Chapter 17

RESPIRATORY SYSTEM

OBJECTIVES: 
At the end of the topic, the students will be able to:
A. name the organs forming the respiratory passageway;
B. describe the protective mechanisms of the respiratory system

Respiratory system is the network of organs and tissues that help us breathe.
- helps the body absorb oxygen from the air so the organs can work
- cleans waste gases, such as carbon dioxide, from the blood
The pathway of a breath
When we breathe, air enters through the mouth and nose and travels:
1. down the throat into the trachea
2. into the lungs through the right and left main bronchi
3. into the smaller bronchi airways
4. into the even smaller bronchiole tubes
5. into the alveoli
Each alveolus is covered by a net of tiny blood vessels called capillaries. Oxygen and
carbon dioxide exchange happens here. The heart sends deoxygenated blood to the
lungs. This is blood that is carrying carbon dioxide rather than oxygen.

As the blood passes through the tiny, thin-walled capillaries, they get oxygen from
the alveoli. They return carbon dioxide through the thin walls to the alveoli.
The oxygen-rich blood from the lungs is sent back to the heart, where it is pumped to
the entire body. The carbon dioxide is breathed out of the lungs and alveoli through
the mouth and nose.

The respiratory system has many functions. Besides helping us inhale (breathe in)
and exhale (breathe out), it:
1. Allows us to talk and to smell.
2. Brings air to body temperature and moisturizes it to the humidity level the
body needs.
3. Delivers oxygen to the cells in the body.
4. Removes waste gases, including carbon dioxide, from the body when
exhalation..
5. Protects the airways from harmful substances and irritants.

Parts of the respiratory system

1. Mouth and nose: Openings that pull air from outside the body into the
respiratory system.
2. Sinuses: Hollow areas between the bones in the head that help regulate the
temperature and humidity of the air inhaled.
3. Pharynx (throat): Tube that delivers air from the mouth and nose to the
trachea (windpipe).
4. Larynx (voice box): routes air and food into the proper channels and plays a
role in speech.
5. Trachea (wind pipe): Passage connecting your throat and lungs.
6. Bronchial tubes: Tubes at the bottom of your windpipe that connect into
each lung.
7. Lungs: Two organs that remove oxygen from the air and pass it into the
blood.
From the lungs, the bloodstream delivers oxygen to all the organs and other tissues.
Muscles and bones help move the air we inhale into and out of the lungs. Some of
the bones and muscles in the respiratory system are:
1. Diaphragm: Muscle that helps the lungs pull in air and push it out
2. Ribs: Bones that surround and protect the lungs and heart
When breathing out, blood carries carbon dioxide and other waste out of the body.
Other components that work with the lungs and blood vessels include:
1. Alveoli: Tiny air sacs in the lungs where the exchange of oxygen and carbon
dioxide takes place.
2. Bronchioles: Small branches of the bronchial tubes that lead to the alveoli.
3. Capillaries: Blood vessels in the alveoli walls that move oxygen and carbon
dioxide.
4. Lung lobes: Sections of the lungs – three lobes in the right lung and two in
the left lung.
-Accessory lobe (Azygos lobe) - referred as lingual of left lung, 1% of the
population , at the apicomedial of the right lung, separated from the remainder
of the upper lobe by a fissure ; NO significant clinical implications, an
incidental finding in radiological studies
5. Pleura: Thin sacs that surround each lung lobe and separate lungs from the
chest wall.

Other components of respiratory system:

1. Cilia: Tiny hairs that move in a wave-like motion to filter dust and other
irritants out of the airways.
2. Epiglottis: Tissue flap at the entrance to the trachea that closes when
swallowing to keep food and liquids out of the airway.
 3. Larynx (voice box): Hollow organ that allows us to talk and make sounds
when air moves in and out.

Pulmonary ventilation or breathing – movement of air into and out of the lungs
Two phases of Pulmonary ventilation:
a. Inspiration – air into the lungs; inspiratory muscles contract; size of the
thoracic cavity increases; diaphragm moves from its relaxed dome shape to a
flattened position; increasimh the superoinferior volume; external intercostals
lift the rib cage, increasing anteroposterior and lateral dimension
b. Expiration – air passes out of the lungs; inspiratory muscles relax, elastic lung
tissue recoils; both interthoracic and intrapulmonary volumes decrease;
intrapulmonary pressure risesabove atmospheric pressure
External respiration –gas exchanges to and from the pulmonary circuit blood that
occur in the lungs (Oxygen loading, CO2 unloading)
Internal respiration – exchange of gases to and from the blood capillaries of the
systemic circulation (Oxygen unloading and CO2 loading)

sciencedirect.com

When should I call a healthcare provider about an issue with my respiratory

system?
Contact your provider if having breathing trouble or pain. The provider will listen to
the chest, lungs, and heartbeat and look for signs of a respiratory issue such as
infection.
To see if respiratory system is working as it should, healthcare provider may use
imaging tests such as a CT scan or MRI. These tests allow health care provider to
see swelling or blockages in the lungs and other parts of the respiratory system.
Health care provider may also recommend pulmonary function tests, which will
include spirometry. A spirometer is a device that can tell how much air is inhaled
and exhaled.
Upper respiratory system:
1. Nose
2. Pharynx
3. Larynx

