Review of Upper Airway Anatomy (Nursing)

00:00 Hi, welcome back to our video series on respiratory.

00:05 Now we're talking about the introduction and treatment of bronchospasms.

00:09 Man, these are brutal so it's critically important you understand what it's like, what your patient is experiencing so you know how to intervene early and quickly and help them recover.

00:21 Okay, so let's start with some basic kind of anatomy things.

00:24 First of all, what's the difference between a bronchi and a bronchiole? Okay, pause the video, jot some quick notes.

00:38 Okay, if you paused the video, welcome back.

00:42 Let's talk about the difference between a bronchi and a bronchiole.

00:46 See, bronchi - they're the big ones, bronchioles are a lot smaller.

00:51 So the bronchi are the air passages that begin at the end of the trachea and they're located between the trachea and the bronchioles, So bronchioles are the tiny, little ones.

01:03 We're gonna talk about the bronchi - they're the bigger ones first.

01:07 See bronchi have these cartilaginous - that's just such a fun word, bronchi have cartilaginous support.

01:14 If this connective tissue that helps keep them open even when the smooth muscle contracts Okay so we can talk about bronchospasms unless you have in mind how the airway works and this smooth muscles, we're gonna dig down deeper in that in just a minute.

01:30 But first I want you to have it solid in your mind, bronchi are the bigger ones and they have this cartilaginous support in the connective tissue that helps make them stiffer and keep them open even when the smooth muscle contracts.

01:46 Now, let's talk about the trachea, we've all heard about it You see it in movies when people rescue someone might give them a tracheostomy with like a rusty butter knife and a bic pen but let's talk about what it is in your body.

01:59 Now some people call it the windpipe saying like, "I got something stuck in my windpipe", really kind of gonna talking about the trachea.

02:08 Now it's about 4 to 5 inches long, it's a cylinder but it's less than 1 inch in diameter.

02:15 Okay now, that's pretty small so you can see how lodging something in that is gonna be very dramatic, It's gonna have a huge impact on your patient.

02:25 Now the trachea in your body sits in front of the esophagus so that's important for you to remember Remember at the top of that, you have the epiglottis that's that little flap that will protect and cover the airway when you're swallowing your spit or swallowing your food.

02:41 That epiglottis protects the airway but should something wander down in there, remember you've only got about an inch in diameter in your trachea so food or liquids can easily cause an obstruction.

02:54 Okay, so back to the trachea, or it's the windpipe it that 4 to 5-inch long segment, less than inch in diameter and it sits in front of the esophagus.

03:05 That way when you see somebody do a tracheostomy, know that's the first two that you come to.

03:09 So trachea in the front, esophagus in the back.

03:13 It starts just under the larynx, that's where we have the voice box stuffed, and it runs down along behind the sternum.

03:20 Okay, so we've got the first area, we know the difference between the bronchi and the bronchioles We've got the trachea, which is that short 4 to 5-inch cylinder that starts right underneath the larynx and runs down behind the sternum.

03:35 Okay, now it has this incomplete rings of hyaline cartilage and smooth muscle.

03:41 So you got smooth muscle wrapped around your airway, that's something you may or may not realize.

03:47 I want to make sure you're very clear on that.

03:50 Now the trachea divides into two smaller tubes and they're called mainstem bronchi.

03:56 So you got the larynx, the trachea and the trachea breaks into mainstem bronchi, that just means are a little bit bigger.

04:04 Now there is one bronchi for the right one and one bronchi for the left lung.

04:09 Yeah, that's not hard to remember.

04:10 So keep going back over that review, how long is the trachea? what's the diameter of the trachea? and where does it start? where does it go down to? What branches off? Okay good, that's spaced repetition - remembering things and thinking back, pausing, recalling and thinking back on what we just talked about will help that information be supersolid in your own brains.

04:38 So now we're at the mainstem bronchi, now were talking about that branches off one for the right lung one for the left long right off of the trachea.

04:47 Now both the left and the right bronchi are located in the lung.

04:51 So see how we have in the picture there, that's to help you know it's kinda right in the tissue of the lungs.

04:56 Now there's a difference between the right and the left just like they were siblings in a family, not everybody is exactly the same.

05:03 The right mainstem is higher than the left, so that's one difference between the right and the left.

05:10 Now if you compare to the left, the right bronchus is shorter and wider, okay so it's stockier of the two.

05:17 So this would be the sibling that's shorter and thicker, stockier.

05:21 So the right side is shorter, wider, and straighter.

05:26 Okay, so this one kinda looks tight.

05:27 The right mainstem bronchus is approximately 2 and a half centimeters long.

05:32 Now you know the left one is longer, almost twice so it's 5 cm long.

05:38 So we've got the two bronchi, one goes to the right lung, one goes to the left lung.

05:43 The right one is higher than the left one, compared to the left the right one is shorter, wider and straighter.

05:51 The right being 2 and a half, the left being 5 centimeters long.

05:55 Okay, so based on your knowledge of these two, the mainstem bronchi, if I were to inhale something and it went into my trachea instead of my esophagus, where do you think you would most likely land, on the right or the left? Okay, we got a 50/50 chance, on guessing it right correctly So, let's go what do you think right or left, based on your knowledge of the right and left mainstem bronchi.

06:22 Sweet! Did you say the right? Yeah, because it's slightly larger than the left one, its wider and straighter so objects tend to end up there.

06:32 Now because of this, that can be really problematic right, for that right side because you're are gonna be cutting off the oxygen supply to one-half of your lung set.

06:43 So things often end up in the right bronchus because it's larger, it's a little wider, a littlel straighter, and remember it's even higher.