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Respiratory Physiology

Joyce King, CNM, Ph.D.


Primary Function

❚ The exchange of gases between the


environmental air and the blood.
❙ Ventilation
❙ Diffusion
❙ Perfusion
Nonrespiratory Functions of
the Respiratory System

❚ Water loss and heat elimination


❚ Warms and humidifies inspired air
❚ Enhances venous return
❚ Contributes to normal acid-base
balance
❚ Enables speech, singing, etc.
Nonrespiratory Functions of
the Respiratory System

❚ Defends against inhaled foreign


matter.
❚ Removes, modifies, activates various
materials passing through the
pulmonary circulation.
❙ Inactivates prostaglandins
❙ Activates angiotensin II
❚ Nose - organ of smell
Structure of the
Respiratory System

❚ Respiratory airways
❙ Nasal passages
❙ Pharynx
❙ Trachea
❙ Bronchi
❙ Bronchioles
Structure of the
Respiratory System

❚ Lungs - left lung - 2 lobes; right lung


- 3 lobes
❙ Alveoli
❘ Type I alveolar cells
❘ Type II alveolar cells
❘ Alveolar macrophages
❘ Pores of Kohn
Alveolar fluid lining
with pulmonary surfactant Alveolar
Type II alveolar cell macrophage

Type I alveolar cell

Interstitial fluid

Alveolus
Pulmonary
capillary

Erythrocyte
Structure of the
Respiratory System

❚ Lungs, contd.
❙ Pulmonary capillaries
❙ Elastic connective tissue
❙ Pleural sac
❚ Thorax
Respiratory Mechanics
Air moves from an area of high
pressure to an area of low
pressure, following the pressure
gradient.
Respiratory Mechanics

❚ Pressure considerations
❙ Atmospheric pressure
❙ Intra-alveolar pressure
❙ Intrapleural pressure
Major Inspiratory Muscles

❚ Quiet breathing
❙ Diaphragm
❙ External intercostal muscles
❚ Deeper inspirations
❙ Accessory inspiratory muscles
Expiration

❚ Inspiratory muscles relax


❚ Chest wall and lungs recoil
❚ Intra-alveolar pressure increases
❚ Air leaves the lungs
Expiration

Expiration is normally a passive


process.

For more complete and rapid


emptying:
❙ Abdominal muscles
❙ Internal intercostal muscles
Airway Resistance

❚ Bronchoconstriction -
parasympathetic stimulation
❚ Bronchodilation - sympathetic
stimulation
Airway Resistance
Lung Elasticity

❚ Elastic recoil and compliance


❙ Connective tissue
❙ Alveolar surface tension
Pulmonary Surfactant

❚ Secreted by Type II alveolar cells


❚ Reduces alveolar surface tension
❙ Increased pulmonary compliance
❙ Reduces the lungs tendency to recoil
Energy Expenditure is
Increased When:

❚ Pulmonary compliance is decreased


❚ Airway resistance is increased
❚ Elastic recoil is decreased
❚ There is need for increased
ventilation
Lung Volumes

❚ Normal range:
❙ Male - 5.7 liters
❙ Female - 4.2 liters
❘ 500 ml of air are inspired and expired
❘ At end of quiet expiration, the lungs
still contain 2,200 ml of air
Lung Volumes

❚ Gas exchange continues during


expiration
❙ Maintains constant gas content
❙ Decreased energy utilization
Lung Volumes

❚ Tidal volume
❚ Residual volume
❚ Vital capacity
❚ Total lung capacity
❚ Forced expiratory volume in one
second
Alveolar Ventilation

❚ Pulmonary ventilation
❚ Respiratory Rate
❚ Anatomical dead space
❚ Alveolar ventilation
❚ Alveolar dead space
Local Regulation

Goal - Maximally match blood flow to


airflow

↓Airflow in comparison to blood flow →


↑ CO2 → relaxation of airway → ↑
airflow

↑ blood flow in comparison to air flow


→ ↓ O2 in alveolus and surrounding
tissues → vasoconstriction of
Gas Exchange

❚ Simple diffusion down partial


pressure gradients
Partial Pressure

The individual pressure exerted


independently by a particular gas
within a mixture of gases.
Partial Pressure

The air we breath exerts a total


atmospheric pressure of 760 mm Hg
(at sea level) and is composed of:
❙ 79% Nitrogen - PN2 = 760 mm Hg x .79 -
600 mm Hg
❙ 21% Oxygen - PO2 = 760 mm Hg x .21 =
160 mm Hg
❙ The partial pressure of CO2 is negligible
at 0.03 mm Hg
Amount of gas that dissolves in
blood depends on:

❚ Solubility of the gas in blood


❚ Partial pressure of the gas

The difference in partial pressure


between pulmonary blood and
alveolar air is known as a partial
pressure gradient.
Alveolar Air

❚ Inspired air is humidified - water vapor


❚ Fresh inspired air mixes with the large
volume of old air and the dead space -
at the end of each inspiration, less than
15% of the air in the alveoli is fresh air.

