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					                       Unit J: Respiratory System

Program Area:      Health Occupations Education

Course Title:      Medical Sciences I                                   Number: 7211

Unit Title:        Respiratory System

Suggested
Time for
Instruction:       5 class periods (90 minute classes)
                   11 class periods (55 minute classes)

Course Percent:    6%

Unit Evaluation:   100 % Cognitive

                   -------------------------------------------------------------------------------

Competency:        MD10. Analyze the anatomy and physiology of the respiratory
                   system.

Specific Objectives:

       MD10.01     Describe the structure of the respiratory system.

       MD10.02     Analyze the function of the respiratory system.

       MD10.03     Analyze characteristics and treatment of common respiratory
                   disorders.




                                       Summer 2005 J.1
                       Unit J Master Outline


J.   Respiratory System

     MD10.01   Describe the structure of the respiratory system.
               A. Nasal cavity (nose)
                  1. Nasal septum divides nose into R and L sides
                  2. Cilia – hairs that trap dirt and particles
               B. Sinuses
                  1. Cavities in skull
                  2. Connected to nasal cavity by ducts
                  3. Lined with mucous membrane
               C. Pharynx
                  1. Throat
                  2. 5” long
               D. Larynx (voice box)
                  1. Triangular chamber below pharynx
                  2. Contains vocal cords
                  3. Adam’s apple
                  4. Epiglottis – covers larynx during swallowing
               E. Trachea (windpipe)
                  1. 4 ½” long
                  2. Walls have bands of C-shaped cartilage
                  3. Lined with ciliated mucous membrane
               F. Bronchi and Bronchioles
                  1. Lower end of trachea divides into R and L bronchus
                  2. Become bronchial tubes and bronchioles as branches enter lungs
               G. Alveoli
                  1. Clusters of thin-walled sacs made of single layer epithelial tissue
                  2. Inner surfaces covered with surfactant
                  3. Each alveolus surrounded by capillaries
               H. Lungs
                  1. Fill thoracic cavity
                  2. Upper part = apex
                  3. Lower part = base
                  4. Lung tissue porous and spongy, it floats
                  5. R lung larger and shorter, 3 lobes
                  6. L lung has 2 lobes
               I. Pleura
                  1. Membrane that covers lungs
                  2. Double-walled sac
                  3. Space is pleural cavity
                  4. Pleural cavity filled with pleural fluid to prevent friction
               J. Upper respiratory tract




                                 Summer 2005 J.2
MD10.02   Analyze the function of the respiratory system.
          A. Cilia – hair in nose that traps dirt and particles
          B. Sinuses
             1. Lined with mucous membrane to warm and moisten air
             2. Give resonance to the voice
          C. Pharynx
             1. Common passageway for air and food
             2. When food swallowed, epiglottis closes over opening to larynx,
                  preventing food from entering lungs
          D. Larynx
             1. Produces sound (voice box)
             2. Made of cartilage fibrous plates
          E. Trachea
             1. C-shaped cartilage rings keep trachea open and more rigid
             2. Coughing and expectoration get rid of dust-laden mucous
          F. Bronchi and bronchioles – passageway for air from trachea to alveoli in lungs
          G. Alveoli
             1. Surfactant – keep alveoli from collapsing
             2. O2 and CO2 exchange takes place between alveoli and capillaries
          H. Pleura – pleural cavity filled with pleural fluid to prevent friction
          I. Pulmonary ventilation (breathing)
             1. Inspiration (inhalation)
                  a. Intercostal muscles lift ribs outward
                  b. Sternum rises and the diaphragm contracts and moves downward
                  c. This increases the volume of the lungs and air rushes in
             2. Expiration (exhalation)
                  a. Opposite action from inhalation
                  b. Passive process
          J. Respiratory movements
             1. 1 inspiration + 1 expiration = 1 respiration
             2. Normal adult = 14 – 20 respirations/min
             3. Increases with exercise, body temperature, certain diseases
             4. Newborn resp = 40 – 60/min
             5. During sleep – resps decrease
             6. Emotion can change rate of respiration
             7. Coughing – deep breath followed by forceful expulsion of air – to clear
                  lower respiratory tract
             8. Hiccups – spasm of the diaphragm and spasmodic closure of the glottis
             9. Sneezing – air forced through nose to clear respiratory tract
             10. Yawning – deep prolonged breath that fills lungs, increases blood O2
          K. Control of breathing
             1. Neural factors
                  a. Respiratory center located in medulla oblongata
                  b. Increase or decrease of O2 or CO2 in the blood will trigger respiratory
                      center
                  c. Phrenic nerve – stimulates diaphragm
             2. Chemical factors
                  a. Depends on level of blood CO2
                  b. Chemoreceptors in aorta and carotid arteries sensitive to the amount
                      of blood O2




