This document discusses the anatomy and physiology of the respiratory system. It describes the structure and function of the upper airways including the nose, sinuses, and larynx. It then covers the lower airways including the trachea, bronchi, bronchioles, and respiratory units containing the alveoli. It also discusses gas exchange, blood supply, innervation, and control of respiration.
Anatomy & Physiology of The Respiratory System & its DiseasesRaghad AlDuhaylib
This presentation is an overall review of the respiratory system anatomy and physiology. Also, some diseases of the respiratory system are mentioned briefly in the slides.
In humans, the respiratory tract is the part of the anatomy of the respiratory system involved with the process of respiration. Air is breathed in through the nose or the mouth. In the nasal cavity, a layer of mucous membrane acts as a filter and traps pollutants and other harmful substances found in the air.
Anatomy of Tracheobronchial Tree and Bronchopulmonary Segments with summary o...Jega Subramaniam
Edited version of my Presentation in College.
Hope its useful for you rather than sleeping in my desktop.
Sorry if there is any mistakes.
Thanks and god bless.
This PPT covers Anatomy and Physiology of respiratory system. Anatomy of respiratory organs, Mechanism of respiration, Internal Respiration, external respiration, Transport of oxygen in blood, Transport of carbon dioxide in blood, Regulation of respiration, lung volume and lung capacities are explained.
Slideshow is from the University of Michigan Medical School's M1 Cardiovascular / Respiratory sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1Cardio
Anatomy & Physiology of The Respiratory System & its DiseasesRaghad AlDuhaylib
This presentation is an overall review of the respiratory system anatomy and physiology. Also, some diseases of the respiratory system are mentioned briefly in the slides.
In humans, the respiratory tract is the part of the anatomy of the respiratory system involved with the process of respiration. Air is breathed in through the nose or the mouth. In the nasal cavity, a layer of mucous membrane acts as a filter and traps pollutants and other harmful substances found in the air.
Anatomy of Tracheobronchial Tree and Bronchopulmonary Segments with summary o...Jega Subramaniam
Edited version of my Presentation in College.
Hope its useful for you rather than sleeping in my desktop.
Sorry if there is any mistakes.
Thanks and god bless.
This PPT covers Anatomy and Physiology of respiratory system. Anatomy of respiratory organs, Mechanism of respiration, Internal Respiration, external respiration, Transport of oxygen in blood, Transport of carbon dioxide in blood, Regulation of respiration, lung volume and lung capacities are explained.
Slideshow is from the University of Michigan Medical School's M1 Cardiovascular / Respiratory sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1Cardio
Hydrophilic- Water loving / Oil hating
Hydrophobic- Water hating / Oil loving
Surfactants are amphiphilic molecules composed of a hydrophilic or polar moiety known as head and a hydrophobic or nonpolar moiety known as tail.
The nature and number of polar and nonpolar groups – Hydrophilic, Lipophillic or somewhere in between.
Example - Alcohols, Amines and Acids Changes from hydrophilic to Lipophillic as carbons atoms increasing in their alkyl chain.
Conducting an Efficient Literature Search revised.pptxRodolfo Rafael
Literature search is a critical component for any evidence-based project. It helps you to understand the complexity of a clinical issue, gives you insight into the scope of a problem, and provides you with best treatment approaches and the best available evidence on the topic.
Computers in medical education dr. rodolfo rafaelRodolfo Rafael
The goals of medical education are to provide students and graduate clinicians specific facts and information, to teach strategies for applying this knowledge appropriately to the situations that arise in medical practice, and to encourage the development of skills necessary to acquire new knowledge over a lifetime of practice. Students must learn about physiological processes and must understand the relationships between their observations and these underlying processes. They must learn to perform medical procedures, and they must understand the effects of different interventions on health outcomes. Also, the student must learn “softer” skills and knowledge, such as interpersonal and interviewing skills and the ethics of medical care. Medical school faculty employs a variety of strategies for teaching, ranging from the one-way, lecture-based transmission of information to the interactive, Socratic method of instruction. In general, we can view the teaching process as the presentation of a situation or a body of facts that contains the essential knowledge that students should learn; the explanations of what the important concepts and
relationships are, how they can be derived, and why they are important; and the strategy for guiding interaction with a patient.
