Upper and middle respiratory tract. Appointment of organs included in the upper respiratory tract

Human (gas exchange between inhaled atmospheric air and blood circulating in the pulmonary circulation).

Gas exchange is carried out in the alveoli of the lungs, and is normally aimed at capturing oxygen from the inhaled air and releasing carbon dioxide formed in the body into the external environment.

An adult, being at rest, makes an average of 14 respiratory movements per minute, however, the respiratory rate can undergo significant fluctuations (from 10 to 18 per minute). An adult takes 15-17 breaths per minute, and a newborn child takes 1 breath per second. Ventilation of the alveoli is carried out by alternating inspiration ( inspiration) and exhalation ( expiration). When you inhale, atmospheric air enters the alveoli, and when you exhale, air saturated with carbon dioxide is removed from the alveoli.

A normal calm breath is associated with the activity of the muscles of the diaphragm and external intercostal muscles. When you inhale, the diaphragm lowers, the ribs rise, the distance between them increases. The usual calm exhalation occurs to a large extent passively, while the internal intercostal muscles and some abdominal muscles are actively working. When exhaling, the diaphragm rises, the ribs move down, the distance between them decreases.

By way of extension chest There are two types of breathing: [ ]

Structure [ | ]

Airways[ | ]

Distinguish between the upper and lower respiratory tract. The symbolic transition of the upper respiratory tract to the lower is carried out at the intersection of the digestive and respiratory systems in the upper part of the larynx.

The upper respiratory system consists of the nasal cavity (lat. cavitas nasi), nasopharynx (lat. pars nasalis pharyngis) and oropharynx (lat. pars oralis pharyngis), as well as part of the oral cavity, since it can also be used for breathing. The lower respiratory system consists of the larynx (lat. larynx, sometimes referred to as the upper respiratory tract), trachea (other Greek. τραχεῖα (ἀρτηρία) ), bronchi (lat. bronchi), lungs.

Inhalation and exhalation is carried out by changing the size of the chest with the help. During one breath (in a calm state), 400-500 ml of air enters the lungs. This volume of air is called tidal volume(BEFORE). The same amount of air enters the atmosphere from the lungs during a quiet exhalation. The maximum deep breath is about 2,000 ml of air. After maximum exhalation, about 1500 ml of air remains in the lungs, called residual lung volume. After a quiet exhalation, approximately 3,000 ml remains in the lungs. This volume of air is called functional residual capacity (FOYo) lungs. Breathing is one of the few bodily functions that can be controlled consciously and unconsciously. Types of breathing: deep and shallow, frequent and rare, upper, middle (thoracic) and lower (abdominal). Special types of respiratory movements are observed with hiccups and laughter. With frequent and shallow breathing, the excitability of the nerve centers increases, and with deep breathing, on the contrary, it decreases.

respiratory organs[ | ]

The respiratory tract provides connections between the environment and the main organs of the respiratory system - the lungs. Lungs (lat. pulmo, other Greek. πνεύμων ) are located in chest cavity surrounded by bones and muscles of the chest. In the lungs, gas exchange takes place between the atmospheric air that has reached the pulmonary alveoli (lung parenchyma) and the blood flowing through the pulmonary capillaries, which ensure the supply of oxygen to the body and the removal of gaseous waste products from it, including carbon dioxide. Thanks to functional residual capacity(FOI) of the lungs in the alveolar air, a relatively constant ratio of oxygen and carbon dioxide is maintained, since the FOI is several times greater tidal volume(BEFORE). Only 2/3 of the DO reaches the alveoli, which is called the volume alveolar ventilation. Without external respiration human body usually can live up to 5-7 minutes (the so-called clinical death), after which loss of consciousness occurs, irreversible changes in the brain and its death (biological death).

Functions of the respiratory system[ | ]

In addition, the respiratory system is involved in such important functions as thermoregulation, voice production, smell, humidification of the inhaled air. Lung tissue also plays an important role in such processes as: hormone synthesis, water-salt and lipid metabolism. In the abundantly developed vascular system of the lungs, blood is deposited. The respiratory system also provides mechanical and immune protection against factors external environment.

Gas exchange [ | ]

Gas exchange - the exchange of gases between the body and the external environment. From the environment, oxygen continuously enters the body, which is consumed by all cells, organs and tissues; carbon dioxide formed in it and a small amount of other gaseous metabolic products are excreted from the body. Gas exchange is necessary for almost all organisms, without it it is impossible normal exchange substances and energy, and, consequently, life itself. Oxygen entering tissues is used to oxidize products resulting from a long chain chemical transformations carbohydrates, fats and proteins. This produces CO 2 , water, nitrogenous compounds and releases energy used to maintain body temperature and perform work. The amount of CO 2 formed in the body and eventually released from it depends not only on the amount of O 2 consumed, but also on what is predominantly oxidized: carbohydrates, fats or proteins. The ratio of the volume of CO 2 removed from the body to the volume of O 2 absorbed at the same time is called respiratory coefficient, which is approximately 0.7 for fat oxidation, 0.8 for protein oxidation, and 1.0 for carbohydrate oxidation (in humans, with a mixed diet, the respiratory coefficient is 0.85–0.90). The amount of energy released per 1 liter of O 2 consumed (caloric equivalent of oxygen) is 20.9 kJ (5 kcal) for carbohydrate oxidation and 19.7 kJ (4.7 kcal) for fat oxidation. According to the consumption of O 2 per unit of time and the respiratory coefficient, you can calculate the amount of energy released in the body. Gas exchange (respectively, energy consumption) in poikilothermic animals (cold-blooded animals) decreases with a decrease in body temperature. The same relationship was found in homoiothermic animals (warm-blooded) when thermoregulation is turned off (under conditions of natural or artificial hypothermia); with an increase in body temperature (with overheating, some diseases), gas exchange increases.

With a decrease in ambient temperature, gas exchange in warm-blooded animals (especially in small ones) increases as a result of an increase in heat production. It also increases after eating, especially rich in proteins(the so-called specific dynamic action of food). Gas exchange reaches its highest values during muscular activity. In humans, when working at moderate power, it increases, after 3-6 minutes. after it starts, it reaches a certain level and then remains at this level for the entire time of work. When working at high power, gas exchange continuously increases; shortly after reaching the maximum this person level (maximum aerobic work), work has to be stopped, since the body's need for O 2 exceeds this level. In the first time after the end of work, an increased consumption of O 2 is maintained, which is used to cover the oxygen debt, that is, to oxidize the metabolic products formed during work. O 2 consumption can be increased from 200-300 ml/min. at rest up to 2000-3000 at work, and in well-trained athletes - up to 5000 ml / min. Correspondingly, CO 2 emission and energy consumption increase; at the same time, there are shifts in the respiratory coefficient associated with changes in metabolism, acid-base balance and pulmonary ventilation. The calculation of the total daily energy expenditure in people of different professions and lifestyles, based on the definitions of gas exchange, is important for nutritional rationing. Studies of changes in gas exchange during standard physical work are used in the physiology of labor and sports, in the clinic to assess the functional state of systems involved in gas exchange. The relative constancy of gas exchange with significant changes in the partial pressure of O 2 in the environment, disorders of the respiratory system, etc. is ensured by adaptive (compensatory) reactions of the systems involved in gas exchange and regulated by the nervous system. In humans and animals, it is customary to study gas exchange in conditions of complete rest, on an empty stomach, at a comfortable ambient temperature (18-22 ° C). The amounts of O 2 consumed in this case and the released energy characterize the basal metabolism. For the study, methods based on the principle of an open or closed system are used. In the first case, the amount of exhaled air and its composition are determined (using chemical or physical gas analyzers), which makes it possible to calculate the amount of O 2 consumed and CO 2 emitted. In the second case, breathing takes place in a closed system (a sealed chamber or from a spirograph connected to the respiratory tract), in which the emitted CO 2 is absorbed, and the amount of O 2 consumed from the system is determined either by measuring an equal amount of O 2 automatically entering the system, or by downsizing of the system. Gas exchange in humans occurs in the alveoli of the lungs and in the tissues of the body.

Difficult airways: evaluation and prognosis

Key points

Conduct a physical examination of the airway for each patient.
The study of the respiratory tract takes no more than 2 minutes.
Pay close attention to patient reports of difficulty breathing.
Always be prepared for any surprises.
Never inject muscle relaxants if you are not sure that you can “breathe” the patient with a mask.
Oxygenation is the most main point in airway management.