Nose – nostrils or nares to nasal cavity to 3 pairs of lobe-like structures (inferior,

superior, middle nasal conchae) with increase air turbulence. air is warmed,
moistened and filtered by the nasal mucosa
-air beneath the superior part of the nasal cavity stimulate the olfactory receptors
in the mucosa,
- paranasal sinuses: frontal, sphenoid, ethmoid, maxillary bonesact as resonance
chamber in speech; also warm and noisten the incoming air
- hard palate and soft palate separate the nasal cavity from oral cavity
Pharynx (throat):
1. Nasopharynx – posterior to the nasal cavity, above the soft palate; as air
passage; high on the posterior wall are pharyngeal tonsils(lymphoid tissue);
pharyngotympanic (auditory tubes) which allow middle ear pressure to
become equalized to atmospheric pressure, drain into the nasopharynx..
2. Oropharynx –posterior to the oral cavity; extend from soft palate to the
epiglottis of the larynx inferiorly; common conduit of food and air.
-palatine tonsils on the lateral walls of oropharynx
- lingual tonsil covers the base of the tongue
3. Laryngopharynx – accommodates both ingested food and air
Larynx – made up of 9 small cartilages:
1. Thyroid cartilage – largest, shield shape with anterior protrusion (Adam’s
apple)
2. Cricoid cartilage – more inferior ring-shaped
-All laryngeal cartilage are composed of hyaline cartilage except epiglottis ,
flaplike elastic cartilage superior to the opening of the larynx
-True vocal cords or vocal folds – vibrate with expelled air for speech
- Glottis - slit-like passageway between the vocal folds

Lower Respiratory System:

1. Trachea
2. Main or primary bronchi (left, right)
3. Secondary and Tertiary bronchi
 4. Terminal bronchioles to respiratory bronchioles
5. Alveolar ducts to alveolar sacs
6. Alveoli

How your lungs stay healthy

The alveoli stay partly inflated like a balloon even when exhaling air. Lungs make a
fluid called surfactant to help them stay open. Surfactant also contains fatty proteins
that help keep the lungs healthy.
Lungs are self-cleaning. They make mucus (goblet cells) to trap germs and
particles. The mucus is then swept up by cilia, small hairs that line the airways.
Normally, mucus is being swallowed without noticing. If there is respiratory illness,
the lungs may make too much mucus.
The alveoli also contain immune cells called macrophages. These cells “eat” germs
and irritants before they can cause an infection in the lungs.

To keep respiratory system healthy:

1. Avoid pollutants that can damage airways, including secondhand smoke,
chemicals, and radon (a radioactive gas that can cause cancer). Wear a
mask if you are exposed to fumes, dust or other types of pollutants for any
reason.
2. Don't smoke.
3. Eat a healthy diet with lots of fruits and vegetables and drink water to stay
hydrated
4. Exercise regularly to keep lungs healthy.
5. Prevent infections by washing hands often and getting a flu vaccine each
year.
6. Being able to clear mucus out of the lungs and airways is important for
respiratory health.
Thoracotomy – when a lobe of the lung is removed through a long incision on
the side of the chest; spreading the ribs apart to get access of the lungs
Lobectomy - . . .
Lungs can regenerate.

Respiratory Volume:
1. Tidal volume (TV) – volume of air inhaled and exhaled with each normal
respiration; approximately 500 mL (Use spirometer mouthpiece)
2. Expiratory reserve volume (ERV) – volume of air that can be forcibly exhaled
after a normal expiration; 700 – 1200 mL (Use spirometer mouthpiece)
3. Viral capacity (VC) – total exchangeable air of the lungs (TV+IRV+ERV);
3600 mL – 4800 mL; normal is 4500 mL
4. Inspiratory Reserve Volume (IRV) – volume of air that can be forcibly inhaled
following a normal inspiration
IRV = VC – (TV+ERV)
Residual Volume (RV) – respiratory volume that cannot be experimentally
demonstrated; the amount of air remaining in the lungs after a maximal
expiratory effort; 1200 mL (important because it allows gas exchange to go on
continuously-even between breaths

Pneumograph – records variations in breathing patterns

What conditions affect the respiratory system?

