the respiratory system copyright (c) the mcgraw-hill companies, inc. permission required for...
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The Respiratory System
Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display
Breath of Fresh Air
• Anatomy of respiratory system
• Ventilation
• Gas exchange and transport
Respiratory System
• What are some functions of the respiratory system?
• Respiration as a process– Ventilation– External and internal respiration– Cellular respiration
Anatomy
• Principal organs– Nose, pharynx, larynx, trachea, bronchi, and lungs
• Conducting division– Function only in airflow
• Respiratory division– Function in gas exchange
Organs of Respiratory SystemCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Nasalcavity
Nostril
Hardpalate
Larynx
Trachea
Right lung
Posteriornasalaperture
Soft palate
PharynxEpiglottis
Esophagus
Left lung
Left mainbronchusLobarbronchusSegmentalbronchus
Pleuralcavity
Pleura(cut)
Diaphragm
Figure 22.1
The Nose• Functions
– Warms, cleanses, and humidifies inhaled air– Detects odors – Resonating chamber for voice
• Nose extends from nostrils (nares), to a pair of posterior openings called the posterior nasal apertures (choanae)
• Facial part is shaped by bone and hyaline cartilage– superior half nasal bones and maxillae– inferior half lateral and alar cartilages– ala nasi – flared portion at the lower end of nose shaped by alar
cartilages and dense connective tissue
Anatomy of Nasal RegionCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(b)
Nasal bone
Septal nasalcartilage
Lateral cartilage
Minor alarcartilages
Major alarcartilagesDense connectivetissue
© The McGraw-Hill Companies/Joe DeGrandis, photographer
Figure 22.2b
Nasal Cavity
• Nasal fossae – right and left halves of nasal cavity– Divided by nasal septum
• Composed of bone and cartilage– Perpendicular plate– Vomer– Septal cartilage
– Roof and floor• Ethmoid and sphenoid• Hard palate
Nasal Cavity• Vestibule – dilated chamber inside the nares
– Stratified squamus epithelium– Vibrissae
• Nasal Conchae (turbinates) – superior, middle, inferior– Meatus
• Cleanses, warms, and humidifies air
• Epithelium of nasal cavity– Ciliated pseudostratified columnar with goblet cells
• Olfactory– cilia immobile
• Respiratory– cilia mobile
• Erectile tissue – venous plexus in inferior concha– Allows one side of the nasal cavity to recover from drying out by restricting
airflow in that side– Changes sides once or twice per hour
Upper Respiratory Tract
Pharynx• Pharynx (throat) – a muscular funnel extending about 13 cm (5 in.) from the
choanae to the larynx
• Three regions – Nasopharynx
• Passes only air, lined by pseudostratified columnar epithelium
– Oropharynx
– Laryngopharynx
• Oropharynx and laryngopharynx pass air, food, and drink, lined by stratified squamous epithelium Figure 22.3c
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Larynx
Muscles of Larynx
Intrinsic• Operate vocal cords• Pull on corniculate and
arytenoid cartilage– Pivot and abduct or adduct
vocal cords– Air forced through adducted
vocal cords causes them to vibrate
• Produces sound
Extrinsic• Infrahyoid group
• Connect larynx to hyoid
• Elevate larynx during swallowing
Lower Respiratory Tract
Larynx
Trachea
Carina
Mainbronchi
Lobarbronchi
Thyroidcartilage
Cricoidcartilage
Trachealismuscle
Hyalinecartilage ring
LumenMucosa
Mucous gland
Mucous gland
Perichondrium
(c)(a)
(b)
Particlesof debris
Cartilage
Chondrocytes
Mucociliaryescalator
Mucus
Ciliated cell
Segmentalbronchi
Epithelium: Goblet cell
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Figure 22.7 a-c
Trachea• Windpipe, rigid tube about 12 cm in length and 2.5 cm
diameter– Anterior to esophgus– Supported by C-shaped rings
• Trachealis muscle spans opening in rings
• Inner lining– Ciliated pseudostratified columnar epithelium– Mucociliary escalator
• Carina – internal median ridge in lowermost tracheal cartilage
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Lungs• Right lung
– Three lobes divided by horizontal and oblique fissures
• Left lung– Two lobes divided by oblique
fissure
• Pleurae– Visceral– Parietal– Pleural cavity
• Pleural fluid(b) Mediastinal surface, right lung
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The Bronchial Tree• Right main bronchus (primary)
• Superior, middle, inferior lobar bronchi (secondary)
• Segmental bronchi (tertiary), 10– Bronchopulmonary segment
• Bronchioles– Pulmonary lobules
• Terminal bronchioles
• Respiratory bronchioles
• Alveolar ducts
• Alveolar sacs– atrium
• Left main bronchus
• Superior and inferior lobar bronchi
• Segmental bronchi, 8
• Bronchioles
• Terminal bronchioles
• Respiratory bronchioles
• Alveolar ducts
• Alveolar sacs– atrium
Alveoli• ~ 150 million sacs for gas exchange
– Why so many?
