Respiratory System

Overview

The primary function of the respiratory system is to take in oxygen (O2) and to blow off carbon dioxide (CO2). The respiratory system does this through breathing. When we breathe, we inhale oxygen(O2) and exhale carbon dioxide(CO2). This exchange of gases is the respiratory system's means of getting oxygen to the blood.

In normal respirations, the diaphragm contracts, expanding the lungs and drawing in air and O2. The air is drawn in through the mouth and nose -> pharynx > larynx > and goes into the trachea, a tube that enters the chest cavity. The trachea is lined with cilia, little eyelash-like cells that are constantly in a sweeping motion mobilizing the dust filled mucus from inside the lung out to be coughed up and spit out or swallowed. The trachea splits into two smaller tubes called the bronchi and each bronchus then divides again forming the bronchial tubes and continues to divide into many smaller tubes that finally reach the alveoli. The alveoli are where the O2 and CO2 exchange takes place. Here is where the respiratory system connects to the circulatory system. Capillaries are wrapped around the alveoli exchanging O2 and CO2. The average adult's lungs contain about 600 million of these spongy, air-filled sacs that are surrounded by capillaries. The inhaled oxygen passes into the alveoli and then diffuses through the capillaries into the arterial blood. Meanwhile, the waste-rich blood from the veins releases its carbon dioxide into the alveoli. The carbon dioxide follows the same path out of the lungs when you exhale.

The diaphragm's job is to help pump the carbon dioxide out of the lungs and pull the oxygen into the lungs. The diaphragm is a sheet of muscle that lies across the bottom of the chest cavity. As the diaphragm contracts and relaxes, breathing takes place. This is an example of how the musculoskeletal system works in conjunction with the respiratory system.

About the lungs

The right lung is divided into three lobes, and the left lung has two lobes. The lungs occupy most of the space in the thoracic cavity. The heart sits between the right and left lung. The lungs are soft and spongy because they are mostly air spaces surrounded by the alveolar cells and elastic connective tissue. Each lung is enclosed by a double-layered serous membrane, called the pleura. The visceral pleuron is firmly attached to the surface of the lung. Visceral pleura is continuous with the parietal pleura that lines the wall of the thorax. The small space between the visceral and parietal pleurae is the pleural cavity. It contains a thin film of serous fluid that is produced by the pleura. The fluid acts as a lubricant to reduce friction as the two layers slide against each other, and it helps to hold the two layers together as the lungs inflate and deflate. Problems can arise when fluid enters the pleural cavity. The extra fluid can compromise one or both lungs and/or the heart.

The alveoli

The alveoli is where gas exchange takes place. O2 passes through the wall of the alveoli and into the bloodstream. CO2 leaves the bloodstream through the alveoli walls and exits through the lungs. Surfactant is a substance produced by the alveoli that lines the alveoli keeping body fluids on one side and air on the other. It regulates the surface tension to prevent the lungs from collapsing. Premature babies born before their alveoli produces enough surfactant are at risk for Respiratory Distress Syndrome (RDS), their tiny lungs can collapse.

If the pressure from the fluid side is to much for the surfactant to contain, fluid can begin to fill up into the alveoli. This can happen in patients with a fluid overload or those with congestive heart failure, where blood gets backed up into the lungs. You would expect to hear crackles in these patients as you auscultate the lungs. Where there is fluid covering the alveoli, the gas exchange will be impaired and could lead to alterations in blood gasses.

--Anatomy and Physiology of the Respiratory System US Army video
--Bedside emergency: Respiratory distress

Interaction With Other Systems

Musculoskeletal system

The rib cage acts to protect the lungs and supports the structure of the thorax. The diaphragm is the muscle responsible for inflating the lungs. Intercostal muscles, around the ribs, are used to help breathing in disease.

Asthma

--Asthma Basics
--Asthma Checklist For School Nurses
--Asthma health planAction stat: Asthma attack BY Vickie Miracle, RN, CCNS, CCRC, END
--Teach Your Patients About Asthma A Clinician's Guide
--Asthma and Pregnancy

COPD (chronic obstructive pulmonary disease)

--What Is COPD?
--Patient teaching by Barbara B. Pope, RN, CCRN, MSN
--Nutrition for a patient with COPD can be complicated By Peggy O'Neill, RD, LD/N, MS
--Patient Handout
--Respiratory training can help lung patients article
--Nursing Careplan: Fatigue By Karen Kennedy, CCNS

Emphysema

--What is pulmonary emphysema? by Deanna M. Swartout-Corbeil, R.N.
--Chronic bronchitis and emphysema: Clearing the air BY Amy Wisniewski, RN, BSN
--Lung Reduction: The Procedure 14min.video
--Nursing Careplan: Ineffective breathing pattern By Ronda Phillips, CCNS

Chronic Bronchitis (see COPD/Emphysema)

--Nursing Careplan: Impaired gas exchange

Cystic Fibrosis

Interstitial Lung Diseases / Pulmonary Fibrosis

Lung Cancer

Pleural Effusions

Pneumonia

--Illistration of pneumonia
--Overview
--Care Path:Pneumonia
--Patient-Family Teaching Tool
--Orem’s Self Care Deficit Theory Clinical Care Plan by Guiomar Goransson

Pulmonary Hypertension

--What is PH?

Pulmonary Embolism

Pulmonary Sarcoidosis

Pneumothorax/Hemothorax

--Chest Trauma: Nursing Care and Management by Kristi Hudson RN, BSN, CCRN

Severe Acute Respiratory Syndrome (SARS)/Respiratory Distress Syndrome (RDS)

Tuberculosis

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