Structure of the airways

The structure of the respiratory system is diveded into

a conducting zone (or conducting airways)
a respiratory zone lined with alveoli
Conducting zone
It is formed of
the nose, nasopharynx, larynx, trachea, bronchi, bronchioles, and
terminal bronchioles
Functions
bring air into and out of the respiratory zone for gas exchange and to
warm, humidify, and filter the air before it reaches the critical gas exchange
region


Characteristics of the conducting zone
lined with mucus-secreting and ciliated cells
small particles may enter the airways, where they are captured by mucus,
which is then swept upward by the rhythmic beating of the cilia
The walls of the conducting airways contain smooth muscle which is
controlled by
(1) Sympathetic adrenergic neurons activate b2 receptors on bronchial
smooth muscle, which leads to relaxation and dilation of the airways
b2 receptors are activated by circulating epinephrine released from
the adrenal medulla and by b2-adrenergic agonists such as
isoproterenol
(2) Parasympathetic cholinergic neurons activate muscarinic
receptors, which leads to contraction and constriction of the airways

Respiratory Zone
It is formed of the structures that arelined with alveoli and, therefore,
participate in gas exchange:
the respiratory bronchioles
the alveolar ducts
the alveolar sacs
The respiratory bronchioles
are transitional structures. Like the conducting
airways, they have cilia and smooth muscle, but they
also are considered part of the gas exchange region
because alveoli occasionally bud off their walls
alveolar ducts are completely lined with alveoli, but
they contain no cilia and little smooth muscle. The
alveolar ducts terminate in alveolar sacs, which also
are lined with alveoli.
Alveoli
The alveoli are pouchlike evaginations of the walls of the respiratory
bronchioles, the alveolar ducts, and the alveolar sacs.
Each lung has a total of approximately 300 million alveoli. The diameter of each
alveolusis approximately 200 mm.
Functions: Exchange of oxygen (O2) and carbon dioxide (CO2) between alveolar
gas and pulmonary capillary blood can occur rapidly and efficiently
Characteristics of alveoli :
alveolar walls are thin and have a large surface area for diffusion It contains
elastic fibers and lined with epithelial cells, called type I and type II
pneumocytes (or alveolar cells).
The type II pneumocytes synthesize pulmonary surfactant (necessary for
reduction of surface tension of alveoli)
Alveoli have regenerative capacity for the type I and type II pneumocytes.
The alveoli contain phagocytic cells called alveolar macrophages.
Alveolar macrophages keep the alveoli free of dust and debris, since the
alveoli have no cilia to perform this function.
Macrophages fill with debris and migrate to the bronchioles, where the
beating cilia carry debris to the upper airways and the pharynx, where it can
be swallowed or expectorated.


Lung volumes and capcities
Lung volumes
Tidal volume (TV): it is the volume of air inspired or
expired with each breath during resting quiet breathing. It
is about 500 ml.
forced ) inspiration after normal inspiration or in excess of
tidal volume.it is about 3000 ml.
Expiratory reserve volume (ERV): it is the volume of air
expired by deep expiration after normal expiration or in
excess of normal expiration. It is about 1100 ml.
Residual volume (RV) : it is the volume of air that remains
in the lung after deep expiration. It is about 1200 ml. It
increases in old age and in obstructive lung diseases like
bronchial asthma and emphysema. It can't be measured
by spirometer
Inspiratory capacity (IC) : It is the volume of air inspired by deep
inspiration after normal expiration, it equals the tidal volume +
inspiratory reserve volume
Functional residual capacity (FRC): It is the volume of air remaining
in the lung after normal expiration. It equals the inspiratory reserve
volume + residual volume. It can't be measured by spirometer.
Vital capacity (VC): It is the volume of air expired by deep expiration
after deep inspiration. It equals tidal volume + inspiratory reserve
volume + expiratory reserve volume. It is about 4600 ml.
Total lung capacity (TLC) : It is the maximum volume of air that can
be accommodated in the lung after deep inspiration. It equals tidal
volume + inspiratory reserve volume + expiratory reserve volume +
residual volume.




