RESPIRATORY SYSTEM-1

PHYSIOLOGY
Regulation of breathing and cough
SARA GEORGE
School of Medicine
Faculty of Health Sciences
University of Botswana

5th Sept 2012

 Functions of the respiratory system

The delivery of O2 to the lungs and the expulsion of CO2 and H2O out of the lungs.

The diffusion of O2 into the bloodstream and the diffusion of CO2 out of the bloodstream.

The regulation of the acid-base levels of blood.

The process of filtering, warming, and humidifying inspired air.

The production of speech and melody created by the vibration of the vocal folds. 

The process of detecting smell by the use of olfactory receptors.

The process of protecting respiratory surfaces from dehydration and temperature change and defending the
body against inhaled pathogens.
At the end of this section, you should be able to:

• Outline the concept of internal and external

respiration

• Describe the cough reflex

• Describe the central control of respiration

• Describe the concept of partial pressure of gases

• Understand the relationship between respiration

and breathing
Components of the respiratory system:
review
 THE ALVEOLI
Alveoli are tiny, thin-walled air sacs with a rich blood supply.
Their walls are just one cell thick, as are the capillaries that
surround them, meaning that gases diffuse across a distance of
only two cells thick to gain access to the bloodstream.
The internal surface of an alveolus is covered with a moist film
of alveolar fluid allowing oxygen from the air to dissolve into
it.  It contains surfactant, a fluid rich in phospholipids and
proteins that decreases the surface tension in the alveoli,
preventing them from collapsing. Each alveolus contains a
large number of macrophages that phagocytose foreign
particles and debris, killing bacteria that have entered the lungs
and have been trapped on the moist walls.
The alveolar side of the respiratory membrane is
composed of a layer of type 1 and 2 alveolar cells
surrounded by an epithelial basement membrane.
Alveolar macrophages line alveolar wall and
function to remove dust particles. The alveolar
wall is separated from the capillary wall by an
interstitial space.
Type 1 alveolar cells

Type 1 alveolar cells are broad, simple squamous

epithelial cells that make up the majority of the ce
lining the walls of the alveoli.
Function
They lie in a thin, single layer which allows for eas
diffusion of gases across the respiratory membran
Type 2 alveolar cells

Type 2 alveolar cells are cuboidal-shaped cells that line the

remaining space on the walls of the alveoli and are fewer in
number than the type 1 alveolar cells.
Function
They repair the alveolar wall after damage and secrete surfac
The very thin walls of the alveoli are prone to collapse. Surfac
is a phospholipid-proteinous fluid that coats the interior surfa
of the alveoli to prevent the alveoli from collapsing. It does th
by reducing the surface tension of the alveoli and increasing t
compliance of the lungs; it prevents the alveoli from sticking
together with each breath by keeping the surface between th
cells and air moist.
Alveolar basement membrane

The alveolar epithelial basement membrane is the thin,

extracellular membrane that surrounds the alveolar wall. It
consists of a basal lamina and fibrous reticular lamina.

Function
It anchors the alveolar cells to the surrounding connective tissue.
Alveolar macrophages

Alveolar macrophages are large mononuclear phagocytes that

reside on the inner epithelial surface of the alveoli.

Function
They phagocytose (ingest) any debris or micro-organisms that
have become stuck to the respiratory surfaces. When confronted
with a large number of infectious particles, macrophages will also
trigger an immune response (inflammation and recruiting
neutrophils to the area).

Interstitial space

The interstitial spaces or tissue spaces are the minute gaps found
between cells and tissues; interstitial fluid fills these spaces
bathing the surrounding cells.

