Physiology of The Respiratory System

Respiratory System Divisions

Upper tract
Nose, pharynx and associated structures

Lower tract
Larynx, trachea, bronchi, lungs

Nasal Cavity
Nose:
External nose Nasal cavity Functions: Passageway for air Cleans the air Humidifies, warms air Smell Along with paranasal sinuses are resonating chambers for speech

Nasal Cavity and Pharynx

Pharynx
Common opening for digestive and respiratory systems Three regions
Nasopharynx Oropharynx Laryngopharynx

Larynx

Functions Maintain an open passageway for air movement Epiglottis and vestibular folds prevent swallowed material from moving into larynx Vocal folds are primary source of sound production

Vocal Folds

Tracheobronchial Tree
Conducting zone
Trachea to terminal bronchioles which is ciliated for removal of debris Passageway for air movement Cartilage holds tube system open and smooth muscle controls tube diameter

Bronchioles and Alveoli

Respiratory zone
Respiratory bronchioles to alveoli Site for gas exchange

Alveolus and Respiratory Membrane

Thickness = 0.5um

Surface area = 100m2

Types of alveolar cells

Type I cells: are thin primary lining cells. Type II cells thick with many inclusions bodies (granular pneumocytes). They secrete surfactant. Other cells: e.g. pulmonary alveolar macrophages (PAMs) lymphocytes, mast cells and plasma cells.

Lungs
Two lungs: principal organs of respiration Right lung: three lobes Left lung: two lobes Divisions: Lobes, bronchopulmonary segments, lobules Pulmonary interstitial tissues include elastin, collagen fibers, lymphocytes, plasma cells, and mast cells

Pleura

Pleural fluid produced by pleural membranes

Acts as lubricant Helps hold parietal and visceral pleural membranes together

Thoracic Walls Muscles of Respiration

Thoracic Volume

Air Passages
Air passages start by the nose and end by the respiratory bronchioles that contain the alveoli. Nose p trachea p two main branches p their branches p bronchioles p terminal bronchiolesp respiratory bronchioles p alveolar ducts p alveoli.

Air Passages
Between the trachea and the alveoli, the airways divide 23 times: The first 16 divisions (up to the terminal bronchioles) form the conducting zone that will transport gases and perform air conditioning function. The remaining 7 divisions form the respiratory zone (from respiratory bronchioles) where gas exchange takes place with blood and the alveoli. There are 300 millions of alveoli in human lungs that will have a total surface area 70 100 m2.

Pulmonary Circulation
1.Pulmonary Artery : Contains venous blood and the pulmonary ABP equals 25/10 mmHg, so: - Upper lung (above the level of heart ) is less perfused. - Middle lung (at the level of heart) is better perfused. - Lower lung (below the level of heart) is well perfused. 2. Pulmonary arterioles: They are less muscular and less innervated than those of the systemic circulation. They are constricted by hypoxia (so the blood is shifted to the better ventilated areas), NOR, angiotensin and PG-F2 alpha. They are dilated by Ach and PG- I 2.

3.Pulmonary veins : They are more distensible than those of the systemic circulation so they act as blood reservoir

4.Pulmonary Capillaries : They are large, with multiple anastomoses, so that each alveolus sets in a capillary basket. Pulmonary capillary hydrostatic pressure is only 10 mmHg, while colloid osmotic pressure of plasma proteins is 25 mmHg. This leads to H2O reabsorption from lung => lung remains dry which is important for its elasticity.

5.Physiologic shunt : Some venous blood (from the bronchial and short cardiac veins) does not pass to the pulmonary capillaries to be oxygenated, but instead, it passes to the left side of the heart i.e blood in the left side of heart is not 100 % oxygenated, it is only 2 % less oxygenated than blood in the pulmonary alveoli, i.e arterial Hb is not 100 % saturated with O2 (about 0.5 1% less).

Vascularizatia si inervatia plamanului

Circulatia functionala;
- a. pulmonara (VD), se capilarizeaza la nivelul alveolelor pulmonare; circulatia de intoarcere asigurata de vv. pulmonare (se varsa in AS). - a. pulmonara contine sange neoxigenat ce se incarca cu O2 la plamani si se intoarce prin vv. pulmonare (sange oxigenat, rosu) in AS.

