Respiratory systemRespiratory system

5 Functions of the 5 Functions of the Respiratory SystemRespiratory System

1.1. Provides extensive gas exchange Provides extensive gas exchange surface area between air and surface area between air and circulating bloodcirculating blood

2.2. Moves air to and from exchange Moves air to and from exchange surfaces of lungssurfaces of lungs

5 Functions of the 5 Functions of the Respiratory SystemRespiratory System

3.3. Protects respiratory surfaces from Protects respiratory surfaces from outside environmentoutside environment

4.4. Produces sounds-speaking, singingProduces sounds-speaking, singing

5.5. Participates in olfactory senseParticipates in olfactory sense

The respiratory tractThe respiratory tract

Organization of the Organization of the Respiratory SystemRespiratory System

The respiratory system is divided into The respiratory system is divided into the the upper respiratory systemupper respiratory system, above the , above the larynx, and the larynx, and the lower respiratory lower respiratory systemsystem, from the larynx down, from the larynx down

The Respiratory TractThe Respiratory Tract

Consists of a Consists of a conducting portionconducting portion::– from from nasal cavitynasal cavity to to terminal bronchiolesterminal bronchioles

Consists of a Consists of a respiratory portionrespiratory portion::– the the respiratory bronchiolesrespiratory bronchioles and and alveolialveoli - -

Are air-filled pockets within the lungsAre air-filled pockets within the lungs where all gas exchange takes placewhere all gas exchange takes place

Nasal cavityNasal cavity

External nares External nares (nostrils)(nostrils)

Nasal septumNasal septum Mucous membraneMucous membrane Posterior nasal Posterior nasal

aperture (internal aperture (internal nares)nares)

21.3a

The Nasal CavityThe Nasal Cavity

The The nasal septumnasal septum::– divides divides nasal cavitynasal cavity into left and right into left and right

Mucous secretions from paranasal Mucous secretions from paranasal sinus and tears:sinus and tears:– clean and moisten the nasal cavityclean and moisten the nasal cavity

Superior portion of nasal cavity is the Superior portion of nasal cavity is the olfactory regionolfactory region::– provides sense of smellprovides sense of smell

The The Nasal MucosaNasal Mucosa

Warm and Warm and humidify inhaled humidify inhaled air for arrival at air for arrival at lower respiratory lower respiratory organs organs

Breathing Breathing through mouth through mouth bypasses this bypasses this important stepimportant step

The PharynxThe Pharynx A chamber A chamber

shared by shared by digestive and digestive and respiratory respiratory systemssystems

Extends from Extends from internal nares to internal nares to entrances to entrances to larynx and larynx and esophagusesophagus

Divisions of the PharynxDivisions of the Pharynx

NasopharynxNasopharynx OropharynxOropharynx LaryngopharynxLaryngopharynx

The The NasopharynxNasopharynx

Superior portion of Superior portion of the pharynxthe pharynx

Contains Contains pharyngeal tonsils pharyngeal tonsils and openings to and openings to left and right left and right auditory tubesauditory tubes

The The OropharynxOropharynx

Middle portion of Middle portion of the pharynxthe pharynx

Communicates Communicates with oral cavitywith oral cavity

The The LaryngopharynxLaryngopharynx Inferior portion of Inferior portion of

the pharynxthe pharynx Extends from Extends from

hyoid bone to hyoid bone to entrance to larynx entrance to larynx and esophagus and esophagus

The LarynxThe Larynx The The larynxlarynx is a cartilaginous structure lying is a cartilaginous structure lying

between the pharynx and the trachea.between the pharynx and the trachea. The larynx houses the The larynx houses the vocal cordsvocal cords.. A flap of tissue called the A flap of tissue called the epiglottisepiglottis covers covers

the the glottisglottis, an opening to the larynx. , an opening to the larynx. In young men, rapid growth of the larynx In young men, rapid growth of the larynx

and vocal cords changes the voice.and vocal cords changes the voice.

