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Lp 13 respiratory system 2008

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  • 1. Respiratory SystemVTT 235/245 Anatomy & Pathology Lab
  • 2. Introduction The body’s cells need a constant supply of oxygen to produce energy. Carbon dioxide is a waste product of these energy-producing reactions and must be eliminated.
  • 3. Types of Respiration External- occurs in the lungs and is the exchange of O2 and CO2 between the air in the lungs and the blood flowing through the pulmonary capillaries. Internal- occurs all over the body.  It is the exchange of O2 & CO2 between the blood and the cells & tissues. Both types of respiration are constantly taking place.
  • 4. Secondary Functions **Voice Production- “phonation”  The process begins in the **larynx (voice box).  Vocal cords stretch across the lumen of the larynx and vibrate as air passes over them.
  • 5. Secondary Functions… Body Temperature Regulation-  A network of superficial blood vessels just under the epithelium of the nasal passages helps warm inhaled air before it reaches the lungs.  The respiratory system prevents over- heating by panting.
  • 6. Secondary Functions… Acid-base Balance Regulation-  For normal chemical reactions to occur, the relative acidity or alkalinity of their environment must be controlled carefully.  The unit used to express acidity or alkalinity is pH.  The respiratory system uses its ability to influence the amount of CO2 in the blood.  The more CO2 there is in the blood, the lower the blood pH.
  • 7. StructuresUpper Respiratory System
  • 8. Nose Begins with the nostrils (nares) which lead to the nasal passages. The nasal passages are located between the nostrils and the **pharynx (throat). A midline wall separates the right from the left nasal passage called the nasal septum. The hard & soft palates separate the nasal passages from the mouth.
  • 9. Nose Turbinates-  Thin, scroll-like bones that help warm and humidify inspired air.  They also filter particulate matter, such as dust and pollen, before it can reach the lungs.
  • 10. Nose Paranasal Sinuses-  Contained within the spaces of the maxillary and frontal bones of the skull.
  • 11. Pharynx The nasal passages lead back into the pharynx . It is the common passageway for the respiratory and digestive systems. The soft palate divides the pharynx into the dorsal nasopharynx (respiratory passageway) and the ventral oropharynx (digestive passageway).
  • 12. Pharynx… At the caudal end, the pharynx opens dorsally into the esophagus and ventrally into the larynx. The larynx & pharynx work together to prevent swallowing from interfering with breathing.
  • 13. Larynx “Voice box” A short, irregular tube that connects the pharynx with the trachea. The larynx is supported in place by the hyoid bone.
  • 14. Larynx…Contents… Vocal folds- the most lateral structures, located on the lateral edges of the glottis. Epiglottis- a triangular flap of tissue that covers or protects the glottis when in the “up” position. Glottis- the most ventral opening of the larynx.
  • 15. Larynx…Functions Voice production Keeps foreign material out of the lungs by the trapdoor action of the epiglottis. It controls airflow to the lungs by adjusting the diameter of the glottis.
  • 16. Glottis Closure of the glottis even aids in non- respiratory functions that involve straining such as: urination, defecation, and parturition.  Straining begins with the animal holding the glottis closed while applying pressure to the thorax with the breathing muscles.
  • 17. Glottis… This stabilizes the thorax and allows the abdominal muscles to effectively compress the abdominal organs when they contract. Without the closed glottis, contraction of the abdominal muscles merely forces air out of the lungs.
  • 18. Trachea A short, wide tube that extends from the larynx to the thorax where it divides into the two main bronchi that enter the lungs. This division is called the bifurcation of the trachea and it occurs at the level of the base of the heart.
  • 19. Trachea The trachea is composed of fibrous tissue and smooth muscle held open by hyline cartilage rings. If nothing held the trachea open, it would collapse each time the animal inhaled as a result of the partial vacuum created by the inhalation process. Each tracheal ring is C-shaped with the open part of the C facing dorsally. The gap of each ring is bridged by smooth muscle.
  • 20. StructuresLower Respiratory Tract
  • 21. Lower Respiratory Tract Starts with the bronchi, ends with the alveoli, and includes all the air passages in between. Most of the structures in the lower respiratory tract are located within the lungs.
  • 22. Bronchial Tree The air passages that lead from the bronchi to the alveoli. After it enters the lungs, each main bronchus divides into smaller and smaller bronchi until they become tiny bronchioles.** The smallest air passageways are called alveolar ducts.**
  • 23. Bronchial Tree… The alveolar ducts end in groups of alveolar sacs. The diameter of each bronchi can be adjusted by smooth muscle-  Bronchiodilation  Bronchioconstriction
  • 24. Alveoli External respiration takes place in the alveoli. They are tiny, thin- walled sacs that are surrounded by networks of capillaries. The wall of each alveoli is composed of thin epithelium.
  • 25. Alveoli… The capillary walls are composed of the same thin epithelium. These two thin layers allow oxygen and carbon dioxide to diffuse back and forth.
