1. RESPIRATORY SYSTEM
Yunus Elon, MSNYunus Elon, MSN
Faculty of NursingFaculty of Nursing
Universitas Advent IndonesiaUniversitas Advent Indonesia
Hi I am O2
,you can call
me oxygen, and I will be your guide today.
I advise you keep all feet
and hands inside the ride at all times.
08/21/16 YunelDocRespiratory 1
2. Value Integration:
Mazmur 139:14
Aku bersyukur kepada-Mu olehAku bersyukur kepada-Mu oleh
karena kejadianku dahsyat dan ajaib;karena kejadianku dahsyat dan ajaib;
ajaib apa yang Kaubuat, dan jiwakuajaib apa yang Kaubuat, dan jiwaku
benar-benar menyadarinya.benar-benar menyadarinya.
And I praise You because of the
wonderful way You created me.
Everything You do is marvelous!
Of this I have no doubt
(ACEV)
3. Human Respiratory SystemHuman Respiratory System
Functions:Functions:
Works closely with circulatory system,Works closely with circulatory system,
exchanging gases between air and blood:exchanging gases between air and blood:
Takes up oxygen from air and supplies it toTakes up oxygen from air and supplies it to
blood (for cellular respiration).blood (for cellular respiration).
Removal and disposal of carbon dioxideRemoval and disposal of carbon dioxide
from blood (waste product from cellularfrom blood (waste product from cellular
respiration).respiration).
Homeostatic Role:Homeostatic Role:
Regulates blood pH.Regulates blood pH.
Regulates blood oxygen and carbon dioxideRegulates blood oxygen and carbon dioxide
levels.levels.08/21/16 YunelDocRespiratory 3
9. Human Respiratory SystemHuman Respiratory System
1. Nasal cavity:1. Nasal cavity: Air enters nostrils, is filtered by hairs,Air enters nostrils, is filtered by hairs,
warmed, humidified, and sampled for odors as it flowswarmed, humidified, and sampled for odors as it flows
through a maze of spaces.through a maze of spaces.
2. Pharynx (Throat):2. Pharynx (Throat): Intersection where pathway for airIntersection where pathway for air
and food cross. Most of the time, the pathway for air isand food cross. Most of the time, the pathway for air is
open, except when we swallow.open, except when we swallow.
3. Larynx (Voice Box):3. Larynx (Voice Box): Reinforced with cartilage. ContainsReinforced with cartilage. Contains
vocal cordsvocal cords, which allow us to make sounds by, which allow us to make sounds by
voluntarily tensing muscles.voluntarily tensing muscles.
High pitched sounds:High pitched sounds: Vocal cords are tense, vibrateVocal cords are tense, vibrate
fast.fast.
Low pitched sounds:Low pitched sounds: Vocal cords are relaxed,Vocal cords are relaxed,
vibrate slowly.vibrate slowly.
More prominent in males (More prominent in males (Adam’s appleAdam’s apple).).
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12. Human Respiratory SystemHuman Respiratory System
4. Trachea (Windpipe):4. Trachea (Windpipe): Rings of cartilage maintain shapeRings of cartilage maintain shape
of trachea, to prevent it from closing. Forks into twoof trachea, to prevent it from closing. Forks into two
bronchi.bronchi.
5. Bronchi5. Bronchi (Sing. Bronchus):(Sing. Bronchus): Each bronchus leads into aEach bronchus leads into a
lung and branches into smaller and smallerlung and branches into smaller and smaller bronchiolesbronchioles,,
resembling an inverted tree.resembling an inverted tree.
6. Bronchioles:6. Bronchioles: Fine tubes that allow passage of air. MuscleFine tubes that allow passage of air. Muscle
layer constricts bronchioles. Epithelium of bronchioleslayer constricts bronchioles. Epithelium of bronchioles
is covered with cilia and mucus.is covered with cilia and mucus.
Mucus traps dust and other particles.Mucus traps dust and other particles.
Ciliary EscalatorCiliary Escalator: Cilia beat upwards and remove: Cilia beat upwards and remove
trapped particles from lower respiratory airways.trapped particles from lower respiratory airways.
Rate about 1 to 3 cm per hour.Rate about 1 to 3 cm per hour.
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14. Pulmonary Function Tests
Assessed by spirometry.Assessed by spirometry.
Subject breathes into a closed system inSubject breathes into a closed system in
which air is trapped within a bell floatingwhich air is trapped within a bell floating
in Hin H220.0.
