Hi, welcome back to our
video series on respiratory.
Now we're talking about the introduction
and treatment of bronchospasms.
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.
Okay, so let's start with some
basic kind of anatomy things.
First of all, what's the difference
between a bronchi and a bronchiole?
Okay, pause the video, jot some quick notes.
Okay, if you paused the video, welcome back.
Let's talk about the difference
between a bronchi and a bronchiole.
See, bronchi - they're the big
ones, bronchioles are a lot smaller.
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.
We're gonna talk about the
bronchi - they're the bigger ones first.
See bronchi have these cartilaginous - that's just
such a fun word, bronchi have cartilaginous support.
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.
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.
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.
Now some people call it the windpipe saying
like, "I got something stuck in my windpipe",
really kind of gonna talking about the trachea.
Now it's about 4 to 5 inches long, it's a
cylinder but it's less than 1 inch in diameter.
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.
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.
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.
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.
That way when you see somebody do a tracheostomy,
know that's the first two that you come to.
So trachea in the front, esophagus in the back.
It starts just under the larynx, that's
where we have the voice box stuffed,
and it runs down along behind the sternum.
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.
Okay, now it has this incomplete rings
of hyaline cartilage and smooth muscle.
So you got smooth muscle wrapped around your
airway, that's something you may or may not realize.
I want to make sure you're very clear on that.
Now the trachea divides into two smaller
tubes and they're called mainstem bronchi.
So you got the larynx, the trachea and
the trachea breaks into mainstem bronchi,
that just means are a little bit bigger.
Now there is one bronchi for the right
one and one bronchi for the left lung.
Yeah, that's not hard to remember.
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.
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.
Now both the left and the right
bronchi are located in the lung.
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.
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.
The right mainstem is higher than the left, so
that's one difference between the right and the left.
Now if you compare to the left, the right bronchus is
shorter and wider, okay so it's stockier of the two.
So this would be the sibling
that's shorter and thicker, stockier.
So the right side is shorter, wider, and straighter.
Okay, so this one kinda looks tight.
The right mainstem bronchus is
approximately 2 and a half centimeters long.
Now you know the left one is
longer, almost twice so it's 5 cm long.
So we've got the two bronchi, one goes
to the right lung, one goes to the left lung.
The right one is higher than the left one, compared to
the left the right one is shorter, wider and straighter.
The right being 2 and a half,
the left being 5 centimeters long.
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.
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.
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.
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.