Human Anatomy & Physiology: Chapter 21-1

Human Anatomy & Physiology
Second Edition
Chapter 21-1
The Respiratory System
PowerPoint® Lectures created by Suzanne Pundt, University of Texas at Tyler
Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved

Study guide
1. What is the difference between internal and external respiration?
2. As always, know the functions of the respiratory system. Be able to tell if a structure is
part of the 2 anatomical or 2 functional divisions – e.g. alveoli are part of the lower
respiratory system and the respiratory division.
3. Briefly describe the mucosa and some of the defense systems in place. Talk about the
functions of structures in the conducting portion of the respiratory system such as what
the mucosa and nasal conchae do (warm, moisten and filter the air).
4. Know the three parts of the pharynx and know generally the structure and function of
laryngeal components such as the epiglottis, thyroid cartilage, laryngeal prominence, and
vocal folds. How the sound is produced? The pitch of the sound is varied by what
factors? What is the phonation and the articulation?
5. Be able to trace the flow of air through the conducting and respiratory portions of the
respiratory system.
6. Know the main cell types of the alveoli and their functions.
7. Understand what surfactant is and what it does for the alveoli. Can you describe the
pleura?
8. What are the three steps of external respiration?

9. What do the terms anoxia and hypoxia mean?
10. Have a good understanding of Boyle’s law and how that drives the function of the lungs.
When pressure in the lungs goes down, air flows into the lungs. How does this happen
mechanically? In other words, what muscles are involved in expanding the volume of the
thoracic cavity? (By increasing the volume, we decrease the pressure, right?)
11. What is compliance? What factors influence compliance? Can you describe how
intrapulmonary and intrapleural pressures combine with the elastic components of the
lungs to keep lung tissue inflated?
12. Can you describe the difference between active and passive exhalation and inhalation?
Why is there a difference? What muscles are always used in breathing? What about
quiet versus forced breathing?
13. Describe the basic volumes of spirometry such as tidal volume, respiratory minute volume
and IRV and ERV. What is anatomic dead space?
14. Be able to discuss the gas laws (Dalton’s and Henry’s) and how they determine the
exchange of gasses in the alveoli. Know the basic composition of atmospheric air (%
composition of the four elements mentioned in the book). Can you explain why nitrogen
is not found in large quantities in our blood despite being the dominant gas in our
atmosphere? Can you list the reasons that make diffusion so efficient in our alveoli? If
given the partial pressures of gasses in blood and a tissue, can you explain which
direction those gasses will diffuse?
15. Can you further explain why gasses are more concentrated in blood and/or tissue?
How does the body maintain these gradients? (blood is constantly moving through
pulmonary circuit to be reoxygenated while tissues use the oxygen delivered to
metabolize food and are constantly creating CO 2).
16. Describe how oxygen and carbon dioxide are transported in the blood. What three tissue
factors control how much oxygen is off-loaded in the tissues? Who wins the oxygen tug
of war between fetal and maternal hemoglobin?
17. Describe the basic levels of control the brainstem has over respiration. Can you
describe the relationship between the DRG and the VRG? What structures in the pons
modify the DRG and VRG? What are the respiratory reflexes and how to they affect
breathing? Is respiration solely controlled by the brainstem?

Useful links
• https://www.youtube.com/watch?v=GERsMFWYZrw............ The Miracle Of
Respiration
• http://www.youtube.com/watch?v=5LjLFrmKTSA............................... Oxygen Transport

from Lungs to Cells
• https://www.youtube.com/watch?v=HYbvwMSzqdY …………………Oxygen
Hemoglobin Dissociation Curve
• https://www.youtube.com/watch?v=V2vR5_B6C5I........................... Sneeze, Cough,

and Hiccup
• https://www.youtube.com/watch?v=b89RSYCaUBo....................... How the Larynx

Produces Sound
• https://www.youtube.com/watch?v=-XGds2GAvGQ................ Vocal Cords up close

while singing
• https://www.youtube.com/watch?v=HPBoyWkLHe8 ...................cystic fibrosis
MODULE 21.1 OVERVIEW OF
THE RESPIRATORY SYSTEM

Anatomy of the Respiratory System
• Organs of this system are found in head, neck, and thoracic cavity
(Figure 21.1)
– Includes:
 Blood vessels of pulmonary circuit
 Rib cage
 Respiratory muscles
 Both lungs
 Respiratory tract

– Respiratory tract consists of hollow
Nasal cavity Frontal sinus
passages; Sphenoidal sinus Nasal conchae

Nose
Internal nares
– Nose and nasal cavity – encased in UPPER Pharynx Tongue

RESPIRATORY
SYSTEM
cranial and facial bones LOWER
Hyoid bone
Larynx
Esophagus
RESPIRATORY Trachea
Clavicle
– Pharynx (throat) SYSTEM Bronchus
Bronchioles
– Larynx or voice box – in anterior neck
– Trachea or windpipe – in
mediastinum RIGHT
RIGHT LEFT
LUNG
LUNG LUNG
– Bronchial tree – collection of

branching tubes
Ribs Diaphragm

Figure 21.1 Organs of the respiratory system.