Anatomy of the LarynxAnatomy of the Larynx

Figure 23–4

Cartilages of the LarynxCartilages of the Larynx

3 large, unpaired 3 large, unpaired cartilages form the cartilages form the larynxlarynx::– the the thyroid cartilagethyroid cartilage – the the cricoid cartilagecricoid cartilage– the the epiglottisepiglottis

The The Thyroid CartilageThyroid Cartilage Also called the Adam’s Also called the Adam’s

appleapple Is a hyaline cartilageIs a hyaline cartilage Forms anterior and Forms anterior and

lateral walls of larynxlateral walls of larynx Ligaments attach to Ligaments attach to

hyoid bone, epiglottis, hyoid bone, epiglottis, and laryngeal cartilagesand laryngeal cartilages

The The Cricoid CartilageCricoid Cartilage

Is a hyaline Is a hyaline cartilagecartilage

Form posterior Form posterior portion of larynxportion of larynx

Ligaments attach Ligaments attach to first tracheal to first tracheal cartilagecartilage

Articulates with Articulates with arytenoid arytenoid cartilagescartilages

The The EpiglottisEpiglottis

Composed of Composed of elastic cartilageelastic cartilage

Ligaments Ligaments attach to thyroid attach to thyroid cartilage and cartilage and hyoid bonehyoid bone

Cartilage FunctionsCartilage Functions

Prevents entry of food and liquids into Prevents entry of food and liquids into respiratory tract respiratory tract – During swallowing:During swallowing:– the larynx is elevatedthe larynx is elevated– the epiglottis folds back over glottisthe epiglottis folds back over glottis

Thyroid and cricoid cartilages support and Thyroid and cricoid cartilages support and protect:protect:– the the glottisglottis – the entrance to trachea the entrance to trachea

The GlottisThe Glottis

Figure 23–5

Sound ProductionSound Production Air passing through glottis:Air passing through glottis:

– vibrates vocal foldsvibrates vocal folds– produces sound wavesproduces sound waves

Sound VariationSound Variation

Sound is varied by:Sound is varied by:– tension on vocal foldstension on vocal folds– voluntary muscles (position arytenoid cartilage voluntary muscles (position arytenoid cartilage

relative to thyroid cartilage) relative to thyroid cartilage)

SpeechSpeech

Is produced by:Is produced by:– phonationphonation::

sound production at the larynxsound production at the larynx

– articulationarticulation:: modification of sound by other structuresmodification of sound by other structures

The TracheaThe Trachea The The tracheatrachea, supported by C-shaped , supported by C-shaped

cartilaginous rings, is lined by ciliated cartilaginous rings, is lined by ciliated cells, which sweep impurities up toward cells, which sweep impurities up toward the pharynx. the pharynx.

Smoking destroys the cilia.Smoking destroys the cilia. The trachea takes air to the bronchial tree. The trachea takes air to the bronchial tree. Blockage of the trachea requires an Blockage of the trachea requires an

operation called a operation called a tracheostomytracheostomy to form an to form an opening. opening.

TracheaTrachea

Larynx to bronchi (C6-T7)Larynx to bronchi (C6-T7) Air passagewayAir passageway

21.1

The Trachea The Trachea Also called the Also called the

windpipewindpipe Extends from Extends from

the cricoid the cricoid cartilage into cartilage into mediastinummediastinum– where it where it

branches into branches into rightright and and left left pulmonary pulmonary bronchibronchi

The The Tracheal CartilagesTracheal Cartilages

15–20 15–20 tracheal cartilagestracheal cartilages::– strengthen and protect airwaystrengthen and protect airway– discontinuous where trachea contacts discontinuous where trachea contacts

esophagusesophagus

Ends of each tracheal cartilage are Ends of each tracheal cartilage are connected by:connected by:– an elastic ligament and an elastic ligament and trachealis muscletrachealis muscle

The Bronchial TreeThe Bronchial Tree The trachea divides into right and left The trachea divides into right and left

primary bronchiprimary bronchi which lead into the right which lead into the right and left lungs.and left lungs.