The bell moves up when the subjectThe bell moves up when the subject
exhales and down when the subject inhales.exhales and down when the subject inhales.
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15. Spirogram
Tidal volume:Tidal volume:
Amount of air expired with each breath.Amount of air expired with each breath.
Vital capacity:Vital capacity:
The maximum amount of air that can be forcefully exhaled after maximumThe maximum amount of air that can be forcefully exhaled after maximum
inhalation.inhalation.
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16. Table 16.3 Terms Used to Describe Lung Volumes and
Capacities
Term Definition
Lung Volumes The four nonoverlapping components of the total lung
capacity
Tidal volume The volume of gas inspired or expired in an unforced
respiratory cycle
Inspiratory reserve volume The maximum volume of gas that can be inspired during
forced breathing in addition to tidal volume
Expiratory reserve volume The maximum volume of gas that can be expired during
forced breathing in addition to tidal volume
Residual volume The volume of gas remaining in the lungs after a maximum
expiration
Lung Capacities Measurements that are the sum of two or more lung volumes
Total lung capacity The total amount of gas in the lungs after a maximum
inspiration
Vital capacity The maximum amount of gas that can be expired after a
maximum inspiration
Inspiratory capacity The maximum amount of gas that can be inspired after a
normal tidal expiration
Functional residual capacity The amount of gas remaining in the lungs after a normal tidal
expiration08/21/16 YunelDocRespiratory 16
18. Anatomical Dead Space
Not all of the inspired air reached the alveoli.Not all of the inspired air reached the alveoli.
As fresh air is inhaled it is mixed with anatomicalAs fresh air is inhaled it is mixed with anatomical
dead space.dead space.
Conducting zone and alveoli where 0Conducting zone and alveoli where 022
concentration is lower than normal and C0concentration is lower than normal and C022
concentration is higher than normal.concentration is higher than normal.
Alveolar ventilation: f x (TV- DS)Alveolar ventilation: f x (TV- DS)
F = frequency (breaths/min.).F = frequency (breaths/min.).
TV = tidal volume.TV = tidal volume.
DS = dead space.DS = dead space.
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19. Restrictive and Obstructive
Disorders
RestrictiveRestrictive
disorder:disorder:
Vital capacityVital capacity
is reduced.is reduced.
FVC is normal.FVC is normal.
ObstructiveObstructive
disorder:disorder:
VC is normal.VC is normal.
FEVFEV11 isis
reduced.reduced.08/21/16 YunelDocRespiratory 19
21. Breathing Ventilates the LungsBreathing Ventilates the Lungs
Breathing:Breathing: Alternation of inhalation and exhalation.Alternation of inhalation and exhalation.
Supplies our lungs with oxygen rich air, and expels excessSupplies our lungs with oxygen rich air, and expels excess
carbon dioxide.carbon dioxide.
Inhalation:Inhalation: Diaphragm contracts, moving downward andDiaphragm contracts, moving downward and
causing rib cage, chest cavity, and lungs to expand. Aircausing rib cage, chest cavity, and lungs to expand. Air
rushes in, due to decrease in internal lung pressure asrushes in, due to decrease in internal lung pressure as
lungs expand.lungs expand.
Exhalation:Exhalation: Diaphragm relaxes, moving upwards andDiaphragm relaxes, moving upwards and
causing rib cage, chest cavity, and lungs to contract. Aircausing rib cage, chest cavity, and lungs to contract. Air
rushes out, due to the increase in internal lung pressure asrushes out, due to the increase in internal lung pressure as
lungs contract.lungs contract.
Breathing is controlled by centers in the nervous system toBreathing is controlled by centers in the nervous system to
keep up with body’s demands.keep up with body’s demands.
08/21/16 YunelDocRespiratory 21
29. Hemoglobin helps transport COHemoglobin helps transport CO22 and bufferand buffer
bloodblood
Hemoglobin is found in red blood cellsHemoglobin is found in red blood cells
Functions:Functions:
Transports oxygenTransports oxygen
Transport carbon dioxideTransport carbon dioxide
Helps buffer bloodHelps buffer blood
As carbon dioxide is picked up from tissues it is convertedAs carbon dioxide is picked up from tissues it is converted
into carbonic acid:into carbonic acid:
COCO22 + H+ H22O <-----> HO <-----> H22COCO33 <----> H<----> H++
+ HCO+ HCO33
--
CarbonCarbon Carbonic acidCarbonic acid CarbonateCarbonate
ionion
dioxidedioxide
Hemoglobin picks up most HHemoglobin picks up most H ++
ions, so they don’t acidify theions, so they don’t acidify the
blood.blood.