Anatomy of the Respiratory System (4 of 4)
Classified anatomically into upper and lower tracts
Upper – passageways from nasal cavity to larynx
Lower – passageways from trachea to respiratory tract’s terminal

structures (alveoli)
– Alveoli (alveolus, singular) – tiny air sacs; arranged in grapelike

clusters, where gases are exchanged
– Lungs –
 Pair of spongy organs in thoracic cavity; enclosed within
boundaries of rib cage and diaphragm
 Each is collection of millions of alveoli and their blood vessels
embedded in elastic connective tissue with local branches of
respiratory tract
Basic Functions of the Respiratory System
• Classified functionally into conducting and respiratory zones:
– Tubes of conducting zone are conduits through which air travels

on its way into (inspired or inhaled) and out (expired or exhaled)
of body
 Air is filtered, warmed, and moistened as it travels through

zone
 Includes structures from nose and nasal cavity to

bronchioles
– Respiratory zone – where gas exchange occurs; includes only

structures that contain alveoli

Organization of the Respiratory System
1. Conducting portion
2. Respiratory portion

Components of the Respiratory System
• Alveoli are air-filled pockets within the lungs, where all gas
exchange takes place
– For gases to exchange efficiently:
– Alveoli walls must be very thin (<1 µm)
– Surface area must be very great (about 35 times the surface area
of the body)

• The Respiratory Mucosa
• Lines the conducting portion
Movement
• Consists of: of mucus
to pharynx Ciliated columnar
1. An epithelial layer (mostly ciliated) epithelial cell
Mucous cell
2. An layer of areolar tissue called the Stem cell
lamina propria
• In the upper respiratory system,
trachea, and bronchi
Mucus layer
• It contains mucous glands that secrete
Lamina propria
onto epithelial surface
• In the conducting portion of lower
respiratory system (bronchioles) A diagrammatic view of the
respiratory epithelium of the
• It contains smooth muscle cells that trachea, indicating the direction
encircle lumen of bronchioles of mucus transport inferior to
the ©pharynx.
Copyright 2019, 2016 Pearson Education, Inc. All Rights Reserved
The Respiratory Epithelium of the Nasal Cavity and Conducting
Portion of the Respiratory Tract.
Cilia
Foreign particles are
trapped in mucus
Lamina
Ciliated cells propel propria
debris and mucus Nucleus of
columnar
toward posterior epithelial cell
Mucous cell
nasal cavity and
Basement
pharynx membrane
Stem cell
c
A sectional view of the respiratory epithelium,
a pseudostratified ciliated columnar epithelium.

• Structure of Respiratory Epithelium
1. Nasal cavity and superior portion of the pharynx
• Pseudostratified ciliated columnar epithelium with
numerous mucous cells
2. Inferior portions of the pharynx
• Stratified squamous epithelium
3. Superior portion of the lower respiratory system
• Pseudostratified ciliated columnar epithelium
4. Smaller bronchioles
• Cuboidal epithelium with scattered cilia
• Alveolar Epithelium
– Is a very delicate, simple squamous epithelium

• Respiration – primary function of system; provides body cells with
oxygen and removes waste product carbon dioxide; includes four
separate processes:
– Pulmonary ventilation (often shortened to ventilation) –

movement of air in and out of lungs
– Pulmonary gas exchange – movement of gases between lungs

and blood
– Gas transport – movement of gases through blood
– Tissue gas exchange – movement of gases between blood and

tissues

• Other functions – serve to maintain homeostasis:
– Mechanism for speech and sound production
– Neurons for sense of smell
– It is possible to expel contents from abdominopelvic cavity, to

assist with defecation, urination, and childbirth by increasing
pressure in thoracic cavity
– Pressure changes in thoracic cavity assist with flow of venous
blood and lymph in both thoracic and abdominopelvic cavities
– Critical in maintaining acid-base balance in extracellular fluid
– Synthesizes an enzyme involved in production of angiotensin-II;
critical to maintenance of blood pressure and fluid
homeostasis

• The Respiratory Defense System
– Consists of a series of filtration mechanisms
– Removes particles and pathogens
– Components of the Respiratory Defense System
– Nasal hairs
 Are in nasal vestibule
 Are the first particle filtration system to remove large particles
– Mucous cells and mucous glands

 Produce mucus that bathes exposed surfaces
– Cilia
 Sweep debris trapped in mucus toward the pharynx (mucus
escalator)
– Alveolar macrophages engulf small particles that reach lungs
MODULE 21.2 ANATOMY OF
THE RESPIRATORY SYSTEM

The Nose and Nasal Cavity
• Nose and nasal cavity are entryway
into respiratory system;
– Inhaled air is warmed and

humidified
– Debris is filtered from inhaled

air
– Antibacterial substances are

secreted
– Olfactory receptors are housed
– Enhance resonance of voice

– External anatomy of nose:
 Covered with skin and supported by muscle, bone, and
cartilage
 Superiorly positioned pair of nasal bones; lateral and alar
cartilages inferiorly give rise to following external surface
features Root and bridge of nose are between eyebrows and
eyes respectively

The Nasal Cavity
• Hard palate is a bone which forms the floor of the nasal cavity.
• The nasal septum, divides nasal cavity into left and right
• The posterior portion is bony
• The anterior portion is made of hyaline cartilage which support the
bridge and apex of the nose
• The superior, middle and inferior nasal conchae project toward the nasal
septum
• The nasal cavity opens into the nasopharynx through a connection
called internal nares
• Fleshy soft palate, connected to Uvula extends posterior to the hard
palate.
• Mucous secretions from paranasal sinus and tears clean and moisten
the nasal cavity Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
– Nasal conchae curl around Frontal sinus
three narrow passages: Nasal cavity
Nasal conchae
Superior
– superior, middle, and inferior Middle
Internal nares
nasal meatuses; Entrance to auditory tube
Inferior
Pharyngeal tonsil Nasal vestibule
 create turbulence that rids Pharynx External nares
dust and debris from Nasopharynx Hard palate
Oral cavity
inspired air Oropharynx
Laryngopharynx Tongue
– Paranasal sinuses – hollow Soft palate
Palatine tonsil
cavities within frontal, ethmoid, Mandible
sphenoid, and maxillary bones; Epiglottis Lingual tonsil
Hyoid bone
connected to nasal cavity by Glottis
Vocal fold Thyroid cartilage
small passageways Cricoid cartilage
Trachea
Esophagus
 Warm and humidify air Thyroid gland
 Enhance voice resonance The nasal cavity and pharynx, as seen in sagittal
section with the nasal septum removed
 Reduce weight of skull

While filtration procedure is followed by our
nose
Breathing through the mouth can result in
sore throats, ear infections and even
tonsillitis.

