RESPIRATORY SYSTEM &
PATHOPHYSIOLOGY
JANET J. NELSON RN,CMA
OBJECTIVES
o 1. Identify and label structures of respiratory
system.
o Describe functions of respiratory organs
o Explain ...
Do you know??
o What is snoring?
o Why do we yawn?
o What is a hiccup?
o Can you breath and swallow at
the same time?
Respiratory Structures
Nasal cavity
Nose shapes and sizes
o Provides airway
o Moistens and warms
air
o Filters air
o Resonating chamber
for speech
o Olfactory...
Palate & Uvula
Paranasal Sinuses
Pharynx
Notice:
Pharyngeal tonsils
Palatine tonsils
Nasopharynx
Oropharynx
Laryngopharynx
and
Epiglottis
Tonsils
#1 Pharyngeal Tonsil #3 Lingual Tonsil
#2 Palatine tonsil #4 Epiglottis
Larynx & Epiglottis
VIDEO http://www.bing.com/videos/search?
q=epiglottis+video&mid=DE5E1D1F3ADC1D
A51116DE5E1D1F3ADC1DA51...
Vocal Folds
o Glottis is the space between the vocal cords
o Laryngeal muscles control length and size of
opening by movin...
Glottis
Animation of cough
o http://www.pennmedicine.org/encyclopedia/e
=000039&ptid=17
Trachea
C-Shaped rings and esophagus
Bronchi & Bronchioles
Primary Bronchus
Secondary Bronchus
Tertiary Bronchus
Bronchiole
Alveoli
Notice:capillaries,smooth muscle and
elastic fibers
Hilum
Mediastinum
Lungs
o How many lobes
on the right?
o How many lobes
on the left?
o Why the
differences?
o What is the
cardiac notch?
Pleura
PNEUMOTHORAX HEMOTHORAX
Animation of breathing
o http://www.pennmedicine.org/encyclopedia/e
=000018&ptid=17
Notice:
**Diaphragm
moves down
and ribs move
out with
inspiration
**Expiration is
passive with
diaphragm &
intercostal
mus...
HYPERPNEA
Nerve Control
o Medulla
Oblongata
o Pons
o Phrenic Nerve
o Intercostal
Nerves
Lung Capacity
o Tidal Volume
o Inspiratory Reserve Volume
o Expiratory Reserve Volume
o Vital Capacity
o VC=TV+IRV+ERV
o F...
Dissection 26 min
http://videos.med.wisc.edu/videos/1253
Format for Pathophysiology
1. BRIEF DESCRIPTION
2. ETIOLOGY
3. SYMPTOMS AND SIGNS (S&S)
4. DIAGNOSIS (DX)
5. PREVENTION AN...
Types of Respirations
* Eupnea * Hypoxia
* Apnea * Suffocation
* Dyspnea * Asphyxia
* Hyperpnea * Cheyne Stokes
* Orthopne...
General Manifestations
of Respiratory Disease
Sneezing:
Coughing:
Sputum: Yellowish-green, cloudy - bacterial
Rusty or dar...
General Manifestations cont.
Breathing patterns may be altered in
respiratory diseases. Normal 12-20/min
Kussmauls respira...
Lung sounds
The R.A.L.E. Repository
Green box on left---repository—normal—rales--wheeze
Tobacco Related Diseases
Destruction of respiratory cilia
Addictive
Carcinogenic (Lung and oral cancer)
Emphysema
COPD
MI
...
Health Effects of Smoking
More than 4,000 individual compounds have been
identified in tobacco and tobacco smoke. Among
th...
Health Effects of Smoking
About half of all Americans who continue to
smoke will die because of the habit. Each
year, abou...
Health Effects of Smoking
Cigarette smoking accounts for at least 30% of all
cancer deaths. It is a major cause of cancers...
Other risks of smoking
Higher incidence of SIDS & mothers
that smoke
Children's asthma attacks and severity
are worsened i...
COPD
Chronic Obstructive Pulmonary Disease is a group of
common chronic respiratory disorders that are
characterized by pr...
