Physiology of the respiratory system

56. General characteristics of the respiratory system. The main stages of breathing. Biomechanics of
inhalation and exhalation?

General functions of respiratory system

 The respiratory system comprises of the nose, mouth, throat, larynx, trachea, bronchi and lungs.
The function of the respiratory system is to facilitate gaseous exchange to take place in the lungs
and tissue cells of the body.
 Oxygen is required by cells in the body to allow various metabolic reactions to take place and to
produce energy and is therefore essential to life. The respiratory system may be defined as the
organs and tissues through which air is passed into and out of the body to allow the necessary
gaseous exchanges to take place.

The process of breathing (respiration) is divided into two distinct phasesinspiration (inhalation) and
expiration (exhalation).

1. During inspiration, the diaphragm contracts and pulls downward while the muscles between
the ribs contract and pull upward. This increases the size of the thoracic cavity and decreases
the pressure inside. As a result, air rushes in and fills the lungs.
2.
3. During expiration, the diaphragm relaxes, and the volume of the thoracic cavity decreases,
while the pressure within it increases. As a result, the lungs contract and air is forced out.

Inspiration

 Active process
 Requires muscular effort.
 Mostly diaphragm at rest.
 Intercostals used on exertion (accessory muscles).
 Inspiratory effort causes:
 ↓ intrapleural pressure.
 ↓ alveolar pressure.
 Pressure gradient from mouth to alveoli.
 Gas flow down pressure gradient.
 Accessory muscles of inspiration: Scalene, SCM, Trapezium, External intercostals

Expiration

 Passive process (usually).

 Due to lung recoil.
 Relaxation of inspiratory muscles causes:
 ↑ intrapleural pressure (intrapleural pressure becomes less negative).
 ↑ alveolar pressure.
 Pressure gradient from alveoli to mouth.
  Gas flow down pressure gradient
 Accessory muscles of expiration: Intercostals (internal), Abdominal

Lung Volume:

Total lung volume (TLV) = IRV + TV + ERV + RV.

Vital capacity (VC) = TLV − RV.

57. An elastic thrust lungs, pleural negative pressure in the gap?

Surface tension in lungs: The walls of alveoli are coated with a thin film of water & this creates a
potential problem. Water molecules, including those on the alveolar walls, are more attracted to each
other than to air, and this attraction creates a force called surface tension. This surface tension increases
as water molecules come closer together, which is what happens when we exhale & our alveoli become
smaller (like air leaving a balloon). Potentially, surface tension could cause alveoli to collapse and, in
addition, would make it more difficult to 're-expand' the alveoli (when you inhaled). Both of these would
represent serious problems: if alveoli collapsed they'd contain no air & no oxygen to diffuse into the
blood &, if 're-expansion' was more difficult, inhalation would be very, very difficult if not impossible.
Fortunately, our alveoli do not collapse & inhalation is relatively easy because the lungs produce a
substance called surfactant that reduces surface tension.

Pressure in the lungs and intrapleural pressure

Intrapleural pressure is always lower than the alveolar one:

First: chest is a sealed container.

Second, the lungs are characterized by elastic tension, which is due to these factors:

1. presence of ellastic fibers, which make 1 / 3 of elastic tention;

2. surface tension of the liquid layer on the inner surface of alveoli, which makes 2 / 3 of the
elastic tension of the lungs.

Thirdly, “negative” pressure in the pleural cavity is maintained by the large absorption capacity of
pleural leaves.
58. External breathing. Indicators of respiratory and evaluation?

External respiration, which is the processes by which external air is drawn into the body in order to
supply the lungs with oxygen, and (used) air is expelled from the lungs in order to remove carbon
dioxide from to body. The processes of internal respiration concern the exchange of gases in the lungs
with those in the tissues

59. Anatomical and physiological "dead space", its physiological role?

DEAD SPACE

VD = Volume of air not participating in gas exchange.

Anatomic dead space.

 Typically 150 mL.

 Volume of nonventilated gas in airways.
 No gas exchange occurs within the nasal passages, pharynx, trachea, bronchi.

Physiologic dead space.

 Due to alveoli that are ventilated but not perfused.

 Usually insignificant, unless there is disease.

Benefits do accrue to a seemingly wasteful design for ventilation that includes dead space.

1. Carbon dioxide is retained, making a bicarbonate-buffered blood and interstitium possible.

2. Inspired air is brought to body temperature, increasing the affinity of hemoglobin for oxygen,
improving O2 uptake.[3]
3. Particulate matter is trapped on the mucus that lines the conducting airways, allowing its
removal by mucociliary transport.
4. Inspired air is humidified, improving the quality of airway mucus

60. The transport of oxygen in blood. Oxygen capacity of blood?

Amount of O2 in Blood is equal to Dissolved O2 + O2 bound to Hb.

