Respiratory System: Oxygen Delivery System

The primary function of the respiratory system is to supply the blood with oxygen in order for the blood to deliver oxygen to all parts of the body. The respiratory system does this through breathing. When we breathe, we inhale oxygen and exhale carbon dioxide. This exchange of gases is the respiratory system's means of getting oxygen to the blood. Respiration is achieved through the mouth, nose, trachea, lungs, and diaphragm. Oxygen enters the respiratory system through the mouth and the nose. The oxygen then passes through the larynx (where speech sounds are produced) and the trachea which is a tube that enters the chest cavity. In the chest cavity, the trachea splits into two smaller tubes called the bronchi. Each bronchus then divides again forming the bronchial tubes. The bronchial tubes lead directly into the lungs where they divide into many smaller tubes which connect to tiny sacs called alveoli. The average adult's lungs contain about 600 million of these spongy, air-filled sacs that are surrounded by capillaries. The inhaled oxygen passes into the alveoli and then diffuses through the capillaries into the arterial blood. Meanwhile, the waste-rich blood from the veins releases its carbon dioxide into the alveoli. The carbon dioxide follows the same path out of the lungs when you exhale. The diaphragm's job is to help pump the carbon dioxide out of the lungs and pull the oxygen into the lungs. The diaphragm is a sheet of muscles that lies across the bottom of the chest cavity. As the diaphragm contracts and relaxes, breathing takes place. When the diaphragm contracts, oxygen is pulled into the lungs. When the diaphragm relaxes, carbon dioxide is pumped out of the lungs. Human Respiratory System The human respiratory system consists of a complex set of organs and tissues that capture oxygen from the environment and transport the oxygen into the lungs. The organs and tissues that comprise the human respiratory system include the nose and pharynx, the trachea, and the lungs. Nose and pharynx The respiratory system of humans begins with the nose, where air is conditioned by warming and moistening. Bone partitions separate the nasal cavity into chambers, where air swirls about in currents. Hairs and hairlike cilia trap dust particles and purify the air. The nasal chambers open into a cavity at the rear of the mouth called the pharynx (throat). From the pharynx, two tubes called Eustachian tubes open to the middle ear to equalize air pressure there. The pharynx also contains tonsils and adenoids, which are pockets of lymphatic tissue used to trap and filter microorganisms.

Trachea After passing through the pharynx, air passes into the windpipe, or trachea. The trachea has a framework of smooth muscle with about 16 to 20 open rings of cartilage shaped like a C. These rings give rigidity to the trachea and ensure that it remains open. The opening to the trachea is a slitlike structure called the glottis. A thin flap of tissue called the epiglottis folds over the opening during swallowing and prevents food from entering the trachea. At the upper end of the trachea, several folds of cartilage form the larynx, or voicebox. In the larynx, flaplike pairs of tissues called vocal cords vibrate when a person exhales and produce sounds. At its lower end, the trachea branches into two large bronchi (singular, bronchus). These tubes also have smooth muscle and cartilage rings. The bronchi branch into smaller bronchioles, forming a bronchial tree. The bronchioles terminate in the air sacs known as alveoli. Lungs Human lungs are composed of approximately 300 million alveoli, which are cup-shaped sacs surrounded by a capillary network. Red blood cells pass through the capillaries in single file, and oxygen from each alveolus enters the red blood cells and binds to the hemoglobin. In addition, carbon dioxide contained in the plasma and red blood cells leaves the capillaries and enters the alveoli when a breath is taken. Most carbon dioxide reaches the alveoli as bicarbonate ions, and about 25 percent of it is bound loosely to hemoglobin. When a person inhales, the rib muscles and diaphragm contract, thereby increasing the volume of the chest cavity. This increase leads to reduced air pressure in the chest cavity, and air rushes into the alveoli, forcing them to expand and fill. The lungs passively obtain air from the environment by this process. During exhalation, the rib muscles and diaphragm relax, the chest cavity area diminishes, and the internal air pressure increases. The compressed air forces the alveoli to close, and air flows out. The nerve activity that controls breathing arises from impulses transported by nerve fibers passing into the chest cavity and terminating at the rib muscles and diaphragm. These impulses are regulated by the amount of carbon dioxide in the blood: A high carbon-dioxide concentration leads to an increased number of nerve impulses and a higher breathing rate. The Human Respiratory System The Pathway