  • 26. Lungs The base of each lung lies directly on top of the diaphragm. Between each lung is an area called the mediastinum, which contains:  Heart  Large blood vessels  Nerves  Trachea  Esophagus  Lymphatic vessels & lymph nodes
  • 27. Lungs… **The left lung has 2 lobes-  Cranial and Caudal **The right lung has 4 lobes-  Cranial, middle, caudal, & accessory. Each lung has a well-defined area on its medial side called a hilus where blood, lymph, and nerves enter and exit the lung.
  • 28. Lungs… Physically the lungs are very light and have a spongy consistency. If a piece of lung from an animal that has taken one breath was placed under water, it would float.
  • 29. Thorax A thin membrane called pleura lines the thoracic cavity and its organs.  Organs- visceral pleura  Cavity- parietal pleura The diaphragm is the thin sheet of skeletal muscle that forms the caudal boundary of the thorax.
  • 30. Physiology
  • 31. Physiology… The process of respiration requires effective movement of air in and out of the lungs at an appropriate rate and sufficient volume.
  • 32. Negative Intrathoracic Pressure The pressure within the thorax is negative with respect to the atmospheric pressure. A partial vacuum exists within the thorax. That partial vacuum pulls the lungs against the thoracic wall and aids in the return of blood to the heart.
  • 33. Inspiration The basic mechanism for inspiration is enlargement of the thoracic cavity by the inspiratory muscles. The main muscles of inspiration are the diaphragm and the external intercostals.
  • 34. Expiration The main muscles of expiration are the internal intercostals and the abdominal muscles. When abdominal muscles contract, they push abdominal organs into the diaphragm. Expiration does not require as much work because gravity pulls the ribs down helping to decrease the thoracic cavity volume.
  • 35. Respiratory Volumes Tidal Volume- the amount of air inspired and expired in one breath. Minute Volume- the amount of volume inspired and expired in one minute.
  • 36. Gas Exchange Occurs in the alveoli. Gas exchange follows the laws of simple diffusion. Basically, gas molecules from areas of a high concentration like to move to areas of low concentration.
  • 37. Gas Exchange…
  • 38. Control of Breathing Breathing is controlled by an area of the brain stem known as the respiratory center. The body has two main systems that control breathing:  Mechanical system  Chemical system
  • 39. Mechanical Control
  • 40. Mechanical Control…
  • 41. Chemical Control
  • 42. Pathology
  • 43. Sinusitis Usually involves the frontal or maxillary sinus in the dog. It can manifest as a collection of pus in the area, resulting in a swelling over the sinus. It can be a result of the openings of the nasal passages swelling shut or becoming plugged.  This results in the fluid from the sinuses having nowhere to go.
  • 44. Sinusitis… A common cause of this problem is a tooth root abscess.
  • 45. Kennel Cough Infectious Canine Tracheobronchitis Caused by the bacteria Bordatella bronchiseptica. The disease is characterized by a dry, hacking cough that can be stimulated by palpating the throat.
  • 46. Tracheal Collapse This defect involves tracheal rings that lose their ability to remain firm, subsequently collapsing during respiration. ***Obese toy and miniature breeds of dogs are predisposed. The usually narrow space between the ends of several of the C-shaped tracheal rings is wider than normal.
  • 47. Tracheal Collapse… When the animals inhales, the widened area of the smooth muscle gets sucked down into the lumen of the trachea and partially blocks it. This can cause a dry, honking cough and difficulty breathing (dyspnea).
  • 48. Tracheal Collapse… Therapy includes:  Weight loss for obese animals  Exercise restriction  Reduction of excitement & stress  Surgical therapy
  • 49. Feline Asthma p. 255 A disease characterized by spontaneous bronchioconstriction & airway inflammation. Clinical signs include:  Coughing  Wheezing  Labored breathing
  • 50. Feline Asthma… Airway epithelium may hypertrophy, goblet cells and submucosal glands may produce excess mucus, and the bronchial mucosa can become infiltrated with inflammatory cells.
  • 51. Feline Asthma… All these changes result in decreased air flow. A 50% decrease in the lumen of the trachea is possible.
  • 52. Feline Viral Rhinotracheitis A highly contagious disease that is extremely severe in young kittens. Infections occur year-round in both vaccinated and un-vaccinated cats. Transmission occurs through aerosolization (sneezing) and direct contact.  Queens may transmit the disease to their kittens during grooming.
  • 53. Pleural Effusion The build-up of fluid in the pleural space which results in respiratory distress. Right-sided CHF is the principal cause of pleural effusion in both canine & feline patients.
  • 54. Pleural Effusion… As systemic venous hypertension increases, significant amounts of the fluid accumulates in the pleural space, causing respiratory difficulty.
  • 55. Pleural Effusion… All pleural effusions produce symptoms of respiratory distress, dyspnea, cough, & circulatory compromise.
  • 56. Pneumothorax & Lung Collapse p. 258  Pneumothorax: the presence of free air in the pleural space.
