Module 4

Respiratory Anatomy and Physiology

Overview/Introduction

The majority of the human metabolism requires oxygen because aerobic respiration is the most
efficient metabolic process in producing energy in the form of Adenosine TriPhosphate. Since humans
are multicellular, the body needs an efficient mechanism for it to acquire and deliver the needed oxygen
towards the entire body. Another metabolic byproduct must also be removed from the body, the
Carbon Dioxide. This gas causes acid formation when accumulated in the body systems. Thus, the
respiratory system is an essential part of the human organism. Any deviation in the processes involved
in the respiratory process will precipitate disease formation. In this module, you are expected to
understand the processes and phenomenon involved in the acquisition of Oxygen and the removal of
Carbon Dioxide.

Course objectives.

After the Module, you are expected to

1. Identify the parts and function of the respiratory system
2. Discuss the process of ventilation and identify the different lung volumes
3. Describe the process of diffusion and gas exchange between the alveoli and lung capillaries and
vice versa

Course Content

Respiration
1. Movement of air into and out of the lungs (Ventilation or Breathing)

2. Exchange of O2 and CO2 between the lungs and the blood

3. Transport of these gases
4. Exchange of O2 and CO2 between the blood and the tissues

The Following are the Function of the respiratory system

1. Gas exchange – oxygen enters the lungs while carbon dioxide exits the lungs. Oxygen coming
from the lungs is transported to the tissues and in this area, oxygen enters the tissues for it to
be used while Carbon Dioxide is transported to the blood to be brought back to the lungs for
exhalation
2. Regulation of blood pH- when Carbon Dioxide builds up, Carbonic Acid is formed making the
body more acidic, if Carbon Dioxide is lost in great volume, the Carbonic Acid becomes deficient
making the blood alkaline. Balance in the body pH is done by the Bicarbonate Buffer System.
3. Voice production – the Larynx or Voice Box has vibrating caritalages that forms sounds making it
produce voice. The voice of the person is affected mainly by the quality of the vibration,
movement of the tongue and lips as well as the power of the air that moves through the voice
box
 4. Olfaction – the nose contains nerves that are sensitive to chemicals. The chemicals in the
environment carried by the air can be sensed by these nerves. It also plays in the role in
enhancing the taste of foods.
5. Protection – the respiratory system is equipped with protective structures such the hair inside
the nose which filters air coming to the nose, cilia in the lining of the nasipharynx and trachea
and mucous covering the lining of the respiratory tract. It is alse equipped with physiologic
response to expel violently any foreign materials coming to the respiratory tract. These
phenomenon are called sneezing and coughing

Upper respiratory tract: external nose, nasal cavity, pharynx, and associated structures

The Nose
The Nose Consist of the external nose and the
nasal cavity. The External nose is theonly visible
structure.

The Nasal cavity has the following structures

• Nares or Nostrils – external openings
• Choanae – openings to pharynx
• Vestibule – anterior portion of nasal cavity
• Hard palate – separates the nasal cavity
from the oral cavity
• Nasal septum – divides nose into right and
left parts
• Conchae – boney ridges in the nasal cavity
• Meatus – Passageway beneath each
conchae

The Functions of the nose are the following

• Provides an airway for respiration
• Moistens and warms the entering air
• Filters inspired air and cleans it of foreign matter
• Serves as a resonating chamber for speech
• Houses the olfactory receptors

The Pharynx
• Connects the nasal cavity and mouth to the larynx and esophagus inferiorly
•
• Common passageway for air, food, and drink
• Commonly called the throat
• There are 3 regions:
– Nasopharynx: air only
• posterior to the choanae and superior to the soft palate
• soft palate separates the nasopharynx from the oropharynx
 – Oropharynx: air and food
• From the soft palate to the epiglottis
– Laryngopharynx: primarily food and drink
• From the epiglottis to the esophagus

Larynx or Voice Box

The larynx is located Anterior part of the throat, from the base of the tongue to the trachea
The three functions of the larynx are:
1. To provide an airway-
2. To act as a switching mechanism to route air and food into the proper channels
• Epiglottis: elastic cartilage that covers the laryngeal inlet during swallowing
• Closure of the vestibular and vocal folds
3. To function in voice production