The right and left primary bronchi divide The right and left primary bronchi divide into ever smaller into ever smaller bronchiolesbronchioles to conduct to conduct air to the alveoli. air to the alveoli.

An An asthma attackasthma attack occurs when smooth occurs when smooth muscles in the bronchioles constrict and muscles in the bronchioles constrict and cause wheezing.cause wheezing.

The Primary BronchiThe Primary Bronchi RightRight and and left primary bronchileft primary bronchi::

– separated by an internal ridge (the separated by an internal ridge (the carinacarina))

The The Right Primary BronchusRight Primary Bronchus

Is larger in diameter than the leftIs larger in diameter than the left Descends at a steeper angleDescends at a steeper angle

Bronchial treeBronchial tree

11 bronchi bronchi 22 bronchi bronchi 33 bronchi bronchi ~23 branches~23 branches

21.8

BronchiolesBronchioles

<1 mm diameter<1 mm diameter Terminal Terminal

bronchiolesbronchioles– <0.5 mm diameter<0.5 mm diameter

Respiratory Respiratory bronchiolesbronchioles– Scattered alveoliScattered alveoli

21.9a

Alveolar ductsAlveolar ducts

Continuous alveoliContinuous alveoli AtriumAtrium Leads to alveolar sacsLeads to alveolar sacs

21.9a

Alveolar wallAlveolar wall

Respiratory membraneRespiratory membrane– Type I cellType I cell

Simple squamous Simple squamous epitheliumepithelium

– Basal lamina (shared)Basal lamina (shared)– Endothelium of capillaryEndothelium of capillary

21.10cd

Alveolar wallAlveolar wall

Type II cellType II cell– Secretes surfactantSecretes surfactant– Begins at birthBegins at birth

Alveolar Alveolar macrophagesmacrophages– Dust cellsDust cells

21.10c

PleuraPleura

Serous membraneSerous membrane Parietal pleuraParietal pleura

– Lines thoracic cavityLines thoracic cavity

Visceral pleuraVisceral pleura– Covers lungsCovers lungs

Pleural cavityPleural cavity– Pleural fluidPleural fluid– LubricationLubrication 21.11

Gross anatomy of the lungsGross anatomy of the lungs

ApexApex– Deep to clavicleDeep to clavicle

BaseBase– On diaphragmOn diaphragm

Pneumothorax – Pneumothorax – air in pleural cavityair in pleural cavity

21.12a

Gross anatomy of the lungsGross anatomy of the lungs

Costal surfaceCostal surface– Next to rib cageNext to rib cage

Mediastinal Mediastinal surfacesurface– MedialMedial

Hilus Hilus

21.12b

Blood supply to the lungsBlood supply to the lungs

Pulmonary arteriesPulmonary arteries– Deoxygenated Deoxygenated

blood from R blood from R ventricleventricle

Pulmonary veinsPulmonary veins– Oxygenated blood Oxygenated blood

to L atriumto L atrium

21.12b

R L

Gas exchange in the lungsGas exchange in the lungs

The LungsThe Lungs LungsLungs are paired, cone-shaped organs are paired, cone-shaped organs

that lie on either side of the heart and that lie on either side of the heart and within the thoracic cavity. within the thoracic cavity.

The right lung has three lobes, and the left The right lung has three lobes, and the left lung has two lobes, allowing for the space lung has two lobes, allowing for the space occupied by the heart. occupied by the heart.

The lungs are bounded by the ribs and The lungs are bounded by the ribs and diaphragm. diaphragm.

COUGHCOUGH

Cough is a natural defense mechanism of Cough is a natural defense mechanism of the body which helps in clearing or throwing the body which helps in clearing or throwing of the inhaled foreign substance & of the inhaled foreign substance & excessive secretion of respiratory tract.excessive secretion of respiratory tract.

