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Respiratory system

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marino estrella

on 20 June 2014

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Transcript of Respiratory system

Respiratory system
Nasal cavity
Is the first region of upper respiratory system. It serves as protection cavity to filter certain particles that comes form the air. It also warms or cools the air to fit the normal body temperature
Nasal cavity
The irrigation of the nasal cavity comes from the external carotid artery and they are:

Sphenopalatine and Greater palatine arteries, branches of the maxillary artery.
Anterior ethmoidal artery, a branch of the ophthalmic artery
Branches of facial artery supplying the vestibule of the nasal cavity.

Venous drainage of the nasal cavity has the same veins for each artery,
all derived from venous plexus that collaborates on the air warming.

General sensory innervation is by branches of the trigeminal nerve (V)

Is the second region of upper respiratory system. Is a conducting zone for both respiratory and digestive system, and has the function of filter, warm, and moisten air and conduct it into the lungs.
The irrigation of the pharinx comes from the external carotid artery and they are:

The tonsillar artery branch of the facial artery.
The laryngopharinx includes the superior thyroid artery, the lingual artery and the ascending pharyngeal artery

Venous drainage of the pharinx comes from the External palatine vein.

Motor innervation comes from branches of the Vagus nerve (X), with the exception of the Stylopharyngeus muscle innervated by the glossopharyngeal nerve (IX); and the muscle tensor of the soft palate innervated by the mandiibular branch of the trigeminal nerve (V)

Is the Third and last region of upper respiratory system. Is involved in breathing, sound production, and protecting the trachea against food aspiration.
The irrigation of the larinx comes from the external carotid artery and they are:
The laryngeal arteries that are branches of the superior and inferior thyroid arteries.

Venous drainage of the larinx has the same veins for each artery,

The larinx is innervated by the recurrent laryngeal nerve and the superior laryngeal nerve branches of the vagus nerve (X). The recurrent laryngeal nerve branches innervate all intrinsic muscles of the larynx with the exception of the cricothyroid (which is innervated by the external branches of the superior laryngeal nerve).

Therefore the recurrent laryngeal nerve represents the principal motor nerve of the larynx.

Respiratory system
The respiratory system is in charge of the exchange of gases.

inspiration takes in O2 and expiration takes out C02.

Hysology level
Pseudostratified ciliated epithelium with goblet cells
Clinical Orientation: Upper respiratory tract
Thyroid surgery and the frequent lesion of the innervation of the larynx
During the surgery of a thyroid gland for the treatment of goiters and other pathologies, it is common to see complications secondary to the lesion of the recurrent laryngeal nerve.
Is the first region of the lower respiratory tract. The trachea, or windpipe, is a tube that connects the pharynx and larynx to the lungs.
Upon emergency and a quick acces to the respiratory system is needed, Cricothyroidotomy method can be used when endotracheal intubation is contraindicated.
Upper respiratoy tract: Head
Lower respiratoy tract:

The irrigation of the trachea comes from the inferior thyroid gland and the bronchial arteries

Is the 2nd region of the lower respiratory tract. Is a passage of airway in the respiratory tract that conducts air into the lungs

The irrigation of the bronchi comes from the the bronchial arteries.

The drainage comes from veins with the same name as the arteries

His innervation comes from the pulmonary plexus, which are branches of the vagus nerve (X) and the sympathetic trunk

Is the final region of the lower respiratory tract. Is the organ in charge of receiving the deoxygenated blood from the right ventricule of the heart; and sending the oxygenated blood to left atrium of the heart.
The right lung has 3 lobules and the left lung has 2 lobules.
The lungs are located in the thorax filling in all the space outside the mediastinum, called the pleural cavity.
The lungs are sorrounded by a membrane called the pleural membrane, which has a visceral pleura and a parietal pleura, and between the 2 is the pleural space
Hystology level
Pseudostratified ciliated epithelium with goblet cells. This type of tissue continues up to the bronchioles where it changes to colummnar and cuboidal epithelium. Furthermore once in the alveole it changes to simple squamous epithelium
The irrigation of the lungs is given by the bronchial arteries.

The drainage of the lungs is given by the bronchial veins and the pulmonary veins.

