ANATOMY AND PHYSIOLOGY

BACHELOR OF SCIENCE IN NURSING

YEAR 1

SEMIFINALS: THE RESPIRATORY SYSTEM

THE RESPIRATORY SYSTEM

● Consists of:
1. Respiratory Tract
▪ Nose through bronchi
2. The Lungs

RESPIRATORY TRACT
● Divided into
o upper
o lower respiratory tract

● UPPER RESPIRATORY TRACT

o From the nose through the pharynx
● Cartilage Ring: Trachea and primary bronchi
● Cartilage Plates: Secondary and Tertiary bronchi
● Pneumonia: alveoli is affected
● Bronchial asthma: bronchioles is affected

CILIARY LINING OF THE LOWER RESPIRATORY

TRACT
● Cross Section
o Cilia - beat upward and drive the debris-
laden mucus to the pharynx, where it is
● LOWER RESPIRATORY TRACT swallowed.
o The Bronchial Tree ● Longitudinal Section
o From the larynx to tertiary bronchi
o The bronchial tree extends to bronchioles
and alveoli

THE LUNGS
● The lungs overlap with the respiratory tract
● Consist of the left and the right lungs
● The left lung is divided into two lobes; the right into
three
● Receives the bronchus, blood and lymphatic vessels,
and nerves through its hilum
BRONCHIOLES AND ALVEOLI
● The bronchi extend into the alveoli
● Primary Bronchi
● Inside the lungs:
o Secondary Bronchi
o Tertiary Bronchi
o Bronchioles
o Alveoli

1
By: ino zuii javier
 ALVEOLI ● DEAD SPACE
o Starts from nose to terminal bronchiole
o Where there is no gas exchange
o 150 ml

● 700 SF surface area

● Consists of :
1. Type I alveolar cells (95%), thin
2. Type II alveolar cells (5%), secrete
surfactant
3. Macrophages (dust cells), defense

SUMMARY: ANATOMY OF THE RESPIRATRY

SYSTEM
● The Respiratory Tract
● The Lungs
● Each alveolus is surrounded with a basket of
capillaries ● Alveoli
● Alveoli contain elastic fibers which helps expiration
● Gas exchange occurs only in alveoli
● Low blood pressure keeps alveoli dry

● The respiratory membrane
1. The wall of the alveolus
2. The endothelial wall of the capillary
3. Their fused basement membranes
MECHANICS OF VENTILATION
● Driving Force for Air flow
● Resistance to Airflow
● Measurements of Ventilation
● Alveolar Ventilation
● Terms:
o Inspiration or inhalation: breathing in
o Expiration or exhalation: breathing out

By: ino zuii javier

 DRIVING FORCE FOR AIR FLOW
● Airflow driven by the pressure difference between
atmosphere (barometric pressure) and inside the
lungs (intrapulmonary pressure)

● During inspiration: the volume of air in the lungs

increases while the pressure decreases
● During expiration: the volume of air in the lungs
decreases but the pressure will be increased
● According to Boyle's law, if a given amount of gas
has a constant temperature, increasing its volume
decreases its pressure, and vice-versa.

MAJOR RESPIRATORY MUSCLES

● The diaphragm
● External Intercostal Muscles
● Internal Intercostal Muscles
● The Abdominal Muscles

1. The diaphragm
o The principal muscle of inspiration
o Pulls the diaphragm down, increasing all
three dimension of the thoracic cage
2. External Intercostal Muscles
o Inspiration muscles
o Increases the anteroposterior and
transverse dimensions of the chest
3. The Abdominal Muscles
o Expiration muscles
o Pulls the diaphragm up, reducing the
vertical dimension of the thoracic cage
4. The Abdominal Muscles
o Extra Expiration Muscles

COUPLING BETWEEN LUNGS AND THORACIC

CAGE
● The lungs and thoracic cage are coupled by the
pleurae.
o Visceral pleura covers the surface of each
lung; parietal pleura lines the chest cavity
● The two pleurae form the pleural cavity
● The pleural fluid serves the reduce friction during
chest expansion
● Intrapleural pessure: Th pressure in the pleural
MECHANISMS FOR THE CHANGE IN cavity is negative
INTRAPULMONARY PRESSURE
● Boyle’s law: Volume x Pressure = Constant

By: ino zuii javier

 FORCED EXPIRATION: ACTIVE
● Relaxation of:
o Diaphragm
o External Intercostal Muscles
o Contraction of abdominal, internal
intercostal and other accessory respiratory
muscles

● Generation of the negative intrapleural pressure

o The thoracic cage is larger than the natural
size of the lungs

SUMMARY: DRIVING FORCE FOR AIR FLOW

● Atmosphere-lung pressure gradient
● Major Respiratory Muscles
● Coupling between lungs and thoracic cage

RESISTANCE TO AIRFLOW
● RESISTANCE
o Alveolar Surface Tension
o Elastic Resistance
o Airway Resistance
● COMPLIANCE
INSPIRATION: ACTIVE
ALVEOLAR SURFACE TENSION
● Contraction of:
o Diaphragm ● Generated by a thin film of liquid over the surface of
o External Intercostal Muscles alveolar epithelium
● Tends to cause a collapse of the alveoli

