FEU-NRMF [PHYSIOLOGY DEPARTMENT]

Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
Disclaimer: This trans is just a supplement to your studies/ readings. This is not ■ Rectus abdominis, Internal & External
intended to replace nor substitute any written information in our prescribed text obliques
books. Please use at your own risk. Goodluck! Godbless!
■ Transversus abdominis
MECHANICS OF BREATHING ■ INTERNAL Intercostals

➔ Boyle’s Law states that at constant temperature the volume of a Two Structure-Three Compartment Model:
gas is inversely proportional to pressure
◆ As the volume decreases, the pressure increases [and ➔ Involves the lungs and chest wall
vice versa] A. Lungs tend to recoil INWARDS or
◆ Container analogy: given a container with a large COLLAPSE
volume, the gas molecules tend to have a less chance B. Chest wall recoil OUTWARDS
of colliding with each other → hence low pressure. But C. Lung and Chest wall: Opposes
as the volume of that container decreases, gas each other
molecules will have more chance to collide with each
other → producing an increase in pressure.
➔ K=PxV
★ Intrathoracic or Intrapleural Pressure
○ Created by the interaction of the lungs and thorax
○ -3 to -5 cmH2O [in other books: -4 to -6 cmH2O]
★ Intrapulmonic or intra-alveolar Pressure
○ Equal to Atmospheric pressure
○ 0 cmH2O or 760 mmHg

★ Muscles of Respiration
○ Inspiration
■ Diaphragm
● “Major muscle for Respiration”
● Supplied by 2 phrenic nerves
from C3 to C5
● Increases VERTICAL DIMENSION Pressure/Volume Resting state Inspiration/ Expiration/
and TRANSVERSE DIAMETER of Contraction* Relaxation*
the thorax
● When it contracts, you INCREASE Intra-alveolar 0 cmH20 Low High
the volume of the thoracic
cavity. Intra-pleural -3 to -6 Low High
■ EXTERNAL Intercostals cmH20
● Connects adjacent ribs
● Moves the ribs UPWARD and Volume of 0 Liters High Low
FORWARD [“Bucket handle Thorax
analogy”]
*of the diaphragm
● Increases the AP-Lateral
Diameter ★ Compliance
● Supplied by the Intercostal ○ Measure of distensibility of matter and specifies the
nerves ease with which matter can be stretched or distorted
■ Accessory muscles
● Scalenes
● Sternocleidomastoids
○ Expiration ○ Expandability of the lungs and thoracic wall
Note: During normal quiet breathing, no muscles are contracting. The ○ Change in volume divided by the change in pressure
relaxation of diaphragm is enough for the person to exhale. During active ○ Inverse of elastance
exhalation/expiration – forced expiration, laughing, coughing, exercise. The ■ Elasticity – ability to oppose stretch or
following muscles are used: distortion and ability to return to its
original shape after distortion of an
external force

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
Main Factors in Lung Compliance: Additional Concepts mentioned in the lecture:
➢ Elastic fibers ● Bernoulli's principle
○ Confers the elasticity of the lungs ○ Within a horizontal flow of fluid, points of higher
○ Nylon stocking [criss-cross arrangement] fluid speed will have less pressure than points of
➢ Pulmonary surfactant slower fluid speed.
○ DECREASES/REDUCES surface tension ○ So within a horizontal water pipe [for example] that
○ Making the lungs easier to expand changes diameter, regions where the water is
➢ Interdependence of the Alveolar Sacs [Figure B] moving fast will be under less pressure than
○ When they are inflated, the tendency of the walls is regions where the water is moving slow.
to move away from one another (like playing tug of ○ In other words: when a fluid/air with high velocity
war), the space in between becomes larger. passes through a tube [i.e. bloodvessel/airway
○ Movement of alveoli from one another making the respectively], the pressure exerted will be low on
alveoli to open up more = more compliance the walls of the tube..
● Venturi Effect
○ “the velocity of a fluid passing through a
constricted area will increase and its static pressure
will decrease.”
○ In other words: when a fluid/air passes through a
small opening, the velocity of the fluid/air will
increase.
(This is how I get the concept, correct me na lang if I’m wrong~)

