The Respiratory System

Chapter 13
 Functional Anatomy of the
Respiratory System
• The organs of the respiratory system
include the nose, pharynx, larynx,
trachea, bronchi, and lungs, which
contain the alveoli (terminal air sacs).
• Every part (except for the alveoli) are
considered conducting passageways that
are responsible for purifying, humidifying,
and warming incoming air.  rid of irritants
 THE NOSE
• Only EXTERNALLY VISIBLE PART
• EXTERNAL NARES (notstrils) – air enters
here first
• NASAL CAVITY – interior of nose
 THE NOSE: Nasal Cavity
• Divided down midline by nasal septum
• Olfactory receptors located in the slitlike
superior part of nasal cavity
• Rest of the mucosa lining the nasal cavity is
respiratory mucosa
• Mucosa’s glands moisten the air and trap
incoming bacteria and foreign debris
• Ciliated cells move contaminated mucous toward
pharynx and eventually to the stomach where it
is digested by stomach juices (acid).
THE NOSE: Nasal Cavity
• Conchae – mucosa-covered
projections or lobes (INCREASE
surface area of mucosa exposed
to air & INCREASE air turbulance
in nasal cavity)
• Separated from oral cavity by the
PALATE (anteriorly – hard palate,
and posteriorly – soft palate)
• Paranasal cavities – lighten skull
and act as resonance chambers.
They produce mucous, which
drains into the nasal cavities.
• Nasolacrimal ducts also drain into
the nasal cavities.
 Homeostatic Imbalances
• Cleft palate (failure of bones forming the palate to
fuse medially) results in breathing, chewing, and
speaking problems.
• Rhinitis – inflamation of the nasal mucosa;
caused by cold viruses and allergens
• Sinusitis – sinus inflammation; passageways
connecting sinuses to nasal cavities are blocked
and air in sinus cavities is absorbed – sinus
headaches
 THE PHARYNX
• Commonly called the throat
• Muscular passageway that is about 13 cm long.
• Common passageway for food and air.
• Continuous with nasal cavity anteriorly via
internal nares.
• Nasopharynx – superior portion; air enters here
from nasal cavity
• Oropharynx – middle portion; air comes here
after going through nasopharynx
• Laryngopharynx – lower portion; air comes here
after going through oropharynx
THE PHARYNX
• Air is directed to larynx after
going through pharynx.
• Food is directed to
esophagus after going
through pharynx.
• Auditory tubes (drain middle
ear) open into nasopharynx.
• Otitis media – ear infections
 THE PHARYNX
• Tonsil – clusters of lymphatic
tissue
• Pharyngeal tonsil (also called
adenoid) – located high in
nasopharynx.
• Palantine tonsils – in oropharynx
at end of soft palate
• Lingual tonsils – at base of
tongue
• Function of tonsils: trap and
remove any bacteria or other
foreign pathogens entering the
throat
• Homeostatic Imbalance: Tonsillitis
– inflammation of tonsils
 THE LARYNX
• Also called the voice box
• Routes air and food into proper channels; speech
• Formed by 8 rigid hyaline cartilages and the epiglottis
(spoon-shaped elastic cartilage)
• Thyroid cartilage – largest; commonly called Adam’s
apple
• Epiglottis – “guardian of airways”; protects superior
opening of the larynx; directs food into esophagus
• Cough reflex – happens when anything other than air
enters larynx; does not work when unconscious
• Vocal folds (true vocal cords) – formed by part of mucous
membrane; vibrate with expelled air
• Glottis – slitlike passageway between vocal folds.
THE TRACHEA
• Also called the windpipe
• Lined with ciliated mucosa
• Cilia beat continuously
and in opposite direction
of incoming air; propel
mucous with dust particles
and debris away from
lungs toward the throat
• C-shaped rings of hyaline
cartliage  open ends
work with esophagus
(allow expansion); solid
part supports trachea
walls & keeps it patent
(open)
 Homeostatic Imbalances
• Smoking inhibits ciliary activity & destroys
cilia.
– Coughing prevents mucous from accumulating
in the lungs – smoker’s cough
• Choking – causes suffocation because air
cannot enter lungs
– Heimlich maneuver
– Emergency tracheostomy
PRIMARY BRONCHI
• Right & Left primary
bronchi form from
division of trachea
• Runs obliquely and goes
into medial depression
(HILUS) of the lung.
• Right side is wider,
shorter, & straighter –
more common side for
foreign objects to become
lodged.
 THE LUNGS
• Occupy the entire thoracic cavity, except for
