ANATOMY AND PHYSIOLOGY

RESPIRATORY SYSTEM

The respiratory system

is made up of the
organs involved in the
exchange of oxygen
and carbon dioxide.
Respiration includes
four processes: (1)
ventilation, the
movement of air into
and out of the lungs;
(2) gas exchange
between the air in the lungs and the blood, sometimes called external respiration; (3) the
transport of oxygen and carbon dioxide in the blood; and (4) gas exchange between the
blood and the tissues, sometimes called internal respiration.

For all air-breathing vertebrates, respiration is handled by the lungs, but these are
far from the only components of the respiratory system. In fact, the system is composed
of the following biological structures: nose and nasal cavity, mouth, pharynx, larynx,
trachea, bronchi and bronchioles, lungs and the muscles of respiration. The diaphragm
and the muscles of the thoracic and abdominal walls are responsible for respiratory
movements. There are two ways of classifying the parts of the respiratory system:
structurally and functionally. Structurally, the respiratory system is divided into the upper
respiratory tract and the lower respiratory tract. The upper respiratory tract includes the
external nose, the nasal cavity, the pharynx with its associated structures, and the larynx;
the lower respiratory tract includes the trachea, the bronchi and smaller bronchioles, and
the lungs.

Nose
 The nose and nasal cavity constitute the
main external opening of the respiratory
system. They represent the entryway to
the respiratory tract – a passage through
the body which air uses for travel in order
to reach the lungs. The nose is made out
of bone, muscle, cartilage and skin, while
the nasal cavity is, more or less, hollow
space. Although the nose is typically
credited as being the main external
breathing apparatus, its role is actually to provide support and protection to the nasal
cavity. The cavity is lined with mucus membranes and little hairs that can filter the air
before it goes into the respiratory tract. They can trap all harmful particles such as dust,
mold and pollen and prevent them from reaching any of the internal components. At the
same time, the cold outside air is warmed up and moisturized before going through the
respiratory tract. During exhalation, the warm air that is eliminated returns the heat and
moisture back to the nasal cavity, so this forms a continuous process.

Pharynx

The pharynx is the next

component of the respiratory tract,
even though most people refer to it
simply as the throat. It resembles a
funnel made out of muscles that
acts as an intermediary between
the nasal cavity and the larynx and
esophagus. It is divided into three
separate sections: nasopharynx,
oropharynx and laryngopharynx. The nasopharynx is the upper region of the structure,
which begins at the posterior of the nasal cavity and simply allows air to travel through it
and reach the lower sections. The oropharynx does something similar, except it is located
at the posterior of the oral cavity. Once the air reaches the laryngopharynx, something
called the epiglottis Rosario divert it to the larynx. The epiglottis is a flap that performs a
vital task, by switching access between the esophagus and trachea. This ensures that air
Rosario travel through the trachea, but that food which is swallowed and travels through
the pharynx is diverted to the esophagus.

Oropharynx

The oropharynx extends from the soft palate to the epiglottis. The oral cavity
opens into the oropharynx through the fauces. Thus, air, food, and drink all pass through
the oropharynx. Moist stratified squamous epithelium lines the oropharynx and protects it
against abrasion. Two sets of tonsils, called the palatine tonsils and the lingual tonsils are
located near the fauces. The laryngopharynx extends from the tip of the epiglottis to the
esophagus and passes posterior to the larynx. Food and drink pass through the
laryngopharynx to the esophagus.

Larynx

The larynx is the next component, but represents

only a small section of the respiratory tract that
connects the laryngopharynx to the trachea. It is
commonly referred to as the voice box, and it is
located near the anterior section of the neck, just
below the hyoid bone. The aforementioned
epiglottis is part of the larynx, as are the thyroid
cartilage, the cricoid cartilage and the vocal
folds. Both cartilages offer support and
protection to other components, such as the vocal
folds and the larynx itself. The thyroid cartilage also goes by a more common name – the
Adam’s apple – although, contrary to popular belief, it is present in both men and
women. It is typically more pronounced in adult males. The vocal folds are mucous
membranes that tense up and vibrate in order to create sound, hence the term voice box.
The pitch and volume of these sounds can be controlled by modifying the tension and
speed of the vocal folds.
 Trachea

The trachea is a longer section of the

respiratory tract, shaped like a tube and
approximately 5 inches in length. It has
several C-shaped hyaline cartilage rings
which are lined with pseudostratified
ciliated columnar epithelium. (2) Those
rings keep the trachea open for air all
the time. They are C-shaped in order to
allow the open end to face the esophagus. This allows the esophagus to expand into the
area normally occupied by the trachea in order to permit larger chunks of food to pass
through. The trachea, more commonly referred to as the windpipe, connects the larynx to
the bronchi and also has the role of filtering the air prior to it entering the lungs. The
epithelium which lines the cartilage rings produces mucus which traps harmful particles.
The cilia then move the mucus upward towards the pharynx, where it is redirected
towards the gastrointestinal tract in order for it to be digested.

