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28-1
The Respiratory System
PowerPoint® presentation to accompany:
Medical Assisting
Third Edition
Booth, Whicker, Wyman, Pugh, Thompson
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-2
Learning Outcomes
28.1 Explain the functions of the respiratory system.
28.2 Explain the difference between internal
respiration and external respiration.
28.3 Describe how the larynx produces voice sounds.
28.4 List the structures contained within the lungs.
28.5 Describe the coverings of the lungs and chest
cavity.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-3
Learning Outcomes (cont.)
28.6 Describe the events that lead to the inspiration
and expiration of air.
28.7 Explain how the brain controls breathing and how
normal breathing patterns can be disrupted.
28.8 Describe how oxygen is transported from the
lungs to body cells.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-4
Learning Outcomes (cont.)
28.9 Describe how carbon dioxide is transported from
body cells to the lungs.
28.10 List and explain various respiratory volumes and
tell how they are used to diagnose respiratory
problems.
28.11 Describe the causes, signs, and symptoms,
causes, and treatments of various diseases and
disorders of the respiratory system.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-5
Introduction

Function

Move air in an out of lungs (ventilation)
Delivers oxygen (O2)

Removes carbon dioxide (CO2)



O2
External respiration

Occurs in the lungs
Internal respiration

CO2
O2
Lungs
CO2
CO2
O2
Occurs in the hemoglobin
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-6
Organs of the Respiratory System

Nose

Pharynx

Larynx

Trachea

Bronchial tree

Lungs
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28-7
Organs of the Respiratory System (cont.)

Nasal cavity

Nasal septum divides the cavity into right and left
portions

Nares – openings of the nose

Nasal conchae extend from walls of nasal cavity

Mucous membrane warms and moistens the air

Cilia help eliminate particles
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28-8
Organs of the Respiratory System (cont.)

Paranasal sinuses

Air-filled spaces within
the skull bones



Gives the voice its
certain tone

Skull bones with
sinuses include:
Open into the nasal cavity
Reduce the weight of the
skull



Equalizes pressure


Frontal
Sphenoid
Ethmoid
Maxillae bones
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-9
Organs of the Respiratory System (cont.)

Pharynx
 Serves both the respiratory and digestive system
 Larynx
 Also called the “voice box”
 Moves air in and out of the trachea and produces voice
 Composed of three cartilages:

Thyroid cartilage

Epiglottic cartilage

Cricoid cartilage
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28-10
Organs of the Respiratory System (cont.)

Vocal cords

Stretched between the
thyroid cartilage and
the cricoid cartilage

Upper – false cords

Lower – true vocal
cords

Glottis – the opening
between the vocal cords

Stretch = pitch of voice
Posterior
Portion
of
Tongue
Glottis
False
Vocal
Cords
True
Vocal
Cords
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-11
Organs of the Respiratory System (cont.)

Trachea




Referred to as the windpipe
Tubular organ made of rings of
cartilage and smooth muscle
Extends from the larynx to the
bronchi
Lined with cells possessing
cilia (microscopic hair-like
Trachea
projections)
Cilia move mucus up to the throat, where
it is swallowed. Smoking destroys cilia.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-12
Organs of the Respiratory System (cont.)

Bronchial tree

Bronchi
Bronchi

First branches off trachea


Bronchioles


Secondary branches
Alveoli


Thin sacs of cells
surrounded by capillaries
Secrete surfactant
Bronchioles
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-13
Organs of the Respiratory System (cont.)

Bronchial tree

Alveoli

Thin sacs of cells
surrounded by
capillaries

Secrete surfactant


Fatty substance
Helps maintains the inflation of the alveoli between
inspirations
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-14
Organs of the Respiratory System (cont.)

