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ISI
The respiratory system is the anatomical system of an organism that introduces
respiratory gases to the interior and performs gas exchange. In humans and other mammals,
the anatomical features of the respiratory system include airways, lungs, and the respiratory
muscles. Molecules of oxygen and carbon dioxide are passively exchanged, by diffusion,
between the gaseous external environment and the blood. This exchange process occurs in the
alveolar region of the lungs.
The respiratory system is crucial to every human being. Without it, we would cease to
live outside of the womb. Let us begin by taking a look at the structure of the respiratory
system and how vital it is to life. During inhalation or exhalation air is pulled towards or
away from the lungs, by several cavities, tubes, and openings. The human respiratory system
consists of a complex set of organs and tissues that capture oxygen from the environment and
transport the oxygen into the lungs. The primary function of the respiratory system is to
supply the blood with oxygen in order for the blood to deliver oxygen to all parts of the body.
The respiratory system does this through breathing. When we breathe, we inhale oxygen and
exhale carbon dioxide. This exchange of gases is the respiratory system's means of getting
oxygen to the blood. Respiration is achieved through the mouth, nose, trachea, lungs, and
diaphragm.
A. Anatomy
Nose and pharynx
1. Nose: this is made of cartilage. Nose jobs involve taking a mallet, breaking the nasal
bone and shaving the cartilages.
a. Nasal cavity: this is where the nostrils are. They have hairs which filter large
particles in the respiratory tract. (insects, etc).
the functions of the nasal cavity is for the air you breathe:
1. Warm (cold air can freeze lungs); warmed by superficial veins
2. Clean (dirty air can clog lungs); mucous is sticky, and cilia will move that dirt
down the back of the throat, then it’s swallowed.
3. Humidify (dry lungs can crack). The fluid secreted by glands makes the
moisture, even on windy days the air goes to 100% humidity by the time it gets
to the lungs.
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When you have a cold and get extra fluid (edema)  stuffed up or runny nose, and the
pressure can cause sinus headaches.
The respiratory system of humans begins with the nose, where air is conditioned by
warming and moistening. Bonepartitions separate the nasal cavity into chambers, where air
swirls about in currents. Hairs and hair like cilia trap dust particles and purify the air.the nasal
chambers open into a cavity at the rear of the mouth called the pharynx (throat). From the
pharynx, two tubes called eustachian tubes open to the middle ear to equalize air pressure
there. The pharynx also contains tonsils and adenoids, which are pockets of lymphatic tissue
used to trap and filter microorganisms.
2. Pharynx is where the nasal passages join with the oral passages. The auditory tube
from the ears is located here.
A. Soft palate: move your tongue along the roof of your mouth, and going from
the front to the back you’ll feel the hard part turning into a soft part on the roof
of your mouth.
B. Uvula: located at the end of the soft palate (seen in cartoons).
the function of the soft palate and uvula is to move upward when swallowing, to
prevent food from going into nasal cavities. When you vomit, they don’t close, and food and
stomach acids go into nasal cavity and cause problems. Can also see tonsils (lymph nodes)
and vocal cords.
Larynx
This is a very complex structure (show overhead). Made up of cartilages
It has two functions:
1. Produce sounds (vocal cords are located in the larynx)
2. Prevent food from entering lungs
a. Epiglottis closes when you swallow so nothing will go into the trachea and lungs.
When you get hiccoughs, it’s from a sudden movement of air into the lungs, so the
epiglottis closes to prevent more air from going in. It’s unknown why you get
hiccoughs. All the treatments you can try involve interrupting the normal breathing
patterns.
b. Glottis is the opening.
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c. Vocal cords
Vocal cords are attached to cartilage. If these cartilages move, the vocal cords open.
The type and pitch of sounds you make depend on how far apart the vocal cords are. Way
open = no sound (like when breathing). Mostly closed = sounds. Men: their thyroid cartilage
is larger, so their vocal cords are longer = deeper voice.Laryngitis: inflamed vocal cords (↓
sound production).Singers can get scar tissue nodules, requires surgery.The number one sign
that a person is lying is voice irregularities.
Trachea
Trachea this is a tube that carries air from the larynx to the lungs. (see model)It’s
fairly rigid from about 16 rings of cartilage.The purpose of the cartilage rings is to keep the
trachea open like a hollow tube. Otherwise, when you inhale, the trachea would collapse like
when you suck hard on a straw. That’s why your vacuum cleaner has rings on the hose.
