Physiology of Respiratory

System

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Outlines:
- General functions of the respiratory
system
- Functional anatomy of the respiratory
system.
- The mechanics of breathing
- Pulmonary function tests
- Gas exchange and transport
- Acid base regulation
- Regulation of ventilation
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 INTRODUCTION:

 Life begins and ends with breathing!!!

‘The Bible states that God “breathed into [Adam’s]

nostrils the breath of life” and then later used part of
Adam’s ventilatory apparatus—a rib—to give life to
Eve’.
• At rest, a normal human breathes 12 to 15 times a
minute.

• ~7 L of air per minute enters into the lungs.

• Resting O2 consumption averages about 250 ml/min, and

CO2 production averages about 200 ml/min.

• Changes in blood chemistry, mood, level of alertness, and

body activity affects the rate of consumption.

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Organization of the Respiratory System:

I. An air pump system

II. A surface for gas exchange.

III. Mechanisms for carrying of gases in the
blood.

IV. A circulatory system.

V. A mechanism for regulating ventilation.

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 Respiration:
• The process of taking up O2 and removing
CO2 from cells in the body.
• Respiration encompasses two separate but
related processes:
 Cellular respiration

 External respiration.

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1. EXTERNAL RESPIRATION;
• Refers to the entire sequence of events in the exchange of
O2 and CO2 between the external environment and the
cells of the body.
• Encompasses four steps;
I. The transfer of O2 and CO2 between the atmosphere
and the lungs( Ventilation).
II. O2 and CO2 are exchanged between air in the alveoli
and blood within the pulmonary capillaries
III. Transport of O2 & CO2 in blood
IV. The exchange of O2 and CO2 occuring between the
systemic blood and the metabolically active tissue.
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2. Cellular Respiration፡
– Refers to the intracellular metabolic processes
carried out within the mitochondria, which use
O2 and produce CO2 while deriving energy from
nutrient molecules.

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 External Respiration

Internal Respiration

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Functions of Respiratory System:

1. Primary function:
 Exchange of gases between the atmosphere and blood
2. Secondary function:
 Warming and humidification of inspired air
Olfaction
 Regulation of acid-base balance
 Protection from inhaled pathogens and irritants
 Vocalization
 Homeostatic role in water and heat loss
 Metabolization and activation of certain biologically
active substances.
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 Functional Structures of Respiratory
System:
General structural
setup:
• Air passages
• Lungs
• Pleural sac
• Thoracic cage
• Muscles of breathing
• Nerve centers in the
brain stem

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• Respiratory system Can be classified
according to either structure or function:
I. Structurally:
1. The upper respiratory system:
• The nose, nasal cavity, pharynx, larynx and
associated structures.
2. The lower respiratory system:
•Trachea, bronchi, and lungs.

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II. Functionally:
1. The Conducting Zone:
• Consists of a series of inter-connecting cavities
and tubes both outside and within the lungs.
• The nose, nasal cavity, pharynx, larynx,
trachea, bronchi, bronchioles, and terminal
bronchioles;
• Their function is to filter, warm, and moisten
air and conduct into the lungs.
• No gas exchange take place.

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2. The Respiratory Zone:
• Consists of tubes and tissues within the lungs
where gas exchange occurs.
• Include the respiratory bronchioles, alveolar
ducts, alveolar sacs, and alveoli.
• Are the main sites of gas exchange between
air and blood.

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Air way Branching:

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 The Alveoli:
• Tiny hollow sacs whose open ends are continuous
with the lumens of the airways.
• Thin-walled, inflatable air sacs( 200-250μm).

• The fundamental unit of gas exchange.

• Adult lungs contain 300 - 500 million alveoli.

• A network of billions of capillaries surrounds each
alveolus.
• Gases move across the thin-walled alveolus by
diffusion.
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• The alveoli are lined by several types of epithelial
cells:
1. Pneumocytes-type I:
• Primary lining cells, covering ~ 95% of the alveolar epithelial
surface area.
• Are flat cells with large cytoplasmic extensions
• Where gas exchange takes place;
2. Type II Pneumocytes:
• Thicker and contain numerous lamellar inclusion bodies.
• Make up ~ 5% of the surface area
• Represent ~ 60% of the epithelial cells in the alveoli.
• * Secrete surfactant

3. Others :
- alveolar macrophages, lymphocytes, mast cells…
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The Mechanics of Breathing
 How ventilation is achieved?
 How Gas Gets in to and out of the Alveoli ?
 How do we create pressure differences
so that air will flow into and out of the
lungs?

