Breathing

And
Gas exchange
● Cells get their energy by oxidising foods such as glucose, during the process
called respiration.

● If cells are to respire aerobically, they need a continuous supply of oxygen

from the blood.
● In addition, carbon dioxide from respiration needs to be removed from the
body.
● In humans, these gases are exchanged between the blood and the air in the
lungs.
You need to understand the difference between respiration
and breathing.

Respiration is the oxidation reaction that releases energy

from foods such as glucose .

Breathing is the mechanism that moves air into and out of

the lungs, allowing gas exchange to take place.

The lungs and associated structures are often called the

'respiratory system' but this can be confusing.

It is better to call them the gas exchange system and this is

the term we use in this book.
THE STRUCTURE OF THE GAS EXCHANGE SYSTEM

The lungs are enclosed in the chest or thorax by the

ribcage and a muscular sheet of tissue called the
diaphragm.

As you will see, the actions of these two structures

bring about the movements of air into and out of the
lungs.

Joining each rib to the next are two sets of muscles

called intercostal muscles ('costals' are rib bones).

https://youtu.be/Mf8xTqfspp4
The diaphragm separates the contents of the thorax from the abdomen.
It is not flat, but a shallow dome shape, with a fibrous middle part forming the
'roof' of the dome, and muscular edges forming the walls.
The air passages of the lungs form a highly branching network.

This is why it is sometimes called the bronchial tree.

The walls of trachea and bronchi contain rings of gristle or
cartilage.

These support the airways and keep them open when we

breathe in.

They are rather like the rings in a vacuum cleaner hose -

without them the hose would squash flat when the cleaner
sucks air in.

This acts as lubrication, so that the surfaces of the lungs don't

stick to the inside of the chest wall when we breathe.
The inside of the thorax is separated from the lungs by two thin, moist membranes called the pleural
membranes.

They make up a continuous envelope around the lungs, forming an airtight seal.

Between the two membranes is a space called the pleural cavity, filled with a thin layer of liquid
called pleural fluid.
● https://youtu.be/mD9goLXYhYU
 KEEPING THE AIRWAYS CLEAN
The trachea and larger airways are lined with a layer of cells that have an important role
in keeping the airways clean.

Some cells in this lining secrete a sticky liquid called mucus, which traps particles of dirt
or bacteria that are breathed in.
Other cells are covered with tiny hair-like structures called cilia (Figure 3.4).
The cilia beat backwards and forwards, sweeping the mucus and trapped particles out
towards the mouth.

https://youtu.be/rgphaHmAC_A
In this way, dirt and bacteria are prevented
from entering the lungs, where they might
cause an infection.

As you will see, one of the effects of smoking

is that it destroys the cilia and stops this
protection mechanism from working properly.
VENTILATION OF THE LUNGS

Ventilation means moving air in and out of the lungs.

This requires a difference in air pressure - the air moves from a place where the
pressure is high to one where it is low.

Ventilation depends on the fact that the thorax is an airtight cavity.

When we breathe, we change the volume of our thorax, which alters the pressure
inside it.

This causes air to move in or out of the lungs.

https://youtu.be/Q6EJCPuqDHY
antagonistic muscle
There are two movements that bring about ventilation: those of the ribs and the
diaphragm.

If you put your hands on your chest and breathe in deeply, you can feel your ribs
move upwards and outwards.

They are moved by the intercostal muscles .

The outer (external) intercostals contract, pulling the ribs up.

At the same time, the muscles of the diaphragm contract, pulling the diaphragm
down into a more flattened shape.

Both these movements increase the volume of the chest and cause a slight drop
in pressure inside the thorax compared with the air outside.

Air then enters the lungs (inhalation).

The opposite happens when you breathe out deeply.

The external intercostals relax, and the internal intercostals contract, pulling the
ribs down and in.

At the same time, the diaphragm muscles relax and the diaphragm goes back to
its normal dome shape.

The volume of the thorax decreases, and the pressure in the thorax is raised
slightly above atmospheric pressure.

This time the difference in pressure forces air out of the lungs (Figure 3.6b).

Exhalation is helped by the fact that the lungs are elastic, so that they have a
tendency to collapse and empty like a balloon.
Key point
It is important that you remember the changes in volume and pressure during
ventilation.

If you have trouble understanding these, think of what happens when you use a
bicycle pump.

If you push the pump handle, the air in the pump is squashed, its pressure rises
and it is forced out of the pump.

If you pull on the handle, the air pressure inside the pump falls a little, and air is
drawn in from outside.

This is similar to what happens in the lungs. In exams, students sometimes talk
about the lungs forcing the air in and out - they don't!
GAS EXCHANGE IN THE ALVEOLI

You can tell what is happening during gas exchange if you compare the amounts
of different gases in atmospheric air with the air breathed out.

