RESPIRATORY

SYSTEM
ANATOMY & PHYSIOLOGY
WHY DO WE BREATHE?
THINK OF ALL THE
REASONS WHY WE NEED A
RESPIRATORY SYSTEM.

RESPIRATION
RESPIRATION
In physiology, respiration is defined as the transport of oxygen from the
outside air to the cells within tissues, and the transport of carbon dioxide
in the opposite direction.

Breathing (which in organisms with lungs is called ventilation and
includes inhalation and exhalation) is a part of physiologic respiration.
Thus, in precise usage, the words breathing and ventilation are
hyponyms, not synonyms, of respiration; but this prescription is not
consistently followed, even by most health care providers, because the
term respiratory rate (RR) is a well-established term in health care, even
though it would need to be consistently replaced with ventilation rate if
the precise usage were to be followed.
RESPIRATION
Respiration is used several different ways:
Cellular respiration is the aerobic breakdown of glucose in
the mitochondria to make ATP.
Respiratory systems are the organs in animals that
exchange gases with the environment.
Respiration is an everyday term that is often used to
mean breathing.

RESPIRATION
Breathing (pulmonary ventilation). consists of two
cyclic phases:
inhalation, also called inspiration - draws gases into
the lungs.
exhalation, also called expiration - forces gases out
of the lungs.

FUNCTIONS
Respiration includes the following processes:

1. Ventilation or breathing
2. The exchange of oxygen and carbon dioxide between the air
in the lungs and blood
3. Transport of oxygen and carbon dioxide in the blood
4. The exchange of oxygen and carbon dioxide between the
blood and the tissues.
FUNCTIONS
1. supplies the body with oxygen and disposes of
carbon dioxide
2. filters inspired air
3. produces sound
4. contains receptors for smell
5. rids the body of some excess water and heat
6. helps regulate blood pH


FUNCTIONS
Oversees gas exchanges (oxygen and carbon
dioxide) between the blood and external
environment
Exchange of gasses takes place within the lungs in
the alveoli(only site of gas exchange, other
structures passageways
Passageways to the lungs purify, warm, and
humidify the incoming air
Shares responsibility with cardiovascular system

Anatomy of the Respiratory
system
Nose
Pharynx
Larynx
Trachea
Bronchi
Lungs
alveoli
Upper Respiratory Tract
22-13
NOSE
Functions
warms, cleanses, humidifies inhaled air
detects odors
resonating chamber that amplifies the voice
Bony and cartilaginous supports
superior half: nasal bones medially and maxillae laterally
inferior half: lateral and alar cartilages
ala nasi: flared portion shaped by dense CT, forms lateral wall of each nostril
22-14
ANATOMY OF NASAL
REGION
22-15
ANATOMY OF NASAL
REGION
22-16
NASAL CAVITY
Extends from nostrils to posterior nares
Vestibule: dilated chamber inside ala nasi
stratified squamous epithelium, vibrissae (guard hairs)
Nasal septum divides cavity into right and left chambers
called nasal fossae
Nasal cavity
Nasal septum divides the cavity into right and
left portions
Nares openings of the nose

Nasal conchae extend from walls of nasal
cavity

Mucous membrane warms and moistens the air

Cilia help eliminate particles
Paranasal sinuses
Air-filled spaces within
the skull bones
Open into the nasal cavity

Reduce the weight of
the skull

Equalizes pressure


Gives the voice its
certain tone

Skull bones with
sinuses include:
Frontal
Sphenoid
Ethmoid
Maxillae bones

UPPER RESPIRATORY TRACT
UPPER RESPIRATORY TRACT
NASAL CAVITY - CONCHAE AND
MEATUSES
Superior, middle and inferior nasal conchae
3 folds of tissue on lateral wall of nasal fossa
mucous membranes supported by thin scroll-like turbinate bones
Meatuses
narrow air passage beneath each conchae
narrowness and turbulence ensures air contacts mucous membranes
22-22
NASAL CAVITY - MUCOSA
Olfactory mucosa
lines roof of nasal fossa
Respiratory mucosa
lines rest of nasal cavity with ciliated pseudostratified
epithelium
Defensive role of mucosa
mucus (from goblet cells) traps inhaled particles
bacteria destroyed by lysozyme