                             Summer 2005 J.3
MD10.03   Identify characteristics and treatment of common respiratory
          disorders.
          A. Pleurisy
             1. Inflammation lining lungs in conjunction with lung infection
             2. Symptoms – sharp, stabbing pain with breathing, dyspnea and fever
          B. Common Cold
             1. Contagious viral, respiratory infection
             2. Contributing factors – chilling, fatigue, poor nutrition, not enough sleep
             3. Rx – stay in bed, drink warm liquids and fruit juice, good nutrition
             4. Good handwashing = best prevention
          C. Pharyngitis – red, inflamed throat
          D. Laryngitis
             1. Inflammation of larynx
             2. Symps – sore throat, hoarseness, loss of voice, difficulty swallowing
          E. Sinusitits
             1. Infection of mucous membrane that lines sinus
             2. Caused by bacteria or virus
             3. Symps – headache, pressure, thick nasal discharge, loss of voice
                  resonance
             4. Rx – symptomatic, surgery for chronic sinusitis
          F. Bronchitis
             1. Inflammation of mucous membranes of trachea and bronchi
             2. Symps – cough, fever, substernal pain and rales (raspy sound)
             3. Chronic bronchitis – middle or old age, caused by cigarette smoking
          G. Influenza (Flu)
             1. Viral infection upper respiratory tract
             2. Symps – fever, mucopurulent discharge, muscular pain, extreme
                  exhaustion
             3. Rx – symptomatic
          H. Pneumonia
             1. Infection of lung
             2. Caused by bacteria or virus
             3. Alveoli fill with thick fluid
             4. Symps – chest pain, fever, chills, dyspnea
             5. Diagnosis – x-ray and listening to lungs
             6. Rx – oxygen and antibiotics
          I. Tuberculosis
             1. Infectious bacterial lung disease
             2. Tubercles (lesions) form in lungs
             3. Symps – cough, low grade fever in the afternoon, weight loss, night
                  sweats
             4. Diagnosis – skin test, if positive, follow up with chest x-ray and sputum
             5. Rx – antibiotics
          J. Rhinitis – runny nose
          K. Asthma
             1. Inflammatory airway obstruction
             2. Caused by allergen or psychological stress
             3. 5% of Americans have asthma
             4. Symps – difficulty exhaling, dyspnea, wheezing, tightness in chest
             5. Rx – antinflammatory drugs, inhaled broncholdilator




                             Summer 2005 J.4
L. Emphysema
   1. Alveoli become distended, lose their elasticity, can’t rebound, may
       eventually rupture
   2. Air becomes trapped in alveoli, can’t exhale, forced exhalation required
   3. Dyspnea increases as disease progresses
   4. Rx – alleviate symptoms, decrease exposure to respiratory irritants,
       prevent infections
M. Cancer of the Lungs
   1. Found mainly in smokers
   2. Symps – cough and weight loss
   3. Diagnosis – x-ray and bronchoscopy (flexible tube passed through
       mouth or nose into bronchi and lungs)
   5. Rx – surgery, chemotherapy, and/or radiation
N. Pulmonary embolism
   1. Blood clot breaks off and travels to lung
   2. Often occurs after surgery when a person has been on bedrest
   3. Symps – sudden, severe pain in chest, dyspnea
   4. Rx – anticoagulants
O. Sudden Infant Death Syndrome (SIDS)
   1. Crib death
   2. Usually between 2 wks to 1 year
   3. Cause – unknown
   4. Rx – sleep monitor
P. Epistaxis
   1. Nosebleed
   2. Rx – elevate head, tilt forward, pinch nostrils, cold packs
Q. Related terms
   1. Apnea
   2. Dyspnea
   3. Tachypnea
   4. Hyperpnea
   5. Orthopnea
   6. Hyperventilation
   7. Rales




                  Summer 2005 J.5
Unit J:                         Respiratory System

Competency MD10:                Describe the structure of the respiratory system.

Materials/Resources

Scott, Ann Senisi and Elizabeth Fong. Body Structures & Functions. Delmar Publishers, Latest
        Edition, 1998. www.DelmarAlliedHealth.com

National HOSA Handbook: Section B. Published by HOSA, Flower Mound, Texas. Current
       Edition. www.hosa.org




Teaching/Learning Indicators: The following letters are used to indicate specific
skills/areas required in the instructional activity.

       R      Reading                      SS    Social Studies
       W      Writing                      S     Science
       M      Math                         A     The Arts
       H      Health professional/parent/community involvement




                                     Summer 2005 J.6
Objective MD10.01           Describe the structure of the respiratory system.

Teaching/Learning Activities

          • Cognitive       S
            Have students label the diagram of the lung. (Appendix MD10.01B)

          • Basic Skills       S, R
            Instruct the students to read pages 255-261 in Body Structures and Functions. Complete
            the “Respiratory Structure” Worksheet. (Appendix MD10.01C)

          • Cognitive      S
            Divide students into small groups. Give each group a ball (or orange) and an empty
            mesh bag. After a class discussion of alveoli, instruct the students to explain, in their
            own words, the relationship of alveoli to capillaries. Have them demonstrate the
            relationship with the ball and mesh bag. (The mesh bag should simulate the capillaries
            that surround the alveoli.) Allow one group to volunteer to present their understanding to
            the class.