Nosebleed

Fairly common due to extensive
vascularization of nasal cavity

The Pharynx
• Pharynx (throat) – next anatomical segment of respiratory tract that
inspired air enters after exiting nasal cavity;
– divided into three anatomical divisions:
– Nasopharynx –Extends from posterior nares to uvula (part of soft
palate)
 Uvula and soft palate move posteriorly during swallowing to
prevent food from entering nasopharynx and nasal cavity

The Pharynx
• Oropharynx – next segment; located posterior to oral cavity
– Extends from uvula to tip of larynx (epiglottis)
• Laryngopharynx – last segment; extends from hyoid bone to

esophagus (tube that connects oral cavity to stomach)
 Anteriorly – opens into larynx (voice box)
 Posteriorly – opens into esophagus
 Also a common passageway for both air and food;

The Larynx (1 of 15)
• Larynx (voice box) –
– keeps food and liquids out of the remaining respiratory tract;
– also houses vocal cords (Figure 21.5)
– Nine separate sections of cartilage (three unpaired and 3 paired)
provide flexible framework for larynx;
– also supported by muscles that connect it to the surrounding neck and
by muscles within larynx itself
• Six major Cartilages Epiglottis
• Three large, unpaired cartilages

Lesser cornu
Hyoid bone
1. Thyroid cartilage Thyrohyoid

ligament
contain (Adam apple)
Laryngeal
2. Cricoid cartilage (cry.co.eed) prominence
Thyroid
Larynx
3. Epiglottis cartilage
Cricothyroid
• Thyroid and cricoid cartilages ligament

Cricoid cartilage
support and protect:

Cricotracheal
ligament
Trachea
• The entrance to trachea Tracheal
cartilages
(the glottis) Anterior view

• The Larynx also contains
three Pairs smaller Hyaline Cartilages
1. Arytenoid cartilages
2. Corniculate cartilages
3. Cuneiform cartilages
• Corniculate and arytenoid cartilages

function in:
1. Opening and closing of glottis
2. Production of sound
• Cuneiform lie within folds of tissue
that extends between lateral
surface of each arytnoids and
epiglottis Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
The Larynx
Epiglottis Hyoid bone

Lesser cornu
Epiglottis
Hyoid bone
Thyroid
Thyrohyoid cartilage
ligament Vestibular
ligament
Corniculate
Laryngeal Vocal cartilage
prominence ligament
Thyroid Arytenoid
Larynx cartilage
cartilage
Cricothyroid Cricoid
Cricothyroid ligament cartilage
ligament
Cricotracheal Tracheal
Cricoid cartilage ligament cartilages
Cricotracheal
ligament
Trachea
Tracheal
cartilages ANTERIOR POSTERIOR
Anterior view Posterior view Sagittal section

The Larynx
– Inner surface of larynx is made up of Hyoid bone
folds of mucosa projecting into

Epiglottis
laryngeal lumen (Figure 21.6a)
 Vestibular folds (false vocal cords) Thyroid
cartilage
extend from arytenoid cartilages to Vestibular
ligament
thyroid cartilage; close off glottis Corniculate
during swallowing; play no role Vocal cartilage
ligament
in sound production
Arytenoid
 True vocal cords – inferior to cartilage
vestibular folds; also attached to Cricothyroid

ligament
Cricoid
cartilage
both arytenoid cartilages and Cricotracheal Tracheal
thyroid cartilage ligament cartilages
 Vocal ligaments – elastic bands

at the core of vocal cords; give
structure whitish appearance;
ANTERIOR POSTERIOR
vibrate to produce sound when air
passes over them Sagittal section

• Sound Production
• Air passing through glottis
– Vibrates vocal folds
– Produces sound waves
– With increase in distance, vocal folds tense and pitch rises and
vice versa
– The faster the vocal folds vibrate, the higher the pitch.

The Larynx
• Sound is produced as expired air passes over vocal ligaments
– Sound loudness is determined by force of airstream; greater force of
expiration = louder sound
– Pitch of sound is largely determined by tension of vocal cords and
speed of vibration
• Musculature of larynx controls length and tension of vocal cords by
causing arytenoid and corniculate cartilages to pivot
– When cartilages rotate inward, they adduct vocal cords, and glottis
narrows
– When cartilages rotate outward, they abduct vocal cords, and glottis
opens
• Adult males typically have deeper (lower-pitched) voices than females
because their vocal ligaments are longer and thicker as a result of their
wider larynx, and thus vibrate more slowly
• Note: Air movement over vocal cords only produces buzzing sound;
• actual speech requires coordinated efforts of structures superior to glottis
including muscles of pharynx, soft palate, plus tongue and lips
The Larynx
 During swallowing, larynx is elevated by the surrounding
muscles and glottis is closed by epiglottis to prevent food
and liquids from entering larynx
 Cough reflex helps to expel food and/or liquids that manage

to get through glottis into larynx; prevents damage to
remaining respiratory tract
Figure 21.6b Changes in the vocal ligaments during speech.

The Trachea (1 of 3) Hyoid
bone
Trachea (windpipe) – next structure that Larynx
inspired air flows through on its way to lower

respiratory tract; begins in inferior neck and
extends to mediastinum (Figure 21.7a)
Trachea
Tracheal
cartilages
Location of carina
Root of (internal ridge)
right lung Root of
left lung
Lung
tissue Primary
bronchi
Secondary
bronchi
Figure 21.7a Anatomy of the trachea.

RIGHT LUNG LEFT LUNG
The Trachea
• Hyaline cartilage rings cover anterior and lateral surfaces of
trachea in C shape, leaving posterior surface uncovered (Figure
21.7b)
 Rings are supportive enough to keep trachea open

(patent);flexible enough to allow trachea to change in diameter
during pulmonary ventilation
– Posterior surface of trachea is covered with elastic connective

tissue and smooth muscle;
 allows esophagus to expand during swallowing

 Contraction of muscle reduces the diameter of the trachea
 Under sympathetic stimulation the diameter increases
 Parasympathetic stimulation decrease the diameter
Figure 21.7b Anatomy of the trachea. Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
The Trachea
– Carina – last tracheal cartilage ring; forms “hook” that curves
down and back to form partial rings that surround first branches of
bronchial tree;
– carina’s mucosa contains sensory receptors that trigger
violent cough reflex if foreign materials contact them
Figure 21.7c Anatomy of the trachea.

