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Overview

Mader: Understanding Human Anatomy & Physiology, Fifth Edition

I. Human Organization

1. Organization of the Body

The McGrawHill Companies, 2004

MECHANICS OF BREATHING
ASST. PROF. NARONGRIT THONGON, PH.D.
Mader: Understanding Human Anatomy & Physiology, Fifth Edition IV. Maintenance of the Body 14. The Respiratory System The McGrawHill Companies, 2004

Figure 1.1

Levels of organization of the human body. Each level is more complex than the previous level.

Every cell needs energy


food + O2 ATP + CO2 + H2O
Molecule Organ system Atom

O2

CO2
Macromolecule Organ Organelle Organism

Mader: Understanding Human Anatomy & Physiology, Fifth Edition

Body Unicellular

IV. Maintenance of the

14. The Respiratory System

Multi-cellular

The McGrawHill Companies, 2004


Cell Tissue

FACULTY OF ALLIED HEALTH SCIENCES BURAPHA UNIVERSITY


Figure 14.1 The respiratory tract extends from the nasal cavities to the lungs, which are composed of air sacs called alveoli. Gas exchange occurs between the air in the alveoli and the blood within a capillary network that surrounds the alveoli. Notice in the blow-up that the pulmonary arteriole is colored blueit carries O2poor blood away from the heart to the alveoli. Then carbon dioxide leaves the blood, and oxygen enters the blood. The pulmonary venule is colored redit carries O2-rich blood from the alveoli toward the heart.

14.3 Gas Exchange and Transport

14.1 The Respiratory System


The primary function of the respiratory system is to allow oxygen from the air to enter the blood and carbon dioxide from the blood to exit into the air. During inspiration, or inhalation (breathing in), and expiration, or exhalation (breathing out), air is conducted toward or away from the lungs by a series of cavities, tubes, and openings, illustrated in Figure 14.1. The respiratory system also works with the cardiovascular system to accomplish these four respiratory events: 1. breathing, the entrance and exit of air into and out of lungs; 2. external respiration, the exchange of gases (oxygen and carbon dioxide) between air and blood; 3. internal respiration, the exchange of gases between blood and tissue uid; 4. transport of gases to and from the lungs and the tissues. Cellular respiration, which produces ATP, uses the oxygen and produces the carbon dioxide that makes gas exchange with the environment necessary. Without a continuous supply of ATP, the cells cease to function. The four events listed here allow cellular respiration to continue.

Respiratory and Nonrespiratory Patterns

Overview

nasal cavity nostril

pharynx epiglottis glottis larynx trachea right bronchus bronchiole

The Respiratory Tract


Table 14.1 traces the path of air from the nose to the lungs. As air moves in along the airways, it is cleansed, warmed, and moistened. Cleansing is accomplished by coarse hairs just inside the nostrils and by cilia and mucus in the nasal cavities and the other airways of the respiratory tract. In the nose, the hairs and the cilia act as screening devices. In the trachea and other airways, the cilia beat upward, carrying mucus, dust, and occasional bits of food that went down the wrong way into the pharynx, where the accumulation can be swallowed or expectorated. The air is warmed by heat given off by the blood vessels lying close to the surface of the lining of the airways, and it is moistened by the wet surface of these passages. Conversely, as air moves out during expiration, it cools and loses its moisture. As the air cools, it deposits its moisture on the lining of the trachea and the nose, and the nose may even drip as a result of this condensation. The air still retains so much moisture, however, that upon expiration on a cold day, it condenses and forms a small cloud.

lung diaphragm pulmonary venule pulmonary arteriole alveolus

The normal pattern of quiet breathing is termed eupnea. A condition called Cheyne-Stokes respiration is characterized by alternate periods of hyperpnea (deep and labored breathing) and apnea (no breathing or shallow breathing). In this condition, the respiratory center is apparently being controlled largely by chemical input so that the breathing rate rst increases when CO2 and H are high and O2 is low and then decreases when CO2 and H are low and O2 is high. CheyneStokes respiration is associated with abnormal environmental conditions (e.g., high altitude) or physiological disorders (e.g., congestive heart failure). Other factors can also affect respiration. A sudden cold stimulus, such as a plunge into cold water, causes temporary apnea. A sudden, severe pain has the same effect, but prolonged pain triggers the stress syndrome, which causes an increased breathing rate. A rather interesting stimulus is stretching of the anal sphincter muscle, which causes inspiration. Various other patterns of nonrespiratory air movements are of interest. Prior to a cough, the glottis closes. Then the glottis suddenly opens as a blast of air is forced upward from the lower respiratory tract. A sneeze is like a cough except that the blast of air is directed into the nasal passages by a depression of the uvula that closes off the pharynx and mouth. When a person laughs or cries, air is released in a series of short expirations; therefore, it is necessary to study the facial expression to know if a person is crying or laughing. A hiccup occurs when the diaphragm contracts spasmodically while the glottis is closed. Air striking the vocal cords causes the hiccup. Sighing and yawning require a long inspiration followed by a shorter expiration. The sound that accompanies expiration serves as a means of communication. Yawning has the benet of making a person more alert when drowsiness occurs. The neurophysiology of yawning is complex, and knowledge of its mechanisms is incomplete because it is apparently under the control of various neurotransmitters.