the volumes and capacities not measured by spirometry
RV
FRC
TLC
Physiological factors
Age: decrease in old age
Sex : higher in male than female
Posture: higher in standing than sitting or supine position
Pregnancy: decrease due to limited mobility of diaphragm
Athletes :has higher Vital capacity
Pathological factors:
Obstructive lung diseases : bronchial asthma and emphysema
Restrictive lung diseases: lung fibrosis and pneumonia
Factors affecting vital capacity
Residual volume
It is the volume of air remaining in the lung
after deep expiration
It is about 1200 ml
Functions of residual volume:
It allows areation of the lung and gas exchange
between breaths
It helps to start next inflation easier
Measurement
Helium dilution technique:
the person inspire through spirometer cylinder
filled with know volume and concentration
helium and after equilipration the volume of
lung at the end of normal expiration final
helium concentration is determined and so
final volume which is then equal the initial
spirometer volume + lung volume which is FRC:
Initial helium concentration X Spirometer

volume = final helium concentration X(Lung
volume + spirometer volume)
Body plethsmograph:
it is a tight air box where the person sits in
at first the pressure X volume of the box equal
the pressure X volume of the lung
if the patient inspires starting from FRC inside
the box the final state will show that pressre X
volume of the box will equal pressure X
volume in the lung by the two equations we
can find the initial lung volume which is FRC


BODY PLETHYSMOGRAPHY
P
boxi
X V
boxi
= P
boxf

X (V
boxi
-V)
(V
boxi
-V) = V
boxf
P
Mi
x V
Li
= P
Mf
x
(V
Li
+ V)
(V
Li
+ V) = V
Lf

Dead Space
Dead space: It is the volume of air in the respiratory system
which does not share in gas exchange
Anatomical dead space : is the volume of air inside air
passages down to the respiratory bronchioles. It is the
conducting zone without alveoli normally 150 ml
Alveolar dead space : is the volume of air inside inactive or
nonfunctioning alveoli normally zero in healthy persons
Physiological dead space : is the volume of air in the
respiratory system which does not share in gas exchange.
Physiological dead space = anatomical dead space + alveolar
dead space and normally physiologal dead space =
anatomical dead space.
Dead space ventilation = volume of dead space x RR
Pulmonary ventilation = Tidal volume x RR
Alveolar ventilarion = (TV- DSV) x RR

Significance of dead space
It is the function of the coducting zone which
include
Mosturing and warming air before it enters the
alveoli
defense function
responsible for difference between alveolar air
and expired air(expired more o2 less co2 than
alveolar)
Dead space increases during rapid breathing
and during decrease lung perfusion


Measurement of dead space
Fowler Methos
The person breath in pure oxygen
then make single expiration
During expiration the volume of air
expired is recorded on spirometry
and the pressure of nitrogrn in
expired air is recorded
Three phases will be obtained
Phase I % of nitrogrn in the expired
air is zero: this air represent dead
space air which contains pure
oxygen
Phase II: % of nitrgen gradually
increases till become constant
represent transition zone from
dead space to alveolar space
Phase III : constant nitrogen
concentration represent alveolar
air
Dead space is calculated by volume
of air expired during phase I and
of phase II
Measurement of physiological dead space Bohr
equation
It depends on the idea that amount of CO
2
expired equal amount of
CO
2
coming from DS plus amount of CO
2
coming from alveolar
space
As CO
2
coming from dead space is nearly zero so Co
2
in the expired
air = CO
2
coming from alveolar aie
CO2 content = fracional Concentration of CO
2
X volume of the space
concerned
F
ECO2
x TV= F
ACO2
X alveolar space
F
ECO2
X TV = F
ACO2
X (TV- DV)
Fractional concentration can be replaced by partial pressure
P
ECO2
X TV = P
ACO2
X (TV- DV)
Arrangement of this equation gives
DV/TV= (P
ACO2
-

P
ECO2
)/

P
ACO2
P
ACO2
is measure as the end tidasl Co2 which could be replaced by
arterial PCO2 the equaion could be
DV/TV= (P
aCO2
-

P
ECO2
)/

P
aCO2