What is a difficult airway?

Difficult airway prediction is a very important aspect of any anesthesiologist's work, as this procedure allows adequate preparation for airway management in a given patient.

What is a difficult airway? It is not easy to define this concept. The generally accepted wording is the American Society of Anesthesiologists. Difficult airway is a clinical situation in which a trained and trained anesthesiologist has difficulty with mask ventilation and tracheal intubation. Today, this definition can be supplemented by the phrase "as well as difficulties with the installation of a laryngeal mask."

Inflammation of the upper respiratory tract in medical terms.

Rhinitis - inflammation of the nasal passages; sinusitis - inflammation of the sinuses; pharyngitis - inflammation of the pharynx and tonsils; tonsillitis - inflammation of the tonsils; laryngitis - inflammation of the larynx; laryngotracheitis - inflammation of the larynx and trachea.

Is an upper respiratory infection contagious?

Epiglottitis. It usually occurs in children between the ages of two and seven years, and the peak incidence occurs between three and five years of age.

Laryngitis and laryngotracheitis. Croup or laryngotracheobronchitis can develop at any age, but is more common in children aged 6 months to 6 years. The peak incidence occurs during the second year of life.

Clinic.

Anamnesis.

Detailed information about the patient's medical history (anamnesis) can help in differentiating the common cold from conditions that require targeted therapy, such as streptococcal pharyngitis, bacterial sinusitis, and lower respiratory tract infections. The table below shows the differences in symptoms of URTI influenza and allergies (according to the National Institute of Allergy and Infectious Diseases).

Table. Allergy, URTI and flu symptoms.

Symptoms	Allergy	IVDP	flu
Itchy, watery eyes
Discharge from the nose
Nasal congestion
sneezing	Often	Often
A sore throat	Sometimes (postnasal drip)	Often
Cough		Often, dry, mild to moderate	Often, there may be a severe, choking, dry cough
Headache
Fever	Not visible	Rare in adults, quite common in children	Very common, fever 100-102°F (38-39°C) or higher, lasts 3-4 days, may have chills
General malaise			Often
Weakness, fatigue			Very common, can last for weeks, at the very beginning of the disease, extreme loss of strength
Myalgia	Not visible		Very common, can be severe
Duration	Few weeks	three or four days to two weeks	7 days, then a few more days of coughing and general weakness

Symptoms

Allergy

IVDP

flu

Itchy, watery eyes

Rarely; adenovirus infection may develop conjunctivitis

Pain inside the orbit, sometimes conjunctivitis

Discharge from the nose

Nasal congestion

sneezing

Often

A sore throat

Cartilage is present down to the small bronchi. In the trachea they are C-rings of hyaline cartilage, while in the bronchi the cartilage takes the form of interspersed plates.

The tonsils abound in the upper airways, but there is less lower down and they are absent starting in the bronchioles. The same goes for goblet cells, although there are scattered ones in the first bronchioles.

Smooth muscle begins in the trachea, where it joins the C-rings of cartilage. It continues down the bronchi and bronchioles that it completely surrounds.

Instead of hard cartilage, the bronchi and bronchioles are made up of elastic tissue.

Function

Most airways exist simply as a piping system for air to travel in the lungs, and the alveoli are the only part of the lung that exchanges oxygen and carbon dioxide with the blood.

Even though the cross-sectional area of each bronchus or bronchiole is smaller because there are so many, the total surface area is larger. This means that there is less resistance in the terminal bronchioles. (Most of the resistance around subdivision 3-4 is from the trachea due to turbulence.)

solid particles that harmful effect to the respiratory tract- (less than 2.5 microns in size) [A.S. Goldberg. English Russian Energy Dictionary. 2006] Energy topics in general EN respirable particulate matter ... Technical translator's guide

Diaphragm- in anatomy - a muscular septum that separates the chest cavity from the abdominal cavity. The diaphragm has openings through which the esophagus passes. large vessels and nerves. The diaphragm is an important respiratory muscle.

17. Idiopathic lung hemosiderosis

18. Hydrothorax

19. Arterial pulmonary hypertension

20. Cystic hypoplasia

21. Histoplasmosis

22. Wegener's granulomatosis

23. Pulmonary eosinophilic infiltrate

24. Candidiasis

25. Bronchogenic lung cysts

26. Coccidiosis

27. Cryptococcosis

28. Laryngitis

29. Acute obstructive laryngitis (croup)

30. Leiomyoiatosis

Which leads to acidification of the internal environment of the body. These changes are recorded by the chemoreceptors of the respiratory center, which is located in the medulla oblongata. They signal a change in homeostasis, which leads to the activation of the respiratory center. The latter sends impulses to the respiratory muscles - the first breath occurs. The glottis opens, and air rushes into the lower respiratory tract and further into the alveoli of the lungs, straightening them. The first exhalation is accompanied by the appearance of a characteristic cry of a newborn. On the exhalation, the alveoli no longer stick together, as this is prevented by the surfactant. In premature babies, as a rule, the amount of surfactant is not enough to ensure normal ventilation of the lungs. Therefore, after birth, they often experience various respiratory disorders. 2 in the blood of the fetus gradually decreases. At the same time, the content of CO 2 constantly increases. After childbirth, the supply of oxygen to the body of the newborn stops, as the umbilical cord is tied. Concentration 0

To assess lung function, the determination of tidal volumes is of great importance, i.e. the amount of inhaled and exhaled air. This study carried out using special devices - spirometers. Respiratory volumes.

Tidal volume, inspiratory and expiratory reserve volumes, lung capacity, residual volume, total lung capacity are determined.

Tidal volume (DO) - the amount of air that a person inhales and exhales during quiet breathing in one cycle (Fig. 8.13). It averages 400 - 500 ml. The volume of air passing through the lungs during quiet breathing in 1 minute is called the respiratory minute volume (MOD). It is calculated by multiplying the DO by the respiratory rate (RR). At rest, a person needs 8-9 liters of air per minute, i.e. about 500 liters per hour, 12,000 - 13,000 liters per day.

BEFORE. 3 With heavy physical work, the MOD can increase many times (up to 80 or more liters per minute). It should be noted that not the entire volume of inhaled air is involved in the ventilation of the alveoli. During inhalation, part of it does not reach the acini. It remains in the airways (from the nasal cavity to the terminal bronchioles), where there is no possibility for diffusion of gases into the blood. The volume of the airways in which the air does not take part in gas exchange is called "respiratory dead space". In an adult, the "dead space" accounts for about 140-150 ml, i.e. approximately V

DO - tidal volume; ROVd - inspiratory reserve volume; ROvyd - expiratory reserve volume; VC - vital capacity of the lungs Rice. 8.13. Spirogram:

The amount of air that a person can inhale at the strongest maximum breath after a quiet breath, i.e. over tidal volume. It averages 1500-3000 ml. Inspiratory reserve volume (IRV)

The amount of air that a person can additionally exhale after a normal exhalation. It is about 700-1000 ml. Expiratory reserve volume (ERV)

This is the amount of air that a person can exhale as much as possible after the deepest breath. This volume includes all the previous ones (VC = DO + ROVd + ROVd) and averages 3500-4500 ml. Vital capacity (VC)

This is the amount of air remaining in the lungs after maximum exhalation. This figure is on average 1000-1500 ml. Due to the residual volume, lung preparations do not sink in water. Based on this phenomenon Forensic-medical examination stillbirth: if the fetus was born alive and breathed, its lungs, being immersed in water, do not sink. In the case dead birth not breathing fetus, the lungs will sink to the bottom. By the way, the lungs got their name precisely because of the presence of air in them. Air greatly reduces the overall density of these organs, making them lighter than water. Residual lung volume (RLV)

This is the maximum amount of air that can be in the lungs. This volume includes the vital capacity and residual volume (RTV = VC + RTL). It averages 4500-6000 ml. Total lung capacity (TLC)

The vital capacity of the lungs is directly dependent on the degree of development of the chest. It is known that physical exercises and training of the respiratory muscles at a young age contribute to the formation of a wide chest with well-developed lungs. After 40 years, VC begins to gradually decrease.