Circulatia nutritiva
- face parte din marea circulatie, aduce plamanului sange incarcat cu substante nutritive si oxigen. - asigurata de aa. bronsice, ramuri ale aortei toracice; ele iriga arborele bronsic. - o parte din sange se intoarce in vv. bronsice care se varsa in vv. azygos si acestea in VCS si AD; o alta parte din sange se intoarce prin vv. pulmonare in AS.

Cantitatea de sange ce trece prin anastomozele bronsice este 1% din totalul sangelui care iriga plamanul. In conditii patologice (insuficienta cardiaca, bronsiectazii) debitul anastomotic poate ajunge la 80% din totalul sangelui care iriga plamanul.

Respiratory System Functions

Gas exchange: Oxygen enters blood and carbon dioxide leaves Regulation of blood pH: Altered by changing blood carbon dioxide levels Voice production: Movement of air past vocal folds makes sound and speech Olfaction: Smell occurs when airborne molecules drawn into nasal cavity Protection: Against microorganisms by preventing entry and removing them

Non-respiratory function
Smell sensation (nose) Sound production (vocalization) via larynx Heat regulation Act as circulatory filter (preventing clots from entering the circulation) and secretion of heparin and fibrinolytic agent Acid base balance (regulation of blood pH) via change the rate of CO2 removal from blood Release of prostaglandins. Removal of some chemical substances (serotonin and norepinephrine) Produce Angiotensin Converting Enzyme (ACE).

Respiration
Ventilation: Movement of air into and out of lungs Air moves from area of higher pressure to area of lower pressure Pressure is inversely related to volume External respiration: Gas exchange between air in lungs and blood Transport of oxygen and carbon dioxide in the blood Internal respiration: Gas exchange between the blood and tissues

I. Inspiration
It is due to contraction of:
1. 2. Diaphragm: External intercostal muscles: (like a handle of a bucket). This will increase both the antero-posterior and the transverse diameters of the chest. The pressure inside the thoracic cavity decreases only 1 mmHg below the atmospheric pressure, so, air rushes inside the lungs.

3.

On DEEP inspiration there will be: 1. More contraction of the diaphragm (7 cm descent) and the external intercostal. 2. Contraction of the accessory muscles of inspiration : - Sternocleidomastoid elevates the sternum . - Serratus anterior - elevates many ribs more. - Scaleni muscles - elevates first rib. Lungs follow passively the movements of the chest wall due to presence of a thin layer of fluid between the parietal and the visceral pleurae. The diaphragm is responsible for 75 % of inspiration, yet , when it is paralyzed the external intercostal alone can produce inspiration needed for moderate activity .

II. Expiration
During normal breathing (eupnea) , it does not need muscle contraction but it is due to elastic recoil of the lung and the chest wall, so the volume of the thoracic cavity decreases and the pressure inside the thorax increases only by 1 mmHg more than the atmospheric causing air to rush out the lungs. Expiration becomes active (i.e. needs muscle contraction) during : 1. Forced expiration. 2. Bronchial obstruction e.g. bronchial asthma. 3. Decreased lung elasticity e.g. emphysema.

Now expiration will be caused by contraction of: 1- Abdominal muscles: that will increase the pressure inside the abdominal cavity pushing the diaphragm upward. 2- Internal intercostal muscles : that causes lowering of the ribs leading to decreased transverse and AP chest diameters. Respiratory Rate : normally it is about 12- 16 cycles /min. Respiratory cycle : is composed of : 1-Short inspiration (I) 2-Longer expiration (E) 3-Expiratory pause (during which the glottis is closed).

The alveolo-capillary membrane

(The respiratory membrane)

It consists of the fluid film lining the alveolus, alveolar epithelium, interstitial space, and capillary endothelium. The thickness of the membrane is about 0.5 um and the total surface area is about 70 m2. In the alveolar wall and the pulmonary interstitial tissue, there are elastin and collagen fibers. These elastic fibers allow alveolar and lung distention, but at the same time, present a recoil force in the distended lung.

Thickness = 0.5um

Surface area = 100m2

Sneeze reflex
Stimulus:: Irritation of nasal mucosa Receptor: in the nasal cavity Afferent: Trigeminal N. Response:
deep inspiration Forced expiration against open glottis

Action: get rid of irritant

Cough reflex
Stimulus: Irritation of respiratory mucosa Receptor: trachea & bronchi Afferent: Vagus N. Response: deep inspiration forced expiration against closed glottis which open suddenly Action: get rid of irritant