Respiratory

Organs
Atmungsorgane

Paranasal
Sinuses

Often, people become aware of their sinuses

only when they are blocked and develop
Sinus cavities with connections to the airways sinusitis!

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 The trachea branches off
into progressively smaller
bronchi, which finally open VocalCords(Glottis)
into the alveoli where gas
exchange takes place.

Seitliche Betrachtung

Right Lung (3 lobes) and Left Lung (2 lobes)

Diaphragm contracts Diaphragm relaxes

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 Diaphragm(abdominal) Diaphragm

Diaphragm: Central Rib cage

Tendon
CT

Diaphragm:
Muscular portion

M. quadratus
lumborum
Anterior view of the Diaphragm:
abdomen M. psoas major Inferior view

Breathing: Movement in the Frontal Plane Breathing: Movement in Sagittal Plane

When viewed from the side, the sternum rises and falls
Viewed from the front, the ribs rise and fall like a like the handle of a water pump (pump handle
bucket handle. mechanism)

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 Trachea
Facettengelenk

Ri
Rippen-Wirbelgelenk
Wi b l l k

Rippe

Rippen-Querfortsatzgelenk

Dornfortsatz

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 Bronchi:
Blood Supply

Respiratory Volumes
ForcedExpiratoryVolume(FEV)

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Spirographic tracings of forced expiration, comparing a
normal tracing (A) and tracings in obstructive (B) and
parenchymal restrictive (C) disease.
Asthma:Prevalence
Oneofthemostcommonchronicdiseasesglobally.~300millionpeople
affected.
Prevalencehasriseninaffluentcountriesoverlast30yearsbutnowappears
tohavestabilized,with~1012%ofadultsand15%ofchildrenaffected.
Indevelopingcountries,risingincidence(associatedwithincreased
urbanization?).
Prevalenceofatopy andotherallergicdiseaseshasalsoincreasedoverthe
sametime reasonsarelikelysystemicratherthanconfinedtothelungs.
Thisepidemiologicobservationsuggeststhatthereisamaximumnumberof
i di id l i th
individualsinthecommunitywhoareliabletobeaffectedbyasthma,likelyby
it h li bl t b ff t d b
geneticpredisposition.
Mostpatientswithasthmainaffluentcountriesareatopic,withallergic
sensitizationtothehousedustmiteDermatophagoides pteronyssinus and
otherenvironmentalallergens.
Flow-volume curves in different conditions: O, obstructive disease; R(P), parenchymal
restrictive disease; R(E), extraparenchymal restrictive disease with limitation in inspiration and
expiration.
Asthma:Prevalence
Canpresentatanyage;peakageof3years.
Inchildhood,male:female
In childhood, male:female =2:1.Equalizesbyadulthood.
2:1. Equalizes by adulthood.
Manychildrenwithasthmabecomeasymptomaticduring
adolescence.Insome,asthmamayreturnduringadultlife,
particularlyinchildrenwithpersistentsymptomsandsevere
asthma.
Adultswithasthma,includingthosewithonsetduringadulthood,
rarelybecomepermanentlyasymptomatic.
th lik l b
Severityofasthmadoesnotvarysignificantlywithinagivenpatient;
thosewithmildasthmararelyprogresstomoreseveredisease,
whereasthosewithsevereasthmausuallyhaveseverediseaseat
theonset.
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 Asthma:RiskFactors Asthma:RiskFactors
Endogenousfactors EnvironmentalFactors
Geneticpredisposition Indoorallergens
Atopy Outdoorallergens
Airwayhyperresponsiveness Occupationalsensitizers
Gender Passivesmoking
Ethnicity? Respiratoryinfections
Respiratory infections

Asthma:Triggers
Allergens
U
Upperrespiratorytractviralinfections
i t t t i l i f ti
Exerciseandhyperventilation
Coldair
Sulfurdioxide
Drugs (betablockers aspirin)
Drugs(betablockers,aspirin)
Stress
Irritants(householdsprays,paintfumes)
Inflammation in the airways of asthmatic patients leads
to airway hyper responsiveness and symptoms.

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8
 Therapie

NumerousCellsandMediators
involvedinAsthma

MetabolismofInhaledCorticosteroids MedicalTreatmentofAsthma

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 Chest X-ray, PA
view

Normal
COPD

Increased AP diameter, flattening of the diaphragm, decreased lung markings.

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