Breathing, or respiration, involves inspiration and expiration of air through the nose or mouth. During inspiration, muscles contract to expand the chest cavity and draw air into the lungs. Expiration occurs when these muscles relax and the chest cavity decreases in size, pushing air out of the lungs. Various structures like the nose, mouth, larynx, pharynx, lungs and diaphragm are involved. Factors like activity level, age, smoking, emotions, pain and illness can influence breathing rate and depth. Oxygen therapy provides supplemental oxygen through masks, cannulas or tents to treat low blood oxygen levels.

1. BREATHING

2. Definition
The process of respiration during which air is
inhaled into the lungs through the mouth or
nose due to muscle contraction and then
exhaled due to muscle relaxation
It is divided into two distinct phases,
inspiration(inhalation) and
expiration(exhalation)

3. Structures involved
 Nose
 Mouth
 Larynx
 Pharynx
 Lungs
 diaphragm

4. Mechanism of breathing
it involves two processes
 Inspiration
 expiration

5. Inspiration
In this process there would be a contraction of
muscles attached to the ribs on the outer side
which pulls out the ribs and results in the
expansion of the chest cavity. Later, the
diaphragm contracts, moves downwards and
expands the chest cavity resulting in the
contraction of the abdominal muscles. The
expansion of the chest cavity produces a partial
vacuum which sucks air into the lungs and fills
the expanded alveoli.

6. Mechanism of inspiration
 When the volume of the thoracic cavity increases and
the air pressure decreases, inspiration takes place
 Contraction of the external intercostal muscles
increases the volume of the thoracic cavity
 Contraction of the diaphragm further increases the size
of the thoracic activity. Simultaneously, the lungs
expand
 With the expansion of the lungs, the air pressure inside
the lungs decreases
 The pressure equalizes and the atmospheric air rushes
inside the lungs

7. Expiration
It is considered once after the gaseous exchange
occurs in the lungs and the air is expelled out.
This expulsion of air is called expiration. During
this process, muscles attached to the ribs
contract, the muscles of the diaphragm and the
abdomen relax which leads to a decrease in the
volume of the chest cavity and increases the
pressure of the lungs, causing the air in the
lungs to be rushed out through the nose.

8. Mechanism of expiration
 It occurs when the size of the thoracic cavity
decreases and the air pressure outside increases
 Now the external intercostal muscles relax and
the internal intercostal muscles contract
 As a result, the ribs are pulled inward and the size
of the thoracic cavity is reduced
 The diaphragm is relaxed and the lungs get
compressed
 Consequently, the pressure increases and the air
is forced out.

9. Factors that influence breathing
 Physical activities
 Age
 Smoking habits
 Emotions
 Rest
 Pain
 Anxiety
 Illness

10. Normal respiration values
 Adults- 10bm to 22bm
 Children- 20bm to 26bm
 Infants- 30bm to 40bm

11. Types of breathing
 Thoracic breathing
Shallow breathing or chest breathing which is
the drawing of minimal breath into the lungs,
usually by drawing air into the chest area using
the intercostal muscles rather than throughout
the lungs via the diaphragm. This is the manner
in which females breathe

12. Cont…
 Abdominal breathing
Diaphragmatic breathing or deep breathing, is
breathing that is done by contracting the
diaphragm, a muscle located horizontally
between thoracic cavity and abdominal cavity.
Air enters the lungs, the chest does not rise and
the belly expands during this type of breathing.
It is usually seen in children and males

13. Deviations from normal breathing
• Abnormal rate (increased or decreased)
Increased rate (tachypnoea)
a) Tuberculosis and pneumonia
b) Thoracic and abdominal pain
c) Severe haemorrhage and anaemia
d) Obstruction of the air passage
Decreased rate (Bradypnoea)
a) Increased intracranial pressure
b) Depressed respiration
c) Exposure to cold

14. Cont…
 Abnormal depth (deep or shallow)
Deep breathing (hyperpnoea)
a) Respiratory stimulants e.g. inhalation of CO2
b) Coma due to alcoholism, uraemia and head injuries,
brain diseases
c) Severe blood loss with oxygen deficiency and acidosis
Shallow breathing
a) Pain in the chest, e.g. in pleurisy
b) Suppression of the respiratory centre in shock and
collapse
c) Severe abdominal pain as a result of peritonitis

15. Breathing sounds
Bubbly sound
Snoring
Gasping sound
Whistle sound

16. Cont…
 Shortness of breath (air hunger) on exertion
(this is an indication either of reduced vital capacity or oxygen
carrying capacity of the blood)
Causes
1. Diseases of the lungs e.g. pneumonia, tb, chronic
bronchitis and pneumoconiosis
2. Diseases of the heart, e.g. left-sided cardiac failure with
pulmonary oedema and congestive cardiac failure
3. Paresis of respiratory muscles
4. Pleural effusion and pneumothorax
5. Anaemia and low oxygen tension of the air at high
altitudes

17. Cont…
 Dyspnoea (difficult breathing which takes place
with effort)
Causes
a) obstruction of the airways in asthma and
chronic bronchitis
b) Reduced compliance of the lungs in pulmonary
oedema
c) Mechanical interference with the lungs, e.g. in
pneumothorax and pleural effusion
d) Pain due to pleurisy

18. Rules to consider while taking
respiration
 Ensure comfort
 Do not inform the patient about taking
respiration
 Observe the (rate, depth and rhythm)

19. Common respiratory problems
 Cough
 Chronic cough
 Dyspnoea
 Haemoptysis
 Cyanosis
 Acute respiratory failure
Read from GEYER et al. (2016: 314-322)

20. OXYGEN THERAPY
Also known as supplemental oxygen, is the use
of oxygen as the medical treatment. This can
include for low blood oxygen, carbon monoxide
toxicity, cluster head aches and to maintain
enough oxygen while inhaled anasthetics are
given.

21. Sources of oxygen
 Atmosphere
 Tiny sea plants (phytoplankton)

22. Functions in the body
 Oxygen is used in breakdown of food to supply
cells with energy (oxidation)
 Helps in metabolism

23. Results of hypoxia (cyanosis)
 Headache
 Shortness of breath while resting
 Feeling of choking
 Frequent cough
 fatigue

24. Causes of hypoxia
 Athsma
 Pneumonia
 COPD-Chronic Obstructive Pulmonary
Diseases
 Ventilation & perfusion mismatch
 Diffusion impairment
 Hypoventilation

25. Resources
 Masks (for more details visit Geyer Et al. 2016
pg 324)
 Nasal cannula
 The funnel
 Oxygen tents

26. Dangers of oxygen therapy
 Explosion and fire
 Overheating (in an oxygen tent)
 Blindness in premature infants (due to retrolental
fibroplasia)
 CO2 narcosis (if O2 supply fails and a mask is
used) or if respirations are shallow
 Expansion and rupture of the lungs, if the oxygen
forced in cannot be exhaled
 Drying of the airway

27. Humidification of oxygen
Vlok pg 675

28. Steam inhalation
Vlok pg 669

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