RESPIRATOR

Y SYSTEM
Respiratory System
• Consist of upper and lower respiratory
tracts
• Works closely with the circulatory
system
• Function
• Gas Exchange
• Regulation of blood pH –
• Sound Production – speech
• Olfaction
• Thermoregulation
• Protection against
microorganisms
Respiration
• Process by which living organisms inhale oxygen from the
surrounding atmosphere and then exhale carbon dioxide
• Controlled by the Medulla oblongata
• Steps:
1. Ventilation = Inspiration and Expiration (Exchange of air between the
lungs and the atmosphere)
2. External Respiration = exchange of gases in the lungs
3. Transport of gases in the blood
4. Internal Respiration = exchange of gases between blood and cells
Inhaled and Exhaled Air Composition
• Inhaled (Breath In):
• 79% Nitrogen Gas
• 20.9% Oxygen
• 0.04% CO2
• water
• Exhaled (Breath out):
• 79% Nitrogen Gas
• 16.3% Oxygen
• 4.5% CO2
• water
Muscles Used for Breathing
Muscles Used for Breathing
 Cells lining the Respiratory Tract

• Pseudostratified ciliated
columnar epithelial cells

• Cilia - sweeps mucus,

germs and debris toward
the throat.

• Goblet Cells – produces

mucus
Upper Respiratory Tract
The Respiratory
System
UPPER RESPIRATORY
SYSTEM Sinuses
• Cavities in skull
•Filters,
• Lighten head
warms, and
•Warm
moistens air
and
Nasal cavity moisten
• Produces air
mucus Pharynx
•Filters, •Passagewa
warms, and y for
moistens air air and food
• Olfaction

RESPIRATORY
MUSCLES
•Cause
breathing
Intercostal
muscles Diaphragm
•Muscle
•Move ribs
sheet between
during breathing chest and abdominal
cavities with a role in
breathing
Upper Respiratory Tract
Upper Respiratory Tract

Nose and Nasal Cavity

• Two hollow spaces (divided by the

septal cartilage) lined with
mucous membrane and hair-like
structures that traps dirt and
pathogens
• Warms, filters and moistens the air as
it enters the cavities (sinuses)
• Regions
• Vestibule
• Olfactory
• Respiratory
Upper Respiratory Tract

Nose and Nasal Cavity

• Filters or entraps particles (>10 μm), warms (10F), and humidifies

(2 to 3%) inspired air
• Olfactory function
• Volume – 20 mL (> greater surface area)
• Volume of air entering the nose per day – 10,000 to 15,000 L
• Airflow Resistance - ~50% (~8 cm H2O/L/sec)
Upper Respiratory Tract : Nose and Nasal Cavity

• pseudostratified columnar
epithelium and olfactory
• Lined
cells
with stratified
squamous epithelium and
sebaceous glands
• Contain vibrissae-nasal
hair, first line of defense,
function to filter inspired air

• Passages composed of conchae (turbinate bones)

through which air travels into respiratory system
• Highly vascular and contains ciliated, pseudostratified
columnar epithelium
• Contains Goblet cells
Upper Respiratory Tract

Sinuses

• Air spaces that help lighten the skull

• Offer resonance to the voice
• EX: sinusitis or cold or nasal
congestion
• Protect the brain during frontal trauma
Upper Respiratory Tract

Pharynx
• Cone-shaped passageway between the oral, nasal cavities down to the
head of the esophagus and larynx
• Circular muscles - help push food to esophagus and prevent air from
being swallowed
• Longitudinal fibers - lift the walls of the pharynx during swallowing

• Subdivisions
• Nasopharynx
• Oropharynx
• Laryngopharynx
Upper Respiratory Tract : Pharynx

• Upper section behind the nasal

cavity that contains pharyngeal
tonsils and opens to the
Eustachian tube from the ear
• Filters bacteria and foreign
particles from inspired air

• Located behind the oral cavity

• Receives air from the
nasopharynx and food/air from
the mouth

• Connects the upper and lower

airway
• Branches into the trachea and
esophagus
Upper Respiratory Tract : Pharynx

Epiglottis
• flap that covers the glottis that leads to the
larynx and trachea during swallowing
Lower Respiratory Tract
The Respiratory
System
LOWER RESPIRATORY
SYSTEM
• Exchanges gases