The trachea is lined with epithelium interspaced with goblet cells, which are the cells
that produce mucous to trap dirt. The epithelial cells also have little hairs on them called cilia
which sweep dirt to larynx  swallowed. In this way, the respiratory passage is filtered.
Therefore, the cilia have several functions: they move the mucus, remove debris and harmful
organisms, and circulate the air.
The trachea branches out into smaller tubes called bronchi.Bronchi branch out into
smaller tubes called bronchioles. Bronchioles branch out into smaller tubes that empty into a
sack = alveoli (overhead picture). This sac is like a balloon surrounded by a capillaries. The
alveoli are where the gas exchange occurs: oxygen goes from the air in the lungs into the red
blood cells passing by there, and carbon dioxide diffuses out of the cells and into the air in
the lungs where it is exhaled. Therefore, inspired air (breathe in) contains oxygen, and
expired air (breathe out) contains more carbon dioxide than oxygen.
By the time these air tubes are this small, they don’t have any more cilia, so any
particle that gets down that far has to be eaten by macrophages or just stay there. Therefore,
within the alveoli are macrophages to eat the foreign object.
After passing through the pharynx, air passes into the windpipe, or trachea. The
trachea has a framework of smooth muscle with about 16 to 20 open rings of cartilage shaped
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like a c. These rings give rigidity to the trachea and ensure that it remains open.the opening to
the trachea is a slit like structure called the glottis. A thin flap of tissue called the epiglottis
folds over the opening during swallowing and prevents food from entering the trachea. At the
upper end of the trachea, several folds of cartilage form the larynx, or voice box. In the
larynx, flap like pairs of tissues called vocal cords vibrate when a person exhales and produce
sounds.at its lower end, the trachea branches into two large bronchi (singular, bronchus).
These tubes also have smooth muscle and cartilage rings. The bronchi branch into smaller
bronchioles, forming a bronchial “tree.” The bronchioles terminate in the air sacs known as
alveoli.
Lungs
Human lungs are composed of approximately 300 million alveoli, which are cup-
shaped sacs surrounded by a capillary network. Red blood cells pass through the capillaries in
single file, and oxygen from each alveolus enters the red blood cells and binds to the
hemoglobin. In addition, carbon dioxide contained in the plasma and red blood cells leaves
the capillaries and enters the alveoli when a breath is taken. Most carbon dioxide reaches the
alveoli as bicarbonate ions, and about 25 percent of it is bound loosely to hemoglobin.when a
person inhales, the rib muscles and diaphragm contract, thereby increasing the volume of the
chest cavity. This increase leads to reduced air pressure in the chest cavity, and air rushes into
the alveoli, forcing them to expand and fill. The lungs passively obtain air from the
environment by this process. During exhalation, the rib muscles and diaphragm relax, the
chest cavity area diminishes, and the internal air pressure increases. The compressed air forces
the alveoli to close, and air flows out.the nerve activity that controls breathing arises from
impulses transported by nerve fibers passing into the chest cavity and terminating at the rib
muscles and diaphragm. These impulses are regulated by the amount of carbon dioxide in the
blood: a high carbon-dioxide concentration leads to an increased number of nerve impulses
and a higher breathing rat
Diaphragm is a muscle on the floor of the chest cavity. It is involved in breathing.
Myth: cover your head or catch a cold: although 90% of the heat lost from the body is lost
from the head, covering your head will not prevent this heat loss. The heat is lost from the
warm air that you exhale.

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B. Fisiologi
Ventilation = mechanisms of breathing -- based on pressure changes
a. Inspiration
1. Need for O
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2. Increased need for more air
3. Diaphragm contracts and goes down; external intercostals contract and lift lungs up and
out
4. Intra pleural pressure changes from 760 mm hg -- decreases
5. Eupenea, costal breathing, diaphragmatic breathing
6. Lasts about 2 seconds normally
b. Expiration
1. Passive (no muscle contraction) unless disease or stress
2. Internal intercostals and abdominal muscles contract only during labored exhalation
3. Lasts about 3 sec normally
c. Collapsed lung
1. Loss of surfactant
d. Compliance and resistance = elasticity and surface tension (disease and obstruction)
1. Alveolar surface tension
2. Alveolar ventilation
a. Dead air space and dead air in the conducting parts (non alveolar)
e. Modified respiratory movements - in lab - p.