At the same time, prolonged inhalation of this gas causes Negative consequences. 2 - 5.6%). This is due to the fact that when exhaling, the contents of the acini mix with the air in the "dead space". As already mentioned, the air of this space does not take part in gas exchange. The amount of inhaled and exhaled nitrogen is practically the same. During exhalation, water vapor is released from the body. The remaining gases (including inert ones) make up a negligible part of the atmospheric air. It should be noted that a person is able to tolerate large concentrations of oxygen in the air surrounding him. So, in some pathological conditions, as medical event use inhalation 100% 0 2 - 14.4%, CO 2 - 4%. It should be noted that the exhaled air differs in composition from the alveolar air, i.e. located in the alveoli (0 2 about 16-17%, CO 2 - 0.03%. In the exhaled: 0 2 about 21%, CO 2 The composition of the inhaled and exhaled air is fairly constant. The inhaled air contains 0 Diffusion of gases.

Respiratory tract diseases are most often associated with mucosal damage. As the most frequent, they were named simply from the Greek or Latin name organ ending with the Latin word for inflammation. Rhinitis is inflammation of the nasal mucosa, pharyngitis is the pharyngeal mucosa, laryngitis is the larynx, tracheitis is the windpipe, and bronchitis is the bronchi.

These include: muscle cramps, headaches, depression, anxiety, chest pain, fatigue, etc. To avoid these problems, you need to know how to breathe correctly.

There are the following types of breathing:

Lateral costal - normal breathing, in which the lungs receive enough oxygen for daily needs. This type of respiration is associated with aerobic energy system, with it, the two upper lobes of the lungs are filled with air.
Apical - shallow and rapid breathing, which is used to get the maximum amount of oxygen to the muscles. Such cases include sports, childbirth, stress, fear, etc. This type of respiration is associated with the anaerobic energy system and leads to oxygen debt and muscle fatigue if energy requirements exceed oxygen intake. Air enters only the upper lobes of the lungs.
Diaphragmatic - deep breathing, associated with relaxation, which makes up for any oxygen debt received as a result of apical breathing, In which the lungs can completely fill with air.

Proper breathing can be learned. Practices like yoga and tai chi place a lot of emphasis on breathing technique.

As far as possible, breathing techniques should accompany procedures and therapy, as they are beneficial for both the therapist and the patient and allow the mind to be cleared and the body to be energized.

Begin the treatment with a deep breathing exercise to release the patient's stress and tension and prepare him for therapy.
Ending the procedure with a breathing exercise will allow the patient to see the relationship between breathing and stress levels.

Breathing is underestimated, taken for granted. Nevertheless, special care must be taken to ensure that the respiratory system can perform its functions freely and efficiently and does not experience stress and discomfort, which I can not avoid.

The respiratory system is a collection of organs and anatomical formations, providing the movement of air from the atmosphere to the lungs and vice versa (respiratory cycles inhalation - exhalation), as well as gas exchange between the air entering the lungs and the blood.

Respiratory organs are the upper and lower respiratory tract and lungs, consisting of bronchioles and alveolar sacs, as well as arteries, capillaries and veins of the pulmonary circulation.

The respiratory system also includes the chest and respiratory muscles (the activity of which provides stretching of the lungs with the formation of inhalation and exhalation phases and a change in pressure in the pleural cavity), and in addition, the respiratory center located in the brain, peripheral nerves and receptors involved in the regulation of breathing .

The main function of the respiratory organs is to ensure gas exchange between air and blood by diffusion of oxygen and carbon dioxide through the walls of the pulmonary alveoli into the blood capillaries.

Diffusion A process in which a gas moves from an area of higher concentration to an area where its concentration is low.

A characteristic feature of the structure of the respiratory tract is the presence of a cartilaginous base in their walls, as a result of which they do not collapse.

In addition, the respiratory organs are involved in sound production, odor detection, the production of certain hormone-like substances, lipid and water-salt exchange in maintaining the body's immunity. In the airways, purification, moistening, warming of the inhaled air, as well as the perception of thermal and mechanical stimuli take place.

Airways

The airways of the respiratory system start from the external nose and nasal cavity. The nasal cavity is divided by an osteochondral septum into two parts: right and left. The inner surface of the cavity, lined with a mucous membrane, equipped with cilia and permeated with blood vessels, is covered with mucus, which traps (and partially neutralizes) microbes and dust. Thus, in the nasal cavity, the air is cleaned, neutralized, warmed and moistened. That is why it is necessary to breathe through the nose.

During a lifetime, the nasal cavity retains up to 5 kg of dust

passed pharyngeal part airways, air enters the next organ larynx, which looks like a funnel and is formed by several cartilages: the thyroid cartilage protects the larynx from the front, the cartilaginous epiglottis, when swallowing food, closes the entrance to the larynx. If you try to speak while swallowing food, it can get into the airways and cause suffocation.

When swallowing, the cartilage moves up, then returns to former place. With this movement, the epiglottis closes the entrance to the larynx, saliva or food goes into the esophagus. What else is in the throat? Vocal cords. When a person is silent, the vocal cords diverge; when he speaks loudly, the vocal cords are closed; if he is forced to whisper, the vocal cords are ajar.

Trachea;
Aorta;
Main left bronchus;
Main right bronchus;
Alveolar ducts.

The length of the human trachea is about 10 cm, the diameter is about 2.5 cm

From the larynx, air enters the lungs through the trachea and bronchi. The trachea is formed by numerous cartilaginous semirings located one above the other and connected by muscle and connective tissue. The open ends of the half rings are adjacent to the esophagus. In the chest, the trachea divides into two main bronchi, from which the secondary bronchi branch off, continuing to branch further to the bronchioles (thin tubes about 1 mm in diameter). The branching of the bronchi is a rather complex network called the bronchial tree.

Bronchioles are divided into even thinner tubes - alveolar ducts, which end in small thin-walled (wall thickness - one cell) sacs - alveoli, collected in clusters like grapes.

Mouth breathing causes deformation of the chest, hearing impairment, disruption of the normal position of the nasal septum and the shape of the lower jaw

The lungs are the main organ of the respiratory system.

The most important functions of the lungs are gas exchange, the supply of oxygen to hemoglobin, the removal of carbon dioxide, or carbon dioxide, which is the end product of metabolism. However, lung functions are not limited to this alone.

The lungs are involved in maintaining a constant concentration of ions in the body, they can also remove other substances from it, except for toxins ( essential oils, aromatics, "alcohol plume", acetone, etc.). When breathing, water evaporates from the surface of the lungs, which leads to cooling of the blood and the whole body. In addition, the lungs create air currents that vibrate the vocal cords of the larynx.

Conditionally, the lung can be divided into 3 sections:

air-bearing (bronchial tree), through which air, as through a system of channels, reaches the alveoli;
alveolar system in which gas exchange occurs;
circulatory system of the lung.

The volume of inhaled air in an adult is about 0 4-0.5 liters, and the vital capacity of the lungs, that is, the maximum volume, is about 7-8 times larger - usually 3-4 liters (in women it is less than in men), although athletes can exceed 6 liters

Trachea;
Bronchi;
apex of the lung;
Upper lobe;
Horizontal slot;
Average share;
Oblique slit;
lower lobe;
Heart cutout.

The lungs (right and left) lie in the chest cavity on either side of the heart. The surface of the lungs is covered with a thin, moist, shiny membrane of the pleura (from the Greek pleura - rib, side), consisting of two sheets: the inner (pulmonary) covers the surface of the lung, and the outer (parietal) - lines the inner surface of the chest. Between the sheets, which are almost in contact with each other, a hermetically closed slit-like space, called the pleural cavity, is preserved.

In some diseases (pneumonia, tuberculosis), the parietal pleura can grow together with the pulmonary leaf, forming so-called adhesions. At inflammatory diseases, accompanied by excessive accumulation of fluid or air in the pleural fissure, it expands sharply, turns into a cavity

The pinwheel of the lung protrudes 2-3 cm above the clavicle, going into the lower region of the neck. The surface adjacent to the ribs is convex and has the greatest extent. The inner surface is concave, adjacent to the heart and other organs, convex and has the greatest length. The inner surface is concave, adjacent to the heart and other organs located between the pleural sacs. It has a gate easy place through which the lungs enter main bronchus and the pulmonary artery and two pulmonary veins exit.

Each lung is divided by pleural grooves into two lobes (upper and lower), right into three (upper, middle and lower).

The tissue of the lung is formed by bronchioles and many tiny pulmonary vesicles of the alveoli, which look like hemispherical protrusions of the bronchioles. The thinnest walls alveoli are a biologically permeable membrane (consisting of a single layer of epithelial cells surrounded by a dense network of blood capillaries) through which gas exchange occurs between the blood in the capillaries and the air filling the alveoli. From the inside, the alveoli are covered with a liquid surfactant, which weakens the forces of surface tension and prevents the alveoli from completely collapsing during exit.