EMPHYSEMA
A serious, chronic lung condition where the
alveoli enlarge, losing elasticity and
capillaries around alveoli ar...
Emphysema cont.
S&S: Onset is insidious…dyspnea,
hyperventilation, barrel chest, pursed lips with
exhalation, anorexia wit...
Barrel Chest
Permanently inflated
Alveoli
DISTENTED ALVEOLI IN EMPHYSEMA.
NOTICE THE CO2 TRAPPED IN THE
ALVEOLI EVEN AFTER DEATH
CHRONIC BRONCHITIS
The mucosa of the LR tract become severely
inflamed and produce excessive mucous.
Impaired ventilation ...
Chronic Bronchitis
cont.
DX: History, chest X-ray, PFT
and bronchoscopy.
View:MedlinePlus Interactive Tutorials:
Bronchosc...
Voluminous sero-mucinous secretion in the trachea in a
patient with chronic bronchitis.
ASTHMA
Chronic condition of increased reactivity of the
tracheobronchial tree.
Two types: Extrinsic-involves acute episode...
Asthma cont.
S&S: cough, dyspnea, wheezing, possible
sternal retractions, thick and tenacious mucous,
tachycardia, hypoxia...
Google Image Result for
http://kidshealth.org/broadcast
/article_images/article43940/1
115822895616.button_asthma
-movie.g...
LUNG CANCER
Lung cancer is common site of both primary and
secondary lung cancer.
Primary lung cancer is 90% HO smoking. L...
Cancer cont.
S&S: Insidious, because “smokers cough” masks
S&S. Early: persistent productive cough,
hemoptysis, dyspnea, +...
Left lung cancer
The lymphatic and circulatory system can deliver
cancer cells to the lung = secondary cancer
PULMONARY TUBERCULOSIS
An infectious and inflammatory disease of the lungs,
acquired by inhaling droplets containing bacte...
TB Cont.
DX: Mantoux test, Chest X-ray, (walled off lesions
are identified), positive sputum culture.
TX: Drug therapy wit...
Typical X-ray of TB After treatment
Respiratory Syncytical Virus
This viral, infective condition is most common in
young & elderly. RSV is one of the most
imp...
RSV Cont.
S&S: Cold-like symptoms with nasal congestion,
otitis media, cough and URI. As the virus
progresses downward to ...
CYSTIC FIBROSIS
CF is a chronic dysfunction of the exocrine
glands affecting multiple body systems; it
is the most common ...
Each of us inherits two CFTR genes, one from each parent.
Children who inherit an abnormal CFTR gene from each parent will...
CF CONT.
S&S:May be apparent soon after birth or develop
in childhood.Primarily attacks the lungs and
digestive tract with...
CF Cont.
TX: CF is considered a fatal disease. However,
with early diagnosis and treatment, the life
expectancy has improv...
URI
Include: coryza, sinusitis, laryngotracheo-
bronchitis, epiglottitis, & influenza.
Viral etiology for cold, croup and ...
URI cont.
S&S: Colds are usually 7 days in duration while
the flu is sudden with fever, fatique lasting for
weeks. Croup-b...
LRI
Include: bronchiolitis (RSV), acute bronchitis,
& pneumonia.
Etiology: Acute bronchitis may be bacterial
secondary inf...
LRI cont.
S&S: Acute bronchitis is often preceded by URI.
Cough is initially dry and nonproductive and then
changes to vis...
Pneumonia fills the lung's alveoli with fluid, keeping oxygen
from reaching the bloodstream. The alveolus on the left is
n...
Pneumonia as seen on chest x-ray. A: Normal chest x-ray. B:
Abnormal chest x-ray with shadowing from pneumonia in the righ...
REVIEW
http://msjensen.cehd.umn.edu/webanat
omy/timed/default.asp
Respiratory #1
Upper Respiratory #1
Bronchial Tree #2
Re...