          • Teamwork        S
            Activity Title: As the Air Goes
            Give individual students one index card with the name of one structure of the Respiratory
            System. Have students read about the structure they’re been given in their textbook. On
            a signal given by the teacher, the students arrange themselves in a line in the order that
            air would pass through them.

            Students will need to decide what to do with the mouth and nose as air comes in both,
            and the right and left bronchus as air goes thorough both. It is possible that you have
            more students than parts, in which case you could divide the class in half and let the two
            groups arrange themselves, or use multiple bronchiole and alveoli cards.

          • Technology         S
            Take students to the computer lab and have them work through anatomy software such
            as A & P Challenge. Check with your media specialist or anatomy teacher for titles
            available. Students may work individually or in pairs.

          • HOSA       S
            Using HOSA Competitive Event Guidelines for Medical Spelling, hold a spelling bee
            using the terms in the Terminology List. If they spell the word correctly, allow them to go
            to an anatomical wall chart or model and point out the location of the structure they
            spelled.

          • Critical Thinking         S, A
            Have students create “Model Lungs” using the directions provided. (Appendix
            MD10.01D)

          • Special Needs
            Each student will reach the highest level of mastery in the least restrictive environment as
            recommended in the student’s IEP.




                                       Summer 2005 J.7
Objective MD10.02           Analyze the function of the respiratory system.

Teaching/Learning Activities

          • Basic Skills      S, R
            Have students read pages 263-265 in Body Structures and Functions and answer the
            matching questions on page 271.

            In addition, have students create five additional matching questions. They can exchange
            papers and answer the peer-created questions

          • Critical Thinking S
            Give students a hoola hoop and ask them to demonstrate diffusion. Explain that half of
            them will be oxygen molecules and the other half will be carbon dioxide molecules. They
            are to use the hoop as the alveolus and must arrange the molecules to represent
            diffusion. (Students must “duck” underneath the hoop to move in and out.)

            Have students brainstorm how they think the respiratory system responds to the need for
            oxygen. Then, introduce the section on “Control of Breathing” (Body Structures and
            Functions). Have them complete the worksheet provided. (Appendix MD10.02A)

          • Technology/Employability             S, H
            Have students use a pulse oxygen saturation monitor (pulse oximeter) to determine their
            own oxygen saturation level. If the HOE department does not have this piece of
            equipment, arrange to borrow one from a local hospital or other health facility.

            You can also invite a respiratory therapist to speak with the class who can bring the
            monitor for the session. Have the students determine if their own oxygen saturation is
            within normal levels. Have the Respiratory Therapist discuss gas exchange and control
            of breathing.

          • Teamwork         S, A
            Have students work in small groups to create a song that they will sing to the class. The
            lyrics must explain the production of sound. They may use the tunes from familiar songs
            such as Twinkle, Twinkle, Row Your Boat, etc.

          • Cognitive      S, M
            In small groups, have the students complete the “Respiratory Rate Comparison”
            worksheet. (Appendix MD10.02B)

          • Special Needs
            Each student will reach the highest level of mastery in the least restrictive environment as
            recommended in the student’s IEP.




                                       Summer 2005 J.8
Objective MD10.03           Analyze characteristics and treatment of common
                            respiratory disorders.

Teaching/Learning Activities

          • Basic Skills S, R, W
            Have students read about respiratory disorders in the textbook and complete the
            “Respiratory Disease Fact Chart” provided. (Appendix 010.03A)

            Call the American Lung Association to obtain material for the “Great American
            SmokeOut” which is usually held in November. Have students review the information,
            and plan activities for the student body and community. (Appendix MD10.01B)

          • HOSA      S, W
            Have students write an oral report on one of the following diseases: common cold,
            pharyngitis, laryngitis, bronchitis, tuberculosis, emphysema, pneumonia, asthma, or
            influenza. The report should include the etiology, signs and symptoms, treatment, and
            preventative measures.

            Use the Prepared Speaking guidelines to evaluate the speeches.

          • Critical Thinking/Technology             S, M, R
            Have students research the incidence of tuberculosis in their county, state, and country.
            Have them interview local health care providers to determine current treatment
            modalities, and any measures which will help reduce the incidence.

            Have students present their findings using PowerPoint or Hyperstudio. Also, have
            students create pie charts or graphs to show the number of cases, age of patients,
            relation to other diseases, etc.

          • Teamwork        S
            Have students create “Jeopardy” questions for respiratory diseases. Each question
            should include a clue, but should NOT contain a form of the answer. (Example: If the
            answer is laryngitis, the question should not contain the word larynx.) Gather all the
            questions, revise as necessary. Divide the class into teams and play “Jeopardy”.

