ANATOMY AND PHYSIOLOGY

CHAPTER 15: RESPIRATORY

SYSTEM The respiratory tract is divided into two regions: the
upper respiratory tract (from the nose to the larynx) and
15.1 ANATOMY OF THE RESPIRATORY SYSTEM
the lower respiratory tract (from the trachea to the
The respiratory system is essential for acquiring oxygen alveoli in the lungs). The upper respiratory tract is a
and removing carbon dioxide from the blood. Oxygen is common site for infections.
needed for the body's cells to create ATP, a crucial
The respiratory tract can also be divided into structures
energy molecule, while carbon dioxide is a by-product of
used for ventilation (conducting zone) and those used for
ATP production and needs to be eliminated to maintain
respiration (respiratory zone). Gas exchange occurs in
blood pH within a narrow range for homeostasis.
the respiratory zone within the lungs.
The respiratory system comprises seven key structures:
Four simultaneous processes are involved in gas
1. External nose: It encloses the air inspiration exchange between air and blood:
chamber, distinct from the mouth, which is part of 1. Ventilation: The act of breathing, which brings air
the digestive system. into and out of the respiratory passages.
2. Nasal cavity: This area cleans, warms, and 2. External Respiration: Oxygen moves from the
humidifies incoming air. alveolar air into the blood, while carbon dioxide
3. Pharynx (throat): It serves as a shared passageway diffuses out of the blood into the alveoli.
for both food and air. 3. Gas Transport: Oxygen and carbon dioxide travel to
4. Larynx (voice box): The larynx maintains the airway and from cells in the blood.
open and helps produce sound. 4. Internal Respiration: Oxygen exits the blood and
5. Trachea (windpipe): This tube cleans the air and enters cells, while carbon dioxide exits cells and
directs it to the lungs. enters the blood.
6. Bronchi: These tubes further direct air into the lungs.
7. Lungs: Each lung consists of a complex network of It's important to note that "respiration" can refer to both
air sacs (alveoli) and capillaries for gas exchange the respiratory process and cellular metabolism (cellular
between air and blood. respiration). Breathing provides oxygen for cellular
respiration, which produces ATP from glucose and
removes carbon dioxide.
15.2 FUNCTIONS OF THE RESPIRATORY The respiratory system also serves other functions:
SYSTEM 1. Regulation of Blood pH: The respiratory system can
Respiration, also known as breathing, plays a crucial role influence blood pH by changing carbon dioxide
in maintaining the body's balance, or homeostasis. levels.
2. Production of Chemical Mediators: It produces
There are two main aspects of respiration: ventilation enzymes like angiotensin-converting enzyme (ACE)
and respiration. that play a role in blood pressure regulation.
1. Ventilation: This involves the movement of air into 3. Voice Production: Air passing over vocal folds
and out of the lungs. enables speech and sound production.
2. Respiration: This process involves the exchange of 4. Olfaction: The sensation of smell occurs when
gases across cell membranes. airborne molecules enter the nasal cavity.
5. Protection: The respiratory system helps protect
against microorganisms by preventing their entry
Respiration in the body can be categorized into two
and removing them from respiratory surfaces.
types:
1. External Respiration: This is the exchange of gases
between the atmospheric air in the lungs and the
bloodstream.
2. Internal Respiration: This involves the exchange of
gases between the bloodstream and the body's cells.
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15.3 STRUCTURES AND HISTOLOGY OF THE - It houses the vocal folds (true vocal cords), which
RESPIRATORY TRACT vibrate during sound production.
- The larynx also functions to protect the lower
The respiratory system comprises several key structures
respiratory tract from foreign materials and aids in
that facilitate the flow of air and enable gas exchange.
swallowing.
These structures include the upper respiratory tract,
2. Trachea (Windpipe):
which includes the nose and nasal cavity, and the lower
- The trachea is a membranous tube reinforced by C-
respiratory tract, which extends from the trachea to the
shaped cartilaginous rings to prevent collapse.
alveoli. Here's a breakdown of important information
- It extends from the larynx to the bronchi and is lined
about each of these components:
with a ciliated mucous membrane to trap debris.