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Muscles of Respiration:
• The contraction and relaxation of respiratory
muscles change the volume of the thoracic
cavity, causing a corresponding change in lung
volume.

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Muscles of Inspiration:

I. Diaphragm:
– Is the main muscle of inspiration.

– Contraction enlarges the cavity in which the lung

is enclosed, increasing volume.
– At rest, during inspiration, the diaphragm
contracts and pushes the abdominal contents
downward.
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II. External intercostals muscles.

– Lie between the ribs

– Elevate the ribs and the sternum upward and outward.
– Enlarges the thoracic cavity in both the lateral (side-to-
side) and antero-posterior (front-to-back) dimensions.

III. The Accessory Muscles of Inspiration:

- Scalene muscles
• Sternocleidomastoid muscles

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Expiration:
• Is passive during resting conditions.
• The diaphragm relaxes and returns to its dome shape, and
the rib cage is lowered.
• Thoracic cavity decreases in volume(size)
• During forced expiration expiration become active
involving the contraction of internal intercostal muscles
pulling the rib cage downward and inward.
• The abdominal muscles also contract and help pull the rib
cage downward, compressing thoracic volume.

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  Air Flow Dynamics
Why Does Air Flow?
---> Pressure and Volumes changes;

 If the volume of a container of gas changes, the

pressure of the gas will change in an inverse manner
( Boyle’s Law)

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  Boyle’s law
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1. Atmospheric (barometric) pressure:
– Is the pressure exerted by the weight of the air in the
atmosphere on objects on Earth’s surface.
– At sea level it equals 760 mm Hg.
2. Intra-alveolar pressure:
• Is the pressure within the alveoli.

 Air flows due to pressure gradients established

between the alveoli and atmosphere by cyclic
respiratory muscle activity.

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  Relationships required for ventilation.
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3. Pleural Pressure:
• The pressure in the pleural cavity between the lung and
chest wall.
• Is critical for lung inflation and deflation;
• Is subatmospheric and essential factor for keeping the
lungs partially expanded.
• It rises and falls during respiration, but is usually about
4mm Hg less than intrapulmonary pressure.
• Always negative(amount of suction required to hold
the lungs open at resting level) !!
• Ppl = -3mmHg to –10 mmHg

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 vacuum
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Discussion:

1. What creates pressure gradient for air

movement ?
2. What is intrapleural pressure?
3. Factors affecting ventilation?

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Part III. Measurements of Lung
Functions

1. Breathing Frequency
2. Alveolar Ventilation
3. Spirometry
4. Blood gas analysis

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Minute Ventilation:
• Tidal volume times breathing frequency
• Frequency = 12 breaths /min in adults
• MV = VT X f
= 500ml/12breaths/min= 6000ml/min

Alveolar ventilation:
• The volume of air reaching alveoli per minute.
 VA = (VT -Vd)f
Dead space?
Shunt?

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 Lung volumes and
Capacities
• Different degrees of effort in breathing move
different volumes of air in and out of the lungs.
• The capacity of the lungs varies with the size and
age of the person.
• Taller people have larger lungs than do shorter
people.
• As age increases our lung capacity diminishes.

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 Respiratory Volumes

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 Respiratory Capacities
 Always consist of two or more lung volumes

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• Spirometer:
• A device that measures the volume of air inspired and
expired and therefore the change in lung volume.
• The record is called a spirogram.
• Inhalation is recorded as an upward deflection, and
exhalation is recorded as a downward deflection.

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 Simple Spirometer

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Part IV: Gas Exchange in the
Lungs
• The ultimate purpose of breathing is to provide a
continual supply of fresh O2 for pickup by the blood
and to constantly remove CO2 unloaded from the
blood.
• Blood acts as a transport system for O2 and CO2
between the lungs and tissues, with the tissue cells
extracting O2 from the blood and eliminating CO2 into
it.
• Alveolo-capillary membrane is the site for
exchanging of air with blood.
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Respiratory Membrane:

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Drivers of the diffusion of Gases:

• Gas exchange occurs by simple diffusion down partial

pressure gradients.
 Partial pressures:
– The individual pressure exerted independently by a
particular gas within a mixture of gases.
– Total Pressure = sum of the partial pressures of each
gas

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  Basic Composition of Air:
– 79% Nitrogen
– 21% Oxygen
– ~ 0.03% Carbon Dioxide
– Others

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Fig: Concept of partial pressures.