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
Respiratory &  pathophysiology
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  • DRINKING STRAW ACTIVITY
  • Respiratory & pathophysiology

    1. 1. RESPIRATORY SYSTEM & PATHOPHYSIOLOGY JANET J. NELSON RN,CMA
    2. 2. OBJECTIVES o 1. Identify and label structures of respiratory system. o Describe functions of respiratory organs o Explain physiology of respirations o Define four respiratory events o Define respiratory capacity terms o Distinguish between respiratory disorders
    3. 3. Do you know?? o What is snoring? o Why do we yawn? o What is a hiccup? o Can you breath and swallow at the same time?
    4. 4. Respiratory Structures
    5. 5. Nasal cavity
    6. 6. Nose shapes and sizes o Provides airway o Moistens and warms air o Filters air o Resonating chamber for speech o Olfactory receptors
    7. 7. Palate & Uvula
    8. 8. Paranasal Sinuses
    9. 9. Pharynx Notice: Pharyngeal tonsils Palatine tonsils Nasopharynx Oropharynx Laryngopharynx and Epiglottis
    10. 10. Tonsils #1 Pharyngeal Tonsil #3 Lingual Tonsil #2 Palatine tonsil #4 Epiglottis
    11. 11. Larynx & Epiglottis VIDEO http://www.bing.com/videos/search? q=epiglottis+video&mid=DE5E1D1F3ADC1D A51116DE5E1D1F3ADC1DA51116&view=det ail&FORM=VIRE8
    12. 12. Vocal Folds o Glottis is the space between the vocal cords o Laryngeal muscles control length and size of opening by moving cartilages o Sound is produced by the vibration of vocal cords as air is exhaled
    13. 13. Glottis
    14. 14. Animation of cough o http://www.pennmedicine.org/encyclopedia/e =000039&ptid=17
    15. 15. Trachea
    16. 16. C-Shaped rings and esophagus
    17. 17. Bronchi & Bronchioles Primary Bronchus Secondary Bronchus Tertiary Bronchus Bronchiole
    18. 18. Alveoli
    19. 19. Notice:capillaries,smooth muscle and elastic fibers
    20. 20. Hilum
    21. 21. Mediastinum
    22. 22. Lungs o How many lobes on the right? o How many lobes on the left? o Why the differences? o What is the cardiac notch?
    23. 23. Pleura
    24. 24. PNEUMOTHORAX HEMOTHORAX
    25. 25. Animation of breathing o http://www.pennmedicine.org/encyclopedia/e =000018&ptid=17
    26. 26. Notice: **Diaphragm moves down and ribs move out with inspiration **Expiration is passive with diaphragm & intercostal muscles relaxing
    27. 27. HYPERPNEA
    28. 28. Nerve Control o Medulla Oblongata o Pons o Phrenic Nerve o Intercostal Nerves
    29. 29. Lung Capacity o Tidal Volume o Inspiratory Reserve Volume o Expiratory Reserve Volume o Vital Capacity o VC=TV+IRV+ERV o Forced Vital Capacity o Residual Volume
    30. 30. Dissection 26 min http://videos.med.wisc.edu/videos/1253
    31. 31. Format for Pathophysiology 1. BRIEF DESCRIPTION 2. ETIOLOGY 3. SYMPTOMS AND SIGNS (S&S) 4. DIAGNOSIS (DX) 5. PREVENTION AND TREATMENT (TX) 6. PROGNOSIS (PX)
    32. 32. Types of Respirations * Eupnea * Hypoxia * Apnea * Suffocation * Dyspnea * Asphyxia * Hyperpnea * Cheyne Stokes * Orthopnea * Cyanosis * Tachypnea * Anoxia
    33. 33. General Manifestations of Respiratory Disease Sneezing: Coughing: Sputum: Yellowish-green, cloudy - bacterial Rusty or dark-colored – pneumococcal pneumonia Large amounts purulent with foul odor – bronchiectasis Thick, tenacious mucous - asthma or cystic fibosis Blood tinged – chronic cough, tumor or TB Hemoptysis with frothy sputum – pulmonary edema
    34. 34. General Manifestations cont. Breathing patterns may be altered in respiratory diseases. Normal 12-20/min Kussmauls respirations: Wheezing: Stridor: Breath sounds: Rales, Rhonchi, Absence of breath sounds
    35. 35. Lung sounds The R.A.L.E. Repository Green box on left---repository—normal—rales--wheeze
    36. 36. Tobacco Related Diseases Destruction of respiratory cilia Addictive Carcinogenic (Lung and oral cancer) Emphysema COPD MI Cardiac arrhythmias CVA Peripheral Artery Disease Duodenal and gastric ulcers “Crows feet” Low birth weigh infants for a smoking mom
    37. 37. Health Effects of Smoking More than 4,000 individual compounds have been identified in tobacco and tobacco smoke. Among these are more than 60 compounds that are known carcinogens (cancer-causing agents). There are hundreds of substances added by manufacturers to cigarettes to enhance the flavor or to make the smoking experience more pleasant. Some of the compounds found in tobacco smoke include ammonia, tar, and carbon monoxide. Exactly what effects these substances have on the cigarette consumer’s health is unknown.