Smoker’s Cough
• Deep, rattling cough of smoker is linked directly to numerous
adverse effects of smoke on respiratory system
• Chemicals in smoke
– Act as irritants, increasing mucus secretion
– Partially paralyze and eventually destroy cilia lining tract
• As a result, more mucus is present, but cilia are less able to

sweep it out of airways
• Cough develops as only way to prevent mucus buildup
• Cilia will reappear within few months after the smoking stops

The Bronchial Tree
• Once inhaled air reaches carina, it can enter either left or
right primary bronchus (enters left or right lung at
hilum)
• Once inside the lung, each bronchus branches into

bronchial tree – series
of progressively smaller tubes that end in alveoli
– Primary bronchi – beginning of bronchial tree;
divide into left and right branches at carina
 Right primary bronchus – wider, shorter, and
straighter
 Left primary bronchus – narrower, longer,
and more horizontal)
 differences are due to the position of heart in
relation to left lung
Right lung is a more likely side for inhaling foreign objects because of
these anatomical differences
The Bronchial Tree
• Primary bronchi branch into secondary bronchi once inside each
lung; three on right and two on left (again due to position of heart)
• Secondary bronchi branch
into about 10 smaller tertiary
bronchi per lung and continue
to branch into smaller and
smaller branches
Figure 21.8a Branching pattern of the bronchial tree.

The Bronchial Tree (6 of 10)
• Bronchioles – smallest airways; features differ from larger airways
Simple cuboidal epithelium with few cilia, if any; enclosed
within thick ring of smooth muscle; devoid of hyaline cartilage
– Conducting zone of respiratory tract ends when inspired air

reaches terminal bronchioles
– Terminal bronchioles branch into two or more smaller
respiratory bronchioles surrounded by thin layer of smooth
muscle
– Respiratory zone begins with respiratory bronchioles with
alveoli budding from walls
Figure 21.9 Anatomy of the respiratory zone.

The Bronchial Tree
• As airways divide and get smaller, histology changes
significantly;
• primary bronchi are nearly identical to trachea, but three changes are
evident as bronchi become smaller:
– Cartilage changes from C-shaped to complete rings to

progressively fewer irregular plates
– Epithelium gradually changes
– Amount of smooth muscle increases and hyaline cartilage

decreases as bronchi get progressively smaller; tiny
airways must be able to change diameter to control air flow
in bronchioles and alveoli Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
The Bronchial Tree
– Each respiratory bronchiole branches into two or more alveolar
ducts; also have alveoli attached to their walls
– Alveolar ducts end in alveolar sacs, grapelike clusters of alveoli;

inspired air has arrived where gas exchange occurs
Respiratory
Branch of
epithelium
Bronchiole pulmonary
artery
Bronchial artery (red),
vein (blue), and
Smooth muscle
nerve (yellow)
around terminal
Terminal bronchiole
bronchiole
Respiratory
bronchiole
Elastic fibers
Capillary
Arteriole Lymphatic
Branch of beds
pulmonary vessel
Alveolar
vein duct Alveoli
Alveolar sac
Interlobular
septum
Visceral pleura
Pleural cavity
Parietal pleura
Figure 21.9 Anatomy of the respiratory zone.
The structure of a single pulmonary lobule, part of a
bronchopulmonary segment
The Bronchial Tree (summary)
To get to alveoli, our inhaled air had to pass through as shown:

Alveoli and the Respiratory Membrane
• Alveoli are final destination for inspired air within respiratory tract;
each single, round, thin-walled alveolus has three cell types
(Figure 21.10a):
– Type I alveolar cells – squamous cells that account for about
90% of cells in alveolar wall; very thin; structural feature allowing
for rapid diffusion of gases across cell membranes
 Type I cells are one of three components of respiratory
membrane; barrier through which inspired gases must diffuse
Pneumocyte Pneumocyte
type II type I
Alveolar
macrophage
Elastic
fibers
Alveolar macrophage
Capillary
Endothelial
cell of capillary
A diagrammatic view of alveolar structure. A single capillary may
be involved in gas exchange with several alveoli simultaneously.
Alveoli and the Respiratory Membrane
• Type II alveolar cells – small cuboidal cells
that account for about 10% of cells in alveolar
Alveoil
wall; responsible for synthesis of surfactant
(chemical that helps reduce surface tension Respiratory
bronchiole
on alveoli)
Alveolar
sac
Surfactant
Arteriole
• Is an oily secretion, contains phospholipids

and proteins
• Coats alveolar surfaces and reduces
surface tension LM × 14
Histology of the lung
• With out surfactant the surface tension b Low-power micrograph of

lung tissue.
would collapse the alveoli
• Alveolar macrophages – mobile
phagocytes; derived from bone marrow;
clean up and digest debris that made its way
into alveolus Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
• Respiratory Membrane
Red blood cell
• The thin membrane of alveoli
where gas exchange takes place
Capillary lumen
• Three Layers formed by the
Capillary Nucleus of
fusion of simple squamous cells endothelium endothelial cell
of alveolus with endothelial cells
of pulmonary capillary
0.5 m
– of the Respiratory Membrane
1. Squamous epithelial cells
lining the alveolus
Fused Alveolar Surfactant
2. Endothelial cells lining an basement epithelium
adjacent capillary membrane
Alveolar air space
3. Fused basement
membranes between the
The respiratory membrane,
alveolar and endothelial which consists of an alveolar
cells epithelial cell, a capillary
endothelial cell, and their fused
basement membranes.
Tuberculosis
• Caused by bacterium Mycobacterium tuberculosis; spreads easily
via air, by coughs or sneezes
• 90% of infections are latent (asymptomatic); remaining 10% are
active (show symptoms)
• Symptoms – persistent cough with blood-tinged sputum, fever,
night sweats, weight loss
• Alveolar infection triggers inflammation; immune cells attempt
to “wall off” infected area; results in granuloma
• May also involve non-respiratory organs (bones, CNS)
• Diagnosis – detection of granuloma on x-ray, positive tuberculin

skin test (indicates antibodies to bacterium), presence of bacterium
in sputum
• Treatment – cocktail of several antibiotics for a period of six months
for active infections; single antibiotic used to keep latent infections
from becoming active