• Cells types– Squamous alveolar cells (type I)
• 95% of surface, thinness allows rapid gas exchange
– Great alveolar cells (type II)• Repair alveolar epithelium• Secrete surfactant
– Alveolar macrophages (dust cells)• Phagocytize dust particles, bacteria,
debris
• Respiratory membrane
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Ventilation
• Respiratory cycle– Inspiration– Expiration
• Respiratory muscles– Diaphragm– Intercostals– Accessory muscles of respiration
• Sternocleidomastoids, scalenes, pectoralis muscles, serratus anterior, erector spinae
Sternocleidomastoid(elevates sternum)
Scalenes(fix or elevate ribs 1–2)
External intercostals(elevate ribs 2–12,widen thoracic cavity)
Pectoralis minor (cut)(elevates ribs 3–5)
Internal intercostals,intercartilaginous part(aid in elevating ribs)
Diaphragm(descends andincreases depthof thoracic cavity)
Inspiration
Internal intercostals,interosseous part(depress ribs 1–11,narrow thoracic cavity)
Diaphragm(ascends andreduces depthof thoracic cavity)
Rectus abdominis(depresses lower ribs,pushes diaphragm upwardby compressingabdominal organs)
External abdominal oblique(same effects asrectus abdominis)
Forced expiration
Respiratory Muscles
Figure 22.13
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Neural Control of Breathing• Conscious and sub-conscious control
• Three pairs of respiratory centers in reticular formation of medulla and pons– Ventral respiratory group (VRG)
• Inspiratory (I) neurons• Expiratory (E) neurons
– Dorsal respiratory group (DRG)• External influence of VRG• Integrating center
– Central and peripheral chemoreceptors, stretch receptors, irritant receptors– Pontine respiratory group
• Integrates input from higher brain centers• Influences VRG and DRG• Modifies breathing to sleep, emotional responses, exercise, other
special circumstances
Respiratory Control Centers
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Central chemoreceptors
Spinal integratingcenters
Glossopharyngeal n.
Vagus n.
Diaphragm and intercostal muscles
Accessory musclesof respiration
Ventral respiratorygroup (VRG)
Dorsal respiratorygroup (DRG)
Medulla oblongata
Pontine respiratorygroup (PRG)
Pons
Output fromhypothalamus,limbic system, andhigher brain centers
Phrenic n.
Intercostalnn.
KeyInputs to respiratorycenters of medulla
Outputs to spinal centersand respiratory muscles
Figure 22.14
Taking a Breath• Inspiration
– Boyle’s law• Pressure of a gas inversely proportional to its volume at constant
temp.
