MODULE-2

RESPIRATORY SYSTEM: RESPIRATION, COMPONENTS OF

RESPIRATORY SYSTEM, MECHANICS OF BREATHING,
REGULATION AND CONTROL OF BREATHING,
VENTILATION, DIFFUSION, PERFUSION, ACID-BASE
REGULATION
Lungs as Purification System
Respiration
• The goals of respiration are to provide
oxygen to the tissues and to remove carbon
dioxide. To achieve these goals, respiration
can be divided into four major functions:
(1) Pulmonary ventilation, which means the
inflow and outflow of air between the
atmosphere and the lung alveoli
(2) Diffusion of oxygen and carbon dioxide
between the alveoli and the blood
(3) Transport of oxygen and carbon dioxide in
the blood and body fluids to and fro from the
body’s tissue cells
(4) Regulation of ventilation and other facets
of respiration.
Respiratory System
• In addition to gas exchange, your respiratory system performs other
roles important to breathing.
• These include:
• Bringing air to the proper body temperature and moisturizing it to the
right humidity level.
• Protecting your body from harmful substances. This is done by
coughing, sneezing, filtering, or swallowing them.
• Supporting your sense of smell.
Architecture

• The primary function of the lungs is gas exchange. However, the lungs
perform several important non-respiratory functions that are vital for normal
physiology.
• The lung, with its unique ability to distend and recruit pulmonary vasculature,
acts as a reservoir of blood, fine-tuning preload to the left heart to optimize
cardiac output.

 The lung acts as a filter against endogenous and exogenous emboli,

preventing them from accessing systemic circulation.
 Pulmonary epithelium forms the first line of defense against inhaled particles.
 Pulmonary endothelial cells are responsible for the uptake, metabolism, and
biotransformation of several exogenous and endogenous substances.
 Pulmonary metabolic capacity is easily saturated, but pulmonary endothelial
binding of some drugs alters their pharmacokinetics.
Architecture of Lungs
Architecture
• The architecture of the lung is designed to maximize surface area for efficient
gas exchange.
• The lung is divided into several parts, including the trachea, bronchi,
bronchioles, and alveoli.
• Trachea: The trachea is the main airway that leads from the larynx (voice box)
to the lungs. It is lined with cilia and mucus-secreting glands that help to filter
out harmful substances and trap them in the mucus.
• Bronchi: The trachea branches into two main bronchi, one for each lung. The
bronchi are larger airways that continue to branch into smaller airways called
bronchioles.
• Bronchioles: The bronchioles are smaller airways that eventually lead to the
alveoli. They are surrounded by tiny air sacs called alveoli, which are the sites of
gas exchange.
• Alveoli: The alveoli are tiny air sacs that are lined with a network of capillaries.
This close proximity of the alveoli and capillaries allows for efficient diffusion
of oxygen and carbon dioxide between the air in the alveoli and the bloodstream.
Function of Lungs
• The lung purifies air by removing harmful substances and adding oxygen to the
bloodstream.
• The process of purifying air in the lungs can be described as follows:

