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The Upper Airways CHAPTER © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 1NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORThe SALE Upper OR DISTRIBUTION AirwaysNOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Golatckii Nikolai/Shutterstock. © Golatckii © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION CHAPTER OUTLINE KEY TERMS Breathing © Jones & Bartlett Learning, LLCairway edema ©nasal Jones turbinates & Bartlett Learning, LLC The Nose and Nasal CavityNOT FOR SALE OR DISTRIBUTIONalar collapse NOTnasal FORvalve collapse SALE OR DISTRIBUTION The Sinuses ankyloglossia nasal vestibules Conditions of the Nose arytenoid cartilages nasopharyngeal airways The Oral Cavity breathing nasopharynx Swallowing and Deglutition Apnea bronchoscopy nose Conditions of the Oral Cavity bronchospasm oral candidiasis The© Pharynx Jones & Bartlett Learning, LLC cilia © Jones & Bartlettoral cavity Learning, LLC TheNOT Nasopharynx FOR SALE OR DISTRIBUTION ciliated epitheliumNOT FOR SALEoropharyngeal OR DISTRIBUTION airways The Oropharynx columnar epithelium oropharynx The Laryngopharynx corniculate cartilages otitis media The Larynx cricoid cartilage peritonsillar abscess Cartilages of the Larynx croup pharyngeal reflex Muscles of the Larynx cuboidal epithelium pharynx © Jones & ConditionsBartlett of theLearning, Pharynx or Larynx LLC © Jonescuneiform & Bartlett cartilages Learning,pseudostratified LLC Bronchoscopy dysphagia columnar epithelium NOT FOR SALEArtificial ORAirways DISTRIBUTION NOTendotracheal FOR SALE tubes OR DISTRIBUTIONquinsy epiglottis respiration CHAPTER OBJECTIVES epiglottitis rhinitis epistaxis simple squamous After completing this chapter, you will be able to: extrinsic muscles epithelium 1. Identify the structures,© Jones physiologic & processes,Bartlett and Learning, functions LLChyperactive gag reflex ©sinusitis Jones & Bartlett Learning, LLC of the upper airway. intrinsic muscles stratified squamous 2. Explain the differenceNOT between FOR breathing SALE and OR respiration. DISTRIBUTIONlaryngeal edema NOTepithelium FOR SALE OR DISTRIBUTION 3. Discuss the filtration, humidification, and warming of inhaled laryngitis stylet gases. laryngopharynx supraglottic airways 4. Describe the histology of the upper airway. laryngoscope thyroid cartilage 5. Provide examples of abnormal physiologic processes of the laryngospasm tonsillitis nose, sinuses, oral cavity, and pharynx. larynx tracheostomy tubes 6.© JonesDescribe the & structure Bartlett and functionLearning, of the larynx. LLC nares © Jones & Bartlettupper airwayLearning, LLC 7.NOT Discuss FOR the useSALE of bronchoscopy. OR DISTRIBUTION nasal cavityNOT FOR SALEuvula OR DISTRIBUTION 8. Identify different types of artificial airways. nasal conchae vallecula epiglottis nasal congestion Valsalva maneuver nasal flaring vibrissae nasal polyps vocal cord dysfunction nasal septum (VCD) © Jones & Bartlett Learning, LLC © Jonesnasal trumpets& Bartlett Learning,Waldeyer’s LLC ring NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1 © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 9781284430240_CH01_001_018.indd 1 25/06/20 5:35 PM 2 CHAPTER 1 The Upper Airways © Jones &Breathing Bartlett Learning, LLC © JonesAs air& Bartlettmoves into Learning, and out of the LLC body, it passes through the conducting airways to the lungs. The con- The natural act of breathing is simply moving air into NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION ducting airways include the upper airway and lower and out of the body. Once inside the body, a series of airway. The upper airway includes the nose, nasal cavity, physiologic processes warm, filter, and humidify the air; oral cavity (mouth), and the pharynx, which is divided extract oxygen and nutrients; and eliminate carbon di- into the nasopharynx, oropharynx, and laryngophar- oxide and other by-products. The process of moving air ynx. The larynx, or voice box, is usually considered the involves a network of© nerves, Jones muscles, & Bartlett and tissues Learning, that LLC © Jones & Bartlett Learning, LLC demarcation between the upper and lower airways. The facilitate respiration,NOT or gas FOR exchange. SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION lower airway includes the trachea, tracheobronchial tree, bronchioles, and the alveoli. The lower airway pro- vides access to the lungs. The lungs are divided into five lobes, three lobes on the right of the body and two lobes CLINICAL© Jones FOCUS:& Bartlett Breathing, Learning, LLC on the left (©Figure Jones 