1. Speaking, laughing, sneezing, etc.

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Control
Ventilation occurs under the control of the autonomic nervous system from parts of
the brain stem, the medulla oblongata and the pons. This area of the brain forms the
respiration regulatory center, a series of interconnected brain cells within the lower and
middle brain stem which coordinate respiratory movements. The sections are the
pneumotaxic center, the apneustic center, and the dorsal and ventral respiratory groups. This
section is especially sensitive during infancy, and the neurons can be destroyed if the infant is
dropped and/or shaken violently. The result can be death due to "shaken baby syndrome"
Inhalation
inhalation is initiated by the diaphragm and supported by the external intercostal
muscles. Normal resting respirations are 10 to 18 breaths per minute, with a time period of 2
seconds. During vigorous inhalation (at rates exceeding 35 breaths per minute), or in
approaching respiratory failure, accessory muscles of respiration are recruited for support.
These consist of sternocleidomastoid, platysma, and the scalene muscles of the neck. Pectoral
muscles and latissimus dorsi are also accessory muscles.
Under normal conditions, the diaphragm is the primary driver of inhalation. When the
diaphragm contracts, the ribcage expands and the contents of the abdomen are moved
downward. This results in a larger thoracic volume and negative pressure (with respect to
atmospheric pressure) inside the thorax. As the pressure in the chest falls, air moves into the
conducting zone. Here, the air is filtered, warmed, and humidified as it flows to the lungs.
During forced inhalation, as when taking a deep breath, the external intercostal
muscles and accessory muscles aid in further expanding the thoracic cavity. During
inhalation the diaphragm contracts.
Exhalation
Exhalation is generally a passive process; however, active or forced exhalation is
achieved by the abdominal and the internal intercostal muscles. During this process air is
forced or exhaled out.
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The lungs have a natural elasticity: as they recoil from the stretch of inhalation, air
flows back out until the pressures in the chest and the atmosphere reach equilibrium.
During forced exhalation, as when blowing out a candle, expiratory muscles including
the abdominal muscles and internal intercostal muscles, generate abdominal and thoracic
pressure, which forces air out of the lungs
Gas exchange
The major function of the respiratory system is gas exchange between the external
environment and an organism's circulatory system. In humans and other mammals, this
exchange facilitates oxygenation of the blood with a concomitant removal of carbon dioxide
and other gaseous metabolic wastes from the circulation. As gas exchange occurs, the acid-
base balance of the body is maintained as part of homeostasis. If proper ventilation is not
maintained, two opposing conditions could occur: respiratory acidosis, a life threatening
condition, and respiratory alkalosis.
Upon inhalation, gas exchange occurs at the alveoli, the tiny sacs which are the basic
functional component of the lungs. The alveolar walls are extremely thin (approx. 0.2
micrometres). These walls are composed of a single layer of epithelial cells (type i and type ii
epithelial cells) close to the pulmonary capillaries which are composed of a single layer of
endothelial cells. The close proximity of these two cell types allows permeability to gases
and, hence, gas exchange. This whole mechanism of gas exchange is carried by the simple
phenomenon of pressure difference. When the air pressure is high inside the lungs, the air
from lungs flow out. When the air pressure is low inside, then air flows into the lungs.
Non-respiratory functions
Lung defense mechanisms
Airway epithelial cells can secrete a variety of molecules that aid in lung defense.
Secretory immunoglobulins (iga), collectins (including surfactant a and d), defensins and
other peptides and proteases, reactive oxygen species, and reactive nitrogen species are all
generated by airway epithelial cells. These secretions can act directly as antimicrobials to
help keep the airway free of infection. Airway epithelial cells also secrete a variety of
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chemokines and cytokines that recruit the traditional immune cells and others to site of
infections.