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• Partial pressure of Oxygen(PO2):
– Systemic arteries = 100 mmHg
– Systemic veins = 40 mmHg
• Partial pressure of Carbon dioxide(PCO2 ):
– Systemic arteries = 40 mmHg
– Systemic veins = 46 mmHg

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Summary:
• Spirometer?
• What is dead space?
• Discuss ventilation/ perfusion relation ship
• What is the normal PO2 & PCO2 in the
arterial blood?
• What is shunt?

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Part IV: Gas Transport in the Blood:
1. Transport of O2:
• O2 delivery to a particular tissue depends on the:

 Amount of O2 entering the lungs,

 Adequacy of pulmonary gas exchange,

 Blood flow to the tissues,

 Capacity of the blood to carry O2.

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i. Dissolved in plasma:
• Accounts for only about 1.5% of the O2 transported.
• 3 ml of O2 can dissolve in 1 liter of blood.
• Is responsible for PO2 in blood.
ii. Bound with hemoglobin- oxyhemoglobin
• Hemoglobin, an iron-bearing protein molecule
contained within the RBCs, can form a loose, easily
reversible combination with O2.
• 98.5 % of oxygen combines with hemoglobin

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• Each iron atom can bind one oxygen molecule.

• Up to 4 molecules of O2 can bind one Hb molecule.

• Each gram of Hb combines with 1.34 mL O2.

• With normal Hb levels, each dL of blood contains

about 20 mL O2.

• When 4 oxygen molecules are bound to Hb, it is 100%

saturated, with fewer, it is partially saturated.

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 Hb + O2 ↔ HbO2(Reversible).

– In the lungs where PO2 is high, the rxn proceeds

to the right forming OxyHemoglobin.

– In the tissues where PO2 is low, the rxn

reverses(deoxyhemoglobin).

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The Hemoglobin-Oxygen Dissociation Curve:

• Describes the relationship between the arterial P O2 and

Hb saturation.
• The Hb- O2 Dissociation Curve plots the percent
saturation of Hb as a function of the PO2.
• Shows us how much haemoglobin is saturated with
oxygen.
• Saturation – when hemoglobin is loaded with oxygen.
• Dissociation – when oxygen is unloaded from the
hemoglobin.

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• The higher the PO2, the higher percentage of oxygen
saturation to hemoglobin.
• Oxygen associates with hemoglobin at the lungs and
dissociates at the tissues.
• In the lungs the partial pressure is ~100mm Hg.
• At this Partial Pressure hemoglobin has a high affinity to
O2 and is ~98% saturated.
• In the tissues a typical PO2 is 40 mmHg and hemoglobin
has a lower affinity for O2.

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 NB: When hemoglobin leaves the
tissues it is still 75% saturated.

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 Factors affecting Hgb Affinity for O2

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Carbon dioxide Transport:

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Part VI: Control of Respiration

Components of respiratory Regulation:

1. Chemoreceptors… Peripheral and Central

2. Control centers- Neural

3. Effectors-respiratory muscles

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Neural regulation of respiration:

1. Voluntary breathing center:

- Cerebral cortex
2. Automatic (involuntary) breathing center
- Medulla oblongata- rhythmic center
- Pons; modulation

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Chemical control of Respiration:
• Chemoreceptors:
i. Central chemoreceptors: medulla
• ƒ Stimulated by ↑ [H+] or ↑Pco2 in the CSF ƒ
ii. Peripheral chemoreceptors:
 Carotid body
 Aortic body-
– Stimulated by arterial PO2↓ or [H+] ↑

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Clinical Note:
1. Artificial Ventilation:
• Mouth-to-mouth breathing “kiss of life”.
• Mechanical respiration
2. Pulse oximetry
3. Pneumothorax

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• Dyspnea: rapid, shallow and labored breathing with
shortness of breath.

• Hyperpnea: rate and depth of respiration

• Hypopnea: rapid, shallow breathing with ↓↓TV

• Tachypnea: very rapid and shallow breathing

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 Hypoxia:
– Hypoxic hypoxia
– Anaemic hypoxia
– Stagnant:(ischaemic) hypoxia
– Histotoxic hypoxia

 Hypercarbia

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