Respiratory System

ORGANS OF THE RESPIRATORY SYSTEM

Anatomical Division:
• Upper respiratory system:
• nose, nasal cavity, paranasal sinuses,
and pharynx (throat).
• These passageways filter, warm, and
humidify incoming air,
• Protect the more delicate surfaces of
the lower respiratory system.
• They also reabsorb heat and water
from the outgoing air
• Lower respiratory system.
• larynx (voice box), trachea
(windpipe), bronchi, bronchioles, and
alveoli of the lungs.
Functional Division:
• Conducting zone
• airways that serve as a conduit to move air.
• Most of the respiratory tract is actually the conducting system
• begins at the entrance to the nasal cavity and extends through the pharynx, larynx,
trachea, bronchi, and larger bronchioles.
• Respiratory zone.
• includes the smallest, thinnest bronchioles and the associated alveoli,
• air-filled pockets within the lungs where all gas exchange between air and blood takes
place.
• The gas exchange areas are the alveoli.
• Type I alveolar cells (squamous alveolar cells) are thinly stretched epithelial cells that
make up 95% of the surface area of the lung.
• Type II cells which are more plentiful than Type I cells but cover much less area.
• produce surfactant, which will be
• Also found in the alveoli are macrophages which clean up debris and help fight infection.
• Thoracic cavity is protected by the ribcage and separated from the abdomen by the
diaphragm.
• The lungs themselves are not anchored to the inside of the ribcage but rather move with the
ribcage due to suction between the visceral pleura (membrane on the outer surface of the
lung) and the parietal pleura (membrane covering the inner surface of the ribcage.
• There is a very small amount of fluid in the space between the visceral and parietal pleura
(the intrapleural space), which lubricate the visceral and parietal pleura as they slip across
each other.
• intrapleural space is considered a potential space because in reality there is very little
space there. However, if an injury occurs blood or air is allowed into that space.
 PULMONARY VENTILATION
Respiration occurs in three basic steps:
1. pulmonary ventilation,
2. external respiration,
3. internal respiration.

Pulmonary ventilation (also called breathing) is the physical movement of air into and
out of the respiratory tract.
• Its primary function is to maintain adequate alveolar ventilation,
• the movement of air into and out of the alveoli.
• Alveolar ventilation prevents the buildup of carbon dioxide in the alveoli.
• It also ensures a continuous supply of oxygen that keeps pace with absorption by the
bloodstream.
• The actions responsible for these air movements are termed inspiration, or inhalation, and
expiration, or exhalation.
• One inspiration plus the following expiration is called a respiratory cycle.
INSPIRATION
• Inhalation (inspiration) is the process of bringing air into the lungs.
• Atmospheric pressure is the force that moves air into the lungs.
• At sea level, this equals 760 millimeters (mm) of mercury (Hg).
• Air pressure is exerted on all surfaces in contact with the air, and because people breathe
air, the inside surfaces of their lungs are also subjected to pressure.
• Pressure and volume are related in an opposite, or inverse, way (this is known as Boyle’s law).
• If the pressure inside the lungs and alveoli (intra-alveolar pressure) decreases, atmospheric
pressure pushes outside air into the airways.
• This happens during resting inspiration,
• uses muscle fibers in the dome-shaped diaphragm.
• The muscle fibers of the diaphragm are stimulated to contract by impulses conducted
on the phrenic nerves.
• the diaphragm moves downward, the thoracic cavity enlarges,
• the intra-alveolar pressure falls about 2 mm Hg below atmospheric pressure.
• In response to this decreased intra-alveolar pressure, atmospheric pressure forces
air into the alveoli.
• While the diaphragm is
contracting and moving
downward,
• the external (inspiratory)
intercostal muscles and
certain thoracic muscles may
be stimulated to contract.
• This action elevates the
ribs and the sternum,
increasing the size of the
thoracic cavity even
more.
• The intra- alveolar
pressure falls further,
and atmospheric
pressure forces more air
into the alveoli.
• Lung expansion in response to movements of the diaphragm and chest wall depends on
movements of the pleural membranes.
• Separation of the pleural membranes decreases pressure in the intrapleural space, resisting
further separation and holding these membranes together.
• pleural fluid greatly attract the pleural membranes and each other, helping to hold the moist
surfaces of the pleural membranes tightly together.
• Thus, when the intercostal muscles move the thoracic wall upward and outward, the parietal
pleura moves too, and the visceral pleura follows it, expanding the lung in all directions.

