Respiratory System

Dr. Dini Sri Damayanti,MKes

Respiration

Exchange of gases (oxygen and carbon dioxide) between a living organism and its environment = respiration.

In animals (people) this takes place in the lungs (alveoli) where the air and blood come in close contact.

Pulmonary ventilation breathing, the process that moves air into and out of the lungs. Also called external respiration.

Internal respiration process by which an exchange of gases occurs between the blood and the cells of the body. Cellular respiration actual use of O2 by cells in the process of metabolism.

Mechanics of Breathing

Muscles control the size of the chest cavity.

External intercostals between the ribs move the chest up and out when they contract. Diaphragm dome shaped muscle between the thoracic and abdominal cavities, moves down when it contracts increasing the volume in the thorax.

Hiccups (singultus) involuntary, spasmodic contraction of the diaphragm. Causes by irritation to the phrenic nerve or some types of brain injury.

Mechanics of Breathing

Pulmonary ventilation has 2 phases:

Inspiration or inhalation moving air into lungs. Expiration or exhalation moving air out of the lungs.

Inspiration occurs as the thorax enlarges (contraction of the external intercostals and diaphragm). Because of the positioning of the pleura, the lungs expand as the thorax expands and air rushes in and down to the alveoli.

Mechanics of Breathing

Expiration
Passive process that begins when the muscles relax decreasing the size of the thorax and lungs air moves out of the lungs. Forceful expiration internal intercostals and abdominal muscles contract and depress the rib cage decreasing the depth (front to back) of the thorax. Pressure increases and air flows out of the lungs.

Gas Exchange

CO2 moves into the lungs and leaves the body during expiration. At the tissues O2 is low and CO2 high whereas the blood reaching them is just the opposite. O2 moves out of and CO2 moves into the blood. Most of the CO2 is carried in the blood as a bicarbonate ion, some is dissolved in the plasma and some combines with hemoglobin to form carbaminohemoglobin.

Respiratory Function

Spirometer - device used to measure the amount of air exchanged during breathing. Tidal volume amount of air taken into our lungs during normal inspiration; about 500 ml. Vital capacity largest amount of air that we can breathe in or out in one inspiration/expiration; about 4800 ml in normal young men.

Respiratory Function

Expiratory reserve amount of air that can be forcibly exhaled after exhaling the tidal volume. Inspiratory reserve amount of air that can be forcibly inhaled over and above normal inhalation. Residual volume air that remains in the lungs after the most forceful expiration. Residual volume + Vital Capacity = Total Lung Capacity.

Physical Principles of Gas Exchange

Diffusion of gases through the respiratory membrane

Depends on membranes thickness, surface areas of membrane, partial pressure of gases in alveoli and blood

Relationship between ventilation and pulmonary capillary flow

Increased ventilation or increased pulmonary capillary blood flow increases gas exchange

Oxygen and Carbon Dioxide Diffusion Gradients

Oxygen

Carbon dioxide

Moves from alveoli into blood. Blood is almost completely saturated with oxygen when it leaves the capillary P02 in blood decreases because of mixing with deoxygenated blood Oxygen moves from tissue capillaries into the tissues

Moves from tissues into tissue capillaries Moves from pulmonary capillaries into the alveoli

Changes in Partial Pressures

Hemoglobin and Oxygen Transport

A shift of the curve to the right because of a decrease in pH, an increase in carbon dioxide, or an increase in temperature results in a decrease in the ability of hemoglobin to hold oxygen The substance 2.3-bisphosphoglycerate increases the ability of hemoglobin to release oxygen Fetal hemoglobin has a higher affinity for oxygen than does maternal

Oxygen-Hemoglobin Dissociation Curve at Rest

Bohr effect:

Temperature effects:

Shifting the Curve

Transport of Carbon Dioxide

Carbon dioxide is transported as bicarbonate ions (70%) in combination with blood proteins (23%) and in solution with plasma (7%) Hemoglobin that has released oxygen binds more readily to carbon dioxide than hemoglobin that has oxygen bound to it (Haldane effect) In tissue capillaries, carbon dioxide combines with water inside RBCs to form carbonic acid which dissociates to form bicarbonate ions and hydrogen ions

Transport of Carbon Dioxide

In lung capillaries, bicarbonate ions and hydrogen ions move into RBCs and chloride ions move out. Bicarbonate ions combine with hydrogen ions to form carbonic acid. The carbonic acid is converted to carbon dioxide and water. The carbon dioxide diffuses out of the RBCs. Increased plasma carbon dioxide lowers blood pH. The respiratory system regulates blood pH by regulating plasma carbon dioxide levels

CO2 Transport and Cl- Movement

Respiratory Areas in Brainstem

Medullary respiratory center

Dorsal groups stimulate the diaphragm Ventral groups stimulate the intercostal and abdominal muscles

Pontine (pneumotaxic) respiratory group

Involved with switching between inspiration and expiration

Respiratory Structures in Brainstem

Rhythmic Ventilation

Starting inspiration

Medullary respiratory center neurons are continuously active Center receives stimulation from receptors and simulation from parts of brain concerned with voluntary respiratory movements and emotion Combined input from all sources causes action potentials to stimulate respiratory muscles More and more neurons are activated Neurons stimulating also responsible for stopping inspiration and receive input from pontine group and stretch receptors in lungs. Inhibitory neurons activated and relaxation of respiratory muscles results in expiration.

Increasing inspiration

Stopping inspiration

Modification of Ventilation

Cerebral and limbic system

Chemical control

Respiration can be voluntarily controlled and modified by emotions

Carbon dioxide is major regulator

Increase or decrease in pH can stimulate chemosensitive area, causing a greater rate and depth of respiration

Oxygen levels in blood affect respiration when a 50% or greater decrease from normal levels exists

Modifying Respiration

Regulation of Blood pH and Gases

Herring-Breuer Reflex

Limits the degree of inspiration and prevents overinflation of the lungs

Infants

Reflex plays a role in regulating basic rhythm of breathing and preventing overinflation of lungs Reflex important only when tidal volume large as in exercise

Adults

Ventilation in Exercise

Ventilation increases abruptly

At onset of exercise Movement of limbs has strong influence Learned component

Ventilation increases gradually

After immediate increase, gradual increase occurs (4-6 minutes) Anaerobic threshold is highest level of exercise without causing significant change in blood pH

If exceeded, lactic acid produced by skeletal muscles

Effects of Aging

Vital capacity and maximum minute ventilation decrease Residual volume and dead space increase Ability to remove mucus from respiratory passageways decreases Gas exchange across respiratory membrane is reduced

pH Disturbances

Respiratory change in gas exchange; lungs

Acidosis blood pH is acid due to increased levels of CO2 in the blood. Alkalosis blood pH is alkaline or basic due to decreased levels of CO2 in the blood.

In any fluid that contains water: CO2 + H2O H2CO3 H+ + HCO3The brain senses the H+ concentration that develops in the CSF because CO2 diffuses into the CSF from the blood.

Metabolic change in pH that is not due to changes in gas exchange in the lungs.

Acidosis diabetes mellitus, kidney disease or severe diarrhea increase H+ in the blood. Respiratory compensation increased rate and depth. Alkalosis vomiting, medications decrease H+ in the blood. Respiratory compensation decreased rate and depth.