The Lungs and Pleurae
• Right and left lungs are separated by heart and mediastinum
– Lung’s inferior flat base rests on diaphragm; superior apex sits just
below clavicle
– Anterior, posterior, and lateral lung surfaces are in contact with
rib cage; called costal surfaces of lung; medial lung surface, in
contact with mediastinum, is mediastinal surface
 Hilum – triangular depression on mediastinal surface of
each lung where primary bronchi, blood and lymphatic vessels,
and nerves enter and exit lung

• Cardiac notch – groove in mediastinal surface of left lung
where it comes in contact with heart
• Each lung is divided into lobes; right lung has three lobes; left lung has only
two lobes due to the space required for heart
– Right lung is divided into superior, middle, and inferior lobes;
horizontal fissure separates superior from middle lobe and oblique fissure
separates middle from inferior lobe
– Left lung is divided into superior and inferior lobe separated by oblique
fissure
Lateral Surfaces
The curving anterior and Apex The cardiac Apex
lateral surfaces of each lung Superior notch
follow the inner contours of lobe accommodates
the rib cage. the pericardial Superior lobe
cavity, which
Horizontal fissure
Middle sits to the left of
Oblique fissure lobe the midline. Oblique
Inferior fissure
lobe Inferior
lobe
Base Base
Right lung Left lung

• Each lung is divided into lobes (continued):
– Each secondary bronchus supplies one

lobe of lung; commonly called lobar
bronchi
– Lobes are further divided by thin walls of

connective tissue into bronchopulmonary
segments;
– tertiary bronchi is therefore commonly

called segmental bronchi
– Each bronchopulmonary segment is further

divided into dime-sized hexagonal structures
called lobules Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
• Each lung is found within pleural cavity;
subdivision of thoracic cavity; located between
two layers of serous membrane (Figure 21.12)
– Parietal pleura – outer layer of serous
membrane; fused to rib cage,
diaphragm, and other local structures
– At hilum, parietal pleura turns over on itself
to create visceral pleura; inner layer of
membrane; continuous with the surface
of lungs; dives into fissures between
lobes
– Pleural membranes secrete thin layer of
serous fluid (pleural fluid) that fills space
between layers and serves to lubricate
delicate surfaces of lungs as they expand
and contract during ventilation

Changes in the histology of different portions of respiratory tract are summarized in
Table 21.1
Table 21.1 Function and Composition of Regions of the Conducting and Respiratory Zones
Pleuritis and Pleural Friction Rub
(1 of 2)
• Many conditions (heart failure to pneumonia) can cause inflammation
of visceral and parietal pleura (pleuritis)
• Pleuritic pain – one of the most common symptoms; chest pain with
inhalation; results from inflamed pleura rubbing together as lungs
expand and contract
• Rubbing can sometimes be heard with stethoscope, termed pleural
friction rub; resembles sandpaper rubbing against itself
• Treatment – underlying condition must be addressed; may persist for
months (even after condition has resolved) due to lasting inflammation

MODULE 21.3 PULMONARY
VENTILATION

• Respiration – primary function of system; provides body cells with
oxygen and removes waste product carbon dioxide; includes four
separate processes:
– Pulmonary ventilation (often shortened to ventilation) –

movement of air in and out of lungs
– Pulmonary gas exchange – movement of gases between lungs

and blood
– Gas transport – movement of gases through blood
– Tissue gas exchange – movement of gases between blood and

tissues

The Pressure–Volume Relationship
• First process of respiration is
breathing (pulmonary ventilation);
consists of two phases:
– Inspiration (inhalation) – brings air
into lungs
– Expiration (exhalation) – moves air
out of lungs
• Pressure – volume relationship
provides driving force for pulmonary
ventilation
• Air – mixture of gas molecules
– Gas molecules move from areas of
high pressure to areas of low
pressure

The Pressure–Volume Relationship
• Boyle’s law describes the relationship between pressure and
volume; states that at constant temperature and number of gas
molecules, pressure and volume of gas are inversely related
such that
– As volume of container increases, pressure gas exerts on
container decreases
– As volume of container decreases, pressure gas exerts on
container increases

The Process of Pulmonary Ventilation
• Process of pulmonary ventilation (inspiration and expiration)
involves volume changes in thoracic cavity and lungs that lead
to creation of pressure gradient
• Gradient causes air to move into or out of lungs (like open syringe in
this figure)

Ribs and
sternum
elevate
Diaphragm
contracts
As the rib cage is elevated or

the diaphragm is depressed,
the volume of the thoracic
cavity increases.

The Mechanics of Breathing
– Inhalation
 Always active
– Exhalation
 Active or passive
• The Respiratory Muscles

– Most important are:
 The diaphragm
 External intercostal muscles of the ribs
 Accessory respiratory muscles
– Activated when respiration increases significantly

Muscles Used in Inhalation
Accessory Muscle
of Inhalation
• Diaphragm (active when needed)
– Contraction draws air into Sternocleidomastoid
lungs muscle
Scalene muscles
– 75% of normal air Pectoralis minor muscle
movement
Serratus anterior muscle
• External intercostal muscles
– Assist inhalation Primary Muscle
of Inhalation
– 25% of normal air
External intercostal muscles
movement
Diaphragm
• Accessory muscles assist in
elevating ribs
– Sternocleidomastoid
– Serratus anterior
– Pectoralis minor
– Scalene muscles Inhalation. A lateral view during inhalation,
showing the muscles that elevate the ribs.
Figure 23-16b The Respiratory Muscles
Accessory Muscles Primary Muscle of Inhalation

of Inhalation
External intercostal muscles
Sternocleidomastoid
muscle
Scalene muscles Accessory Muscles

of Exhalation
Pectoralis minor Internal intercostal

muscle muscles
Serratus anterior
muscle Transversus thoracis
muscle
Primary Muscle
External oblique
of Inhalation
muscle
Diaphragm
Rectus abdominus
Internal oblique
muscle
An anterior view at rest (with no
air movement), showing the
primary and accessory
respiratory muscles. Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
• Muscles Used in forced
Exhalation
• Internal intercostal and transversus
thoracis muscles
– Depress the ribs
• Abdominal muscles
– Compress the abdomen
– Force diaphragm upward