  • 57. Pneumothorax & Lung Collapse…  Without negative intrathoracic pressure, normal breathing cannot take place.  If air leaks into the pleural space, that negative pressure is lost.  This results in the lung falling away from the thoracic wall.
  • 58.  The dark black region on the right side of this CT image clearly shows where the lung has separated from the chest wall. Note the difference between the two lungs. One is fully expanded and fills up the chest cavity, the other is shrunken (i.e. collapsed) and only fills up part of the chest cavity.
  • 59. Pneumothorax & Lung Collapse…  The general cause is the air comes either from the outside, as in the case of a penetrating wound, or from the lung itself due to the rupture of the alveoli as a result of lung disease or injury.
  • 60. Pneumothorax & Lung Collapse…  Treatment consists of re-establishing the partial vacuum within the pleural space by:  Sucking out the air with a needle.  Placement of a chest tube.
  • 61. Coughs, Sneezes, Yawns, Sighs, & Hiccups p. 262  All Are temporary interruptions in the normal breathing pattern.  They can be:  Responses to irritation (coughs & sneezes)  Attempts to correct imbalances (yawns & sighs).  Or they may occur for unknown reasons (hiccups).
  • 62. Coughs, Sneezes, Yawns, Sighs, & Hiccups  A cough is a protective reflex that is stimulated by irritation of foreign matter in the trachea or bronchi.  It consists of a sudden, forceful expiration of air.
  • 63. Coughs, Sneezes, Yawns, Sighs, & Hiccups  A sneeze is similar to a cough, but the irritation originates in the nasal passages.  The burst of air is directed through the nose and mouth in an effort to eliminate the irritant.  A yawn is a slow, deep breath taken through a wide-open mouth.  It may be stimulated by a slight decrease in the oxygen level of blood, or it may just be due to boredom, drowsiness, or fatigue.
  • 64. Coughs, Sneezes, Yawns, Sighs, & Hiccups  A sigh is a slightly deeper than normal breath.  It may be a mild corrective action when the blood level of oxygen gets a little low.  It may also serve to expand the lungs more than the normal breathing pattern does.
  • 65. Coughs, Sneezes, Yawns, Sighs, & Hiccups  Hiccups are spasmodic contractions of the diaphragm accompanied by sudden closure of the glottis, causing the characteristic “hiccup” sound.
  • 66. Other Respiratory Pathology Aspiration pneumonia (p. 253)-  An inflammatory condition of the lungs produced by inhalation of foreign material. Reverse Sneeze-  Asthmatic symptoms, usually from post nasal drip.
  • 67. Other Respiratory Pathology…  Emphysema-  The alveoli sacs loose elasticity, remain stretched and full, CO2 bulids up in the blood and can lead to cardiac arrest.
  • 68. Other Respiratory Pathology…  Pulmonary Hypertension-  Left CHF, the left side of the heart can’t pump fast enough,  Pressure rises, no gas exchange can occur.  Pulmonary Edema-  Increase in fluid in the alveoli resulting in compromised gas exchange.
  • 69. Other Respiratory Pathology…  Diaphragmatic Hernia  A break in the diaphragm allows the protrusion of abdominal viscera into the thorax.
  • 70. Parasites of the Respiratory System
  • 71. Aleurostrongylus abstrusus Nematode Feline lung worm Lives in the alveolar ducts Recovered by tracheal wash
  • 72. Capillaria aerophila  Nematode  Often confused with Trichuris (whipworm found in the intestine)  Diagnosed by standard fecal floatation
  • 73. Paragonimus kellicotti Trematode “Lung fluke” of dogs Found in sputum & feces Single operculated
  • 74. Laboratory
  • 75. Pleural FluidCollection & Analysis
  • 76. Collection By thoracocentesis Review in the McCurnin
  • 77. Indications Air or fluid is present in the pleural space causing the lungs to not expand completely Diagnostic and therapeutic
  • 78. Analysis Volume- subjective Color- colorless to straw or yellow Turbidity- transparent to slightly turbid Odor- none Total Nucleated Cell Counts Cytologic Examination Total Protein- refractometer Fibrinogen Concentrations
  • 79. Tracheal FluidCollection & Analysis
  • 80. Collection- Tracheal Wash Orotracheal- directly through an endotracheal tube Nasotracheal-  Via the nasal passages Transtracheal-  Through the skin and trachea  Infuse sterile saline as a wash solution  May collect tracheal, bronchial or bronchioalveolar washes  Collect into RRT and LTT
  • 81. Tracheal Wash Specimens
  • 82. Tracheal Wash Specimens
  • 83. Tracheal Wash Specimens
  • 84. Tracheal Wash Specimens
  • 85. Tracheal Wash Specimens
  • 86. Tracheal Wash Specimens
  • 87. Tracheal Wash Specimens
  • 88. Tracheal WashSpecimens
  • 89. Analysis Record cell numbers during smear evaluation Little mucous-  Decreased cell numbers  Prepare smear from sediment Heavy mucous-  Increased cell numbers  Don’t centrifuge, make an impression smear
  • 90. THE END

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