• The moist inner surfaces of the alveoli have the opposite effect.
• In the alveoli, the attraction of water molecules to each other creates a force called
surface tension that makes it difficult to inflate the alveoli and may collapse them.
• surfactant, a mixture of lipoproteins which is secreted continuously into alveolar air
spaces reduces the alveoli’s tendency to collapse and eases inspiratory efforts to expand
the alveoli.
• The steps of inspiration:
1. Impulses are conducted on phrenic nerves to muscle fibers in the diaphragm, contracting
them.
2. As the dome-shaped diaphragm moves downward, the thoracic cavity expands.
3. At the same time, the external intercostal muscles may contract, raising the ribs and
expanding
the thoracic cavity further.
4. The intra-alveolar pressure decreases.
6. Atmospheric pressure, greater than intra-alveolar pressure, forces air into the respiratory
tract
through the air passages.
7. The lungs fill with air.
• If a person needs to take a deeper than normal breath:
• the diaphragm and external intercostal muscles contract more forcefully.
• Additional muscles, such as the pectoralis minors, sternocleidomastoids, and the scalenes,
can also pull the thoracic cage farther upward and outward, enlarging the thoracic cavity
and decreasing intra-alveolar pressure even more.
EXHALATION
• Exhalation (expiration) is the movement of air out of the lungs.
• occurs when alveolar pressure is higher than atmospheric pressure.
• Relaxation of the diaphragm and external intercostal muscles results in elastic recoil of the
chest wall and lungs, which increases intrapleural pressure, decreases lung volume, and
increases alveolar pressure so that air moves from lungs to the atmosphere.
• There is also an inward pull of surface tension due to the film of alveolar fluid.

• A person can exhale more air than normal

• contracting the posterior internal (expiratory) intercostal muscles. These muscles pull the
ribs and sternum downward and inward,
• increasing the air pressure in the lungs, forcing more air out.
• abdominal wall muscles, including the external and internal obliques, the transversus
abdominis, and the rectus abdominis, squeeze the abdominal organs inward.
• In this way, the abdominal wall muscles can increase pressure in the abdominal cavity and
force the diaphragm still higher against the lungs, pushing additional air out of the lungs.
The steps of expiration
1. The diaphragm and external respiratory muscles relax.
2. Elastic tissues of the lungs, stretched during inspiration, suddenly recoil, and surface
tension pulls in on alveolar walls.
3. Tissues recoiling around the lungs increase the intra-alveolar pressure.
4. Air is forced out of the lungs.
 Two other factors affect the rate of airflow and ease of pulmonary ventilation:
1. Compliance of the lungs,
2. Airway resistance.
Compliance refers to how much effort is required to stretch the lungs and chest wall.
• High compliance means that the lungs and chest wall expand easily; low compliance means
that they resist expansion.
• The lungs normally have high compliance and expand easily because elastic fibers in lung
tissue are easily stretched and surfactant in alveolar fluid reduces surface tension.
• Decreased compliance occurs when
1) there is scar lung tissue (tuberculosis)
2) lung tissue is filled with fluid (pulmonary edema),
3) surfactant deficiency,
4) when lung expansion is hindered in any way (paralysis of the intercostal muscles).
• Increased lung compliance occurs in emphysema because elastic fibers in alveolar walls are
destroyed.
Resistance The walls of the airways, especially the bronchioles, offer some resistance to the
normal flow of air into and out of the lungs.
• Larger-diameter airways have decreased resistance.
• Airway resistance then increases during exhalation as the diameter of bronchioles decreases.
• Airway diameter is also regulated by the degree of contraction or relaxation of smooth muscle
in the walls of the airways.
• Bronchodilation results in decreased resistance and bronchoconstriction increased resistance.
CLINICAL CONNECTION
Respiratory Distress Syndrome
• Respiratory distress syndrome (RDS) is a breathing disorder of premature newborns in which
the alveoli do not remain open due to a lack of surfactant.
• There is an increased risk of developing RDS in more premature newborns, in infants whose
mothers are diabetic, in males.
• Symptoms of RDS include difficulty and irregular breathing, alar flaring, during inhalation,
grunting during exhalation, and cyanosis.
• Besides the symptoms, RDS is diagnosed based on chest radiographs and a blood test.
• Newborns with mild RDS may require only supplemental oxygen administered through an
oxygen hood or through a nasal cannula.
• In severe cases, oxygen may be delivered by continuous positive airway pressure (CPAP).
• Surfactant may be administered directly into the lungs.
EXCHANGE OF OXYGEN AND CARBON DIOXIDE
• According to Dalton’s Law, each gas in a mixture of gases exerts its own pressure as if all the
other gases were not present.
• The partial pressure of a gas is the pressure exerted by that gas in a mixture of gases.
• The total pressure of a mixture is calculated by simply adding all the partial pressures. It is
symbolized by P.
• The amounts of O2 and CO2 vary in inspired (atmospheric), alveolar, and expired air.

