2.  Respiration › Unconscious exchange of air between lungs and the external environment › Breathing  Two types › External  Exchange of carbon dioxide and oxygen between the environment and the organism › Internal  Exchange of O2 and CO2 between internal body fluids (Ex: blood and individual cells)

3.  Oxygen › Breathed into the lungs (O 2 ) › Body has a 4-6 minute supply of oxygen  Carbon Dioxide › Exhaled out of the lungs › CO2  Gas exchange › Transfer of oxygen from inhaled air into the blood and the transfer of carbon dioxide from the blood into the exhaled air

4.  Nose/mouth › Route to take in O2 and expel CO2. mucous membranes warm and humidify air  Cilia › Tiny hairs that protect the nasal passages, trachea and bronchi › Move back and forth as air is inhaled, pushing foreign particles (dust) toward the nostrils or pharynx  Pharynx › Throat http://cache.eb.com/eb/image?id=82620&rendTypeId=4

5.  Larynx - voicebox  Trachea › Windpipe › Connects the pharynx to the lungs › Wrapped in cartilage for protection  Bronchus (plural bronchi) › The trachea divides into two main bronchi (left mainstem and right mainstem) › Main airways within the lungs  Bronchioles › Branch off of the bronchi. › Do not contain cartilage › Small airways within the lungs

6.  Alveolar sacs › Located at the end of the bronchioles › Look like a bunch of grapes › Surrounded by capillaries › Site of gas exchange  Lungs › Right lung: 3 lobes › Left lung: 2 lobes Why is the left lung smaller than the right?

8. Normal vs. Abnormal lung structure

9.  Auscultation › Listening to sounds within the body using a stethoscope  Percussion › Tapping on a surface to determine the difference in the density of the underlying tissue › “is the underlying tissue solid or filled with air? › Lungs should sound hollow when tapping over them; should NOT sound solid › http://www.youtube.com/watch?v=CvyrA8c5cY0&NR=1  Sputum › Mucous expelled from the respiratory tract mixed with saliva › Able to make diagnoses based on color and composition of sputum

10.  Rales › Clicking, rattling and crackling noises › Caused by the opening of small airways (alveoli collapse by fluid or lack of air) › Heard during inspiration where there is fluid or pus in the alveoli › Cause: pneumonia, bronchitis  Wheezing › Whistling sound caused by bronchial airways being narrowed or obstructed › Cause: asthma, bronchitis

11.  Rhonchi › Coarse rattling sound (like snoring) caused by sputum in the bronchial airways › Heard during inhalation and exhalation › Cause: bronchitis http://www.stethographics.com/main/physiology_ ls_vesicular.html

12.  Chest X ray (CXR) › X ray of the thoracic region of the body to look for lung problems (pathology) › Diagnose pneumonia, TB, asthma

14.  Hypoxemia  Hypoxemia - low levels of oxygen in the blood  Dyspnea  Dyspnea - difficult, painful breathing  Shortness of breath  Shortness of breath (SOB) - difficulty “catching” your breath  Intubation  Intubation - placement of an endotracheal (ET) tube into the trachea of a person who is unable to breathe on their own

15.  http://www.youtube.com/watch?v=eRkleyIJi9U http://www.youtube.com/watch?v=eRkleyIJi9U

16.  Upper respiratory infection (URI) › The common cold, Viral illness, highly contagious › Lasts for a week › Symptoms: runny nose, cough, fever, sore throat, congestion Would antibiotics be effective as treatment? Why/why not?  Influenza › The flu, Viral illness, highly contagious › Symptoms: chills, fever, cough, sore throat, runny nose, muscle pain, fatigue › Annual vaccination is recommended for the elderly, health care workers, people with chronic diseases and pregnant women Why is a vaccine needed every year?

17.  Chronic, no cure  Alveoli lose elasticity and deteriorate, CO 2 becomes trapped in alveoli and they become over expanded, gas exchange is poor smoking  Usually caused by heavy smoking  Symptoms: dyspnea, feeling of suffocation, barrel chest, chronic cough, cyanosis  Treatment: bronchodilators, oxygen, avoiding smoking, prompt treatment of infections

18.  Smoker’s lung with emphysema  Normal lungs

20.  Chronic Obstructive Pulmonary Disease  Any chronic lung disease that results in obstruction of the airways  Chronic bronchitis, emphysema, asthma and tuberculosis can lead to COPD  Smoking is the primary cause

21.  Airflow obstruction due to bronchospasm, swelling of the bronchioles and/or bronchi, and increased mucous in the airways. › Bronchospasm: severe contraction of smooth muscle covering bronchioles/bronchi  Symptoms: wheezing, cough, dyspnea, chest tightness, SOB  Reversible with inhaled medications that relieve the bronchospasm

23.  Bronchoscopy › A bronchoscope (camera) is inserted into the airways through the nose or mouth so the doctor may look for abnormalities within the bronchi.  Tracheostomy › An airway is created by making an incision into the trachea through the neck › Used as an emergency or a permanent fix