ANATOMY AND PHYSIOLOGY

Human
Respiratory System

The respiratory system consists of all the organs involved in breathing. These include the
nose, pharynx, larynx, trachea, bronchi and lungs. The respiratory system does two very
important things: it brings oxygen into our bodies, which we need for our cells to live and
function properly; and it helps us get rid of carbon dioxide, which is a waste product of
cellular function.

The respiratory system has many different parts that work together to help a person breathe.
Each group of parts has many separate components.

The airways deliver air to the lungs. The airways are a complicated system that includes:
 Mouth and nose: Openings that pull air from outside of the body into the respiratory
system.
 Sinuses: Hollow areas between the bones in the head that help regulate the temperature
and humidity of the air being inhaled.
 Pharynx (throat): Tube that delivers air from mouth and nose to the trachea.
 Trachea(windpipe): Passage connecting throat and lungs.
 Bronchial tubes: Tubes at the bottom of the windpipe that connect into each lung.
 Lungs: Two organs that remove oxygen from the air and pass it into the blood.

From the lungs, the bloodstream delivers oxygen to all other organs and tissues.

Muscles and bones help move the air being inhaled into and out of the lungs. Some of the
bones and muscles in the respiratory system include:

 Diaphragm: Muscle that helps lungs pull in air and push it out.
 Ribs: Bones that surround and protect the lungs and heart.

When a person breaths out, the blood carries carbon dioxide and other waste out of the body.
Other components that work with the lungs and blood vessels include:

 Alveoli: Tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide
takes place.
 Bronchioles: Small branches of the bronchial tubes that lead to the alveoli.
 Capillaries: Blood vessels in the alveoli walls that move oxygen and carbon dioxide.
 Lung lobes: Sections of the lungs — three lobes in the right lung and two in the left
lung.
 Pleura: Thin sacs that surround each lung lobe and separate your lungs from the chest
wall.

Some of the other components of your respiratory system include:

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

LUNGS

 Location. The lungs occupy the entire

thoracic cavity.
 Division. Each lung is divided into
lobes by fissures; the left lung has two
lobes, and the right lung has three.
 Bronchioles. The smallest of the
conducting passageways are the
bronchioles.
 Alveoli. The terminal bronchioles lead
to the respiratory zone structures, even
smaller conduits that eventually
terminate in alveoli, or air sacs.
 Respiratory zone. The respiratory
zone, which includes the respiratory
bronchioles, alveolar ducts, alveolar
sacs, and alveoli, is the only site of gas
exchange.
 Conducting zone structures. All other respiratory passages are conducting zone
structures that serve as conduits to and from the respiratory zone.
Coverings of the Lungs

 Serosa covers the outer surface of the lungs

 Pulmonary (visceral) pleura covers the lung surface

 Parietal pleura lines the walls of the thoracic cavity

 Pleural fluid fills the area between layers to allow gliding and decrease friction during
breathing.
 Pleural space (between the layers) is more of a potential space.

The Respiratory Membrane

 Thin squamous epithelial layer lines alveolar walls.

 Alveolar pores connect neighboring air sacs.
 Pulmonary capillaries cover external surfaces of alveoli.
 Respiratory membrane (air-blood barrier).
 On one side of the membrane is air, and on the other side is blood flowing past.
 Formed by alveolar and capillary walls.
 Gas crosses the respiratory membrane by diffusion
 Oxygen enters the blood
 Carbon dioxide enters the alveoli
 Alveolar macrophages (“dust cells”) add protection by picking up bacteria, carbon
particles, and other debris.
 Surfactant (a lipid molecule) coats gas-exposed alveolar surfaces.

Four Events of Respiration

1. Pulmonary ventilation - moving air into and out of the lungs (commonly called
breathing).
2. External respiration - gas exchange between pulmonary blood and alveoli.
 Oxygen is loaded into the blood.
 Carbon dioxide is unloaded from the blood.
3. Respiratory gas transport - transport of oxygen and carbon dioxide via the bloodstream.
4. Internal respiration - gas exchange between blood and tissue cells in systemic capillaries.

Mechanics of Breathing (Pulmonary Ventilation)

Two phases:
1. Inspiration = inhalation
 Flow of air into lungs
 Diaphragm and external intercostal muscles contract
 The size of the thoracic cavity increases
 External air is pulled into the lungs as a result of:
 Increase in intrapulmonary volume
 Decrease in gas pressure
 Air is sucked into the lungs
2. Expiration = exhalation
 Air leaving lungs
 Largely a passive process that depends on natural lung elasticity.
 As muscles relax, air is pushed out of the lungs as a result of:
 Decrease in intrapulmonary volume
 Increase in gas pressure
 Forced expiration can occur mostly by contraction of internal intercostal muscles to
depress the rib cage.

