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Respiratory system

5 Functions of the
Respiratory System
1. Provides extensive gas exchange
surface area between air and
circulating blood
2. Moves air to and from exchange
surfaces of lungs
5 Functions of the
Respiratory System
3. Protects respiratory surfaces from
outside environment
4. Produces sounds-speaking, singing
5. Participates in olfactory sense
The respiratory tract
Organization of the
Respiratory System
 The respiratory system is divided into
the upper respiratory system, above the
larynx, and the lower respiratory
system, from the larynx down
The Respiratory Tract
 Consists of a conducting portion:
– from nasal cavity to terminal bronchioles
 Consists of a respiratory portion:
– the respiratory bronchioles and alveoli -
Are air-filled pockets within the lungs
 where all gas exchange takes place
Nasal cavity
 External nares
(nostrils)
 Nasal septum
 Mucous membrane
 Posterior nasal
aperture (internal
nares)
21.3a
The Nasal Cavity
 The nasal septum:
– divides nasal cavity into left and right
 Mucous secretions from paranasal
sinus and tears:
– clean and moisten the nasal cavity
 Superior portion of nasal cavity is the
olfactory region:
– provides sense of smell
The Nasal Mucosa

 Warm and
humidify inhaled
air for arrival at
lower respiratory
organs
 Breathing
through mouth
bypasses this
important step
The Pharynx
 A chamber
shared by
digestive and
respiratory
systems
 Extends from
internal nares to
entrances to
larynx and
esophagus
Divisions of the Pharynx
 Nasopharynx
 Oropharynx
 Laryngopharynx
The
Nasopharynx
 Superior portion of
the pharynx
 Contains
pharyngeal tonsils
and openings to
left and right
auditory tubes
The
Oropharynx
 Middle portion of
the pharynx
 Communicates
with oral cavity
The
Laryngopharynx
 Inferior portion of
the pharynx
 Extends from
hyoid bone to
entrance to larynx
and esophagus
The Larynx
 The larynx is a cartilaginous structure lying
between the pharynx and the trachea.
 The larynx houses the vocal cords.
 A flap of tissue called the epiglottis covers
the glottis, an opening to the larynx.
 In young men, rapid growth of the larynx
and vocal cords changes the voice.
Anatomy of the Larynx

Figure 23–4
Cartilages of the Larynx
 3 large, unpaired
cartilages form the
larynx:
– the thyroid cartilage
– the cricoid cartilage
– the epiglottis
The Thyroid Cartilage
 Also called the Adam’s
apple
 Is a hyaline cartilage
 Forms anterior and
lateral walls of larynx
 Ligaments attach to
hyoid bone, epiglottis,
and laryngeal cartilages
The Cricoid Cartilage

 Is a hyaline
cartilage
 Form posterior
portion of larynx
 Ligaments attach
to first tracheal
cartilage
 Articulates with
arytenoid
cartilages
The Epiglottis
 Composed of
elastic cartilage
 Ligaments
attach to thyroid
cartilage and
hyoid bone
Cartilage Functions

 Prevents entry of food and liquids into respiratory


tract
– During swallowing:
– the larynx is elevated
– the epiglottis folds back over glottis
 Thyroid and cricoid cartilages support and protect:
– the glottis
– the entrance to trachea
The Glottis

Figure 23–5
Sound Production
 Air passing through glottis:
– vibrates vocal folds
– produces sound waves

Sound Variation
 Sound is varied by:
– tension on vocal folds
– voluntary muscles (position arytenoid cartilage
relative to thyroid cartilage)
Speech
 Is produced by:
– phonation:
 sound production at the larynx
– articulation:
 modification of sound by other structures
The Trachea
 The trachea, supported by C-shaped
cartilaginous rings, is lined by ciliated
cells, which sweep impurities up toward
the pharynx.
 Smoking destroys the cilia.
 The trachea takes air to the bronchial tree.
 Blockage of the trachea requires an
operation called a tracheostomy to form
an opening.
Trachea
 Larynx to bronchi (C6-T7)
 Air passageway

21.1
The Trachea
 Also called the
windpipe
 Extends from
the cricoid
cartilage into
mediastinum
– where it
branches into
right and left
pulmonary
bronchi
The Tracheal Cartilages
 15–20 tracheal cartilages:
– strengthen and protect airway
– discontinuous where trachea contacts
esophagus
 Ends of each tracheal cartilage are
connected by:
– an elastic ligament and trachealis muscle
The Bronchial Tree
 The trachea divides into right and left
primary bronchi which lead into the right
and left lungs.
 The right and left primary bronchi divide
into ever smaller bronchioles to conduct
air to the alveoli.
 An asthma attack occurs when smooth
muscles in the bronchioles constrict and
cause wheezing.
The Primary Bronchi
 Right and left primary bronchi:
– separated by an internal ridge (the carina)