• Modes of Breathing
– Respiratory movements are classified
 By pattern of muscle activity
 Quiet breathing
 Forced breathing

• Quiet Breathing (Eupnea)
– Involves active inhalation and passive exhalation
 Diaphragmatic breathing or deep breathing
– Is dominated by diaphragm
 Costal breathing or shallow breathing
– Is dominated by rib cage movements
• Elastic Rebound
– When inhalation muscles relax
 Elastic components of muscles and lungs recoil
 Returning lungs and alveoli to original position

Forced Breathing (Hyperpnea)
– Involves active inhalation and
exhalation
– Assisted by accessory muscles
– During Maximum levels abdominal
muscles take part in exhalation
– Their contractions compresses the
abdominal contents pushing them up
against the diaphragm

Three pressure gradients influence pulmonary ventilation:
• Atmospheric pressure – molecules that make up air are subject to the

force of gravity
– At sea level, atmospheric pressure is about 760 mm Hg
– It increases as you go below sea level, and it decreases as you rise

above sea level

Three pressure gradients influence pulmonary ventilation (continued):
• Intrapulmonary pressure – air pressure within alveoli is called

intrapulmonary pressure;
– rises and falls with inspiration and expiration;
– always eventually equalizes with atmospheric pressure due to

pressure gradients reaching equilibrium
• Intrapleural pressure – pressure found within pleural cavity
– Like intrapulmonary pressure, intrapleural pressure also

rises and falls with inspiration and expiration.
– Does not equalize with atmospheric pressure; normally about 4

mm Hg less than intrapulmonary pressure Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
How do pressures change during quiet ventilation? (Figure 21.13)
• Step 1 – lungs at rest between breaths; intrapulmonary pressure is
same as atmospheric pressure at 760 mm Hg
– No air flows in or out of lungs
– Intrapleural pressure is 4 mm Hg below atmospheric, at 756
mm Hg
• Step 2 – For inspiration to occur, intrapulmonary pressure must be less

than atmospheric pressure:
– Accomplished by increasing the volume of lungs, which decreases
intrapulmonary pressure to about 758 mm Hg
– As intrapulmonary pressure decreases, air moves into lungs
– Intrapleural pressure remains lower than intrapulmonary pressure

• Step 3 – Air will continue to move into lungs until gradient no longer
exists
– Happens when intrapulmonary pressure equals atmospheric
pressure
– At this point between inspiration and expiration, no air movement
occurs, as there is no pressure gradient to drive its movement
• Step 4 – Air moves out of lungs when pressure gradient is created
during expiration; intrapulmonary pressure rises above atmospheric
pressure to about 762 mm Hg
– Lungs do not fully deflate because of slight suction effect
from intrapleural pressure and outward recoil of chest wall
– Both forces oppose lungs’ elastic recoil, keeping lungs
inflated and most alveoli open at all times
– Expiration stops when intrapulmonary pressure equals
atmospheric pressure


Intrapulmonary Pressure (intra-alveolar pressure)
Volume of thoracic cavity changes with expansion or contraction of
diaphragm or rib cage that create changes in the Intrapulmonary Pressure
760=760mm Hg 760˃759=-1 760˂761=+1
Pleural
cavity
Cardiac
notch
Diaphragm
Poutside  Pinside
Volume increases Volume decreases
Pressure outside and inside are Poutside > Pinside Poutside < Pinside
equal, so no air movement occurs
Pressure inside falls, so air flows in Pressure inside rises, so air flows out
At rest.
Inhalation. Elevation of the rib Exhalation. When the rib cage
cage and contraction of the returns to its original position
Normal atmospheric pressure diaphragm increase the size of and the diaphragm relaxes, the
1 atm = 760 mm Hg the thoracic cavity. Pressure volume of the thoracic cavity
within the thoracic cavity decreases. Pressure rises, and
decreases, and air flows into air moves out of the lungs.
the lungs. Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
Pressure and Volume Changes during Inhalation and Exhalation
Tidal Volume (VT)
Amount of air moved in and out of lungs in a single
respiratory cycle
INHALATION EXHALATION
Trachea Intrapulmonary
pressure
(mm Hg)
Changes in
intrapulmonary
Bronchi pressure during a
single respiratory cycle
Lung Intrapleural
pressure
(mm Hg)
Diaphragm
Changes in intrapleural
pressure during a
single respiratory cycle
Right pleural Left pleural

cavity cavity Tidal
volume
(mL)
A plot of tidal volume,

the amount of air
moving into and out of
the lungs during a
Time © 2019, 2016 Pearsonsingle
(sec)
Copyright respiratory
Education, cycle
Inc. All Rights Reserved
Figure 21.13 Pressure changes in pulmonary ventilation.

