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 THE RESPIRATORY SYSTEM

Learning Objectives: Discuss the function of the respiratory

system Enumerate the parts of the respiratorysystem and discuss how they areinvolved in the breathing process andgas exchange

Discuss how the respiratory systemprotects itself from harmful substances inthe environment

What is the function of the respiratory system? 

The function of the respiratory systemis to bring oxygen (O2) into the body and toremove carbon dioxide (CO2).

Oxygen  is a gas that provides usenergy while carbon dioxide  is a wasteproduct or “exhaust” of the body.

The Respiratory System

What are the parts of the respiratory system? 

The respiratory system includes thenose, trachea (“windpipe”), main bronchi,lungs and some parts of the musculoskeletalsystem (these are the muscles of the rib 

cage  and the diaphragm ) that are used forbreathing.

How does air get into the body? 

To deliver oxygen to the body, air isbreathed in through the nose, mouth or both.The nose serves as a filter for unwantedparticles in the air like dust and smoke. Thenose also heats and adds moisture into the

air that is breathed in.

The Lung Airways

The airways  in the lungs look like anupside-down tree with many branches. Afterentering the nose or mouth, air travels downthe trachea or “windpipe”. The trachea isthe large tube lying closest to the neck. Thetrachea divides into two smaller breathingtubes that are called bronchi . The leftbronchus leads to the left lung and the rightbronchus leads to the right lung. Thebronchi further divide into smaller tubescalled bronchioles . The bronchioles end intiny air sacs called alveoli .

nose

trachea/ windpipe

lung

diaphragm

trachea

bronhus

bronhioles

alveoli

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The alveoli or air sacs are surroundedby a network of blood vessels calledcapillaries . Oxygen from the alveoli diffusesinto the capillaries then circulates to the restof the body. Carbon dioxide diffuses fromthe capillaries to the alveoli and is eventuallyexpelled from the body when people exhale.

This process is called gas exchange .

Air sacs or alveoli Gas exchange

There are over 300 million alveoli innormal lungs. If the alveoli were openedand laid out flat, they would cover the areaof a tennis court. This large surface areamakes gas exchange easier or efficient.

Which muscles help in the breathing process? 

Many different muscles are used inbreathing. The largest and most importantmuscle for breathing is the diaphragm . Thediaphragm lies under the lungs andseparates the chest cavity from the organsbelow, such as the stomach, intestines, liver,etc. As the diaphragm moves down or

flattens, the ribs flare outward, the lungsexpand and air is drawn in. This process iscalled inhalation  or inspiration . As thediaphragm relaxes, air leaves the lungs andthey spring back to their original position.This is called exhalation  or expiration . Thelungs, like balloons, require energy to blowup but no energy is needed to get air out.Aside from the diaphragm, muscles in

between the ribs, neck and shoulders arealso used when breathing.

How does the lung protect itself? 

The lung has several ways of

protecting itself from irritants. First, the nose  acts as a filter when breathing in,

How lungs protect itself

preventing large particles of pollutants fromentering the lungs. If harmful particlesenter the lung, it will get stuck in the thinlayer of mucus  (also called sputum or phlegm ) that lines the inside of the breathingtubes. The mucus is “swept up” toward themouth by little hairs called cilia that line thebreathing tubes. Cilia moves mucus fromthe lungs upward toward the throat to themouth where it can be coughed out from thebody.

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Another way to protect the lungs is bycoughing . Coughing can expel the mucusfrom the lungs faster than cilia.

The last of the common methodsused by the lungs to protect themselves canalso create problems. The airways in the

lungs are surrounded by bands of muscle.When the lungs are irritated, these musclebands tighten, making the breathing tubenarrower as the lungs try to keep harmfulparticles out. The rapid tightening of thesemuscles is called bronchospasm or broncho- constriction.

CHRONIC OBSTRUCTIVEPULMONARY DISEASE (COPD)

Learning Objectives: Define chronic obstructive pulmonary

disease (COPD) Recognize that smoking is the most

common cause of COPD Explain how COPD develops and

discuss the signs and symptoms of thedisease

Discuss that COPD is progressive,irreversible and is one of the leadingcauses of death

Recognize that the most importantstrategy to prevent COPD is not to startsmoking

What is Chronic Obstructive Pulmonary Disease (COPD)? 

