ANATOMY AND PHYSIOLOGY

UPPER RESPIRATORY TRACT

Respiration is defined in two ways. In common usage, respiration refers to the act of breathing,
or inhaling and exhaling. Biologically speaking, respiration strictly means the uptake of oxygen
by an organism, its use in the tissues, and the release of carbon dioxide. By either definition,
respiration has two main functions: to supply the cells of the body with the oxygen needed for
metabolism and to remove carbon dioxide formed as a waste product from metabolism. This
lesson describes the components of the upper respiratory tract.

The upper respiratory tract conducts air from outside the body to the lower respiratory tract
and helps protect the body from irritating substances. The upper respiratory tract consists of
the following structures:

The nasal cavity, the mouth, the pharynx, the epiglottis, the larynx, and the upper trachea. The
oesophagus leads to the digestive tract.

One of the features of both the upper and lower respiratory tracts is the mucociliary apparatus
that protects the airways from irritating substances, and is composed of the ciliated cells and
mucus-producing glands in the nasal epithelium. The glands produce a layer of mucus that traps
unwanted particles as they are inhaled. These are swept toward the posterior pharynx, from
where they are either swallowed, spat out, sneezed, or blown out.
Air passes through each of the structures of the upper respiratory tract on its way to the lower
respiratory tract. When a person at rest inhales, air enters via the nose and mouth. The nasal
cavity filters, warms, and humidifies air. The pharynx or throat is a tube like structure that
connects the back of the nasal cavity and mouth to the larynx, a passageway for air, and the
esophagus, a passageway for food. The pharynx serves as a common hallway for the respiratory
and digestive tracts, allowing both air and food to pass through before entering the appropriate
passageways.

The pharynx contains a specialised flap-like structure called the epiglottis that lowers over the
larynx to prevent the inhalation of food and liquid into the lower respiratory tract.

The larynx, or voice box, is a unique structure that contains the vocal cords, which are essential
for human speech. Small and triangular in shape, the larynx extends from the epiglottis to the
trachea. The larynx helps control movement of the epiglottis. In addition, the larynx has
specialised muscular folds that close it off and also prevent food, foreign objects, and secretions
such as saliva from entering the lower respiratory tract.

LOWER RESPIRATORY TRACT

The lower respiratory tract begins with the trachea, which is just below the larynx. The trachea,
or windpipe, is a hollow, flexible, but sturdy air tube that contains C-shaped cartilage in its
walls. The inner portion of the trachea is called the lumen.

The first branching point of the respiratory tree occurs at the lower end of the trachea, which
divides into two larger airways of the lower respiratory tract called the right bronchus and left
bronchus. The wall of each bronchus contains substantial amounts of cartilage that help keep
the airway open. Each bronchus enters a lung at a site called the hilum. The bronchi branch
sequentially into secondary bronchi and tertiary bronchi.

The tertiary bronchi branch into the bronchioles. The bronchioles branch several times until
they arrive at the terminal bronchioles, each of which subsequently branches into two or more
respiratory bronchioles.

The respiratory bronchiole leads into alveolar ducts and alveoli. The alveoli are bubble-like,
elastic, thin-walled structures that are responsible for the lungs’ most vital function: the
exchange of oxygen and carbon dioxide.

Each structure of the lower respiratory tract, beginning with the trachea, divides into smaller
branches. This branching pattern occurs multiple times, creating multiple branches. In this way,
the lower respiratory tract resembles an “upside-down” tree that begins with one trachea
“trunk” and ends with more than 250 million alveoli “leaves”. Because of this resemblance, the
lower respiratory tract is often referred to as the respiratory tree.

In descending order, these generations of branches include:

  trachea
 right bronchus and left bronchus
 secondary bronchi
 tertiary bronchi
 bronchioles
 terminal bronchioles
 respiratory bronchioles
 alveoli

THE LUNGS

The thoracic cage, or ribs, and the diaphragm bound the thoracic cavity. There are two lungs
that occupy a significant portion of this cavity.

The diaphragm is a broad, dome-shaped muscle that separates the thoracic and abdominal
cavities and generates most of the work of breathing. The inter-costal muscles, located
between the ribs, also aid in respiration. The internal intercostal muscles lie close to the lungs
and are covered by the external intercostal muscles.

The lungs are cone-shaped organs that are soft, spongy and normally pink. The lungs cannot
expand or contract on their own, but their softness allows them to change shape in response to
breathing. The lungs rely on expansion and contraction of the thoracic cavity to actually
generate inhalation and exhalation. This process requires contraction of the diaphragm.

To facilitate the movements associated with respiration, each lung is enclosed by the pleura, a
membrane consisting of two layers, the parietal pleura and the visceral pleura.