Poiseuille Equation for Laminar flow: Formula for Resistance

V = air flow -“Inverse of flow”
P = Pressure gradient (P1-P2) -Radius: Major/Principal determinant of
r = radius resistance
n= viscosity
l = length of tubes

★ Airway Resistance
[Left diagram] Factors Affecting the Airway Resistance:
● Lung volume will not start at 0 because of residual volume ● Lung Volume
● Inspiration: starts with a slight increase in volume/air. ○ Greater volume = lower resistance
● Due to interdependence, as the lung expands the more ● Neurohormonal regulation
compliant it will be. ○ Parasympathetic → bronchoconstriction
● During mid-inspiration: highest compliance ○ Sympathetic → bronchodilation
[Right diagram] Sites of Resistance: In a normally
● In patients with too much elastin fiber and collagen, lungs functioning lung
become hardened (Ex. fibrosis), even if the pressure is -The area of Highest resistance is
increased, only a small amount of air can enter the lungs located in the Medium size
because the lungs are not compliant and will not expand. airways/ segmental bronchi
● In patients with destroyed elastin (congenitally or -The are of Lowest resistance is
emphysema), lungs are very compliant but elasticity is lost,
located in the Terminal
thus during inspiration, the lungs will expand even with little
Bronchioles
pressure, however with no elasticity, exhalation is
-Point zero corresponds to
compromised, only a small amount of air is expelled, thus
trachea*
decreased lung capacity in the next inhalation and CO2 is also
trapped inside

★ Dynamic Lung Mechanics In patients with a respiratory tree problem [like Bronchiolitis or
○ Factors for AIR INFLOW in the AIRWAYS Bronchial asthma] → the radius of the airways becomes smaller
■ Pattern of Gas Flow therefore increasing the resistance to airflow → less amount of pressure
will be generated and less amount [volume[ of air can go in. Going back
to the patterns of airflow, in patients with such diseases → the flow of air
in these smaller airways would be turbulent [instead of laminar].

★ Air in the Lungs [memorize na lang daw ito~]

LUNG VOLUMES:
● Tidal volume [TV]: volume of air inspired and expired during
normal quiet breathing
● Inspiratory reserve volume [IRV]: extra volume of air that can
be inspired beyond tidal volume

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
● Expiratory reserve volume [ERV]: extra volume of air after close, causing airways to close before the lungs totally deflates reason
forceful expiration and tidal expiration for residual volume
● Residual volume [RV]: volume of air left in the lungs after B: In an obstructed lung [ex. COPD], there’s bronchoconstriction &
forceful expiration airway inflammation resulting in smaller opening of airways; plus, more
mucus is produced = obstruction. ↓radius = ↑resistance = ↓airflow; This
will cause airways to close earlier than usual; more air is trapped inside
the lungs = ↓FEV1 Ratio of FEV1/FVC is lower in obstructive; because FEV1
is markedly lower than VC
C: In restrictive lung diseases [ex. Fibrosis], there’s stiffness of lungs,
only small expansion is possible having a small amount of lung volume
so there is also a small amount of air that can be expelled.

LUNG CAPACITIES:
● Total lung capacity [TLC]: maximum volume at which the
lungs can be expanded with greatest possible effort
● Vital capacity [VC]: maximum amount of air that can be
expelled after maximal inspiration
● Inspiratory capacity [IC]: amount of air that can be maximally
inspired after tidal expiration
● Functional residual capacity [FRC]: amount of air remaining in
the lungs at the end of normal expiration
● Timed vital capacity or Forced expiratory volume in 1 second VENTILATION
(FEV1):
○ amount of air expired by forceful expiration in 1
second
○ 80 – 85% 0f VC

Three most important volumes and capacities:

1. Tidal volume
2. Residual volume
3. Vital capacity
Factors affecting Vital Capacity [V.C.]:

Increased VC Decreased VC
● Standing ● Supine/Lying down
● Exercise[athletes] ● Malnourished
● Wind instrumentalist ● Females*
● Males* ● Obesity
*All pulmonary volumes and capacities ● Decreased lung
are usually about 20 to 25 percent less surfactant
in women than in men, and they are
● Chest wall problems The total cross sectional area in the conducting zone is almost the same.
greater in large and athletic people than
[ex. scoliosis] When it reaches the respiratory zone, the total cross sectional area
in small and asthenic people.
increases
The concept of FORCED EXPIRATORY VOL IN. 1 SECOND [FEV1]
★ Total Pulmonary Ventilation
○ Measured by collecting all the expired gas over a given
time
○ Tidal volume x respiratory rate (RR)
○ Aka Minute Respiratory Volume (MRV)
★ Alveolar Ventilation
○ Volume of air that reaches the alveoli
○ Tidal volume – anatomic dead space x RR
➔ Measurement of Alveolar Ventilation:

A: In a normal lung, during exhalation, because of interdependence, ● VCO2 volume of exhaled CO2 per unit of time Partial
alveoli will move towards one another, in effect pushing the airways to pressure of CO2 in the blood.

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
● Double the ventilation the PCO2 is halved and if you
3. Respiratory Acidosis ● Hypotension
decrease ventilation into half you double the PCO2
● Hypoxia
★ Anatomic Dead space
Effects:
○ Volume of the conducting airways = 150 ml
1. Low PCO2
○ Measured by Fowler’s method or nitrogen washout
2. Respiratory Alkalosis
technique
○ Measures the volume of conducting airways down to
the area of rapid diffusion
○ Reflects the morphology of the lung TRANSPORT OF GASES
○ Can be estimated using the person’s weight in ★ Gay Lussac or Charles’ Law
POUNDS [lbs]
★ Physiologic Dead space If the pressure of a given quantity
○ Areas with absence of blood flow (perfusion) of a gas remains constant the
○ Ratio of pulmonary blood flow to alveolar ventilation volume of a gas increases in
is low directly proportional to its
○ Measured by Bohr method absolute temperature.
■ Volume of lung that does not eliminate CO2

★ Vapor Pressure of Water

○ All gaseous mixtures are saturated with water vapor
○ Vapor pressure of H2O depends on the Temp of water
and gases
○ Higher temperature greater molecular activity
○ Water vapor pressure at 37 degrees C = 47 mmHg
★ Solution of Gases in Water
○ Factors affecting solubility of gas in water at
equilibrium:
★ Regional differences in Ventilation [V] ■ Pressure of the gas surrounding the water
○ Most dependent area has greater ventilation ■ Solubility coefficient of the gas in water at
■ Upright Position: Base of the lungs its temperature
■ Supine Position: Posterior of the lungs ○ Example of solubility coefficient of gases at 37 degrees
★ Regional differences in perfusion (Q) Celsius:
○ Greater at the base ■ O2 = 0.024
○ Relative change from the apex to base is greater than ■ CO2 = 0.57 [highest; most soluble of all]
ventilation ■ N2 = 0.012
○ V/Q low at base and high at the apex ■ He = 0.008
Lung Ventilation [V] Perfusion [Q] ★ Partial Pressure of Gases
○ Dalton’s Law – the total pressure exerted by a gas
mixture is equal to the sum of the pressures of the
APEX LOW LOWER
individual gases
PB = 760 mmHg = PH20 (47mmHg) + PO2(149.2) + PN2(563.5) + PCO2 (0.3)
BASE HIGH HIGHER
DIFFUSION
★ Variations in V/Q Ratio
★ Diffusion of Gases
V/Q = Zero (0) No alveolar ventilation ○ From area of high concentration to a low
concentration
Low V/Q Most of the small bronchioles are obstructed ○ From high pressure to low pressure
○ Pressure gradient or diffusion gradient
V/Q = No capillary blood flow ★ Respiratory membrane
Infinity(∞)
-A layer of fluid containing surfactant
High V/Q Some of the capillaries are destroyed w/ continued that lines the alveolus and reduces the
ventilation surface tension of the alveolar fluid
-thin interstitial space between the
alveolar epithelium and the capillary
membrane
Hypoventilation Hyperventilation
-Alveolar epithelium: which is
composed of thin epithelial cells; an
Decreased or insufficient volume Increase in ventilation in excess of
epithelial basement membrane
of air enters the alveoli what is required
-Capillary endothelial membrane:
Effects: Causes:
around 1 μm – very thin so that the gas
1. Poor oxygenation of ● Acidosis
can move from the space towards the
blood ● Anxiety
capillaries; fuses with the alveolar
2. CO2 retention ● CNS Injuries
epithelial basement membrane

