Respiratory Physiology

Chapter 16

Objectives of Chapter 16
To understand the:
Structure and function of the lungs

Mechanics of breathing

Assessment of pulmonary function

Principles of gas exchange

Respiration
Encompasses 3 related functions:
Ventilation: breathing
Gas exchange: occurs between air and blood in the lungs and
between the blood and body tissues
Oxygen utilization: cellular respiration

Ventilation:
External respiration ventilation moves air in and out
of lungs for gas exchange with blood
Internal respiration gas exchange between the blood
and other tissues, and O2 use by tissues
Gas exchange is passive via diffusion

Structures of Respiratory System

Inhaled air passes from pharynx larynx trachea right and
left bronchi bronchioles terminal bronchioles respiratory
bronchioles alveoli

Pharynx and Larynx

Air enters the trachea from the pharynx
Air must enter or leave trachea and lungs thru the glottis
between the vocal folds
ventricular and vocal folds are part of the larynx (voice box)

Structure of Respiratory System

Respiratory zone region of gas exchange occurs only in
respiratory bronchioles and the terminal alveoli sacs

Conducting zone airways that conduct air to the respiratory zone

Lung Alveoli and Pulmonary Capillaries

Gas exchange occurs across
the 300 million alveoli (6080 m2 total surface area)
Alveolus one cell-layer
thick
Total air-blood barrier only
2 thin cells across
Between lung air and
blood: 1 alveolar cell and 1
endothelial cell

EM of a Capillary within
the Alveolar Wall

Alveoli
Polyhedral in shape clustered at ends of respiratory
bronchioles, like units of honeycomb
Air in 1 cluster can pass to others through pores

2 types of alveolar cells

Type I: comprise 95 97% of total surface lung area
Primarily where gas exchange occurs
Diffusion distance between blood and air as little as 0.3 m

Type II: secrete pulmonary surfactant and reabsorb Na+ and

H2O
Prevents fluid buildup within the alveoli

SEM of Lung Tissue

A small bronchile passes
between many alveoli
Arrow indicating an
alveolar pore
air can pass from one
cluster to another

Tensile strength of alveolar

wall provided by fused
basement membranes
(collagen) of the capillaries
and alveolar walls

Conducting Zone
Warms and humidifies inspired air reaches respiratory zone at
37 C
Mucus lining filters and cleans inspired air mucous moved by
cilia to be expectorated

Thoracic Cavity
Created by the diaphragm contains heart, large blood vessels,
trachea, esophagus, thymus, and lungs
Abdominopelvic cavity below the diaphragm contains liver,
pancreas, GI tract, spleen, and genitourinary tract

Physical Aspects of Ventilation

Ventilation results from pressure differences induced by
changes in lung volumes
Air moves from higher to lower pressure
Compliance, elasticity, and surface tension of lungs influence
ease of ventilation

Intrapulmonary and Intrapleural Pressures

Visceral and parietal pleurae normally adhere to each other so
that lungs remain in contact with chest walls
And expand and contract with thoracic cavity
Intrapleural space contains a thin layer of lubricating fluid

Intrapulmonary and Intrapleural Pressures

During inspiration, intrapulmonary pressure is about -3 mm Hg
pressure; during expiration is about +3 mm Hg
Positive transmural pressure (intrapulmonary minus intrapleural
pressure) keeps lungs inflated

Boyles Law (P = 1/V)

Implies that changes in intrapulmonary pressure occur
as a result of changes in lung volume
Pressure of a given quantity of gas is inversely proportional to
its volume

Increase in lung volume during inspiration decreases

intrapulmonary pressure to subatmospheric levels
air therefore goes in

Decrease in lung volume raises intrapulmonary

pressure above that of the atmosphere
Expelling air from the lungs

Changes in lung volume occur as a consequence of

changes in thoracic volume

Physical Properties of the Lungs

In order for inspiration to occur lungs must be able to
expand when stretched
Lung compliance how easily lung expands with
pressure

Lung compliance is defined as the change in lung

volume per change in transmural pressure (V/P)
Compliance is reduced by factors that cause resistance
to distension

Elasticity
For expiration to occur, lungs must get smaller when
tension is released
Elasticity tendency to return to initial size after
distension
Due to high content of elastin proteins

Elastic tension increases during inspiration and is reduced

by recoil during expiration

Surface Tension (ST)

And elasticity forces that promote alveolar collapse
and resist distension
Lungs secrete and absorb fluid (antagonistic processes),
normally leave a very thin film of fluid on alveolar
surface
Fluid absorption occurs by osmosis driven by Na+ active
transport
Fluid secretion is driven by active transport of Cl- out of
alveolar epithelial cells
This film causes ST because H20 molecules are attracted to
other H2O molecules
ST acts to collapse alveoli; thus increasing pressure of air
within alveoli

Surface Tension
Law of Laplace states
that pressure in alveolus is
directly proportional to ST;
and inversely to radius of
alveoli
Thus, pressure in smaller
alveoli would be greater
than in larger alveoli, if ST
were same in both
Greater pressure of smaller
alveolus would cause it to
its empty air into the larger
one

Surfactant
Consists of
phospholipids secreted
by Type II alveolar cells
Lowers ST by getting
between H2O molecules
at the water-air
interface
Reducing their ability to
attract each other via
hydrogen bonding
As a result the ST of thhe
alveoli is negligible

Surfactant
Prevents ST from collapsing alveoli

Surfactant secretion begins in late fetal life

Premies are often born with insufficient surfactant =
Respiratory Distress Syndrome or RDS
Have trouble inflating lungs

In adults, septic shock (fall in BP due to widespread

vasodilation) as a result of a systemic infection
Inflammation increases capillry and alveolar permeability
leading to accumulation of protein-rich fluid in the lungs
may cause acute respiratory distress syndrome (ARDS) which
decreases compliance and surfactant secretion

Mechanics of Breathing
Pulmonary ventilation consists
of inspiration (inhalation) and
expiration (exhalation)
Accomplished by alternately
increasing and decreasing
volumes of thorax and lungs

Quiet Breathing
Inspiration occurs
mainly because
diaphragm contracts,
increasing thoracic
volume vertically

Parasternal and external

intercostal contraction
contributes a little by
raising ribs
increasing thoracic
volume laterally

Expiration is due to
passive recoil

Deep Breathing
Inspiration involves
contraction of extra
muscles to elevate ribs:
scalenes, pectoralis
minor, and
sternocleidomastoid

Expiration involves
contraction of internal
intercostals and
abdominal muscles

Mechanics of Pulmonary Ventilation

During inspiration, intrapulmonary pressure is lower while
During expiration it is greater than atmospheric pressure

Table 16.4 Ventilation Terminology

Pulmonary Function Tests

Spirometry method that measures volumes of air
moved during inspiration and expiration

Subject breathes in a closed system

Air is trapped within a light plastic bell floating in water
Bell moves up with exhalation and down with inhalation
Movements of the bell cause movement os a pen that
traces a record of the breathing (spirogram)

Anatomical dead space is air in conducting zone

where no gas exchange occurs

Pulmonary Function Tests

Tidal volume amount of air expired/breath in quiet breathing
Vital capacity amount of air that can be forcefully exhaled after a
maximum inhalation
= sum of inspiratory reserve, tidal volume, and expiratory reserve