Cough is an involuntary reflex which is Cough is an involuntary reflex which is controlled by cough center situated in the controlled by cough center situated in the medula of the brain.medula of the brain.

Cough Cough

There are receptors situated in nose, There are receptors situated in nose, nasopharynx, larynx, auditory canal, trachea. nasopharynx, larynx, auditory canal, trachea. When these receptors senses the presence of any When these receptors senses the presence of any foreign particle or excessive secretion they send foreign particle or excessive secretion they send message to medula & in turn they are getting message to medula & in turn they are getting signal to throw out the foreign particle & clean the signal to throw out the foreign particle & clean the secretion.secretion.

It is important to note that cough usually manifests It is important to note that cough usually manifests in cold but it might be the initial manifestation of in cold but it might be the initial manifestation of serious illness such as pneumonia, T.B, left serious illness such as pneumonia, T.B, left ventricle failure or asthma. ventricle failure or asthma.

Types of coughTypes of cough

Dry cough- also named as ineffective cough as it Dry cough- also named as ineffective cough as it does not carry any secretion. This type of cough is does not carry any secretion. This type of cough is chronic in nature & is caused by dry irritation. It chronic in nature & is caused by dry irritation. It may be because of weakness of muscles of may be because of weakness of muscles of respiration & disease of cilia.respiration & disease of cilia.

Productive cough- also named as wet cough oe Productive cough- also named as wet cough oe effective cough as it carries secretion. This type of effective cough as it carries secretion. This type of cough are acute in nature & caused by bacterial or cough are acute in nature & caused by bacterial or viral infection. This type of cough must not be viral infection. This type of cough must not be suppressed otherwise recurrent infection will be suppressed otherwise recurrent infection will be there. there.

Types of coughTypes of cough

Acute cough- last for 2-3 weeks.Acute cough- last for 2-3 weeks. Chronic cogh- last for more than 3 weeks.Chronic cogh- last for more than 3 weeks. Dry cough-Dry cough- Wet cough-Wet cough- Bovine cough- because of paralysis of Bovine cough- because of paralysis of

larynx.larynx. Psychogenic cough- to draw attention.Psychogenic cough- to draw attention.

SYMPTOMS OF COUGHSYMPTOMS OF COUGH

Cough itself is a symptom but usually Cough itself is a symptom but usually associated with---associated with---

Nose block, Breathlessness, Disturbance in Nose block, Breathlessness, Disturbance in sleep, Restlessness, Body aches, sleep, Restlessness, Body aches, Haemoptysis , Nausea, VomitingHaemoptysis , Nausea, Vomiting

CONSEQUENCESCONSEQUENCES

May aggravate piles or fissure as the anus May aggravate piles or fissure as the anus gets tightly closed during cough.gets tightly closed during cough.

Pressure in abdomen increases hence may Pressure in abdomen increases hence may cause hernia.cause hernia.

Suture may open in patient who has under Suture may open in patient who has under gone surgery.gone surgery.

Due to pressure in chest air emphysema Due to pressure in chest air emphysema may develop.may develop.

Prevention of coughPrevention of cough

Avoid -1. smoking & dust exposureAvoid -1. smoking & dust exposure

2.Cold food item, 3. contact with infected 2.Cold food item, 3. contact with infected person. 4.continuous sage of medication.person. 4.continuous sage of medication.

Take-1. rest with good ventilation. 2. plenty of Take-1. rest with good ventilation. 2. plenty of fluid. 3.frequent light & small meal. 4. steam fluid. 3.frequent light & small meal. 4. steam inhalation to loosen the phlegm.5. vit.C & Zn inhalation to loosen the phlegm.5. vit.C & Zn to shorten the duration.to shorten the duration.