– Charles’s law• Volume of a gas directly proportional to its temperature at constant
pressure
• Expiration– Passive process, elastic recoil of thoracic cage
• Resistance to airflow– Diameter of bronchioles– Pulmonary compliance– Surface tension of alveoli
Measurements of Ventilation• Spirometer
• Dead space– Approx. 150 ml of air remain in conductive division– Alveolar ventilation rate (AVR) – volume of air used in gas exchange X breaths/min
• Tidal volume (TV) – one cycle of quite breathing, about 500 ml
• Inspiratory reserve volume (IRV) – amount that can be inhaled beyond TV inhalation, 3000 ml
• Expiratory reserve volume (ERV) – amount that can be forcefully exhaled beyond TV exhalation, 1200 ml
• Residual volume (RV) – volume of air that remains even after maximal expiration, 1300 ml
Lung Volumes and CapacitiesCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Lung
vol
ume
(mL)
6,000
5,000
4,000
3,000
2,000
1,000
0
Maximum possible inspiration
Inspiratoryreserve volume
Expiratoryreserve volume
Residualvolume
Maximum voluntaryexpiration
Functional residualcapacity
Total lung capacity
Tidalvolume
Inspiratorycapacity
Vital capacity
Spirometry• Restrictive disorders
– Reduce pulmonary compliance– Appear as a reduced vital capacity
• Obstructive disorders– Blockage or narrowing of airway– More difficult to inhale/exhale given amount of air– Measure by forced expiratory volume (FEV)
• Percentage of vital capacity that can be exhaled in a given time interval
– 75-85% in 1 second for healthy adult
Gas Exchange
• Involves oxygen and carbon dioxide
• Composition of air– 78.6% N2, 20.9% O2, .04% CO2, 0.5% H2O
• Dalton’s law – total atmospheric pressure is sum of partial pressures of individual gases
Driving Force Behind Alveolar Exchange
• Diffusion down concentration gradient– Have to consider that we are going from air to water
• Henry’s law – for a given temperature, at the air-water interface the amount of gas that dissolves in the water is determined by its solubility in water and its partial pressure in air
• Erythrocytes load O2 and unload CO2
• Efficiency of exchange may be affected by:– Pressure gradients, solubility, membrane thickness
and area, ventilation-perfusion coupling
Gas Transport
• Oxygen binds to hemoglobin (98.5%)– Oxyhemoglobin (HbO2)
• Carbon dioxide– Carbonic acid (90%)– Carbamino compounds (carbaminohemoglobin,
HbCO2)– Dissolved gases
Systemic Gas Exchange• Systemic gas exchange - the unloading of O2 and loading of CO2 at
the systemic capillaries
• CO2 loading– CO2 diffuses into the blood– carbonic anhydrase in RBC catalyzes
• CO2 + H2O H2CO3 HCO3- + H+
– chloride shift• keeps reaction proceeding, exchanges HCO3
- for Cl-
• H+ binds to hemoglobin
• O2 unloading– H+ binding to HbO2 reduces its affinity for O2
• tends to make hemoglobin release oxygen• HbO2 arrives at systemic capillaries 97% saturated, leaves 75%
saturated –
– venous reserve – oxygen remaining in the blood after it passes through thecapillary beds
– Utilization coefficient – given up 22% of its oxygen load
Systemic Gas ExchangeCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Respiring tissue Capillary blood
Dissolved CO2 gas
CO2 + plasma protein
CO2
CO2
O2Dissolved O2 gas
Carbamino compounds
Cl–
7%
23%
70%
98.5%
1.5%
CO2 + Hb
CO2 + H2O
O2 + HHb HbO2+ H+
H2CO3 HCO3– + H+
HbCO2
CAH
Key
Chloride shift
CO2
O2
HbCO2 Carbaminohemoglobin
Hb Hemoglobin
HHb Deoxyhemoglobin
CAH Carbonic anhydrase
HbO2 Oxyhemoglobin
Figure 22.24
Alveolar Gas Exchange• Reactions that occur in the lungs are reverse of
systemic gas exchange
• CO2 unloading– As Hb loads O2 its affinity for H+ decreases, H+
dissociates from Hb and bind with HCO3-
• CO2 + H2O H2CO3 HCO3- + H+
– Reverse chloride shift• HCO3
- diffuses back into RBC in exchange for Cl-, free
CO2 generated diffuses into alveolus to be exhaled
Alveolar Gas ExchangeCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Respiratory membrane Capillary blood
CO2
O2
Alveolar air
Carbamino compounds
7%
23%
70%
98.5%
1.5%
HbCO2
CAH
Key
ClChloride shift
CO2
CO2
O2 Dissolved O2 gas
O2 + HHb HbO2 + H+
HCO3 + H+H2 CO3CO2 + H2O