• What happens if intrapleural pressure increases to a level at or
above atmospheric pressure?
• Intrapleural pressure no longer exerts suction effect that prevents lungs
from collapsing; added pressure enhances lungs’ elastic recoil; lungs
immediately collapse
• Many things can increase intrapleural pressure above atmospheric,
including;
– excess fluid (pleural effusion),
– air (pneumothorax) or
– blood (hemothorax) in cavity
Pneumothorax caused by knife

wound

(Summary)
Mechanics of Inspiration and Expiration – volume changes during
ventilation, rely on skeletal muscle of thoracic cavity; lungs cannot
change their volume on their own (Figure 21.14 and Table 21.2)
• Muscles increase lung volume indirectly by increasing volume

of thoracic cavity
– Parietal pleura – attached to inner surface of thoracic cavity
– As thoracic cavity expands it pulls on parietal pleura;
– pulls on visceral pleura; pulls lungs outward, increasing their

volume
(Summary)
• Inspiratory muscles
– Diaphragm – main inspiratory muscle; divides thoracic cavity
from abdominopelvic cavity
 Dome-shaped when relaxed; bulges up into thoracic cavity
 Pulls down to become flat during contraction; increases
height of thoracic cavity
– External intercostals – muscles between ribs
 Relaxed external intercostal muscles cause rib cage, and
therefore lungs, to be at reduced size
 Pull rib cage superiorly and anteriorly during contraction;
increases height and diameter of thoracic cavity

(summary)
• When inspiration is deep or forced, inspiratory muscles contract more
forcefully
• In addition, accessory muscles of inspiration contract and further
increase the size of thoracic cavity
• Unlike inspiration, normal expiration is mostly passive; does not
utilize muscle contraction
– Two things happen when inspiratory muscles relax:
 Diaphragm returns to its original dome shape; pushes up on
lungs
 Elastic tissue in lungs recoils
– Recoil and diaphragm relaxation together decrease lung volume and
raise intrapulmonary pressure above atmospheric pressure, so air
flows out of lungs

Figure 21.14 Volume changes in pulmonary ventilation: structure and function of the
inspiratory muscles in quiet breathing.
(Summary)
– Accessory muscles of expiration, used for forceful expiration
 Include internal intercostals and abdominal muscles, certain back
muscles
 Forcefully decrease the size of thoracic cavity
 Reason why abdominal and back muscles are often sore after having
cough

Putting It All Together: The Big Picture of
Pulmonary Ventilation (1 of 2)
Figure 21.15 The big picture of pulmonary ventilation.

– Heimlich maneuver – delivering abdominal thrusts that push
up on diaphragm; used on people who are choking, in hope
that forceful expiration will dislodge obstruction and restore
breathing

Physical Factors Influencing Pulmonary
Ventilation (1 of 7)
• Three primary physical factors of respiratory tract and lungs
influence the overall effectiveness of pulmonary ventilation:
– Airway resistance – defined as anything that impedes air flow

through respiratory tract (Figure 21.16)
– Alveolar surface tension – alveoli are covered with thin film of

liquid composed mainly of water creating gas–water boundary
– Pulmonary compliance – refers to the ability of lungs and chest

wall to stretch

• Airway resistance – largely determined by airway diameter
– Resistance decreases slightly during inspiration as airways are

pulled open as lungs expand
– Resistance increases slightly as lungs recoil and airways narrow

during expiration
Figure 21.16 Relationship between airway resistance and airway diameter.

• Diameter of bronchioles is controlled by
smooth muscle contraction and relaxation
and ANS
– Relaxation (bronchodilation)
increases the diameter of bronchioles;
decreases airway resistance and
increases air flow
– Contraction (bronchoconstriction)
decreases the diameter of bronchioles;
increases airway resistance and
decreases air flow
Figure 21.16 Relationship between airway resistance and airway diameter.
• Autonomic Control
– Regulates smooth muscle
 Controls diameter of bronchioles
 Controls airflow and resistance in lungs
• Bronchodilation
– Dilation of bronchial airways
– Caused by sympathetic ANS activation
– Reduces resistance
• Bronchoconstriction
– Constricts bronchi
 Caused by Parasympathetic ANS activation
 Histamine release (allergic reactions)

• Bronchitis
– Inflammation of bronchial
walls
 Causes constriction and
breathing difficulty
Asthma
Excessive stimulation and
bronchoconstriction
Stimulation severely restricts
airflow

• Alveolar surface tension – another physical factor affecting pulmonary
ventilation; alveoli are covered with thin film of liquid (mainly water)
– Creates surface tension; greatest when alveoli are at their

smallest diameter during expiration

• Alveolar surface tension (continued):
• High amount of unopposed surface tension
causes alveolus to collapse during
expiration; called atelectasis (Figure 21.17a)
• Surfactant, produced by Type II alveolar cells,
is a component of liquid film coating the cells of
alveolus; opposes surface tension’s collapsing
force
• Chemical structure – similar to detergent; has
both polar and nonpolar end; disrupts water’s
ability to hydrogen bond with itself; reduces
surface tension and allows alveolus to remain
partially open even during expiration (Figure
21.17b)
Figure 21.17 Effect of surfactant on alveolar surface tension.

• Pulmonary compliance –ability of lungs and chest wall to stretch
• Determined by three factors:
– Ability of the chest wall to move or stretch during inspiration;

increases compliance
– Distensibility of elastic tissue gives lungs the ability to stretch during

inflation; increases compliance
– Degree of alveolar surface tension – increased surface tension

resists the ability of alveolus to inflate, decreasing compliance;
surfactant counteracts this collapsing force; increases compliance
– If compliance decreases, lungs are less able to expand and

effectiveness of pulmonary ventilation decreases
Infant Respiratory Distress Syndrome
• Inadequate surfactant makes alveolar inflation
between breaths very difficult because surface
tension increases and compliance decreases
• Surfactant is not produced significantly until
last 10–12 weeks of gestation; premature
newborns may therefore suffer from infant
respiratory distress syndrome (RDS)
• Risk factors – prematurity, male gender,
maternal diabetes history, family history of RDS,
caesarean delivery
• Treatment – delivery of surfactant by inhalation;
also positive airway pressure (CPAP); slightly
pressurized air prevents alveoli from collapsing
during expiration; mechanical ventilation is used
in severe cases

Pulmonary Volumes and Capacities (1 of 9)
• Pulmonary volumes: measuring volumes of air that person
exchanges with each breath; useful tool for assessment of pulmonary
function
• Spirometer produces graph that records normal and forced inhalation

and exhalation (Figure 21.18)
• Three volumes can be measured using this tool:
– Tidal volume (TV)
– Inspiratory reserve volume (IRV)
– Expiratory reserve volume (ERV)