22-23
NASAL CAVITY - CILIA AND ERECTILE
TISSUE
Function of cilia of respiratory epithelium
sweep debris-laden mucus into pharynx to be swallowed
Erectile tissue of inferior concha
venous plexus that rhythmically engorges with blood and
shifts flow of air from one side of fossa to the other once or
twice an hour to prevent drying
Spontaneous epistaxis (nosebleed)
most common site is inferior concha
22-24
REGIONS OF PHARYNX
Structures of the Pharynx
Auditory tubes enter the
nasopharynx
Tonsils of the pharynx
Pharyngeal tonsil (adenoids) in the
nasopharynx
Palatine tonsils in the oropharynx
Lingual tonsils at the base of the
tongue
PHARYNX
Nasopharynx (pseudostratified epithelium)
posterior to choanae, dorsal to soft palate
receives auditory tubes and contains pharyngeal tonsil
90 downward turn traps large particles (>10m)
Oropharynx (stratified squamous epithelium)
space between soft palate and root of tongue, inferiorly as far as hyoid
bone, contains palatine and lingual tonsils
Laryngopharynx (stratified squamous)
hyoid bone to level of cricoid cartilage
Larynx (Voice Box)
Routes air and food into proper
channels
Plays a role in speech
Made of eight rigid hyaline
cartilages and a spoon-shaped
flap of elastic cartilage
(epiglottis)
Structures of the Larynx
Thyroid cartilage
Largest hyaline cartilage
Protrudes anteriorly (Adams apple)
Epiglottis
Superior opening of the larynx
Routes food to the larynx and air
toward the trachea
Structures of the Larynx
Vocal cords (vocal folds)
Vibrate with expelled air to
create sound (speech)
Glottis opening between
vocal cords
LARYNX
Glottis vocal cords and opening between
Epiglottis
flap of tissue that guards glottis, directs food and drink to
esophagus
Infant larynx
higher in throat, forms a continuous airway from nasal
cavity that allows breathing while swallowing
by age 2, more muscular tongue, forces larynx down
22-31
VIEWS OF LARYNX
NINE CARTILAGES OF
LARYNX
Epiglottic cartilage - most superior
Thyroid cartilage largest; laryngeal prominence
Cricoid cartilage - connects larynx to trachea
Arytenoid cartilages (2) - posterior to thyroid cartilage
Corniculate cartilages (2) - attached to arytenoid cartilages
like a pair of little horns
Cuneiform cartilages (2) - support soft tissue between
arytenoids and epiglottis
22-33
WALLS OF LARYNX
Interior wall has 2 folds on each side, from thyroid to arytenoid cartilages
vestibular folds: superior pair, close glottis during swallowing
vocal cords: produce sound
Intrinsic muscles - rotate corniculate and arytenoid cartilages
adducts (tightens: high pitch sound) or abducts (loosens: low pitch sound)
vocal cords
Extrinsic muscles - connect larynx to hyoid bone, elevate larynx
during swallowing
22-34
ACTION OF VOCAL CORDS
TRACHEA
Rigid tube 4.5 in. long and 2.5 in. diameter, anterior to
esophagus
Supported by 16 to 20 C-shaped cartilaginous rings
opening in rings faces posteriorly towards esophagus
trachealis spans opening in rings, adjusts airflow by expanding
or contracting
Larynx and trachea lined with ciliated pseudostratified
epithelium which functions as mucociliary escalator
Trachea (Windpipe)
Connects larynx with bronchi
Lined with ciliated mucosa
Beat continuously in the opposite
direction of incoming air
Expel mucus loaded with dust and other
debris away from lungs
Walls are reinforced with C-shaped
hyaline cartilage
22-37
LOWER RESPIRATORY
TRACT
22-38
LUNGS - SURFACE ANATOMY
Lungs
Occupy most of the thoracic cavity
Apex is near the clavicle (superior
portion)
Base rests on the diaphragm
(inferior portion)
Each lung is divided into lobes by
fissures
Left lung two lobes
Right lung three lobes
Lungs
22-41
LUNG TISSUE
Coverings of the Lungs
Pulmonary (visceral) pleura
covers the lung surface
Parietal pleura lines the walls of
the thoracic cavity
Pleural fluid fills the area between
layers of pleura to allow gliding
Respiratory Tree Divisions
Primary bronchi
Secondary bronchi
Tertiary bronchi
Bronchioli
Terminal bronchioli
22-44
BRONCHIAL TREE
Primary bronchi (C-shaped rings)
from trachea; after 2-3 cm enter hilum of lungs
right bronchus slightly wider and more vertical (aspiration)
Secondary (lobar) bronchi (overlapping plates)
one secondary bronchus for each lobe of lung
Tertiary (segmental) bronchi (overlapping plates)
10 right, 8 left
bronchopulmonary segment: portion of lung supplied by each
22-45
BRONCHIAL TREE
Bronchioles (lack cartilage)
layer of smooth muscle
pulmonary lobule
portion ventilated by one bronchiole
divides into 50 - 80 terminal bronchioles
ciliated; end of conducting division
respiratory bronchioles
divide into 2-10 alveolar ducts; end in alveolar sacs
Alveoli - bud from respiratory bronchioles,
alveolar ducts and alveolar sacs
main site for gas exchange
Bronchioles
Smallest
branches of
the bronchi
Bronchioles
All but the smallest
branches have
reinforcing cartilage
Bronchioles
Terminal
bronchioles end
in alveoli
Respiratory Zone
Structures
Respiratory bronchioli
Alveolar duct
Alveoli
Site of gas exchange
Alveoli
Structure of alveoli
Alveolar duct
Alveolar sac
Alveolus
Gas exchange