Larynx
• Air passageway Lungs
•Structures that
•Prevents food and
contain alveoli and air
drink from entering lower
passageways
respiratory system •Allow exchange of
• Produces voice
oxygen and carbon
Bronchi dioxide between
•Two branches of atmosphere and blood
trachea that conduct
Trachea
air from trachea to •Connects larynx
each lung
with bronchi leading
to each lung
Bronchioles
•Conducts air to
•Narrow
and from bronchi
passageways to
conduct air from
bronchi to alveoli Alveoli
•Microscopic
chambers for gas
exchange
Lower Respiratory Tract
Larynx
• Houses vocal folds which manipulates pitch and volume
• Pseudostratified ciliated columnar epithelium (except true VC)
• Cartilages
• Thyroid cartilage – protrudes into the so-called “Adam’s apple”
• Cricoid cartilage
• Arytenoids
• Epiglottis
Lower Respiratory Tract : Larynx

Sound Production
• Two Folds
• Vestibular / False VF
• Vocal Cord / True VF

• Allows sound production by voluntarily

tensing the muscles
• High pitched sound – tense vocal cords; fast
vibration
• Low pitched sound – relaxed vocal cords’ slow
vibration
• Air passing through the glottis vibrates the
vocal folds producing sound waves
Lower Respiratory Tract

Trachea
• Composed of 20 rings of tough cartilage
with the back part made up of muscles and
CT which connects the larynx to
primary bronchi
• Composition:
• Mucosa: ciliated pseudostratified
columnar epithelium, goblet cells
• Submucosa: dense
connective tissue and seromucous glands
• Hyaline cartilage: C-
shaped; stabilize opening
• Adventitia: connective tissue
that covers cartilage
Lower Respiratory Tract

Bronchi
Portions
• Primary bronchi
• enters into the lungs via
the hilus PA
• Secondary / Tertiary bronchi PV Bronchus
• Innervated with
sympathetic and
parasympathetic nerves
• Contains seromucous
glands
Lower Respiratory Tract

Right Main Bronchus Left Main Bronchus

Bronchi Wider and Shorter Thinner and Longer
More vertical
More prone to aspiration of
food particles
Lower Respiratory Tract

Bronchioles
• Mucosa lined by respiratory
epithelium with Clara cells
(replacing goblet cells) - secrete
glycosaminoglycans and
secretory proteins
• No cartilage Clara Cell
Lower Respiratory Tract

Lungs
• Located in the two pleural
cavity surrounded by the rib
cage and intercostal muscles
• Right lung
• three lobes: superior, middle, and
inferior
• Separated by horizontal and
oblique fissures
• Left lung
• two lobes: superior and inferior
• Separated by an oblique fissure
Lower Respiratory Tract

Lungs
Lower respiratory tract : lungs

Alveoli
• Site of gas exchange (~ 300-500M alveoli in the lungs)
• Tiny, balloon-shaped air sacs at the very end of the respiratory tree
• One cell thick lined by surfactant - maintains shape and surface tension of the air sac
Lower respiratory tract : lungs

Alveoli Type I
• Type 1 Pneumocytes
• 95%-97%
• flat dark oval nucleus and thin
cytoplasm Type II
• Forms barrier for gas exchange
• Type II Pneumocytes
• can divide and replace type I
cells
• corner of alveoli
• secrete components of pulmonary
surfactant.
• Alveolar macrophages
• aka dust cells / Type III
• located in septa
• contain phagocytized material
Lower respiratory tract : lungs

Alveoli

• Pore of Khon
• Small holes in the walls of
adjoining alveoli (alveolar septa)
Lower respiratory tract : lungs

Alveoli
Lower respiratory tract : lungs

Surfactant

• Thin film lining the alveolar surface

• Phospholipid produced by Alveolar Type II Cells
• Main Component: Dipalmitoylphosphatidylcholine (DPPC)
• Production starts at 24 weeks AOG
Lower respiratory tract : lungs

Surfactant

Functions
• Lowers surface tension; “anti-stick” property
• Promotes stability among alveoli of different sizes by
decreasing tendency of small alveoli to collapse
(interdependence)
• Reduces capillary filtration forces
Lower respiratory tract : lungs

Mechanism of the Lungs

Inhalation
• Nerve impulse from MO travel to
external intercostal muscles and
diaphragm pulling ribs upward
• Diaphragm muscle contracts,
increasing volume inside the
lungs, thus, decreasing pressure
inside the lungs compared to the air
outside the body
• Air rushes in and the lungs
inflates
Lower respiratory tract : lungs

