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Respiratory, Endocrine, Male and Female Reproductive Systems, and STIs

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Review of structure and function of the respiratory system including asthma, circulation and ventilation, perfusion, respiratory tract infections, childhood disorders, chronic bronchitis and emphysema, COPD, cystic fibrosis, acute respiratory distress. Notes also include endocrine and male and female reproductive systems including STIs.

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Structure & Function of the Respiratory System
Sleep-related breathing disorders




Ventilation → movement of air in & out of the lungs (inspiration & expiration)
●​ With inspiration the diaphragm contracts
●​ With expiration diaphragm moves upward because it is relaxing
Perfusion → flow of blood through the lungs
Diffusion → transfer of gas between air-filled spaces of the lungs & the blood → crosses the alveolar/capillary
membrane. Affected by:
●​ Surface area available for diffusion → decreased in lung disease, lobectomy, pneumonectomy
●​ Thickness of alveolar capillary membrane → pneumonia, pulmonary edema
●​ Partial pressure of alveolar gasses → CO2 diffuses faster than O2

,Respiratory system structure and the conducting and respiratory airways
Lung structure
●​ Separated by the mediastinum & its contents
●​ Left lung = 2 lobes
●​ Right lung = 3 lobes
●​ Apex = upper part of the lung (lies against the top of the thoracic cavity)
●​ Base = lower part of the lung (lies against the diaphragm)




Respiratory system structure
●​ Nasopharynx, Oropharynx, and Larynx (connects the oropharynx to the trachea)
●​ The Trachea is supported by C-shaped rings of hyaline cartilage (divides into right and left main
bronchial at T5) → Has both vestibular folds & vocal folds that help produce speech & protect lungs
from substances other than air
●​ Carina (located between the main bronchi) has sensitive cells that cause violent coughing when
stimulated
●​ Tracheobronchial tree → trachea, bronchi and bronchioles
○​ Trachea splits off into L & R bronchus → then to the bronchioles → then to the alveoli (where
gas exchange happens)

,Conducting airways → air moves as it passes between the atmosphere & the lungs
Respiratory airways → where gas exchange takes place




Bronchial and pulmonary circulations that supply the lungs
Pulmonary Circulation → comes from the pulmonary artery and provides for gas exchange. Oxygenated
blood leaves the right side of the heart and into the pulmonary artery. The pulmonary artery divides into left &
right. The pulmonary vein returns oxygenated blood to the left atrium

Bronchial Circulation → comes from the thoracic aorta and supplies the lungs with oxygen, distributes blood
to conducting airways, and warms & humidifies incoming air
●​ DOES NOT participate in gas exchange because it doesn’t pass through the alveolar capillaries (is
deoxygenated blood)
●​ Bronchial blood vessels form new blood vessels & can provide collateral circulation (example – if
someone has a pulmonary embolism and the pulmonary vessels in circulation are blocked…the
bronchial blood vessels develop a collateral circulation)

, Intrathoracic, intrapleural, and intra-alveolar pressures
Intrapulmonary (Alveolar) Pressure → pressure inside the airway & alveoli of the lungs
●​ During expiration pressure ↑ as the thoracic cavity volume decreases → when expiration stops the
pressure = atmospheric pressure
Intrapleural Pressure → pressure in the pleural cavity
●​ During inspiration, pressure drops causing ↓ intrathoracic airway pressure & airflow
Intrathoracic Pressure → pressure in the thoracic cavity = to the intrapleural pressure
●​ This is the pressure the heart, lungs, and great vessels are exposed to
●​ Ex → if someone is performing the valsalva maneuver unintentionally while pooping, intrathoracic
pressure increases; decreasing venous return to the heart




Lung compliance → the change in lung volume that can be achieved with a change in respiratory pressure
(takes more pressure to move air into noncompliant lungs than it does compliant lungs)
Airway resistance → volume of air that moves into & out of the air exchange portion of the lungs → friction
caused by movement of air throughout the respiratory system & conducting airways
●​ Directly related to the pressure difference between the lungs & the atmosphere
●​ Inversely related to the resistance the air encounters as it moves through the airways


Definitions
●​ Tidal Volume (TV) → amount of air that moves into & out of the lungs during a normal breath
●​ Inspiratory Reserve Volume (IRV) → max amount of air that can be inspired on top of normal TV
●​ Expiratory Reserve Volume (ERV) → max amount of air that can be exhaled on top of normal TV
●​ Residual volume (RV) → air that stays in the lungs after forced respiration
●​ Vital capacity = IRV + TV + ERV → amount of air that can be exhaled from the point of max inspiration
●​ Inspiratory capacity = TV + IRV → amount of air a person can breathe in starting the normal
expiratory level & maximum distending of the lungs
●​ Functional residual capacity → IRV + ERV → volume of air that remains in the lungs after expiration
●​ Total lung capacity → sum of all the volumes in the lungs
●​ Forced expiratory volume in 1 second (FEV1.0) → expiratory volume achieved in 1 second

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