2. RESPIRATORY ILO 2022/23
Table of Contents
ANATOMY.....................................................................................................................................................................2
Respiratory Block...............................................................................................................................................................................2
Gross Anatomy: Anatomy of Breathing.............................................................................................................................................2
2.1.3.4__Anatomy and Consequences of Coughing..........................................................................................................................3
Histology Lecture...............................................................................................................................................................................4
Embryology Lecture...........................................................................................................................................................................6
Dissection...........................................................................................................................................................................................7
WEEK 1...................................................................................................................................................................8
MONDAY........................................................................................................................................................................ 8
2.1.1.1__Physiology 1 – Overview of respiration and respiratory mechanics Lecture 1..................................................................8
2.1.1.2__Physiology 2 – Respiratory Mechanics Lecture 2...............................................................................................................9
TUESDAY:.................................................................................................................................................................... 13
2.1.2.1__Physiology 3 Gas Exchange..............................................................................................................................................13
2.1.2.2__Physiology 4 – Gas transport in the blood Part 1..............................................................................................................14
2.1.2.4__SCRIPT Module - Guided Independent Study..................................................................................................................15
WEDNESDAY:.............................................................................................................................................................15
2.1.3.1__Physiology 5 – Gas transport in the blood Part 2 – carbon dioxide..................................................................................15
2.1.3.2__Physiology 6 – Control of Respiration..............................................................................................................................16
THURSDAY.................................................................................................................................................................. 16
2.1.4.1__Allied Health Professionals (AHP Tutorial).....................................................................................................................16
2.1.4.2__Radiology of the Thorax Part 1.........................................................................................................................................18
FRIDAY.........................................................................................................................................................................20
2.1.5.2__Oxygen and Respiratory Failure.......................................................................................................................................20
WEEK 2.................................................................................................................................................................20
MONDAY...................................................................................................................................................................... 21
2.2.1.1__Smoking Cessation............................................................................................................................................................21
2.2.1.2__Obstructive airways disease overview Asthma COPD.....................................................................................................23
2.2.1.3__PVB Ethics & Law 2 Tutorials.........................................................................................................................................26
TUESDAY.....................................................................................................................................................................27
2.2.2.2__Overview of PFTs.............................................................................................................................................................27
2.2.2.3__Radiology Tutorial 1.........................................................................................................................................................29
2.2.2.3__Radiology Tutorial 2.........................................................................................................................................................30
WEDNESDAY............................................................................................................................................................... 30
2.2.3.1__Pharmacology 1: Asthma..................................................................................................................................................30
2.2.3.1__Pharmacology 2: (Treatment) Asthma..............................................................................................................................31
2.2.3.3__Therapeutics of Obstructive Airways Disease – Professor Brian J Lipworth...................................................................32
THURSDAY.................................................................................................................................................................. 34
2.2.4.1__Pharmacology 3: COPD....................................................................................................................................................34
2.2.4.2__Primary Care Management of Asthma:.............................................................................................................................35
2.2.4.3__Secondary Care of Management of Asthma.....................................................................................................................36
FRIDAY.........................................................................................................................................................................37
2.2.5.1__Pharmacology 4: Cough/Rhinitis......................................................................................................................................38
2.2.5.2__Primary Care Management of COPD................................................................................................................................38
2.2.5.3__Secondary Care Management of COPD............................................................................................................................39
CS CLINICAL SKILLS........................................................................................................................................40
,CCS CLINICAL COMMUNICATION SKILLS.................................................................................................41
ANATOMY
Respiratory Block
Topic Description
Upper and The upper respiratory tract consists of the nose, pharynx, and larynx, while the
Lower lower respiratory tract consists of the trachea, bronchi, bronchioles, and lungs.
Respiratory
Tract
Chest Walls, The chest walls are made up of the ribs and the sternum, forming a bony cage
Chest Cavity, that protects the lungs and heart. The chest cavity is the space within the chest
Mediastinum, walls. The mediastinum is the central space in the chest cavity that contains the
Pleural Cavities heart, great blood vessels, trachea, and esophagus. The pleural cavities are the
two spaces on either side of the mediastinum that contain the lungs.
Mechanics of The mechanics of breathing involve the expansion and contraction of the rib
Breathing cage and diaphragm, resulting in changes in the volume of the chest cavity and
the pressure within it. This movement of air in and out of the lungs is known as
ventilation.
Lines and The lines and palpable features of the chest include the manubriosternal
Palpable junction, the jugular notch, the xiphoid process, the costal margins, and the
Features of the intercostal spaces.