Female reproductive functions can be divided into two major phases:
preparation of the female body for conception and pregnancy and
(2) the period of pregnancy itself.
This lecture is concerned with preparation of the female body for pregnancy, and presents the physiology of pregnancy and childbirth
Growth of the fetus begins soon after fertilization, when the first cell division occurs.
Cell division, hypertrophy, and differentiation are highly coordinated events that result in the growth and development of specialized organ systems.
The fetus, fetal membranes, and placenta develop and function as a unit throughout pregnancy, and their development is interdependent or symbiotic.
The growth trajectory of fetal mass is relatively flat during the first trimester, increases linearly at the beginning of the second trimester, and rises rapidly during the third trimester.
Asthma is a serious public health problem throughout the world, affecting people of all ages. When uncontrolled, asthma can place severe limits on daily life, and is sometimes fatal.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
4. Structure and Function of the
Respiratory System
gas exchange
host defense
metabolic organ
5. LUNG ANATOMY
contained in a space 4L- surface area for gas
exchange (∼85 m2)
demonstrate functional unity- similar to
kidney
Weight 1 kg
60% tissue
Alveolar spaces
lung volume
interstitium- collagen, potential space for fluid
and cells to accumulate
7. Upper Airways
condition inspired air
nose
filter entrap, clear particles
> 10μm, and provides the
sense of smell
20ml
surface area increase by
the nasal turbinates
8. Upper Airways
10,000 to 15,000 L/day
Nasal resistance
50% nose
8cm H2O/L/sec
viral infections, exercise
high mouth breathing
Interior of the nose - respiratory epithelium-
surface secretory cells
immunoglobulins, inflammatory mediators, and
interferons.
9. Upper Airways
The paranasal sinuses (frontal sinuses, maxillary
sinus, sphenoid sinus, ethmoid sinus)
ciliated epithelium ?
The sinuses have two major functions-
they lighten the skull
they offer resonance to the voice.
They may also protect the brain during frontal trauma.
In some sinuses (e.g., the maxillary sinus), the opening
(ostium) is at the upper edge- retention of mucus.
Sinusitis-obstructed ostia
nasal edema retention of secretions
10. Upper Airways
The major structures of the larynx include the
epiglottis
arytenoids
vocal cords
infectionsedematous airflow resistance.
The epiglottis and arytenoids "hood" or cover the
vocal cords during swallowing.
The act of swallowing food after mastication
(chewing) usually occurs within 2 seconds, and it
is closely synchronized with muscle reflexes that
coordinate opening and closing of the airway.
11. Lower Airways-Trachea, Bronchi,
Bronchioles, Respiratory Unit
The right lung, located in the right
hemithorax
divided into three lobes (upper, middle, and
lower) by two interlobular fissures (oblique,
horizontal)
Left lung, located in the left hemithorax
is divided into two lobes (upper, including the
lingula, and lower) by an oblique fissure
12.
13. Lower Airways
Visceral pleura
Parietal pleura
The interface of these two pleuras allows for
smooth gliding of the lung as it expands in the
chest and produces a potential space.
Air – pneumothorax
Fluid- pleural effusion empyema
14. Lower Airways
The trachea bifurcates (branches) into two
main stem bronchi
main stem bronchi lobar bronchi (one for each
lobe) segmental bronchi bronchioles
alveolus
15.
16.
17. Lower Airways
lung supplied by a segmental bronchus - functional
anatomic unit of the lung.
Bronchi and bronchioles differ
size
cartilage
type of epithelium
blood supply
dichotomous or asymmetric branching pattern- terminal
bronchioles
respiratory bronchioles results in decreased diameter * the
total surface area for that generation increases in size and
number until the respiratory bronchiole terminates in an
opening to a group of alveoli
18.
19. Lower Airways
The alveoli
polygonal in shape and about 250 μm in diameter.
5 × 108 alveoli
Type I and type II epithelial cells
1:1 ratio.