Chronic obstructive pulmonarydisease (COPD) is a condition in which theairways are damaged permanently making ithard for air to get in and out of the lungs.The most common cause of COPD iscigarette smoking.

COPD is a disease that includes bothchronic bronchitis  and emphysema . Aperson may have one or the other or morecommonly, a combination of the two.

Chronic Obstructive Pulmonary Disease

Chronic bronchitis  involves swellingand narrowing of the large and smallairways or breathing tubes. The walls of thebreathing tubes thicken and become swollen

making the passageway for air inside thetube smaller. The lining inside the breathingtubes also get clogged with excess mucusmaking it more difficult for air to passthrough to reach the air sacs or alveoli.

Airways in Chronic Bronchitis

Emphysema  involves damage of theair sacs or alveoli. The walls of the air sacs

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are destroyed making the lungs lose theirelasticity. In normal individuals, the air sacsare stretchy and springy, like little balloons.It takes effort to blow up the normal air sacswhile it takes no energy to empty thembecause they spring back to their originalsize. In emphysema, the air sacs act more

like paper bags. A paper bag is easy toblow up, but more effort is needed tosqueeze the bag to get the air out. Itbecomes difficult to push all of the air out ofthe lungs. The lungs do not empty efficientlyand therefore contain more air than normal.This is called hyperinflation  or air trapping .The combination of constantly having extraair in the lungs and the extra effort neededto breathe, results in the feeling of shortnessof breath.

Aside from losing elasticity, the airsacs of people with emphysema do notfunction well at exchanging oxygen andcarbon dioxide. This leads to lack of oxygenin the body and sometimes accumulation ofcarbon dioxide.

Airways in Emphysema

What causes COPD? 

Inhaling harmful particles such assmoke  or air pollutants  can causedestruction of the breathing tubes (bronchiand bronchioles) and the air sacs or alveoli.COPD can develop if small amounts ofthese harmful particles are inhaled over a

long period of time or if large amounts areinhaled over a short period of time.

Smoke and air pollutants

Cigarette smoking  is the most

common cause of COPD. Pipe, cigar andother types of tobacco smoking have alsobeen strongly linked to COPD.

Smoking

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  Second hand smoke also plays a rolein causing COPD. This means that evennon-smokers may develop COPD if they areconstantly exposed to cigarette smoke frompeople who smoke around them.Household members of people who smokeare also at risk of developing COPD.

Second hand smoke

Heavy exposure to certain dusts atwork, chemicals and indoor or outdoor airpollution can contribute to COPD. Thereason why some smokers never developCOPD and why some never-smokers getCOPD is not fully understood. Family genesor heredity probably play a major role onwho develops COPD.

Heavy exposure to air pollution

What are the signs and symptoms of COPD? 

The symptoms of COPD includecough, sputum (phlegm) production,shortness of breath, wheezing (whistling sound when breathing), tiredness (fatigue)

and chest tightness . Cough that ispersistent or does not go away, andincreased sputum or phlegm production arethe most common symptoms of COPD.

Symptoms of COPD: cough, sputumproduction, tiredness and chest tightness

These symptoms eventually limit theperson’s activities and sometimes makethem unable to do simple things by

themselves like eating, going to thebathroom or grooming. Patients often feelhelpless and depressed as the symptomsprogress.

COPD develops slowly, and it maytake many years before shortness of breathis noticed. Most of the time, COPD isdiagnosed among middle-aged people of 40years old and above.

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Will COPD ever go away? 

The severity of symptoms dependson how much of the lung has beendestroyed. The more a person smokes, thefaster is the destruction of the lungs. Thedamage in the lungs cannot be reversed .

There is no cure for COPD. Once COPDdevelops, a person will have it for life .Stopping smoking is the only thing that canslow down the progression of the disease,but even this will not make the lungs normalagain.

The damage in the lungs cannot be reversed.There is no cure for COPD.