Upper Respiratory Tract: 3. Bronchi and Bronchial Tree:
1. Nose and Nasal Cavity: - The trachea divides into two main bronchi, each
- The nose is a prominent facial feature composed of leading to a lung.
hyaline cartilage plates. - The bronchial tree further branches into lobar
- The nasal cavity is the initial entry point for air into bronchi, segmental bronchi, bronchioles, and
the respiratory system, starting at the nostrils (nares). terminal bronchioles, each with diminishing
- The nasal cavity is divided into right and left halves cartilage and increasing smooth muscle.
by the nasal septum, with cartilage in the anterior - Changes in bronchial diameter, termed
part and bone in the posterior part. bronchodilation and bronchoconstriction, impact
- Conchae, or bony ridges, create turbulence in airflow.
airflow, increasing contact with the mucous 4. Alveoli:
membrane that lines the nasal cavity. - Alveoli are small air-filled sacs where gas exchange
- The nasal cavity warms, humidifies, and cleans occurs.
incoming air. - Composed of thin squamous epithelial cells and
- Sinusitis is inflammation of the sinus mucous surfactant-secreting cells, alveoli are covered by
membrane, often caused by viral infections, and it pulmonary capillaries.
can lead to pain and blockages. - The respiratory membrane, formed by alveolar walls
- The nasal cavity also contains the nasolacrimal duct and capillary endothelium, facilitates gas diffusion.
for tear drainage and plays a role in smell and voice
resonance.
Additional Notes:
2. Pharynx (Throat):
- The thoracic wall and associated muscles, such
- The pharynx is the common passage for both the
as the diaphragm, play crucial roles in
respiratory and digestive systems.
ventilation.
- It has three regions: nasopharynx, oropharynx, and
- Lymphatic vessels and phagocytic cells help
laryngopharynx.
remove debris from the lungs.
- The nasopharynx connects to the nasal cavity, has a
- The lungs are housed in pleural cavities, covered
soft palate to prevent food entry, and contains the
by the parietal and visceral pleura.
pharyngeal tonsil.
- The oropharynx is posterior to the mouth and
participates in both air and food passage. The respiratory system serves essential functions in
- The laryngopharynx connects to the larynx and breathing and gas exchange, ensuring the body receives
esophagus, directing air and food to their respective oxygen and expels carbon dioxide.
routes.

Lower Respiratory Tract: 15.4 BEHAVIOR OF GASES

1. Larynx (Voice Box)
- The larynx contains several cartilages, including the Breathing involves ventilation and respiration, and we
thyroid, cricoid, epiglottis, arytenoid, corniculate, need to understand the relationships governing gas
and cuneiform cartilages. movement. Ventilation comprises muscle actions and air
pressure gradients.
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Muscles of Respiration: - Total lung capacity (inspiratory reserve volume
- Muscles of inspiration increase thoracic cavity + expiratory reserve volume + tidal volume +
volume. residual volume)
- Diaphragm contraction, in quiet inspiration, moves • Forced vital capacity is a vital pulmonary test
the central tendon downward.
- External intercostals raise the ribs and expand the
thoracic cavity. Alveolar Ventilation:
- Muscles of expiration decrease thoracic volume. - Alveolar ventilation measures air volume available
- Internal intercostals and transverse thoracis stiffen for gas exchange.
the thoracic wall, preventing collapse during - Dead space, including anatomical and physiological
inspiration. dead space, affects this.

Muscles of Inspiration: Factors Affecting Ventilation:

- Diaphragm contraction, with assistance from - Gender, age, body size, and physical fitness
abdominal muscle relaxation, increases thoracic influence respiratory volumes and capacities.
volume. - Disease states, like emphysema, can alter dead
- External intercostals elevate the ribs, expanding the space.
thoracic cavity. - Adaptation to high altitudes involves increased
breathing rate.
Muscles of Expiration:
- In quiet breathing, expiration is passive due to elastic
tissues. Behavior of Gases and Respiration:
- During labored breathing, inspiratory and expiratory - Ventilation provides air to the alveoli.
muscles contract more forcefully for greater volume - External respiration involves gas diffusion between
changes. alveoli and pulmonary capillaries.
- Gas movement depends on partial pressure
Pressure Gradients and Ventilation: gradients.
- The relationship between volume and pressure is - The percentage of gases in alveolar air differs from
inverse. atmospheric air due to humidification, diffusion, and
- During inspiration, thoracic cavity volume increases, partial replacement.
decreasing air pressure.
- During expiration, thoracic cavity volume decreases,
increasing air pressure.
- Air flows from higher to lower pressure areas, aided
15.5 PHYSIOLOGY OF THE RESPIRATORY
by atmospheric pressure.
SYSTEM
Measurement of Lung Function: The major driving force for ventilation is the pressure
• Spirometry measures pulmonary volumes, including: difference between atmospheric air and the thoracic
- Tidal volume (500 mL at rest) cavity. Here's a breakdown of the key information
- Expiratory reserve volume (around 1100 mL) related to alveolar ventilation and the factors affecting it:
- Residual volume (around 1200 mL)
- Inspiratory reserve volume (around 3000 mL) Mechanisms of Alveolar Ventilation:
• Pulmonary capacities are combinations of volumes: 1. Alveolar Pressure vs. Atmospheric Pressure: During
- Inspiratory capacity (tidal volume + inspiratory a respiratory cycle, there are four key steps:
reserve volume) - Alveolar pressure equals atmospheric pressure.