 Normal pressure within the pleural space is always negative (intrapleural pressure).
 Differences in lung and pleural space pressures keep lungs from collapsing.
 Atelectasis is collapsed lung.
 Pneumothorax is the presence of air in the intrapleural space.

External Respiration, Gas Transport, and Internal Respiration
 Gas exchanges occur as a result of diffusion.
 Movement of the gas is toward the area of lower concentration.

External Respiration
 Oxygen is loaded into the blood
 The alveoli always have more oxygen than the blood
 Oxygen moves by diffusion towards the area of lower concentration
 Pulmonary capillary blood gains oxygen
 Carbon dioxide is unloaded out of the blood
 Blood returning from tissues has higher concentrations of carbon dioxide than
air in the alveoli
 Pulmonary capillary blood gives up carbon dioxide to be exhaled
 Blood leaving the lungs is oxygen rich and carbon dioxide poor
Gas Transport in the Blood
 Oxygen transport in the blood
 Most oxygen travels attached to hemoglobin andforms oxyhemoglobin (HbO2)
 A small dissolved amount is carried in the plasma

 Carbon dioxide transport in the blood

 Most carbon dioxide is transported in the plasma asbicarbonate ion (HCO3–)
 A small amount is carried inside red blood cells on hemoglobin, but at different
binding sites from those of oxygen

Internal Respiration
 Exchange of gases between blood and body cells
 An opposite reaction to what occurs in the lungs
 Carbon dioxide diffuses out of tissue to blood (called loading)
 Oxygen diffuses from blood into tissue (called unloading)
Liver
 Largest solid organ in the body.
 It is reddish-brown and shaped approximately like a cone or a wedge, with the small end
above the spleen and stomach and the large end above the small intestine.
 Located below the lungs in the right upper abdomen.
 Weighs between 3 and 3.5 pounds.

Have 2 distinct sources that supply blood to the liver, including the following:
Oxygenated blood flows in from the hepatic artery
Nutrient-rich blood flows in from the hepatic portal vein

Structure
The liver consists of four lobes: the larger right lobe and left lobe, and the smaller
caudate lobe and quadrate lobe. The left and right lobe are divided by the falciform (“sickle-
shaped” in Latin) ligament, which connects the liver to the abdominal wall. The liver’s lobes
can be further divided into eight segments, which are made up of thousands of lobules (small
lobes). These lobules are connected to small ducts (tubes) that connect with larger ducts to
form the common hepatic duct. The common hepatic duct transports the bile made by the
liver cells to the gallbladder and duodenum (the first part of the small intestine) via the
common bile duct.
Parts
The following are some of the most important individual parts of the liver:

1. Common Hepatic Duct: A tube that carries bile out of the liver. It is formed from the
intersection of the right and left hepatic ducts.
2. Falciform Ligament: A thin, fibrous ligament that separates the two lobes of the liver
and connects it to the abdominal wall.
3. Glisson’s Capsule: A layer of loose connective tissue that surrounds the liver and its
related arteries and ducts.
4. Hepatic Artery: The main blood vessel that supplies the liver with oxygenated blood.
5. Hepatic Portal Vein: The blood vessel that carries blood from the gastrointestinal tract,
gallbladder, pancreas, and spleen to the liver. 
6. Lobes: The anatomical sections of the liver.
7. Lobules: Microscopic building blocks of the liver.
8. Peritoneum: A membrane covering the liver that forms the exterior.

Functions of the Liver

 Albumin Production: Albumin is a protein that keeps fluids in the bloodstream from
leaking into surrounding tissue. It also carries hormones, vitamins, and enzymes through
the body.
 Bile Production: The bile produced in the liver essential for the digestion of fats. Bile is
formed in the liver, stored in the gallbladder or released directly into the small intestine.
After being stored in the gallbladder, the bile becomes more concentrated than when it
left the liver; this increases its potency and intensifies its effect in digesting fats.
 Filters Blood: All the blood leaving the stomach and intestines passes through the liver,
which removes toxins, byproducts, and other harmful substances.
 Regulates Amino Acids: The production of proteins depend on amino acids. The liver
makes sure amino acid levels in the bloodstream remain healthy.
 Regulates Blood Clotting: Blood clotting coagulants are created using vitamin K, which
can only be absorbed with the help of bile, a fluid the liver produces.
 Resists Infections: As part of the filtering process, the liver also removes bacteria from
the bloodstream. 
 Stores Vitamins and Minerals: The liver stores significant amounts of vitamins A, D,
E, K, and B12, as well as iron and copper.
 Processes Glucose: The liver removes excess glucose (sugar) from the bloodstream and
stores it as glycogen. As needed, it can convert glycogen back into glucose.