require respiratory system


ach temporarily stores food, secretes digestive juices, and passes on partially digested food to the small intestine. Anatomy and physiology are closely connected in that the structure of an organ suits its function. For example, the stomachs pouchlike shape and ability to expand are suitable to its function of storing food. In addition, the microscopic structure of the stomach wall is suitable to its secretion expired air inspired of airdigestive juices, as we shall see in Chapter 15. O2 O2

Gas exchange and transport are critical to homeostasis. As mentioned previously, respiration ex- in turn join to form macromolecules. For example, mol1.1 The Human Body includes not only the can ecules change of gases in the lungs, but also the exchange of gases in called amino acids join to form a macromolecule Anatomy and physiology is the study of the human body. called protein, which makes up the bulk of our muscles. the tissues. Recall that diffusion is the movement of molecules Macromolecules are found in all cells, the basic units of Anatomy is concerned with the structure of a part. For from the area higher to the area of lower example, the of stomach is concentration a J-shaped, pouchlike organ all living things. Within cells are organelles, tiny structures concentration. The principles of diffusion alone govern (Fig. 1.1). The stomach wall has thick folds, which disappear that perform cellular functions. For example, the organelle as the stomach expands increase its capacity. Physiology is called reproducwhether oxygen (O2) to or carbon dioxide (CO2) enters or the nucleus is especially concerned with cell 2 concerned with the of aand part.in For example, the stomtion; another organelle, called the mitochondrion, supplies leaves the blood infunction the lungs the tissues.

Overview

external respiration

the cell with energy. Tissues are the next level of organization. A tissue is composed of similar types of cells and performs a specic function. An organ is composed of several types of tissues and performs a particular function within an organ system. For example, the stomach is an organ that is a part of the digestive system. It has a specic role in this system, whose overall function is to supply the body with the nutrients needed for growth and repair. The other systems of the body (see page 13) also have specic functions. CO2 CO2 Organization of Body Parts All of the body systems together make up the organism The structure of the body can be studied at different levels of such as, a human being. Human beings are complex animals, organization (Fig. 1.1). First, all substances, includingalveolar body air but this complexity can be broken down and studied at ever parts, are composed of chemicals made up of submicroscopic simpler levels. Each simpler level is organized and constructed O2 particles called atoms. Atoms join to form molecules, which in a particular way. CO2
O2

Part I Human Organization

CO2

O2-poor blood
gas transport

O2-rich blood O2 CO2

O2 CO2

internal respiration

O2 tissue fluid CO2 O2 CO2

capillary network

Figure 14.9 External and internal respiration. During external respiration in the lungs, CO2 leaves the blood and O2 enters the blood passively by diffusion. During internal respiration in the tissues, O2 leaves the blood and CO2 enters the blood passively by diffusion.

respiring tissues

Mechanics of Breathing
The mechanism of air ows into and out off the lung during inhalation and exhalation. Air (Gas) is uid that tends to ow and to conform to the outline of its container. Air (Gas) ows down its pressure gradient.

Mechanics of Breathing; Trans-pulmonary pressure

Inhalation
Air ows into the lungs Pa < Patm

Exhalation
Air ows out off the lungs Pa > Patm

Mechanics of Breathing;

Resting state;
Patm = 0 cmH2O Pa = 0 cmH2O Ppl = 5 cmH2O Boyles law (P1V1= P2V2)

chest wall recoil outward alveoli recoil inward pleural pressure tend to increase Ppl = 5 cmH2O trans-mural pressure (PaPpl) expand alveoli

The mechanism of change in transpulmonary pressure.


Patm = 101.325 kPa, 760 mmHg (torr), 29.92 inHg, 14.696 PSI, 1013.25 millibars Patm (Respiratory Physiology) = 0 cmH2O

Mechanics of Breathing

Mechanics of Breathing; Trans-pulmonary pressure


Inspiration
Boyles law (P1V1= P2V1) Inspiratory muscle contraction (diaphragm & external intercostal m.) chest wall expand parietal pleura expand increase volume of pleural space decrease Ppl (8 cmH2O) increase trans-mural pressure (PaPpl) expand alveoli decrease Pa (1 cmH2O) Pa (1 cmH2O) < Patm (0 cmH2O) air ows into alveoli active process
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Mechanics of Breathing; Trans-pulmonary pressure


Expiration
Inspiratory muscle relaxation chest wall recoil inward parietal pleura recoil inward decrease volume of pleural space increase Ppl (Boyles law) decrease trans-mural pressure (PaPpl) alveolar recoil inward increase Pa (+1 cmH2O) Pa (+1 cmH2O) > Patm (0 cmH2O) air ows out off alveoli passive process

Mechanics of Breathing; Conclusion

Factors affecting breathing mechanism


Chest wall compliance
chest wall elastic recoil muscles of respiration Amyotropic lateral sclerosis (ALS)

Factors affecting breathing mechanism


Lung compliance
lung elastic recoil hyper (pulmonary brosis) hypo (emphysema)