Metabolic and endocrine functions of the lungs
In addition to their functions in gas exchange, the lungs have a number of metabolic
functions. They manufacture surfactant for local use, as noted above. They also contain a
fibrinolytic system that lyses clots in the pulmonary vessels. They release a variety of
substances that enter the systemic arterial blood and they remove other substances from the
systemic venous blood that reach them via the pulmonary artery. Prostaglandins are removed
from the circulation, but they are also synthesized in the lungs and released into the blood
when lung tissue is stretched. The lungs also activate one hormone; the physiologically
inactive decapeptide angiotensin i is converted to the pressor, aldosterone-stimulating
octapeptide angiotensin ii in the pulmonary circulation. The reaction occurs in other tissues as
well, but it is particularly prominent in the lungs. Large amounts of the angiotensin-
converting enzyme responsible for this activation are located on the surface of the endothelial
cells of the pulmonary capillaries. The converting enzyme also inactivates bradykinin.
Circulation time through the pulmonary capillaries is less than 1 s, yet 70% of the angiotensin
i reaching the lungs is converted to angiotensin ii in a single trip through the capillaries. Four
other peptidases have been identified on the surface of the pulmonary endothelial cells
Vocalization
The movement of gas through the larynx, pharynx and mouth allows humans to
speak, or phonate. Vocalization, or singing, in birds occurs via the syrinx, an organ located at
the base of the trachea. The vibration of air flowing across the larynx (vocal chords), in
humans, and the syrinx, in birds, results in sound. Because of this, gas movement is
extremely vital for communication purposes.
Temperature control
panting in dogs and some other animals provides a means of controlling body temperature.
This physiological response is used as a cooling mechanism.
Coughing and sneezing
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Irritation of nerves within the nasal passages or airways, can induce coughing and
sneezing. These responses cause air to be expelled forcefully from the trachea or nose,
respectively. In this manner, irritants caught in the mucus which lines the respiratory tract are
expelled or moved to the mouth where they can be swallowed.
The respiratory system lies dormant in the human fetus during pregnancy. At birth,
the respiratory system becomes fully functional upon exposure to air, although some lung
development and growth continues throughout childhood. Pre-term birth can lead to infants
with under-developed lungs. These lungs show incomplete development of the alveolar type
ii cells, cells that produce surfactant. The lungs of pre-term infants may not function well
because the lack of surfactant leads to increased surface tension within the alveoli. Thus,
many alveoli collapse such that no gas exchange can occur within some or most regions of an
infant's lungs, a condition termed respiratory distress syndrome. Basic scientific experiments,
carried out using cells from chicken lungs, support the potential for using steroids as a means
of furthering development of type ii alveolar cells.
[11]
in fact, once a pre-mature birth is
threatened, every effort is made to delay the birth, and a series of steroid shots is frequently
administered to the mother during this delay in an effort to promote lung growth
C. Disease
disorders of the respiratory system can be classified into four general areas:
 Obstructive conditions (e.g., emphysema, bronchitis, asthma)
 Restrictive conditions (e.g., fibrosis, sarcoidosis, alveolar damage, pleural effusion)
 Vascular diseases (e.g., pulmonary edema, pulmonary embolism, pulmonary
hypertension)
 Infectious, environmental and other "diseases" (e.g., pneumonia, tuberculosis,
asbestosis, particulate pollutants):
coughing is of major importance, as it is the body's main method to remove dust,
mucus, saliva, and other debris from the lungs. Inability to cough can lead to infection. Deep
breathing exercises may help keep finer structures of the lungs clear from particulate matter,
etc.
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The respiratory tract is constantly exposed to microbes due to the extensive surface
area, which is why the respiratory system includes many mechanisms to defend itself and
prevent pathogens from entering the body.
Disorders of the respiratory system are usually treated internally by a pulmonologist
and respiratory therapist.
Problems with the lungs
In allergic conditions, bronchioles will constrict, blocking air flow to the lungs =
asthma. This can also be caused by irritants in the environment, especially by pollution in the
city.
Smoking
Smoking destroys cilia, and smoke of any kind is toxic. Particles in the lungs can’t
clear. Cigarettes contain tar, which is the same kind of tar used to pave roads. When there is
a thin lining of tar on the alveoli, there is no oxygen exchange to the lungs there. Large
chunks of the lung become useless. Damage to the lungs shows up several ways.