20. The type I cell
occupies 96% to 98% of the surface area of the
alveolus
the primary site for gas exchange.
the basement membrane of type I cells and the
capillary endothelium are fused
The type II epithelial cell
small and cuboidal and is usually found in the
"corners" of the alveolus
occupies 2% to 4% of its surface area
synthesize pulmonary surfactant
21. Lower Airways
Alveolar-capillary network
Gas exchange occurs
1 to 2 μm in thickness
type I alveolar epithelial cells, capillary endothelial cells, and
basement membranes.
< 1 second
Injury and type I cell deaththe type II cell replicates and
differentiates into type I cells to restore normal alveolar
architecture
Phylogeny
recapitulating ontogeny- embryonic development the epithelium
of the alveolus- composed of type II cells
22. Lung Interstitium
Composed of connective tissue, smooth muscle,
lymphatics, capillaries, and a variety of other
cells.
Fibroblasts are prominent cells in the
interstitium of the lung
collagen and elastin
Collagen is the major structural component of the
lung that limits lung distensibility.
Elastin is the major contributor to elastic recoil of the
lung.
Cartilage
Kultschitzky cells- neuroendocrine cells-
biogenic amines- fetus- bronchial carcinoid
23. BLOOD SUPPLY TO THE LUNG-PULMONARY AND
BRONCHIAL CIRCULATIONS
The lung has two separate blood supplies.
The pulmonary circulation
deoxygenated blood- right ventricle to the gas-
exchanging units for removal of CO2 and
oxygenation.
The bronchial circulation
arises from the aorta- nourishment to the lung
parenchyma.
24. Pulmonary Circulation
The pulmonary
capillary bed
largest in the body
surface area of 70 to 80
m2
The network of
capillaries is so dense
that it might be
considered to be a
sheet of blood
interrupted by small
vertical supporting
posts
25. Pulmonary Circulation
The capillary volume in the lung at rest is
70 mL.
During exercise- volume increases
200 mL.
Increase?
The pulmonary veins
return blood to the left atrium - supernumerary
conventional branches
provide a large reservoir for blood, and they can either
increase or decrease their capacitance to provide constant
left ventricular output in the face of variable pulmonary
arterial flow.
Pulmonary arteries and veins with diameters larger
than 50 μm contain smooth muscle.
26. Bronchial Circulation
The bronchial
arteries
three in number
provide a source of
oxygenated,
systemic blood to the
lungs
accompany the
bronchial tree and
divide with it
27. Bronchial Circulation
bronchi, bronchioles, blood vessels, and nerves
perfuse the lymph nodes and visceral pleura.
1/3 of the blood returns to the right atrium- bronchial
veins
2/3 drains into the left atrium- pulmonary veins.
Cystic fibrosis, the bronchial arteries, which normally
receive only 1% to 2% of cardiac output, increase in
size (hypertrophy) and receive as much as 10% to
20% of cardiac output.
The erosion of inflamed tissue into these vessels
secondary to bacterial infection- hemoptysis
28. INNERVATION
Breathing is automatic - central nervous system
(CNS).
The peripheral nervous system (PNS) includes
both sensory and motor components.
conveys and integrates signals from the environment
to the CNS.
Sensory and motor neurons of the PNS transmit
signals from the periphery to the CNS.
Somatic motor neurons- skeletal muscles
Autonomic neurons- smooth muscle, cardiac
muscle, and glands.
The lung- autonomic nervous system of the PNS,
which is under CNS control
29.
30. INNERVATION
There are four distinct components of the
autonomic nervous system:
parasympathetic (constriction)
sympathetic (relaxation)
nonadrenergic noncholinergic inhibitory (relaxation)
nonadrenergic noncholinergic stimulatory
(constriction).
(+) parasympathetic system leads to airway
constriction, blood vessel dilation, and increased
glandular secretion.
(+) sympathetic system causes airway relaxation,
blood vessel constriction, and inhibition of
glandular secretion
31.
32. INNERVATION
As with most organ systems, the CNS and
PNS work in cohort to maintain homeostasis.