Compared with the volume of the lungs of a newborn, by the age of 12, lung volume increases 10 times, by the end of puberty - 20 times

The total thickness of the walls of the alveoli and the capillary is only a few micrometers. Due to this, oxygen easily penetrates from the alveolar air into the blood, and carbon dioxide from the blood into the alveoli.

Respiratory process

Breathing is difficult process gas exchange between the environment and the body. Inhaled air differs significantly in its composition from exhaled air: oxygen, a necessary element for metabolism, enters the body from the external environment, and carbon dioxide is released outside.

Stages of the respiratory process

filling the lungs with atmospheric air (pulmonary ventilation)
the transfer of oxygen from the pulmonary alveoli into the blood flowing through the capillaries of the lungs, and the release from the blood into the alveoli, and then into the atmosphere of carbon dioxide
delivery of oxygen from the blood to the tissues and carbon dioxide from the tissues to the lungs
oxygen consumption by cells

The processes of air entering the lungs and gas exchange in the lungs are called pulmonary (external) respiration. The blood brings oxygen to the cells and tissues, and carbon dioxide from the tissues to the lungs. Constantly circulating between the lungs and tissues, blood thus provides a continuous process of supplying cells and tissues with oxygen and removing carbon dioxide. In the tissues, oxygen from the blood goes to the cells, and carbon dioxide is transferred from the tissues into the blood. This process of tissue respiration occurs with the participation of special respiratory enzymes.

The biological significance of respiration

providing the body with oxygen
removal of carbon dioxide
oxidation of organic compounds with the release of energy, necessary for a person for life
removal of metabolic end products (water vapor, ammonia, hydrogen sulfide, etc.)

Mechanism of inhalation and exhalation. Inhalation and exhalation occur due to the movements of the chest (thoracic breathing) and the diaphragm ( abdominal type breathing). The ribs of a relaxed chest go down, thereby reducing its internal volume. Air is forced out of the lungs, much like air being forced out of an air pillow or mattress. By contracting, the respiratory intercostal muscles raise the ribs. The chest expands. Situated between the chest and abdominal cavity the diaphragm contracts, its tubercles smooth out, and the volume of the chest increases. Both pleural sheets (pulmonary and costal pleura), between which there is no air, transmit this movement to the lungs. A rarefaction occurs in the lung tissue, similar to that which appears when an accordion is stretched. Air enters the lungs.

The respiratory rate in an adult is normally 14-20 breaths per 1 minute, but with significant physical exertion it can reach up to 80 breaths per 1 minute

When the respiratory muscles relax, the ribs return to their original position and the diaphragm loses tension. The lungs contract, releasing exhaled air. In this case, only a partial exchange occurs, because it is impossible to exhale all the air from the lungs.

With calm breathing, a person inhales and exhales about 500 cm 3 of air. This amount of air is the respiratory volume of the lungs. If you take an additional deep breath, then about 1500 cm 3 more air will enter the lungs, called the inspiratory reserve volume. After a calm exhalation, a person can exhale about 1500 cm 3 more air - the expiratory reserve volume. The amount of air (3500 cm 3), consisting of the tidal volume (500 cm 3), inspiratory reserve volume (1500 cm 3), expiratory reserve volume (1500 cm 3), is called the vital capacity of the lungs.

Of the 500 cm 3 of inhaled air, only 360 cm 3 pass into the alveoli and give oxygen to the blood. The remaining 140 cm 3 remain in the airways and do not participate in gas exchange. Therefore, the airways are called "dead space".

After a person exhales 500 cm 3 tidal volume), and then takes a deep breath (1500 cm 3), approximately 1200 cm 3 of residual air volume remains in his lungs, which is almost impossible to remove. Therefore, lung tissue does not sink in water.

Within 1 minute a person inhales and exhales 5-8 liters of air. This is the minute volume of breathing, which during intense physical activity can reach 80-120 liters in 1 minute.

In trained, physically developed people, the vital capacity of the lungs can be significantly greater and reach 7000-7500 cm 3. Women have less vital capacity than men

Gas exchange in the lungs and transport of gases in the blood

The blood that comes from the heart to the capillaries surrounding the pulmonary alveoli contains a lot of carbon dioxide. And in the pulmonary alveoli there is little of it, therefore, due to diffusion, it leaves the bloodstream and passes into the alveoli. This is also facilitated by the walls of the alveoli and capillaries, which are moist from the inside, consisting of only one layer of cells.

Oxygen enters the blood also through diffusion. There is little free oxygen in the blood, because hemoglobin in erythrocytes continuously binds it, turning into oxyhemoglobin. The arterial blood leaves the alveoli and travels through the pulmonary vein to the heart.

In order for gas exchange to take place continuously, it is necessary that the composition of gases in the pulmonary alveoli be constant, which is maintained by pulmonary respiration: excess carbon dioxide is removed to the outside, and oxygen absorbed by the blood is replaced by oxygen from a fresh portion of the outside air.

tissue respiration occurs in the capillaries of the systemic circulation, where the blood gives off oxygen and receives carbon dioxide. There is little oxygen in the tissues, and therefore, oxyhemoglobin breaks down into hemoglobin and oxygen, which passes into tissue fluid and there it is used by cells for the biological oxidation of organic substances. The energy released in this case is intended for the vital processes of cells and tissues.

A lot of carbon dioxide accumulates in the tissues. It enters the tissue fluid, and from it into the blood. Here, carbon dioxide is partially captured by hemoglobin, and partially dissolved or chemically bound by blood plasma salts. Venous blood carries it to the right atrium, from there it enters the right ventricle, which pushes out the venous circle through the pulmonary artery. In the lungs, the blood becomes arterial again and, returning to the left atrium, enters the left ventricle, and from it into the systemic circulation.

The more oxygen is consumed in the tissues, the more oxygen is required from the air to compensate for the costs. That is why during physical work, both cardiac activity and pulmonary respiration are simultaneously enhanced.

Due to the amazing property of hemoglobin to enter into combination with oxygen and carbon dioxide, the blood is able to absorb these gases in significant quantities.

In 100 ml arterial blood contains up to 20 ml of oxygen and 52 ml of carbon dioxide

The effect of carbon monoxide on the body. The hemoglobin of erythrocytes is able to combine with other gases. So, with carbon monoxide (CO) - carbon monoxide, formed during incomplete combustion of fuel, hemoglobin combines 150 - 300 times faster and stronger than with oxygen. Therefore, even with a small amount of carbon monoxide in the air, hemoglobin does not combine with oxygen, but with carbon monoxide. In this case, the supply of oxygen to the body stops, and the person begins to suffocate.

If there is carbon monoxide in the room, a person suffocates, because oxygen does not enter the tissues of the body

Oxygen starvation - hypoxia- can also occur with a decrease in the hemoglobin content in the blood (with significant blood loss), with a lack of oxygen in the air (high in the mountains).

If a foreign body enters the respiratory tract, with swelling of the vocal cords due to the disease, respiratory arrest may occur. Asphyxiation develops - asphyxia. When breathing stops, artificial respiration is performed using special devices, and in their absence, according to the mouth-to-mouth, mouth-to-nose method or special techniques.

Breathing regulation. Rhythmic, automatic alternation of inhalations and exhalations is regulated from the respiratory center located in the medulla oblongata. From this center impulses: come to motor neurons vagus and intercostal nerves innervating the diaphragm and other respiratory muscles. The work of the respiratory center is coordinated by the higher parts of the brain. Therefore, a person can a short time hold or intensify breathing, as happens, for example, when talking.

The depth and frequency of breathing is affected by the content of CO 2 and O 2 in the blood. These substances irritate chemoreceptors in the walls of large blood vessels, nerve impulses from them enter the respiratory center. With an increase in the content of CO 2 in the blood, breathing deepens, with a decrease in 0 2, breathing becomes more frequent.

Answers to school textbooks

Pulmonary respiration provides gas exchange between air and blood. Tissue respiration produces gas exchange between blood and tissue cells. There is cellular respiration, which ensures the use of oxygen by cells for the oxidation of organic substances with the release of energy used for their life.

2. What are the advantages of nasal breathing over mouth breathing?

When breathing through the nose, the air passing through the nasal cavity warms up, is cleaned of dust and is partially disinfected, which does not happen when breathing through the mouth.

