Physiology of Respiratory System: Gusbakti Prof .DR Physiology University MUHAMMADYAH North Sumatra

Physiology of Respiratory System
Gusbakti
Prof .Dr Physiology
University MUHAMMADYAH North Sumatra
gus17
Functions
1. Gas exchange
2. Regulation of blood ph
3. Voice phonation
4. Olfaction
5. Innate immunity
gus17
Anatomy
Upper Respiratory tract

Nose, nasal cavity, pharynx and associated structures
Lower Respiratory tract

Larynx, trachea, bronchi, and lungs
gus17
Upper Respiratory Tract
gus17
Anatomy
gus17
Nose and Nasal Cavity
Epithelial lining
 Stratified squamous epithelium with coarse hair,
traps dust particles and humidifies air.
 Pseudostratified ciliated columnar epithelium with

goblet cells
gus17
gus17
 Nares (nostrils), external opening

 Choane, openings into the pharynx
 Nasal septum, divides the cavity in to left and
right halves
 Hard palate, floor of the nasal cavity
 Conchae, prominent bony ridges on the lateral
wall of each nasal cavity
– Increase surface area
gus17
gus17
Paranasal Sinuses
 Paranasal sinuses, air filled spaces with in the

bone (skull)
 Maxillary, frontal, ethmoidal and sphenoidal
– Open into the nasal cavity
– Reduce weight, produce mucus and act as resonating
chambers
– Susceptible to infection and inflammation
 Nasolacrimal duct
gus17
Paranasal Sinuses
gus17
Paranasal Sinuses
gus17
Paranasal Sinuses
1.Sinus frontalis
2.Cellulae ethmoidales
3.Septum nasi
4.Concha nasalis inferior
5.Processus alveolaris
mandibulae with teeth
6.Sinus maxillaris
7.Margo infraorbitalis
8.Linea innominata
9.Lamina orbitalis ossis
ethmoidalis
10.Margo supraorbitalis
gus17
Pharynx
Common passageway for air and solid particles.

Leads to the respiratory and digestive systems.
3 regions:
1. Nasopharynx
2. Oropharynx
3. Laryngopharynx
gus17
Pharynx
gus17
Pharynx (Nasopharynx)
Superior part of the pharynx,
from the choane to the
level of the uvula.
 Soft palate, floor of the
nasopharynx
 Auditory tubes opens into
the nasopharynx
 Pharyngeal tonsils
gus17
Pharynx
gus17
Pharynx (Oropharynx)
From the uvula to the
epiglottis
 Palatine tonsils, lateral
walls near the border oral
cavity and oropharynx
 Lingual tonsils, surface on
the posterior part of the
tongue
gus17
Pharynx
gus17
Pharynx (Laryngopharynx)
Posterior to the larynx and
extend from the tip of the
epiglottis to the esophagus
gus17
Lower Respiratory Tract
gus17
Larynx
 Connected superiorly to
the pharynx and inferiorly
to the trachea.
 Consist of 3 unpaired and
6 pair cartilages
gus17
Larynx (Function)
 Open passageway, prevent swallowed material

from the larynx
 Primary source of sound production.
gus17
Larynx (Function)
Air moving past vocal cords causes vibration.

 The greater the amplitude (greater force of air) of
vibrations the louder the sound.
 The frequency of vibrations determines pitch.
– Higher pitched tones are produced only when the
anterior portions vibrate and progressively lower tones
as the length of the involved cords increases
gus17
Larynx (Unpaired Cartilages)
 Thyroid cartilage (Adams apple), superiorly

attached to the hyoid bone
 Cricoid cartilage, base of the larynx
 Epiglottis, made of elastic cartilage. Its inferior
margin is attached to the thyroid cartilage
anteriorly and it superior part projects freely
toward the tongue
gus17
Larynx (Unpaired Cartilages)
gus17
Larynx
gus17
Larynx (Epiglottis)
 During swallowing, the larynx elevates and the

epiglottis moves posteriorly to cover the opening
of the pharynx
gus17
Larynx (Epiglottis)
gus17
Larynx (Paired Cartilages)
Posterior side of the pharynx