ALVEOLUS
Fig. 22.11
b and c
ALVEOLAR BLOOD SUPPLY
Gas Exchange
Gas crosses the respiratory
membrane by diffusion
Oxygen enters the blood
Carbon dioxide enters the alveoli
Macrophages add protection
Surfactant coats gas-exposed
alveolar surfaces
FACTORS AFFECTING GAS
EXCHANGE
Concentration gradients of gases
PO
2
= 104 in alveolar air versus 40 in blood
PCO
2
= 46 in blood arriving versus 40 in alveolar air
Gas solubility
CO
2
20 times as soluble as O
2
O
2
has conc. gradient, CO
2
has solubility
FACTORS AFFECTING GAS
EXCHANGE
Membrane thickness - only 0.5 m thick
Membrane surface area - 100 ml blood in alveolar
capillaries, spread over 70 m
2

Ventilation-perfusion coupling - areas of good ventilation
need good perfusion (vasodilation)
22-56
CONCENTRATION GRADIENTS OF
GASES
AMBIENT PRESSURE AND
CONCENTRATION GRADIENTS
22-58
PERFUSION ADJUSTMENTS
22-59
VENTILATION ADJUSTMENTS
Events of Respiration
Pulmonary ventilation moving
air in and out of the lungs
External respiration gas
exchange between pulmonary
blood and alveoli
Events of Respiration
Respiratory gas transport
transport of oxygen and carbon
dioxide via the bloodstream
Internal respiration gas
exchange between blood and
tissue cells in systemic
capillaries
Mechanics of Breathing
(Pulmonary Ventilation)
Completely mechanical process
Depends on volume changes in
the thoracic cavity
Volume changes lead to pressure
changes, which lead to the flow of
gases to equalize pressure
Mechanics of Breathing
(Pulmonary Ventilation)
Two phases
Inspiration flow of air into lung
Expiration air leaving lung
Inspiration
Diaphragm and intercostal
muscles contract
The size of the thoracic cavity
increases
External air is pulled into the
lungs due to an increase in
intrapulmonary volume
Inspiration
Exhalation
Largely a passive process
which depends on natural lung
elasticity
As muscles relax, air is pushed
out of the lungs
Forced expiration can occur
mostly by contracting internal
intercostal muscles to depress
the rib cage
Exhalation
Nonrespiratory Air
Movements
Can be caused by reflexes or
voluntary actions
Examples
Cough and sneeze clears lungs of
debris
Laughing
Crying
Yawn
Hiccup
Respiratory Volumes and
Capacities
Normal breathing moves about 500 ml of
air with each breath (tidal volume [TV])
Many factors that affect respiratory
capacity
A persons size
Sex
Age
Physical condition
Residual volume of air after exhalation,
about 1200 ml of air remains in the lungs
Respiratory Volumes and
Capacities
Inspiratory reserve volume (IRV)
Amount of air that can be taken in
forcibly over the tidal volume
Usually between 2100 and 3200 ml
Expiratory reserve volume (ERV)
Amount of air that can be forcibly
exhaled
Approximately 1200 ml