Gas Atmospheric air / % Exhaled air / %

nitrogen 78 79

oxygen 21 16

Carbon dioxide 0.04 4

Other gases (mainly argon) 1 1

Hint
Be careful when interpreting percentages!
The percentage of a gas in a mixture can vary, even if the actual amount of the gas
stays the same.
This is easiest to understand from an example.
Imagine you have a bottle containing a mixture of 20% oxygen and 80% nitrogen.
If you used a chemical to absorb all the oxygen in the bottle, the nitrogen left would
now be 100% of the gas in the bottle, despite the fact that the amount of nitrogen
would still be the same.
That is why the percentage of nitrogen in inhaled and exhaled air is slightly different.
Exhaled air is also warmer than atmospheric air, and is saturated with water
vapour.
The amount of water vapour in the atmosphere varies depending on weather
conditions.
Clearly, the lungs are absorbing oxygen
into the blood and removing carbon
dioxide from it.

This happens in the alveoli.

To do this efficiently, the alveoli must have

a structure which brings the air and blood
very close together, over a very large
surface area.
1. LARGE SURFACE AREA

There are enormous numbers of alveoli.

It has been calculated that the two lungs contain about

700,000,000 of these tiny air sacs, giving a total surface
area of 60 m2.

That's bigger than the floor area of an average

classroom!

Viewed through a high-powered microscope, the alveoli

look rather like bunches of grapes, and are covered with
tiny blood capillaries (Figure 3. 7)
● Total A= 60m2
● Number 7x108
● 60/7x108= 8.57x10-8 m2
2. THIN SURFACE
Deoxygenated blood is pumped from the heart to the lungs
and passes through the capillaries surrounding the alveoli.

The blood has come from the respiring tissues of the body,
where it has given up some of its oxygen to the cells, and
gained carbon dioxide.

Around the lungs, the blood is separated from the air inside
each alveolus by only two cell layers; the cells making up the
wall of the alveolus, and the capillary wall itself.

This is a distance of less than a thousandth of a millimetre.

Be careful - students sometimes write 'The alveolus has cell walls'.

This statement is not correct - a cell wall is part of a plant cell!

The correct way to describe the structure is: 'The alveolus has a wall made of
cells'.
Because the air in the alveolus has a higher concentration of oxygen than the
blood entering the capillary network, oxygen diffuses from the air, across the wall
of the alveolus and into the blood.

At the same time there is more carbon dioxide in the blood than there is in the air
in the lungs.

In Lung In Blood
> oxygen < oxygen
> carbon oxide
< Carbon dioxide
● This means that there is a diffusion gradient for carbon dioxide in the other
direction, so carbon dioxide diffuses the other way, out of the blood and into
the alveolus.
● The result is that the blood which leaves the capillaries and flows back to the
heart has gained oxygen and lost carbon dioxide.
● The heart then pumps the oxygenated blood around the body again, to supply
the respiring cells.
 EXTENSION WORK

3. MOIST LINING
The thin layer of fluid lining the inside of the alveoli comes
from the blood.

The capillaries and cells of the alveolar wall are 'leaky' and
the blood pressure pushes fluid out from the blood plasma
into the alveolus.

Oxygen dissolves in this moist surface before it passes

through the alveolar wall into the blood.
Activity 1
Practical: Comparing the carbon dioxide content of inhaled and exhaled
air ( https://youtu.be/zHg_S5M9_bM )

The apparatus in Figure 3.8 can be used to compare the amount of carbon dioxide
in inhaled and exhaled air.

A person breathes gently in and out through the middle tube.

Exhaled air passes out through one tube of indicator solution and inhaled air is
drawn in through the other tube.

If lime water is used, the limewater in the 'exhaled' tube will turn cloudy before the
limewater in the 'inhaled' tube. {If hydrogen carbonate indicator solution is used
instead, it changes from red to yellow.)
It is easy to show the effect of exercise on a person's breathing rate.
They sit quietly for five minutes, making sure that they are completely relaxed.
They then count the number of breaths they take in one minute, recording their results in a
table.
They wait a minute, and then count their breaths again, recording the result, and repeating if
necessary until they get a steady value for the 'resting rate'.
The person then carries out some vigorous exercise, such as running on the spot for three
minutes.
Immediately after they finish the exercise, they sit down and record the breathing rate as
before.
They then continue to record their breaths per minute, every minute, until they return to their
normal resting rate.
The table shows the results from an investigation into the breathing rate of two
girls, A and B, before and after exercise .