3. How do the protective barriers that block the entry of infection into the lungs work?

The path of air to the lungs begins with the nasal cavity. The ciliated epithelium, which lines the inner surface of the nasal cavity, secretes mucus, which moisturizes the incoming air and traps dust. The mucus contains substances that have a negative effect on microorganisms. On the upper wall of the nasal cavity there are many phagocytes and lymphocytes, as well as antibodies. Cilia of the ciliated epithelium expel mucus from the nasal cavity.

The tonsils, located at the entrance to the larynx, also contain great amount lymphocytes and phagocytes that destroy microorganisms.

4. Where are the receptors that perceive odors located?

The olfactory cells that perceive odors are located at the back of the nasal cavity at the top.

5. What refers to the upper and what - to the lower respiratory tract of a person?

The upper respiratory tract includes the nasal and oral cavities, nasopharynx, and pharynx. To the lower respiratory tract - larynx, trachea, bronchi.

6. How are sinusitis and frontal sinusitis manifested? Where do the names of these diseases come from?

The manifestations of these diseases are identical: nasal breathing, there is an abundant secretion of mucus (pus) from the nasal cavity, the temperature may rise, and efficiency decreases. The name of the disease sinusitis comes from the Latin “sinus sinus” (maxillary sinus), and frontal sinusitis comes from the Latin “sinus frontalis” (frontal sinus).

7. What signs make it possible to suspect the growth of adenoids in a child?

In children, the bite and dentition are formed incorrectly, the lower jaw grows, protrudes forward, but acquires a “Gothic” shape. With all this, the nasal septum is deformed, as a result of which nasal breathing is difficult.

8. What are the symptoms of diphtheria? Why is it unsafe for the body?

The main symptoms of diphtheria include:

Gradual increase in temperature, lethargy, loss of appetite;

A grayish-white coating appears on the tonsils;

The neck swells from inflammation of the lymphatic glands;

Wet cough at first disease, gradually turning into a rough, barking, and then silent;

Breathing is noisy, difficult to inhale;

Increasing respiratory failure, pallor of the skin, cyanosis of the nasolabial triangle;

Violent restlessness, cool sweat;

Loss of consciousness, a sharp pallor of the skin precede the deadly finale.

Diphtheria toxin, which is a waste product of diphtheria bacillus, affects the conduction system of the heart and the heart muscle. With all this, a severe and dangerous heart disease appears - myocarditis.

9. What is introduced into the body during treatment with antidiphtheria serum, and what - during vaccination against this disease?

The anti-diphtheria serum contains specific antibodies obtained from horses. When vaccinated, a small amount of antigen is injected.

Mechanical asphyxia- this is a complete or partial blockage of the respiratory tract, leading to a violation in the vital organs due to oxygen starvation. Asphyxia can lead to death if the cause of its occurrence is not eliminated in time. Frequent victims of asphyxia can be infants, the elderly, those with epilepsy, those who are able to alcohol intoxication.

Asphyxia is an urgent condition and requires urgent measures to eliminate it. Knowing some general rules, such as examining the oral cavity for the presence of a foreign body, tilting the head to the side to avoid dropping the tongue, mouth-to-mouth artificial respiration can save a person's life.

Interesting Facts

The most sensitive organ in oxygen starvation is the brain.
The average time to death in asphyxia is 4-6 minutes.
Playing with asphyxia is a childish way of getting euphoria as a result various ways for a short-term introduction of the body into a state of oxygen starvation.
During asphyxia, an involuntary act of urination and defecation is possible.
Most frequent sign asphyxia - convulsive excruciating cough.
Asphyxia is diagnosed in 10% of newborns.

What are the mechanisms of asphyxia?

To understand the mechanisms of development of asphyxia, it is necessary to consider in detail the human respiratory system.

Breath is physiological process required for normal life person. During breathing, when you inhale, oxygen enters the body, and when you exhale, carbon dioxide is released. This process is called gas exchange. The respiratory system provides all organs and tissues with oxygen, which is necessary for the work of absolutely all cells of the body.

The structure of the respiratory tract:

upper respiratory tract;
lower respiratory tract.

upper respiratory tract

The upper respiratory tract includes the nasal cavity, the oral cavity, and the nasal and oral parts of the pharynx. Passing through the nose and nasopharynx, the air is warmed, moistened, cleaned of dust particles and microorganisms. An increase in the temperature of the inhaled air occurs due to its contact with the capillaries ( the smallest vessels ) in the nasal cavity. The mucous membrane contributes to the humidification of the inhaled air. The cough and sneeze reflexes help prevent various irritating compounds from entering the lungs. Some substances found on the surface of the nasopharyngeal mucosa, such as, for example, lysozyme, have antibacterial action and are able to neutralize pathogens.

Thus, passing through the nasal cavity, the air is cleaned and prepared for further entry into the lower respiratory tract.

From the nasal and oral cavities, air enters the pharynx. The pharynx is simultaneously part of the digestive and respiratory systems, being a connecting link. It is from here that food can enter not into the esophagus, but into the respiratory tract and, as a result, become the cause of asphyxia.

lower respiratory tract

The lower respiratory tract is the final section of the respiratory system. It is here, or rather, in the lungs, that the process of gas exchange takes place.

The lower respiratory tract includes:

Larynx. The larynx is a continuation of the pharynx. Below the larynx borders on the trachea. The hard skeleton of the larynx is the cartilaginous framework. Distinguish between pairs and unpaired cartilages which are interconnected by ligaments and membranes. The thyroid cartilage is the largest cartilage in the larynx. It consists of two plates, articulated at different angles. So, in men, this angle is 90 degrees and is clearly visible on the neck, while in women this angle is 120 degrees and it is extremely difficult to notice the thyroid cartilage. Important role epiglottic cartilage plays. It is a kind of valve that prevents food from entering the lower respiratory tract from the pharynx. The larynx also includes the vocal apparatus. The formation of sounds occurs due to a change in the shape of the glottis, as well as when stretching the vocal cords.
Trachea. The trachea, or windpipe, is made up of arcuate tracheal cartilages. The number of cartilages is 16 - 20 pieces. The length of the trachea varies from 9 to 15 cm. The mucous membrane of the trachea contains many glands that produce a secret that can destroy harmful microorganisms. The trachea divides and passes below into the two main bronchi.
Bronchi. The bronchi are a continuation of the trachea. The right main bronchus is larger than the left, thicker and more vertical. Like the trachea, the bronchi are made up of arcuate cartilage. The place where the main bronchi enter the lungs is called the hilum of the lungs. After that, the bronchi repeatedly branch into smaller ones. The smallest of them are called bronchioles. The entire network of bronchi of various calibers is called the bronchial tree.
Lungs. The lungs are a paired respiratory organ. Each lung is made up of lobes, with right lung there are 3 lobes, and in the left - 2. Each lung is pierced by an extensive network of the bronchial tree. Each bronchiole ends the smallest bronchus) transition to the alveolus ( hemispherical sac surrounded by vessels). It is here that the process of gas exchange takes place - oxygen from the inhaled air enters the circulatory system, and carbon dioxide, one of the end products of metabolism, is released with exhalation.

Asphyxiation process

The process of asphyxia consists of several successive phases. Each phase has its own duration and specific features. In the last phase of asphyxia, there is a complete cessation of breathing.

In the process of asphyxia, 5 phases are distinguished:

preasphyxic phase. This phase is characterized by a short-term cessation of breathing for 10-15 seconds. Often there is erratic activity.
Breathlessness phase. At the beginning of this phase, there is an increase in breathing, the depth of breathing increases. After a minute, expiratory movements come to the fore. At the end of this phase, convulsions occur, involuntary defecation and urination.
Brief cessation of breathing. During this period, breathing is absent, as well as pain sensitivity. The duration of the phase does not exceed one minute. During a short-term stoppage of breathing, you can only determine the work of the heart by feeling the pulse.
Terminal breath. Attempt to take one last deep breath. The victim opens his mouth wide and tries to catch air. In this phase, all reflexes are weakened. If by the end of the phase the foreign object has not left the respiratory tract, then complete cessation of breathing occurs.
The phase of complete cessation of breathing. The phase is characterized by the complete failure of the respiratory center to support the act of breathing. Persistent paralysis of the respiratory center develops.

reflex cough
When a foreign object enters the respiratory system, a cough reflex occurs. In the first stage of the cough reflex, a shallow breath occurs. If a foreign object has only partially closed the lumen of the respiratory tract, then with a high degree of probability it will be pushed out during a forced cough. If there is a complete blockage, then a shallow breath can aggravate the course of asphyxia.

oxygen starvation
As a result of complete closure of the airway lumen, mechanical asphyxia leads to respiratory arrest. As a result, oxygen starvation occurs in the body. The blood, which is enriched with oxygen in the alveoli at the level of the lungs, contains extremely small reserves of oxygen due to the cessation of breathing. Oxygen is essential for most enzymatic reactions in the body. In its absence, metabolic products accumulate in the cells, which can damage the cell wall. In case of hypoxia ( oxygen starvation), the energy reserves of the cell are also sharply reduced. Without energy, the cell is not able to perform its functions for a long time. Different tissues react differently to oxygen starvation. So, the brain is the most sensitive, and Bone marrow– least sensitive to hypoxia.

