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The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)

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Page 1: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)
Page 2: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)
Page 3: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)

The Respiratory System at a Glance

Page 4: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)
Page 5: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)

The RespiratorySystem at a GlanceJeremy P.T. Ward

Jane Ward

Richard M. Leach

With contributions from

Charles M. Wiener

Third edition

A John Wiley & Sons, Ltd., Publication

Page 6: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)

©

Library of Congress Cataloging-in-Publication Data

©

Page 7: The Respiratory System at a Glancedownload.e-bookshelf.de/.../17/L-G-0000595117-0002362646.pdfRespiratory bronchioles (generations 17–19) Alveolar ducts and sacs (generations 20–23)

Contents

Structure and function

History, examination and investigation

Diseases and treatment

Cases and self assessment

Contents 5

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Preface to third edition

The Respiratory Systemat a Glance

At a Glance

6 Preface to third edition

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Units and symbols

Units

Pressure conversion: = · −

=

= == = == =

≈ = = =

Contents −

· −

· − = · − = · −

=

=

Standard symbolsPrimary symbols

===

P ===

=Q =

Secondary symbolsGas = Blood =

= == === == ′

= =

Tertiary symbols Examples= =

= PAco ==

Typical values

Po

PoPo

PoPo < <

>

· − · −

PcoPco

Pco· − · −

+ · −

Po· − · −

Pco· − · −

Units and symbols 7

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List of abbreviations

A–a gradient PoPo

AAT α

AHIAIDSAIP

ALIANAANCAAPARDSATPSATSBALBALTBCGBiPAP

BPBTPSBTSCAcAMPCAPCCFCFCFACFTRCL � � =

CMVCMVCNSCOAD

COLD

COPD

COXCPAPCREST

CSACSFCTCTPACWPCXRDIPDLCO

DLgDLO2

DRG

DVTEBVECGECMOECPEEGEGFELISAEMGEOGERVESRFDGFDG PETFEF25−75

FERFEV1

FEV1/FVC

FGFFRCFVCGBMGM-CSFGUHAARTHAPHCAPHIVHRHRCTICUIFN-γ γ

IgILILDINPVIPF

IPPVIRVIVCJVPK CO D co

KSLALDHLGLIPLMWHLTLVMBP

8 List of abbreviations

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MDRMIMIEMMVMOFMRSA Staphylococcus aureusMVVNANCNHLNIPPVNRDSNREMNSAIDNSCNSIPOSAP50

PA

PAPAPACO

PaCO2

PACO2

PAFPAHPaO2

PCP Pneumocystis cariniiPD20FEV1

PDGFPEPEEPPEFRPETPgPHpHapKA

PMFPMI

PPD

PPHNPSPRRADRANTES

RAWRBBBRBCREMRVRVRVDSaO2

SCSCUBASIADH

SIMVSLESO2

SPSTPDSVCTBTGFβ β

TLCT LCO

DL coUFHUIPVAPVA/Q

VCVEGFVIPV̇O2maxVRGVT

WBCWCCWG

List of abbreviations 9

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�1 Structure of the respiratory system: lungs,airways and dead space

(a) Lung lobes

Right lateralaspect

Anterior aspect

Left lateralaspect

RURMRLLULL

= Right upper= Right middle= Right lower= Left upper= Left lower

Posterior aspect

(c) Bohr equation for measuringdead space

Anatomical dead space,Volume = VD

Respiratory zone:Alveolar CO2 fraction = FACO2

End of inspiration End of expiration

End-tidal =alveolar gas

Anatomical dead space,Volume = VD In an expired breath

none of the CO2 expiredcame from the dead space region

∴ Quantity of CO2in mixed expired air = quantity of CO2

from alveolar region

VT x = (VT –VD) x

∴ VD = VT ( – )/

Mixed expired gas: Volume = VT ;Mixed expired CO2 fraction =

CO2 -free gas CO2 -containing gas

RU

RMRL

LU

LL

RU

RMRL

LU

LL

LU

LL RL

RU

T1

T12

T2

T3

T4

T5

T6

T7

T8

T9

T10

T11

C7C6

(b) The airways

Sternal angle(angle of Louis)

Ste

rnum

Xiphoidprocess

Diaphragm

Nasal cavity

Pharynx

Epiglottis

Larynx

Cricoid

Trachea (generation 0)

Carina

R and L main bronchi (generation 1)

Bronchi (generations 2–11)

Bronchioles (generations 12–16)

Respiratory bronchioles(generations 17–19)

Alveolar ducts and sacs(generations 20–23)

Body

Manubrium

FECO2

FECO2

FECO2

FACO2

FACO2FACO2

10 The Respiratory System at a Glance, 3e. By J.P.T. Ward, J. Ward, R.M. Leach. Published 2010 Blackwell Publishing Ltd.

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Lungslungs thoracic

cage

right lung transverse oblique fissuresleft lung oblique

fissurehilum

bronchopulmonary seg-ments

pulmonary nerve plexusvagi ganglia

sympathetic trunk

β

visceral pleuraparietal pleura

costodi-aphragmatic recess

intercostal nervesphrenic nerve pleurisy

Lymph channelsbronchopulmonary

nodes tracheobronchial nodesposterior

mediastinal nodesupper respiratory tract

lower respiratory tractcricoid cartilage

right left main bronchisternal angle

Airwaysgeneration

trachea main bronchi

segmental bronchi

Bronchioles

terminal bronchiolesrespiratory bronchioles

alveolar ductsalveolar sacs

alveoli

bronchial arteries

pulmonary circulation

ciliated columnar epithelial cells Goblet cells submucosalglands mucus

mucociliary clearance

type I alveolar pneumocytessquamous epithelium

alveolar–capillary membranetype II pneumocytes

surfactant

Dead space

conducting airwaysanatomical dead space

pulmonary embolusalveolar dead space

physiological dead space

tidal volumerespiratory frequency

minute ventilation= × Alveolar ventilation

= − ×Bohr method

∼ ∼Alveolar gas

end-tidal gasPco

ideal alveoli

Structure of the respiratory system: lungs, airways and dead space Structure and function 11