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Module A2: Upper Airway Anatomy & Physiology

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1 Module A2: Upper Airway Anatomy & Physiology

2 Objectives Classify epithelial tissue based on cell type and tissue layers. Identify location of tissue epithelium in the respiratory system. Describe the major structures and functions of the upper and lower airways. Contrast and compare mouth and nose breathing. Explain how placing an endotracheal tube in the airway will affect the humidification and filtering process.

3 The lung is for gas exchange.
John B. West Respiratory Physiology: The Essentials

4 Function of the Lungs/Heart
Provide Ventilation Provide Respiration Exchange of Carbon Dioxide and Oxygen Humidify and Protect Pump oxygen to vital organs Cellular metabolism

5 Failure of the Lungs/Heart
Hypoxemia – low oxygen level in the blood Decreased PaO2 Hypoxia - low oxygen level at the tissue level Decreased oxygen at the cellular level can cause death of the tissue Presence of anaerobic respiration

6 Ventilation Brain Muscles Lungs Inability of the lungs to remove carbon dioxide leads to hypercarbia, which is an elevated amount of carbon dioxide in the blood stream (PaCO2)


8 ARTIFICIAL AIRWAYS Tracheotomy with tracheostomy tube: 1 - Vocal cords 2 - Thyroid cartilage 3 - Cricoid cartilage 4 - Tracheal cartilages 5 - Balloon cuff INTUBATION

9 Intubation – Insertion of an Endotracheal Tube Extubation – Removal of the Endotracheal Tube

10 Anatomy of the Respiratory System
Tissue Epithelium Upper Airway Lower Airway Site of Gas Exchange Pulmonary Vascular System Neural Control Lungs Mediastinum Thorax Muscles of Ventilation

11 Four Tissue Types Epithelial Tissue Connective Tissue Muscle Tissue
Bone, Cartilage, Blood, Fibrous Muscle Tissue Nervous Tissue Neurons conduct electrical impulses

12 Epithelial Tissue Epithelium Covers and protects the body surface
Lines body cavities Forms many glands Specializes in moving substances into and out of the blood

13 Epithelial Cell Type Squamous Cells Cuboidal Cells Columnar Cells

14 HISTOLOGY 101 Lots of Surface Area aka Pavement, Sunny-side up egg
Lots of Surface Area aka Pavement, Sunny-side up egg Great for Diffusion of Gases Lots of Volume Volume = Cytoplasm Cytoplasm means metabolism Less diffusion Height is 2x Width Usually associated with secretion or absorption of material Very little diffusion

15 Classification of Epithelium by Layers
Simple Epithelium – Single Layer Simple squamous Simple cuboidal Simple columnar Stratified Epithelium – Multiple Layers Pseudostratified – Single Layer but appears stratified Pseudo means “false”


17 Nose to Large Bronchioles
Goblet Cells Nose to Large Bronchioles Secrete mucus

18 Stratified Squamous Epithelium
Associated with PROTECTION Anterior portion of nasal cavity Oral cavity Oropharynx Laryngopharynx

19 Pseudostratified Columnar Epithelium
SECRETION OF AND SWEEPING OF MUCUS Posterior 2/3 of nose Tracheobronchial tree Function of cilia

20 Simple Cuboidal Epithelium
PRIMARY FUNCTION IS SECRETION, FILTRATION & ABSORPTION Bronchioles Clara Cells Non-ciliated cells that secrete “surface-active agents” which prevent collapse. Simple Cuboidal also found in alveoli (Type II cells that secrete surfactant)

21 Simple Squamous Epithelium
PRIMARY FUNCTION – GAS EXCHANGE Alveoli (Type I pneumocytes) Pulmonary capillaries

22 Upper Airway Anatomy Nose Oral Cavity Pharynx Throat

23 Upper Airway Function of the Upper Airway Conduct Air
To prevent foreign materials from entering the lower airway Smell/Speech

24 Nose Function Heat, Humidify and Filter the incoming gas Smell Speech

25 Anatomy of the Nose Bone and Cartilage
Partition in the nose is called the nasal septum Air enters through the nostrils or nares Two nasal passages are called choanae Vibrissae filter the incoming gas Whiskers First 1/3 is stratified squamous epithelium (PROTECTION) Posterior 2/3 is pseudostratified ciliated columnar epithelium (MUCUS SECRETION)

26 Anatomy of the Nose Mucous secreting glands are found in the posterior 2/3 of nose Bony Protrusions on the lateral wall are called nasal turbinates or conchae Separate incoming gas into turbulent airstreams – more contact Extensive capillary network Constrict or dilate to change blood flow

27 Nasal Conchae

28 Deviated Septum The nasal septum can be deviated to the right or left
More often to the left

29 PURPOSE: They serve a dual purpose; the mucus secreted keeps the nose form drying out and keeps the air we breathe in moist, and because they contain air, they make the voice we produce echo and resonate.

30 Rhinitis: Inflammation of the nasal membrane 20% of Population
NONE Rhinitis: Inflammation of the nasal membrane 20% of Population $5.3 Billion/Year

31 Physiology of the Nose Nose can filter particles down to 5 m (microns) in diameter Two factors which decrease the humidification and filtering ability of the nose is: Mouth Breathing Placement of an ET (endotracheal) tube

32 Paranasal Sinuses Empty air spaces found in the bones of the skull; Paired Frontal Ethmoid Sphenoid Maxillary They contain mucous secreting goblet cells which drain into the nasal cavity


34 Nose and Nasal Cavities

35 http://evolvels. elsevier. com/section/default. asp

36 Anatomy of the Oral Cavity
Roof of the mouth is formed by the hard and soft palate Hard – Bony portion Soft – Fleshy portion Uvula is the soft fleshy structure Epithelium is stratified squamous epithelium which is non-ciliated. Palatine (faucial) tonsils are located on each side of the oral cavity.



39 Pharynx - Throat Nasopharynx Oropharynx Laryngopharynx

40 Nasopharynx Located posterior to nasal cavity
Pseudostratified ciliated columnar epithelium Includes pharyngeal tonsils or adenoids Eustachian Tubes (auditory tubes) Connects the middle ear and nasopharynx Middle ear infection is called otitis media Complication of ET tubes

41 Oropharynx Lies behind the oral cavity
Lingual tonsils lie at the root of the tongue Statified squamous epithelium

42 Laryngopharynx Lies between the base of the tongue and the entrance to the esophagus Lies posterior to the epiglottis Stratified squamous epithelium aka Hypopharynx


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