Lungs
no voluntary motor
no pain fibers
Pain fibers
33. INNERVATION
The parasympathetic innervation - medulla in
the brainstem (cranial nerve X, the vagus).
Preganglionic fibers - vagal nuclei vagus
nerve ganglia adjacent to airways and blood
vessels in the lung.
Postganglionic fibers – ganglia smooth
muscle cells, blood vessels, and bronchial
epithelial cells (including goblet cells and
submucosal glands).
Both preganglionic and postganglionic fibers
contain excitatory (cholinergic) and inhibitory
(nonadrenergic) motor neurons.
Acetylcholine and substance P
dynorphin and vasoactive intestinal peptide
34. INNERVATION
Parasympathetic
(+) vagus nerve--> slight constriction of smooth
muscle tone in the normal resting lung.
bronchial glands--> increase the synthesis of
mucus glycoprotein, raises the viscosity of mucus.
greater larger airways, and it diminishes toward
the smaller conducting airways in the periphery.
Response of the parasympathetic nervous
system very specific and local
Response of the sympathetic nervous system
more general.
35. INNERVATION
Sympathetic Nervous System
Mucous glands and blood vessels
mucous glands increases water secretion.
Upsets the balanced response of increased
water and increased viscosity between the
sympathetic and parasympathetic pathways
36. Central Control of
Respiration
Breathing is an automatic, rhythmic, and
centrally regulated process with voluntary
control.
brainstem- main control center for respiration
Regulation of respiration requires
generation and maintenance of a respiratory rhythm
modulation of this rhythm by sensory feedback loops
and reflexes that allow adaptation to various
conditions while minimizing energy costs
recruitment of respiratory muscles that can contract
appropriately for gas exchange.
37.
38. MUSCLES OF RESPIRATION-DIAPHRAGM,
EXTERNAL INTERCOSTALS, SCALENE
The major muscles of respiration include the
diaphragm
the external intercostals
scalene
Skeletal muscles
provide the driving force for ventilation
the force of contraction increases when they are stretched
and decreases when they shorten.
The force of contraction of respiratory muscles
increases at larger lung volumes.
The process of respiration or gas exchange begins
with the act of inspiration, which is initiated by
contraction of the diaphragm.
39. Diaphragm
Contraction
protrudes into the abdominal cavity
decrease chest pressure
inspiration
Relaxation
exhalation
increase chest pressure
Major muscle of respiration
Divides the thoracic cavity from the abdominal
cavity
airway pressure= 150-200 cmH2O
Quiet breathing- 1 cm
Deep-Breathing= 10 cm
R and L phrenic nerves
40. FLUIDS LINE THE LUNG EPITHELIUM AND
PLAY IMPORTANT PHYSIOLOGICAL ROLES
The respiratory system is lined with three fluids:
periciliary fluid
mucus
surfactant
Periciliary fluid and mucus
components of the mucociliary clearance system and line the
epithelium of the conducting airways from the trachea to the
terminal bronchioles.
they form the basis for the mucociliary clearance system, which
aids in the removal of particulates (e.g., bacteria, viruses, toxins)
from the lung
Surfactant
lines the epithelium of the alveolus and provides an "antistick"
function that decreases surface tension in the alveolus
41. Cells of the Mucociliary
Clearance System
The respiratory tract to the level of the
bronchioles is lined by a pseudostratified, ciliated
columnar epithelium
maintain the level of periciliary fluid
5-μm layer of water and electrolytes in which cilia and the
mucociliary transport system function.
depth is maintained by the movement of various ions-
chloride secretion and sodium absorption
Mucus and inhaled particles - rhythmic beating of
the cilia on the top of the pseudostratified,
columnar epithelium.
Each epithelial cell contains about 250 cilia.
42.
43. Cells Regulating Mucus Production
Goblet or surface secretory cells
produce mucus
increase in number in response to chronic cigarette smoke (and
environmental pollutants) increased mucus and airway obstruction in
smokers.