Medication Medication

Cough suppressant( codeine, Noscapine, Cough suppressant( codeine, Noscapine, Dextromethorphen )Dextromethorphen )

Cough expectorant (Sodium citrate, Cough expectorant (Sodium citrate, Ammonium chloride guaiphenesin)Ammonium chloride guaiphenesin)

Anti allergic (CPM, CETRIZINE, Anti allergic (CPM, CETRIZINE, LORATIDINE, DIPHENHYDRAMINE, LORATIDINE, DIPHENHYDRAMINE, PROMETHAZINE)PROMETHAZINE)

Mucolytic (AMBROXOL, BROMOHEXINE) Mucolytic (AMBROXOL, BROMOHEXINE)

Allergy Allergy

An allergy can occur when the body’s natural An allergy can occur when the body’s natural defense system overreacts to an foreign defense system overreacts to an foreign substance such as pollen.substance such as pollen.

Some common allergens are-Some common allergens are-

PollenPollen

Moulds,Moulds,

ChemicalsChemicals

House dustHouse dust

Symptoms Symptoms

SneezingSneezing CoughingCoughing RhinorrhoeaRhinorrhoea ItchingItching HeadacheHeadache Nasal congestionNasal congestion

PHYSIOLOGICAL ROLE OF PHYSIOLOGICAL ROLE OF HISTAMINEHISTAMINE

Histamine is a chemical which helps in-Histamine is a chemical which helps in-Regulation –Regulation –The regulation of gastric secretion,The regulation of gastric secretion,Act as neurotransmitter in brain,Act as neurotransmitter in brain,Helps in tissue synthesis.Helps in tissue synthesis.The cell which contain histamine are known as mast The cell which contain histamine are known as mast

cell.cell.The histamine locked inside the mast cell are friend . The histamine locked inside the mast cell are friend .

The moment they are librated from it the problem The moment they are librated from it the problem of allergy starts.of allergy starts.

Release of HistamineRelease of Histamine

Histamine are released as a result of antigen-Histamine are released as a result of antigen-antibody reaction. The moment antigen enters in antibody reaction. The moment antigen enters in our body the bodies defense which is constituted our body the bodies defense which is constituted of WBC get activated & produces 5-type of of WBC get activated & produces 5-type of immunoglobulins ( out of which 4 types swims in immunoglobulins ( out of which 4 types swims in blood to kill the antigen whereas the 5blood to kill the antigen whereas the 5 thth one is Y one is Y shaped known as IGe has got high affinity for mast shaped known as IGe has got high affinity for mast cell). Up to first visit of allergen the above series of cell). Up to first visit of allergen the above series of reaction takes place.reaction takes place.

Release of HistamineRelease of Histamine

Allergic manifestation occurs when same allergens Allergic manifestation occurs when same allergens attack second time then it get attached to the arms attack second time then it get attached to the arms of IGe without undergoing the previous reaction. of IGe without undergoing the previous reaction. Now the arms of each IGe is attached with the Now the arms of each IGe is attached with the help of antigen. This is called bridge formation. help of antigen. This is called bridge formation. Then a series of reaction takes place which Then a series of reaction takes place which causes rupturing of mast cell & release of causes rupturing of mast cell & release of Histamine which then gets attached to H1 receptor Histamine which then gets attached to H1 receptor & gives rise to allergic condition.& gives rise to allergic condition.

Release of HistamineRelease of Histamine

Histamine action on H1-receptor in blood Histamine action on H1-receptor in blood vessels causes fluid & proteins to leak out.vessels causes fluid & proteins to leak out.

Capillary leakage causes edema.Capillary leakage causes edema. Itching & pain due to irritated sensory nerve Itching & pain due to irritated sensory nerve

ending.ending.

Allergic manifestation Allergic manifestation

VasodilatationVasodilatationReddening & local edemaReddening & local edemaConstriction of smooth musclesConstriction of smooth musclesFall of blood pressureFall of blood pressureIncrease in cardiac rateIncrease in cardiac rateIncrease in the secretion of saliva,tears,gastric& Increase in the secretion of saliva,tears,gastric&

pancreatic juice.pancreatic juice.Nasal irritationNasal irritationWatery discharge from eyes & nose Watery discharge from eyes & nose

Any question ?Any question ?