Air enters the nostrils

passes through the nasopharynx, the oral pharynx through the glottis into the trachea into the right and left bronchi, which branches and rebranches into bronchioles, each of which terminates in a cluster of alveoli

Only in the alveoli does actual gas exchange takes place. There are some 300 million alveoli in two adult lungs. These provide a surface area of some 160 m2 (almost equal to the singles area of a tennis court and 80 times the area of our skin!). Breathing In mammals, the diaphragm divides the body cavity into the

abdominal cavity, which contains the viscera (e.g., stomach and intestines) and the thoracic cavity, which contains the heart and lungs.

The inner surface of the thoracic cavity and the outer surface of the lungs are lined with pleural membranes which adhere to each other. If air is introduced between them, the adhesion is broken and the natural elasticity of the lung causes it to collapse. This can occur from trauma. And it is sometimes induced deliberately to allow the lung to rest. In either case, reinflation occurs as the air is gradually absorbed by the tissues. Because of this adhesion, any action that increases the volume of the thoracic cavity causes the lungs to expand, drawing air into them.

During inspiration (inhaling), o The external intercostal muscles contract, lifting the ribs up and out. o The diaphragm contracts, drawing it down . During expiration (exhaling), these processes are reversed and the natural elasticity of the lungs returns them to their normal volume. At rest, we breath 1518 times a minute exchanging about 500 ml of air. In more vigorous expiration, o The internal intercostal muscles draw the ribs down and inward o The wall of the abdomen contracts pushing the stomach and liver upward. Under these conditions, an average adult male can flush his lungs with about 4 liters of air at each breath. This is called the vital capacity. Even with maximum expiration, about 1200 ml of residual air remain.

The table shows what happens to the composition of air when it reaches the alveoli. Some of the oxygen dissolves in the film of moisture covering the epithelium of the alveoli. From here it diffuses into the blood in a nearby capillary. It enters a red blood cell and combines with the hemoglobin therein. At the same time, some of the carbon dioxide in the blood diffuses into the alveoli from which it can be exhaled.

. Composition of atmospheric air and expired air in a typical subject. Note that only a fraction of the oxygen inhaled is taken up by the lungs. Component N2 (plus inert gases) O2 CO2 H2O Atmospheric Air (%) 78.62 20.85 0.03 0.5 100.0% Expired Air (%) 74.9 15.3 3.6 6.2 100.0%

The ease with which oxygen and carbon dioxide can pass between air and blood is clear from this electron micrograph of two alveoli (Air) and an adjacent capillary from the lung of a laboratory mouse. Note the thinness of the epithelial cells (EP) that line the alveoli and capillary (except where the nucleus is located). At the closest point, the surface of the red blood cell is only 0.7 m away from the air in the alveolus. (Reproduced with permission from Keith R. Porter and Mary A. Bonneville, An Introduction to the Fine Structure of Cells and Tissues, 4th. ed., Lea & Febiger, 1973.)

Central Control of Breathing The rate of cellular respiration (and hence oxygen consumption and carbon dioxide production) varies with level of activity. Vigorous exercise can increase by 2025 times the demand of the tissues for oxygen. This is met by increasing the rate and depth of breathing. It is a rising concentration of carbon dioxide not a declining concentration of oxygen that plays the major role in regulating the ventilation of the lungs. Certain cells in the medulla oblongata are very sensitive to a drop in pH. As the CO2 content of the blood rises above normal levels, the pH drops