Time from start of Breathing rate/ breaths per minute

experiment (min)
A B

1 13 13

2 14 12

3 14 12

Rate after 3 min vigorous exercise

7 28 17

8 24 13

9 17 12

10 14 12
Plot a line graph of these results, using the same axes for both subjects.

Join the data points using straight lines, and leave a gap during the period of
exercise, when no readings were taken.

Why does breathing rate need to rise during exercise?

Explain as fully as possible.

Why does the rate not return to normal as soon as a subject finishes the exercise?

Describe the difference in the breathing rates of the two girls (A and B)after
exercise. Which girl is more fit? Explain your reasoning.
THE EFFECTS OF SMOKING

In order for the lungs to exchange gases properly, the air passages need
to be clear, the alveoli need to be free from dirt particles and bacteria, and
they must have as big a surface area as possible in contact with the
blood.

There is one habit that can upset all of these conditions - smoking.

Links between smoking and diseases of the lungs are now a proven fact.
Smoking is associated with lung cancer, bronchitis and emphysema.
It is also a major contributing factor to other conditions, such as coronary
heart disease and ulcers of the stomach and intestine.
Pregnant women who smoke are more likely to give birth to underweight
babies.
Coronary heart disease will be described in Chapter 5 after you have
studied the structure of the heart.
Here we will look at a number of other medical conditions that are caused
by smoking.
EFFECTS OF SMOKE ON THE LINING OF THE AIR PASSAGES

● You saw above how the lungs are kept

free of particles of dirt and bacteria by
the action of mucus and cilia.
● In the trachea and bronchi of a smoker,
the cilia are destroyed by the chemicals
in cigarette smoke.
● The reduced numbers of cilia mean that the mucus is not
swept away from the lungs, but remains to block the air
passages.
● This is made worse by the fact that the smoke irritates the
lining of the airways, stimulating the cells to secrete more
mucus.
● The sticky mucus blocking the airways is the source of
'smoker's cough'.
● Irritation of the bronchial tree, along with infections from
bacteria in the mucus, can cause the lung disease
bronchitis.
● Bronchitis blocks normal air flow, so the sufferer has
difficulty breathing properly.
EMPHYSEMA

● Emphysema is another lung disease that

kills about 20 000 people in Britain every
year.
● Smoking is the cause of one type of
emphysema. Smoke damages the walls of
the alveoli, which break down and fuse
together again, forming enlarged, irregular
air spaces.
● This greatly reduces the surface area for gas
exchange, which becomes very inefficient.
● The blood of a person with emphysema carries
less oxygen.
● In serious cases, this leads to the sufferer being
unable to carry out even mild exercise, such as
walking.
● Emphysema patients often have to have a supply
of oxygen nearby at all times (Figure 3.10).
● There is no cure for emphysema, and usually the
sufferer dies after a long and distressing illness
Lung Cancer
● Evidence of the link between smoking and lung cancer first appeared in the 1950s.
● In one study, a number of patients in hospital were given a series of questions
about their lifestyles.
● They were asked about their work, hobbies, housing and so on, including a
question about how many cigarettes they smoked.
● The same questionnaire was given to two groups of patients.
● The first group were all suffering from lung cancer.
● The second (Control) group were in hospital with various other illnesses, but not
lung cancer.
● To make it a fair comparison, the Control patients were matched with the lung
cancer patients for sex, age and so on.
● When the results were compared, one difference stood out (Table 3.2).
● A greater proportion of the lung cancer patients were smokers than in the
Control patients.
● There seemed to be a connection between smoking and getting lung cancer.

Percentage of patients Percentage of patients

who who smoked more
were non·smokers than
15 cigarettes a day
lung cancer patients 0.5 25

Control patients (with 4.5 13

illnesses
other than lung cancer)
● Although the results didn't prove that smoking caused lung cancer, there was
a statistically significant link between smoking and the disease: this is called a
'correlation'.
● Over 20 similar investigations in nine countries have revealed the same
findings.
● In 1962 a report called 'Smoking and health' was published by the Royal
College of Physicians of London, which warned the public about the dangers
of smoking.
● Not surprisingly, the first people to take the findings seriously were doctors,
many of whom stopped smoking.
● This was reflected in their death rates from lung cancer.
● In ten years, while deaths among the general male population had risen by
7%, the deaths of male doctors from the disease had fallen by 38%.
● Cigarette smoke contains a strongly addictive drug -
nicotine.
● Smoke contains over 7000 chemicals, including; carbon
monoxide, arsenic, ammonia, formaldehyde, cyanide,
benzene, and toluene.
● More than 60 of the chemicals are known to cause cancer.
● These chemicals are called carcinogens, and are contained
in the tar that collects in a smoker's lungs.
● Cancer happens when cells mutate and start to divide
uncontrollably, forming a tumour (Figure 3.11).
● If a lung cancer patient is lucky, they may have the tumour removed by
an operation before the cancer cells spread to other tissues of the body.
● Unfortunately tumours in the lungs usually cause no pain, so they are
not discovered until it is too late - it may be inoperable, or tumours may
have developed elsewhere.
● If you smoke you are not bound to get lung cancer, but the risk that you will
get it is much greater.
● In fact, the more cigarettes you smoke, the more the risk increases (Figure
3.12).
● The obvious thing to do is not to start smoking.
● However, if you are a smoker, giving up the habit soon improves your chance
of survival (Figure 3.14).
● After a few years, the likelihood of your dying from a smoking-related
disease is almost back to the level of a non-smoker.
CARBON MONOXIDE IN SMOKE