The parietal pleura comprise the outer layer and are attached to the chest wall. The visceral
pleura are directly attached to the outer surface of each lung. The two pleural layers are
separated by a normally tiny space called the pleural cavity. A thin film of serous or watery fluid
called pleural fluid lines and lubricates the pleural cavity. This fluid prevents friction and holds
the pleural surfaces together during inhalation and exhalation.

Nose

 The hairs in the nostrils prevent the entry of particles of dust into the nasal chamber.

 The inner lining of the nasal chamber contains a fluid called the mucus spread over it.
This liquid traps disease causing microorganisms.

 The air going inside is moistened as it flows through the nasal chambers on coming in
contact with mucus.

 The air going inside is warmed in the nasal chamber, as the nasal chamber contains
blood vessels through which the temperature of the air can be regulated.
  The nose has an additional function of smell. Sensory cells that have the ability to smell
are present in the nasal chamber. When we sniff, little wafts of air go high up in the
nasal chamber into a special pocket where these sensory cells are located.

Pharynx

 The pharynx is a common passageway for food and air, because on one hand the nasal
chambers open into it from above, and on the other hand the mouth opens into it from
below the nasal chambers. It leads into two tubes, the windpipe, also called as the
trachea, and the food pipe, also called as the esophagus.  
 To prevent food from entering the wind pipe, there is a cartilaginous flap present over
the wind pipe, called the epiglottis. The epiglottis acts as a lid for the wind pipe, and
keeps it covered while swallowing food. Thus, it prevents the entry of food into the wind
pipe. 
 Larynx

 The larynx is a hollow, cartilaginous structure located at the point of meeting of the
pharynx and the trachea (wind pipe).
 It can be felt with the hands at the front part of the neck. It is not a passageway for air
like the pharynx, nasal chamber and the trachea, but it is an essential part of the
respiratory system, as we are able to speak only when we respire air in and out of the
body.
 It is made up of two folds of cartilage, hollow in the middle, through which air passes as
it flows in and out of the wind pipe. This is the organ by which gives us the ability to
speak: As air passes through the opening in between its two chords, the two chords
 vibrate producing sound. There are a set of muscles located near the chords, which help
us in changing the tension of the two chords. By changing the tension of the two chords
and passing air through it, one is able to produce different sounds from the larynx. Thus
it is called the voice box of the human body.

Trachea

 It is the wind pipe. It is partly covered by the thyroid gland in the neck. The food pipe
(esophagus) is present along with the trachea in the neck, but its walls remain collapsed
when not eating or drinking food, thus providing space for the trachea to take in and
expel out air.

 The walls of the trachea are made up of C shaped rings of cartilage. These rings provide
strength to the trachea and keep it distended (expanded) permanently
Bronchi

 Close to the lungs, the trachea divides into two tubes, called the bronchi. Each of these
tubes enters one lung. The bronchi also have C shaped rings in their walls like the
trachea, to keep the air passage permanently and fully distended.
 As the two bronchi enter the two lungs respectively, they divide into finer tubes called
the secondary bronchi. In the lungs, the secondary bronchi divide further into still finer
tubes called tertiary bronchi, which further divide into still finer tubes called the
bronchioles. The bronchioles are very  fine tubes and their diameter is 1 mm. Each
bronchiole divides and subdivides until it produces groups of many tiny air sacs, called
alveoli.


 The alveoli are the final branchings of the respiratory tree and act as the primary gas
exchange units of the lung. The gas-blood barrier between the alveolar space and the
pulmonary capillaries is extremely thin, allowing for rapid gas exchange. To reach the
 blood, oxygen must diffuse through the alveolar epithelium, a thin interstitial space, and
the capillary endothelium; CO2 follows the reverse course to reach the alveoli.