The Larynx has vocal cords that enables a person to create understandable sounds
• Two pairs of ligaments
• False vocal cords (vestibular folds)
– Superior mucosal folds
– Have no part in sound production
• True vocal cords (vocal folds)
– Inferior mucosal folds composed of elastic fibers
– The medial opening between them is the glottis
– They vibrate to produce sound as air rushes up from the lungs
– Laryngitis: Inflammation of the vocal folds
Sound Production
Sound is the result of the Vibration of the vocal folds as air moves past them. The Loudness
depends on the amplitude of the vibration, which is determined by the force at which the air rushes
across the vocal cords. The Pitch is determined by the length and tension of the vocal cords, which
changes the frequency of the vibrations. The Sound is “shaped” into language by action of the tongue,
lips, teeth, and other structure. The pharynx resonates, amplifies, and enhances sound quality

The Tracheobronchial Tree

The Tracheobronchial Tree is a
series of branching organs. The tissues
commonly seen in this tree are the tracheal
cartilages which U-shaped cartilage are
made of hyaline cartilage that keeps the
airway open. It is also lined with smooth
muscles that constricts or dilates depending
on the need of breathing. Special tissues
found on the tracheobronchial tree are the
squamous tissues lining the tree.

The Trachea
The Trachea descends from the
larynx through the neck to the fifth thoracic
vertebra it is composed of dense regular
connective tissue and smooth muscle
reinforced with 15-20 C-shaped rings of
hyaline cartilage, which protect the trachea and keep the airway open The mucous membrane lining the
trachea is made up of goblet cells and pseudostratified ciliated columnar epithelium. Goblet cells are
special cells that produce mucus. This mucous maintains moisture and covers the line of the trachea and
can trap dirt that escapes the nosal defenses. It ends by dividing into the two primary bronchi.

The Main Bronchi

The right and left bronchi are formed by the
division of the trachea. Right primary bronchus is wider,
shorter and more vertical than the left. The right
primary bronchi common site for an inhaled object to
become lodged By the time that incoming air reaches
the bronchi, it is warmed, cleansed and saturated with
water vapor. The Main Bronchi divides forming the
lobar bronchi. There are three lobes on the right lung
while 2 lobes on the left lung. Hence, there are three
right lobar bronchi and two left lobar bronchi. The lobar
bronchi will divide forming the segmental bronchi. This
division continues until it reaches the terminal
bronchioles, respiratory bronchioles and alveoli. There
are 16 generations of branching from the trachea to the
terminal bronchioles. As the structure descends, the
size and thickness of the cartilages decreases, the smooth muscle increases and the epithelial cells thins
into a squamous tissue.
The Lungs

The Lungs is the Principal organs of respiration Base rest on diaphragm and the apex extends
superiorly to ~2.5 cm above the clavicle. Right lung has 3 lobes, while the left has only 2 lobes. The Lungs
is covered by two layers of pleura, the visceral and the parietal pleura, with a spaces between bathed
with pleural fluid. This pleural fluid acts as a lubricant so that the two pleura covering the lungs passes
through each other smoothly and without friction.

The Alveoli
The end of the tracheobronchial tree are the alveoli.
Alveolar walls are a single layer of type I pneumocytes,
Squamous epithelial cells, compose 90% of the alveolar
surface and it permit gas exchange by simple diffusion. The
type II pneumocytes are Round or cube-shaped secretory
cells that produce surfactant. Surfactant reduces surface
tension, which makes it easier for the alveoli to expand.
Without surfactant, the hydrogen bonding between the
water molecules on the alveolar walls will prevent the alveoli
from expanding. Adjacent to the alveolar wall are the
alveolar capillaries made of simple squamous epithelium. The
thin wall of the alveolar wall and the alveolar capillaries
enables them to exchange gasses. Carbon dioxide going
inside the alveoli and oxygen going inside the alveolar
capillaries. The carbon dioxide will then be exhaled to the
environment while the oxygen binded to the blood in the
alveolar capillaries will be transported to the tissues