Lungs




Cone-shaped organs
Right lung – three lobes
Left lung – two lobes
Pleura – membranes surrounding the lungs
The lungs contain connective tissue, the bronchial tree,
nerves, lymphatic vessels, and blood vessels.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-15
Apply Your Knowledge
Which of the following sites would be the most
lethal if obstructed by a foreign body?
ANSWER:
a. Right bronchus
b. Left bronchus
c. Trachea
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-16
The Mechanisms of Breathing
Inspiration
Expiration
 Air rich in O2 enters the lungs
 Air rich in C02 exits the lungs
from the atmosphere
 The diaphragm contracts or
 The diaphragm relaxes
 The intercostal muscles
flattens
 The intercostal muscles raise
lower the ribs
the ribs
Breathing, or pulmonary ventilation, consist of inspiration
(inhalation) and expiration (exhalation).
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-17
The Mechanisms of Breathing (cont.)

Respiratory center
of the brain


Medulla oblongata –
controls rhythm and
depth of breathing
Pons – controls the rate
of breathing

Other factors

CO2 levels in the blood

pH of the blood

Fear and pain

Inflation reflex
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-18
The Mechanisms of Breathing (cont.)

Causes of altered breathing patterns







Coughing
Sneezing
Laughing
Crying
Hiccups
Yawning
Speaking
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28-19
Apply Your Knowledge
Indicated whether each statement refers to (I) inhalation or (E)
exhalation:
ANSWER:
__
E The intercostal muscles lower the ribs
I The diaphragm contracts or flattens
__
I The intercostal muscles raise the ribs
__
__
E The diaphragm relaxes
I Air rich in O2 enters the lungs from the atmosphere
__
E Air rich in C02 exits the lungs
__
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-20
The Transport of Oxygen and Carbon
Dioxide in the Blood

Most of the oxygen
binds to hemoglobin


Oxyhemoglobin
Bright red in color

Some oxygen remains
dissolved in plasma

If CO2 combines with hemoglobin at O2 sites, it forms
carboxyhemoglobin
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-21
The Transport of Oxygen and Carbon
Dioxide in the Blood

Carbon dioxide gets into the bloodstream



Reacts with water in plasma and forms carbonic
acid
Carbonic acid ionizes and releases hydrogen and
bicarbonate ions
Bicarbonate ions attach to hemoglobin

Exhaled as waste product in the lungs
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-22
Apply Your Knowledge
Describe what happens to carbon dioxide in the blood.
ANSWER: Carbon dioxide can combine with hemoglobin
and form carboxyhemoglobin. Most reacts with water in
plasma to form carbonic acid. The carbonic acid ionizes
and releases hydrogen and bicarbonate ions. The
bicarbonate ions then attach to hemoglobin and are
exhaled as a waste product from the lungs.
Super!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-23
Respiratory Volumes

Different volumes of
air move in and out of
lungs with different
intensities of breathing

Measured to assess
health of respiratory
system
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28-24
Respiratory Volumes (cont.)
Tidal Volume
Amount of air that moves in or out of the
lungs during a normal breath
Inspiratory
Reserve
Volume
Amount of air that can be forcefully
inhaled following a normal inhalation
Expiratory
Reserve
Volume
Amount of air that can be forcefully
exhaled following a normal exhalation
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-25
Respiratory Volumes (cont.)
Residual
Volume
Volume of air that always remains in the
lungs even after a forceful exhalation
Vital
Capacity
Amount of air that can be forcefully
exhaled after the deepest inhalation
possible
Total Lung
Capacity
The total amount of air the lungs can hold
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-26
Apply Your Knowledge
Match the following:
ANSWER:
___
C Amount of air that moves during a
normal breath
B Amount of air that always remains
___
in the lungs
A Total amount of air the lungs can
___
hold
D Amount of air forcefully exhaled
___
after deepest inhalation possible
A. Total lung
capacity
B. Residual volume
C. Tidal volume
D. Vital capacity
Good Job!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-27
Snoring



Due to vibration of soft
tissues when muscles of the
palate, tongue, and throat
relax

Common Causes

Enlargement of tonsils
or adenoids

Being overweight
Affects approximately 50%
of men and 25% of women
over the age of 40

Alcohol consumption

Nasal congestion
Causes daytime sleepiness


Deviated nasal septum
May be associated with
obstructive sleep apnea
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28-28
Snoring (cont.)
Mayo Clinic’s Sleep Disorders Center rating of snoring:
Heard from close proximity
Heard from anywhere in the bedroom
Heard from just outside the bedroom door with
door open
Heard outside the bedroom door with the
door closed
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-29
Snoring (cont.)