    38. 38. Health Effects of Smoking About half of all Americans who continue to smoke will die because of the habit. Each year, about 438,000 people die in the US from tobacco use. Nearly 1 of every 5 deaths is related to smoking. Cigarettes kill more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined.
    39. 39. Health Effects of Smoking Cigarette smoking accounts for at least 30% of all cancer deaths. It is a major cause of cancers of the lung, larynx (voice box), oral cavity, pharynx (throat), and esophagus, and is a contributing cause in the development of cancers of the bladder, pancreas, cervix, kidney, stomach, and some leukemias. About 87% of lung cancer deaths are caused by smoking. Lung cancer is the leading cause of cancer death among both men and women, and is one of the most difficult cancers to treat. Fortunately, lung cancer is largely a preventable disease.
    40. 40. Other risks of smoking Higher incidence of SIDS & mothers that smoke Children's asthma attacks and severity are worsened in home with smoker. Increase risk for hypertension Leukoplakia Gum recession Stained teeth and halitosis
    41. 41. COPD Chronic Obstructive Pulmonary Disease is a group of common chronic respiratory disorders that are characterized by progressive tissue degeneration and obstruction in the airways of the lung. These disorders are emphysema, chronic bronchitis and asthma. Fifth leading cause of death and disability in the U.S. Features in common: HO smoking Dyspnea with progression in severity Cough with frequent pulmonary infections Hypoxia with retained Carbon dioxide
    42. 42. EMPHYSEMA A serious, chronic lung condition where the alveoli enlarge, losing elasticity and capillaries around alveoli are destroyed. (Permanently inflated alveolar air spaces). Patient loses the ability to exhale CO2 and must use incredible amount of energy to exhale. Etiology: cigarette smoking, environment pollutants, genetics.
    43. 43. Emphysema cont. S&S: Onset is insidious…dyspnea, hyperventilation, barrel chest, pursed lips with exhalation, anorexia with weight loss. DX: Chest X-ray, PFT. TX: Avoid irritants, stop smoking, pulmonary rehab programs, bronchodilators, O2, antibiotics with infection, maintain nutrition. PX: Some reversal of airway obstruction with S&S improvement can be obtained initially, but long term the prognosis is less favorable.
    44. 44. Barrel Chest Permanently inflated Alveoli
    45. 45. DISTENTED ALVEOLI IN EMPHYSEMA. NOTICE THE CO2 TRAPPED IN THE ALVEOLI EVEN AFTER DEATH
    46. 46. CHRONIC BRONCHITIS The mucosa of the LR tract become severely inflamed and produce excessive mucous. Impaired ventilation is the result, with increase risk of pneumonia. (Remember smokers are missing cilia). Etiology: HO cigarette smoking or living in urban industrial area. S&S: constant cough, tachypnea, SOB, thick & purulent sputum, rhonchi & cough worse in a.m., cyanosis, weight loss and signs of cor pulmonale.
    47. 47. Chronic Bronchitis cont. DX: History, chest X-ray, PFT and bronchoscopy. View:MedlinePlus Interactive Tutorials: Bronchoscopy TX: Reducing exposure to irritants, prompt treatment of infection, Use of expectorants, bronchodilators and low flow O2. PX: Guarded; although consistent treatment can slow the progression.