central area  mediastinum (houses heart, great
blood vessels, bronchi, & esophagus)
• APEX – narrow superior portion
• BASE – broad area that rests on diaphragm
• Fissures – divide each lung into lobes (Left – 2
lobes; Right – 3 lobes)
 THE LUNGS
• Pulmonary (visceral) pleura – visceral serosa that covers
each lung
• Parietal pleura – serosa that lines the thoracic cavity
• Pleural space – potential space between pleurae
• Pleural fluid – allows lungs to glide easily over thorax wall
during breathing; two pleural layers cling together
 Homeostatic Imbalance
• Pleurisy – inflammation of the pleura;
caused by decreased or increased
secretion of pleural fluid.
• If decreased, surfaces are dry and rough –
friction  stabbing pains during breathing
• May produce too much fluid – not as
painful, but still trouble breathing
 THE LUNGS
• Primary bronchi divide into secondary and then
tertiary bronchi and then finally to the bronchioles
(smallest conducting passageways).
• Makes a bronchial or respiratory tree.
• Terminal bronchioles lead to respiratory zone
structures (respiratory bronchioles, alveolar
ducts, alveolar sacs, and alveoli)
• All the other structures are considered conducting
zone structures  lead to and from resp. zone
• Alveoli – look like grapes; make up most of
lungs; final point in respiratory passageway
THE LUNGS
 The Respiratory Membrane
• Simple squamous epithelial cells line walls of
alveoli
• Alveolar pores – connect neighboring air sacs
and provide alternate routes for air to reach
alveoli whose feeder bronchioles have been
clogged by mucous.
• Pulmonary capillaries cover external walls of
alveoli.
• Respiratory Membrane (air-blood barrier) –
alveolar and capillary walls and their fused
basement membranes; gas flowing on one side &
blood on the other side
 The Respiratory Membrane
• Gas exchanges occur by simple diffusion through
respiratory membrane.
• Oxygen from alveolar air into capillary blood
• Carbon dioxide from capillary blood into alveolus
• Healthy man = 50-70 square meters of surface area for
gas exchange
• Alveoli are the final line of defense for the respiratory
system.
• Macrophages (dust cells) – pick up bacteria, carbon
particles, and other debris
• Surfactant – lipid (fat) molecule that is produced by
scattered cuboidal cells
– lowers surface tension of film of water lining each alveolar sac so
that the alveoli do not collapse between each breath
Respiratory Physiology
 FUNCTION: supply the body with oxygen and to
dispose of carbon dioxide
 Four events must occur: RESPIRATION
 1. Pulmonary ventilation – air moves into and out of
lungs to exchange gases; breathing
 2. External respiration – Gas exchange between
pulmonary blood and alveoli
 3. Respiratory gas transport – oxygen and carbon
dioxide transported to and from lungs and tissue cells
of the body via bloodstream.
 4. Internal respiration – gas exchange made between
blood and tissue cells.
Mechanics of Breathing
 Also known as pulmonary ventilation
 Volume changes lead to pressure changes, which lead
to the flow of gases to equalize the pressure.
 Gas conforms to the shape of its container AND fills its
container.
 So, in large volume, gas molecules will be far apart and
pressure will be low.
 If volume is reduced, pressure will rise.
 Inspiration – air flowing into the lungs
 Expiration – air leaving the lungs
Inspiration
 Inspiratory muscles: diaphragm and external
intercostals
 When these contract, the thoracic cavity increases in
size  diaphragm moves inferiorly; external
intercostals lifts ribcage and pushes sternum forward
 Intrapulmonary volume (volume w/in the lungs)
increases and gases spread to fill the larger space.
 Increased volume = decreased pressure, which
produces a partial vacuum (pressure < atm. Pressure)
that sucks air into lungs
 Air moves in until pressure equalizes.
Expiration
 Passive process
 Inspiratory muscles relax making the thoracic and
intrapulmonary volumes decrease.
 Volume decreases = pressure increases (higher than
atmospheric pressure), which pushes the gases out to
equalize pressure.
 Active process in asthma, chronic bronchitis, and
pneumonia (uses ATP-energy).
 Normal pressure in pleural space (intrapleural
pressure) is ALWAYS negative – prevents lungs from
collapsing
Homeostatic Imbalance