[CO2 + H2O HCO3 + H+], and the medulla oblongata responds by increasing the number and rate of nerve impulses that control the action of the intercostal muscles and diaphragm. This produces an increase in the rate of lung ventilation, which quickly brings the CO2 concentration of the alveolar air, and then of the blood, back to normal levels. However, the carotid body in the carotid arteries does have receptors that respond to a drop in oxygen. Their activation is important in situations (e.g., at high altitude in the unpressurized cabin of an aircraft) where oxygen supply is inadequate but there has been no increase in the production of CO2. Local Control of Breathing The smooth muscle in the walls of the bronchioles is very sensitive to the concentration of carbon dioxide. A rising level of CO2 causes the bronchioles to dilate. This lowers the resistance in the airways and thus increases the flow of air in and out. Diseases of the Lungs Pneumonia Pneumonia is an infection of the alveoli. It can be caused by many kinds of both bacteria (e.g., Streptococcus pneumoniae) and viruses. Tissue fluids accumulate in the alveoli reducing the surface area exposed to air. If enough alveoli are affected, the patient may need supplemental oxygen. Asthma In asthma, periodic constriction of the bronchi and bronchioles makes it more difficult to breathe in and, especially, out. Attacks of asthma can be

triggered by airborne irritants such as chemical fumes and cigarette smoke airborne particles to which the patient is allergic.

Emphysema In this disorder, the delicate walls of the alveoli break down, reducing the gasexchange area of the lungs. The condition develops slowly and is seldom a direct cause of death. However, the gradual loss of gas-exchange area forces the heart to pump ever-larger volumes of blood to the lungs in order to satisfy the body's needs. The added strain can lead to heart failure. The immediate cause of emphysema seems to be the release of proteolytic enzymes as part of the inflammatory process that follows irritation of the lungs. Most people avoid this kind of damage during infections, etc. by producing an enzyme inhibitor (a serpin) called alpha-1 antitrypsin. Those rare people who inherit two defective genes for alpha-1 antitrypsin are particularly susceptible to developing emphysema.

Chronic Bronchitis Any irritant reaching the bronchi and bronchioles will stimulate an increased secretion of mucus. In chronic bronchitis the air passages become clogged with mucus, and this leads to a persistent cough. Chronic bronchitis is usually associated with cigarette smoking. Chronic Obstructive Pulmonary Disease (COPD) Irritation of the lungs can lead to asthma, emphysema, and chronic bronchitis. And, in fact, many people develop two or three of these together. This constellation is known as chronic obstructive pulmonary disease (COPD). Among the causes of COPD are

cigarette smoke (often) cystic fibrosis (rare)

Cystic fibrosis is a genetic disorder caused by inheriting two defective genes for the cystic fibrosis transmembrane conductance regulator (CFTR), a transmembrane protein needed for the transport of Cl and HCO3 ions through the plasma membrane of epithelial cells. Defective secretion of HCO3 lowers the pH of the fluid in the lungs making it more hospitable to colonization by inhaled bacteria. The resulting inflammation leads to the accumulation of mucus which plugs the airways and hampers the ability of ciliated cells to move it up out of the lungs. All of this damages the airways interfering with breathing and causing a persistent cough. Cystic fibrosis is the most common inherited disease in the U.S. white population. Lung Cancer Lung cancer is the most common cancer and the most common cause of cancer deaths in U.S. males. Although more women develop breast cancer than lung cancer, since 1987 U.S. women have been dying in larger numbers from lung cancer than from breast cancer. Lung cancer, like all cancer, is an uncontrolled proliferation of cells. There are several forms of lung cancer, but the most common (and most rapidly increasing) types are those involving the epithelial cells lining the bronchi and bronchioles. Ordinarily, the lining of these airways consists of two layers of cells. Chronic exposure to irritants

causes the number of layers to increase. This is especially apt to happen at forks where the bronchioles branch. The ciliated and mucus-secreting cells disappear and are replaced by a disorganized mass of cells with abnormal nuclei. If the process continues, the growing mass penetrates the underlying basement membraneAt this point, malignant cells can break away and be carried in lymph and blood to other parts of the body where they may lodge and continue to proliferate. It is this metastasis of the primary tumor that eventually kills the patient.