 Cuneiform cartilage, superiorly located
 Corniculate cartilage, middle
 Arythenoid cartilage, inferiorly located and
articulated with the cricoid cartilage
gus17
Larynx
gus17
Larynx (Vocal Cords)
Ligaments
 Vestibular folds (false
vocal cords)
 Vocal cords (true vocal
cords)
gus17
Larynx (Vocal Cords)
gus17
Trachea
 Membranous tube that
consists of dense
connective tissue and
smooth muscle reinforced
with “C” shaped cartilage
 Trachealis muscle –
contraction of this smooth
muscle narrows the
diameter of the trachea
gus17
Trachea
 Primary bronchi – trachea divides to form two

smaller tubes.
 Carina – the most inferior tracheal cartilage, which
separates the opening into the two primary
bronchi. It is very sensitive to mechanical
stimulation and foreign objects reaching it will
produce a powerful cough.
gus17
Trachea
gus17
Trachea
gus17
Trachea
gus17
Tracheobronchial Tree
 Beginning with the trachea, all respiratory

passageways
– Main bronchi → lobar bronchi (2 left, 3 right) →
segmental bronchi (bronchopulmonary segments) →
bronchioles → terminal bronchiole → respiratory
bronchioles → alveolar duct → alveoli
 Conducting zone: From the trachea to the terminal
bronchioles
 Respiratory zone: Extends from terminal
bronchioles to alveoli
gus17
gus17
gus17
gus17
gus17
Tracheobronchial Tree (Alveoli)
 The tissue surrounding the alveoli contain elastic

fibers that allow the alveoli to expand and recoil.
 Type I pneumocytes – form 90% of alveolar wall,
gas exchange
 Type II pneumocytes – secretory cells that
produce surfactant
gus17
gus17
Respiratory membrane – of the lungs is where gas
exchange between air and blood takes place.
To facilitate the diffusion of gases

– Thin layer of fluid lining the alveolus
– Alveolar epithelium simple squamous epithelium
– Basement membrane of the alveolar epithelium
– Thin interstitial space
– Basement membrane of capillary endothelium
– Capillary endothelium simple squamous epithelium
gus17
a = alveoli, with thin
interalveolar septa
between them
b = smooth muscle in its
wall
c = blood vessel, filled
with r.b.c.'s
d = bronchiole
gus17
gus17
gus17
Lungs
Principal organs of respiration

 Hilum – region on the medial surface for entry and
exit of blood vessels, lymphatic vessels, nerves,
and primary bronchus
 Root of the lung – all structures passing through
the hilum
 Right lung has three lobes.
 Left lung has 2 lobes.
gus17
Lungs
gus17
Lungs
gus17
Lungs
gus17
Lungs
gus17
Lungs
gus17
Lungs
gus17
Lungs
gus17
Muscles of Respiration
 Diaphragm – dome shaped, attaches to the inner

circumference of the inferior thoracic wall.
 Inspiration – diaphragm, external intercostals
pectoralis minor, and scalenes.
 Expiration – diaphragm, abdominal muscles and
internal intercostals.
gus17
MECHANICS OF
BREATHING
 It includes forces that support and move the
chest wall & the lung, together with
resistances they overcome and the resulting
flows
Muscles of respiration
Muscles of respiration cont..
• Muscles of inspiration-
1) Diaphragm
- attached to lower ribs, sternum
& vertebral column
- dome shaped
- moves down on contraction
- supplied by phrenic nerve
- increase vertical dimension of
thorax
- cause ribs to move outward &
upward
2) External intercostals-
- between adjacent ribs
- runs downwards &
forwards
- increase in AP & lateral
diameter
3) Accessory muscles of
inspiration
(i) scalenei- elevate first two
ribs
(ii) sternocleidomastoids-
elevate sternum
• Muscles of
expiration
1) Internal
intercostals- run
downwards &
backwards
2) Abdominal
muscles
-external oblique
-internal oblique
-rectus abdominis
-transversus
abdominis
Abdominal muscles
INSPIRATION
• Bucket handle
movement- lower
ribs(7-10) move out
increasing transverse
diameter
• Pump handle
movement- upper
ribs(2-6) move
forwards and upwards
increasing AP
diameter
EXPIRATION
gus17
gus17
Respiratory Physiology (Ventilation)
The process of moving air into and out of the lungs.

