RESPIRATORY SYSTEM

PHARMACOLOGY
 Upon completion of this chapter, you will be able to:

Describe the major structures of the respiratory system,

11 including the role of each in respiration

Describe the process of respiration, with clinical examples

22 of problems that can arise with alterations in the
O
B respiratory membrane
J
E
C Learning Diff erentiate between the common conditions that affect the
T 33 upper respiratory system
I
V
E
Objectives
S

44 Identify three conditions involving the lower respiratory tract,

including the clinical presentations of these conditions.

Discuss the process involved in obstructive respiratory

55 diseases, correlating this to the signs and
symptoms of these diseases.
 ST R U C T U R E A N D
01 FUNCTION OF
T H E R ES P I R ATO RY
SYS T E M
The respiratory system is essential for survival
 The respiratory system consists of t
wo major components:

upper respiratory tract lower respiratory tract.

composed of the made up of the

01 nose, mouth, pharynx,
02 bronchial tree
larynx, and
trachea
 T h e U p p e r R e s p i r a t o r y Tr a c t

The Upper Respiratory Tract

primarily involved in the movement of air in

and out of the body, called ventilation.

Air usually moves into the body through the

nose and into the nasal cavity

The nasal hairs catch and filter

foreign substances that may be present in the
inhaled air.
 T h e U p p e r R e s p i r a t o r y Tr a c t

The Upper Respiratory Tract

-The air is warmed and humidified as it passes by blood

vessels close to the surface of the epithelial lining in the
nasal cavity.
-The epithelial lining contains goblet cells that produce
mucus.
-This mucus traps dust, microorganisms, pollen, and any
other foreign substances.
-The epithelial cells of the lining also contain cilia—
microscopic, hair-like projections of the cell membrane—
which are constantly moving and directing the mucus and
any trapped substances down toward the throat
 T h e U p p e r R e s p i r a t o r y Tr a c t

-The action of the goblet cells and cilia is

commonly called the mucociliary
escalator

Pairs of sinuses (air-fi lled passages through

the skull) open into the nasal cavity

Because the epithelial lining

of the nasal passage is continuous with the lining of the
sinuses, the mucus produced in the sinuses drains into
the nasal cavity. From there, the mucus drains into the
throat and is swallowed into the gastrointestinal tract,
where stomach acid destroys foreign materials
Air moves from the nasal cavity into the pharynx
and larynx.

larynx contains the vocal chords and the

epiglottis, which closes during swallowing to protect the
lower respiratory tract from any foreign particles.

From
the larynx, air proceeds to the trachea, the main conducting airway into the lungs.

trachea bifurcates, or divides, into two main bronchi, which further divide into smaller and
smaller branches

All of these tubes contain mucus-producing goblet cells and cilia to entrap any particles that
may have escaped the upper protective mechanisms.
The cilia in these tubes move the mucus up the
trachea and into the throat, where again it is swallowed

The walls of the trachea and conducting bronchi are highly sensitive to irritation.

When receptors in the walls are stimulated, a central nervous system refl ex is initiated
and a cough results.

The cough causes air to be pushed through the bronchial tree

under tremendous pressure, cleaning out any foreign irritant.

This reflex, along with

the similar sneeze reflex (which is initiated by receptors
in the nasal cavity), forces foreign materials directly out
of the system, opening it for more effi cient fl ow of gas.
Throughout the airways, many macrophage scavengers freely move about the epithelium and
destroy invaders.

Mast cells are present in abundance and release

histamine, serotonin, adenosine triphosphate, and other
chemicals to ensure a rapid and intense inflammatory
reaction to any cell injury.

The end result of these various defense mechanisms is that the lower respiratory
tract is virtually sterile—an important protection against
respiratory infection that could interfere with essential
gas exchange.
 T h e L o w e r R e s p i r a t o r y Tr a c t

The Lower Respiratory Tract

composed of the bronchial tree, the smallest

bronchioles, and the alveoli

The bronchial tubes are composed of three

layers: cartilage, muscle, and epithelial cells.
 T h e L o w e r R e s p i r a t o r y Tr a c t
muscles also keep the bronchi open

muscles in the bronchi become smaller

and less abundant, with only a few muscle fi bers
remaining in the terminal bronchi and
alveoli.

alveoli at the end of the bronchioles form

the respiratory membrane.