Respiratory Volumes and
Capacities
Residual volume
Air remaining in lung after
expiration
About 1200 ml
Respiratory Volumes
and Capacities
Slide
13.28
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Vital capacity
The total amount of exchangeable air
Vital capacity = TV + IRV + ERV
Dead space volume
Air that remains in conducting zone and
never reaches alveoli
About 150 ml
Respiratory Volumes and
Capacities
Functional volume
Air that actually reaches the
respiratory zone
Usually about 350 ml
Respiratory capacities are
measured with a spirometer
Respiratory Capacities
RESPIRATORY VOLUMES
Different volumes of air
move in and out of
lungs with different
intensities of breathing

Measured to assess
health of respiratory
system
RESPIRATORY VOLUMES
(CONT.)
Amount of air that moves in or out of
the lungs during a normal breath
Amount of air that can be forcefully
inhaled following a normal inhalation
Amount of air that can be forcefully
exhaled following a normal exhalation
Tidal Volume
Inspiratory
Reserve
Volume
Expiratory
Reserve
Volume
RESPIRATORY VOLUMES
(CONT.)
Amount of air that can be forcefully
exhaled after the deepest inhalation
possible
Volume of air that always remains in
the lungs even after a forceful
exhalation
The total amount of air the lungs can
hold
Residual
Volume
Total Lung
Capacity
Vital
Capacity
Respiratory Sounds
Sounds are monitored with a
stethoscope
Bronchial sounds produced by
air rushing through trachea and
bronchi
Vesicular breathing sounds soft
sounds of air filling alveoli
THE TRANSPORT OF
OXYGEN AND CARBON
DIOXIDE IN THE BLOOD
Most of the oxygen
binds to hemoglobin
Oxyhemoglobin
Bright red in color

Some oxygen remains
dissolved in plasma

If CO
2
combines with hemoglobin at O
2
sites, it
forms carboxyhemoglobin
22-80
OXYGEN TRANSPORT
Concentration in arterial blood
20 ml/dl
98.5% bound to hemoglobin
1.5% dissolved
Binding to hemoglobin
each heme group of 4 globin chains may
bind O
2

oxyhemoglobin (HbO
2
)
deoxyhemoglobin (HHb)
22-81
OXYGEN TRANSPORT
Oxyhemoglobin dissociation curve
relationship between hemoglobin saturation and PO
2
is not
a simple linear one
after binding with O
2
, hemoglobin changes shape to
facilitate further uptake (positive feedback cycle)
22-82
OXYHEMOGLOBIN DISSOCIATION
CURVE
THE TRANSPORT OF
OXYGEN AND CARBON
DIOXIDE IN THE BLOOD
Carbon dioxide gets into the
bloodstream
Reacts with water in plasma and
forms carbonic acid
Carbonic acid ionizes and
releases hydrogen and
bicarbonate ions
Bicarbonate ions attach to
hemoglobin
Exhaled as waste product in the lungs
Gas Transport in the Blood
Carbon dioxide transport in the
blood
Most is transported in the plasma as
bicarbonate ion (HCO
3