 Atelectasis – lung collapse; happens when air

enters pleural space through chest wound or
from a rupture of the visceral pleura
 Pneumothorax – presence of air in intrapleural
space; disrupts fluid bond between pleurae
 Pneumothorax is reversed by drawing air out of
the intrapleural space with chest tubes (allows
lung to reinflate)
Nonrespiratory Air Movements

 Examples are coughs, sneezes, laughing,

crying, hiccups, yawn
 Result from reflex activity (some voluntary)
 See Table on page 414 in book
Respiratory Volumes and Capacities
 Affected by many factors – size, sex, age, and physical
condition
 Normal quiet breathing = 500 mL of air into and out
with each breath = TIDAL VOLUME (TV)
 INSPIRATORY RESERVE VOLUME (IRV) = amount of
air that can be taken in forcibly over the TV (2100-3200
mL)
 EXPIRATORY RESERVE VOLUME (ERV) = amount of
air that can be forcibly exhaled after tidal expiration
(1200 mL)
Respiratory Volumes and Capacities

 
 About 1200 mL still remains
in lungs – cannot be expelled
= RESIDUAL VOLUME (RV)
 RV allows gas exchange to
continuously go on; keeps
alveoli open (inflated)
 VITAL CAPACITY (VC) =
total amount of exchangeable
                                                                       
air (4800 mL)
 VC = TV + IRV + ERV
Respiratory Volumes and Capacities
 Dead space volume = air that remains in
conducting zone passageways (doesn’t reach
alveoli) – about 150 mL
 Functional volume = air that reaches respiratory
zone – about 350 mL
 Spirometer – measures respiratory capacities
 Pneumonia – inspiration problems, so IRV and
VC 
 Emphysema – expiration problems, so ERV 
Respiratory Sounds

 Bronchial sounds – produced by air rushing

through the large respiratory passageways
(trachea & bronchi)
 Vesicular breathing sounds – as air fills alveoli;
soft and muffled
 HOMEOSTATIC IMBALANCE: Rales = rasping
sound; WHEEZING = whistling sound (produced
by diseased resp. tissue, mucous, or pus)
External Respiration, Gas Transport, and
Internal Respiration 
External respiration =
actual exchange of
gases between the
alveoli and blood
(pulmonary gas
exchange)
 Internal respiration = gas
exchange process that
occurs between systemic
capillaries and tissue
cells
 See Fig. 13.10 on page
416
External Respiration
 Dark, red blood in pulmonary circuit picks up
oxygen and becomes scarlet color;
HEMOGLOBIN picks up oxygen
 CO2 is being dropped off
 Always more O2 in alveoli than in blood
 Concentration of CO2 is higher in pulmonary
capillaries than in alveolar air
 Blood draining from lungs is O2 rich and CO2
poor – take oxygen to rest of body
Gas Transport in the Blood
 Most oxygen attaches to hemoglobin molecules
in RBC’s to form oxyhemoglobin – HbO2
 Small amount of oxygen is dissolved in plasma.
 Most carbon dioxide is transported in plasma as
the bicarbonate ion (HCO3-) – blood buffer
system
 Small amount of carbon dioxide is carried inside
RBC’s hemoglobin
 O2 and CO2 bind at different places on Hb
Gas Transport in the Blood

 CO2 must be released from bicarbonate ion form

before diffusing out of the blood into the alveoli
 Bicarbonate ion must combine with hydrogen
ions to form carbonic acid (H2CO3)
 HCO3- + H+  H2CO3  H2O + CO2
 Then carbon dioxide can diffuse from blood and
enter alveoli
Gas Transport in Blood

