Medical Training - Anatomy - For internal use only.

Medical Training- Anatomy -

For internal use only

© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008 2

Objective of the Presentation

• This presentation on the subject of anatomy of the respiratory system gives participants an overview of the anatomical structures required for normal respiration in a human being.


Contents

• Conducting airways• Gas exchange system• Lungs, thorax, diaphragm• Central controller• Upper and lower airways• Oxygen transport


Overview

• The respiratory system includes – in addition to the air-conducting and gas exchanging respiration tract – all other structures involved in breathing.

• They are categorized in groups according to anatomical descriptions (upper/lower airways) or to basic functions (air-conducting/gas-exchanging system).


Conducting Airways

The conducting airways are divided into:• Nose• Mouth• Pharynx• Larynx• Trachea• Bronchial tree

Within the conducting airways the air is warmed, moistened and transported.


Gas Exchange System

•The gas exchange system is subdivided into– alveoli– capillary network

Within the gas exchange system oxygen is taken up by the blood and carbon dioxide is removed from the lungs.


Lungs

Two lungs: right lung and left lungHilum of lung: main bronchus and vesselsRight:

Superior lobe (3 segments)Median lobe (2 segments)Inferior lobe (5 segments)

Left: Superior lobe (4 – 5 segments)Inferior lobe (5 segments)

Base of lung (basis pulmonis)Apex of lung (apex pulmonis)Visceral pleura (= pleura pulmonalis)


Thorax and Diaphragm

• Osseous Thorax– Thoracic spine– Ribs (costae)– Breastbone (sternum)– Parietal pleura

• Diaphragm• Intercostal muscles

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Respiratory Controller

• Respiratory center in brainstem

• Medulla oblongata

© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008


Upper Airways

• The upper airways begin with the mouth or nose and come together in the pharynx and end near the larynx.

• The upper airways also contain the pathway for nutrition (oropharyngeal area).

• Airway assistance such as nasopharyngeal (Wendl) tubes or oropharyngeal (Guedel) tubes can be used within the upper airways.


Nasal Cavity

• Organ for inspiration and expiration• Warms respiratory air• Moistens respiratory air• Filters out foreign bodies (by means of nasal hair and cilia)


Pharynx

• Throat• Part of the respiratory and digestive systems• Mucosal covering• Component of upper airways


Larynx

• = voice box• Transition from upper to lower airways• Made up of three large pieces of cartilage

– Thyroid cartilage (cartilage thyroidea)– Cricoid cartilage (cartilago cricoidea) – Epiglottis

• Function: closes off the airways– to swallow– to cough– to generate sound


Lower Airways

• The lower airways start at the subglottis• The lower airways contain the trachea, main bronchus, segmental

bronchi• The lower airways run to the alveoli level and, together with the

upper airways, form the air-conducting system.


Trachea• = windpipe• Length: approximately 10 – 12 cm• Width: approx. 16 –18 mm • 16 – 20 rings of cartilage with membrane of connective tissue and

muscles• Mucus membrane: ciliated epithelium with goblet cells• Bifurcation: Division of trachea (at 70° angle)

into right and left main bronchus


Bronchial Tree• Two (left and right) main

bronchi (bronchi principales) • Two to three lobar bronchi

(bronchi lobares )• Two to five segmental

bronchi• Subsegmental bronchi• Bronchioles• Terminal bronchioles• Respiratory bronchioles• Alveoli system (alveolar

ducts, alveolar atria, alveolar sacs)


Surfactant

• Surface active agent • Surface active substance on the interior surface of alveoli• Reduction of surface tension by a factor of 15 to 20 • Reduction of “opening pressure” of small alveoli • To increase pulmonary compliance• To prevent collapse of alveoli at end of expiration


Alveoli

Cells of alveoli wall• Pneumocyte Type I• Pneumocyte Type II• Capillary endothelium• Interstitial cells (fibrocytes,

lymphocytes, mastocytes)• Alveolar macrophage


Gas Exchange

• Transfer of O2 from the

alveoli into blood or of CO2 from blood into alveoli by means of alveolar-capillary membrane


Alveolar epithelium

Interstitium

Capillary endothelium

Plasma

Erythrocyte

Alveolar-Capillary Membrane


Oxygen Transport

• 98.5 % binds to hemoglobin (Hb)– Hemoglobin = red blood pigment in erythrocytes– Cooperative binding of four oxygen molecules– 1 gram Hb can bind 1.34 ml oxygen

• 1.5 % physiologically dissolved


Summary

• Basic knowledge of anatomy of airways makes respiratory disorders more understandable.

• Basic knowledge of anatomy is a prerequisite for understanding respiratory physiology.

• Basic knowledge of anatomy and physiology are fundamental prerequisites for patient adaptive ventilation.

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Medical Training - Anatomy - For internal use only.

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