OXYGEN CONTENT

 Total amount of oxygen carried in blood (PO2 + O2–Hb).

 Determined mostly by the amount of hemoglobin and its saturation.
 Amount of hemoglobin is affected by anemia (production, loss, or destruction).
 The more hemoglobin in blood, the more O2 that can be carried.

OXYGEN SATURATION

 The amount of Hb saturated with O2.

 Corresponds to O2–Hb curve.
 Determined by:
o PO2 (important; see table corresponding SaO2 : PO2).
o O2 affinity of Hb altered by:
 Changes in Hb molecule.
 Intrinsic (hemoglobinopathies).
 Extrinsic (eg, changes in pH, PCO2, temperature, etc.).
 Competition for Hb binding (eg, CO poisoning).

NORMAL VALUES

 Oxygen content (per 1 g Hb) = 1.34 mL of O2.

 Hemoglobin concentration = ~15 g/dL.
o Women: 12–16 g/dL.
 Women have ↓ Hb concentrations than men
o Men: 14–18 g/dL.
o Infants: 14–20 g/dL.
 Oxygen concentration = ~20 g-mL/dL (or 15 g/dL × 1.34 mL)—just 20.1 mL.

61. Transport of carbon dioxide in blood?

Carbon Dioxide

 Carbon dioxide (CO2) is carried in blood as:

o Bicarbonate in serum (most).
o Bicarbonate in RBC.
 o Carbaminohemoglobin.
 CO2+ NH2 group of Heme (not Fe2+ of Heme like O2 or CO).
o Dissolved in blood (PCO2).

CHLORIDE SHIFT

 Bicarbonate carried in serum is generated within the RBC.

 It is transported to the serum in exchange for Cl−.
 Cycle:
o CO2 in blood diffuses passively into RBC.
o Carbonic anhydrase (within RBC) combines intracellular CO2 with H2O to form
bicarbonate and H+.
o Bicarbonate passes across the RBC membrane into serum in exchange for Cl−.

62. The physiological role of the respiratory tract, regulation of their lumen?

Conducting zone airways contain mucous-secreting cells:

 Goblet cells
 Mucous cells
 The epithelium is pseudostratified ciliated columnar- mucociliary escalator is a major barrier
against infection. Microorganisms hoping to infect the respiratory tract are caught in the sticky
 mucus and moved up by the mucociliary escalator. Note how our purple invader has been
trapped in the mucus and is being pushed upward towards the throat.

Respiratory zone, alveolar wall has:

 Type I epithelial cells

 Type II epithelial cells ↓ pneumocytes
o Produce surfactant

63. Respiratory center, its structure, regulation of breathing?

RESPIRATORY REGULATION

Respiratory Drive

 Based on arterial PCO2, specifically H+.

 The H+ (derived from CO2) that acts at central chemoreceptors (medulla).

PATHWAY

 As ↑ PCO2 → CO2 diffuses from cerebral blood vessels into CSF → carbonic acid (H2CO3) is
formed → dissociates into bicarbonate (HCO3 −) and protons (H+s) → these protons (H+s)
stimulate the central chemoreceptors→↑ ventilation.
o CO2 can diffuse from the blood vessels into CSF across the BBB because it is nonpolar.

↑RESPIRATORY DRIVE

 Central chemoreceptors (medulla)

o ↑ PCO2 (as its byproduct, H+, in CSF or brain interstitial fluid sensed in medulla).
 Peripheral chemoreceptors (carotid or aortic bodies)
o ↑ H+ (in blood or brain interstitial fluid).
o ↓ PO2 (in blood)(<60 mm Hg).

FUNCTION OF RESPIRATORY REGULATION

 Keep alveolar PCO2 stable (prevent hypercarbia or hypocarbia).

 Buffer acid–base changes.
 Prevent hypoxemia (↑ PO2 when it falls).
64. The role of mechanoreceptors in the regulation of breathing?
Hering–Breuer Reflex (Reflex to Prevent Overinflation)

 Inflate lungs → expiration.

 Deflate lungs → inspiration.
 Mediated by myelinated slow responding receptors (stretch receptors).
 Vagus nerve (afferent).

Pulmonary Chemoreflex

 Lung hyperinflation causes:

o First apnea.
o Then:
 Rapid breathing (tachypnea).
 Bradycardia.
 Hypotension.
 Mediated by:
o J (juxtacapillary) (vagus nerve) receptors—in alveolar insterstitium.
 C fiber endings (unmyelinated) close to pulmonary vessels ↓ O2, hyperinflation,
chemical administration.

65. The role of the central and peripheral chemoreceptor’s in regulating breathing?