Function
Interstitial fluid allows the diffusion of gases to occur across the
respiratory membrane.
 TYPE 2 ALVEOLAR CELL

TYPE 1
ALVEOLAR
CELL

MICROP
HAGE
 EXCHANGE OF GASES
• The process of gas exchange in the body ,called
respiration, has three basic steps:
• Pulmonary ventilation: this includes the
inhalation and exhalation of air between the
atmosphere and the alveoli
• External respiration(pulmonary)exchange of
gases between the alveoli of he lungs and the
blood in pulmonary capillaries. In this process
the blood gains O2 and loses CO2.
• Internal respiration(tissue) is the exchange of
gases in the systemic capillaries and tissue cells.
Internal and External Respiration
Ventilation

Gas Exchange –diffusion

down partial pressure
gradient

Gas Transport

Gas Exchange –diffusion

down partial pressure
gradient
 PULMONARY VENTILATION
• In pulmonary ventilation, the air flows between the
atmosphere and the alveoli because of alternating
pressure gradient created by the contraction and
relaxation of the respiratory muscles. The rate of air
flow and the amount of effort needed for breathing is
also influenced by alveolar surface tension, Compliance
of the lungs, surfactant and air way resistance. Air move
into the lungs when air pressure inside the lung is lesser
than the atmosphere and air moves out when the
pressure inside the lung is greater than the atmosphere.
 BOYLE'S LAW

In order to understand the mechanisms of breathing, it is important to understand the

relationship between pressure and volume.

This is explained through Boyle’s law, which states that the pressure (p) of a gas in a
closed container is inversely proportional to the volume (V) of the container:
pV = The
K alveolar
(constant)
side of the respiratory membrane is composed of a layer of type 1 and 2 alveolar cells surrounded by an epithelial basement membrane.
Alveolar macrophages line alveolar wall and function to remove dust particles. The alveolar wall is separated from the capillary wall by an interstitial
space.
These differences in air pressure provide the primary force for airflow during pulmonary ventilation. Three other factors affect the ease of breathing:
surface tension of alveolar fluid, lung compliance, and airway resistance.

If the size of the closed container is decreased, the pressure of the gas inside the
container increases, and that if the size of the container increases, the pressure of the
gas inside the container decreases.
 Partial Pressures of Gases
Partial pressure exerted by each
gas in a mixture= total pressure X
the fractional composition of this
gas in the mixture

Gas exchange involves

simple diffusion of O2 and
CO2 down their partial
pressure gradients at both
the pulmonary and tissue
capillaries
 PRESSURE CHANGES DURING PULONARY VENTILATION
INHALATION
During inhalation, air pressure in the atmosphere is higher than in the lungs, so air flows into the lungs.
Conversely, during exhalation, air pressure in the lungs is higher than in the atmosphere, so air flows out of
• INHALATION
the lungs. According to Boyle’s law, increasing the volume of the lungs will decrease the air pressure within
the lungs. During inhalation, the lungs expand, pressure in the lungs drops compared to atmospheric
pressure, and air flows in. This is achieved by contracting the muscles of inhalation.
These include the diaphragm, which increases the vertical diameter of the thoracic cavity, pulling the lungs
down, and the external intercostal muscles, which elevate the ribs, thereby increasing the antero-posterior
and lateral dimensions of the thoracic cavity.

The diaphragm is responsible for 75% of the air entering the lungs and the external intercostal muscles are
responsible for the remaining 25%.
EXHALATION

Conversely, decreasing the volume of the lungs will increase the air pressure in
the lungs, and air flows out. During exhalation, the lungs revert back to their
original size, pressure in the lungs rises compared to atmospheric pressure, and
air moves out. This deflation of the lungs is due to relaxation of the muscles of
inhalation. During quiet breathing, this passive process results from the elastic
recoil of the lungs and the inward pull of surface tension. Exhalation can also
become an active process. During forceful breathing, for example when
exercising, the abdominal and internal intercostal muscles contract. As they
contract, they decrease the volume of the abdominal region and thoracic cavity,
which increases the pressure in the lungs, causing air to flow out faster.
Respiration metabolic functions:

• Converts angiotensin I (a peptide) to angiotensin II by

angiotensin-converting enzyme (ACE).
• Inactivates another peptide, bradykinin by ACE as well.
• Removes serotonin (5-hydroxytryptamine) through an
uptake and storage process.
• Removes norepinephrine through an uptake process.
• Removes prostaglandin E1, E2 & F2
• Removes leukotrienes
Angiotensin 11 stimulates the adrenal cortex to secrete aldosterone ,contraction of smooth
muscles resulting in vasoconstriction of arterioles
2 .Bradykinin is a peptide that causes blood vessels to dilate (enlarge), and therefore causes
blood pressure to lower. A class of drugs called ACE inhibitors, which are used to lower blood
pressure, increase bradykinin (by inhibiting its degradation) further lowering blood pressure.
3. Serotonin
Serotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from
tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central
nervous system of animals including humans.
4. Norepinephrine
Norepinephrine, or noradrenaline, is a catecholamine with multiple roles including as a hormone
and a neurotransmitter. Areas of the body that produce or are affected by norepinephrine are
described as noradrenergic.
5. A prostaglandin is any member of a group of lipid compounds that are derived enzymatically
from fatty acids and have important functions in the animal body.
6. Leukotrienes are fatty signaling molecules. They were first found in leukocytes (hence their
name). One of their roles (specifically, leukotriene D4) is to trigger contractions in the smooth
muscles lining the trachea; their overproduction is a major cause of inflammation in asthma and
allergic rhinitis.[ Leukotriene antagonists are used to treat these diseases by inhibiting the
production or activity of leukotrienes.
 Regulation of Respiration
All participate in establishing the
rhythmic pattern of breathing Hering-Breuer
Inflation Reflex
DRG- mostly inspiratory neurons
VRG- Both inspiratory & expiratory
neurons

Pre-Botzinger complex- currently

believed to generate the rhythmic
pattern
Pneumotaxic center- sends signals
to the DRG, switches off inspiratory
neurons & dominates the apneustic
center
Controls rate & depth of breathing

Apneustic center- opposes the

pneumotaxic center
 CONTROL OF RESPIRATION
• Our respiratory rate, or the number of breaths we take per minute,
and the depth at which we respire with each breath is controlled by
the respiratory center, located in the brainstem.
• It ensures that our respiratory effort matches the metabolic demands
of our body.
• The respiratory center controls respiration by influencing the
contraction and relaxation of the muscles of respiration. It is located
in the brainstem and consists of several clusters of neurons which
each exert their own influence over breathing rhythm and co-
ordination.
• The respiratory center responds involuntarily to the body's need for
oxygen and carbon dioxide and interprets various afferent signals
from other parts of the body.
 CONTROL OF RESPIRATION

• Two parts of the brainstem are primarily

responsible for this control: the medulla
oblongata and the pons. These areas can be
further subdivided into three important
control areas: the medullary rhythmicity area,
located in the medulla oblongata, and the
pneumotaxic and apneustic areas, located in
the pons.
Medullary rhythmicity area
The medullary rhythmicity area is located in the medulla oblongata of the
brainstem.

It can be further divided into the inspiratory area, also known as the dorsal
respiratory group or DRG, and expiratory area, also known as the ventral
respiratory group or VRG.

ction The medullary rhythmicity area is responsible for sending inhibitory and
stimulatory impulses to the muscles of respiration to regulate breathing
rhythm.

Inspiratory area (DRG)

The inspiratory area stimulates spontaneous ventilation and is responsible

for the resting breathing rate. It responds to afferent signals from
chemoreceptors and mechanoreceptors present in the body and sends
impulses via the intercostal and phrenic nerves to the muscles of
respiration.

Expiratory area (VRG)

The expiratory area responds to stimulation beyond that of normal

breathing; during normal quiet breathing this area is usually dormant. It is
particularly sensitive to the body's changing needs for oxygen and responds
by altering breathing pattern, sending impulses to the muscles of expiration.
Pneumotaxic area
The pneumotaxic area is located in the
pons of the brainstem and is responsible
for regulating the transition between
inspiration and expiration.
Function
The pneumotaxic area transmits inhibitory
nerve impulses to the inspiratory area of
the medullary rhythmicity area, switching
it off before the lungs become too full of
air. When active, it also overrides signals
sent from the apneustic area.