Why is it important to learn more about COPD? 

COPD is a widespread healthproblem. It is the 4th leading cause of deathand disability in worldwide statistics. In thePhilippines, COPD is the 7th leading causeof death according to the Department ofHealth. Aside from death, COPD causessignificant suffering of afflicted people andtheir families. People with COPD are unable

to work, do simple things by themselves anddo things they used to enjoy. Learning moreabout this condition is important in order toprevent it.

How is COPD prevented and treated? 

Quitting smoking  is the single mostimportant thing that can prevent COPD andslow the progress of the disease. It isimportant to stay away from places whereone can be exposed to second hand smoke.Avoiding harmful particles such as pollution,dust, and certain cooking and heating fumesis likewise essential. In the workplace,special protective gear and precautionsshould be practiced to prevent exposure.

Stop Smoking

As well as helping patients quitsmoking, the doctor may prescribemedicines that widen the breathing tubes (bronchodilators), reduce swelling in the breathing tubes (anti-inflammatory drugs) or

Bronchodilators, anti-inflammatory agentsand antibiotics 

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treat infection (antibiotics). Medicationsmust be taken everyday, probably for therest of the patient’s life. In severe cases,patients are given extra inhaled oxygen toimprove levels in the blood and to decreasesymptoms.

Currently, there is no treatmentavailable to repair damaged bronchi frombronchitis or alveoli affected by a largeamount of emphysema. Unfortunately, thedamage that has been done to the alveoli ispermanent.

Aside from doctors and other healthpersonnel, patients with COPD need thesupport of their family in dealing with thisserious disease. Patients are taught to

maximize the use of their lung power,assisted to quit smoking and givenemotional and psychological support.

REVIEW QUESTIONS

Fill in the blanks.1. _______ is the gas that provides energy

to the body. _______ is the main wasteproduct of the body that is expelledthrough the respiratory system.

2. ______ is the large tube-like structurethat lies closest to the neck that isinvolved in conducting air from the noseand mouth to the chest.

3. The process by which oxygen from thealveoli diffuses into the capillaries and

carbon dioxide diffuses from thecapillaries to the alveoli is called

  ______ ______.4. ______ are small hairs lining the

breathing tubes that help in “sweeping”mucous upward the throat andepiglottis.

5. COPD stands for _____ _____ ______  ______.

True or False 6. Chronic bronchitis involves damage of

the air sacs making lungs lose theirelasticity. This also causeshyperinflation.

7. Cigarette smoking is the most commoncause of COPD.

8. Second hand smoke also causesCOPD.

9. The damage in the lungs in a personwith COPD is reversible.

10. Stopping smoking is the most importantintervention to prevent or reduce therisk of COPD.

References: American Thoracic Society Patient educationMaterials; COPD Statement: Patient

Education Section;http://www-test.thoracic.org/COPD/patients.asp 

Global Initiative for Chronic Obstructive LungDisease (GOLD) Executive Summary,National Institute of Health, national Heart,Lung and Blood Institute

National Heart, Lung and Blood Institute;http:www.nhlbi.nih.gov/health/dci/Diseases/Copd

Pictures: Bodyworks 3.0 by Softkey International Inc. 1994

http://www.aku.edu/akuh/pollutionhttp://www.aquila.com/pollution/jpeghttp://www.battelle.org/environment/publhttp://www.br-online.comhttp://www.ccswla.com/kidshealthhttp://www.conexor.comhttp:// www.copd-helper.comhttp://www.copd.upmc.comhttp://www.deborah.orghttp://www.diseases-explained.com/COPD/homehttp://www.healthwaymagazinehttp://www.greendiary.comhttp://www.ifap.dehttp://www.img.tfd.comhttp://www.medem.comhttp://www.nposonline.nethttp://www.utopia.duth.gehttp://www.tuberculosis/images_tb.html 

Answers: (1) Oxygen, Carbon dioxide (2)Trachea or windpipe(3) gas exchange (4) Cilia(5) Chronic Obstructive Pulmonary Disease(6) False (7) True (8) True (9) False (10) True

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