CO2 + Hb
CO2 + plasma protein
Dissolved CO2 gas
Hb Hemoglobin
HbCO2 Carbaminohemoglobin
HbO2 Oxyhemoglobin
HHb Deoxyhemoglobin
CAH Carbonic anhydrase
Figure 22.25
Concentration Gradients of Gases
Figure 22.19
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Alveolargas exchange
O2 loading
CO2 unloading
Gas transport
O2 carriedfrom alveolito systemictissues
CO2 carriedfrom systemictissues toalveoli
Systemicgas exchange
O2 unloading
CO2 loading
Expired air Inspired air
PO2 116 mm HgPCO2 32 mm Hg
Alveolar air
PO2 104 mm Hg
PCO2 40 mm Hg
Tissue fluid
PO2 40 mm HgPCO2 46 mm Hg
Deoxygenatedblood
PO2 40 mm HgPCO2 46 mm Hg
Oxygenated blood
PO2 95 mm HgPCO2 40 mm Hg
PO2 159 mm Hg
PCO2 0.3 mm Hg
CO2
Pulmonary circuit
Systemic circuit
CO2O2
O2
Adjustment to the Metabolic Needs of Individual Tissues
• Hemoglobin unloads O2 to match metabolic needs of different states of activity of the tissues
• Four factors that adjust the rate of oxygen unloading– ambient PO
2
• active tissue has PO2 ; O2 is released from Hb
– temperature• active tissue has temp; promotes O2 unloading
– Bohr effect• active tissue has CO2, which lowers pH of blood ; promoting O2 unloading
– bisphosphoglycerate (BPG)• RBCs produce BPG which binds to Hb; O2 is unloaded
• Haldane effect – rate of CO2 loading is also adjusted to varying needs of the tissues, low level of oxyhemoglobin enables the blood to transport more CO2
• body temp (fever), thyroxine, growth hormone, testosterone, and epinephrine all raise BPG and cause O2 unloading
• metabolic rate requires oxygen
Blood Gases and theRespiratory Rhythm
• Rate and depth of breathing adjust to maintain levels of:– pH 7.35 – 7.45
– PCO2 40 mm Hg
– PO2 95 mm Hg
• Brainstem respiratory centers receive input from central and peripheral chemoreceptors that monitor the composition of blood and CSF
• Most potent stimulus for breathing is pH, followed by CO2, and least significant is O2
Hydrogen Ions
• Acidosis – blood pH lower than 7.35
• Alkalosis – blood pH higher than 7.45
• Hypocapnia – PCO2 less than 37 mm Hg (normal 37 – 43 mm Hg)
• most common cause of alkalosis
• Hypercapnia – PCO2 greater than 43 mm Hg• most common cause of acidosis
Effects of Hydrogen Ions• Respiratory acidosis and respiratory alkalosis – pH imbalances resulting from a
mismatch between the rate of pulmonary ventilation and the rate of CO2 production
• Hyperventilation is a corrective homeostatic response to acidosis – “blowing off ” CO2 faster than the body produces it
– pushes reaction to the left CO2 (expired) + H2O H2CO3 HCO3
- + H+
– reduces H+ (reduces acid) raises blood pH towards normal
• Hypoventilation is a corrective homeostatic response to alkalosis – allows CO2 to accumulate in the body fluids faster than we exhale it
– shifts reaction to the right– CO2 + H2O H2CO3 HCO3
- + H+
– raising the H+ concentration, lowering pH to normal
Effects of Oxygen
• PO2 usually has little effect on respiration
• Chronic hypoxemia, PO2 less than 60 mm Hg, can
significantly stimulate ventilation
– Hypoxic drive – respiration driven more by low PO2 than by CO2 or pH
– Emphysema, pneumonia
– High elevations after several days
Respiration and Exercise• Causes of increased respiration during exercise
1. When the brain sends motor commands to the muscles• Also sends this information to the respiratory centers
• Increase pulmonary ventilation in anticipation of the needs of the exercising muscles
2. Exercise stimulates proprioceptors of the muscles and joints• Transmit excitatory signals to the brainstem respiratory centers
• Increase breathing because they are informed that the muscles have been told to move or are actually moving
• Increase in pulmonary ventilation keeps blood gas values at their normal levels in spite of the elevated O2 consumption and CO2 generation by the muscles
Effect of SmokingCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(a) Healthy lung, mediastinal surface (b) Smoker's lung with carcinoma
Tumors
a: © The McGraw-Hill Companies/Dennis Strete, photographer; b: Biophoto Associates/Photo Researchers, Inc.
Figure 22.27 a-b