Violation of the cardiovascular system
After a few minutes, hypoxemia ( reduced content oxygen in the blood) leads to significant disturbances in cardiovascular system. The heart rate decreases, blood pressure drops sharply. There are disturbances in the heart rhythm. In this case, there is an overflow of venous blood, rich in carbon dioxide, of all organs and tissues. There is a bluish complexion - cyanosis. The cyanotic shade occurs due to the accumulation in the tissues of a large amount of protein that carries carbon dioxide. In case of serious vascular diseases cardiac arrest can occur at any phase of the asphyxial state.

Damage to the nervous system
The next link in the mechanism of asphyxia is the defeat of the central nervous system ( central nervous system). Consciousness is lost at the beginning of the second minute. If within 4 - 6 minutes the flow of oxygen-rich blood is not renewed, then the nerve cells begin to die. For normal functioning the brain should consume approximately 20 - 25% of all oxygen received by breathing. Hypoxia will lead to death in case of extensive damage to the nerve cells of the brain. In this case, there is a rapid oppression of all vital important functions organism. That is why changes in the central nervous system are so destructive. If asphyxia develops gradually, then the following manifestations are possible: impaired hearing, vision, spatial perception.

Involuntary acts of urination and defecation are often found in mechanical asphyxia. Due to oxygen starvation, the excitability of the soft muscles of the intestinal wall and Bladder grows, and the sphincters ( circular muscles that act as valves) relax.

The following types of mechanical asphyxia are distinguished:

Dislocation. Occurs as a result of the closure of the lumen of the respiratory tract by displaced damaged organs ( tongue, mandible, epiglottis, submaxillary bone).
Strangulation. Occurs as a result of strangulation by hands or a loop. This type of asphyxia is characterized by extremely strong compression of the trachea, nerves and vessels of the neck.
Compression. Compression of the chest with various heavy objects. In this case, due to the weight of the object, squeezing the chest and abdomen, it is impossible to make respiratory movements.
Aspiration. Penetration into the respiratory system during inhalation of various foreign bodies. Common causes of aspiration are vomit, blood, and stomach contents. As a rule, this process occurs when a person is unconscious.
Obstructive. There are two types of obstructive asphyxia. First type - asphyxia of closing the lumen of the respiratory tract, when foreign objects can enter the respiratory tract ( food, dentures, small objects). Second type - asphyxia from closing the mouth and nose with various soft objects.

Obstructive asphyxia is a private and the most common type of mechanical asphyxia.

The following types of obstructive asphyxia are distinguished:

closing of the mouth and nose;
closure of the airway.

Closure of the mouth and nose

Closure of the mouth and nose is possible due to an accident. So, if a person during epileptic seizure falls on a soft object with his face, then it can lead to death. Another example of an accident is when, while breastfeeding, the mother unknowingly closes the baby's nasal cavity with her mammary gland. With this type of asphyxia, the following signs can be detected: flattening of the nose, a pale part of the face that was adjacent to a soft object, a bluish hue of the face.

Closure of the airway

The closure of the lumen of the respiratory tract is observed when a foreign body enters them. Also, the cause of this type of asphyxia can be various diseases. A foreign body can block the airway during fright, screaming, laughing, or coughing.

Obstruction by small objects occurs, as a rule, in small children. Therefore, you need to carefully monitor that the child does not have access to them. Elderly people are characterized by asphyxia caused by the ingress of a denture into the lumen of the respiratory tract. Also, the absence of teeth and, as a result, poorly chewed food can lead to obstructive asphyxia. Alcohol intoxication is also one of the most common causes of asphyxia.

The course of asphyxia can be affected by the following individual characteristics body:

Floor. To determine the reserve capacity of the respiratory system, the concept of VC is used ( lung capacity). VC includes the following indicators: tidal volume, inspiratory reserve volume and expiratory reserve volume. It has been proven that women have VC by 20-25% less than men. It follows that male body better tolerates the state of oxygen starvation.
Age. The VC parameter is not a constant value. This indicator varies throughout life. It reaches its maximum by the age of 18, and after 40 years it gradually begins to decline.
Susceptibility to oxygen starvation. Regular exercise helps to increase the vital capacity of the lungs. These sports include swimming, athletics, boxing, cycling, climbing, rowing. In some cases, the VC of athletes exceeds the average of untrained people by 30% or more.
Presence of comorbidities. Some diseases can lead to a decrease in the number of functioning alveoli ( bronchiectasis, lung atelectasis, pneumosclerosis). Another group of diseases can restrict respiratory movements, affect the respiratory muscles or nerves of the respiratory system ( traumatic rupture of the phrenic nerve, injury of the dome of the diaphragm, intercostal neuralgia).

Causes of asphyxia

The causes of asphyxia can be varied and, as a rule, depend on age, psycho-emotional state, the presence of respiratory diseases, diseases digestive system or associated with a hit small items into the respiratory tract.

Causes of asphyxia:

diseases of the nervous system;
diseases of the respiratory system;
diseases of the digestive system;
aspiration of food or vomit in children;
weakened infants;
psycho-emotional states;
alcohol intoxication;
talking while eating;
haste in eating;
lack of teeth;
dentures;
entry of small objects into the respiratory tract.

Diseases of the nervous system

Some diseases of the nervous system can affect the airway. One of the causes of asphyxia can be epilepsy. Epilepsy is a chronic neurological disease person who is characterized sudden onset seizures. During these seizures, a person may lose consciousness for several minutes. In the event that a person falls on his back, then he may experience a tilting of the tongue. This condition can lead to partial or complete closure of the airways and, as a result, to asphyxia.

Another type of disease of the nervous system leading to asphyxia is the defeat of the respiratory center. Respiratory center refers to a limited area medulla oblongata responsible for the formation of the respiratory impulse. This impulse coordinates all respiratory movements. As a result of traumatic brain injury or swelling of the brain, the nerve cells of the respiratory center may be damaged, which can lead to apnea ( cessation of breathing). If during a meal paralysis of the respiratory center occurs, this inevitably leads to asphyxia.

Neuritis can lead to impaired swallowing and possible blockage of the airways. vagus nerve. This pathology is characterized by hoarseness of the voice and a violation of the swallowing process. Due to unilateral damage to the vagus nerve, vocal cord paresis can occur ( weakening of voluntary movements). Also, the soft palate cannot be held in its original position, and it descends. With a bilateral lesion, the act of swallowing is sharply disturbed, and the pharyngeal reflex is absent ( swallowing, coughing or gag reflexes with irritation of the pharynx impossible).

Respiratory system diseases

Exists whole line diseases of the respiratory system, leading to blockage of the respiratory tract and causing asphyxia. Conventionally, these diseases can be divided into infectious and oncological.

Asphyxia can be caused by the following diseases:

Abscess of the epiglottis. This pathology leads to swelling of the epiglottic cartilage, an increase in its size and a decrease in its mobility. During a meal, the epiglottis is not able to perform its functions as a valve that closes the lumen of the larynx during the act of swallowing. This inevitably leads to food entering the respiratory tract.
Quinsy. Phlegmonous tonsillitis or acute paratonsillitis is a purulent-inflammatory disease of the tonsils. Occurs as a complication lacunar tonsillitis. This pathology leads to swelling of the soft palate and the formation of a cavity containing pus. Depending on the location of the purulent cavity, blockage of the airways is possible.
Diphtheria. Diphtheria is a disease infectious nature, which usually affects the oral part of the pharynx. In this case, the occurrence of croup, a condition in which there is a blockage of the respiratory tract with a diphtheria film, is of particular danger. The lumen of the airways can also be blocked in case of extensive edema of the pharynx.
Tumor of the larynx. A malignant tumor of the larynx leads to the destruction of surrounding tissues. The degree of destruction depends on the size of food that can penetrate from the pharynx into the larynx. Also, the tumor itself can cause asphyxia if it partially or completely blocks the lumen of the larynx.
Tumor of the trachea. Depending on the shape, the tumor is able to protrude into the lumen of the trachea itself. At the same time, stenosis is observed ( constriction) lumen of the larynx. It's in to a large extent make it difficult to breathe and further lead to mechanical asphyxia.

