THE PULMONARY

SYSTEM
EMRITA C. MENDOZA, R.N.,
M.D.
 FUNCTIONS OF THE
PULMONARY SYSTEM
 Inhalation and
exhalation of
air through
airways to and
from the lungs
(Ventilation)
 To exchange
gases between
alveoli and
capillaries
(Perfusion)
 FLOW OF AIR
THROUGH THE AIRWAYS
 Nostrils
 Nasal passages and
sinuses
 Pharynx
 Epiglottis
 Larynx
 Trachea (windpipe)
 Main Bronchi (R & L)
 Secondary Lobar
Bronchi
 Tertiary Lobular
Bronchi
 Terminal
ANATOMY OF
THE AIRWAYS
 Larynx:
muscular
cords
protected by
circular
cartilages
 Trachea:
continues as
hyaline
cartilages
with inner
ciliated lining
 ANATOMY OF THE AIRWAYS
 Right main
bronchus is
shorter & wider
than the left.
 Trachea divides
into the R & L
primary bronchi
at the carina.
 BRONCHUS
secondary
bronchi
tertiary or
segmental
bronchi
respiratory
 LOCATION OF THE LUNGS
 Two large,
spongy organs
occupying the
thoracic cavity
on either side
of the heart
 Composed of
elastic
connective
tissue whose
linings are
coated with
PLEURAL MEMBRANES
 Each lung is lined
with visceral
pleura
 Continuous with
the parietal
pleura of the
thoracic cavity
 Space in between
is the pleural
cavity or sac,
which is
lubricated for
 RELATIONS OF THE LUNGS
 Lungs lie within
the borders of
the thoracic
cage
 Floor is the
diaphragm,
which is higher
on the right
 Heart lies in
between and
anterior,
occupying the
 Rib Levels of the Lungs

 Apex or Apical
region = neck
of the
first rib
 Hilar region is
where a
bronchus
enters
 Basilar region
lies along the
base
 Pleural Cavities

Costodiaphragmatic
recesses
: Spaces in the
pleural cavities
below each lung,
superior to the
diaphragm.
 Lobes of the Lungs
 (R) lung = 3
lobes
- upper,
middle, lower
fissures:
horizontal,
oblique
 (L) lung = 2
lobes
- upper with
lingula,
lower
 Bronchopulmonary
Segments
 The anatomical,
functional, and
surgical lung unit
 Composed of:

A. tertiary bronchi
B. branch of
pulmonary
artery
C. lung
parenchyma
 Histology of the Airways
 Conductive  Conductive
portion of the bronchioles: do not
contain cartilage but
respiratory tree:
Clara cells which
A. hyaline secrete cytochrome
cartilage P-450 to attack
B. smooth muscle airborne toxins
C. inner elastic
layer: lined with
ciliated epithelium
with mucus-
secreting goblet
cells
 Histology of Respiratory
 Respiratory
Parenchyma
bronchioles are
unciliated.
 Interstitial
connective tissue
supports the ducts
 Alveoli contain
macrophages and
pneumocytes:
Type I
–
simple squamous
epithelium
sensitive to
neutrophilic
lysozymes
Mechanics of Ventilation
INSPIRATION EXPIRATION
respiratory muscles Respiratory muscles relax
contract
(diaphragm,intercostal
m.) Decreased thoracic
diameter

increased thoracic
Increased pressure
diameter

Decreased pressure Air goes out

Air goes in
 Respiratory Rate (RR)

 Inspiration-
expiration cycle
is measured in
cpm (cycles per
minute)
 Normal adult RR:
14-20cpm
 Children 20-30
cpm
 Infants 40-60
cpm
 Regulation of Respiration
 RESPIRATORY  CAROTID AND AORTIC
CENTER in the CHEMORECEPTORS
BRAINSTEM.
- activated by acidic - help regulate
blood pH due to breathing
excess CO2 which - High [CO2] or low
forms carbonic acid: [O2] in the blood will
 CO2 + H20  H2CO3 make chemoreceptors
send nervous impulses
to the medulla and
pons to inform the
phrenic nerve
 Phrenic nerve
stimulates the
 Breathing Patterns
 BIOTS:  CHEYNE-STOKES:
common but
breathing with usually abnormal
irregularly periods of apnea
alternating
periods of apnea lasting 10-60
and hyperpnea seconds followed
 e.g.meningitis by gradual
and brain increase then
disorders that decrease
cause ⇑ ICP  e.g. frontal lobe
and diencephalic
dysfunction
 Breathing Patterns
 COGWHEEL  KUSSMAUL
– – deep,
respiratory gasping
murmur, not breathing
continuous but
broken into
 e.g. diabetic
waves ketoacidosis and
 e.g. bronchitis coma
and possible TB
 Alveolar Ventilation/
Perfusion
 VENTILATION
VENTILATION
(V) -refers
to air flow
 PERFUSION (Q)

-refers to blood
flow
 V/Q measured
in ml/min
 Normal V/Q:
0.8 ml/min
 V/Q mismatch
occurs when
 ARTERIAL BLOOD GASES
(ABG)
 Measurements of the amounts of gases in the
bloodstream useful to help diagnose
conditions like acute respiratory distress
syndrome (ARDS)
PULMONARY FUNCTION
TESTS (PFT)
•A spirometer can also be used to measure air flow.
• Patient is guided to exhale forcefully into a tube
which can measure RR and various lung volumes