The Right Primary Bronchus


 Is larger in diameter than the left
 Descends at a steeper angle
Bronchial tree
 1° bronchi
 2° bronchi
 3° bronchi
 ~23 branches

21.8
Bronchioles
 <1 mm diameter
 Terminal
bronchioles
– <0.5 mm diameter
 Respiratory
bronchioles
– Scattered alveoli

21.9a
Alveolar ducts
 Continuous alveoli
 Atrium
 Leads to alveolar sacs

21.9a
Alveolar wall

 Respiratory membrane
– Type I cell
 Simple squamous
epithelium
– Basal lamina (shared)
– Endothelium of capillary

21.10cd
Alveolar wall
 Type II cell
– Secretes surfactant
– Begins at birth
 Alveolar
macrophages
– Dust cells

21.10c
Pleura

 Serous membrane
 Parietal pleura
– Lines thoracic cavity
 Visceral pleura
– Covers lungs
 Pleural cavity
– Pleural fluid
– Lubrication 21.11
Gross anatomy of the lungs
 Apex
– Deep to clavicle
 Base
– On diaphragm
 Pneumothorax –
air in pleural cavity

21.12a
Gross anatomy of the lungs

 Costal surface
– Next to rib cage
 Mediastinal
surface
– Medial
 Hilus

21.12b
Blood supply to the lungs

 Pulmonary arteries
– Deoxygenated
blood from R
ventricle
 Pulmonary veins
– Oxygenated blood R L
to L atrium

21.12b
Gas exchange in the lungs
The Lungs
 Lungs are paired, cone-shaped organs
that lie on either side of the heart and
within the thoracic cavity.
 The right lung has three lobes, and the left
lung has two lobes, allowing for the space
occupied by the heart.
 The lungs are bounded by the ribs and
diaphragm.
COUGH
 Cough is a natural defense mechanism of
the body which helps in clearing or throwing
of the inhaled foreign substance &
excessive secretion of respiratory tract.
 Cough is an involuntary reflex which is
controlled by cough center situated in the
medula of the brain.
Cough
 There are receptors situated in nose, nasopharynx,
larynx, auditory canal, trachea. When these
receptors senses the presence of any foreign
particle or excessive secretion they send message
to medula & in turn they are getting signal to throw
out the foreign particle & clean the secretion.
 It is important to note that cough usually manifests
in cold but it might be the initial manifestation of
serious illness such as pneumonia, T.B, left
ventricle failure or asthma.
Types of cough
 Dry cough- also named as ineffective cough as it
does not carry any secretion. This type of cough is
chronic in nature & is caused by dry irritation. It
may be because of weakness of muscles of
respiration & disease of cilia.
 Productive cough- also named as wet cough oe
effective cough as it carries secretion. This type of
cough are acute in nature & caused by bacterial or
viral infection. This type of cough must not be
suppressed otherwise recurrent infection will be
there.
Types of cough
 Acute cough- last for 2-3 weeks.
 Chronic cogh- last for more than 3 weeks.
 Dry cough-
 Wet cough-
 Bovine cough- because of paralysis of
larynx.
 Psychogenic cough- to draw attention.
SYMPTOMS OF COUGH
Cough itself is a symptom but usually
associated with---
Nose block, Breathlessness, Disturbance in
sleep, Restlessness, Body aches,
Haemoptysis , Nausea, Vomiting
CONSEQUENCES
 May aggravate piles or fissure as the anus
gets tightly closed during cough.
 Pressure in abdomen increases hence may
cause hernia.
 Suture may open in patient who has under
gone surgery.
 Due to pressure in chest air emphysema
may develop.
Prevention of cough
 Avoid -1. smoking & dust exposure
2.Cold food item, 3. contact with infected
person. 4.continuous sage of medication.
Take-1. rest with good ventilation. 2. plenty of
fluid. 3.frequent light & small meal. 4. steam
inhalation to loosen the phlegm.5. vit.C & Zn
to shorten the duration.
Medication
 Cough suppressant( codeine, Noscapine,
Dextromethorphen )
 Cough expectorant (Sodium citrate,
Ammonium chloride guaiphenesin)
 Anti allergic (CPM, CETRIZINE,
LORATIDINE, DIPHENHYDRAMINE,
PROMETHAZINE)
 Mucolytic (AMBROXOL, BROMOHEXINE)
Allergy
An allergy can occur when the body’s natural
defense system overreacts to an foreign
substance such as pollen.
Some common allergens are-
Pollen
Moulds,
Chemicals
House dust
Symptoms
 Sneezing
 Coughing
 Rhinorrhoea
 Itching
 Headache
 Nasal congestion
PHYSIOLOGICAL ROLE OF
HISTAMINE
Histamine is a chemical which helps in-
Regulation –
The regulation of gastric secretion,
Act as neurotransmitter in brain,
Helps in tissue synthesis.
The cell which contain histamine are known as mast
cell.
The histamine locked inside the mast cell are friend .
The moment they are librated from it the problem
of allergy starts.
Release of Histamine
Histamine are released as a result of antigen-
antibody reaction. The moment antigen enters in
our body the bodies defense which is constituted
of WBC get activated & produces 5-type of
immunoglobulins ( out of which 4 types swims in
blood to kill the antigen whereas the 5th one is Y
shaped known as IGe has got high affinity for mast
cell). Up to first visit of allergen the above series of
reaction takes place.
Release of Histamine
Allergic manifestation occurs when same allergens
attack second time then it get attached to the arms
of IGe without undergoing the previous reaction.
Now the arms of each IGe is attached with the
help of antigen. This is called bridge formation.
Then a series of reaction takes place which
causes rupturing of mast cell & release of
Histamine which then gets attached to H1 receptor
& gives rise to allergic condition.
Release of Histamine
 Histamine action on H1-receptor in blood
vessels causes fluid & proteins to leak out.
 Capillary leakage causes edema.
 Itching & pain due to irritated sensory nerve
ending.
Allergic manifestation
Vasodilatation
Reddening & local edema
Constriction of smooth muscles
Fall of blood pressure
Increase in cardiac rate
Increase in the secretion of saliva,tears,gastric&
pancreatic juice.
Nasal irritation
Watery discharge from eyes & nose
Any question ?
Always remember “ question are guaranteed
but answers are not”.