An increase in the firing rate of the

pneumotaxic area will increase the
breathing rate, so the pneumotaxic area
can be said to indirectly influence
breathing rhythm.
Apneustic area

The apneustic area is located in the pons of

the brainstem and is responsible for
regulating the transition between
inspiration and exhalation.

Function
The apneustic area constantly transmits
stimulatory nerve impulses to the
inspiratory area of the medullary
rhythmicity area, which if left alone, would
cause prolonged, deep inhalations.
However, when active, the pneumotaxic
area overrides the action of the apneustic
area and prevents over-inflation of the
lungs.
Regulation of respiration- central chemoreceptors

•Chemiosensitive center in the medulla

• sensitive to increase brain ECF H+ generated from CO2

 CONTROL OF THE RESPIRATORY CENTER
• An important feature of the respiratory center is its ability to
respond to afferent signals from the body, concerning the need
for oxygen and accumulation of carbon dioxide. When the body
is running low on oxygen, it is important that breathing rate is
increased in order to replenish supplies.

There are a number of factors that can influence the respiratory

center of the brain and affect breathing rhythm. These include
cortical influences, chemoreceptor regulation, proprioceptive
stimulation, and the inflation reflex. Other factors contributing
to the regulation of respiration include the limbic system, blood
pressure, pain, temperature, and irritation of the airways.
 Regulation of respiration- peripheral chemoreceptors

• Sensitive to oxygen, only if

PO2 is less than 60mmHg.

•H+ and CO2 less sensitive

 Regulation of respiration- during exercise

• Ventilationincreases up to 25-fold during moderate to vigorous

exercise intensity

•The exact mechanism (s) which regulate this increase is

unknown.

•Several mechanisms have been proposed:

 Reflex originating around joints

 Increase in body temperature
 Increase in epinephrine release
 signals from cerebral cortex
 Cough Reflex
A reflex initiated by irritants or foreign matter lodging on the lower respiratory
passages

Sensory signals from the trachea, bronchi, larynx and bronchioles are sent to
the medulla via the vagus nerve

PROCESS involves:
1.Rapid inspiration of large amount of air
2.Closure of the epiglottis and vocal cords, trapping the inspired air
3. Forceful contraction of abdominal and internal intercostals, pushing against
the diaphragm, therefore raising the inter-alveolar pressure
4. The result is a rapid and forceful opening of the epiglottis and vocal cords,
releasing the entrapped air to the outside; removal of foreign matter presently
lodging in the trachea and bronchi
 Sneeze Reflex

Similar to the cough reflex but:

Initiated by irritants or foreign matter lodging on the nasal

passages

Sensory signals from the nasal passages are sent to the medulla
via the CN V

Uvula is depressed

Release of the inspired air to the outside is mainly through the

NOSE rather than the mouth.
Pulmonary air volumes refer to the set of average
volumes that can be applied to certain aspects of
pulmonary ventilation. Pulmonary volumes and
capacities vary from person to person depending on
their age, relative size, and build.

There are four major pulmonary volumes: tidal

volume, residual volume, expiratory reserve volume
and inspiratory reserve volume. The relative sums of
these volumes make up the pulmonary capacities.
 Tidal volume
The tidal volume is the volume of air inhaled or
exhaled with one normal breath. The tidal
volume multiplied by the respiratory rate
(number of breaths per minute) gives the minute
ventilation.
Volume It is typically about 500 ml.

Residual volume
Residual volume refers to the volume of air
that remains in the alveoli after a forced
expiration.

Volume It is typically about 1,100 ml in females and

1,200ml in males.
xpiratory reserve volume
The expiratory reserve volume is the volume of air that can be
forcefully expelled from the lungs after a normal expiration.
t is typically about 700 ml in females and 1,200ml in males.

spiratory reserve volume

The inspiratory reserve volume is the additional volume of air
you can inspire following a normal inspiration.
t is typically about 1,900 ml in females and 3,100 ml in males.
 END
THANK YOU