The innervation is given by the pulmonary plexus which has branches from the vagus nerve (X) and the sympathetic trunk
Clinical Orientation: Trachea and bronchi
Principal Bronchi difference: The aspiration of foreign bodies to the respiratory system.
The right bronchus is wider, more vertical and shorter in length, when compared to the left bronchus. This explains why the right bronchus is more susceptible to foreign body aspirations.
Endotracheal intubation
Upon emergency, and a quick acces to the respiratory system is needed, Endotracheal intubation can be used when noninvasive actions (like chin lift) has not been sufficient to maintain respiration.
Clinical Orientation: Lungs and pleural space
Citology level
In the alveolar epithelium we find 2 type of cells: Type 1 and type 2 alveolar cells.
Type 1 is the more abundant and his main role is to provide a barrier of minimal thickness that is readily permeable to gases such as oxygen and carbon dioxide
Type 2 are responsible for the production and secretion of surfactant (the majority of which are dipalmitoylphosphatidylcholine), a group of phospholipids that reduce the alveolar surface tension.
The Type 2 can replicate in the alveoli and replace damaged Type I pneumocytes. This event is very important because type 1 cells cannot replicate

Occupation in the pleural space
The space between the pleura membranes can be occupied by:
Blood (Hemothrorax)
Air (Pneumothorax)
Pus (Pyothorax)
Lymph (Chylothorax)

Cardiovascular system
The cardiovascular system is in charge of contraction of blood from the heart to the tissues.

Taking high O2 blood from the heart to the tissues and bringing the C02 blood back from the tissues to the heart; and from the heart to the lungs in order to be oxygenated.

Cardiovascular and pulmonary system: Integration points
The right atrium of the heart receives the deoxygenated blood from the tissues, sends that blood to the right ventricle, the right ventricle contracts and sends that blood to the lungs to be oxygenated.

The deoxygenated blood goes to the lungs and through the gas exchange, expires the CO2 to the atmosphere and inspires the oxygen, afterwards sends the oxygenated blood to the left atrium through the pulmonary veins .

This circulation is called the MINOR circulation

Clinical Orientation:
Integration point
Pulmonary edema
Is fluid accumulation in the air spaces and parenchyma of the lungs.
It leads to impaired gas exchange and may cause respiratory failure.
It is due to either failure of the left ventricle of the heart to adequately remove blood from the pulmonary circulation ("cardiogenic pulmonary edema"), or an injury to the lung parenchyma or vasculature of the lung ("noncardiogenic pulmonary edema").

Nervous system

The Nervous system is in charge of excitation and depression of neural signaling

Nervous and pulmonary system: Integration points

The medulla, an organ that belongs to brainstem in the central nervous system is in charge of the regulation of respiration.

Furthermore the branches of the vagus nerve (X) and the sympathetic trunk upon stimuly can create physiological changes to the bronchus smooth muscle.

Renal system

The renal system is in charge of the balance of water and electrolytes, balance of pH, Vitamind D balance and other noble functions

Renal, cardiovascular and pulmonary system:
Integration points

The renin-angiotensin-aldosterone system, is a system that detects the decreasement of plasmatic volumes to the kidneys and creates a cascade for the increasement of blood pressure.

The lungs produces the angiotensin converter enzyme which converts the angiotensin I to angiotensin II, a potent vasoconstrictor, increasing blood pressure

In Chronic idiopathic hypertension, one of the treatment options that we can use are the drugs called angiotensin converter enzyme inhibitors (ACEI). This drug inhibits an enzyme produced in the lung whose objective is the increasement of pressure upon detection of decreasement of plasmatic volume in the kidneys.

This also explains why one of the most common side effects of ACEI is cough.

Clinical Orientation:
Integration point
The stimuli of the parasympathetic on smooth muscle of the lungs produces broncho constriction meanwhile the stimuli of the sympathetic produces broncho dilatation.

In asthma, a disease chracterize by lack of air because of edema and broncho constriction in the lungs, they are certain drugs that stimulates the sympathetic receptors on the lungs and produces bronchodilatation decreasing the lack of air symptoms
Clinical Orientation:
Integration point
Autonomous Nervous system reactions on the respiratory system
Muscular system

Is the system in charge of contraction and relaxation of muscle, with the aid of the skeletal system.

Muscular and Pulmonary systems:
Integration points

Without the aid of muscles contraction and relaxation, respiration couldn´t be posible.

The muscle called diaphragm separates the abdominal cavity from the thoracic cavity, descending with inspiration and ascending with expiration.

Furthermore muscle of the chest and the abdomen aids also in the respiration.

Is a pathology characterize by the lesion to the nerve that innervates the diaphragm, causing dyspnea and difficulty breathing.

Phrenic nerve paralysis
Integration of the pulmonary system with other systems of the human body
Clinical Orientation:
Integration point
Alberts et. Al Molecular Biology 5th Ed. 2008

Guyton A. et. al Medical Physiology 12th Ed. Elsevier 2010

Harrison T. R. et. Al Principles of internal Medicine 18th Ed McGraw Hill 2012

Moore K. et. al Clinically oriented anatomy 6th Ed. Wolters Kluwer Health 2010

Lesson R. et al Text atlas of Histology W.B. Saunders Company 2000

Bibliographic references
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