Mechanism of the Lungs

Exhalation
• Passive
• External intercostal muscles and
diaphragm relax, pulling ribs
downwards
• Diaphragm relaxes and becomes dome-
shaped, making the volume of the lungs
lower, thus, pressure inside lungs is
increased compared to the outside of the
body
• Air is forced out, lungs deflate
Lower respiratory tract : lungs

Physical Properties of the Lungs

COMPLIANCE
• Ease with which the lungs can expand/open
• Inversely correlated with elasticity
• Dependent on elasticity
• The more elastic the lungs, the lower the compliance
• Greater Compliance – easier to change in pressure to cause
explansion
• Lower compliance – lungs and thorax are harder to expand
Lower respiratory tract : lungs

Physical Properties of the Lungs

ELASTICITY
• Tendency of the lungs to return to its initial size
after distention (usual position: collapsed)
• Lungs has high content of elastin proteins
• Elastic tension increases during inspiration and is
reduced by recoil during expiration
Lower respiratory tract : lungs

Physical Properties of the Lungs

SURFACE TENSION
• Laplace Law
• Surface tension in the alveolar cells
creates a Collapsing Pressure
• Pressure in alveoli is directly
proportional to surface tension; and
inversely proportional to radius of
alveoli
• ↓ Surface Tension = ↓ Collapsing
Pressure = ↑ Radius of Alveoli
• Factors that prevent lung collapse:
surfactant and small airway collapse
 INNERVATION OF THE RESPIRATORY
SYSTEM
AUTONOMIC NERVOUS CONTROL
Sympathetic Control
Activation of B2 Adrenergic Receptors  bronchodilatation

Parasympathetic Control
Activation of Muscarinic Receptors  bronchoconstriction

Vasoactive Intestinal Peptide (VIP)

A noncholinergic, non-adrenergic innervation of bronchioles

bronchodilatation
 INNERVATION OF THE RESPIRATORY
SYSTEM
LOCAL CONTROL
Exerted by substances released in the lungs by mast cells
upon exposure to unwanted organisms
Histamine
o Binds to H1 Receptor □ constriction
o Binds to H2 Receptor □ dilatation

SRS-A (Slow Reactive Substance of Anaphylaxis)

Allergic response  severe bronchoconstriction 
hypoxemia
Conducting Airways and Respiratory Units
of the Lungs
 Conducting Airways and Respiratory Units
of the Lungs

CONDUCTING ZONE/AIRWYAY

• Starts from the trachea, bronchus, terminal bronchiole

• Conducts/delivers air
• Not involved in gas exchange
• Volume of air in the conducting airways is termed as
“Dead Space Volume”
• The volume of air that does not participate in gas
exchange anatomically is said to 150 mL or cc
Conducting Airways and Respiratory Units
of the Lungs

RESPIRATORY ZONE/UNIT

• Involved in gas exchange

• Respiratory bronchioles, alveolar ducts, and alveolar
sacs
• Note that the actual gas exchange takes place in the
Respiratory Membrane
 Medical
Application
OBSTRUCTIVE PULMONARY DISEASE
• Involves the conducting airways
• Airflow obstruction (excessive mucus, inflammation,
and bronchospasm)
• Can be seen in patients with:
• Bronchial asthma
• Chronic bronchitis
• Bronchiolitis
• Cystic Fibrosis
 Ventilation
• Exchange of air between the lungs and the atmosphere
• maintains concentration gradients of oxygen and carbon dioxide between air in
alveoli and blood
NAME DESCRIPTION EXAMPLEs
Eupnea Normal quiet breathing
Hyperpnea Increased respiratory rate Exercise
with increased metabolism
Hyperventilation Increased respiratory rate Emotional hyperventilation
without increased
metabolism
Hypoventilation Decreased alveolar Shallow breathing; asthma;
ventilation restrictive lung disease
Tachypnea Rapid breathing Panting
Dyspnea Difficulty breathing “air Various pathologies or hard
hunger” exercise
Apnea Cessation of breathing Voluntary breath-holding; depression
of CNS control centers
 Measuring Breathing

Vital
capacity Total lung • Tidal volume - amount you breathe in
6000 Inspiratory capacity and out in one normal breath
reserve
• Vital capacity - maximum volume of
5000
air you can breathe out after
breathing in as much as you can.
4000
• Residual volume - amount of air left
Lung Volume

in your lungs after you have breathed out

3000
as hard as you can.
• Expiratory RV - additional air that
(ml)

2000 Expiratory
reserve can be forcibly exhaled after the
Tidal expiration of a normal tidal volume.
1000 volume
• Inspiratory RV - additional air that
Residual
Volume
can be forcibly inhaled after the
0 inspiration of a normal tidal volume.
SPIROGRAM
Factors affecting vital capacity
• Age
• Sex
• Height
• Body Built
• Trained Athletes
Breathing during exercise
• Muscle cells consume more O2 and produce increased CO2.