The Pleura
The Pleura is a thin, double-layered serous membranes
that covers the lungs. The Parietal pleura Covers the thoracic
wall, diaphragm, and mediastinum. The Visceral pleura
Covers the external lung surface. The Pleural cavity is a
Negative pressure space between the parietal and visceral
pleura.. it contains Pleural Fluid that Fills the pleural cavity,
Made by the pleural membranes, Serves as a lubricant and
Holds the pleural membranes together
Blood Supply to Lungs
The Lungs are perfused by two circulations: pulmonary and bronchial. The Pulmonary
circulation is made of Pulmonary arteries and Pulmonary Veins. The Pulmonary arteries supply
deoxygenated systemic blood to be oxygenated. These blood came from the systemic circulation and
is high in carbon dioxide. The Pulmonary veins carry oxygenated blood from lungs back to the heart.
The heart then pumps the blood to the systemic circulation. This blood just released its carbon
dioxide content to the lungs and accepted the oxygen that are present in the lungs
The Bronchial circulation includes Bronchial arteries which provide systemic oxygenated
blood to the lung tissue. This blood is used to nourish the lung tissues. Lung tissues does not
consume the blood from the pulmonary circulation. The Bronchial arteties Supply all lung tissue
except the alveoli. Bronchial veins carry the deoxygenated blood back to the heart

Ventilation
Inspiration is the movement of air into the lungs. During inspiration, chest rises and
expands. The muscles involved are the diaphragm and those that elevate the ribs and sternum. As the
diaphragm and other muscles of inspiration contract and the rib cage rises and thoracic volume
increases. The rise in thoracic volume decreases the Pressure inside the lungs thereby creating a
suction like effect that draws air from the environment to the lungs. This air is rich in oxygen and will
be transported to the blood.
Expiration is the movement of air out of the lungs. During expiration, the chest wall falls
and the diaphragm relaxes thereby decreasing the thoracic volume and increasing pressure. This then
pushes the air out of the lungs. The muscles actively involved are those that depress the ribs and
sternum (usually only with forceful expiration). It is largely a passive process. The cycle of inspiration
and exhalation is called breathing or ventilation. The average adult performs normally 12 to 20 cycles
of breathing every minute.
 Lung Recoil
The tendency for an expanded lung to decrease in size is due to the elastic fibers in its
connective tissues. Another is the surface tension from the hydrogen bonding of the water molecules
on the alveolar wall. This lung recoil is important because it allows air to move out preparing the lungs
for a new cycle of breath. If the lungs cannot recail, like in patients with Chronic Obstructive
Pulmonary Diseases, carbon dioxide will be trapped inside the lungs. The person needs to exert extra
effort to move the air out. Despite the tendency to recoil, the lungs is prevented from collapsing
because of the presence of surfactant. Surfactant is made of Lecithin and Sphingomyelin, lipoprotein
substances that decreases the surface tension in the lungs. Pleural pressures in the pleural space
prevents also the lungs from collapsing. Pleural pressure is always negative regardless of the cycle of
breathing allowing the lungs to remain expanded by suctioning it to the chest wall

Gas Exchange in Tissues

Here are the series of events that happen during gas
exchange in tissues
1. In the tissues, CO2 diffuses into the plasma and into
RBC. Some of the CO2 remains in the plasma
2. In RBC, CO2 reacts with H2O to form carbonic acid
(H2CO3) in a reaction catalyzed by the enzyme
carbonic anhydrase (CA)
3. H2CO3 dissociates to form bicarbonate ions (HCO3-)
and hydrogen ions (H+)
4. In the chloride shift, as HCO3- diffuses out of the RBC,
electrical neutrality is maintained by the diffusion of
chloride ions (Cl-) into them
5. Oxygen (O2) is released from hemoglobin (Hb). O2
diffuses out of RBCs and plasma into the tissues
6. H+ combine with Hb, which promotes the release of
O2 from Hb (Bohr effect)
7. CO2 combines with Hb. Hb that has released O2 readily combines with CO2 (Haldane effect)

TEACHING/ LEARNING ACTIVITIES

1. Breath normally and answer the following questions
a. how many cycles of breaths did you make
b. describe the movement of your chest
c. describe the efforts you make during inspiration and exhalation
2. stop breathing as long as you can
a. how long did you last?
b. what did you feel when you stopped breathing?
c. what made you feel to breath again
Assessment tasks
1. trace the path of air as it enters and exits the lungs.
2. trace the path of air through the respiratory membranes.
3. describe the exchange of oxygen and carbon dioxide in the lungs and in the tissues.

References
Geb, Elaine N. (2019), Essentials of Human Anatomy and Physiology, 8th Edition
Philip (2009), Seely’s Principles of Anatomy and Physilogy