    48. 48. Voluminous sero-mucinous secretion in the trachea in a patient with chronic bronchitis.
    49. 49. ASTHMA Chronic condition of increased reactivity of the tracheobronchial tree. Two types: Extrinsic-involves acute episodes triggered by a hypersensitivitiy reaction to an inhaled allergen. Intrinsic, with an adult onset, is a response to other stimuli, e.g. cold, exercise, stress, irritants like smoke. Genetics plays a part in etiology. Characterized by episodes of reversible airway obstruction, due to, bronchoconstriction, mucous production and mucosa edema.
    50. 50. Asthma cont. S&S: cough, dyspnea, wheezing, possible sternal retractions, thick and tenacious mucous, tachycardia, hypoxia. DX: The best tool is a PFT during attack, then chest X-ray shows hyperinflation, allergy test, and a CBC with elevated eosinophils. TX: Minimize attacks, use of bronchiodilators. PX: Acute episodes can be life threatening. Status astmaticus: is a persistent severe attack of asthma that does not respond to therapy. It may be fatal.
    51. 51. Google Image Result for http://kidshealth.org/broadcast /article_images/article43940/1 115822895616.button_asthma -movie.gif
    52. 52. LUNG CANCER Lung cancer is common site of both primary and secondary lung cancer. Primary lung cancer is 90% HO smoking. Low cure rate-less than 7% survive over 5 years. Secondary: Metastasis develop as cancer cells travel in blood and lymph from heart to first small vessels in the the lungs. Etiology: Smoking (cilia missing and not able to remove the carcinogens caught in mucous), occupational exposure of chemicals e.g silica, asbestos.
    53. 53. Cancer cont. S&S: Insidious, because “smokers cough” masks S&S. Early: persistent productive cough, hemoptysis, dyspnea, + Chest X-ray. Chest pain as the pleura and/or mediastinum involved. DX: Chest X-ray, bronchoscopy with biopsy. TX: Complete resection of the diseased lung, but with rapid metastasis, often not a choice. Radiation and chemotherapy but many tumors are not responsive. PX: Continues to be poor, unless tumor is in very early stages of development.
    54. 54. Left lung cancer
    55. 55. The lymphatic and circulatory system can deliver cancer cells to the lung = secondary cancer
    56. 56. PULMONARY TUBERCULOSIS An infectious and inflammatory disease of the lungs, acquired by inhaling droplets containing bacteria. Etiology: Mycobacterium tuberculosis is causative agent. The primary lesion is usually in lung with bacteria surviving in dried form for months. . The infection begins with a primary lesion which causes necrosis, fibrosis and calcification. The infection than goes dormant for possible years. S&S: Vague with anorexia, malaise, fatique, weight loss. Later- low grade fever, night sweats,hemoptysis, chest pain and weakness.
    57. 57. TB Cont. DX: Mantoux test, Chest X-ray, (walled off lesions are identified), positive sputum culture. TX: Drug therapy with multiple antituberculosis agents. Contacts of patient must receive prophylactic treatment for one year and receive TB testing. TB is considered infectious; therefore good handwashing and respiratory precautions must be practiced. Place patient in isolation with HCW using N-95or HEPA respirator mask & room air is vented for UV ray exposure. PX: Early and complete treatment offers an excellent prognosis. Other organs can be involved without adequate treatment.
    58. 58. Typical X-ray of TB After treatment
    59. 59. Respiratory Syncytical Virus This viral, infective condition is most common in young & elderly. RSV is one of the most important causes of lower respiratory tract illness and can be fatal. Etiology: RSV is the causative agent. The greatest occurrence is during the winter months. Premature infants are at greatest risks. Most people have experienced several RSV infections in their life. Most are self limiting. RSV is spread by contact with infective secretions.
    60. 60. RSV Cont. S&S: Cold-like symptoms with nasal congestion, otitis media, cough and URI. As the virus progresses downward to the lower respiratory tract, the patient experiences fever, malaise, lethargy, cough and dyspnea. DX: The clinical picture and thorough PE are key. If necessary a nasal lavage with viral culture can be ordered. TX: Palliative. Hospitalization may be necessary to ensure adequate respiration.