A. Anatomy and Physiology

Respiration is the process by which living organisms take in oxygen
and release carbon dioxide. The human respiratory system, working in
conjunction with the circulatory system, supplies oxygen to the body's
cells, removing carbon dioxide in the process. The exchange of these
gases occurs across cell membranes both in the lungs (external
respiration) and in the body tissues (internal respiration). Breathing, or
pulmonary ventilation, describes the process of inhaling and exhaling air.
The human respiratory system consists of the respiratory tract and the
lungs.
 Respiratory tract
 The respiratory tract cleans, warms, and moistens air during its trip to
the lungs. The tract can be divided into an upper and a lower part. The
upper part consists of the nose, nasal cavity, pharynx (throat), and larynx
(voice box). The lower part consists of the trachea (windpipe), bronchi,
and bronchial tree.
The nose has openings to the outside that allow air to enter. Hairs inside
the nose trap dirt and keep it out of the respiratory tract. The external
nose leads to a large cavity within the skull, the nasal cavity. This cavity
is lined with mucous membrane and fine hairs called cilia. Mucus
moistens the incoming air and traps dust. The cilia move pieces of the
 mucus with its trapped particles to the throat, where it is spit out or swallowed.
Stomach acids destroy bacteria in swallowed
mucus. Blood vessels in the nose and nasal cavity release heat and warm the entering
air.
Air leaves the nasal cavity and enters the pharynx. From there it passes into the larynx,
which is supported by a framework of
cartilage (tough, white connective tissue). The larynx is covered by the epiglottis, a flap
of elastic cartilage that moves up and
down like a trap door. The epiglottis stays open during breathing, but closes during
swallowing. This valve mechanism keeps
solid particles (food) and liquids out of the trachea. If something other than air enters
the trachea, it is expelled through
automatic coughing.
 Alveoli: Tiny air-filled sacs in the lungs where the exchange of oxygen and carbon
dioxide occurs between the lungs and the
 bloodstream.
 Bronchi: Two main branches of the trachea leading into the lungs.
 Bronchial tree: Branching, air-conducting subdivisions of the bronchi in the lungs.
Diaphragm: Dome-shaped sheet of muscle located below the lungs separating the thoracic and
abdominal cavities that
contracts and expands to force air in and out of the lungs.
Epiglottis: Flap of elastic cartilage covering the larynx that allows air to pass through the trachea
while keeping solid particles
and liquids out.
Pleura: Membranous sac that envelops each lung and lines the thoracic cavity.

Air enters the trachea in the neck. Mucous membrane lines the trachea and C-shaped cartilage
rings reinforce its walls. Elastic
fibers in the trachea walls allow the airways to expand and contract during breathing, while the
cartilage rings prevent them
from collapsing. The trachea divides behind the sternum (breastbone) to form a left and right
branch, called bronchi
(pronounced BRONG-key), each entering a lung.

The lungs

The lungs are two cone-shaped organs located in the chest or thoracic cavity. The heart
separates them. The right lung is
somewhat larger than the left. A sac, called the pleura, surrounds and protects the lungs. One
layer of the pleura attaches to the
wall of the thoracic cavity and the other layer encloses the lungs. A fluid between the two
membrane layers reduces friction and
allows smooth movement of the lungs during breathing.
The lungs are divided into lobes, each one of which receives its own bronchial branch. Inside
the lungs, the bronchi subdivide
repeatedly into smaller airways. Eventually they form tiny branches called terminal bronchioles.
Terminal bronchioles have a
diameter of about 0.02 inch (0.5 millimeter). This branching network within the lungs is called
the bronchial tree.
The terminal bronchioles enter cup-shaped air sacs called alveoli (pronounced al-VEE-o-leye).
The average person has a total of
about 700 million gas-filled alveoli in the lungs. These provide an enormous surface area for gas
exchange. A network of
capillaries (tiny blood vessels) surrounds each alveoli. As blood passes through these vessels
and air fills the alveoli, the
exchange of gases takes place: oxygen passes from the alveoli into the capillaries while carbon
dioxide passes from the
capillaries into the alveoli.
This process—external respiration—causes the blood to leave the lungs laden with oxygen and
cleared of carbon dioxide. When
this blood reaches the cells of the body, internal respiration takes place. The oxygen diffuses or
passes into the tissue fluid, and
then into the cells. At the same time, carbon dioxide in the cells diffuses into the tissue fluid and
then into the capillaries. The
carbon dioxide-filled blood then returns to the lungs for another cycle.

Breathing

Breathing exchanges gases between the

outside air and the alveoli of the lungs. Lung
expansion is brought about by two important
muscles, the diaphragm (pronounced DIE-a-fram)
and the intercostal muscles. The diaphragm is a
dome-shaped sheet of muscle located below the
lungs that separates the thoracic and abdominal
cavities. The intercostal muscles are located
between the ribs.

Nerves from the brain send impulses to

the diaphragm and intercostal muscles,
stimulating them to contract or relax. When the
diaphragm contracts, it moves down. The dome is
flattened, and the size of the chest cavity is
increased. When the intercostal muscles contract,
the ribs move up and outward, which also
increases the size of the chest cavity. By
contracting, the diaphragm and intercostal
muscles reduce the pressure inside the lungs
relative to the pressure of the outside air. As a
consequence, air rushes into the lungs during
inhalation. During exhalation, the reverse occurs.
The diaphragm relaxes and its dome curves up
into the chest cavity, while the intercostal
muscles relax and bring the ribs down and
inward. The diminished size of the chest cavity
increases the pressure in the lungs, thereby
forcing air out.

A healthy adult breathes in and out about

12 times per minute, but this rate changes with
exercise and other factors. Total lung capacity is
about 12.5 pints (6 liters). Under normal
circumstances, humans inhale and exhale about
one pint (475 milliliters) of air in each cycle. Only
about three-quarters of this air reaches the
alveoli. The rest of the air remains in the
respiratory tract. Regardless of the volume of air