• Tidal volume (TV) – amount of air inspired or expired during
normal quiet ventilation; about 500 ml in healthy adults; calculated
rates or volumes associated with TV:
– Minute volume – TV multiplied by number of breaths per

minutes; total volume of air that moves in and out of lungs each
minute; at 12 breaths per minute in average adult, equals 6 liters
per minute
– Only 350 ml of TV is available for gas exchange; remaining 150

ml is anatomical dead space; air that remains in conducting
zone; never makes it to respiratory zone

• Alveolar ventilation rate (AVR) – volume of air that reaches alveoli multiplied by
number of breaths per minute; averages 4.2 liters per minute; removes anatomical
dead space from equation
• Inspiratory reserve volume (IRV) – volume of air that can be forcibly inspired after
normal TV inspiration; IRV averages 2100–3300 ml depending on gender and body
size
• Expiratory reserve volume (ERV) – essentially opposite of IRV; amount of air that
can be forcibly expired after normal tidal expiration
– ERV averages 700–1200 ml of air; much less than IRV
– Difference between IRV and ERV is about 1400–2100 ml; even with most
forceful expiration, some air remains in lungs (residual volume (RV))
– RV is due to intrapleural pressure, and outward recoil of chest wall; keeps lungs
slightly inflated Copyright © 2019, 2016 Pearson Education, Inc. All Rights Reserved
• TV – amount of air inspired or expired during normal quiet ventilation
• IRV – volume of air that can be forcibly inspired after normal TV
inspiration
• ERV – amount of air that can be forcibly expired after normal tidal
expiration
• RV – air remaining in lungs after forceful expiration
• Two or more pulmonary volumes can be combined to calculate four
pulmonary capacities:
– Inspiratory capacity – total amount of air that person can inspire
after tidal volume:
(TV + IRV = inspiratory capacity)
– Functional residual volume – amount of air that is normally left
in lungs after tidal expiration: (ERV + RV = functional residual
volume)
– Vital capacity – calculated as total amount of exchangeable air,
or total amount of air that can move in and out of lungs: (TV +
IRV + ERV = vital capacity)
 Forced vital capacity (FVC) – measured in lab; subject

follows maximal inspiration with maximal expiration
 FVC can provide useful clinical information about respiratory

diseases
– Total lung capacity (TLC) – sum of all pulmonary volumes;

represents total amount of exchangeable and nonexchangeable
air in lungs: (IRV + TV + ERV + RV = TLC)

Pulmonary Volumes and Capacities
Pulmonary Volumes and Capacities (adult male)
6000
Resting Inspiratory Inspiratory

tidal volume reserve capacity
(VT  500 mL) volume (IRV)
Volume (mL)
Vital
capacity
2700
Total lung
capacity
2200
Expiratory
reserve
volume (ERV)
Functional
1200 residual
capacity
(FRC)
Residual
volume
Minimal volume
(30–120 mL)
0
Time

TV – volume inspired/expired; Inspiratory capacity = TV Vital capacity = TV +

normal quiet ventilation + IRV IRV + ERV
IRV – volume forcibly inspired after
Functional residual Total lung capacity =
a normal TV inspiration
volume = ERV + RV IRV + TV + ERV + RV
ERV – volume forcibly expired after
a normal tidal expiration
RV – air remaining in lungs after
forceful expiration
Figure 21.18 Graph of pulmonary volumes and capacities.
– Pulmonary function tests
• Measure rates and volumes of air movements
– Total lung volume is divided into a series of volumes and

capacities
• Measured with a spirometer
102
Table 21.4 summarizes pulmonary volumes and capacities and gives average values for
each in adults; except for tidal volume, values for all volumes and capacities are lower in
females than in males; also vary with person’s height, age, and health
Table 21.4 Pulmonary Volumes and Capacities


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8. What are the three steps of external respiration?

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• http://www.youtube.com/watch?v=5LjLFrmKTSA............................... Oxygen Transport

• https://www.youtube.com/watch?v=V2vR5_B6C5I........................... Sneeze, Cough,

• https://www.youtube.com/watch?v=b89RSYCaUBo....................... How the Larynx

• https://www.youtube.com/watch?v=-XGds2GAvGQ................ Vocal Cords up close

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 Blood vessels of pulmonary circuit

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passages; Sphenoidal sinus Nasal conchae

– Nose and nasal cavity – encased in UPPER Pharynx Tongue

– Larynx or voice box – in anterior neck

– Bronchial tree – collection of

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Figure 21.1 Organs of the respiratory system.

Upper – passageways from nasal cavity to larynx

Lower – passageways from trachea to respiratory tract’s terminal

– Alveoli (alveolus, singular) – tiny air sacs; arranged in grapelike

– Tubes of conducting zone are conduits through which air travels

 Air is filtered, warmed, and moistened as it travels through

 Includes structures from nose and nasal cavity to

– Respiratory zone – where gas exchange occurs; includes only

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– For gases to exchange efficiently:

– Alveoli walls must be very thin (<1 µm)

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• Cuboidal epithelium with scattered cilia

– Is a very delicate, simple squamous epithelium

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– Pulmonary ventilation (often shortened to ventilation) –

– Pulmonary gas exchange – movement of gases between lungs

– Gas transport – movement of gases through blood

– Tissue gas exchange – movement of gases between blood and

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– Mechanism for speech and sound production

– Neurons for sense of smell

– It is possible to expel contents from abdominopelvic cavity, to

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– Mucous cells and mucous glands

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– Inhaled air is warmed and

– Debris is filtered from inhaled

– Antibacterial substances are

– Olfactory receptors are housed

– Enhance resonance of voice

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 Reduce weight of skull

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vascularization of nasal cavity

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• Laryngopharynx – last segment; extends from hyoid bone to

 Anteriorly – opens into larynx (voice box)

 Posteriorly – opens into esophagus

 Also a common passageway for both air and food;

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• Three large, unpaired cartilages