gas exchange, where oxygen from inhaled air is transferred into the bloodstream and carbon dioxide, a waste product, is transferred from the blood into the air to be exhaled.

BRONCHIOLES

carry the oxygen into the alveoli

smallest airways

CAPILLARIES

delicate blood vessels that deliver nutrients and oxygen to cells throughout your body.

where unsaturated and saturated blood pass through

Right LUNG (3 lobes), Left LUNG (2 Lobes)

LUNG LOBES

CILIA

short, fine hairs that provide a constant whipping motion that serves to propel mucus and foreign substances away from the lung toward the larynx

protects airways from irritants/microorganisms

Subjective Data

information gathered from a person's perspective, such as their feelings, experiences, opinions, and perceptions, and it cannot be directly measured or verified by others.

A. Cough

B. Sputum Characteristics

C. Dyspnea

D. Chest pain

E. Ask about associated symptoms

F. History

ASSESSMENT OF RESPIRATORY SYSTEM (SUBJECTIVE)

a. how many days

b. is it barking or hoarse cough

c. is it a productive or dry cough

d. how persistent is the cough

Assessment for Cough

color, consistency, volume, presence of blood

Assessment for Sputum Characteristics

dyspnea

subjective experience that describes an uncomfortable or painful breathing sensation when either at rest or while walking or climbing stairs; also commonly referred to as shortness of breath

shortness of breath at times of rest, with or without activity

Assessment for Dyspnea

chest pain during inhalation/expiration

persistent pain/pain scale

chest pain during coughing

location of pain

Assessment for Chest Pain

colds, fever, fatigue

Assessment for associated symptoms

asthma, allergies, past injuries, lifestyle/activities, environment/occupation, medications, travel history, HIV/AIDS, smoking

Assessment for history

I saw it

SIGNS

You tell me

SYMPTOMS

Objective Data

is fact-based, observable information gathered through senses or measurements that is verifiable and remains consistent regardless of personal feelings or opinions.

Inspection

one of the four primary technique in physical assessment

uses the eyes for observation

facial expression, skin color, moisture, and temperature

Visual inspection begins with observation of

a) Skin should be warm and dry, and skin color should be uniform and consistent with ethnicity.

b) Facial expression should be relaxed, without signs of distress or apprehension.

c) Observe nail beds, lips, mouth, ears, and conjunctiva for oxygen saturation.

d) Observe the neck for contraction of the sternomastoid muscles

Visual inspection

Emphysema

PINK PUFFERS

Chronic Bronchitis

BLUE BLOATERS

Palpation

Using the palmar surface of the fingers, palpate the anterior and posterior chest

Vocal fremitus

is a vibration felt on the posterior chest using the ulnar side of the hand.

tenderness, mass, vibration, lumps, pain

palpation is done to assess if there is presence of

Percussion

is helpful to determine the density of the underlying lung tissue and identify the position of the diaphragm during inspiration and expiration.

dullness or resonance in the sound of lung tissue

Percussion is helpful to determine if there is

Auscultation

uses stethoscope, note for breath sounds

Eupnea (12-20/min)

normal breathing

Tachypnea (more than 20/min)

rapid breathing

commonly associated with various conditions, including respiratory issues like asthma, pneumonia, COPD, and pulmonary embolism; cardiac problems such as heart failure;

Bradypnea (less than 12/min)

slow breathing, central nervous system disorders like head injuries and brain tumors, narcotic or heavy alcohol use, hypothyroidism

Apnea (0/min)

absent breathing, commonly associated with sleep apnea, particularly obstructive sleep apnea (OSA)

Hyperpnea (12-20/min)

deep breathing, commonly associated with exercise, high altitude, anemia, and conditions like asthma, chronic obstructive pulmonary disease (COPD), metabolic acidosis, and panic disorder.

Hypopnea (12-20/min)

shallow breathing, commonly associated with obstructive sleep apnea (OSA)

Cheyne Stokes Breathing (variable)

periodic breathing; gradual hyper/hypo and apnea

an abnormal breathing pattern characterized by a cyclical pattern of gradually increasing (crescendo) and then decreasing (decrescendo) breaths, interspersed with temporary pauses in breathing (apnea or hypopnea)

• hypoperfusion of the brain

Biot’s breathing

ataxic respiration

periodic breathing; hyperpnea and apnea

neuron damage

an abnormal breathing pattern characterized by periods of irregular, deep breaths mixed with unpredictable pauses (apnea) of varying duration

Kussmaul’s Breathing

hyperpnea

a pattern of deep, rapid, and labored breathing that signals a medical emergency, occurring when the body attempts to compensate for metabolic acidosis by expelling excess carbon dioxide

K- ketones (diabetic ketoacidosis)

U- uremia

S - sepsis

S - salicylates

M- methanol

A- aldehydes

L- lactic acid/lactic acidosis

KUSSMAULS

eu

good/well

pnea

breath/respiration

Crackles

Rhonchi

wheeze

Stridor

Pleural friction rub

BREATH SOUNDS