Lifestyle modifications to reduce snoring






Lose weight
Change sleeping position
Avoid using alcohol or medications that induce sleep
Use nasal strips to widen the nasal passages
Use dental devices to keep airways open
Treatments



CPAP
Surgery (uvulotomy)
Laser surgery
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-30
Common Diseases and Disorders
Disease
Description
Allergic
Rhinitis
Hypersensitivity reaction to various airborne
allergens
Asthma
A condition in which the tubes of the bronchial
tree become obstructed due to inflammation
Atelectasis
Collapsed lung
Bronchitis
Inflammation of the bronchi often follows a
cold; one type of COPD
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28-31
Common Diseases and Disorders (cont.)
Disease
Description
Chronic Obstructive
Pulmonary Disease
(COPD)
Emphysema
A group of lung disorders that limit airflow
to lungs and usually cause enlargement of
the alveoli
A chronic condition associated with
smoking that damages the alveoli; one type
of COPD
A viral disease that attacks the respiratory
system; commonly called the flu
Influenza
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28-32
Common Diseases and Disorders (cont.)
Disease
Laryngitis
Legionnaire’s
Disease
Lung Cancer
Pleural Effusion
Description
An acute inflammation of the larynx causing
hoarseness (dysphonia)
Acute bacterial pneumonia caused by
Legionnaire bacteria that usually grows in the
standing water of air conditioning systems
Cancer closely associated with smoking and
exposure to second-hand smoke; four types
of lung cancers
A buildup of fluid in the pleural cavity
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28-33
Common Diseases and Disorders (cont.)
Disease
Description
Pleuritis / Pleurisy
Inflammation of the membranes that cover
the lungs, known as pleura
Pneumoconiosis
Lung diseases that result from years
environmental or occupational exposure to
different types of dust; three types
Pneumonia /
Pneumonitis
An inflammation of the lungs that is most
often caused by a a bacterial, or viral, or
fungal infection
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28-34
Common Diseases and Disorders (cont.)
Disease
Description
Pneumothorax
A collection of air in the chest around the
lungs, which may cause atelectasis
Pulmonary
Edema
A condition in which fluids fill spaces within
the lungs, making it very difficult for the
lungs to oxygenate the blood
Pulmonary
Embolism
A blood clot (embolism) that travels usually
from the legs and blocks an artery in the lungs
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-35
Common Diseases and Disorders (cont.)
Disease
Description
Respiratory Distress Syndrome in which a lack of surfactant in
Syndrome (RDS)
the lungs allows the alveoli to collapse on
exhalation, resulting in poor oxygenation
Severe Acute
A viral respiratory disease that is very
Respiratory
contagious and sometimes fatal
Syndrome (SARS)
Sinusitis
An inflammation of the membranes lining
the sinuses of the skull
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-36
Common Diseases and Disorders (cont.)
Disease
Description
Sudden infant death
syndrome (SIDS)
A syndrome without characteristic signs or
symptoms; usually a baby with this
disorder simply goes to sleep and never
wakes up
Primarily a respiratory disease caused by
various strains of the bacterium
Mycobacterium tuberculosis
Coryza, or the common cold
Tuberculosis
Upper Respiratory
(Tract) Infection
(URI)
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
28-37
Apply Your Knowledge
The medical assistant working for a general practitioner is taking
the medical history of a new patient. The patient states, “Even
after sleeping 8 to 9 hours, I still feel really tired.” The patient’s
spouse states, “Well, you sure snore loud, as if the sleep is so
good.” Which of the following is a possible cause for the
excessive fatigue?
ANSWER:
a. Sleep apnea
b. Depression
c. Tuberculosis
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28-38
End of Chapter
The air of ideas
is the only air
worth breathing.
~Edith Wharton
© 2009 The McGraw-Hill Companies, Inc. All rights reserved