Pleural pressure (Ppl)


always negative pneumothorax Pleural effusion
Hydrothorax Hemothorax Chylothorax Pyrothorax

atelectasis

Factors affecting breathing mechanism


Lung compliance Alveolar surface tension air-liquid interface

relating lung volume changes to changes in transpulmonary Compliance pressure. Diagram Note that the relation is373 different for of the Lungs. Figure is a diagram inspiration and lung expiration. curve is recorded by relating volume Each changes to changes in transpulchanging the transpulmonary pressure in small stepsfor monary pressure. Note that the relation is different inspiration and volume expiration. Each curve is recorded and allowing the lung to come to a steady level by

pressure. That is, every time the transpulmonary pressure increases 1 centimeter of water, the lung volume, Compliance Diagram of the Lungs. Figure 373 is a diagram after 10 to 20 seconds, will expand 200 milliliters.

the normal adult human averages about 200 milsure increases 1 centimeter of being water, the lung volume, of air per will centimeter of water transpulmonary after 10 liliters to 20 seconds, expand 200 milliliters.

Factors affecting breathing mechanism


normal lung compliance

changing the transpulmonary pressure in small steps and allowing the lung volume to come to a steady level

saline solution and when lled with air.When the saline solutionlled lungs, there is the no lungs air-uid are lled therefore, with air, there an interface between interface; the is surface tension effect the is not alveolar uid and theelastic air in the alveoli. the case in of the presentonly tissue forces are In operative the saline solutionlled lungs, there is no air-uid saline solutionlled lung. interface; therefore, the surface tension effect is not Note that transpleural pressures required to presentonly tissue elastic forces are operative inexpand the air-lled lungs are about saline solutionlled lung.three times as great as those required to expand saline solutionlled lungs. Thus, Note that transpleural pressures required to expand one can conclude the tissue elastic forces tending air-lled lungs are that about three times as great as those to expand solutionlled lungs. Thus, torequired cause collapse ofsaline the air-lled lung represent only one can the tissue elastic forces tending the about oneconclude third of that the total lung elasticity, whereas to cause collapse of the air-lled lung represent only about one third of the total lung elasticity, whereas the

Laplaces law
Lung volume change (liters)

0.50

Lung volume change (liters)

0.50

Lung volume change (liters)

P = 2T r

Saline-filled
Lung volume change (liters)

Air-filled
Air-filled

0.50
0.50

Saline-filled

Expiration

Expiration

Expiration
0.25

Expiration

0.25 0.25

0.25

Inspiration Inspiration

Inspiration Inspiration 0

00 0
0 2 4 6 2 4 6 Pleural pressure (cm H2O) 8

0 4

Pleural pressure (cm H2O)

5 5pressure (cm H O) Pleural 2

Pleural pressure (cm H2O)

alveolar collapse
Figure 373

Figure 374
Comparison of the compliance diagrams of saline-lled and airlled lungs when the alveolar pressure is maintained at atmos14 airComparison of the compliance diagrams of saline-lled and pheric pressure (0 cm H2O) and pleural pressure is changed.

Figure 373

Figure 374

Compliance diagram in a healthy person. This diagram shows compliance of the lungs alone.

Compliance diagram in a healthy person. This diagram shows compliance of the lungs alone.

lled lungs when the alveolar pressure is maintained at atmospheric pressure (0 cm H2O) and pleural pressure is changed.

Factors affecting breathing mechanism


Lung compliance
Alveolar surface tension Surfactant
Dipamlmitoyl phospatidyl choline (DPPC) ~75% phosphatidylglycerol (PG) ~ 10% surfactant protein (SP)-A, SP-B, SP-C, SP-D), hydrolase, acid phosphatase ~15% decrease surface tension synthesized and secreted from pneumocyte II preterminfants InfantRespiratory Distress Syndrome (RDS) or Hyaline Membrane Disease (HMD)
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Factors affecting breathing mechanism


Lung compliance
Alveolar surface tension air-liquid interface alveolar interdependent

collateral ventilation Alveolar pore (pores of Khon)


~ 5-15 mm in diameter in the alveolar wall ~ 1-6 per septum permit air to pass between alveoli

canals of Lambert
openings in the walls of terminal bronchioles respiratory bronchioles

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Factors affecting breathing mechanism


Airways resistance
air ow resistance

Factors affecting breathing mechanism


Airways resistance
tissue resistance; airways bication parallel series

1
Rtotal

1
R1

1
R2

+...

1
Rn

Poiseuilles law

R=

8l r4

Total airways resistance depend on the larger airways. Smaller airways are the silent zone.

Factors affecting breathing mechanism


Airways resistance
tissue resistance; airways Factors affecting the larger airway resistance
smooth muscle contraction irritant receptor CO2 histamine, leukotrienes, acetylcholine, thromboxane A2 stretch receptor autonomic nervous system mucus secretion inammation of epithelial cells force expiration

Factors affecting breathing mechanism


Airways resistance
tissue resistance; lungs radial traction
The more lung volume the more airway conductance. In inhalation, alveoli are expanded and displaced outward of body axis. Alveolar wall pulled the airway radially, thus, expanded the airway.