Always remember “ question are guaranteed Always remember “ question are guaranteed but answers are not”.but answers are not”.

Thank youThank you

Rinostat PlusRinostat Plus

CompositionComposition

Rinostat Plus tabletRinostat Plus tablet

Each uncoated tablet contains: Each uncoated tablet contains: Acetaminophen I.P :500mg Acetaminophen I.P :500mg Phenylpropanolamine HCl B.P:25 mg Phenylpropanolamine HCl B.P:25 mg Chlorpheniramine maleate I.P :4mg Chlorpheniramine maleate I.P :4mg

Rinostat Plus LiquidRinostat Plus Liquid

Each 5 ml contains: Each 5 ml contains: Acetaminophen I.P:125 mg Acetaminophen I.P:125 mg Phenylpropanolamine HCl B.P:12.5mg Phenylpropanolamine HCl B.P:12.5mg Chlophenarime Maleate I.P :1mg Chlophenarime Maleate I.P :1mg

Rinostat PlusRinostat Plus

Therapeutic classTherapeutic classAnti-allergic, Decongestant and anti-inflammatoryAnti-allergic, Decongestant and anti-inflammatory

Rinostat Plus - RoleRinostat Plus - Role

AcetaminophenAcetaminophen– Antipyretic, Analgesic, Anti-inflammatory.Antipyretic, Analgesic, Anti-inflammatory.– Potent inhibitor of cyclo-oxygenase in CNSPotent inhibitor of cyclo-oxygenase in CNS– Oral bioavailability is about 80%Oral bioavailability is about 80%– Plasma half-life 1.5 to 3.0hPlasma half-life 1.5 to 3.0h– Plasma protein binding Plasma protein binding < 20%< 20%– Extensively metabolized in liver and excreted Extensively metabolized in liver and excreted

in urinein urine

Rinostat Plus - RoleRinostat Plus - Role Phenylpropanolamine HClPhenylpropanolamine HCl

– Indirectly acting sympathomimetic amineIndirectly acting sympathomimetic amine

– Acts on adrenergic receptors (Acts on adrenergic receptors (αα11)) & & produces vasoconstriction thus reduces produces vasoconstriction thus reduces mucosal edema in Resp. tract & mucosal edema in Resp. tract & decongestant effectdecongestant effect

Rinostat Plus - RoleRinostat Plus - Role

Phenylpropanolamine HClPhenylpropanolamine HCl– Oral absorption Oral absorption > 90%> 90%– Plasma half-life 3-5hPlasma half-life 3-5h– Protein binding negligible Protein binding negligible – Eliminated mainly unchanged in urine Eliminated mainly unchanged in urine

Rinostat Plus - RoleRinostat Plus - Role

• Chlorpheniramine MaleateChlorpheniramine Maleate– AntihistaminicAntihistaminic

– Blocks HBlocks H11 receptor receptor

– Prevents vasodilatation induced by histamine Prevents vasodilatation induced by histamine and suppresses capillary permeability resulting and suppresses capillary permeability resulting in reduction of edema or wheal formation and in reduction of edema or wheal formation and itchitch

Rinostat Plus - RoleRinostat Plus - Role

Chlorpheniramine MaleateChlorpheniramine Maleate– Oral absorption Oral absorption > 80%> 80%– Plasma half – life 15hPlasma half – life 15h– Protein binding 67-72%Protein binding 67-72%– Metabolized in liver and excreted in urineMetabolized in liver and excreted in urine

Rinostat Plus - IndicationsRinostat Plus - Indications

Symptomatic relief from Common cold & Symptomatic relief from Common cold & associated symptomsassociated symptoms

Rinostat Plus - DosageRinostat Plus - Dosage

Adults - One tab Three times a dayAdults - One tab Three times a day Children - 2 to 6 yrs.- 5ml 3-4 times dailyChildren - 2 to 6 yrs.- 5ml 3-4 times daily