Thank you
Rinostat Plus
Composition
 Rinostat Plus tablet

Each uncoated tablet contains:


Acetaminophen I.P :500mg
Phenylpropanolamine HCl B.P:25 mg
Chlorpheniramine maleate I.P :4mg

 Rinostat Plus Liquid

Each 5 ml contains:
Acetaminophen I.P:125 mg
Phenylpropanolamine HCl B.P:12.5mg
Chlophenarime Maleate I.P :1mg
Rinostat Plus
 Therapeutic class
Anti-allergic, Decongestant and anti-
inflammatory
Rinostat Plus - Role

 Acetaminophen
– Antipyretic, Analgesic, Anti-inflammatory.
– Potent inhibitor of cyclo-oxygenase in CNS
– Oral bioavailability is about 80%
– Plasma half-life 1.5 to 3.0h
– Plasma protein binding < 20%
– Extensively metabolized in liver and excreted in
urine
Rinostat Plus - Role
 Phenylpropanolamine HCl
– Indirectly acting sympathomimetic amine
– Acts on adrenergic receptors (α1) & produces
vasoconstriction thus reduces mucosal
edema in Resp. tract & decongestant effect
Rinostat Plus - Role
 Phenylpropanolamine HCl
– Oral absorption > 90%
– Plasma half-life 3-5h
– Protein binding negligible
– Eliminated mainly unchanged in urine
Rinostat Plus - Role
• Chlorpheniramine Maleate
– Antihistaminic
– Blocks H1 receptor
– Prevents vasodilatation induced by histamine
and suppresses capillary permeability resulting
in reduction of edema or wheal formation and
itch
Rinostat Plus - Role
 Chlorpheniramine Maleate
– Oral absorption > 80%
– Plasma half – life 15h
– Protein binding 67-72%
– Metabolized in liver and excreted in urine
Rinostat Plus - Indications
 Symptomatic relief from Common cold &
associated symptoms
Rinostat Plus - Dosage
 Adults - One tab Three times a day
 Children - 2 to 6 yrs.- 5ml 3-4 times daily
6 to 12 yrs.- 10ml 3-4 times a daily
Rinostat Plus - Presentation
 Rinostat Plus tablet - Packing is Strip of 6 tabs.
 Rinostat Plus liquid - Pack of 60 ml bottle
Rinostat Plus - USPs
 Relieves congestion
 Quick relief from headache,fever & other
symptoms
 Nose
 Nose – warms, moistens and filters air;
 functions in olfaction (smell) and
speech
 Pharynx – Nasopharynx – respiration
 Oropharynx and Laryngopharynx –
digestion
 and respiration.
 Larynx – Vocal cords produce sound as they
vibrate
 Though the nose is primarily. An
olfactory.organ,
 it. also plays, a role in the
clearance of foreign substances
 Including dust, allergens and
bacteria. The structure
 structure and function of nose in
‘humans is related
 to the modification of inspired
air, that is warming, '
 humidifying and filtering of
noxious particles by the
 mucociliary function.
 The functions of the mucus include:
 Keeping nasal surfaces moist.
 2. Protecting the mucosa.
 Raping small particles out of inspired air and keeping most
of these from reaching the alveoli of lungs.
 The beating of the cilia moves the mucus-layer along with
particles of dust picked up by it towards the nasopharynx,
from where the material is dispatched by the wiping action
of the palate to the stomach periodically through
swallowing.
 The function of the nose is to warm, moisten and filter the
air inspired.
 Nasal mucocilliary clearance
 Average rate of nasal clearance Is 5-6mm-
1cm/min. This combined action
 Of the mucus layers and nasal cilia is called the
mucocillary clearance. The
 nasal ciliary clearance is one of the most important
physiological defense mechanisms of the
respiratory tract to protect the body against any
noxious material inhaled.
Pathophysiology:

 Inflammatory conditions such as allergy and infection cause the nasal


mucosa, that is the lining to the nasal cavity, to swell When the
mucosa, swells, the area available through which air can pass is
diminished, and therefore one experiences a sense of nasal
obstruction. Allergy is the most common inflammatory cause of nasal
obstruction, but infection, either by viruses such as the common cold or
bacteria as often found in sinusitis may cause nasal obstruction. .
 When the nose is congested, decongestants are administered
intranasal for a more
 rapid onset of action. However their use (or more than three to five
days can result in rebound nasal congestion, which loads to rhinitis
medicammentosa, a disorder characterized by chronic swelling and a
red boggy, edematous (swollen) appearance of the nasal mucosa.
 The swelling (edema) probably results from an irritant effect on the
nasal mucosa
Allergy Basics

 An allergy can occur when the human body's natural


defense system (immune system) overreacts to an
otherwise harmless substance such as pollen.
 Some common allergens include:
 - Pollen
 - Moulds
 - House dust mites
 - Animal dander and saliva (cat, dog, horse, rabbit)
 - Chemicals
 - Some foods and medicines
 Venom from insect stings
Symptoms of Allergy

 Sneezing, coughing, rhinorrhoea, itching (pruritis)


 Headache, nasal congestion, anaphylaxis (severe)
 Antigen
 A protein marker on surface of cells.
 (eg: an allergen)
 -Stimulates production of antibodies
 Antibodies
 Complex protein produced by B-lymphocytes in response
to presence of antigen.
 Antibodies (eg: Immunoglobulins such as IgE) combine
with specific antigens to destroy/control them
Antigen Antibody Reaction
Rhinitis:

 Rhinitis means an inflammation of the nose. The


discharge from the nose can come through the
front of the nose or it can drain through the back of
the nose, a condition, which is, called post-nasal
drip. The discharge may be clear or it may be
colored, most commonly yellow or green.
 Allergy frequently produces a running nose. In
these cases the discharge will be clear or
occasionally white. Infection also causes nasal
discharge, and this will be a purulent discharge
most commonly colored yellow or green. Irritation
to the nose can also cause discharge.
•This discharge is most commonly clear or white and many people
experience it when exposed to nasal irritants. Many individuals exposed
to cold air or to smoke will have nasal discharge and tin's is an irritate
rhinitis. A very common cause of a running nose is a condition called
vasomotor rhinitis. In this condition, the nose responds to stress with a
tremendous production of nasal secretions.
Rinostat XL.
0.1% Nasal Drops

Composition;
Xylometazoline Hydrochloride IP 0.1% w/v.
In an aqueous isotonic solution using purified water i.p.
Preservative: Benzakolium chloride USP 0.011% w/v.
Dosage: Adults and Children over 6 years: 2-3 drops into each nostril per
application.
A total of 3-4 applications per day are usually sufficient.
Rinostat XL 3 drops 3 times for 3 days provides 333 express relief from nasal
congestion.
Rinostat XL provides 333 express relief within 10 minutes without any rebound
congestion.
Xylometazoline
 Xylomeatzoline is a directly acting
sympathomimetic with marked alpha
adrenegeric activity. It is a vasoconstrictor,
which reduces swelling and congestion
when applied to mucous membranes. The
effect begins from 5 to 10 minutes.
 Indication:
 Acute or chronic Rhinitis
 Acute Sinusitis.
 Common cold.

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