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza

★ Decreasing Pressure Gradient

Major components:

a.Fluid lining of the alveolus with

the surfactant
b.Alveolar epithelium
c.Epithelial basement membrane
(BM)
d.Interstitial space between
alveolus and capillary
e.Capillary BM ● In higher altitude places, away from the sea level, oxygen
f.Capillary endothelial membrane becomes thinner pressure of oxygen decreases at around
50mmHg
● Thus smaller pressure gradient (P1-P2) SLOWER DIFFUSION
Factors Influencing Diffusion:
● In normal lungs:
a. Thickness of membrane
○ At almost 0.50sec, is when blood is fully saturated with
b. Surface area of membrane
oxygen. Thus, no hypoxia at rest (leaves at 0.75sec).
c. Diffusion coefficient
○ Activities that may lead to increase heart rate (leaves
d. Pressure gradient
at 0.25sec) may result to hypoxia due to the slower
e. Capillary blood volume
diffusion no O2 saturation
f. Capillary diameter
○ Any abnormalities either mild or severe will lead to
hypoxia in high altitude places because blood will not
★ Diffusing capacity of the respiratory membrane be saturated with oxygen as it leaves the lungs even at
○ Volume of a gas will diffuse each minute for a pressure rest
gradient of 1 mmHg ★ O2 and CO2 Diffusion
○ Diffusing capacity of Oxygen
■ Average adult: 21 ml
○ Diffusing capacity of CO2
■ 20 x faster than O2
■ Average adult at rest: 400-500ml/min
★ Uptake of Oxygen

● When the deoxygenated blood passes through the alveoli,

104mmHg in alveoli & 40mmHg in the deoxygenated blood, there
is a good pressure gradient oxygen will move towards the blood.
● As the oxygenated blood move through the systemic circulation
with 95-98mmHg pressure while 40mmHg pressure in the tissues,
● Blood enters and leaves lungs in less than a second (around
pressure gradient oxygen can now diffuse in the tissues
0.75sec)
● Even though the pressure gradient is small [in the tissues:
● At sea level pressure gradient, in normal lungs:
46mmHg; in veins/ deoxygenated blood: 45mmHg], CO2 is still
○ At 0.25sec, blood is already fully saturated with oxygen
diffused due to its high solubility coefficient.
leaves lungs fully oxygenated
● Increase & accumulation of CO2 indicates that the person is in
○ During exercise, heart rate increases movement of
respiratory failure or ventilation is not that effective.
blood to the lungs will be faster leaves lungs at
● CO2 is diffused towards the blood and be carried back to the
0.25sec no problem blood is fully saturated at 0.25sec
alveoli for elimination as long as the person is ventilating
for normal lungs no hypoxemia
○ In abnormal lungs (i.e. pneumonia): BLOOD FLOW AND METABOLISM
■ In mild pneumonia (1/4 normal in graph),
blood will be saturated with oxygen around
0.75sec, thus it is saturated upon leaving
lungs. However, if subjected to activity that
increases the heart rate (leaves at 0.25sec),
there will be oxygen deficit/hypoxemia.
■ In severe pneumonia (1/8 normal in graph),
there will be hypoxia even at rest, because
blood is not saturated with oxygen before it
leaves the lungs (0.75sec)
● Blood flow begins at the pulmonary artery – which accompanies
the bronchus, divides together until the terminal bronchioles, to
become the pulmonary capillaries, which surrounds the

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
pulmonary vessels and as these vessels coalesce, the pulmonary
decreasing resistance also
vein is formed
● Pressures between the pulmonary and systemic circulation:
These two mechanisms work
○ Systemic pressure is at least ten times higher than the
hand-in-hand. (1) During
pulmonary pressure
inspiration, there is no plugging of
○ Because the pulmonary blood vessels have thinner
the vessels so resistance is still
walls with more smooth muscles unlike in systemic
high. But once you inhale,
circulation where the vessels are thicker and more
extra-alveolar vessels will pull the
muscular
walls of the blood vessels through
○ Systemic circulation also has arterioles which contain
traction. If you increase the lung
a large amount of smooth muscles
volume, you decrease the
➔ When you're running or exercising, you need more blood in the
resistance. (2) Even if the
lower extremities such as the legs and these arterioles regulate
capillaries are thin-walled, they
blood flow to these parts
are still elastic. There will come a
○ Pulmonary circulation is the only vascular bed which
time where the maximum
receives the entire cardiac output so the pressure
elasticity is reached and the
must be low enough to allow easier transport of blood
resistance again decreases
from the ventricles or else the right part of the heart
will have a difficult time in pushing blood towards the
pulmonary circulation
Distribution of Blood Flow:

● Alveolar vessels - which are located at the septum, and once the
alveolar pressure increases, it will compress the alveolar vessels.
So effectively, they are affected by the pressures surrounding
them.
● Extra-alveolar vessels - which are exposed to a pressure less
than alveolar, and are pulled open by the radial traction of the Zone 1
surrounding parenchyma, increasing its caliber - No blood flow during all portions of the cardiac cycle because the local
alveolar capillary pressure in this area of the lung never rises higher than
Pulmonary Vascular Resistance: the alveolar air pressure during any part of the cardiac cycle. (Alveolar Air
Vascular resistance = (input Pressure > Arterial Pressure)
pressure – output pressure) / - blood flow occurs only under abnormal conditions.
blood flow -Occurs when either the pulmonary systolic arterial pressure is too low or
★ increase in pressure, the alveolar pressure is too high to allow flow.
will increase resistance Zone 2
★ Increase in resistance, - Intermittent blood flow
will decrease blood -Only during systole, the pulmonary arterial pressure is greater than the
flow alveolar pressure, thus blood will flow.
This is true only for the systemic - In diastole, the alveolar pressure is greater than the pulmonary arterial
circulation*** pressure,
Note: In pulmonary circulation this no blood flow.
is not true due to thin-walled Zone 3
property and lack of smooth - Continuous blood flow
muscles -the alveolar capillary pressure remains greater than alveolar air pressure
during the entire cardiac cycle.
Concept of Recruitment:
This is the ability of capillaries to
recruit additional vessels during TRANSPORT OF O2 IN THE BLOOD
increase in pressure, resulting in
decrease in resistance. Just like ● 2 forms of O2 in the blood
your small airways, these ○ Combined in the plasma (dissolved state)
capillaries work in parallel and ■ 1 to 3 Liters
somehow function as one big tube ○ Combined with hemoglobin as HbO2
As you recruit more vessels, ■ Concentration of Hgb: 14-15 g/100ml of
resistance further decreases. blood
Concept of Distension: ■ 1 Hgb molecule : 4 O2 molecules
The ability to dilate existing ■ 1 gram of Hgb : 1.34 ml of O2
vessels during increase in pressure ● Combination of O2 with Hemoglobin
increasing the caliber and ○ Oxygen-hemoglobin dissociation curve

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
HOW DO WE BREATHE?

