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 (60-80 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