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31. Respiratory Acid-Base Balance
Ventilation normally adjusted to keepVentilation normally adjusted to keep
pace with metabolic rate.pace with metabolic rate.
HH22COCO33 produced converted to COproduced converted to CO22,,
and excreted by the lungs.and excreted by the lungs.
HH220 + C00 + C022 HH22C0C033 HH++
+ HC0+ HC033
--
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32. Respiratory Acidosis
Hypoventilation.Hypoventilation.
Accumulation of COAccumulation of CO22 in the tissues.in the tissues.
pH decreases.pH decreases.
Plasma HCOPlasma HCO33
--
increases.increases.
PPc02c02 increases.increases.
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33. Respiratory Alkalosis
Hyperventilation.Hyperventilation.
Excessive loss of COExcessive loss of CO22..
pH increases.pH increases.
Plasma HCOPlasma HCO33
--
decreases.decreases.
PPc02c02 decreases.decreases.
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37. Diseases of the Respiratory SystemDiseases of the Respiratory System
Respiratory rate: 1Respiratory rate: 16 to 206 to 20 inhalations/minute.inhalations/minute.
In one day, an average human:In one day, an average human:
Breathes 20,000 timesBreathes 20,000 times
Inhales 35 pounds of airInhales 35 pounds of air
Most of us breathe in air that is heavilyMost of us breathe in air that is heavily
contaminated with solid particles, ozone, sulfurcontaminated with solid particles, ozone, sulfur
oxide, carbon monoxide, nitrogen oxides, and manyoxide, carbon monoxide, nitrogen oxides, and many
other damaging chemicals.other damaging chemicals.
Breathing contaminated air can cause a number ofBreathing contaminated air can cause a number of
diseases including asthma, bronchitis, emphysema,diseases including asthma, bronchitis, emphysema,
and lung cancer.and lung cancer.08/21/16 YunelDocRespiratory 37
40. Diseases of the Respiratory SystemDiseases of the Respiratory System
Respiratory rate: 10 to 14 inhalations/minute.Respiratory rate: 10 to 14 inhalations/minute.
In one day, an average human:In one day, an average human:
Breathes 20,000 timesBreathes 20,000 times
Inhales 35 pounds of airInhales 35 pounds of air
Most of us breathe in air that is heavilyMost of us breathe in air that is heavily
contaminated with solid particles, ozone, sulfurcontaminated with solid particles, ozone, sulfur
oxide, carbon monoxide, nitrogen oxides, and manyoxide, carbon monoxide, nitrogen oxides, and many
other damaging chemicals.other damaging chemicals.
Breathing contaminated air can cause a number ofBreathing contaminated air can cause a number of
diseases including asthma, bronchitis, emphysema,diseases including asthma, bronchitis, emphysema,
and lung cancer.and lung cancer.08/21/16 YunelDocRespiratory 40
41. Diseases of the Respiratory SystemDiseases of the Respiratory System
Cigarette smoke is one of the worse air pollutants.Cigarette smoke is one of the worse air pollutants.
Over 1 million people start smoking every year.Over 1 million people start smoking every year.
Kills about 350,000 people every year in U.S.Kills about 350,000 people every year in U.S.
Contains 4000 different chemicals.Contains 4000 different chemicals.
Each cigarette smoked subtracts about 5Each cigarette smoked subtracts about 5
minutes from life expectancy.minutes from life expectancy.
Cigarette smokeCigarette smoke paralyzes ciliaparalyzes cilia in airways,in airways,
preventing them from removing debris andpreventing them from removing debris and
from protecting delicate alveoli.from protecting delicate alveoli.
Frequent coughing is the only way airways canFrequent coughing is the only way airways can
clean themselves.clean themselves.
Cigarette smoke also causes fetal damage, whichCigarette smoke also causes fetal damage, which
can result in miscarriage, premature birth, lowcan result in miscarriage, premature birth, low
birth weight, and poor development.birth weight, and poor development.08/21/16 YunelDocRespiratory 41
42. Diseases of the Respiratory SystemDiseases of the Respiratory System
Asthma:Asthma: Condition in which breathing isCondition in which breathing is
impaired by constriction of bronchi andimpaired by constriction of bronchi and
bronchioles, cough, and thick mucusbronchioles, cough, and thick mucus
secretions. The severity and incidence ofsecretions. The severity and incidence of
asthma has risen dramatically in recent years,asthma has risen dramatically in recent years,
especially in children. May be fatal if notespecially in children. May be fatal if not
treated.treated.