          • Employability Skills             S, A
            Divide students into small groups for role playing. Assign the following roles: respiratory
            therapist, patient, family member, etc. The patient is diagnosed with a respiratory
            disorder and the therapist must explain the disease and treatment to the patient and the
            family.

            Note: Write the different respiratory disorders studied on note cards, and let each small
            group draw a card to determine their disorder.

          • Special Needs
            Each student will reach the highest level of mastery in the least restrictive environment as
            recommended in the student’s IEP.




                                       Summer 2005 J.9
                                         Daily Lesson Plans
Unit J:          Respiratory System
Lessons:         5
Hours:           7 1/2 clock hours

Steps         Lesson #1                           Lesson #2                         Lesson #3
Focus and     Ask students to recall prior        Collect notecards – ask           Collect and grade breathing
Review        learning from the circulatory       questions from notecards as a     control worksheet.
              system and hematology.              review.
              Brainstorm - What did they                                            On notecards, have students
              learn about the respiratory                                           write 3 questions they have
              system in those units?                                                about respiratory disorders or
                                                                                    careers in respiratory therapy.

Statement     MD10.01               Describe      MD10.02 Analyze the               MD10.03 Analyze
of            the structure of the respiratory    function of the respiratory       characteristics and treatment of
Objectives    system.                             system                            common respiratory disorders.


Teacher       Using overheads, discuss            Using overheads, discuss the      Guest Speaker – Respiratory
Input         respiratory anatomy and             function of the respiratory       Therapist
              important structures of the         system.                           • Have a student introduce
              respiratory system. Use a                                                the speaker
              classroom model to reinforce        Handout “Model Lungs”             • The speaker should talk
              the content.                        instructions and let groups          about his her profession
                                                  make the model.                      and the treatment of
              At the end of class, ask for                                             respiratory disorders
              volunteers to brin g the                                              • The speaker should bring
              supplies needed for “Model                                               as much equipment as
              Lungs.” You may need to find                                             possible for students to
              the plastic tubes, but students                                          see, touch, etc.
              will bring everything else. You
              want enough supplies so that
              small groups can make model
              lungs.
Guided        Complete the “label the lung”       Create model lungs.               As questions that the students
Practice      handout – discuss the final                                           wrote are answered, they
              drawing with a neighbor to          Complete breathing control        should write the answers on the
              assure all parts are properly       worksheet.                        other side of their notecards.
              labeled.
Independent   Write 3 notecards with              Write 3 more notecards with       Use the textbook and answers
Practice      questions about respiratory         questions about respiratory       given by the Respiratory
              anatomy on one side and             physiology on one side and        Therapist to complete the
              answers on the other side.          answers on the other side.        Respiratory Disease Fact
                                                                                    Sheet.
Closure       Handout the “Respiratory            Debrief model lungs activity.     Ask students to debrief what
              Structure Worksheet” and have       Did it help students understand   they learned from the speaker,
              students write in the answers.      lung function.                    sharing what they wrote on
              Correct it in class.                                                  notecards as appropriate.

Materials     Overheads                           Overheads                         Speaker bio for introduction
              Handouts – Label the Lung and       Model lungs and Breathing         Certificate for speaker
              Respiratory Structure               Control handouts
              Worksheet




                                                 Summer 2005 J.10
Unit J:          Respiratory System (Continued)
Steps         Lesson #4                           Lesson #5
Focus and     Collect notecards. Ask              Answer student questions
Review        questions from the notecards        before the test.
              for review.

              Check for completion of
              homework assignment –
              Respiratory Disease Fact
              Sheet.

Statement     MD10.03 Analyze                     MD10.03 Analyze
of            characteristics and treatment of    characteristics and treatment of
Objectives    common respiratory disorders.       common respiratory disorders.

Teacher       Using overheads, review             TEST – Respiratoy System
Input         disorders of the respiratory
              system. Students should check
              their answers in the
              “Respiratory Disease Fact
              Sheet” they did for homework.


Guided        Have students complete the          Take unit test.
Practice      respiratory rate comparison
              activity.                           Grade test in class.

              Teacher should talk about the
              results and relate it to
              Respiratory A&P.

Independent   Study for test.                     Have students look up the
Practice                                          answers to the questions they
                                                  got wrong and turn in their
                                                  corrected test.

                                                  Have a student write a thank-
                                                  you note to the guest speaker.

Closure       With remaining time, use            Introduce the next unit.
              notecards that students created
              over the last 3 days to review      Make a reading assignment.
              for the test. You can use
              HOSA Bowl buzzers or any            Use remaining class time for
              other mechanism for a fun           HOSA business/update.
              review.