RESTING EXPIRATION: PASSIVE

● Relaxation of: ● Resists against inspiration
o Diaphragm ● Surface tension is reduced by surfactant (type II
o External Intercostal Muscles alveolar epithelial cells)
● Pre-term infants don’t have enough surfactant

By: ino zuii javier

 ELASTIC RESISTANCE CHANGES IN SPIROMETRIC MEASURES
● Against inspiration due to elastic fibers in the lungs ● RESTRICTIVE DISORDERS
and chest wall o Pulmonary fibrosis
● Increases in pulmonary fibrosis o ↓compliance and ↓vital capacity (decrease)
● OBSTRUCTIVE DISORDERS
AIRWAY RESISTANCE o No change in respiratory volumes
o ↓FeV1.
● Due to friction, affected by airway caliber o One-second forced expiratory volume
● Against inspiration and respiration
● Increases during asthma attack (smooth muscle
contraction in bronchiole)

COMPLIANCE
● Reciprocal of resistance
● Indicator of ease with which the lungs expand

● SPIROMETER
o Diagnostic device that measures the
amount of air you're able to breathe in and
out and the time it takes you to exhale
completely after you take a deep breath.
o A spirometry test requires you to breathe
SUMMARY: MECHANICS OF VENTILATION
into a tube attached to a machine called a
spirometer. ● Driving Force for Air Flow
● Resistance to Airflow
● Measurements of Ventilation
● Alveolar Ventilation

NEURAL CONTROL OF VENTILATION

CENTER IN THE MEDULLA OBLONGATA

● INSPIRATORY CENTER
o Stimulates inspiration muscles
● EXPIRATORY CENTER
o Inhibits the respiratory center
o Stimulates expiration muscles

By: ino zuii javier

 AFFERENT CONNECTIONS TO THE RESPIRATORY ● The the partial pressure of a gas refers to the share
CENTERS of the total pressure generated by a mixture of gases

● Oxygen and carbon dioxide cross the respiratory

membrane and the air-water interface easily

CHEMORECEPTOR-INITIATED REFLEXES
● Peripheral Chemoreceptors
o Aortic and carotid bodies
o Monitor O2, CO2, and pH of
the blood

● Central Chemoreceptors
o Close to the surface of the
medulla oblongata
o Monitor the pH of the
● Blue UN-oxygenated
cerebrospinal fluid
● Red oxygenated

OVERVIEW OF GAS EXCHANGE IN THE LUNGS

● Voluntary Control
o The motor cortex
o Bypass the brainstem respiratory centers
o Limited voluntary control

GAS EXCHANGE IN THE LUNGS FACTORS THAT AFFECT THE EFFICIENCY OF

● The gas exchange between alveolar air and the ALVEOLAR GAS EXCHANGE
blood is via diffusion of O2 and CO2 ● Partial pressure
● Diffusion of a gas is driven by O2 and CO2 partial ● Solubility
pressure gradient
● Respiratory membrane thickness/area
● Ventilation-perfusion coupling

PARTIAL PRESSURE
o High altitude
o Hyperbaric chamber
o Obstructive disease

By: ino zuii javier

 SOLUBILITY ● BLOOD OXYGEN CONTENT
o Average 20 ml/dL
o Determined by:
1. Saturation of hemoglobin:
Hypoventilation CO poisoning
2. Content of hemoglobin: anemia
● Carbon monoxide competes with oxygen for
heme binding with a much higher affinity
o PROBLEM: deoxygenate hemoglobin
RESPIRATORY MEMBRANE THICKNESS/AREA o TREATMENT: hyperbaric oxygen chamber

GAS EXCHANGE IN TISSUES

1. Carbon Dioxide Loading
2. Oxygen Unloading

VENTILATION-PERFUSION COUPLING
o Average V-P ratio = 0.8
o Autoregulated by:
o ↓PO2 and ↑PCO2
▪ Vasoconstriction of pulmonary
arterioles
▪ Dilation of bronchioles

SUMMARY
● Driving Force for Gas Exchange
● Factors that affect the efficiency of alveolar
gas exchange

UTILIZATION COEFFICIENT
CARBON DIOXIDE TRANSPORT ● The amount of oxygen uptake by tissue versus the
arterial blood oxygen content
● 7% dissolved in the blood as a gas
● 23% as carbamino-hemoglobin
● 70% as carbonic acid in the plasma

OXYGEN TRANSPORT
● 98.5% of O2 in the blood are carried by hemoglobin
● The rest is physically dissolved in plasma

By: ino zuii javier

 FUNCTION OF OXYGEN

OXYGEN TOXICITY
● Excessive oxygen generates hydrogen peroxide
and free radicals, which destroy enzymes and
damage nervous tissue
● Oxidative toxicity with aging

HYPERCAPNIA
o PCO2 > 43 mmHg
o Caused by hypoventilation (respiratory
diseases)

HYPOCAPNIA
o PCO2 > 37 mmHg
o Caused by hyperventilation

By: ino zuii javier

By: ino zuii javier