These structures
are the functional units of the lungs where
gas exchange occurs
The lungs are two spongy organs that fi ll the chest cavity.

They are separated by the mediastinum, which

contains the heart, esophagus, thymus gland, and various blood vessels and nerves.

The lungs are made up of the bronchial tree, the alveoli, the blood supply to the lungs, and the
blood coming from the right ventricle to the alveoli for gas exchange and elastic tissue, which is
important in allowing the expansion and recoil of the lungs to allow ventilation

left lung is composed of two lobes or sections, and the right lung is composed
of three lobes.

The lung tissue receives its blood supply from the bronchial artery, which branches directly
off the aorta.
The alveoli receive unoxygenated blood from the right ventricle via the pulmonary artery.
The delivery of this blood to the alveoli is referred to as pulmonary perfusion.
 Gas Exchange

Gas exchange occurs in the alveoli. In this

process, carbon dioxide is lost from the blood
and oxygen is transferred to the blood.

exchange of gases at the alveolar

level is called respiration.

alveolar sac holds the gas, allowing needed

oxygen to diffuse across the respiratory
membrane into the capillary while carbon
dioxide, which is more abundant in the
capillary blood, diffuses across the membrane
and enters the alveolar sac to be expired.
 Gas Exchange

The respiratory membrane is made up of the

capillary endothelium, the capillary basement
membrane, the interstitial space, the alveolar
basement membrane, the alveolar epithelium,
and the surfactant layer

The sac is able to stay open because the

surface tension of the cells is decreased by
the lipoprotein surfactant.
 Gas Exchange

Absence of surfactant leads to alveolar

collapse. Surfactant is produced by the type II
cells in the alveoli. These cells have other
metabolic functions, including the
conversionof angiotensin I to angiotensin II,
the degradation of serotonin, and possibly the
metabolism of various hormones

The oxygenated blood is returned to the left

atrium via the pulmonary veins; from there it is
pumped throughout the body to deliver
oxygen to the cells and to pick up waste
products
 R e s p i r a ti o n

Respiration, or the act of breathing to allow

gasexchange, is controlled by the central
nervous system.

inspiratory muscles—diaphragm, external

intercostals, and abdominal muscles—are
stimulated to contract by the respiratory
center in the medulla.

medulla receives input from chemoreceptors

(neuroreceptors sensitive to carbon dioxide
and acid levels) to increase the rate and/or
depth of respiration to maintain homeostasis
in the body
 R e s p i r a ti o n

The vagus nerve, a predominantly

parasympathetic nerve, plays a key role in
stimulating diaphragm contraction and
inspiration.

Vagal stimulation also leads to a

bronchoconstriction or tightening.

The sympathetic system also innervates the

respiratory system. Stimulation of the
sympathetic system leads to increased rate
and depth of respiration and dilation of the
bronchi to allow freer fl ow of air through the
system.
 KEY POINTS

■ The respiratory system has two parts: the ■ Gas exchange occurs across the respiratory
upper respiratory tract, which includes the 01 03 membrane in the alveolar sac. The type 2 cells
nose, pharynx, larynx, and trachea, and the of the alveoli produce surfactant, which
lower respiratory tract, which includes the reduces surface tension to keep the alveoli
bronchial tree and alveoli. Gas exchanges open for gas exchange
occur in the alveoli

■ Nasal hairs, mucus-producing goblet cells,

cilia, the superficial blood supply of the upper
The medulla controls respiration, which
respiratory tract, and the cough and sneeze refl
exes all work to keep foreign substances from
02 depends on a functioning muscular system and

entering the lower respiratory tract. 04 a balance between the sympathetic and
parasympathetic systems.