)
A small amount is carried inside red
blood cells on hemoglobin, but at
different binding sites than those of
oxygen
Neural Regulation of
Respiration
Activity of respiratory muscles is
transmitted to the brain by the phrenic and
intercostal nerves
Neural centers that control rate and depth
are located in the medulla
The pons appears to smooth out
respiratory rate
Normal respiratory rate (eupnea) is 1215
respirations per minute
Hypernia is increased respiratory rate
often due to extra oxygen needs
Neural Regulation of Respiration
Factors Influencing Respiratory
Rate and Depth
Physical factors
Increased body temperature
Exercise
Talking
Coughing
Volition (conscious control)
Emotional factors
Factors Influencing Respiratory
Rate and Depth
Chemical factors
Carbon dioxide levels
Level of carbon dioxide in the
blood is the main regulatory
chemical for respiration
Increased carbon dioxide
increases respiration
Changes in carbon dioxide act
directly on the medulla oblongata
Factors Influencing
Respiratory Rate and Depth
Chemical factors (continued)
Oxygen levels
Changes in oxygen concentration
in the blood are detected by
chemoreceptors in the aorta and
carotid artery
Information is sent to the medulla
oblongata
SYSTEMIC GAS EXCHANGE
CO
2
loading
carbonic anhydrase in RBC catalyzes
CO
2
+ H
2
O H
2
CO
3
HCO
3
-

+ H
+
chloride shift
keeps reaction proceeding, exchanges HCO
3
-

for Cl
-
(H
+
binds to hemoglobin)
O
2
unloading
H
+
binding to HbO
2
its affinity for O
2
Hb arrives 97% saturated, leaves 75%
saturated - venous reserve
utilization coefficient
amount of oxygen Hb has released 22%
CHLORIDE SHIFT
High C0
2
levels in tissues causes the
reaction C0
2
+ H
2
O
H
2
C0
3
H
+
+ HC0
3
-
to shift right
in RBCs
Results in high H
+
& HC0
3
-
levels in
RBCs
H
+
is buffered by proteins
HC0
3
-
diffuses down concentration & charge
gradient into blood causing RBC to become more
+
So Cl
-
moves into RBC (chloride shift)

16-75
CHLORIDE SHIFT
Fig 16.38
16-76
REVERSE CHLORIDE SHIFT
In lungs, C0
2
+ H
2
O
H
2
C0
3
H
+
+ HC0
3
-
,
moves to left as C0
2
is
breathed out
Binding of 0
2
to Hb
decreases its affinity for
H+
H+ combines with HC0
3
-
& more C0
2
is formed
Cl- diffuses down
concentration & charge
gradient out of RBC
(reverse chloride shift)
16-77
22-94
SYSTEMIC GAS EXCHANGE
22-95
ALVEOLAR GAS EXCHANGE
REVISITED
Reactions are reverse of systemic gas exchange
CO
2
unloading
as Hb loads O
2
its affinity for H
+
decreases, H
+
dissociates from Hb and bind with HCO
3
-


CO
2
+ H
2
O H
2
CO
3
HCO
3
-

+ H
+
reverse chloride shift
HCO
3
-

diffuses back into RBC in exchange for Cl
-
, free
CO
2
generated diffuses into alveolus to be exhaled
22-96
ALVEOLAR GAS EXCHANGE
22-97
FACTORS AFFECT O
2

UNLOADING
Active tissues need oxygen!
ambient PO
2
: active tissue has PO
2
; O
2
is released
temperature: active tissue has temp; O
2
is released
Bohr effect: active tissue has CO
2
, which lowers pH (muscle
burn); O
2
is released
bisphosphoglycerate (BPG): RBCs produce BPG which binds
to Hb; O
2
is released

body temp (fever), TH, GH, testosterone, and epinephrine all raise BPG and cause O
2
unloading (
metabolic rate requires oxygen)
22-98
OXYGEN DISSOCIATION AND
TEMPERATURE
22-99
OXYGEN DISSOCIATION AND
PH
Bohr effect: release of O
2
in response to low pH
22-100
Haldane effect
low level of HbO
2
(as in active tissue) enables blood to transport more CO
2
HbO
2
does not bind CO
2
as well as deoxyhemoglobin (HHb)
HHb binds more H
+
than HbO
2