If a person smokes for 10 years and then stops, the damage will repair. If they have
been smoking longer than 10 years, they may have some residual damage. It takes 7 years
for lungs to repair. Smoking right after exercise is worse because you are breathing more
deeply, so the particles go in deeper. Pollution in the air can also cause particles in the lungs,
and the ozone can damage the lungs. Living in southern california is like smoking one pack a
day.
A mother who smokes during pregnancy will give birth to a baby with a lower birth
weight. Smoking also is associated with heart disease, cancer of the lung, bladder, and
pancreas. It also causes emphysema, pneumonia, and bronchitis. Some people try to quit
smoking by smoking less, trying not to inhale, or switching to chewing tobacco, but there is
no safe way to use tobacco.
Chronic obstructive pulmonary disease (copd)
Number 5 killer in the usa.
It is a combination of two conditions:
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1. Chronic bronchitis: inflammation of the bronchi, produces mucous, the openings
become smaller = obstructed.
2. Emphysema: loss of elastic tissue on the bronchioles and alveoli, which collapse now
during exhalation. Alveoli lose their shape and their surface area. When you see
someone at the mall with an oxygen tank, they probably have emphysema, and need
pure oxygen.

Lung cancer
There are many types of lung cancers. About 150,000 die each year from them.It is
the #1 or #2 most deadly form of cancer. 85% of lung cancer is caused from smoking.
The problem is that it starts as a hard nodule deep in the spongy tissue of the lung,
where it has no symptoms until it presses against a structure. By then, it has also
metastasized (bits of it break off and travel to another location in the body, lodge there, and
start multiplying).
Surgery on the lung cancer of a smoker won’t work because the lungs are too weak,
and they can’t do without the lung tissue. There are no good screening procedures for lung
cancer.
Surfactant
Surfactant is a slippery agent that is made by the alveoli, which coats it and keeps the
walls of the alveoli from sticking together when they collapse during exhalation. If you have
two wet pieces of paper and stick them together, they are hard to pull apart without ripping.
Put soapy water between them, and you can pull them apart.
The reason this is important is because surfactant is not produced in a fetus until the
ninth month, so premature babies don’t have enough surfactant  respiratory distress
syndrome, which is the #1 cause of death in premature babies. You know how hard it is to
blow up a brand new balloon? Imagine a baby having to do that with every single breath.
You get tired. The treatment is to spray artificial surfactant into the lungs, and put them on a
respirator to push air in. The more distal regions are still collapsed, so there are still
problems.

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Pneumonia
Pneumonia is when there is fluid in the lungs, usually from a viral or bacteria
infection of the bronchi and alveoli. Blood plasma leaks out and fills the lungs, making it
difficult to breathe. Needs hospitalization with iv antibiotics.
Tuberculosis
Tuberculosis is an infection of a really bad bacteria that get in the lungs and make
themselves a capsule to hide in, where antibiotics can’t reach. They set up shop in the lungs
and reproduce. Soon, the lungs fill up with these hard nodes and make it difficult to breathe.
It causes extreme coughing, and then lots of these bacteria break off and get spewed into the
air, where someone else can inhale them. It is extremely contagious and very deadly. If a
person gets tb, the state health department has to be notified. They will show up at your house
every morning for six months and stand there and watch you take your pills. If you don’t
accept this, they have the right to haul you away to a lock-up facility and force the medicine
in you for six months. There are only a few diseases where the state health department will
step in like this: anthrax, typhoid fever, and bubonic plague are other diseases where you
don’t get a choice; you are forced into isolation. Diseases like tb and the plague have almost
wiped out europe! A tb test will be positive if you have been exposed to the organism at any
point in your life. Then you’ll have to go in for an x-ray to see if it is an active case of tb or
not. Once you recover from tb you will always have a positive tb test, so tell the nurse that in
advance. You may have to provide documentation that you have been treated for it already.
Most employers require tb tests before hiring. I had to take one to work here.









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DAFTAR PUSTAKA

http://findebookee.com/a/anatomy-and-physiology-respiratory-system
http://kcfac.kilgore.cc.tx.us/mobleypageap2/unit%204%20res%20dig/respiration%202008%2
011e.pdf
http://click2earneasymoney.yolasite.com/resources/Human%20Respiratory%20System.pdf
http://blog.homeschoolacademy.com/wp-content/uploads/2011/11/Chapter-06-The-Human-
Respiratory-System.pdf