Materials     Overheads                           Test and key.
              Notecards from previous 3
              classes.                            Green pens for grading tests.
              Handouts – Respiratory Rate
              Comparison Activity




                                                 Summer 2005 J.11
                       Unit J: Respiratory System
                             Terminology List

   1.    Alveoli                              15.    Nasal septum
   2.    Apex                                 16.    Nose (nasal cavity)
   3.    Bronchi                              17.    Pharynx
   4.    Bronchioles                          18.    Phrenic nerve
   5.    Cilia                                19.    Pleura
   6.    Coughing                             20.    Pleural cavity
   7.    Epiglottis                           21.    Pleural fluid
   8.    Expiration/exhalation                22.    Respiration
   9.    Hiccups                              23.    Sinuses
   10.   Inhalation/inspiration               24.    Sneezing
   11.   Larynx                               25.    Surfactant
   12.   Lobes                                26.    Trachea
   13.   Lungs                                27.    Ventilation
   14.   Medulla oblongata                    28.    Yawning

Disorders and Related Terminology

   1.    apnea                                14.    orthopnea
   2.    asthma                               15.    pharyngitis
   3.    bronchoscopy                         16.    pleurisy
   4.    bronchitis                           17.    pneumonia
   5.    Common cold                          18.    pulmonary embolism
   6.    dyspnea                              19.    rales
   7.    emphysema                            20.    rhinitis
   8.    epistaxis                            21.    SIDS
   9.    hyperpnea                            22.    sinusitis
   10.   hyperventilation                     23.    tachypnea
   11.   influenza                            24.    tuberculosis
   12.   laryngitis                           25.    URI
   13.   lung cancer




Appendix MD10.01A




                                  Summer 2005 J.12
                                  Label the Lungs


Label the following structures:

   Right lung
   Left lung
   Larynx
   Trachea
   Heart
   Ribs
   Left bronchus
   Right bronchus
   Pleura




Appendix MD10.01B




                                   Summer 2005 J.13
                    Respiratory Structure Worksheet

Directions: Fill in the blanks using the word bank below.

Sinuses             Mediastinum           Anterior Nares        Glottis
Nasal Septum        Epiglottis            Alveoli               Pharnyx
Right               Larynx                Left                  Pleural
Lungs               Trachea               Bronchi               Surfactant

1.    Air enters the nostrils, or _________________, which is divided into two chambers
      by a partition known as the _____________________________________.

2.    _____________________, or small hairs in the nose, entrap and prevent the entry of
      larger dirt particles.

3.    The _______________________ serves as a common passageway for air and food.

4.    The ______________________, a cartilage “lid”, covers the opening into the larynx
      when food is swallowed.

5.    The tube-like passageway which extends from the larynx, passes in front of the
      esophagus, and continues to form two bronchi is the ______________________.

6.    The inner surfaces of the _____________________ are covered with a lipid material
      known as surfactant.

7.    The __________________ lung is larger and broader than the ________________ lung
      due to the location of the heart.

8.    The four cavities of the skull in and around the nasal region are called _____________.

9.    The structure situated between the lungs along the median plane of the thorax
      is known as the _________________________.

10.   The ______________________________ fluid is necessary to prevent friction as the
      two pleural membranes rub against each other during each breath.




Appendix MD10.01C




                                     Summer 2005 J.14
      Answer Key – Respiratory Structure Worksheet


1.    anterior nares, nasal septum

2.    cilia

3.    pharynx

4.    epiglottis

5.    trachea

6.    alveoli

7.    right, left

8.    sinuses

9.    mediastinum

10.   pleural

11.   nasal cavity, pharynx, larynx, trachea, bronchial tree, bronchus, bronchiole,
      alveoli




                                     Summer 2005 J.15
                                     Model Lungs

When you inhale, muscles cause the chest to expand, making the lungs do the same.
When this happens, air is sucked into the lungs. Make a model to demonstrate this.
You will need:

•    Large clear, plastic bottle
•    Three-way hose connector
•    2 rubber bands
•    modeling clay
•    plastic tube
•    3 small balloons
•    scissors

Directions:

1.      Push the plastic tube into one opening of the hose connector. Use modeling
        clay, if necessary, to make an airtight seal. Fix the balloons tightly onto the other
        opening with rubber bands, making sure that the joints between the connector
        and the balloons are airtight.

2.      Carefully cut off the bottom 1 inch from the bottle, using the scissors. Make sure
        the cut edge of the bottle is smooth. Place the balloons and connector inside.
        Seal the plastic tube into the neck of the bottle with the modeling clay to make an
        airtight fit.

3.      Tie a knot in the neck of the third balloon. Then carefully cut it in half, crossways.
        Gently stretch the knotted part of the balloon over the lower end of the bottle, and
        pull it around the sides. Make the balloon as taut as you can-like a drum skin.
        Now hold it by its knot.

4.      The lower balloon represents the diaphragm, the main breathing muscle. Pull it
        down, as though you were inhaling. This lowers the air pressure in the bottle.
        Air from outside rushes in and makes the two balloons expand just like the real
        lungs in your chest.