as H
+
is removed this shifts the
CO
2
+ H
2
O HCO
3
-

+ H
+

reaction to the right
FACTORS AFFECTING CO
2

LOADING
ACID-BASE BALANCE IN
BLOOD
Blood pH is maintained within narrow pH range by lungs
& kidneys (normal = 7.4)
Most important buffer in blood is bicarbonate
H
2
0 + C0
2


H
2
C0
3
H
+
+ HC0
3
-

Excess H
+
is buffered by HC0
3
-

Kidney's role is to excrete H
+
into urine
16-78
2 major classes of acids in body:
A volatile acid can be converted to a gas
E.g. C0
2
in bicarbonate buffer system can be breathed out
H
2
0 + C0
2


H
2
C0
3
H
+
+ HC0
3
-


All other acids are nonvolatile & cannot leave
blood
E.g. lactic acid, fatty acids, ketone bodies

ACID-BASE BALANCE IN
BLOOD CONTINUED
16-80
Acidosis is when pH < 7.35; alkalosis is pH
> 7.45
Respiratory acidosis caused by
hypoventilation
Causes rise in blood C0
2
& thus carbonic acid
Respiratory alkalosis caused by
hyperventilation
Results in too little C0
2

ACID-BASE BALANCE IN
BLOOD CONTINUED
16-81
Metabolic acidosis results from excess of
nonvolatile acids
E.g. excess ketone bodies in diabetes or loss of HC0
3
-
(for buffering) in diarrhea
Metabolic alkalosis caused by too much HC0
3
-
or
too little nonvolatile acids (e.g. from vomiting out
stomach acid)
ACID-BASE BALANCE IN
BLOOD CONTINUED
16-82
Normal pH is obtained when ratio of HCO
3
-
to C0
2

is 20 : 1
Henderson-Hasselbalch equation uses C0
2
& HCO
3
-

levels to calculate pH:
pH = 6.1 + log = [HCO
3
-
]
[0.03P
C02
]
ACID-BASE BALANCE IN
BLOOD CONTINUED
16-83
RESPIRATORY ACID-BASE
BALANCE
Ventilation usually adjusted to metabolic
rate to maintain normal CO
2
levels
With hypoventilation not enough CO
2
is
breathed out in lungs
Acidity builds, causing respiratory acidosis
With hyperventilation too much CO
2
is
breathed out in lungs
Acidity drops, causing respiratory alkalosis
16-84
VENTILATION DURING
EXERCISE
During exercise,
arterial PO
2
, PCO
2
,
& pH remain fairly
constant
16-86
VENTILATION DURING
EXERCISE
During exercise, breathing becomes deeper & more rapid,
delivering much more air to lungs (hyperpnea)
2 mechanisms have been proposed to underlie this increase:
With neurogenic mechanism, sensory activity from
exercising muscles stimulates ventilation; and/or motor
activity from cerebral cortex stimulates CNS respiratory
centers
With humoral mechanism, either PC0
2
& pH may be
different at chemoreceptors than in arteries
Or there may be cyclic variations in their values that
cannot be detected by blood samples
16-87
Developmental Aspects of the
Respiratory System
Lungs are filled with fluid in the
fetus
Lungs are not fully inflated with air
until two weeks after birth
Surfactant that lowers alveolar
surface tension is not present until
late in fetal development and may
not be present in premature
babies
Aging Effects
Elasticity of lungs decreases
Vital capacity decreases
Blood oxygen levels decrease
Stimulating effects of carbon
dioxide decreases
More risks of respiratory tract
infection
Respiratory Rate Changes
Throughout Life
Newborns 40 to 80
respirations per minute
Infants 30 respirations per
minute
Age 5 25 respirations per
minute
Adults 12 to 18 respirations
per minute
Rate often increases
somewhat with old age