Many conditions can affect the organs and tissues that make up the respiratory
system. Some develop due to irritants we breathe in from the air, including viruses or
bacteria that cause infection. Others occur as a result of disease or getting older.
Conditions that can cause inflammation (swelling, irritation, and pain) or otherwise
affect the respiratory system include:
1. Allergies: Inhaling proteins, such as dust, mold, and pollen, can cause
respiratory allergies in some people. These proteins can cause inflammation
in your airways.
2. Asthma: A chronic (long-term) disorder, asthma causes inflammation in the
airways that can make breathing difficult.
3. Infection: Infections can lead to pneumonia (inflammation of the lungs)
or bronchitis (inflammation of the bronchial tubes). Common respiratory
infections include the flu (influenza) or a cold.
4. Disease: Respiratory disorders include lung cancer and chronic obstructive
pulmonary disease (COPD). These illnesses can harm the respiratory
system’s ability to deliver oxygen throughout the body and filter out waste
gases.
5. Aging: Lung capacity decreases while getting older., many old people tend to
become hypoxic during sleep (sleep apnea)
6. Damage: Damage to the respiratory system can cause breathing problems.

Homeostatic imbalance:
1. Cleft palate – failure of the bones of the bones forming the palate to fuse
medially
2. Rhinitis - caused by cold viruses and various allergens that inflamed the
nasal mucosa; has nasal congestion and post nasal drip due to produced
excessive mucus
3. Sinusitis – inflammation of the sinus; difficult to treat and can cause marked
changes in voice quality; sinus headache
4. Tonsillitis –
5. Heimlich maneuver – a procedure in which the air in a person’s own lungs is
used to pop out or expel an obstructing piece of food
6. Tracheostomy – surgical opening of the trahea
7. Smoking inhibits and ultimately destroys cilia.
8. Pleurisy – inflammation of the pleurae caused by insufficient secretion of
pleural fluid; pleural surfaces become dry and rough
9. Atelectasis – lung collapse thus useless for ventilation; when air enters
pleural space through chest wound or due to the rupture of the visceral pleura
10. Hypoxia – inadequate oxygen delivery to body tissues causing a light-skinned
people taking a bluish cast called cyanotic, observed in the dark-skinned
through the mucosae and nail bed
11. Carbon monoxide poisoning – a leading cause of death from fire
12. Hyperventilation – increase in rate and depth of breathing that exceeds the
body’s needs to remove carbon dioxide; exhale more CO2, brought by anxiety
attack (Breathe into a paper bag
13. Apnea – cessation of breathing until CO2 build up in the blood. If longer,
cyanosis occur
14. COPD, Chronic obstructive pulmonary disease – patient has history of
smoking; dyspnea (Difficulty in breathing) referred to as “air hunger”,
coughing and frequent pulmonary infections are common, most COPD are
hypoxic, retain CO2 and respiratory acidosis lead to respiratory failure.
15. Chronic bronchitis – mucosa is severely inflamed with excessive mucus
16. Emphysema – walls of some alveoli are destroyed causing remaining alveoli
to be enlarged, chronic inflammation, has fibrosis. Lungs become less elastic,
airways collapse during expiration and obstruct flow of air.
17. Lung CA, 3 types:
a. Adenocarcinoma – as nodules in peripheral lung areas and develops
from bronchial glands (40%)
 b. Squamous cell CA – (25-30%) – epithelium of larger bronchi, forming
mass and bleed
c. Small Cell CA – (20%) contains lymphocyte-like cells originating from
main bronchi with metastasis , aggressive in small grapelike clusters
18. Infant respiratory distress syndrome (IRDS) – born premature (before 28
weeks) or born to diabetic mother; have dyspnea within few hours after birth,
lung collapse
19. Sudden Infant Death Syndrome (SIDS) – or crib death, can be healthy infant
but die in their sleep

REFERENCES:

https://my.clevelandclinic.org/health/articles/21205-respiratory-system

https://www.sciencedirect.com/topics/medicine-and-dentistry/respiratory-system

https://www.healthline.com/human-body-maps/lung#lung-function

Marieb, Elaine N. and Keller, Suzanne M. (2018). Essentials of Human Anatomy and
Physiology. 12th Edition. Pearson Education South Asia Pte Ltd. Singapore.

Marieb, Elaine N. and Brito, Simone (2019). Anatomy and Physiology coloring
workbook( A complete study guide). 12th Edition. Pearson Education South Asia
Pte Ltd. Singapore