• Filtration: The nose and mouth serve as a first line of defense against harmful
substances in the air, such as dust, dirt, and bacteria. The tiny hairs in the nose, called
cilia, and the mucus produced by the respiratory system trap these substances and
prevent them from entering the lungs.
• Moisturization: The air is also humidified as it passes over the moist lining of the
respiratory tract, which helps to keep the airways moist and prevent them from drying
out.
• Gas Exchange: Once the air reaches the alveoli, the gas exchange process occurs,
where oxygen diffuses across the thin alveolar and capillary walls into the
bloodstream, and carbon dioxide diffuses in the opposite direction, from the
bloodstream into the alveoli to be exhaled.
• This process ensures that the bloodstream is supplied with fresh, oxygen-rich air,
while waste carbon dioxide is removed from the body
COMPONENTS OF RESPIRATORY
SYSTEM
• The respiratory system is made up of the organs included in the exchange of oxygen and
carbon dioxide. It is divided into two areas: the upper respiratory tract and the lower
respiratory tract.
• The upper respiratory tract is made up of the:
1. Nose
2. Nasal cavity
3. Mouth
4. Sinuses
5. Throat (pharynx)
6. Voice box (Larynx)
7. Windpipe (trachea)
• The lower respiratory tract is made up of the:
1. Lungs
2. Large airways (bronchi)
3. Small airways (bronchioles)
4. Air sacs (alveoli)
Lungs
• The lungs take in oxygen because the body's cells need oxygen to live and
carry out their normal functions. The lungs also get rid of carbon dioxide,
a waste product of the cells.
• The lungs are a pair of cone-shaped organs made up of spongy, pinkish-
grey tissue. They take up most of the space in the chest (thorax).
• The lungs are surrounded by a membrane (pleura).
• The lungs are separated from each other by the mediastinum, an area that
contains the:
• Heart and its large vessels
• Trachea
• Esophagus
• Thymus gland
• Lymph nodes
Components of Respiratory system
Continued..
• The right lung has three sections, called lobes. The left lung has two
lobes. When you breathe in:
• Air enters your body through your nose or mouth.
• Air then travels down the throat through the larynx and trachea.
• Air goes into the lungs through tubes called main-stem bronchi.
• One main-stem bronchus leads to the right lung and one to the left
lung:
• In the lungs, the main-stem bronchi divide into smaller bronchi.
• The smaller bronchi divide into even smaller tubes (bronchioles).
• Bronchioles end in tiny air sacs (alveoli) where the exchange of
oxygen and carbon dioxide occurs.
• You then breathe out carbon dioxide.
Mechanics of Breathing
• Pulmonary ventilation is commonly referred to as breathing. It is
the process of air flowing into the lungs during inspiration
(inhalation) and out of the lungs during expiration (exhalation). Air
flows because of pressure differences between the atmosphere and the
gases inside the lungs.
• Air, like other gases, flows from a region with higher pressure to a
region with lower pressure. Muscular breathing movements and recoil
of elastic tissues create the changes in pressure that result in
ventilation. Pulmonary ventilation involves three different pressures:
• Atmospheric pressure
• Intraalveolar (intrapulmonary) pressure
• Intrapleural pressure
Different Types of Pressures
• Atmospheric pressure is the pressure of the air outside the body.
Intraalveolar pressure is the pressure inside the alveoli of the
lungs. Intrapleural pressure is the pressure within the pleural cavity. These
three pressures are responsible for pulmonary ventilation.
Inspiration
• Inspiration (inhalation) is the process of taking air into the lungs. It is the
active phase of ventilation because it is the result of muscle contraction.
During inspiration, the diaphragm contracts and the thoracic cavity increases
in volume. This decreases the intraalveolar pressure so that air flows into the
lungs. Inspiration draws air into the lungs.
Expiration
• Expiration (exhalation) is the process of letting air out of the lungs during the
breathing cycle. During expiration, the relaxation of the diaphragm and
elastic recoil of tissue decreases the thoracic volume and increases the
intraalveolar pressure. Expiration pushes air out of the lungs.
Mechanics Of Breathing
• The lungs can be expanded and contracted in two ways:
(1) by downward and upward movement of the diaphragm to lengthen or
shorten the chest cavity, and
(2) by elevation and depression of the ribs to increase and decrease the
anteroposterior diameter of the chest cavity.
• Normal quiet breathing is accomplished almost entirely by the first method,
that is, by movement of the diaphragm.
• During inspiration, contraction of the diaphragm pulls the lower surfaces of the
lungs downward. Then, during expiration, the diaphragm simply relaxes, and
the elastic recoil of the lungs, chest wall, and abdominal structures compresses
the lungs and expels the air.
• During heavy breathing, however, the elastic forces are not powerful enough to
cause the necessary rapid expiration, so the extra force is achieved mainly by
contraction of the abdominal muscles, which pushes the abdominal contents
upward against the bottom of the diaphragm, thereby compressing the lungs.
Respiratory Volumes and Capacities
• Under normal conditions, the average adult takes 12 to 15 breaths a
minute. A breath is one complete respiratory cycle that consists of one
inspiration and one expiration.
• An instrument called a spirometer is used to measure the volume of
air that moves into and out of the lungs, and the process of taking the
measurements is called spirometry. Respiratory (pulmonary) volumes
are an important aspect of pulmonary function testing because they
can provide information about the physical condition of the lungs.
• Respiratory capacity (pulmonary capacity) is the sum of two or more
volumes.
• Factors such as age, sex, body build, and physical conditioning have
an influence on lung volumes and capacities. Lungs usually reach
their maximum in capacity in early adulthood and decline with age
after that.
Spirometer
Normal Predicted percentage should be between 70% and 85% Percentages of 45% to 60%