Diseases of the digestive system

Diseases of the digestive system can lead to the ingress of food into the lumen of the respiratory tract. Asphyxia can also be caused by aspiration of stomach contents. Swallowing disorders can be the result of burns of the mouth and pharynx, as well as in the presence of defects in the anatomy of the oral cavity.

The following diseases can cause asphyxia:

Cancer of the upper esophagus. A tumor of the esophagus, growing, is able to exert significant pressure on adjacent organs - the larynx and trachea. Increasing in size, it can partially or completely compress the respiratory organs and, thereby, lead to mechanical asphyxia.
Gastroesophageal reflux. This pathology is characterized by the ingestion of the contents of the stomach into the esophagus. In some cases, the contents of the stomach can enter the oral cavity, and when inhaled, enter the respiratory tract ( aspiration process).
Tongue abscess. An abscess is a purulent-inflammatory disease with the formation of a cavity containing pus. The following picture is characteristic of an abscess of the tongue: the tongue is enlarged in volume, inactive and does not fit in the mouth. The voice is hoarse, breathing is difficult, there is profuse salivation. With an abscess of the tongue purulent cavity can be located in the root zone and prevent air from entering the larynx. Also, the increased size of the tongue can cause asphyxia.

Aspiration of food or vomit in children

Aspiration is the process of penetration into the respiratory system by inhalation of various foreign materials. As a rule, vomit, blood, stomach contents can be subjected to aspiration.

Among newborns, aspiration is quite common. It can occur if the mammary gland fits snugly into the baby's nasal passages and makes breathing difficult. The child, trying to breathe, inhales the contents of his mouth. Another reason may be the wrong position of the child during feeding. If the child's head is in a tilted state, the epiglottis is not able to completely block the lumen of the larynx from milk entering it.

Aspiration of regurgitated masses during vomiting is also possible. The cause may be malformations digestive tract (esophageal atresia, esophageal-tracheal fistula).

Birth trauma, toxicosis during pregnancy ( complication of pregnancy, manifested by edema, increased blood pressure and loss of protein in the urine), various malformations of the esophagus significantly increase the chance of asphyxia due to aspiration.

Weakened babies

In debilitated or premature newborns, as a rule, swallowing reflex. This happens due to damage to the central nervous system. Various infectious diseases that the mother of the child suffers during pregnancy, toxicosis or intracranial birth trauma can disrupt the swallowing process. Aspiration breast milk or vomit can cause mechanical asphyxia.

Psycho-emotional states

During a meal, the act of swallowing can be affected by various psycho-emotional states. Sudden laughter, screaming, fright, or crying can cause a food bolus to back up from the throat into the upper respiratory tract. This is explained by the fact that during psycho-emotional manifestations, air must be exhaled from the larynx to create certain sound vibrations. In this case, food from the oral part of the pharynx can be accidentally sucked into the larynx during the next breath.

Alcohol intoxication

The state of intoxication is common cause asphyxia in the adult population. During sleep, aspiration of vomit may occur as a result of a violation of the gag reflex. Due to the inhibition of the functions of the central nervous system, a person is not able to perceive the contents of the oral cavity. As a result, vomit can enter the respiratory tract and cause mechanical asphyxia. Another reason may be the disconnection of the swallowing and respiratory processes. This condition is typical for severe alcohol intoxication. At the same time, food and liquid can freely enter the respiratory system.

Talking while eating

Food particles can enter the respiratory tract while talking while eating. Most often, food enters the larynx. In this case, a person reflexively develops a cough. During coughing, food particles can usually easily leave into the upper respiratory tract without causing harm to health. If a foreign object could fall lower - into the trachea or bronchi, then coughing will have no effect and partial or complete asphyxia will occur.

Haste while eating

Hasty consumption of food not only leads to diseases of the gastrointestinal tract, but can also cause mechanical asphyxia. With insufficient chewing of food, large poorly processed pieces of food can close the lumen of the oropharynx. If the oral cavity contains a large number of poorly chewed pieces of food, swallowing problems may occur. If within a few seconds the food bolus does not release the oral part of the pharynx, then inhalation will be impossible. Air simply cannot penetrate this food bolus and, as a result, a person may choke. The defense mechanism in this case is the cough reflex. If the food bolus is too large and coughing does not lead to its release from the oral cavity, then airway blockage is possible.

Absence of teeth

Teeth perform several functions. First, they mechanically process food to a homogeneous consistency. Chopped food is easier for further processing in the gastrointestinal tract. Secondly, teeth are involved in the process of speech formation. Thirdly, during the process of chewing food, a complex chain of mechanisms arises aimed at activating the work of the stomach and duodenum.

The absence of teeth can be the cause of asphyxia. Once in the mouth, food is not crushed enough. Poorly chewed food can get stuck in the mouth of the pharynx and turn into a foreign object. Large and small molars are responsible for grinding food. The absence of several of them can cause mechanical asphyxia.

Dentures

Dental prosthetics is a highly demanded procedure in dentistry. These services are most often used by older people. Average term operation of dentures vary within 3-4 years. After the expiration of this period, dentures may wear out or loosen. In some cases, they may partially or completely collapse. Getting a denture into the lumen of the respiratory tract will irreversibly lead to the occurrence of asphyxia.

Inhalation of small objects

Foreign objects can become needles, pins or hairpins if used for quick access to cleaning the oral cavity. Children are characterized by asphyxia, in which coins, balls, buttons and other small objects enter the respiratory tract. Also, small fragments of toys can get into the lumen of the respiratory tract. Certain foods can also cause airway occlusion. These include, for example, seeds, peas, beans, nuts, candy, tough meats.

Symptoms of asphyxia

During asphyxia, a person tries to free the airways from a foreign object. There are a number of signs that will help you understand what we are talking about asphyxia.

Symptom	Manifestation	Photo
Cough	When a foreign object enters the larynx, a person will reflexively begin to cough. At the same time, the cough is convulsive, painful, not bringing relief.
Excitation	The person instinctively grabs his throat, coughs, screams and tries to call for help. Small children are characterized by stifled crying, frightened eyes, wheezing and wheezing ( stridor). Less often weeping is stifled and muffled.
forced posture	Tilt the head and torso forward allows you to increase the depth of inspiration.
Bluish complexion	As a result of oxygen starvation, a large amount of blood containing carbon dioxide is concentrated in the tissues. A protein that binds to carbon dioxide and gives the skin a bluish tint.
Loss of consciousness	The blood flowing to the brain contains insufficient oxygen. With hypoxia, the nerve cells of the brain cannot function normally, which leads to fainting.
Respiratory arrest	Respiratory arrest occurs within a few minutes. If the cause of asphyxia is not eliminated and the foreign body from the lumen of the respiratory tract, then after 4 - 6 minutes a person will die.
Adynamia	Decrease motor activity up to its complete cessation. Adynamia occurs due to loss of consciousness.
Involuntary urination and defecation	Oxygen starvation leads to an increase in the excitability of the soft muscles of the walls of the intestines and bladder, while the sphincters relax.

First aid for mechanical asphyxia

Mechanical asphyxia is an emergency. The life of the victim depends on the correctness of first aid. Therefore, each person must know and be able to provide emergency assistance.

First aid in case of mechanical asphyxia:

self-help;
providing first aid to an adult;
giving first aid to a child.

self help

Self-help can be provided only when consciousness is preserved. There are several methods that will help in case of asphyxia.

Types of self-help for asphyxia:

Perform 4 - 5 strong coughing movements. When a foreign body enters the lumen of the respiratory tract, it is necessary to make 4-5 forced cough movements, while avoiding deep breaths. If a foreign object has freed the lumen of the respiratory tract, then a deep breath can again lead to asphyxia or even aggravate it. If a foreign object is located in the pharynx or larynx, then this method may be effective.
Make 3 - 4 pressure in the upper abdomen. The method is as follows: put the fist of the right hand in the epigastric region ( top part the abdomen, which is bounded from above by the xiphoid process of the sternum, and to the right and left by the costal arches), press the fist with the open palm of the left hand and make 3-4 pushes with a quick sharp movement towards you and up. In this case, the fist, making a movement towards the internal organs, increases the pressure inside the abdominal and chest cavities. Thus, the air from the respiratory system tends to the outside and is able to push out the foreign body.
Lean your upper abdomen against the back of a chair or armchair. As in the second method, the method increases intra-abdominal and intra-thoracic pressure.