Submucosal tracheobronchial glands * cartilage in the
tracheobronchial tree.
empty to the surface epithelium through a ciliated duct, and they are
lined by mucus-secreting mucous and serous cells
increase in number and size in chronic bronchitis, and they extend down
to the level of the bronchioles in pulmonary disease.
Clara cells are found at the level of the bronchioles- the goblet cells
and submucosal glands have disappeared.
granules with nonmucinous material and may have a secretory function.
play a role in epithelial regeneration after injury.
44. Surfactant and Surface
Tension
The alveoli are lined with surfactant.
Surface tension
force caused by water molecules at the air-liquid
interface that tends to minimize surface area, thereby
making it more difficult to inflate the lung.
The effect of surface tension on lung inflation is
illustrated by comparing the volume-pressure curves
of a saline-filled versus an air-filled lung.
Higher pressure is required to fully inflate the lung
with air than with saline because of the higher surface
tension forces in air-filled versus saline-filled lungs.
45. Surfactant and Surface
Tension
Surface tension is a measure of the attractive force of the
surface molecules per unit length of material to which
they are attached.
The units of surface tension are those of a force applied
per unit length.
For a sphere (such as an alveolus), the relationship
between the pressure within the sphere (Ps) and the
tension in the wall is described by the law of Laplace:
46.
47. Surfactant and Surface
Tension
In the absence of surfactant
the surface tension at the air-liquid interface would remain
constant and the transmural (transalveolar) pressure needed to
keep it at that volume would be greater at lower lung (alveolar)
volumes
Thus, greater transmural pressure would be required to produce
a given increase in alveolar volume at lower lung volumes than at
higher lung volumes.
Surfactant stabilizes the inflation of alveoli because it
allows the surface tension to decrease as the alveoli
become larger
As a result, the transmural pressure required to keep an alveolus
inflated increases as lung volume (and transpulmonary pressure)
increases, and it decreases as lung volume decreases.
48.
49.
50. Surfactant and Surface
Tension
“Interdependence”
Alveoli surrounded by other alveoli.
The tendency of one alveolus to collapse is opposed
by the traction exerted by the surrounding alveoli.
collapse of a single alveolus stretches and distorts the
surrounding alveoli, which in turn are connected to other
alveoli.
pores of Kohn
canals of Lambert
The pores of Kohn and the canals of Lambert provide
collateral ventilation and prevent alveolar collapse
(atelectasis).
51.
52. Composition and Function of
Surfactant
phospholipids, neutral lipids, fatty acids, and proteins.
85% to 90% lipids, predominantly phospholipids, 10% to
15% proteins.
The major phospholipid- phosphatidylcholine, 75% of
dipalmitoyl phosphatidylcholine (DPPC).
major surface-active component in surfactant.
2nd phosphatidylglycerol (PG)1% to 10% of total surfactant.
important in the spreading of surfactant over a large surface area.
Surfactant is secreted by type II cells
Cholesterol and cholesterol esters account for the majority
of the neutral lipids; their precise functional role is not yet
fully understood, but they may aid in stabilizing the lipid
structure.
53. Composition and Function of
Surfactant
Four specific surfactant proteins
(SP-A, SP-B, SP-C, SP-D)
make up 2% to 5% of the weight of surfactant
SP-A
most studied
which is expressed in alveolar type II cells and in Clara cells in the lung.
involved in the regulation of surfactant turnover, in immune regulation within the
lung, and in the formation of tubular myelin.
Two hydrophobic surfactant-specific proteins are SP-B and SP-C.
SP-B
involved in tubular myelin formation and the surface activity (i.e., surface tension,
spreading ability) of surfactant, and it may increase the intermolecular and
intramolecular order of the phospholipid bilayer.
SP-C
involved in the spreading ability and surface tension activity of surfactant.
The function of SP-D is unknown at this time.
54. Composition and Function of
Surfactant
Secretion of surfactant via exocytosis of the lamellar
body .