- Vital capacity (inspiratory reserve volume + tidal - Alveolar pressure is less than atmospheric
volume + expiratory reserve volume) pressure.
- Functional residual capacity (expiratory reserve - Alveolar pressure again equals atmospheric
volume + residual volume) pressure.
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- Alveolar pressure is greater than atmospheric 15.6 OXYGEN AND CARBON DIOXIDE
pressure. TRANSPORT IN THE BLOOD
2. Factors Affecting Alveolar Ventilation: The two
Important Information on Gas Transport and
main factors are lung recoil and pleural pressure.
Factors Affecting It:
- Lung Recoil: Lungs have a natural tendency to
1. Gas Transport in Blood:
return to their original size after being stretched.
- Oxygen (O2) and carbon dioxide (CO2) interact
Elastic recoil and surface tension play a role in
with blood components.
this process. Surfactant prevents alveoli from
- Hemoglobin is the primary protein for
collapsing due to surface tension.
transporting O2, with each hemoglobin molecule
- Pleural Pressure: Pleural pressure is the pressure
capable of carrying up to four O2 molecules.
between the parietal and visceral pleurae. During
- CO2 is also transported in three ways: dissolved
inspiration, pleural pressure helps expand the
in plasma, bound to hemoglobin, and converted
alveoli. Any separation between these pleurae
to bicarbonate ions (HCO3-).
can lead to a pneumothorax.
2. Transport of O2:
3. Tension Pneumothorax: In this condition, pleural
pressure is always higher than atmospheric pressure, - About 98.5% of O2 is carried by hemoglobin
which can lead to inadequate oxygen delivery. A within red blood cells, and 1.5% is dissolved in
large-bore needle is used to release the pressure. plasma.
- O2 is essential for cellular respiration to produce
Factors Affecting Diffusion Through the Respiratory ATP.
Membrane: 3. Transport of CO2:
1. Partial Pressure Gradients: Gas diffusion depends on - CO2 is a by-product of glucose breakdown
the partial pressure gradient of each gas. O2 moves during ATP production.
from alveoli into the blood, while CO2 moves from - The blood's CO2 concentration must be tightly
the blood into the alveoli. Increasing alveolar regulated to maintain proper pH.
ventilation improves gas exchange. - Three methods of CO2 transport: dissolved in
2. Oxygen Partial Pressure Gradients: The partial plasma, bound to hemoglobin, and conversion to
pressure of O2 in alveolar air is higher than in the bicarbonate ions (HCO3-).
pulmonary capillaries, allowing O2 to diffuse into 4. Transport of CO2 in the Plasma:
the blood. Equilibrium is reached in the pulmonary - About 7% of CO2 dissolves directly in the
veins before reaching the body's cells. plasma.
3. Carbon Dioxide Partial Pressure Gradients: CO2 - The majority of CO2 diffuses into red blood
moves out of the cells into the interstitial fluid and cells, where it can bind to hemoglobin or convert
then into the blood. At the alveoli, CO2 diffuses out to HCO3-.
of the blood. Equilibrium is reached in the venous 5. Transport of CO2 by Hemoglobin:
end of the pulmonary capillaries. - Approximately 23% of CO2 is transported
bound to hemoglobin.
Respiratory Membrane Thickness: Increased thickness - CO2 binding to hemoglobin is influenced by O2
of the respiratory membrane, often due to diseases like levels; lower O2 levels increase CO2 binding.
pulmonary edema, can decrease the rate of gas diffusion. 6. Transport of CO2 as Bicarbonate Ions:
Fluid accumulation in the alveoli is a common cause. - Around 70% of CO2 is carried in the form of
HCO3- in red blood cells or plasma.
Respiratory Membrane Surface Area: In a healthy - An enzyme called carbonic anhydrase catalyzes
adult, the total surface area of the respiratory membrane the reversible reaction, producing carbonic acid
is approximately 70 m². Conditions like emphysema and (H2CO3), which dissociates into H+ and HCO3-
lung cancer can decrease this surface area, affecting gas .
exchange. Surgical removal of lung tissue, cancer, 7. Summary of Gas Transport:
emphysema, or lung fluid accumulation can reduce - Two figures (15.15a and 15.15b) illustrate the
surface area for gas exchange. processes of O2 entering and leaving the blood
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in tissues and lungs, and CO2 transport in the 15.7 REGULATION OF VENTILATION
opposite direction.