Additional assignment:
Read Body Structures and Functions. In your own words, explain the process of
inspiration and expiration. Write your answer on the back of this handout.

Appendix MD10.01D




                                      Summer 2005 J.16
                        Breathing Control Worksheet
I.    Directions:     Read the situations below. If the situation is closely related to the
      NEURAL factors affecting respiration, write an “N” in the blank provided. If the
      situation is more closely related to the CHEMICAL factors, write a “C” in the blank.


_____1.       Donnie jumps in a pool of cold water and “gasps” for air.

_____2.       Maria is “out of breath” after running up four flights of stairs.

_____3.       Emanuel, a health care assistant, determines the respiratory rate of his
              patient, Mr. Nguyen, to be 10 breaths per minute. Emanuel learns that his
              patient is on Morphine for post-operative pain.

_____4.       Sally is allergic to pollen. When she works in her outdoor garden, she
              constantly sneezes.

_____5.       Terrell has been taking diet pills and has experienced an increase in
              respiratory rate.


II.    Directions: Read the statements below and write the answer in the space
       provided.

1.     Where is the body’s respiratory center located? What is the name of the
       structure?


2.     Describe the major function of the phrenic nerves.


3.     Explain how the level of oxygen and carbon dioxide in the blood will trigger
       the respiratory center.


4.     Chemical regulators of respiration, or chemoreceptors are found in which major
       arteries in the body? Briefly explain their function.


5.     Explain how sensory impulses are involved in changing the rhythm of breathing.




Appendix 010.02A




                                      Summer 2005 J.17
      Answer Key – Breathing Control Worksheet


I.

1.    N
2.    C
3.    C
4.    N
5.    C


II.

1.    The respiratory center is located in the brain, the medulla oblongata.

2.    They are motor nerves which lead to the diaphragm and the
      intercostal muscles.

3.    An increase of carbon dioxide or lack of oxygen in the blood will
      trigger the respiratory center.

4.    They are found in the carotid arteries and the aorta. As the arterial
      blood flows around these structures, the chemoreceptors are
      particularly sensitive to the amount of oxygen present. If the level
      become low, impulses are sent from these structures to the
      respiratory center which will stimulate the rate and depth of
      respiration.

5.    Nerve pathways carry sensory impulses from the nose, larynx, lungs,
      skin, and abdominal organs via the vagus nerve in the medulla.




                               Summer 2005 J.18
                       Respiratory Rate Comparison

Directions: Have each student in your group count the number of breaths per minute
            while resting. Record the number in the chart. Then do 2 minutes of
            vigorous exercise, such as running in place or jumping jacks. Have each
            member of the group count the breaths per minute again and record in the
            chart below.

             Once this is done, find the range and mean respiratory rate of your group.
             Answer the questions at the bottom of this page.

           NAME                  RESPIRATORY RATE                 RESPIRATORY RATE
                                      AT REST                      DURING ACTIVITY




1.     What is the range of respiratory rates of your group at rest?__________after
       activity?__________

2.     What is the average respiratory rate of your group at rest?__________after
       Activity?__________

3.     How do these rates compare with the normal rates discussed in your text?




4.     After reviewing the pages listed above, describe other situations that can affect
       the respiratory rate.

Appendix 010.02A




                                    Summer 2005 J.19
                      Respiratory Disease Fact Chart
Directions:   Complete the chart by filling in the “missing” information.

 DISEASE             SIGNS          ETIOLOGY             TREATMENT          PREVENTION
                   SYMPTONS
Common                              Usually viral
cold


                Red, inflamed
              throat and painful
                 swallowing

                                                      Aimed at symptons-
                                                         quit smoking


 Laryngitis



                                                                              Vaccine



              Chest pain, fever,
               chills, dyspnea


                                   Mycobacterium
                                    tuberculosis


                                                              Aniti-
                                                         Inflammatory
                                                        Drugs, broncho-
                                                            Dilators
Emphysema




Appendix 010.03A




                                     Summer 2005 J.20
     IDEAS FOR THE GREAT
     AMERICAN SMOKEOUT
1.   Call your local American Lung Association early in the school year to find out
     how to get materials for this event. The materials are free. If you are not
     teaching this unit at the right time to coincide with the event, this Association will
     let you borrow teaching materials such as diseased and non-diseased lung
     specimens, etc.

2.   Contact your school nurse for assistance in providing school-wide or community
     education related to this event. She may even be able to obtain the materials for
     you.

3.   Students may create displays about the effects of smoking on the respiratory
     system. The displays can be used for the Great American Smokeout.

4.   Have a jar of molasses to represent the tar in the lungs.

5.   Obtain coffee stirrers and set up a station which allows the participant to breathe
     through the stirrer. Ask him/her how it felt to breathe this way. Explain the
     effects of diseases such as emphysema.

5.   Include pledge cards which participants can sign which states they will either
     quit smoking or never start. These cards and stickers are available through the
     American Lung Association.