    61. 61. CYSTIC FIBROSIS CF is a chronic dysfunction of the exocrine glands affecting multiple body systems; it is the most common fatal genetic disease. Etiology: It is an inherited disorder and is transmitted as an autosomal recessive trait.
    62. 62. Each of us inherits two CFTR genes, one from each parent. Children who inherit an abnormal CFTR gene from each parent will have CF. •Children who inherit an abnormal CFTR gene from one parent and a normal CFTR gene from the other parent will not have CF. They will be CF carriers.
    63. 63. CF CONT. S&S:May be apparent soon after birth or develop in childhood.Primarily attacks the lungs and digestive tract with production of copious thick and sticky mucous that accumulates and blocks glandular ducts. Meconium ileus Salty sweat (Mom notices with kiss, positive sweat test) Signs of malabsorption (steatorrhea,& abd.distention) Chronic cough and respiratory infections Failure to meet normal growth milestones DX: Sweat test, check stools for fat content and trypsin (pancreatic enzyme) PFT, Chest X-ray, ABG.
    64. 64. CF Cont. TX: CF is considered a fatal disease. However, with early diagnosis and treatment, the life expectancy has improved greatly during the past few decades. High calorie, high NaCl diet, postural drainage, pancreatic enzyme supplementation, O2 prn. Lung transplants are a last resort.
    65. 65. URI Include: coryza, sinusitis, laryngotracheo- bronchitis, epiglottitis, & influenza. Viral etiology for cold, croup and influenza. Bacterial for sinusitis and epiglottitis. Secondary bacterial infection may follow viral. S&S: Cold and flu-red, swollen mucous membranes of nose & pharynx with increase secretions, rhinorrhea, maybe sore throat and fever. The infection advancing to larynx causes hoarseness and cough (bronchi).
    66. 66. URI cont. S&S: Colds are usually 7 days in duration while the flu is sudden with fever, fatique lasting for weeks. Croup-barking cough,(due to edema and mucous with possible obstruction) with hoarse voice and inspiratory stridor. Epiglottitis-”red ball obstruction”, severe sore throat, refuse to swallow, anxious breathing and inspiratory stridor. DX: History and exam. TX: Viral-palliative, Prevention of influenza with immunization. Bacterial-antibiotics, supportive care. PX: Good with treatment. Secondary infections common.
    67. 67. LRI Include: bronchiolitis (RSV), acute bronchitis, & pneumonia. Etiology: Acute bronchitis may be bacterial secondary infection following URI, or result of irritative inhalants. Pneumonia may be primary or secondary, bacterial or viral. May follow aspiration when fluids pool or cilia are reduced. Classifications of pneumonia: The causative agent Anatomic location Pathophysiologic changes.
    68. 68. LRI cont. S&S: Acute bronchitis is often preceded by URI. Cough is initially dry and nonproductive and then changes to viscid and later abundant and mucoid or mucopurulent. Pneumonia S&S vary: cough, fever, SOB while at rest, chills, chest pain, cyanosis and hemoptysis. DX: History, exam, chest X-ray, sputum C&S. TX: antibiotics, expectorants, broncholdilators. PX” Bronchitis can lead to pneumonia. Pneumonia can range from mild to life threatening, being the 5th leading cause of death in the US.
    69. 69. Pneumonia fills the lung's alveoli with fluid, keeping oxygen from reaching the bloodstream. The alveolus on the left is normal, while the alveolus on the right is full of fluid from pneumonia.
    70. 70. Pneumonia as seen on chest x-ray. A: Normal chest x-ray. B: Abnormal chest x-ray with shadowing from pneumonia in the right lung (left side of image).
    71. 71. REVIEW http://msjensen.cehd.umn.edu/webanat omy/timed/default.asp Respiratory #1 Upper Respiratory #1 Bronchial Tree #2 Respiratory Review Sheet The Incredible Journey
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