Providing first aid to an adult

Providing first aid to an adult is necessary if he is in a state of intoxication, his body is weakened, in a number of certain diseases, or if he cannot help himself.

The first thing to do in such cases is to call an ambulance. Next, you should use special first aid techniques for asphyxia.

Ways to provide first aid to an adult with asphyxia:

Heimlich maneuver. It is necessary to stand behind and wrap your arms around the torso of the victim just below the ribs. Place one hand in epigastric region clenching her into a fist. Put the palm of the second hand perpendicular to the first hand. With a quick jerky movement, press the fist into the stomach. In this case, all the force is concentrated at the point of contact of the abdomen with thumb hand clenched into a fist. The Heimlich maneuver should be repeated 4-5 times until breathing normalizes. This method is the most effective and most likely will help push the foreign object out of the respiratory system.
Make 4 - 5 blows with the palm of your hand on the back. Approach the victim from behind, with the open side of the palm, make 4-5 medium-strength blows on the back between the shoulder blades. Impacts must be directed along a tangent path.
A method of helping if the person cannot be approached from behind or is unconscious. It is necessary to change the position of the person and turn him on his back. Next, position yourself on the hips of the victim and place the open base of one hand in the epigastric region. With the second hand, press on the first and move inward and upward. It is worth noting that the head of the victim should not be turned. You should repeat this manipulation 4-5 times.

If these first aid methods do not work, and the victim is unconscious and not breathing, then you need to urgently resort to performing artificial respiration. There are two methods for performing this manipulation: “mouth to mouth” and “mouth to nose”. As a rule, the first option is used, but in some cases, when it is not possible to inhale into the mouth, one can resort to mouth-to-nose artificial respiration.

Method for providing artificial respiration:

"Mouth to mouth". It is necessary to use any rag material ( handkerchief, gauze, piece of shirt) as a spacer. This will avoid contact with saliva or blood. Next, you need to take a position to the right of the victim and sit on your knees. Inspect the oral cavity for the presence of a foreign body. To do this, use the index and middle fingers of the left hand. If it was not possible to find a foreign object, go to next steps. Cover the victim's mouth with cloth. The head of the victim is thrown back with the left hand, and his nose is clamped with the right hand. Produce 10 - 15 breaths of air per minute or one exhalation every 4 - 6 seconds. It should be in close contact with the victim's mouth, otherwise all the inhaled air will not reach the victim's lungs. If the manipulation is performed correctly, then it will be possible to notice the movements of the chest.
"Mouth to nose". The procedure is similar to the previous one, but has some differences. Exhalation is made into the nose, which is previously covered with material. The number of breaths remains the same - 10 - 15 breaths per minute. It is worth noting that with each exhalation, you need to close the victim's mouth, and in the intervals between blowing air, open the mouth slightly ( this action imitates passive exhalation of the victim).

When weak breathing the victim should synchronize the process of blowing air into the lungs with an independent breath of the injured person.

Providing first aid to a child

Providing first aid to a child is an extremely difficult task. If the child cannot breathe or speak, coughs convulsively, his complexion becomes bluish, you should immediately call an ambulance. Next, free him from the binding clothes ( blanket, diaper) and proceed to the implementation of special first aid techniques for asphyxia.

Ways to provide first aid to a child with asphyxia:

Heimlich maneuver for children under 1 year old. Position the child on your arm so that the face rests on the palm. It is good to fix the baby's head with your fingers. The legs must be different sides from the forearm. It is necessary to slightly tilt the child's body down. Make 5 - 6 tangent pats on the back of the child. Pats are made with a palm in the area between the shoulder blades.
Heimlich maneuver for children older than 1 year. You should put the child on his back and sit on his knees at his feet. In the epigastric region, place the index and middle fingers both hands. Apply moderate pressure in this area until the foreign body clears the airways. The reception must be performed on the floor or on any other hard surface.

If these first aid methods do not help, and the child is not breathing and is unconscious, it is necessary to perform artificial respiration.

For children under the age of 1, artificial respiration is performed using the “mouth to mouth and nose” method, and for children older than 1 year - “mouth to mouth”. First you need to put the child on his back. The surface on which the child is to lie must be firm ( floor, board, table, ground). It is worth checking the oral cavity for the presence of foreign objects or vomit. Further, if a foreign object was not found, put a roller from improvised means under the head and proceed to perform air injections into the child's lungs. It is necessary to use rag material as a gasket. It should be remembered that exhalation is carried out only by the air that is in the mouth. The lung capacity of a child is many times smaller than that of an adult. Forced inhalation can simply rupture the alveoli in the lungs. The number of exhalations for children under one year old should be 30 per 1 minute or one exhalation every 2 seconds, and for children over one year old - 20 per 1 minute. The correctness of this manipulation can be easily checked by the movement of the child's chest during air blowing. It is necessary to use this method until the ambulance team arrives or until the child's breathing is restored.

Do I need to call an ambulance?

Mechanical asphyxia is an urgent condition. Asphyxia status directly threatens the life of the victim and can cause a quick death. Therefore, in case of recognition of signs of asphyxia in a person, it is necessary to immediately call an ambulance, and then proceed to take measures to eliminate asphyxia.

It must be remembered that only an ambulance team will be able to provide high-quality and qualified assistance. If necessary, all necessary resuscitation measures will be carried out - indirect massage heart, artificial respiration, oxygen therapy. Also, emergency physicians may resort to emergency measure- cricoconicotomy ( opening of the wall of the larynx at the level of the cricoid cartilage and the conical ligament). This procedure will allow you to insert a special tube into the hole made, and through it to resume the act of breathing.

Prevention of mechanical asphyxia

Prevention of mechanical asphyxia is aimed at reducing and eliminating factors that can lead to the closure of the airway lumen.

(applicable to children under the age of one year):

Protection against aspiration during feeding. It should be remembered that during feeding the baby's head should be raised. After feeding, it is necessary to provide the child vertical position.
Use of a probe in case of feeding problems. It is not uncommon for a baby to have trouble breathing when bottle-feeding. If holding your breath during feeding occurs frequently, then the way out may be to use a special feeding probe.
The appointment of special treatment for children predisposed to asphyxia. In case of repeated repetition of mechanical asphyxia, the following treatment regimen is recommended: injections of cordiamine, etimizol and caffeine. This scheme can be used only after consultation with your doctor.

To prevent mechanical asphyxia, the following recommendations should be followed(applicable to children over one year old):

Restriction of the child in access to products of solid consistency. Any solid product in the kitchen can cause asphyxia. It is necessary to try to protect such products as seeds, beans, nuts, peas, candies, hard meat from falling into the hands of the child. It is worth avoiding such products for up to four years.
Choosing and buying safe toys. The purchase of toys should be made based on the age of the child. Each toy should be carefully inspected for removable hard parts. You should not buy designers for children under 3 - 4 years old.
Right choice food. Nutrition for a child should strictly correspond to his age. Well-chopped and processed food is a must for children up to three years of age.
Storing small items in safe place. It is worth keeping various office supplies such as pins, buttons, erasers, caps in a safe place.
Teaching children to chew food thoroughly. Solid food should be chewed at least 30-40 times, and soft foods ( porridge, puree) - 10 - 20 times.

To prevent mechanical asphyxia, the following recommendations should be followed(applicable to adults):

Restriction in the use of alcohol. Drinking alcohol in large quantities can lead to a violation of the chewing and swallowing act and, as a result, increase the risk of mechanical asphyxia.
Refusal to talk while eating. During a conversation, involuntary combination of swallowing and respiratory act is possible.
Be careful when eating fish products. Fish bones often enter the lumen of the respiratory tract, causing partial closure of the lumen of the respiratory tract. Also, the sharp part of the fish bone can pierce the mucous membrane of one of the organs of the upper respiratory tract and lead to its inflammation and swelling.
The use of pins, needles and hairpins for their intended purpose. Hairpins and pins can be placed in the mouth for quick access. During a call, the data small objects able to freely enter the respiratory tract and cause asphyxia.