6.   Short video commercials are also available as part of the promotional items for
     this event. Have students meet with administration to plan how they can be used
     for the school wide viewing.

7.   At the conclusion of the event, instruct your students to write their observations
     and evaluation of their participation and the student body’s reaction to the
     activities. You may even follow up with a school-wide survey to determine
     the number of students who continue to follow their pledge of not smoking at
     certain interval (2 weeks, 2 months, 6 months, etc.) Have students graph the
     survey results and include it and an article in the school paper.



     Appendix MD10.03B




                                    Summer 2005 J.21
Unit J:   Respiratory System




            OVERHEAD
          TRANSPARENCY
            MASTERS




             Summer 2005 J.22
Includes the nasal cavity, pharynx, larynx, trachea,
bronchi, bronchioles, alveoli, lungs, and pleura.

NASAL CAVITY
NASAL SEPTUM =
divides nasal cavities into
R and L sides

Turbinates are bones that
protrude into the nasal
cavity – they increase
surface area for filtering
dust and dirt particles by
the mucous membrane.

CILIA – the hairs in your
nose, trap larger dirt
particles




                      Summer 2005 J.23
SINUSES – cavities in the
skull, ducts connect them to
the nasal cavity, lined with
mucous membrane to warm
and moisten the air.
  Frontal
  Maxillary
  Ethmoid
  Sphenoid
Sinuses give resonance to the
voice.


PHARYNX

 The throat
 Common passageway for air and food
 5” long
 When food is swallowed, the EPIGLOTTIS closes
 over the opening to the larynx, preventing food
 from entering the lungs.




                    Summer 2005 J.24
LARYNX

 Voice box
 Triangular chamber below pharynx
 Within the larynx are vocal cords (GLOTTIS)
 Adam’s Apple

TRACHEA

 Windpipe
 4 ½ in. long
 walls are
 alternate bands
 of membrane
 and C-shaped
 rings of hyaline
 cartilage – to
 keep trachea
 open
 Lined with
 ciliated mucous
 membrane
 Coughing and
 expectoration
 gets rid of dust-laden mucous




                   Summer 2005 J.25
BRONCHI and BRONCHIOLES

 Lower end of trachea divides into R and L
 bronchus
 As they enter lungs, subdivide into bronchial tubes
 and bronchioles
 Bronchi – similar to trachea with ciliated mucous
 membrane and hyaline cartilage
 Bronchial tubes – cartilaginous plates (instead of
 C-shaped rings)
 Bronchioles – thinner walls of smooth muscle,
 lined with ciliated epithelium
 At the end, alveolar duct and cluster of alveoli

ALVEOLI

                        Composed of a single layer
                        of epithelial tissue
                        Inner surfaces covered with
                        SURFACTANT – to keep
                        alveoli from collapsing
                        Each alveolus surrounded
                        by capillaries
                        O2 and CO2 exchange takes
                        place between the alveoli
                        and capillaries



                    Summer 2005 J.26
LUNGS

 Fill thoracic cavity
 Upper part = apex Lower part = base
 Base fits snugly over diaphragm
 Lung tissue porous and spongy – it floats
 R lung = larger and shorter (displaced by the liver)
 and has 3 lobes
 L lung smaller (displaced by the heart) and has 2
 lobes

PLEURA

 Thin, moist slippery membrane that covers lungs
 Double-walled sac
 Space is pleural cavity – filled with pleural fluid to
 prevent friction




                      Summer 2005 J.27
FUNCTION OF THE RESPIRATORY SYSTEM

 External respiration, internal respiration, and
 cellular respiration
 Production of sound (vocal cords)

PULMONARY VENTILATION (Breathing)

INSPIRATION
  Intercostal
  muscles lift ribs
  outward, sternum
  rises and the
  diaphragm
  contracts and
  moves downward
  – this increases
  the volume of the
  lungs and air
  rushes in.

EXPIRATION
 Opposite action
 takes place
 Exhalation is a passive process




                      Summer 2005 J.28
Respiratory Movements
 1 inspiration + 1 expiration = 1 respiration
 Normal adult = 14 - 20 respirations per minute
 Increases with exercise, body temperature, certain
 diseases.
 Age - newborn = 40-60/min
 Sleep = respirations
 Emotion can or rate


               Coughing – deep breath followed by
               forceful expulsion of air – to clear
               lower respiratory tract.


Hiccups – spasm of the diaphragm and
spasmotic closure of the glottis –
irritation to diaphragm or phrenic nerve


               Sneezing – air forced through nose
               to clear respiratory tract


Yawning – deep prolonged breath that
fills the lungs, increases oxygen within
the blood


                     Summer 2005 J.29
Control of Breathing

Breathing controlled by neural and chemical factors.