 The flow of air into the lungs requires a pressure
gradient from the outside of the body to the
alveoli.
 Airflow from the lungs requires a pressure
gradient in the opposite direction.
– Movement of air into and out of the lungs results from
changes in thoracic volume, which causes changes in
alveolar pressure
gus17
gus17
 Atmospheric Pressure (Patm) - pressure exerted by

the air surrounding the body. At sea level its equal
to 760mmHg. For our purposes, we'll assume it to
be constant and assign it a value of 0mmHg.
gus17
 Intrapulmonary Pressure (Palv) - pressure exerted

by the air within the alveoli. It rises and falls
during inspiration and expiration, but it always
equalizes with atmospheric pressure.
gus17
 Intrapleural Pressure (Pip) - pressure within the

pleural cavity. It is always lower than both
atmopsheric pressure and intrapulmonary
pressure.
gus17
gus17
gus17
gus17
gus17
gus17
Respiratory Physiology
Lung recoil - causes the alveoli to collapse and it

results from
1. Elastic recoil caused by the elastic fibers in alveolar
walls.
2. Surface tension of the film of fluid that lines the
alveoli.
gus17
Respiratory Physiology
Surfactant - mixture of lipoprotein molecules form a

layer over the surface of the fluid within the
alveoli to reduce surface tension.
– Significantly reduces the tendency of the lungs to
collapse.
gus17
Respiratory Physiology (Gas Exchange)
The factors that influence the rate of gas diffusion

across the respiratory membrane include
1. Thickness of the membrane.

 Increasing membrane thickness decreases
diffusion
– Ex. Pulmonary edema, TB, Pneumonia
gus17
Pulmonary edema
gus17
Pulmonary edema
gus17
Pulmonary edema
CXR
 51 year old male with
shortness of breath.
 bilateral parahilar
infiltrates
gus17
2. Surface area
 Healthy normal individuals 70 square meters
 Decreases in area caused by diseases
– Ex. Emphysema, lung ca.
gus17
Emphysema
gus17
CXR
 65 y/o female with a
120 pack year history
of tobacco use.
– hyperaerated lungs
– flattened diaphragms
– narrow heart shadow
– widened rib spaces
– decreased vascular
markings
gus17
3. Partial pressure difference

 The difference between the partial pressure of the
gas in the alveoli and the partial pressure of gas in
the blood of the pulmonary capillaries.
 Pressure gradient diffuses from high to low.
gus17
Partial Pressure Difference
gus17
Respiratory Physiology (Gas Transport)
1. Molecular oxygen is carried in blood

– 98.5% bound to hemoglobin
– 1.5% in plasma.
 Binds in a reversible fashion.
2. Carbon dioxide is transported in three major ways

– 7% is transported dissolved in plasma.
– 23% transported in combination with blood proteins.
– 70% transported in the bicarbonate form.
 Binds in a reversible fashion.
gus17
3.Haldane effect – hemoglobin that has released its

oxygen binds more readily to carbon dioxide than
hemoglobin that has oxygen bound to it.
4. Chloride shift – Bicarbonate ion concentration
inside RBC’s are lowered by exchanging them for
chloride ions. As bicarbonate ions are produced,
carrier molecules in RBC membranes move
bicarbonate ions out of the RBC’s and chloride
ions into the cell.
gus17
4. Chloride shift – Bicarbonate ion concentration

inside RBC’s are lowered by exchanging them for
chloride ions. As bicarbonate ions are produced,
carrier molecules in RBC membranes move
bicarbonate ions out of the RBC’s and chloride
ions into the cell.
gus17
Regulation of Respiration (CNS)
CNS
 Medullary respiratory system – dorsal
portion of medulla oblongota, and ventral
portion.
– Although the dorsal and ventral respiratory
groups are bilateral, cross communication does
exist, so that respiratory movements are
symmetrical
gus17
 Dorsal respiratory system is most active during