1-1). & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Respiration, and Ventilation The Nose and Nasal Cavity Many people use the terms breathing, respiration, and ventilation interchangeably. However, in clinical The first portion of the anatomy that air encounters as it enters the body is the nose. The nasal cavity extends practice the terms have distinct meanings. Breath- from the external opening of the nose to the oral cav- ing is the process of moving air into (inhaling) and © Jones & Bartlett Learning, LLC © Jonesity (i.e., & the Bartlett mouth). Learning,The opening LLCof the nose through NOT FOR SALEout of OR the bodyDISTRIBUTION (exhaling). Respiration is the pro- NOTwhich FOR air SALE enters ORthe body DISTRIBUTION is called the nostrils, or the cess of gas exchange at the cellular level by which nasal vestibules. Thenasal septum is the partition oxygen is made available to the cells of the body that separates the left and right sides of the nose and and carbon dioxide and other by-products are re- nasal cavity. It is composed of bones and cartilage. The moved. Ventilation is the mechanical movement of nares are the two openings at the end of the exterior air into and out of ©the Jones body. & Bartlett Learning, LLCof the nose and are separated© from Jones each other& Bartlett by the Learning, LLC NOT FOR SALE OR DISTRIBUTIONnasal septum. NOT FOR SALE OR DISTRIBUTION Nasopharynx © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NasalNOT cavity FOR SALE OR DISTRIBUTION Oropharynx Pharynx Upper Mouth airway Epiglottis © Jones & Bartlett Learning, LLC © Jones & BartlettLaryngopharynx Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Trachea Larynx Apex of the lung Artery Alveolus Lower Alveoli Bronchiole airway Bronchioles© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Main bronchiNOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Vein Base of the lung © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Diaphragm NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Capillary Carina network FIGURE 1-1 The respiratory system is divided into the upper and lower airways, which can also be described as the © Jones & Bartlettconducting Learning, airways and LLC the respiratory zone, or nonconducting© Jonesairway. The & conducting Bartlett airways Learning, include all of LLCthe upper airway and the lower airway up until the alveoli. The respiratory zone includes the terminal bronchioles and the alveoli. Gas exchange NOT FOR SALEoccurs OR inDISTRIBUTION the respiratory zone. NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 9781284430240_CH01_001_018.indd 2 25/06/20 5:35 PM The Nose and Nasal Cavity 3 © Jones & BartlettIn addition Learning, to providing LLC sensory receptors for smell © Jonesinclude & the Bartlett inferior nasalLearning, conchae, LLC the middle nasal and aiding in speech, the nose and nasal cavity warm, NOTconchae, FOR SALE and the OR superior DISTRIBUTION nasal conchae. The largest of NOT FOR SALEhumidify, OR and DISTRIBUTION filter the incoming air. These structures these three sets of bones, the inferior nasal concha, is also provide access to the sinuses, a series of hollow located horizontally along the lateral wall of the nasal passages inside the head. The outer, or external, nose is cavity. This structure is responsible for directing the the part that most people see. It is made up of the nasal flow of air through the nasal cavity. By channeling the bones, the frontal processes© Jones of the & maxillae,Bartlett and Learning, five LLCair entering the nasal cavity via© theJones nose through& Bartlett the Learning, LLC cartilages—two lateralNOT nasal FOR cartilages, SALE the OR greater DISTRIBUTION and mucous membrane and cilia,NOT the inferior FOR nasal SALE concha OR DISTRIBUTION lesser alar cartilages, and the septal cartilage. The bones plays a primary role in filtering and humidifying the air of the nose include the ethmoid bone, palatine bones, as it enters the body. The middle conchae are smaller maxilla bone, vomer, and nasal conchae. The cribriform and sit just above the inferior conchae. They function as plate of the ethmoid bone forms the back interior (i.e., a protective structure for the sinuses. The superior nasal roof)© ofJones the nasal & cavity.Bartlett The Learning, palatine bone LLC posteriorly conchae, the© smallest Jones of & the Bartlett three sets Learning, of conchae bones, LLC andNOT the palatine FOR processSALE ofOR the DISTRIBUTION maxilla bone anteriorly sit just aboveNOT the middle FOR conchae.SALE ORThe DISTRIBUTIONsuperior
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