Chapter 23



Chapter 23

THE RESPIRATORY SYSTEM

Outline and Objectives

IINTRODUCTION

1. Discuss the cooperative effect of the respiratory and cardiovascular systems to maintain homeostasis.

2. Define respiration and the three basic processes of respiration.

RESPIRATORY SYSTEM ANATOMY

3. Identify the structures of the respiratory system and indicate whether they are a part of the upper or lower respiratory regions.

Nose

4. Describe the structure and function of the internal and external nose.

4. Discuss rhinoplasty.

Pharynx

6. Describe the distinct structures and epithelium found in the three regions of the pharynx and relate these structures and epithelia to their purpose in ventilation and swallowing.

Larynx

7. Discuss the arrangement of cartilage that supports the laryngeal soft tissue components.

Voice Production

8. Describe the operation of the vocal tissues within the larynx in sound production.

8. Discuss how the pitch of the sound can be changed, and explain what happens when whispering occurs.

Trachea

10. Describe how the connective and epithelial tissue structures of the trachea maintain an open airway and help keep the lungs clear of small particles.

10. Discuss tracheostomy and intubation and why such procedures might be performed.

Bronchi

12. Describe the changes in the cartilaginous support, smooth muscle, and epithelium as the bronchi progressively branch into smaller regions and how their duties are modified.

Lungs

13. Discuss how the lungs are generally positioned and related to the serosal membrane of the pleural cavity.

13. Describe the gross features of the lung structure and the connections to the other organ systems.

Lobes, Fissures, and Lobules

15. Discuss the relative positions of the lobes of the lungs as divided by fissures, and explain why there are an unequal number of lobes on each side.

15. Describe the physical relation of the lobules to the bronchioles, vessels, and alveolar components.

Alveoli

17. Discuss how the different types of cells that populate the alveoli work together, and explain the structure of the alveolar-capillary membrane and its function in the diffusion of respiratory gases.

Blood Supply to the Lungs

18. Describe the route and alternative duties of the two vascular systems that permeate lung tissue.

PULMONARY VENTILATION

19. Define pulmonary ventilation in terms of the physical properties that promote the movement of air.

Inspiration

20. Discuss how Boyle’s law works through the action of the diaphragm and external intercostal muscles in the production of pressure gradients that move air into the lungs.

20. Discuss the properties of the intrapleural space that hold the lung tissue against the chest wall during lung volume changes.

Expiration

22. Describe the characteristics of the lung tissues that assist the internal intercostal muscles in contraction of the lungs during expiration.

Alveolar Surface Tension

23. Discuss how surface tension develops in alveolar fluid and how surfactant limits the tension and collapse during expiration, as well as eases expansion of the alveoli during inspiration.

23. Discuss what happens if an injury of the chest wall allows air to enter the intrapleural space.

Compliance

25. Define compliance and the lung tissues that control it, and list some conditions that compromise compliance.

Airway Resistance

26. List the factors that control airway diameter and consequent resistance and the effect of air flow rate and required pressure gradients.

Breathing Patterns and Modified Respiratory Movements

27. Discuss the various terms used for different breathing frequencies and muscle groups employed in distinct respiratory movements.

27. List the known functions and causes for modified respiratory movements.

LUNG VOLUMES AND CAPACITIES

29. Define the various lung volumes and capacities.

EXCHANGE OF OXYGEN AND CARBON DIOXIDE

30. Describe the cell and fluid compartments through which oxygen and carbon dioxide must diffuse to get from alveolar air to the tissue cells and out of the body.

Gas Laws: Dalton’s and Henry’s Laws

31. Define Dalton’s law in terms of the partial pressure of a gas and the units of pressure, and then demonstrate how to calculate the number of mm Hg produced by a gas with a set partial pressure in a container with a set total pressure.

31. State and explain the partial pressures of oxygen and carbon dioxide in the air and at pertinent points of the body.

32. Define Henry’s law and its relationship to the solubility of the respiratory gases in the blood.

33. Discuss how the external pressure of a gas affects the physical state of that gas dissolved in a fluid.

34. Discuss how Henry’s law can be used to increase the amount of oxygen in a person’s blood.

External Respiration

36. Explain the diffusion of the respiratory gases between the lung alveoli and lung capillaries.

36. Discuss the factors that affect the rate of external respiration.

Internal Respiration

38. Explain the diffusion of the respiratory gases between the tissue capillaries and the tissues.

TRANSPORT OF OXYGEN AND CARBON DIOXIDE IN THE BLOOD

39. Discuss the role of the blood in transporting oxygen and carbon dioxide between the lungs and tissues.

Oxygen Transport

40. Discuss the methods for transporting oxygen in blood.

Hemoglobin and Oxygen Partial Pressure

41. Discuss the effect of oxygen partial pressure on oxygen binding to and dissociating from hemoglobin.

Other Factors Affecting Hemoglobin Affinity for Oxygen

42. Discuss factors other than the partial pressure of oxygen that influence the affinity with which hemoglobin binds oxygen.

Comparison of Adult and Fetal Hemoglobin

43. Explain why it is necessary for fetal hemoglobin to have a greater affinity for oxygen than maternal hemoglobin.

43. Discuss what occurs with carbon monoxide poisoning.

Hypoxia

45. Give the definition, causes, and effects of hypoxia.

Carbon Dioxide Transport

46. Describe the three main forms by which carbon dioxide is transported in blood.

46. Explain how these forms change in the lungs versus the tissues.

Summary of Gas Exchange and Transport in Lungs and Tissues

48. Discuss how all the factors that influence oxygen and carbon dioxide content in the blood interact to facilitate delivery of the gases to their respective destinations.

REGULATION OF RESPIRATION

49. Cite the location of the neural centers that allow the respiratory system to provide the disparate amounts of oxygen needed under the extreme range of metabolic demands.

Respiratory Center

50. Identify the three brain stem centers that regulate respiration.

Medullary Rhythmicity Center

51. Discuss the mechanism by which the medullary rhythmicity center establishes the basic cycle of ventilation.

Pneumotaxic Area

52. Discuss the interactions between the pneumotaxic area and the rhythmicity center to initiate expiration and set the rate of breathing.

Apneustic Area

53. Describe how the apneustic area interacts with the rhythmicity center to control the transition from inspiration to expiration.

Regulation of the Respiratory Center

54. Explain the influences from higher CNS areas and peripheral receptors on ventilation patterns.

Cortical Influences

55. Discuss the means that limit conscious control over respiration.

Chemical Regulation

56. Discuss the negative feedback control system through which differing chemical conditions in the blood regulate the breathing pattern.

57. Give the definition, causes, and effects of hypoxia.

Neural Changes Due to Movement

58. State how muscle movements stimulate appropriate changes in breathing in preparation for exercise.

Inflation Reflex

59. Cite the components involved in the inflation reflex and their purpose.

Other Influences

60. List the other significant factors that influence breathing patterns.

EXERCISE AND THE RESPIRATORY SYSTEM

61. Describe the effects of exercise on the respiratory system.

61. Discuss why smokers have lowered respiratory efficiency.

DEVELOPMENTAL ANATOMY OF THE RESPIRATORY SYSTEM

63. Describe the development of the respiratory system.

AGING AND THE RESPIRATORY SYSTEM

64. Describe the effects of aging on the respiratory system.

DISORDERS: HOMEOSTATIC IMBALANCES

65. Discuss asthma, chronic obstructive pulmonary disease, lung cancer, pneumonia, tuberculosis, coryza and influenza, pulmonary edema, and cystic fibrosis.

MEDICAL TERMINOLOGY

66. Define medical terminology associated with the respiratory system.

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