inspiration but is responsible for stimulation of the
diaphragm.
 Ventral respiratory group is active during both
inspiration and expiration. Stimulate the external
and internal intercostals, and abdominal muscles.
 Pontine Respiratory group – neurons in the pons,
some are active in expiration or inspiration and/or
both.
gus17
gus17
Regulation of Respiration
(Cerebral and Limbic System Control)
 Possible to voluntarily or involuntarily to control
rate of breathing through the cerebral cortex.
 Apnea – absence of breathing.
 Voluntary apnea increases a greater and greater

urge to breathe due to increasing PCO2 levels.
gus17
RESPIRATORY CONTROL: A
SCHEMA
SENSORS
RECEPTORS
F INPUT
E
E
D
CENTER
F
E
B E
OUTPUT
A D
C B EFFECTORS
K A
C
K
VENTILATION
gus17
PONTO MEDULLARY
RESPIRATORY CENTERS
ALL ARE PAIRED & INTERCONNECTED
gus17
INSPIRATORY NEURONS
EXPIRATORY NEURONS
INFERIOR COLLICULUS
PNEUMOTAXIC CENTER
PONS APNEUSTIC CENTER
MEDULLA
PRE BOTTZINGER COMPLEX
OBLONGATA
DORSAL GROUP OF R NEURO
VENTRAL GROUP OF R NEUR
SPINAL CORD
gus17
RESPIRATORY CENTERS
1. PNEUMOTAXIC CENTER:
– Location: Upper Pons
– Absence causes APNEUSTIC BREATHING
(Esp when the vagi are cut)
– Curtails inspiratory activity & thus can increase
the rate of respiration
gus17
APNEUSTIC CENTER
 Location: Lower Pons
 Stimulates the Inspiratory Center and increases
Inspiration
 Gets feed back from Vagi & other Centers.
gus17
MEDULLARY RESPIRATORY
CENTERS
DORSAL GROUP VENTRAL GROUP
 Neurons diffusely  Has both Inspiratory
located in the NTS & Expiratory neurons
 All neurons are of the  Expiratory neurons
Inspiratory type found at Caudal &
 Generates the Rostral ends.
Inspiratory Ramp  Inspiratory neurons
Signal found in the central
 Is autorhythmic area.
gus17
RESPIRATORY CONTROL
ORGANIZATION:MODERN CONCEPT
 All the respiratory centers are termed as the

BULBOPONTINE RESPIRATORY NEURONAL
COMPLEX
 There is an inspiratory ramp generator called
Respiratory Control Pattern Generator: Pre Bottzinger
Complex
gus17
RESPIRATORY CONTROL
ORGANIZATION:MODERN CONCEPT
 The Inspiratory Off switch(IOS) is fine tuned

by PTC & the chemoreceptor drive.
 Both Neural & Chemical controls are well
coordinated.
gus17
PERIPHERAL INFLUENCES
ON RESPIRATORY CONTROL
 LUNG OR PULMONARY RECEPTORS:

– Receptors in and around the lungs.
 CHEMORECEPTORS
– Peripheral Chemoreceptors
– Central Chemoreceptors.
gus17
PERIPHERAL INFLUENCES
 The four influences from the lungs are:
– Pulmonary stretch receptors
– Lung irritant receptors
– J receptors
– Proprioceptors
 Along with the chemoreceptors, these
receptors send information to the respiratory
centers.
gus17
HERING BREUER(HB) REFLEX
 It is a ‘Volume’ reflex.
 Receptors are located in between the smooth
muscles of the small airways.
 These receptors are unmyelinated nerve
endings.
 They are stimulated by the change of shape of
the Airways.
gus17
HB INFLATION REFLEX
A NEGATIVE FEEDBACK SERVOCONTROL SYSTEM
INSPIRATION
TIDAL VOLUME >1lt
DECREASED TIME
FOR INSPIRATION
STRETCH OF THE AIRWAYS
INCREASED
RESPIRATORY RATE
gus17
HB INFLATION REFLEX
I
N
S
P
I
R
A
T
I
O 0.5 lts 1.0 Ltrs 1.5 lts 2.0 lts 2.5 lts 3.0lts 3.5lts
N
TIDAL VOLUME in Liters
T
gus17
HB DEFLATION REFLEX
 Excessive deflation of the lungs causes
Inspiration.
 This reflex prevents Atelectasis.
 Atelectasis is the collapse of the lungs.
 This reflex also opens up collapsed portions of
the lung.
gus17
CHEMICAL CONTROL:THE
THREE MAIN ‘CHEMICALS’
 OXYGEN
– PO2 levels in blood.
 CARBON DIOXIDE:
– PCO2 levels in blood.
 HYDROGEN ION:
– Concentration in blood.
CO2 & [H+] act centrally while the Oxygen
levels act on the peripheral chemoreceptors.
gus17
RESPIRATORY
CHEMORECEPTORS
 CENTRAL:
 CHEMORECEPTOR ZONE:
– BILATERAL
– LOCATED IN THE MEDULLA
– JUST BENEATH IT’S VENTRAL SURFACE
– HIGHLY SENSITIVE TO PCO2 AND [H+]
 FUNCTIONS BY STIMULATING THE
RESPIRATORY CENTERS:
– DRG,VRG & PTC.
gus17
CENTRAL
CHEMORECEPTORS
 PRIMARY STIMULUS:
– [H+]
 PERHAPS THE ONLY IMPORTANT
DIRECT STIMULUS FOR THE CENTRAL
CHEMORECEPTOR CELLS (MEDULLARY
CHEMORECEPTORS)
 But these ions do not cross the Blood Brain
Barrier
 So, the blood PCO2 level has more effect as
CO2 readily crosses the BBB.
gus17
STIMULATION BY
CARBONDIOXIDE
 Is not direct.
 Even the indirect effect of CO2 is most potent.
Why?
 Because CO2 easily crosses the BBB.
 Once it is across the BBB,
 CO2 + H2O H2CO3 H+ + HCO3-
 These increased H+ ions in the brain stimulate
the medullary chemoreceptors.
gus17
QUANTITATIVE EFFECT
OF H+ IONS
 The stimulatory effect of H+ ions increases
in the first few hours.
 It then decreases in the next 1 to 2 days.
 It comes down to about 1/5th the initial
effect.
 This is due to Renal readjustment of [H+] in
the circulating blood.
gus17
QUANTITATIVE EFFECT
OF H+ IONS
 The kidneys increase blood HCO3.
 This bicarbonate binds with the free H+ ions in
the blood & decreases their concentration.
 Bicarbonate also diffuses slowly past the BBB
and decreases the H+ ions in the brain.
 Therefore the effect of H+ ions is:
– POTENT: Acutely
– WEAK : Chronically.
gus17
EFFECT OF CO2
 Change in PCO2 between 35 to 75mmHg
causes peak increase in alveolar ventilation.
 Change in the normal range causes less than

tenth of change in alveolar ventilation.
gus17
EFFECT OF OXYGEN
The partial pressure of Oxygen has
no effect on the medullary
chemoreceptors.
It only has an effect on the peripheral

chemoreceptors.
gus17
PERIPHERAL
CHEMORECEPTORS
 There are two pairs of chemoreceptors:
– Aortic Bodies: located at the arch of aorta.
– Carotid bodies: located at the branching of the
common carotid arteries.
 Their functions are:
– To detect changes in the PO2
– To transmit nervous signals to the Respiratory
Centers.
gus17
PERIPHERAL
CHEMORECEPTORS
 These bodies have two types of special cells
called glomus cells.
 The type 2 glomus cells have special ion
channels sensitive to PO2.
 They fire the nerve endings and send signals
via:
– Aortic bodies: Vagi.
– Carotid bodies: Hering nerve &
Glossopharyngeal nerve.
gus17
PERIPHERAL
CHEMORECEPTORS
 Both these bodies receive their own special
blood supply through minute arteries, directly
from the trunk.
 Their blood flow is roughly 20 times their own
weight.
 THEY ARE ALL THE TIME EXPOSED
ONLY TO ARTERIAL BLOOD.
  PO2 stimulates these chemoreceptors
strongly.
gus17
ARTERIAL PO2 &
IMPULSES IN AORTIC
BODY
  PO2 especially between 60 and 30mm Hg