• Henry’s Law states that the quantity of a gas that will dissolve in a liquid is proportional to the
partial pressure of the gas and its solubility coefficient (its physical or chemical attraction for
water), when the temperature remains constant.
• When there is a difference between the partial pressure of a gas at one point and its partial
pressure at another point, we say there is a partial-pressure gradient.
• Movement of a gas from the point of high partial pressure to the point of low partial
pressure is movement down the gradient.
External respiration or pulmonary gas exchange:
• diffusion of Oxygen from air in the alveoli of the lungs to blood in pulmonary capillaries and
the diffusion of Carbon dioxide in the opposite direction.
• converts deoxygenated blood coming from the right side of the heart into oxygenated blood
that returns to the left side of the heart.
• As blood flows through the pulmonary capillaries, it picks up O2 from alveolar air and unloads
CO2 into alveolar air.

Internal respiration or systemic gas exchange:

• The exchange of O2 and CO2 between systemic capillaries and tissue cells is called.
• As O2 leaves the bloodstream, oxygenated blood is converted into deoxygenated blood.
• Unlike external respiration, which occurs only in the lungs, internal respiration occurs in
tissues throughout the body.
• The rate of pulmonary and systemic gas exchange depends on several factors:
• Partial pressure differences,
• Large surface area for gas exchange,
• Small diffusion distance across the alveolar-capillary (respiratory) membrane,
• Solubility and molecular weight of the gases.
 TRANSPORT OF OXYGEN AND CARBON DIOXIDE IN THE BLOOD
• Oxygen does not dissolve easily in water
• Only about 1.5% of inhaled O2 is dissolved in blood plasma, which is mostly water.
• About 98.5% of blood O2 is bound to hemoglobin in red blood cells.
• Each 100 ml of oxygenated blood contains the equivalent of 20 ml of gaseous O2.

There are several other factors which influence the tightness or affinity with which
hemoglobin binds O2:
(1) Partial Pressure of Oxygen (PO2).
• This is the most important factor that determines how much O2 binds to hemoglobin (Hb)
• The higher the PO2., the more O2 combines with Hb.
• The relationship between the percent saturation of hemoglobin and PO2 is illustrated in the
oxygen–hemoglobin dissociation curve.
• Note that when the PO2 is high, hemoglobin binds with large amounts of O2 and is almost
100% saturated.
• When PO2 is low, hemoglobin is only partially saturated.
• In other words, the greater the PO2, the more O2 will bind to hemoglobin, until all the
available hemoglobin molecules are saturated.
• Therefore, in pulmonary capillaries, where PO2 is high, a lot of O2 binds to hemoglobin.
• In tissue capillaries, where the PO2 is lower, hemoglobin does not hold as much O2, and
the dissolved O2 is unloaded via diffusion into tissue cells.
(2) Acidity (pH).
• As acidity increases (pH decreases), the affinity of hemoglobin for O2 decreases,
• O2 dissociates more readily from hemoglobin.
• Increasing acidity enhances the unloading of oxygen from hemoglobin.
• When pH decreases, the entire oxygen–hemoglobin dissociation curve shifts to the right;
at any given PO2, Hb is less saturated with O2, a change termed the Bohr effect.

(3) Partial pressure of carbon dioxide(PCO2).

• CO2 also can bind to hemoglobin, and the effect is similar to that of H+ (shifting the curve to
the right).
• As PCO2 rises, hemoglobin releases O2 more readily.

(4) Temperature.
• Within limits, as temperature increases, so does the amount of O2 released from hemoglobin.
• In contrast, during hypothermia (lowered body temperature) cellular metabolism slows, the
need for O2 is reduced, and more O2 remains bound to hemoglobin (a shift to the left in the
saturation curve).
(5) BPG.
• A substance found in red blood cells called 2,3-bisphosphoglycerate (BPG), formerly called
diphosphoglycerate (DPG),
• decreases the affinity of hemoglobin for O2 and thus helps unload O2 from hemoglobin.
• The greater the level of BPG, the more O2 is unloaded from hemoglobin.

(6) Oxygen Affinity of Fetal and Adult Hemoglobin.

• Fetal hemoglobin (Hb-F) differs from adult hemoglobin (Hb-A) in structure and in its affinity
for O2.
• Hb-F has a higher affinity for O2 because it binds BPG less strongly.
• Thus, when PO2 is low, Hb-F can carry up to 30% more O2 than maternal Hb-A.
 Under normal resting conditions, gaseous carbon dioxide is transported in the blood in three
main forms:
(1) About 7% is dissolved in blood plasma.
• On reaching the lungs, it diffuses into alveolar air and is exhaled.
(2) About 23%, combines with the amino groups of amino acids and proteins in blood to form
carbamino compounds.
(3) About 70% of CO2 is transported in blood plasma as bicarbonate ions (HCO3−).
• As CO2 diffuses into systemic capillaries and enters red blood cells, it reacts with water in the
presence of the enzyme carbonic anhydrase (CA) to form carbonic acid, which dissociates into
H+ and HCO3