Tracheobronchial Tree

The lower end of the trachea splits the

respiratory tract into two branches that are
named the primary bronchi. These first run
into each of the lungs before further branching
off into smaller bronchi. These secondary
bronchi continue carrying the air to the lobes
of the lungs, then further split into tertiary
bronchi. The tertiary bronchi then split into
even smaller sections that are spread out
throughout the lungs called bronchioles. Each
one of these bronchioles continues to split into even smaller parts called terminal
bronchioles. At this stage, these tiny bronchioles number in the millions, are less than a
millimeter in length, and work to conduct the air to the lungs’ alveoli. The larger bronchi
contain C-shaped cartilage rings similar to the ones used in the trachea to keep the airway
open. As the bronchi get smaller, so do the rings that become progressively more widely
spaced. The tiny bronchioles do not have any kind of cartilage and instead rely on
muscles and elastin.

This system creates a tree-like pattern, with smaller branches growing from the
bigger ones. At the same time, it also ensures that air from the trachea reaches all the
regions of the lungs. Besides simply carrying the air, the bronchi and bronchioles also
possess mucus and cilia that further refine the air and get rid of any leftover
environmental contaminants. The walls of the bronchi and bronchioles are also lined with
muscle tissue, which can control the flow of air going into the lungs. In certain instances,
such as during physical activity, the muscles relax and allow more air to go into the lungs.

Alveoli

The oxygen exchange in the lungs takes

place across the membranes of small
balloon-like structures called alveoli
attached to the branches of the bronchial
passages. These alveoli inflate and deflate
with inhalation and exhalation. It takes
some effort to breathe in because these tiny
balloons must be inflated, but the elastic
recoil of the tiny balloons assists us in the process of exhalation. If the elastic recoil of the
alveoli is compromised, as in the case of emphysema, then it is difficult to exhale
forcibly.

Approximately 300 million alveoli are in the two lungs. The average diameter of
an alveolus is approximately 250 μm, and its wall is extremely thin. Two types of cells
form the alveolar wall. Type I pneumocytes are thin squamous epithelial cells that form
90% of the alveolar surface. Most of the gas exchange between alveolar air and the blood
takes place through these cells. Type II pneumocytes are round or cube-shaped secretory
cells that produce surfactant, which makes it easier for the alveoli to expand during
inspiration.

Lungs

The lungs are two organs located inside the thorax

on the left and right sides. They are surrounded
by a membrane that provides them with enough
space to expand when they fill up with air.
Because the left lung is located lateral to the
heart, the organs are not identical: the left lung is
smaller and has only 2 lobes while the right lung
has 3. Inside, the lungs resemble a sponge made
of millions and millions of small sacs that are named alveoli. These alveoli are found at
the ends of terminal bronchioles and are surrounded by capillaries through which blood
passes. Thanks to an epithelium layer covering the alveoli, the air that goes inside them is
free to exchange gasses with the blood that goes through the capillaries.

The Work of Breathing

Pulmonary ventilation is the

main process by which air
flows in and out of the lungs.
This is done through the
contraction of muscles, as
well as through a negative
pressure system that is
accomplished by the pleural
membrane covering the
lungs. When the lungs are
completely sealed in this membrane, they remain at a pressure that is slightly lower than
the pressure of the lungs at rest. As a result of this, the air passively fills the lungs until
there is no more pressure difference. At this point, if necessary, additional air can be
inhaled by contracting the diaphragm as well as the surrounding intercostal muscles.
During exhalation, the muscles relax and this reverses the pressure dynamic, increasing
the pressure on the outside of the lungs and forcing air to escape them until both
pressures equalize again. Thanks to the elastic nature of the lungs, they revert back to
their state at rest and the entire process repeats itself.

The Diaphragm and Intercostal Muscles

The last component of the respiratory system is a muscle structure known as the
muscles of respiration. These muscles surround the lungs and allow the inhalation and
exhalation of air. The main muscle in this system is known as the diaphragm, a thin sheet
of muscle that constitutes the bottom of the thorax. It pulls in air into the lungs by
contracting several inches with each breath. In addition to the diaphragm, multiple
intercostal muscles are located between the ribs and they also help compress and expand
the lungs.

Respiratory System Defenses

One of the respiratory system's defense mechanisms involves tiny, muscular, hair-
like projections (cilia) on the cells that line the airways. The airways are covered by a
liquid layer of mucus that is propelled by the cilia. These tiny muscles beat more than
1,000 times a minute, moving the mucus that lines the trachea upwards about 0.5 to 1
centimeter per minute (0.197 to 0.4 inch per minute). Particles and pathogens that are
trapped on this mucus layer are coughed out or moved to the mouth and swallowed.

Because of the requirements of gas exchange, alveoli are not protected by mucus
and cilia—mucus is too thick and would slow movement of oxygen and carbon dioxide.
Instead, the body has another defense system. Mobile cells on the alveolar surface called
phagocytes seek out deposited particles, bind to them, ingest them, kill any that are
living, and digest them. The phagocytes in alveoli of the lungs are called alveolar
macrophages. When the lungs are exposed to serious threats, additional white blood cells
in the circulation, especially neutrophils, can be recruited to help ingest and kill
pathogens.