Chest
Anatomy of The female breast consists of glandular, fibrous, and fatty tissue, surrounded by
the Female skin and supported by the underlying muscles and fascia. The milk ducts lead
Breast from the glands to the nipple.
Anatomy Intubation involves the insertion of a tube into the trachea through the mouth
Associated or nose to maintain an open airway and provide artificial ventilation. The
with anatomy associated with intubation includes the larynx, trachea, and carina.
Intubation
Gross Anatomy: Anatomy of Breathing
Intercostal Space The intercostal space is the area between two adjacent ribs. It is
Anatomy: supplied by the intercostal nerves and vessels, which provide sensation
and blood flow to the area.
Diaphragm Anatomy: The diaphragm is a dome-shaped muscle that separates the thorax and
abdomen. Its main function is to contract and relax to control
breathing. It is supplied by the phrenic nerve.
Breastplate Anatomy: The breastplate, also known as the sternum, is a flat bone located in
, the midline of the thorax. It provides attachment for several chest
muscles and protects the underlying thoracic organs.
Pleural Cavities The pleural cavities are two spaces between the lungs and the chest
Anatomy: wall. They contain a thin layer of fluid to reduce friction between the
lungs and chest wall during breathing.
Accessory Muscles of The accessory muscles of respiration are muscles that aid in breathing,
Respiration: such as the scalenes and sternocleidomastoid. They help to expand the
chest and increase the volume of the thorax, allowing for a greater
exchange of air.
Anterolateral The anterolateral abdominal wall muscles include the rectus
Abdominal Wall abdominis, external oblique, and internal oblique muscles. These
Muscles Anatomy: muscles help to support the abdominal contents and assist in breathing
by altering the pressure within the abdomen. They are supplied by the
thoracoabdominal nerves.
2.1.3.4__Anatomy and Consequences of Coughing
Respiratory Anatomy Summary:
Cough Stimulation: Inhalation of irritant into respiratory system
Stretch receptors in airways send signals to cough center in
medulla oblongata
Signals trigger muscle contraction in diaphragm and
intercostal muscles, increasing pressure in lungs
Air is expelled through open glottis (vocal cords), creating the
sound of a cough
Nerve Supply: Nasal cavities, pharynx, and larynx lined with mucosa,
supplied by branches of the trigeminal nerve (Vth)
Lungs sensory & motor nerve supply: Vth, sympathetic, and
parasympathetic fibers
Phrenic nerves arise from cervical spinal cord, descend
through thorax to supply diaphragm
Accessory muscles of inspiration: scalenes,
sternocleidomastoids, and trapezius
Laryngeal cartilages: thyroid, cricoid, arytenoids, epiglottis
Rima glottidis: the narrowest part of the larynx through
which air passes during respiration
Intrinsic muscles of the larynx: regulate opening and closing
of the rima glottidis, allowing control of air flow
Carotid Sheath: Encloses the common carotid artery, internal jugular vein,
and vagus nerve
Provides sensory and motor innervation to head, neck, and
thorax
, Vagus nerves: longest cranial nerves, provide sensory and
motor innervation to various organs and play a role in
regulating respiration
Basic Anatomy: Structures enclosed in carotid sheath: common carotid artery,
internal jugular vein, and vagus nerve.
Histology Lecture
Table: Histology of the Respiratory System
Component Description
Parts
Nasal The nasal cavity is lined by a mucous membrane that contains olfactory
Cavity receptors, cilia, and goblet cells. The mucous membrane provides a moist
surface for the filtering of air, and the cilia help move trapped particles out of
the airways.
Pharynx The pharynx is a muscular tube that connects the nasal and oral cavities to the
larynx and esophagus. Its walls are lined by a mucous membrane and contain
glands that produce mucus.
Larynx The larynx is a cartilaginous structure that helps regulate the flow of air into
and out of the trachea. Its walls are lined by a mucous membrane and contain
the vocal cords.
Trachea The trachea is a muscular tube that extends from the larynx to the bronchi. Its
walls contain C-shaped rings of cartilage that help maintain its patency.
Bronchi The bronchi are two branches of the trachea that enter the lungs. The walls of
the bronchi contain smooth muscle that can regulate the diameter of the
airway.
Bronchiole Bronchioles are smaller branches of the bronchi. They lack cartilage but
s contain smooth muscle.
Alveoli The alveoli are tiny air-filled sacs in the lungs where gas exchange occurs. The
walls of the alveoli are very thin and composed of a single layer of epithelial
cells.
Table: Structural Changes in the Respiratory System
Level Structural Changes
Nasal Cavity to The walls of the airways become thicker and contain more glands and
Pharynx muscle as you descend the respiratory tree.