• Chemoreceptors in the arteries detects increased amount of CO2

and low blood pH
• Signals are sent to the MO which in turn commands
the lungs to increase breathing

• Respiration rate and the volume of air

increases to enhance gas
exchange
• The heart will beat faster to
increase the amount of blood
being pumped
Gas Exchange
- Exchange of oxygen and carbon dioxide between the
alveolar tissues and blood via diffusion

CO2 Transport
1. CO2 is transported
dissolved in the
plasma (10%)
2. CO2 is bound to
hemoglobin (20%)
3. CO2 is converted to
bicarbonate ions
(70%)
Gas Diffusion through Respiratory
Membrane Depends on
- Membrane thickness
- Diffusion coefficient of gas
- Surface area
- Partial pressure difference
 O2 Binding by Hemoglobin
Oxygen is carried in blood in two forms:
• Transported from the lungs to the tissue; Chemical
combination with hemoglobin in the RBC (97%)
• Transported in dissolved state in the plasma (3%)
 Hemoglobin
• Globular protein of 4 subunits (2
alpha, 2 beta)
• Each subunit contains a heme
moiety which is iron-containing
porphyrin
• The iron is in the ferrous state
which binds to O2
• Hemoglobin Variants
• Oxyhemoglbun
• Deoxyhemoglobin
• Methemoglobin
• Myoglobin
• Fetal hemoglobin
• Hemoglobin S
 O2 Transport

Allosterically cooperative
• O2 binding to any
of the heme groups
shape
changes of thethe entire
structure Hb
• Each O2 bound
promotes the binding of the
next O2
• Results to a very steep
Hb- O2 dissociation curve
 Hb-O2 Dissociation Curve

• At low partial O2 pressure, the

association of oxygen and Hb is
low
• Hb has a tight structure if
oxygen is not bound
• Lungs - has high partial
O2 pressure
• Respiring tissues – low
O2 partial pressure
 Hb-O2 Dissociation Curve
• During Exercise, acidosis and
increased temperature
• Curve shifts to the right to
facilitate better O2
unloading
• pH level decreases –
changes Hb structure and
changes affinity to O2

• Presence of CO, high pH, high

temperature
• Curve shifts to the left
decreasing O2 unloading
Diseases of the Respiratory System
Asthma
- common, chronic respiratory condition that causes difficulty breathing due
to inflammation of the airways.

-Symptoms: dry cough,

wheezing, chest tightness and
shortness of breaths
-Causes: Inhalation of allergens,
pollutants, infection, or emotional
stress.
-Treatment: immuno-
suppressors, bronchodilators)
Diseases of the Respiratory System
Pneumonia
- bacterial, viral or fungal infection in the air
Normal chest x-ray
sacs
- Causative organisms: Pneumococci,
Staphylococcus, Streptococcus, H.
influenzae, Respiratory syncytial virus
- Symptoms: cough, fever, shaking
and shortness of breath Lobar pneumonia
chills
Treatment: Antibiotics or other
antimicrobials.
Diseases of the Respiratory System
Emphysema
- Common cause: smoking, pollution, old age, infections
- Trouble exhaling air from their lungs as the alveoli becomes dry
and brittle
- Evolves slowly over years and there is no cure
Diseases of the Respiratory System
Lung Cancer
- Develops in main part of the lungs near the air sacs
- DNA mutations (due to toxins, mutagens, nicotine, etc.) in the lungs
causes tumor growth
- Symptoms: chronic coughing, changes in voice, harsh breathing and
coughing up blood
Diseases of the Respiratory System
Cystic Fibrosis
• mutation of a single gene, the CFTR gene, which controls salt
balance in the lungs
• Mucus blocks bronchioles
• no cure
Diseases of the Respiratory System
Tuberculosis
• Infectious, highly communicable disease
• aerosol transmission of Mycobacterium tuberculosis to
immunocompromised patients
Diseases of the Respiratory System
Respiratory Distress Syndrome
• Lack of surfactant in the lungs
• Infant respiratory distress syndrome (hyaline membrane disease) or Adult
respiratory distress syndrome