Internal Respiration External Respiration

(systemic capillary) (pulmonary capillary)
Internal Respiration
 Exchange between blood and tissue cells
 Oxygen is unloaded and carbon dioxide loaded into blood
 CO2 + H2O (when in blood)  H2CO3  HCO3- + H+
 CARBONIC ANHYDRASE = special enzyme in RBC that
helps convert CO2 to HCO3-
 Then bicarbonate diffuses out into plasma
 O2 released from Hb and diffuses from blood  tissue cells
 Venous blood in systemic circulation = poor in O2, rich in
CO2
 Arterial blood in systemic circulation = rich in O2, poor in CO2
Systemic vs. Pulmonary Circulation
Homeostatic Imbalance
 HYPOXIA – inadequate oxygen delivery to body tissues
(skin becomes bluish – cyanotic)
Caused by anemia, pulmonary disease or blocked blood
circulation
 CARBON MONOXIDE POISONING – competes with
oxygen for Hb binding sites
Leading cause of death from fire
Does not produce cyanosis or respiratory distress
Skin color is red (blush)
Given 100% O2 until CO is cleared from body
Control of Respiration: Neural Regulation
 PHRENIC & INTERCOSTAL NERVES = nerve
impulses regulate diaphragm and external
intercostals
 MEDULLA = sets basic rhythm of breathing;
contains self-exciting inspiratory center
 PONS = smooth out basic rhythm of inspiration
and expiration
 Medulla & Pons give respiratory rate of 12-15
respirations/minute = eupnea
Neural Regulation (cont.)
 HOMEOSTATIC
 Stretch receptors on IMBALANCE: Medulla
bronchioles and alveoli = centers completely
prevent overinflation
suppressed = sleeping
 Receptors send impulse pills, alcohol, morphine
to medulla by the VAGUS  respiration stops and
NERVES – causes
expiration death occurs
 Hyperpnea – breathing
more vigorously
(exercise) – brain sends
more impulses
Factors Influencing Respiratory Rate &
Depth: PHYSICAL
 Examples are talking,
coughing and exercise –
all these can modify rate
and depth
 Also mentioned during
nonrespiratory air
movements
 Increased body
temperature = Increased
rate of breathing
Factors Influencing Respiratory Rate &
Depth: VOLITION (Conscious Control)
 Voluntary holding of breath – ex. Singing,
swimming, swallowing, etc.
 Limited time before respiratory centers start
ignoring messages from the cortex – normally
when O2 is getting low or blood pH is falling
 Involuntary controls will take over!
Factors Influencing Respiratory Rate &
Depth: EMOTIONAL
 Examples include holding breath during
suspense movie, gasp of horror, shock, etc.
 Result from emotional stimuli acting through
centers in hypothalamus.
Factors Influencing Respiratory Rate &
Depth: CHEMICAL
 Levels of carbon dioxide and oxygen in the blood
 Increased CO2 and decreased blood pH = increase in
breathing rate and depth
 Changes in CO2 in blood act directly on medulla
centers
 Changes in O2 in blood are detected by chemoreceptor
regions in the aorta and carotid artery  messages to
medulla when O2 dropping
 MOST IMPORTANT = get rid of CO2!!!
Factors Influencing Respiratory Rate &
Depth: CHEMICAL
 Hyperventilation = breathing deeply and rapidly
(different from hypernea – exercise)
Decreases carbonic acid
 Hypoventilation = breathing shallowly and
slowly
Increases carbonic acid

Acidosis or alkalosis may occur because buffering

system is overwhelmed.
Homeostatic Imbalance
 Apnea = cessation (stopping) of
breathing
 Cyanosis = due to not enough
oxygen in the blood from apnea
 Dizziness and fainting may occur
 Breathing in bag – bag will contain
more CO2 and will get carbonic acid
levels back to normal and end
alkalosis.
Respiratory Disorders

Chronic Obstructive Pulmonary Disease (COPD)

• Chronic bronchitis and emphysema
• Patients almost always have history of smoking
• Dyspnea = difficult breathing – becomes more severe
over time
• Coughing and frequent pulmonary infections are
common
• Most COPD victims are hypoxic – retain CO2 and have
respiratory acidosis and ultimately respiratory failure
Emphysema
 Chronic inflammation of
alveoli  leads to fibrosis of
lungs
 Airways collapse
 Patients always tired
because it takes energy to
exhale and inhale
 Cyanosis appears late in the
disease
 “Pink puffers”
 Permanently expanded chest
Chronic Bronchitis
 Lower passageways
inflamed and produce
                                                                       

  

excessive mucous
 Increases risk of lung
infections – pneumonia
 “Blue bloaters” – hypoxia
and CO2 retention 
cyanosis
Cancer
 1/3 of cancer deaths in US
 Most are aggressive
 Very low survival rate – hard to diagnose until in
late stages
 Smoking increases heart rate, constricts blood
vessels  heart disease
 Most effective treatment is complete removal of
diseased lung
 See pages 420-421 in book
Developmental Aspects of Respiratory
System
 FETUS – lungs filled with fluid; respiratory exchanges
made by placenta
 BIRTH – pathways are drained and fill with air
 Lungs don’t fully inflate for 2 weeks
 Depends on surfactant – lowers surface tension of water lining each
alveolar sac (not present until about 28-30 weeks into pregnancy)
 Respiratory rate highest in newborns = 40-80resp./min.
 Lungs continue to develop until young adulthood
 YOUTH – problems due to external factors; alveoli still
developing
 OLD AGE – thorax becomes more rigid and lungs less
elastic (decreased vital capacity)
Developmental Aspects of Respiratory
System
 Premature infants have problems keeping lungs
inflated (lack of surfactant)
 Birth defects = cleft palate & cystic fibrosis
 Cystic Fibrosis (CF) = causes oversecretion of
thick mucous – clogs passageways (respiratory
and digestive)
Faulty gene that codes for CFTR protein