The Respiratory System

Cells continually use O2 & release CO2 Respiratory system designed for gas exchange Cardiovascular system transports gases in blood Failure of either system
rapid cell death from O2 starvation

Respiratory System Anatomy

Nose Pharynx = throat Larynx = voicebox Trachea = windpipe Bronchi = airways Lungs Locations of infections
upper respiratory tract is above vocal cords lower respiratory tract is below vocal cords

External Nasal Structures

Skin, nasal bones, & cartilage lined with mucous membrane Openings called external nares or nostrils

Nose -- Internal Structures

Large chamber within the skull Roof is made up of ethmoid and floor is hard palate Internal nares (choanae) are openings to pharynx Nasal septum is composed of bone & cartilage Bony swelling or conchae on lateral walls

Functions of the Nasal Structures

Olfactory epithelium for sense of smell Pseudostratified ciliated columnar with goblet cells lines nasal cavity
warms air due to high vascularity mucous moistens air & traps dust cilia move mucous towards pharynx

Paranasal sinuses open into nasal cavity

found in ethmoid, sphenoid, frontal & maxillary lighten skull & resonate voice

Pharynx
Muscular tube (5 inch long) hanging from skull
skeletal muscle & mucous membrane

Extends from internal nares to cricoid cartilage Functions

passageway for food and air resonating chamber for speech production tonsil (lymphatic tissue) in the walls protects entryway into body

Distinct regions -- nasopharynx, oropharynx and laryngopharynx

Nasopharynx

From choanae to soft palate

openings of auditory (Eustachian) tubes from middle ear cavity adenoids or pharyngeal tonsil in roof

Passageway for air only

pseudostratified ciliated columnar epithelium with goblet

Oropharynx

From soft palate to epiglottis

fauces is opening from mouth into oropharynx palatine tonsils found in side walls, lingual tonsil in tongue

Common passageway for food & air

stratified squamous epithelium

Laryngopharynx

Extends from epiglottis to cricoid cartilage Common passageway for food & air & ends as esophagus inferiorly
stratified squamous epithelium

Cartilages of the Larynx

Thyroid cartilage forms Adams apple Epiglottis---leaf-shaped piece of elastic cartilage
during swallowing, larynx moves upward epiglottis bends to cover glottis

Cricoid cartilage---ring of cartilage attached to top of trachea Pair of arytenoid cartilages sit upon cricoid
many muscles responsible for their movement partially buried in vocal folds (true vocal cords)

Larynx

Cartilage & connective tissue tube Anterior to C4 to C6 Constructed of 3 single & 3 paired cartilages

Vocal Cords

False vocal cords (ventricular folds) found above vocal folds (true vocal cords) True vocal cords attach to arytenoid cartilages

The Structures of Voice Production

True vocal cord contains both skeletal muscle and an elastic ligament (vocal ligament) When 10 intrinsic muscles of the larynx contract, move cartilages & stretch vocal cord tight When air is pushed past tight ligament, sound is produced (the longer & thicker vocal cord in male produces a lower pitch of sound) The tighter the ligament, the higher the pitch To increase volume of sound, push air harder

Speech and Whispering

Speech is modified sound made by the larynx. Speech requires pharynx, mouth, nasal cavity & sinuses to resonate that sound Tongue & lips form words Pitch is controlled by tension on vocal folds
pulled tight produces higher pitch male vocal folds are thicker & longer so vibrate more slowly producing a lower pitch

Whispering is forcing air through almost closed rima glottidis -- oral cavity alone forms speech

Trachea
Size is 5 in long & 1in diameter Extends from larynx to T5 anterior to the esophagus and then splits into bronchi Layers
mucosa = pseudostratified columnar with cilia & goblet submucosa = loose connective tissue & seromucous glands hyaline cartilage = 16 to 20 incomplete rings
open side facing esophagus contains trachealis m. (smooth) internal ridge on last ring called carina

Trachea and Bronchial Tree

Full extent of airways is visible starting at the larynx and trachea

Histology of the Trachea

Ciliated pseudostratified columnar epithelium Hyaline cartilage as C-shaped structure closed by trachealis muscle

Airway Epithelium

Ciliated pseudostratified columnar epithelium with goblet cells produce a moving mass of mucus.

Bronchi and Bronchioles

Primary bronchi supply each lung Secondary bronchi supply each lobe of the lungs (3 right + 2 left) Tertiary bronchi supply each bronchopulmonary segment Repeated branchings called bronchioles form a bronchial tree

Histology of Bronchial Tree

Epithelium changes from pseudostratified ciliated columnar to nonciliated simple cuboidal as pass deeper into lungs Incomplete rings of cartilage replaced by rings of smooth muscle & then connective tissue
sympathetic NS & adrenal gland release epinephrine that relaxes smooth muscle & dilates airways asthma attack or allergic reactions constrict distal bronchiole smooth muscle nebulization therapy = inhale mist with chemicals that relax muscle & reduce thickness of mucus

Pleural Membranes & Pleural Cavity

Visceral pleura covers lungs --- parietal pleura lines ribcage & covers upper surface of diaphragm Pleural cavity is potential space between ribs & lungs