strongly stimulates the carotid bodies.
 This is the range wherein the Hb saturation
decreases.
gus17
EFFECT OF PO2
 When PCO2 & [H+] are kept constantly
normal,
 There is no effect if the PO2 is
>100mmHg
 If it falls below 100mmHg, ventilation
doubles upto 60 mmHg.
 It increases upto 5 times at very low PO2
levels
gus17
(Chemical Control of Ventilation)
 The Chemoreceptors involved with the regulation

of respiration responds to changes in hydrogen ion
concentration and PO2, or both.
 Chemosensitive areas are located in the medulla

oblongota.
 Peripheral Chemoreceptors are found in the

carotid and aortic bodies.
gus17
Regulation of Respiration (Effect of pH)
 Chemosensitive area of the medulla oblongota is

bathed in cerebrospinal fluid and is sensitive to
changes in pH.
 The chemosensitive area reacts indirectly to
change in blood pH.
 Carbon dioxide levels change pH.
 Respiratory system plays an important role in
acid-base balance.
gus17
(Effect of Carbon Dioxide)
 The major regulator of respiration.
 Hypercapnia – greater than normal levels of

carbon dioxide in the blood.
 Hypocapnia – lower than normal carbon dioxide

levels.
gus17
(Effect of Carbon Dioxide)
gus17
Regulation of Respiration (Effect of Oxygen)
 Hypoxia – decrease in oxygen levels below

normal levels.
 The effect of oxygen concentration in the blood

has a small role in regulation of respiration.
gus17
O2-Hemoglobin Dissociation Curve
Describes the percentage of hemoglobin saturated with oxygen at any
given PO2
gus17
gus17

Physiology of Respiratory System: Gusbakti Prof .DR Physiology University MUHAMMADYAH North Sumatra

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Physiology of Respiratory System: Gusbakti Prof .DR Physiology University MUHAMMADYAH North Sumatra

Uploaded by

Copyright:

Available Formats

Physiology of Respiratory System

Upper Respiratory tract

Lower Respiratory tract

 Pseudostratified ciliated columnar epithelium with

 Nares (nostrils), external opening

 Paranasal sinuses, air filled spaces with in the

Common passageway for air and solid particles.

 Open passageway, prevent swallowed material

Air moving past vocal cords causes vibration.

 Thyroid cartilage (Adams apple), superiorly

 During swallowing, the larynx elevates and the

Posterior side of the pharynx

 Primary bronchi – trachea divides to form two

 Beginning with the trachea, all respiratory

 The tissue surrounding the alveoli contain elastic

To facilitate the diffusion of gases

Principal organs of respiration

 Diaphragm – dome shaped, attaches to the inner

The process of moving air into and out of the lungs.

 Atmospheric Pressure (Patm) - pressure exerted by

 Intrapulmonary Pressure (Palv) - pressure exerted

 Intrapleural Pressure (Pip) - pressure within the

Lung recoil - causes the alveoli to collapse and it

Surfactant - mixture of lipoprotein molecules form a

The factors that influence the rate of gas diffusion

1. Thickness of the membrane.

3. Partial pressure difference

1. Molecular oxygen is carried in blood

2. Carbon dioxide is transported in three major ways

3.Haldane effect – hemoglobin that has released its

4. Chloride shift – Bicarbonate ion concentration

 Dorsal respiratory system is most active during

 Apnea – absence of breathing.

 Voluntary apnea increases a greater and greater

ALL ARE PAIRED & INTERCONNECTED

PONS APNEUSTIC CENTER

 All the respiratory centers are termed as the

 The Inspiratory Off switch(IOS) is fine tuned

 LUNG OR PULMONARY RECEPTORS:

TIDAL VOLUME >1lt

 Change in the normal range causes less than

It only has an effect on the peripheral

  PO2 especially between 60 and 30mm Hg

 The Chemoreceptors involved with the regulation

 Chemosensitive areas are located in the medulla

 Peripheral Chemoreceptors are found in the

 Chemosensitive area of the medulla oblongota is

 The major regulator of respiration.

 Hypercapnia – greater than normal levels of

 Hypocapnia – lower than normal carbon dioxide

 Hypoxia – decrease in oxygen levels below

 The effect of oxygen concentration in the blood

You might also like