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The Respiratory System at a Glance
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
©
Library of Congress Cataloging-in-Publication Data
©
Contents
Structure and function
History, examination and investigation
Diseases and treatment
Cases and self assessment
Contents 5
Preface to third edition
The Respiratory Systemat a Glance
At a Glance
6 Preface to third edition
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
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
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
�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.
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