Respiratory Rate Regulation:
8. Physiological Factors Affecting Gas Transport:
1. Medulla Oblongata Control: The medulla oblongata,
- Various factors, including blood pH, Pco2, Po2,
part of the brainstem, governs the respiratory rate by
and temperature, modulate the affinity of
stimulating the muscles of respiration. The rate of
hemoglobin for O2 and CO2.
respiration is determined by how frequently these
- Changes in these factors impact the saturation of
muscles are stimulated.
hemoglobin with O2 and the binding of CO2 to
2. Respiratory Areas in the Brainstem: Neurons
hemoglobin.
controlling respiration are located in specific areas in
9. Effect of Po2 on O2 Transport:
the brainstem, including the medullary respiratory
- Hemoglobin's affinity for O2 depends on the
center, which comprises the dorsal and ventral
Po2; lower Po2 levels result in less O2 binding
respiratory groups. The dorsal group primarily
to hemoglobin.
controls inspiration, while the ventral group is active
10. Effect of Po2 on CO2 Transport:
during both inspiration and expiration.
- Low Po2 levels increase CO2 binding to
3. Pontine Respiratory Group: This group in the pons
hemoglobin, reducing hemoglobin's affinity
helps regulate respiration rate by fine-tuning the
for O2.
breathing pattern. It is not considered essential for
11. Effect of pH and Pco2 on O2 Transport:
generating the respiratory rhythm.
- Blood pH and Pco2 levels also affect
4. Generation of Rhythmic Ventilation: The respiratory
hemoglobin's O2-binding affinity.
rhythm is initiated by neurons in the medullary
- Low pH (high H+ levels) decreases affinity,
respiratory center, responding to various inputs.
while high pH increases it.
Inspiration starts and gradually intensifies, followed
12. Effect of pH and Pco2 on CO2 Transport:
by the inhibition of inspiration, leading to expiration.
- Higher Pco2 decreases hemoglobin's O2-binding
This cycle repeats.
ability due to CO2's effect on pH.
5. Effect of Po2 on Respiratory Rate: Oxygen levels
- CO2 can directly impact hemoglobin's O2-
(Po2) can affect respiration, with significant changes
binding ability when it binds to hemoglobin.
causing increased ventilation. Severe Po2 decrease
13. Effect of Temperature on O2 and CO2 Transport:
can lead to respiratory failure and potentially death.
- Elevated temperatures reduce O2's binding to
6. Regulation of Blood pH: Blood pH is normally
hemoglobin, releasing more O2.
regulated within a specific range. If pH increases,
- Increased body temperature due to metabolism
the body reduces breathing rate to maintain balance.
leads to more O2 release and increased CO2
If pH decreases, breathing rate increases to expel
production.
excess CO2 and restore normal pH levels.
14. Effect of Glucose Metabolism on O2 Transport:
7. Effect of Pco2 on Respiratory Rate: Carbon dioxide
- Glucose metabolism in red blood cells produces
levels (Pco2) are a major regulator of respiration.
a by-product that reduces hemoglobin's O2-
Even slight increases in blood CO2 lead to
binding affinity, leading to more O2 release.
significant increases in ventilation. High CO2 levels
- Banked blood becomes unsuitable for
(hypercapnia) or low CO2 levels (hypocapnia) can
transfusion after approximately 6 weeks due to
disrupt breathing.
the decrease in this by-product. 8. Effect of pH on Respiratory Rate: Changes in blood
pH, primarily caused by CO2, stimulate the
These factors play a crucial role in maintaining the respiratory center to adjust breathing rates to
balance of gases and pH in the blood and ensuring maintain normal pH levels, ensuring proper cell
efficient oxygen delivery to tissues and removal of function.
carbon dioxide.
9. Hering-Breuer Reflex: This reflex limits the depth of
inspiration and prevents lung overinflation. It
depends on stretch receptors in the bronchi and
bronchioles, and it influences the respiratory center
to initiate expiration.
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10. Cerebral and Limbic System Control: Breathing rate
can be controlled voluntarily by the cerebral cortex,
influencing activities like talking or singing.
Emotional states, regulated through the limbic
system, can also impact respiratory rate, such as
hyperventilation during strong emotions or crying.
11. Other Modifications of Ventilation: Higher brain
centers can control ventilation in response to touch,
temperature, or pain stimuli. For example, irritants in
the nasal cavity can trigger a sneeze reflex, and
increased body temperature can lead to elevated
ventilation to remove excess CO2.