β-adrenergic agonists, activators of protein kinaseC,
leukotrienes, and purinergic agonists
The major routes of clearance of pulmonary surfactant
within the lung are
reuptake by type II cells, absorption into the lymphatics,
clearance by alveolar macrophages
Pulmonary surfactant serves several physiological roles,
including
(1) reducing the work of breathing by decreasing surface tension
forces
(2) preventing collapse and sticking of alveoli on expiration
(3) stabilizing alveoli, especially those that tend to deflate at low
surface tension.
55. THE LYMPHATIC SYSTEM
Major functions of the lymphatic network in the lung
Host defense
removal of lymph fluid from the lung
The lymphatic capillaries are highly specialized to allow the
transfer of fluid from the interstitial spaces into the
lymphatic capillaries.
Although the lymphatic capillaries are somewhat similar to
blood capillaries, they have several distinct features that
aid in fluid movement and clearance:
(1) there are no tight junctions between endothelial cells
(2) fine filaments anchor the lymph vessels to adjacent
connective tissue such that with each muscle contraction the
endothelial junctions open to allow fluid movement
(3) valves enhance lymph flow in one direction.
57. Lung Volumes
Total lung capacity (TLC), the total volume of air that can be contained in the
lung. Lung volumes are reported in liters either as volumes or as capacities.
59. Lung Volumes
Vital capacity (VC)- The total volume of exhaled air, from a maximal inspiration to
a maximal exhalation
Residual volume (RV) is the air remaining in the lung after a complete exhalation.
Functional residual capacity (FRC) is the volume of air in the lung at the end of
exhalation during quiet breathing and is also called the resting volume of the lung.
FRC is composed of RV and the expiratory reserve volume (ERV; the volume of air
that can be exhaled from FRC to RV).
60. Lung Volumes
The ratio of RV toTLC (RV/TLC ratio)
is used to distinguish different types of pulmonary disease.
In normal individuals, this ratio is usually less than 0.25.
An elevated RV/TLC ratio, secondary to an increase in RV out of proportion
to any increase inTLC, is seen in diseases associated with airway obstruction,
known as obstructive pulmonary diseases.
An elevated RV/TLC ratio can also be caused by a decrease inTLC, which
occurs in individuals with restrictive lung diseases.
61. Determinants of Lung Volume
What determines the volume of air in the
lung atTLC or at RV?
The answer lies in the properties of the lung
parenchyma and in the interaction between the
lungs and the chest wall.
The lungs and chest wall always move
together in healthy individuals.
62. Measurement of Lung Volumes
RV andTLC can be measured in two ways:
helium dilution
body plethysmography.
Both are used clinically and provide valuable
information about lung function and lung disease.
63. Lung Compliance (CL)
is a measure of the elastic properties of the lung.
It is a measure of how easily the lung is
distended.
is defined as the change in lung volume resulting
from a 1-cm H2O change in the distending
pressure of the lung.
The units of compliance are mL (or L)/cm H2O.
High lung compliance refers to a lung that is
readily distended.
Low lung compliance, or a "stiff" lung, is a lung
that is not easily distended.
64. Pressure-Volume Relationships
Air flows into and out of the airways from areas of higher
pressure to areas of lower pressure.
In the absence of a pressure gradient, there is no airflow.
Minute ventilation is the volume of gas that is moved per unit
of time.
It is equal to the volume of gas moved with each breath times
the number of breaths per minute:
VE=VT X f
whereVE is minute ventilation in mL or L/min,VT is tidal volume in mL or L,
and f is the frequency or number of breaths per minute.
66. Airflow in Airways
Air flows through the airways when there is a pressure
difference at the two ends of the airway.
During inspiration, the diaphragm contracts, pleural
pressure becomes more negative (relative to atmospheric
pressure), and gas flows into the lung (from the higher to
the lower pressure).
Gas exchange to meet the changing metabolic needs of the
body depends on the speed at which fresh gas is brought to
the alveoli and the rapidity with which the metabolic
products of respiration (i.e., CO2) are removed.
Two major factors determine the speed at which gas flows
into the airways for a given pressure change:
the pattern of gas flow
resistance to airflow by the airways
67. Airflow in Airways
There are two major patterns of gas flow in
the airways-laminar and turbulent flow.
Laminar flow is parallel to the airway walls and is
present at low flow rates.