6 to 12 yrs.- 10ml 3-4 times a 6 to 12 yrs.- 10ml 3-4 times a dailydaily

Rinostat Plus - PresentationRinostat Plus - Presentation

Rinostat Plus tablet - Packing is Strip of 6 tabs.Rinostat Plus tablet - Packing is Strip of 6 tabs. Rinostat Plus liquid - Pack of 60 ml bottleRinostat Plus liquid - Pack of 60 ml bottle

Rinostat Plus - USPsRinostat Plus - USPs

Relieves congestionRelieves congestion Quick relief from headache,fever & other Quick relief from headache,fever & other

symptomssymptoms

NoseNose Nose – warms, moistens and filters air;Nose – warms, moistens and filters air; functions in olfaction functions in olfaction (smell) and (smell) and

speechspeech Pharynx – Nasopharynx – Pharynx – Nasopharynx – respirationrespiration Oropharynx and Laryngopharynx Oropharynx and Laryngopharynx

– digestion– digestion and respiration.and respiration. Larynx – Vocal cords produce Larynx – Vocal cords produce soundsound as they as they

vibratevibrate

Though the nose is primarily. An Though the nose is primarily. An olfactory.organ,olfactory.organ,

it. also plays, a role in the it. also plays, a role in the clearance of foreign substancesclearance of foreign substances

Including dust, allergens and Including dust, allergens and bacteria. The structurebacteria. The structure

structure and function of nose in structure and function of nose in ‘humans is related‘humans is related

to the modification of inspired to the modification of inspired air, that is warming, 'air, that is warming, '

humidifying and filtering of humidifying and filtering of noxious particles by thenoxious particles by the

mucociliary function.mucociliary function.

The functions of the mucus includeThe functions of the mucus include:: Keeping nasal surfaces moist.Keeping nasal surfaces moist. 2. Protecting the mucosa.2. Protecting the mucosa. Raping small particles out of inspired air and keeping most Raping small particles out of inspired air and keeping most

of these from reaching the alveoli of lungs.of these from reaching the alveoli of lungs. The beating of the cilia moves the mucus-layer along with The beating of the cilia moves the mucus-layer along with

particles of dust picked up by it towards the nasopharynx, particles of dust picked up by it towards the nasopharynx, from where the material is dispatched by the wiping action from where the material is dispatched by the wiping action of the palate to the stomach periodically through of the palate to the stomach periodically through swallowing. swallowing.

The function of the nose is to warm, moisten and filter the The function of the nose is to warm, moisten and filter the air inspired.air inspired.

Nasal mucocilliary clearanceNasal mucocilliary clearance Average rate of nasal clearance Is Average rate of nasal clearance Is

5-6mm-1cm/min. This combined action5-6mm-1cm/min. This combined action Of the mucus layers and nasal cilia is called the Of the mucus layers and nasal cilia is called the

mucocillary clearance. Themucocillary clearance. The nasal ciliary clearance is one of the most important nasal ciliary clearance is one of the most important

physiological defense mechanisms of the physiological defense mechanisms of the respiratory tract to protect the body against any respiratory tract to protect the body against any noxious material inhaled.noxious material inhaled.

Pathophysiology:Pathophysiology:

Inflammatory conditions such as allergy and infection cause the nasal Inflammatory conditions such as allergy and infection cause the nasal mucosa, that is the lining to the nasal cavity, to swell When the mucosa, that is the lining to the nasal cavity, to swell When the mucosa, swells, the area available through which air can pass is mucosa, swells, the area available through which air can pass is diminished, and therefore one experiences a sense of nasal diminished, and therefore one experiences a sense of nasal obstruction. Allergy is the most common inflammatory cause of nasal obstruction. Allergy is the most common inflammatory cause of nasal obstruction, but infection, either by viruses such as the common cold or obstruction, but infection, either by viruses such as the common cold or bacteria as often found in sinusitis may cause nasal obstruction. .bacteria as often found in sinusitis may cause nasal obstruction. .