The average alveolar PO2 is 100 mm


Hg.
O2 and CO2 Exchange

❚ Only small fluctuations occur in alveolar


PO2 throughout both inspiration and
expiration.
❙ Small proportion of total air exchanged
❙ Oxygen rapidly moves down its partial
pressure gradient
O2 and CO2 Exchange

❙ Pulmonary blood PO2 equilibrates


with alveolar PO2
❙ PO2 of arterial blood is fairly
constant
O2 and CO2 Exchange –
Alveoli Level

❚ Alveolar PCO2 also remains fairly


constant at 40 mm Hg.
❚ Partial pressures of gases favor the
movement of O2 from the alveoli into
the blood and CO2 from the blood
into the alveoli.
O2 and CO2 Exchange

❚ O2 uptake matches O2 use even


when O2 consumption increases due
to increased metabolism.
Rate of Diffusion

❚ Surface area
❚ Thickness of the membrane
❚ Diffusion coefficient of the particular
gas.
Rate of Diffusion

These factors are relatively constant


under resting conditions, therefore
the partial pressure is the primary
factor that determines rate of
exchange.
O2 and CO2 Exchange –
Tissue Level

❚ Partial pressures of gases favor the


movement of O2 from the blood into
the adjacent cells and CO2 from the
cells into the capillary blood.
Gas Transport

❚ Oxygen
❙ Dissolved oxygen (1.5%)
❙ Chemically bound to hemoglobin
(98.5%)

The PO2 of the blood is a


measurement only of the
dissolved oxygen.
Hemoglobin

❚ Four polypeptide chains


❚ Four iron-containing heme groups that
are able to combine with an O2
molecule.

If Hb is carrying its maximum O2 load,


it is considered to be fully saturated.
Oxyhemoglobin
Dissociation Curve

❚ Plateau portion
❙ Range that exists at the pulmonary
capillaries.

Note: Minimal reduction of oxygen


transported until the PO2 falls below
60 mm Hg.
Oxyhemoglobin
Dissociation Curve

❚ Steep portion of the curve


❙ Range that exists at the systemic
capillaries

A small drop in systemic capillary PO2


can result in the release of large
amounts of oxygen for the
metabolically active cells.
Hemoglobin

❚ Storage for oxygen


❚ Maintains a low PO2
❚ At the tissue level, as the PO2 falls the
Hb unloads some of its stored
oxygen.
Factors that Affect the Binding
of Hemoglobin and Oxygen

❚ Carbon dioxide
❚ Acidity
❚ Temperature

Bohr effect – Reduction in the


affinity of hemoglobin for oxygen in
response to an increase in blood
carbon dioxide and a decrease in pH.
Gas Transport

❚ Carbon Dioxide
❙ Dissolved CO2 (10%)
❙ Carbamino hemoglobin (30%)
❙ Bicarbonate (60%)
❙ Chloride shift

Haldane effect – the ability of


hemoglobin to pick up CO2 and CO2-
generated H+.
Control of Respiration

❚ Neural control
❚ Chemical stimuli
Neural Control

❚ Respiratory control centers housed


in the brain stem
❙ Inspiratory and expiratory neurons in
the medullary respiratory center
❘ Dorsal respiratory group
❘ Ventral respiratory group
❘ Rostral ventromedial medulla
Neural Control

❚ Respiratory control centers housed


in the brain stem, contd.
❙ Apneustic
❙ Pneumotaxic center
❚ Stretch receptors in the lung (Hering
Breuer reflex)
❙ Prevents overinflation of the lung
Neural Control

❚ Ventilation is matched to the body’s


needs for oxygen uptake and carbon
dioxide removal
❙ Medullary respiratory center receives
input
❙ Appropriate signals sent to motor
neurons
❙ Rate and depth of ventilation adjusted
Chemical Stimuli

❚ Arterial PO2
❚ Arterial PCO2
❚ Arterial H+
Arterial PO2

❚ Monitored by peripheral
chemoreceptors
❚ PO2 must fall below 60 mm Hg to
stimulate increased respiration
❚ Peripheral chemoreceptors respond
to the PO2 and not the total oxygen
content.
Arterial PCO2

❚ Major regulator of ventilation under


resting conditions.
❚ CO2 crosses the blood-brain barrier
forming H+
Arterial PCO2

❚ Central chemoreceptors are


sensitive to changes in CO2-induced
H+ in the brain ECF
❚ An elevation of H+ stimulates
increased ventilation.
Arterial H+

❚ Monitored by aortic and carotid


body peripheral chemoreceptors
❚ Plays a role in adjusting ventilation
in response to alterations in arterial
H+ concentrations unrelated to
fluctuations in PCO2
Every day it’s the same old
thing:

Breathe, breathe, breathe


Respiratory Questions
Contraction of the abdominal
muscles is important in:
a. normal (quiet) inspiration
b. forced (maximum) inspiration
c. normal (quiet) expiration
d. forced (maximum) expiration
Respiratory Questions

Alveolar surfactant acts to increase


pulmonary:
a. surface tension
b. compliance
c. airway resistance
d. blood flow
Respiratory Questions

At the top of a 3000 meter high mountain,


which of the following alveolar partial
pressures would be expected to be lower
than normal?
a. PA-O2
b. water vapor
c. PA-CO2
d. All of the above
d. Only a and b
Respiratory Questions

Compared with systemic arterial


blood, systemic venous blood has a
higher:
a. oxygen content
b. pH
c. bicarbonate ion concentration
d. hemoglobin concentration
Respiratory Questions

An oxyhemoglobin saturation of
systemic venous blood of 25% for a
person at rest is:
a. above normal
b. below normal
c. within the normal range
Respiratory Questions

As blood passes through systemic


capillaries, the enzyme carbonic
anhydrase catalyzes:
a. conversion of dissolved CO2 to carbonic
acid
b. conversion of carbonic acid to
bicarbonate ion
c. binding of carbon dioxide to
hemoglobin, thus displacing oxygen
d. binding of hydrogen ions to