A decrease in the volume of air exhaled or a decrease in the flow rate of the exhaled air can indicate
a restriction in the airways, which can be a sign of a lung condition such as asthma or COPD.
Regulation And Control Of
Breathing
• Human beings have a significant ability to maintain the respiratory
rhythm to suit the body needs. This is called the regulation of
respiration.
• The regulation of respiration is mainly dependent on the
interactions of three components of the respiratory system. These
are as follows:
• Control centres
• These are present in the brain stem (pons varolii and the medulla
oblongata) and are responsible for the automaticity of breathing.
Input for these centres comes from the higher brain centres to
produce the required voluntary breathing efforts.
• Sensors
• These include chemoreceptors and sensory receptors.
Continued..
• The chemoreceptors respond to changes in the blood carbon
dioxide, oxygen, and hydrogen ion concentration by sending
impulses to the control centres. This will alter the breathing
pattern by affecting the effector organs.
• The sensory receptors are located in the upper and lower
airways, the lungs, and the muscles of respiration.
• Effector organs
• This includes the respiratory muscles like the diaphragm, the
rib cage muscles (external intercostal muscles and internal
intercostal muscles) and the abdominal muscles.
Control and Regulation of Breathing
Summary
Types of Respiratory Regulation

• There are two types of respiratory regulations as follows:

1. Neural regulation
2. Chemical regulation
• The respiratory rhythm is regulated by respiratory centres, which are composed of
group neurons located in the hind part of the brain. The rate and depth of breathing
are regulated by these respiratory centres. There are two regions in the brain which
mainly regulate respiration. These are as follows:
• Medulla oblongata
• Pons Varolii
• Medulla oblongata
• It is located in the hindbrain. It can regulate both expiration and inspiration
depending on the neurons activated. It regulates respiratory rhythm according to the
requirements of the body. Medulla oblongata has two respiratory centres as follows:
• Dorsal respiratory group (DRG)
• Ventral respiratory group (VRG)
Continued..
• Dorsal respiratory group (DRG) or inspiratory group (IG)
• It is located in the dorsal portion of the medulla oblongata. This group of neurons
mainly causes inspiration by stimulating the muscles of the diaphragm to flatten and
the external intercostal muscles to raise the ribs. This group mainly maintains
respiratory rhythm and respiratory rate.
• As DNG regulates the process of inspiration, it is also called the inspiratory centre or
respiratory rhythm centre.
• Ventral respiratory group (VRG) or expiratory group (EG)
• It is located in the ventrolateral part of the medulla oblongata. It sends signals for both
inspiration and expiration. To regulate inspiration it sends signals to diaphragm and
external intercostal muscles. To regulate expiration it sends signals to internal
intercostal muscles and muscles of the abdominal wall. It is mainly responsible for
regulation of forceful expiration and is also known as expiratory centre.
• Pons respiratory centres
• It is present in the pons varolii of the hindbrain. It regulates the respiratory rhythm
centre.
Continued…
• There are two respiratory centres present in the pons Varolii as follows:
• Pneumotaxic centre
• Apneustic centre
• The apneustic centre lies in the lower part of the pons Varolii and sends signals for
inspiration for deep and long breaths. It is responsible for exciting the inspiratory
centre. Stimulation of this centre results in a gradual increase in the rate of contraction
of the inspiratory muscles. It increases tidal volume. It normally works in coordination
with the pneumotaxic centre.
• The pneumotaxic centre is located in the dorsal part of the pons Varolii. It can slow
down and reduce the functions of the respiratory rhythm centre. Signals from this
centre can decrease the duration of inspiration which in turn will alter the respiratory
rate. It works through the medullary centres. The pneumotaxic centre sends signals to
inhibit inspiration which allows it to specifically control the respiratory rate. It reduces
the activity of the phrenic nerve and inhibits the signals of the apneustic centre too. It
decreases the overall tidal volume. The apneustic and pneumotaxic centres are
antagonistic in function (work against each other together), thereby controlling the
respiratory rate.
 Chemical Regulation
• Centres associated with chemical regulation of
respiration are Central chemoreceptors and Peripheral
chemoreceptors.
• Central chemoreceptors are present in the medullary
oblongata region around the inspiratory centre. This area
is sensitive to pCO2 and H+ ions concentration. Hence an
increase in pCO2 and H+ ions activate these receptors,
which in turn activate the respiratory rhythm centre or
the inspiratory centre. Activated rhythm centres alter the
rate of respiration or inspiration. This will make
necessary adjustments in the respiratory process by
which these substances will be eliminated.
• Peripheral chemoreceptors include the Aortic bodies
and Carotid bodies.
• These are activated by an increase in pCO2 and H+ ions
in arterial blood. These activate the inspiratory centre or
respiratory rhythm centre to reverse the situation.
Transfer of Oxygen
• Three processes are essential for the transfer of oxygen from the
outside air to the blood flowing through the lungs: ventilation,
diffusion, and perfusion.
• Ventilation is the process by which air moves in and out of the lungs.
• Diffusion is the spontaneous movement of gases, without the use of
any energy or effort by the body, between the alveoli and the
capillaries in the lungs.
• Perfusion is the process by which the cardiovascular system pumps
blood throughout the lungs.
Diffusion
• After the alveoli are ventilated with fresh air, the next step in the
respiratory process is the diffusion of oxygen from the alveoli into the
pulmonary blood and the diffusion of carbon dioxide in the opposite
direction, out of the blood.
• The process of diffusion is simply the random motion of molecules
intertwining their way in all directions through the respiratory
membrane and adjacent fluids.
• Diffusion involves the movement of a substance in a solution (liquid
or air) from higher concentration areas to lower concentration
areas. This process of diffusion is dependent on the characteristics of
each individual gas, the rate of perfusion and the integrity of the
alveolar-capillary membrane.
Diffusion of Gases Through Tissues

• The gases that are of respiratory importance are all highly soluble in
lipids and, consequently, are highly soluble in cell membranes.
• Because of this, the major limitation to the movement of gases in
tissues is the rate at which the gases can diffuse through the tissue
water instead of through the cell membranes.
• Therefore, diffusion of gases through the tissues, including through
the respiratory membrane is almost equal to the diffusion of gases in
water, as given in the preceding list. Oxygen 1.0