When the nose is congested, decongestants are administered When the nose is congested, decongestants are administered intranasal for a moreintranasal for a more

rapid onset of action. However their use (or more than three to five rapid onset of action. However their use (or more than three to five days can result in rebound nasal congestion, which loads to rhinitis days can result in rebound nasal congestion, which loads to rhinitis medicammentosa, a disorder characterized by chronic swelling and a medicammentosa, a disorder characterized by chronic swelling and a red boggy, edematous (swollen) appearance of the nasal mucosa.red boggy, edematous (swollen) appearance of the nasal mucosa.

The swelling (edema) probably results from an irritant effect on the The swelling (edema) probably results from an irritant effect on the nasal mucosa nasal mucosa

Allergy BasicsAllergy Basics

An allergy can occur when the human body's natural An allergy can occur when the human body's natural defense system (immune system) overreacts to an defense system (immune system) overreacts to an otherwise harmless substance such as pollen.otherwise harmless substance such as pollen.

Some common allergens include: Some common allergens include: - Pollen - Pollen - Moulds - Moulds - House dust mites - House dust mites - Animal dander and saliva (cat, dog, horse, rabbit) - Animal dander and saliva (cat, dog, horse, rabbit) - Chemicals - Chemicals - Some foods and medicines - Some foods and medicines Venom from insect stings Venom from insect stings

Symptoms of AllergySymptoms of Allergy

Sneezing, coughing, rhinorrhoea, itching (pruritis)Sneezing, coughing, rhinorrhoea, itching (pruritis) Headache, nasal congestion, anaphylaxis (severe)Headache, nasal congestion, anaphylaxis (severe) AntigenAntigen A protein marker on surface of cells.A protein marker on surface of cells. (eg: an allergen)(eg: an allergen) -Stimulates production of antibodies-Stimulates production of antibodies AntibodiesAntibodies Complex protein produced by B-lymphocytes in response Complex protein produced by B-lymphocytes in response

to presence of antigen.to presence of antigen. Antibodies (eg: Immunoglobulins such as IgE) combine Antibodies (eg: Immunoglobulins such as IgE) combine

with specific antigens to destroy/control themwith specific antigens to destroy/control them

Antigen Antibody ReactionAntigen Antibody Reaction

Rhinitis:Rhinitis:

Rhinitis means an inflammation of the nose. The Rhinitis means an inflammation of the nose. The discharge from the nose can come through the discharge from the nose can come through the front of the nose or it can drain through the back of front of the nose or it can drain through the back of the nose, a condition, which is, called post-nasal the nose, a condition, which is, called post-nasal drip. The discharge may be clear or it may be drip. The discharge may be clear or it may be colored, most commonly yellow or green. colored, most commonly yellow or green.

Allergy frequently produces a running nose. In Allergy frequently produces a running nose. In these cases the discharge will be clear or these cases the discharge will be clear or occasionally white. Infection also causes nasal occasionally white. Infection also causes nasal discharge, and this will be a purulent discharge discharge, and this will be a purulent discharge most commonly colored yellow or green. Irritation most commonly colored yellow or green. Irritation to the nose can also cause discharge. 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.Rinostat XL.0.1% Nasal Drops0.1% 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.

XylometazolineXylometazoline

Xylomeatzoline is a directly acting Xylomeatzoline is a directly acting sympathomimetic with marked alpha sympathomimetic with marked alpha adrenegeric activity. It is a vasoconstrictor, adrenegeric activity. It is a vasoconstrictor, which reduces swelling and congestion which reduces swelling and congestion when applied to mucous membranes. The when applied to mucous membranes. The effect begins from 5 to 10 minutes.effect begins from 5 to 10 minutes.

Indication:Indication: Acute or chronic RhinitisAcute or chronic Rhinitis Acute Sinusitis.Acute Sinusitis. Common cold.Common cold.