Control system:
★ Automatic system
○ Pons and medulla
○ Respiratory motor neurons in the lateral and ventral
[Memorize] portions of SC
Shift to the right means that there is low affinity for O2. ★ Voluntary system
Shift to the left means that there is high affinity for O2 ○ Cerebral cortex
○ Corticospinal tract
● Transport of CO2 in the blood Central Controller:
1. Medullary Respiratory Center
a. DORSAL inspiratory area
● Rhythm of ventilation
● Inhibited by impulses from pneumotaxic
center
● Vagus and glossopharyngeal nerves
b. VENTRAL inspiratory area
● Normally inactive
2. Apneustic Center
● Lower pons
● If transected inspiratory gasps or apneusis
● Seen in severe brain injury
3. Pneumotaxic Center
● Upper pons
● Inhibits inspiration
● Regulates respiratory volume
Dissolved carbon dioxide ● “Fine tuning”
● 0.2 mL/100 mL of blood REGULATION OF RESPIRATION
CO2 + H2O to form carbonic acid
● 0.1 – 0.3 ml/100 ml of blood Basic Elements of Respiratory Control
Bicarbonate ions resulting from dissociation of Carbonic Acid I. Sensory receptors
● 3ml / 100ml 0f blood A. Central Chemoreceptors
● 65 – 70% of CO2 transport from tissue to the lungs ● Ventral surface of the medulla near the 9th
Carbonic compounds from combination of CO2 with Hgb and 10th CN
● 1.5 ml/ 100 ml of blood ● Changes in H ion in CSF (CO2)
○ Governed by the:
Majority is transferred as bicarbonate via the action of the enzyme ■ Condition of CSF
carbonic anhydrase, which joins H2O and CO2 to form carbonic acid ■ Local Blood Flow
(H2CO3) ■ Local Metabolism
- HCO3 diffuses out in exchange for 1 Cl-, called the chloride shift B. Peripheral Chemoreceptors
which helps the cell maintain its osmotic equilibrium. ★ Carotid bodies
- In the process, excess H+ produced binds with the Hgb and is ★ Aortic bodies
converted to the CO2 and H2O back in the lungs via the same enzyme, ● Responds to:
carbonic anhydrase. ○ Decrease PaO2 & pH
Bohr-Haldane Effect ○ Increase in PaCO2 (less
***Significance: uptake of CO2 by RBC important than central
Bohr effect: states the CO2 and H+ decrease the affinity of Hgb to O2 receptors)
molecules; relevant to the tissues. C. Lung and Other Receptors
Haldane Effect: states that O2 decreases the affinity of Hgb to CO2 and 1. Pulmonary stretch (inflation and deflation)
H+. This is related to the lungs which can saturate the blood with oxygen receptors
and cause the release of CO2. It helps increase the CO2 delivery back to ● w/in the smooth muscles
the lungs because the saturated amounts of oxygen in the lungs help the ● inflation of the lung → slowing
release of CO2. of RR
● Deflation → Initiate respiratory
activity

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FEU-NRMF [PHYSIOLOGY DEPARTMENT]
Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
● Herring-Breuer reflex ● Increased ventilation in exercise
2. Irritant receptors b. Effect of pain
● Between epithelial cells c. Effect of temperature
○ Stimulated by: ● Increase in temp. increases ventilation
➔ Noxious gases ● Warming of medullary centers
➔ Cigarette smoke Chemical stimuli of respiration
➔ Dust and Cold Air 1. Increase in PaCO2
● Vagus Nerve ● Most important factor for control of ventilation
● Bronchoconstriction and ● Main stimulus is from central chemoreceptors
Hyperpnea ● Additional stimulus from peripheral receptors
3. J-receptors 2. Decrease in PaO2
● Alveolar walls close to ● Stimulates aortic and carotid bodies
capillaries ● No effect on central chemoreceptors
● “juxta-capillary” or J nerve ● Prolonged hypoxemia may cause MILD cerebral
● Stimulated by: acidosis stimulating ventilation
➔ engorgement of the pulmonary ● Maximal stimulation of chemoreceptors by lack of O2
capillaries is only 65%
➔ Increases in interstitial fluid in ● Increased CO2 and H ion more powerful stimulus
the alveolar wall ● CO2 can increase ventilation by 900% & acidosis by
D. Other receptors outside the lungs 400%
1. Nose and upper airway receptors ● Maximum increase in ventilation Is reached when
● Nose PaCO2 is 9%
● Nasopharynx ○ Coma at 20-30%
● Larynx ○ Anesthetized at 30 -40%
● Trachea ○ Death at 40-50%
➢ Responses: Sneezing, Coughing,
Hypoxia
Bronchoconstriction
● Decrease O2 or inadequate O2 to the tissues
2. Joint and muscle receptors
● There are FOUR TYPES:
● Proprioceptors can stimulate
○ Hypoxic hypoxia – low PO2 in the blood
respiratory centers
○ Anemic Hypoxia – low carrying capacity of blood
3. Gamma system
for O2
● Intercostal muscles & diaphragm
○ Circulatory (Ischemic) hypoxia – low blood flow
4. Arterial baroreceptors
○ Histotoxic hypoxia – inability of cells to utilize O2
● Increase BP causes reflex
hypoventilation
● Severe cases leads to apnea
through the carotid and aortic
sinuses
5. Pain and thermoreceptors
● Causes apnea followed by
hyperventilation
● Increase temperature leads to
hyperventilation
● Hypothalamic Thermostat
Functions of the Respiratory Center
➢ Coordinates activity of respiratory muscles
➢ Regulates frequency of respiration
➢ Regulates strength of respiration
➢ Controls rate and depth of breathing
Nervous Stimuli of Respiration
Cortical Origin
● Voluntary control
● Breath holding is possible but not indefinite ~ #EverUpward #BatchExcelsior *shing*
● Increase levels of PaCO2 → Stimulates respiratory center
SAMPLEX-RATIO + ADDITIONAL NOTES
Neurogenic stimuli of visceral origin
a. Cough reflex 1. A 3 year old boy with pneumonia was referred to you because of oxygen
b. Cessation of respiration, closure of the glottis and desaturation. You hook this boy to oxygen at 3 lpm via nasal cannula. Which
bronchoconstriction among the following laws can explain the role of oxygen support in this
c. Swallowing reflex patient?
d. Hering-Breuer reflex a. Fick’s law
e. Thoracic chemoreflexes (Bezold Jarisch reflex) b. Charle’s law
● Hypoventilation, hypotension & bradycardia c. Boyle’s law
Neurogenic stimuli of somatic origin d. Dalton’s Law
a. Reflexes from joint 2.A 16 year old asthmatic girl was referred to you due to difficulty breathing.
● Back and forth motion of a limb The most likely reason for her condition would be

