Other functions of the respiratory system

Lung defense mechanisms

The respiratory passages that lead from the exterior to the

alveoli do more than serve as gas conduits:
• They humidify and cool or warm the inspired air so that even
in very hot or very cold air is at or near body temperature by
the time it reaches the alveoli.
• The bronchial secretions contain secretory immunoglobulins
(IgA) and other substances that help resist infections, in
addition, the epithelium of the paranasal sinuses appears to
produce NO, which is bacteriostatic and help to prevent
infection.
• The pulmonary alveolar macrophage (PAMs “dust cells”)
ingest inhaled bacteria and small particles. They also help
process inhaled antigen for immunological attack.
• The hair in the nostrils strain out many particles larger than 10
nm in diameter, most of remaining particles of this size settle
on the mucus membrane in the nose and pharynx. They do
not follow the air stream as it curves downward into the
lungs, and they impact on or near the tonsils and adenoids.
Particles 2-10 nm in diameter generally fall on the walls of the
bronchi as the air flow slows in the smaller passages, there
they initiate reflex bronchial constriction and coughing. They
are also moved away from the lungs by the “ciliary escalator “.
The epithelium of the respiratory passages from the anterior
third of the nose to the beginning of the respiratory
bronchioles is ciliated, and the cilia which are covered with
mucus, beat in coordinated fashion at a frequency of 1000-
1500 cycle per minute.
The ciliary mechanism is capable of moving particles away
from the lungs at a rate of at least 16 mm per minute.
Particles less than 2 nm in diameter generally reach the
alveoli, where they are ingested by the macrophages.

Cilia immotility may produced by various air pollutants, or a

may be congenital. One congenital form is Kartagener’s
syndrome, in which the axonemal dynein, the ATPase
molecular motor, that produces ciliary beating, is absent.
Patient with this condition also are infertile because they lack
motile sperm, and they often have situs inversus, presumably
because the cilia necessary for rotating the viscera are
nonfunctional during embryonic development.
• Metabolic and endocrine function of the lung

In addition to their function in gas exchange, the lungs have a

number of metabolic functions:
➢ They manufacture surfactant.
➢ They contain fibrenolytic system that lyses clots in the
pulmonary vessels.
➢ Prostaglandins are removed from the circulation, but they are
also synthesized in the lungs and released into the blood when
lung tissue is stretched.
➢ The inactive angiotensin I is converted to the presser
angiotensin II in the pulmonary circulation.
➢ Removal of serotonin and norepinephrine, reduces the amounts
of these vasoactive substances reaching the systemic
circulation.
Gas Transport between the Lungs and the Tissues

OXYGEN TRANSPORT
Oxygen Delivery to the Tissues
The O2 delivery system in the body consists of the lungs and
the cardiovascular system. O2 delivery to a particular tissue
depends on the amount of O2 entering the lungs, the
adequacy of pulmonary gas exchange, the blood flow to the
tissue, and the capacity of the blood to carry O2.The blood
flow depends on the degree of constriction of the vascular
bed in the tissue and the cardiac output. The amount of O2 in
the blood is determined by the amount of dissolved O2, the
amount of hemoglobin in the blood, and the affinity of
hemoglobin for O2.
Reaction of hemoglobin and Oxygen
The dynamic of the reaction of the hemoglobin with O2 makes it
particularly suitable O2 carrier.
Hemoglobin is a protein made up of four subunits, each of which
contains a heme moiety attached to a polypeptide chain. In normal
adult, most of the hemoglobin molecules contain two a and two B
chains. Heme is a complex made up of a porphyrin and one atom of
ferrous. Each of the four iron atom, can bind reversibly one O2
molecule. The iron stays in the ferrous state. So the reaction is
oxygenation, not an oxidation.
The quaternary structure of the hemoglobin determines its affinity
for O2. In deoxygenation, the globin unites are tightly bound in a
tense (T) configuration which reduces the affinity of the molecule for
O2. When O2 is first bound, the bonds holding the globin unites are
released, producing a relaxed (R) configuration which expose more
O2 binding sites. The net result is 500 fold increases in O2 affinity. In
the tissue this reaction is revered releasing O2.
The oxygen-hemoglobin dissociation curve, the curve
relating percentage saturation of the O2-carrying power of the
hemoglobin to the PO2. It has a characteristic sigmoid shape
due to the T-R interconversion.
When blood is equilibrated with 100% O2 (PO2 =760 mm Hg),
the normal hemoglobin become 100% saturated, when fully
saturated, each gram of normal of normal hemoglobin contain
1.39 mL of O2. However, blood normally contains small
amounts of inactive hemoglobin derivatives, and the
measured value in vivo is lower. The traditional figure is 1.34
mL of O2. The hemoglobin concentration in normal blood is 15
g/dL. Therefore, each dL of blood contains 20.1 mL (1.34mL X
15) of O2 bound to hemoglobin when the hemoglobin 100%
saturated. The amount of dissolved O2 is a liner function of
the PO2 (0.003 mL/dL blood / mm Hg PO2).
➢ In vivo the hemoglobin in the blood at the end of the
pulmonary capillaries is about 97.5% saturated with O2
(PO2=97 mm Hg). Because of a slight admixture with the
venous blood that bypasses the pulmonary capillaries
(physiological shunt). The hemoglobin in the systemic arterial
blood is only 97% saturated. The arterial blood therefore
contains a total about 19.8 mL of O2 per dL. 0.29 mL in a
solution and 19.5 mL bound to hemoglobin. In venous blood
at rest, the hemoglobin is 75% saturated and the total O2
content is about 15.2 mL/dL. 0.12mL in a solution and 15.1 mL
bound to hemoglobin. Thus, at rest tissue removes about 4.6
mL of O2 from each dL of blood passing through them. In this
way, 250 mL of O2 per minute is transported from the blood to
the tissue at rest.