Gross Anatomy of Lungs

Base, apex, costal surface, cardiac notch Oblique & horizontal fissure in right lung results in 3 lobes Oblique fissure only in left lung produces 2 lobes

Mediastinal Surface of Lungs

Blood vessels & airways enter lungs at hilus Forms root of lungs

Structures within a Lobule of Lung

Branchings of single arteriole, venule & bronchiole are wrapped by elastic CT Respiratory bronchiole
simple squamous

Alveolar ducts surrounded by alveolar sacs & alveoli

sac is 2 or more alveoli sharing a common opening

Cells Types of the Alveoli

Type I alveolar cells
simple squamous cells where gas exchange occurs

Type II alveolar cells (septal cells)

free surface has microvilli secrete alveolar fluid containing surfactant

Alveolar dust cells

wandering macrophages remove debris

Alveolar-Capillary Membrane
Respiratory membrane = 1/2 micron thick Exchange of gas from alveoli to blood 4 Layers of membrane to cross
alveolar epithelial wall of type I cells alveolar epithelial basement membrane capillary basement membrane endothelial cells of capillary

Vast surface area = handball court

Double Blood Supply to the Lungs

Deoxygenated blood arrives through pulmonary trunk from the right ventricle Bronchial arteries branch off of the aorta to supply oxygenated blood to lung tissue Venous drainage returns all blood to heart Less pressure in venous system Pulmonary blood vessels constrict in response to low O2 levels so as not to pick up CO2 on there way through the lungs

Breathing or Pulmonary Ventilation

Air moves into lungs when pressure inside lungs is less than atmospheric pressure Air moves out of the lungs when pressure inside lungs is greater than atmospheric pressure Atmospheric pressure = 1 atm or 760mm Hg

Boyles Law

As the size of closed container decreases, pressure inside is increased The molecules have less wall area to strike so the pressure on each inch of area increases.

Quiet Inspiration

Diaphragm moves 1 cm & ribs lifted by muscles Intrathoracic pressure falls and 2-3 liters inhaled

Quiet Expiration

Passive process with no muscle action Elastic recoil & surface tension in alveoli pulls inward Alveolar pressure increases & air is pushed out

Labored Breathing
Forced expiration
abdominal mm force diaphragm up internal intercostals depress ribs

Forced inspiration
sternocleidomastoid, scalenes & pectoralis minor lift chest upwards as you gasp for air

Intrathoracic Pressures

Always subatmospheric (756 mm Hg) As diaphragm contracts intrathoracic pressure decreases even more (754 mm Hg) Helps keep parietal & visceral pleura stick together

Summary of Breathing

Alveolar pressure decreases & air rushes in Alveolar pressure increases & air rushes out

Alveolar Surface Tension

Thin layer of fluid in alveoli causes inwardly directed force = surface tension
water molecules strongly attracted to each other

Causes alveoli to remain as small as possible Detergent-like substance called surfactant produced by Type II alveolar cells
lowers alveolar surface tension insufficient in premature babies so that alveoli collapse at end of each exhalation

Pneumothorax
Pleural cavities are sealed cavities not open to the outside Injuries to the chest wall that let air enter the intrapleural space
causes a pneumothorax collapsed lung on same side as injury surface tension and recoil of elastic fibers causes the lung to collapse
Tortora & Grabowski 9/e 2000 JWS 23-36

Compliance of the Lungs

Ease with which lungs & chest wall expand depends upon elasticity of lungs & surface tension Some diseases reduce compliance
tuberculosis forms scar tissue pulmonary edema --- fluid in lungs & reduced surfactant paralysis
Tortora & Grabowski 9/e 2000 JWS 23-37

Breathing Patterns
Eupnea = normal quiet breathing Apnea = temporary cessation of breathing Dyspnea =difficult or labored breathing Tachypnea = rapid breathing Diaphragmatic breathing = descent of diaphragm causes stomach to bulge during inspiration Costal breathing = just rib activity involved

Lung Volumes and Capacities

Tidal volume = amount air moved during quiet breathing MVR= minute ventilation is amount of air moved in a minute Reserve volumes ---- amount you can breathe either in or out above that amount of tidal volume Residual volume = 1200 mL permanently trapped air in system Vital capacity & total lung capacity are sums of the other volumes

Daltons Law
Each gas in a mixture of gases exerts its own pressure
as if all other gases were not present partial pressures denoted as p

Total pressure is sum of all partial pressures

atmospheric pressure (760 mm Hg) = pO2 + pCO2 + pN2 + pH2O to determine partial pressure of O2-- multiply 760 by % of air that is O2 (21%) = 160 mm Hg

What is Composition of Air?