Carbon dioxide 20.3

Carbon monoxide 0.81

Nitrogen 0.53

Helium 0.95
Perfusion
• The second component of respiration is perfusion. This process
involves the circulation of blood through the capillaries, which
facilitates nutrient exchange.
• External respiration requires adequate delivery of blood to the
capillary beds of the lungs via the pulmonary circulation. In the
absence of this blood supply, there will be no transport mechanism for
O2.
Acid-Base Regulation
• The respiratory system contributes to the balance of acids and bases in the body by
regulating the blood levels of carbonic acid.
• CO2 in the blood readily reacts with water to form carbonic acid, and the levels of
CO2 and carbonic acid in the blood are in equilibrium.
• When the CO2 level in the blood rises (as it does when you hold your breath), the
excess CO2 reacts with water to form additional carbonic acid, lowering blood pH.
• Increasing the rate and/or depth of respiration (which you might feel the “urge” to
do after holding your breath) allows you to exhale more CO2. The loss of CO2 from
the body reduces blood levels of carbonic acid and thereby adjusts the pH upward,
toward normal levels.
• As you might have surmised, this process also works in the opposite direction.
Excessive deep and rapid breathing (as in hyperventilation) rids the blood of
CO2 and reduces the level of carbonic acid, making the blood too alkaline.
• This brief alkalosis can be remedied by rebreathing air that has been exhaled into a
paper bag. Rebreathing exhaled air will rapidly bring blood pH down toward
normal.
Renal Regulation of Acid-
Base Balance
• The renal regulation of the body’s acid-base balance addresses the metabolic
component of the buffering system.
• Whereas the respiratory system (together with breathing centres in the
brain) controls the blood levels of carbonic acid by controlling the
exhalation of CO2, the renal system controls the blood levels of bicarbonate.
• A decrease in blood bicarbonate can result from the inhibition of carbonic
anhydrase by certain diuretics or from excessive bicarbonate loss due to
diarrhoea.
• Blood bicarbonate levels are also typically lower in people who have
Addison’s disease (chronic adrenal insufficiency), in which aldosterone
levels are reduced, and in people who have renal damage, such as chronic
nephritis.
• Finally, low bicarbonate blood levels can result from elevated levels of
ketones (common in unmanaged diabetes mellitus), which bind bicarbonate
in the filtrate and prevent its conservation.
Acid-base Regulation
• Bicarbonate ions, HCO3–, found in the filtrate, are essential to the bicarbonate buffer
system, yet the cells of the tubule are not permeable to bicarbonate ions. The steps
involved in supplying bicarbonate ions to the system are summarized below:
• Step 1: Sodium ions are reabsorbed from the filtrate in exchange for H+ by an
antiport mechanism in the apical membranes of cells lining the renal tubule.
• Step 2: The cells produce bicarbonate ions that can be shunted to peritubular
capillaries.
• Step 3: When CO2 is available, the reaction is driven to the formation of carbonic
acid, which dissociates to form a bicarbonate ion and a hydrogen ion.
• Step 4: The bicarbonate ion passes into the peritubular capillaries and returns to the
blood. The hydrogen ion is secreted into the filtrate, where it can become part of new
water molecules and be reabsorbed as such, or removed in the urine.
• It is also possible that salts in the filtrate, such as sulfates, phosphates, or ammonia,
will capture hydrogen ions.
• If this occurs, the hydrogen ions will not be available to combine with bicarbonate
ions and produce CO2. In such cases, bicarbonate ions are not conserved from the
filtrate to the blood, which will also contribute to a pH imbalance and acidosis.
Ventilator
• Ventilators are medical devices used to assist
or control breathing in individuals who are
unable to breathe adequately on their own.

• There are several different types of

ventilators, including volume-controlled
ventilators, pressure-controlled
ventilators, and bilevel positive airway
pressure (BiPAP) devices.

• The type of ventilator used depends on the

patient's individual needs and the type of
respiratory failure being treated.
Heart Lung Machine

• A heart-lung machine is an apparatus that does the work both of

the heart (i.e., pumps blood) and the lungs (i.e., oxygenates the
blood), for example, during open-heart surgery .
• The basic function of the machine is to oxygenate the body's
venous supply of blood and then to pump it back into the arterial
system.
• Blood returning to the heart is diverted through the machine
before returning to the arterial circulation.
• Some of the more important components of these machines
include pumps, oxygenators, temperature regulators, and filters.
• The heart-lung machine also provides intracardiac suction,
filtration, and temperature control.
 Artificial Lungs
• Artificial lungs are devices designed to
mimic the function of the natural respiratory
system.
• They are used to support patients with acute
respiratory distress syndrome (ARDS) or
acute lung injury (ALI) and to help the
patient's own lungs recover and heal.
Types
• There are two main types of artificial lungs:
• Membrane Oxygenators: These are
devices that use a semipermeable membrane
to transfer oxygen and carbon dioxide
between the blood and the air. The blood is
pumped through the membrane, where it
comes into contact with air, allowing for the
exchange of gases.
Extracorporeal Lung Assist
Devices
• These devices work by removing carbon
dioxide from the blood and adding oxygen,
allowing the patient's natural lungs to rest and
heal.
• One example of an extracorporeal lung assist
device is the extracorporeal membrane
oxygenation (ECMO) machine, which is used
to treat patients with severe respiratory
failure.
• ECMO works by removing carbon dioxide
from the blood and adding oxygen, and it can
be used as a bridge to recovery or as a bridge
to lung transplantation.
The End