Causes:Causes: Attacks may be precipitated byAttacks may be precipitated by
inhalation of allergens (e.g.: pollen, cats, andinhalation of allergens (e.g.: pollen, cats, and
cockroach proteins), pollutants, infection, orcockroach proteins), pollutants, infection, or
emotional stress.emotional stress.
Treatment:Treatment: Alleviates symptoms (e.g.:Alleviates symptoms (e.g.:
immuno-suppressors, bronchodilators), but isimmuno-suppressors, bronchodilators), but is
not a cure.not a cure.08/21/16 YunelDocRespiratory 42
43. Diseases of the Respiratory SystemDiseases of the Respiratory System
Bronchitis:Bronchitis: Inflammation of the mucousInflammation of the mucous
membranes of the bronchi. May present withmembranes of the bronchi. May present with
cough, fever, chest or back pain, and fatigue.cough, fever, chest or back pain, and fatigue.
Causes:Causes: Associated with smoking, pollution,Associated with smoking, pollution,
and bacterial or viral infections.and bacterial or viral infections.
Pneumonia:Pneumonia: Acute inflammation of the lungs.Acute inflammation of the lungs.
Symptoms include high fever, chills, headache,Symptoms include high fever, chills, headache,
cough, and chest pain.cough, and chest pain.
Causes:Causes: Bacterial, fungal, or viral infections.Bacterial, fungal, or viral infections.
Treatment:Treatment: Antibiotics or other antimicrobials.Antibiotics or other antimicrobials.
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44. Diseases of the Respiratory SystemDiseases of the Respiratory System
Emphysema:Emphysema: Permanent and irreversiblePermanent and irreversible
destruction of alveolar walls, resulting in loss ofdestruction of alveolar walls, resulting in loss of
lung elasticity and gas exchange surface.lung elasticity and gas exchange surface.
Symptoms include shortness of breath,Symptoms include shortness of breath,
difficulty exhaling, cough, weakness, anxiety,difficulty exhaling, cough, weakness, anxiety,
confusion, heart failure, lung edema (swelling),confusion, heart failure, lung edema (swelling),
and respiratory failure.and respiratory failure.
Causes:Causes: SmokingSmoking, pollution, old age, and, pollution, old age, and
infections.infections.
Treatment:Treatment: Oxygen to help breathing. NoOxygen to help breathing. No
cure.cure.
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45. Diseases of the Respiratory SystemDiseases of the Respiratory System
Lung Cancer:Lung Cancer: Cancerous growth that invadesCancerous growth that invades
and destroys lung tissue. Very high fatalityand destroys lung tissue. Very high fatality
rate.rate.
Symptoms include bloody sputum, persistentSymptoms include bloody sputum, persistent
cough, difficulty breathing, chest pain, andcough, difficulty breathing, chest pain, and
repeated attacks of bronchitis or pneumonia.repeated attacks of bronchitis or pneumonia.
Causes:Causes: SmokingSmoking (50% of all cases) and(50% of all cases) and
pollution (radon, asbestos). Smokers are 10pollution (radon, asbestos). Smokers are 10
times more likely to develop lung cancer thantimes more likely to develop lung cancer than
nonsmokers.nonsmokers.
Treatment:Treatment: Surgery is most effective, but onlySurgery is most effective, but only
50% of all lung cancers are operable by time of50% of all lung cancers are operable by time of
detection. Other treatments include radiationdetection. Other treatments include radiation
and chemotherapy.and chemotherapy.08/21/16 YunelDocRespiratory 45
50. References
Porth, C. M., (2011). Essential of Pathofisiology. 3Porth, C. M., (2011). Essential of Pathofisiology. 3rdrd
Edition.Edition. Lippincott Williams & Wilkins
Saladin, K. S., (2008). Human Anatomy. 2nd
Edition.
New York McGraw-Hill Companies.
Osborn, K. S., Wraa, C. E., Watson, A. B., and
Holleran, R., (2014). Medical Surgical Nursing.
Preparation For Practice. 2nd
edition., Pearson
Education, Inc: NewJersey
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