Air = 21% O2, 79% N2 and .04% CO2 Alveolar air = 14% O2, 79% N2 and 5.2% CO2 Expired air = 16% O2, 79% N2 and 4.5% CO2 Observations
alveolar air has less O2 since absorbed by blood mystery-----expired air has more O2 & less CO2 than alveolar air? Anatomical dead space = 150 ml of 500 ml of tidal volume

External Respiration
Gases diffuse from areas of high partial pressure to areas of low partial pressure Exchange of gas between air & blood Deoxygenated blood becomes saturated Compare gas movements in pulmonary capillaries to tissue capillaries

Internal Respiration

Exchange of gases between blood & tissues Conversion of oxygenated blood into deoxygenated Observe diffusion of O2 inward
at rest 25% of available O2 enters cells during exercise more O2 is absorbed

Diffusion of CO2 outward

Acidity & Oxygen Affinity for Hb

As acidity increases, O2 affinity for Hb decreases Bohr effect H+ binds to hemoglobin & alters it

pCO2 & Oxygen Release

As pCO2 rises with exercise, O2 is released more easily from Hb CO2 converts to carbonic acid & becomes H+ and bicarbonate ions & lowers pH.

Temperature & Oxygen Release

As temperature increases, more O2 is released Metabolic activity & heat More BPG, more O2 released
RBC activity hormones like thyroxine & growth hormone

Oxygen Affinity & Fetal Hemoglobin

Differs from adult in structure & affinity for O2 When pO2 is low, can carry more O2 Maternal blood in placenta has less O2

Carbon Monoxide Poisoning

CO from car exhaust & tobacco smoke Binds to Hb heme group more successfully than O2 CO poisoning Treat by administering pure O2

Carbon Dioxide Transport

100 ml of blood carries 55 ml of CO2 Is carried by the blood in 3 ways
dissolved in plasma combined with the globin part of Hb molecule forming carbaminohemoglobin as part of bicarbonate ion
CO2 + H2O combine to form carbonic acid that dissociates into H+ and bicarbonate ion

Summary of Gas Exchange & Transport

Role of the Respiratory Center

Respiratory mm. controlled by neurons in pons & medulla 3 groups of neurons
medullary rhythmicity pneumotaxic apneustic centers

Medullary Rhythmicity Area

Controls basic rhythm of respiration Inspiration for 2 seconds, expiration for 3 Autorhythmic cells active for 2 seconds then inactive Expiratory neurons inactive during most quiet breathing only active during high ventilation rates

Pneumotaxic & Apneustic Areas

Pneumotaxic Area
constant inhibitory impulses to inspiratory area
neurons trying to turn off inspiration before lungs too expanded

Apneustic Area
stimulatory signals to inspiratory area to prolong inspiration

Regulation of Respiratory Center

Cortical Influences
voluntarily alter breathing patterns limitations are buildup of CO2 & H+ in blood inspiratory center is stimulated by increase in either if you hold breathe until you faint----breathing will resume

Chemical Regulation of Respiration

Central chemoreceptors in medulla
respond to changes in H+ or pCO2 hypercapnia = slight increase in pCO2 is noticed

Peripheral chemoreceptors
respond to changes in H+ , pO2 or PCO2 aortic body---in wall of aorta
nerves join vagus

carotid bodies--in walls of common carotid arteries

nerves join glossopharyngeal nerve

Negative Feedback Regulation of Breathing

Negative feedback control of breathing Increase in arterial pCO2 Stimulates receptors Inspiratory center Muscles of respiration contract more frequently & forcefully pCO2 Decreases

Regulation of Ventilation Rate and Depth

Types of Hypoxia
Deficiency of O2 at tissue level Types of hypoxia
hypoxic hypoxia--low pO2 in arterial blood
high altitude, fluid in lungs & obstructions

anemic hypoxia--too little functioning Hb

hemorrhage or anemia

ischemic hypoxia--blood flow is too low histotoxic hypoxia--cyanide poisoning

blocks metabolic stages & O2 usage

Exercise and the Respiratory System

During exercise, muscles consume large amounts of O2 & produce large amounts CO2 Pulmonary ventilation must increase
moderate exercise increases depth of breathing, strenuous exercise also increases rate of breathing

Abrupt changes at start of exercise are neural

anticipation & sensory signals from proprioceptors impulses from motor cortex

Chemical & physical changes are important

Tortora & Grabowski 9/e 2000 JWS

decrease in pO2, increase in pCO2 & increased 23-59 temperature

Smokers Lowered Respiratory Efficiency

Smoker is easily winded with moderate exercise
nicotine constricts terminal bronchioles carbon monoxide in smoke binds to hemoglobin irritants in smoke cause excess mucus secretion irritants inhibit movements of cilia in time destroys elastic fibers in lungs & leads to emphysema
trapping of air in alveoli & reduced gas exchange
Tortora & Grabowski 9/e 2000 JWS 23-60

Aging & the Respiratory System

Respiratory tissues & chest wall become more rigid Vital capacity decreases to 35% by age 70. Decreases in macrophage activity Diminished ciliary action Decrease in blood levels of O2 Result is an age-related susceptibility to pneumonia or bronchitis

Disorders of the Respiratory System

Asthma Chronic obstructive pulmonary disease
Emphysema Chronic bronchitis Lung cancer

Pneumonia Tuberculosis Coryza and Influenza Pulmonary Edema Tortora & Grabowski 9/e 2000 JWS Cystic fibrosis

23-62