Cellular unit of Liver

Lobule
The functional unit of the liver is the
lobule. Each lobule is hexagonal and a portal triad
(portal vein, hepatic artery, bile duct) sits at each
corner of the hexagon. The foundation of the
lobule is composed of hepatocytes, which have
physiologically distinct apical and basolateral
membranes. Based on function and perfusion,
hepatocytes are divided into 3 zones.
Zone I is considered to be the periportal region of hepatocytes and are the best perfused and
first to regenerate due to their proximity to oxygenated blood and nutrients. Due to its high
perfusion, zone I plays a large role in oxidative metabolisms such as beta-oxidation,
gluconeogenesis, bile formation, cholesterol formation, and amino acid catabolism.
Zone II is defined as the pericentral region of the hepatocytes and zone II sits between
zones I and III.
Zone III has the lowest perfusion due to its distance from the portal triad. It plays the
largest role in detoxification, biotransformation of drugs, ketogenesis, glycolysis, lipogenesis,
glycogen synthesis, and glutamine formation.
Bile flow is further facilitated by bile canaliculi, which are formed by apical
membranes of neighboring hepatocytes. Due to the 3-dimensional arrangements of
hepatocytes, the canaliculi form a lattice-like network or “chicken-wire pattern,” that helps
increase the surface area of flow. It is important to recognize that bile and blood flow in
opposite directions to each other. This makes sense as the liver produces bile, so bile in the
ducts are leaving the liver; whereas, the dual blood supply is entering the liver to perfuse it.
Blood drains into the branch of the hepatic vein that lies in the lobule's center via sinusoidal
lumens of the lobule.
The space between the sinusoidal lumen and the surrounding basolateral membrane of
hepatocytes is called the space of Disse. This space is occupied by microvilli extending from
the basolateral membrane of the hepatocytes that communicate with the capillary, allowing
the hepatocyte to reach its' blood supply. The space of Disse houses an extracellular matrix
composed of a variety of collagens, proteoglycans, and other proteins that help provide
scaffolding for the hepatocytes and, by extension, the lobule as a whole. The importance of
the scaffolding that takes place in the space of Disse is amplified further by the fact that
hepatocytes do not contain a true basement membrane. The space of Disse also contains
Kupffer cells (macrophages) and Ito cells (stellate cells). The Kupffer cells sit in the space to
filter out unnecessary or pathologic material from the circulation. The Ito cells serve as
storage for fat, such as vitamin A. In the right setting, they can also serve as myofibroblasts
and aid in the regeneration of the liver.
Liver blood supply
Liver actually has a lot of blood supply in order to be oxygenated and in order to
receive nutrients, it have the artery which the aorta coming from the heart which brings
oxygenated blood into body tissues then there's this capillaries of general circulations where
the tissues will then use up the oxygen. Now this blood supply will be deoxygenated it will be
low in oxygen concentration and this deoxygenated blood supply will go back to the heart
through the inferior vena cava.
The artery going into the liver is known as a hepatic artery and this gives the liver
oxygenated blood it gives the liver oxygen to function the artery giving oxygen to intestines
is known as the MIS enteric artery once the spleen stomach and intestine has used the oxygen
from the blood supply the blood supply will be deoxygenated and this deoxygenated blood
supply will be return through veins and actually this vein will not go back to the heart but will
go towards the liver as a big vein known as the portal vein and these veins carry nutrients
from the stomach spleen and the intestines and that is how the liver receives nutrients. In
short we have the hepatic artery bringing oxygen and we have the portal vein bringing in
nutrients and then the liver once it's used all these oxygen there will be another vein leaving
the liver known as the hepatic vein which connects to the inferior vena cava which then goes
back to the heart.
Hepatic cells are organized within the liver and how the the blood supply with oxygen
coming in the portal veins nutrients coming in and that a grain leaving the liver all connects
together and coincide within this organized structure well the liver is over organized in a
hexagonal sort of shape known as a lobby alike called lobule, each lobule here contains many
types of hepatic cells a liver cells. In the center of the lobule we have this central vein which
essentially connects to the hepatic vein we also have liver sinusoids and they they run from
the central vein into the portal triad,they connect with the portal triads. Portal triads consist of
three things the portal vein, the bile duct and the hepatic artery. All these veins connect with
each other and all these three connect with the central vein and this is how the liver receives
its oxygen receives its nutrients and how it sends out bile from the liver into the bile duct.