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Lecture: Basic Course Audit (Respiratory Physiology) - Dr. Carlo Goy Mendoza
a. Increase airway resistance c. resistance
b. decrease lung compliance d. Flow
c. increase airflow 15. Which branch of a normal airway has the lowest resistance?
d. Decrease gas diffusion a. Trachea
3.Stimulating the sympathetic nervous system will b. Segmental bronchi
a. decrease air flow c. Mainstem bronchi
b. increase airway resistance d. Terminal bronchioles
c. no effect on the airways 16. The estimated anatomic dead space of a 175 lbs man is
d. decrease airway resistance a. 175 L
4.Based on Boyle’s law, the following occurs during contraction of the b. 175 ml
diaphragm c. 150 ml
a. thoracic volume decreases, pleural pressure decreases d. 175 mm
b. thoracic volume increases, pleural pressure increases 17. These cells are important for the repair of alveolar structures
c. thoracic volume increases, pleural pressure decreases a. Type II epithelial cells
d. thoracic volume decreases, pleural pressure increases b. Type I epithelial cells
5.This occurs during contraction of the diaphragm c. Type I pneumocytes
a. pleural pressure decreases d. Type II ciliated cells
b. volume of the thorax decreases
c. lung volume decreases
d. alveolar pressure increases
6. The following change/s occur/s during an asthma attack
a. airflow decreases
b. air flow increases
c. vascular resistance decreases
d. airway resistance decreases
7.The respiratory unit is composed of the following
a. alveoli, alveolar ducts, respiratory bronchioles
b. alveoli, alveolar bronchi, alveolar ducts
c. terminal bronchioles, alveolar ducts, alveoli
d. alveolar ducts, respiratory bronchi, alveoli
8.This is the major component of pulmonary surfactant
a. phospholipids
b. cholesterol
c. neutral lipids
d. Proteins
9.A 55 year old male was referred to you for a lung function test. History
revealed that He has been having shortness of breath for several months
now. His pulmonologist is considering COPD due to emphysema. Which
among the following spirometry results is TRUE with this patient?
a. Increased FEV, FVC, normal FEV/FVC ratio
b. Increased FEV, FVC & FEV/FVC ratio
c. Decreased FEV, FVC & FEV/FVC ratio
d. Decreased FEV, FVC, normal FEV/FVC ratio
10. Highest lung compliance is observed during
a. start of inspiration
b. start of expiration
c. mid inspiration
d. end of inspiration
11.The conducting zone of the respiratory tract consist of the following:
a. terminal bronchioles, alveolar ducts, alveoli
b. Trachea, bronchi, respiratory bronchioles
c. Bronchi, terminal & respiratory bronchioles
d. Trachea, bronchi, terminal bronchioles
12. This pattern of gas flow is seen in patients with bronchiolitis
a. Laminar
b. Transitional
c. Turbulent
13. The major muscle for inspiration is
a. Transversus abdominis
b. Diaphragm
c. Internal intercostals
d. Rectus abdominis
14. This is the inverse of compliance
a. interdependence
b. elastance

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