As the flow rate increases and particularly as the
airways divide, the flow stream becomes unsteady
and small swirls occur.
At higher flow rates, the flow stream is
disorganized and turbulence occurs.
French physician Poiseuille
68.
69. Airway Resistance
Airflow resistance is the second major factor that
determines rates of airflow in the airways.
Airflow resistance in the airways (Raw) differs in
airways of different size.
In moving from the trachea toward the alveolus,
individual airways become smaller while the number
of airway branches increases dramatically.
Raw is equal to the sum of the resistance of each of
these airways (i.e., Raw = Rlarge + Rmedium + Rsmall).
The major site of resistance along the bronchial tree is the
large bronchi.
The smallest airways contribute very little to the overall
total resistance of the bronchial tree
70. In a normal lung, most of the resistance to airflow occurs in the
first eight airway generations
71. Factors That Contribute to
Airway Resistance
In healthy individuals, airway resistance is approximately 1 cm
H2O/L · sec.
One of the most important factors affecting resistance is lung
volume.
Increasing lung volume increases the caliber of the airways.
resistance to airflow decreases with increasing lung volume, and it
increases with decreasing lung volume.
Airway mucus, edema, and contraction of bronchial smooth
muscle, all of which decrease the caliber of the airways.
The density and viscosity of the inspired gas also affect airway
resistance.
Breathing a low-density gas such as an oxygen-helium mixture results in
a decrease in airway resistance
72.
73. Neurohumoral Regulation of Airway Resistance
Stimulation of efferent vagal fibers, either directly or reflexively,
increases airway resistance and decreases anatomic dead space secondary to
airway constriction (recall that the vagus nerve innervates airway smooth
muscle).
Stimulation of the sympathetic nerves and release of the postganglionic
neurotransmitter norepinephrine
inhibit airway constriction.
Reflex stimulation of the vagus nerve by the inhalation of smoke, dust,
cold air, or other irritants
result in airway constriction and coughing.
Agents such as histamine, acetylcholine, thromboxane A2,
prostaglandin F2, and leukotrienes (LTB4, LTC4, and LTD4) are released
by resident (e.g., mast cells and airway epithelial cells) and recruited
(e.g., neutrophils and eosinophils) airway cells in response to various
triggers, such as allergens and viral infections.
act directly on airway smooth muscle to cause constriction and an increase in
airway resistance.
Inhalation of methacholine, a derivative of acetylcholine
used to diagnose airway hyperresponsiveness, which is one of the cardinal
features of asthma.
74. The Spirogram
A spirogram displays the volume of gas
exhaled against time
four major test results:
(1) forced vital capacity (FVC)
(2) forced expiratory volume in 1 second (FEV1)
(3) the ratio of FEV1 to FVC (FEV1/FVC)
(4) the average midmaximal expiratory flow
(FEF25-75).
75.
76. Flow-Volume Loop
A newer way of measuring lung function
clinically is the flow-volume curve or loop.
A flow-volume curve or loop is created by
displaying the instantaneous flow rate during
a forced maneuver as a function of the
volume of gas.
This instantaneous flow rate can be displayed
both during exhalation (expiratory flow-
volume curve) and during inspiration
(inspiratory flow-volume curve)
79. Quiz
1. Contraction of diaphragm create______ pressure inside the chest.
2. Relaxation of diaphragm create______ pressure inside the chest.
3. ____________ the total volume of air that can be contained in the lung.
Lung volumes are reported in liters either as volumes or as capacities.
4. _________________The total volume of exhaled air, from a maximal
inspiration to a maximal exhalation
5. __________________is the air remaining in the lung after a complete
exhalation.
6. ____________________is the volume of air in the lung at the end of
exhalation during quiet breathing and is also called the resting volume of
the lung.
7. The ratio of ____________________ is used to distinguish different types
of pulmonary disease.
8. During inspiration, the diaphragm _____________, pleural pressure
becomes more __________ (relative to atmospheric pressure), and gas
flows into the lung.
9. ______ an instrument displays the volume of gas exhaled against time
10. Function of the respiratory system