● One of the harmful chemicals in cigarette

smoke is the poisonous gas carbon monoxide.
● When this gas is breathed in with the smoke, it
enters the bloodstream and interferes with the
ability of the blood to carry oxygen.
● Oxygen is carried around in the blood in the
red blood cells, attached to a chemical called
haemoglobin (see Chapter 5).
● Carbon monoxide can combine with the haemoglobin much more tightly
than oxygen can, forming a compound called carboxyhaemoglobin.
● The haemoglobin will combine with carbon monoxide in preference to
oxygen.
● When this happens, the blood carries much less oxygen around the
body.
● Carbon monoxide from smoking is also a major cause of heart disease
● If a pregnant woman smokes, she will be depriving her unborn fetus of
oxygen (Figure 3.14).
● This has an effect on its growth and development, and leads to the mass of
the baby at birth being lower, on average, than the mass of babies born to
non-smokers.
SOME SMOKING STATISTICS
● It is estimated that there are over 1 billion smokers worldwide.
● In 2014 they consumed 5.8 trillion cigarettes.
● Every year nearly 6 million people are killed by tobacco-related
illnesses.
● If the current trend continues, by 2030 this will rise to 8 million deaths
per year and 80% of these premature deaths will be in developing
countries.
● Smoking causes almost 80% of deaths from lung cancer, 80% of deaths
from bronchitis and emphysema, and 14% of deaths from heart disease.
● More than a quarter of all cancer deaths are attributable to smoking.
● These include cancer of the lung, mouth, lip, throat, bladder, kidney,
pancreas, stomach, liver and cervix.
● While demand for tobacco has steadily fallen in developed countries like the
UK, cigarette consumption is being increasingly concentrated in the
developing world
● 9.6 million adults in the UK smoke cigarettes, 20% of men and 17% of
women. However, 22% of women and 30% of men in the UK are now ex-
smokers. Surveys show that about two-thirds of current smokers would like
to stop smoking
● It is estimated that worldwide, 31 % of men and 8% of women are
smokers.
● Consumption varies widely between different countries, but generally the
areas of the world where there has been no change in consumption, or
an increase, are southern and central Asia, Eastern Europe and Africa.
● In China alone there are about 350 million smokers, who consume about
one-third of all cigarettes smoked worldwide.
● Large multinational tobacco companies have long been keen to enter
the Chinese market.
● In China there are over a million deaths a year from smoking-related
diseases. This figure is expected to double by 2025.
● In developing countries, smoking has a greater economic impact.
Poorer smokers spend significant amounts of their income on
cigarettes rather than necessities like food, healthcare and education.
● Tobacco farming uses up land that could be used for growing food
crops.
● In 2012, 7.5 million tonnes of tobacco leaf were grown on almost 4.3
million hectares of land (an area larger than Switzerland).
GIVING UP SMOKING

● Most smokers admit that they would like to find a way to give up the habit.
● The trouble is that the nicotine in tobacco is a very addictive drug, and causes
withdrawal symptoms when people stop smoking.
● These include cravings for a cigarette, restlessness and a tendency to put on
weight (nicotine depresses the appetite).
● There are various ways that smokers can be helped to give up their habit.
● One method is 'vaping', which involves inhaling a vapour containing nicotine
from an electronic cigarette ore-cigarette (Figure 3.15).
● Other methods use nicotine patches (Figure 3.16) or nicotine chewing gum.
● They all work in a similar way, providing the smoker with a source of nicotine
without the harmful tar from cigarettes.
● The nicotine is absorbed by the body and reduces the craving for a cigarette.
● Gradually, the patient reduces the nicotine dose until they are weaned off the
habit.
● There are several other ways that people use to help them give up smoking,
including the use of drugs that reduce withdrawal symptoms, acupuncture and
even hypnotism.
● You could carry out an Internet search to find out about the different methods
people use to help them give up smoking.
● Which methods have the highest success rate?
● Is there any evidence that suggests e-cigarettes are not safe?