Neural Factors

  Respiratory center located in MEDULLA
  OBLONGATA
     on CO2 or O2 in the blood will trigger
  respiratory center
  PHRENIC NERVE – stimulates the diaphragm

Chemical Factors

  Depends on the levels of CO2 in the blood
  (respiratory center in brain)
  Chemoreceptors in aorta and carotid arteries
  sensitive to the amount of blood O2

Types of Respiration

APNEA – no breathing
DYSPNEA – difficult, labored or painful breathing
HYPERPNEA – increase in depth and rate of
breathing, abnormal exaggeration of respiratory
movements


                     Summer 2005 J.30
ORTHOPNEA – difficult breathing when body is in
horizontal position
TACHYPNEA – rapid and shallow breathing

HYPERVENTILATION
• rapid breathing causes body to lose CO2 too
   quickly, blood CO2 decreases
   which leads to alkalosis
• Symptoms: dizziness and
   possible fainting
• Rx: have person breathe into a
   paper bag




                    Summer 2005 J.31
PLEURISY
•   Inflammation of the lining of the lungs
•   Usually occurs in conjunction with pneumonia
    and other lung infections
•   Symptoms – sharp, stabbing pain when
    breathing, dyspnea and fever

COMMON COLD
• Contagious viral respiratory infection
• Indirect causes - chilling, fatigue, lack of proper
  food, and not enough sleep
• Rx – stay in bed, drink warm liquids and fruit
  juice, good nutrition
• Also called an Upper Respiratory Infection (URI)
• Handwashing – best preventative measure

PHARYNGITIS – red, inflamed throat

LARYNGITIS
• Inflammation of larynx or voice box
• Often secondary to other respiratory infections
• Symptoms – sore throat, hoarseness or loss of
   voice, dysphagia (difficulty swallowing)
                      Summer 2005 J.32
SINUSITIS
• Infection of mucous membrane that lines sinus
   cavities
• Caused by bacteria or virus
• Symptoms – headache or pressure, thick nasal
   discharge, loss of voice resonance
• Rx – symptomatic, surgery for chronic sinusitis

BRONCHITIS
• Inflammation of the mucous membrane of the
   trachea and bronchial tubes, producing
   excessive mucous
• May be acute or chronic
• Acute bronchitis characterized by cough, fever,
   substernal pain and RALES (raspy sound)
• Chronic bronchitis – middle or old age, cigarette
   smoking most common cause




                    Summer 2005 J.33
INFLUENZA (Flu)
• Viral infection causing inflammation of the
   mucous membrane
• Fever, mucopurulent discharge, muscular pain,
   extreme exhaustion
• Complications – pneumonia, neuritis, otitis
   media and pleurisy
• Rx – treat the symptoms

PNEUMONIA
• Infection of the lung
• Caused by bacteria or virus
• Alveoli fill with exudates (thick fluid)
• Symptoms – chest pain, fever, chills, dyspnea
• Rx – O2 and antibiotics

TUBERCULOSIS
• Infectious bacterial lung disease
• Tubercles (lesions) form in the lungs
• Symptoms: cough, low grade fever in the
   afternoon, weight loss, night sweats
• Diagnosis – TB skin test
• If skin test positive – follow up with chest x-ray
   and sputum sample
• RX – antibiotic



                      Summer 2005 J.34
Noninfectious Disorders

RHINITIS
• Inflammation of nasal mucosa with increased
   secretions
• Caused by virus or allergen

ASTHMA
• Inflammatory airway obstruction
• Caused by allergen or psychological stress
• 5% of Americans have asthma
• Symptoms: difficulty exhaling, dyspnea,
   wheezing, tightness in chest
• Rx: anti-inflammatory drugs, inhaled
   bronchodilator




                   Summer 2005 J.35
EMPHYSEMA
• Alveoli become over-dilated, lose their elasticity,
    can’t rebound, may eventually rupture
• Air becomes trapped, can’t exhale – forced
    exhalation required
• Reduced exchange of O2 and CO2
• Dyspnea increases as disease progresses
Rx – alleviate the symptoms, decrease exposure to
respiratory irritants, prevent infections, restructure
activities to prevent need for O2

CANCER OF THE LUNGS
• Found mainly in smokers
• Symptoms: cough and weight loss
• Diagnosis: x-ray and BRONCHOSCOPY
   (flexible tube passed through mouth or nose into
   bronchi and lungs)
• Rx: surgery, chemotherapy, and/or radiation

PULMONARY EMBOLISM
• Blood clot breaks off and travels to the lung
• Occurs after surgery or when a person has been
   on bed rest
• Symptoms: sudden severe chest pain, dyspnea
• Diagnosis: lung scan
• Rx: anticoagulant therapy


                      Summer 2005 J.36
SUDDEN INFANT DEATH SYNDROME (SIDS)
• Crib death
• Usually between 2 weeks and 1 year old
• Cause: unknown
• Rx: sleep monitor

EPISTAXIS – nosebleed, treat by pinching nostrils,
elevate head and tilt forward, cold packs




                    Summer 2005 J.37

				
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