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Chapter Opener 21
In this chapter, you will learn that
The respiratory system supplies cells with oxygen and eliminates carbon dioxide
then exploring
by first examining
Part 2 Respiratory Physiology
Part 1 Functional Anatomy
and then exploring
by asking
looking closer at
21.1 The upper respiratory
21.4 What causes air to
21.8 Control of
system
move in and out of the
lungs?
respiration
21.2 The lower respiratory
system
and
21.5 How do we assess
21.10 What happens
21.3 The lungs and pleurae
21.6 How do gases
move between the lungs,
blood, and tissues?
and
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altitude
ventilation?
includes
The cardiovascular
system Ch. 16–18
21.9 Exercise and high
transported
through
21.7 How does blood
carry oxygen and
carbon dioxide?
when things go wrong?
Figure 21.1 The major respiratory organs in relation to surrounding structures.
Nasal cavity
Nostril
Oral cavity
Pharynx
Larynx
Trachea
Carina of
trachea
Right main
(primary)
bronchus
Left main
(primary)
bronchus
Left lung
Diaphragm
Right lung
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Figure 21.3a The nasal cavity.
Posterior
nasal
aperture
Sphenoidal
sinus
Cribriform
plate of
ethmoid bone
Frontal sinus
Nasal cavity
• Nasal conchae
(superior, middle
and inferior)
• Nasal meatuses
(superior, middle,
and inferior)
• Nasal vestibule
• Nostril
Uvula
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Soft
palate
Tongue
Hard
palate
Figure 21.3b The nasal cavity.
Olfactory
epithelium
Olfactory
nerves
Nasal cavity
• Nasal conchae
(superior, middle
and inferior)
• Nasal meatuses
(superior, middle,
and inferior)
Tubal tonsil
Opening of
pharyngotympanic
(auditory) tube
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Uvula
Soft
palate
Hard
palate
Nasal
vestibule
Figure 21.4a The pharynx, larynx, and upper trachea.
Nasopharynx
Oropharynx
Laryngopharynx
Regions of the pharynx
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Figure 21.4b The pharynx, larynx, and upper trachea.
Posterior nasal
aperture
Nasopharynx
• Pharyngeal tonsil
• Opening of
pharyngotympanic
tube
Oropharynx
• Palatine tonsil
• Isthmus of the
fauces
Hard palate
Soft palate
Tongue
Lingual tonsil
Laryngopharynx
Esophagus
Trachea
Larynx
• Epiglottis
• Vestibular fold
• Thyroid cartilage
• Vocal fold
• Cricoid cartilage
Thyroid gland
(b) Structures of the pharynx and larynx
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Hyoid bone
Figure 21.5 The larynx.
Epiglottis
Thyrohyoid
membrane
Body of hyoid bone
Thyroid cartilage
Laryngeal prominence
(Adam’s apple)
Cricothyroid ligament
Cricoid cartilage
Sternal head
Sternocleidomastoid
Cricotracheal ligament
Clavicular head
Clavicle
Tracheal
cartilages
Jugular notch
Surface view
Anterior view
Epiglottis
Hyoid
bone
Thyrohyoid
membrane
Cuneiform cartilage
Corniculate cartilage
Thyroid
cartilage
Arytenoid cartilage
Arytenoid muscle
Cricoid cartilage
Glottis
Thyrohyoid membrane
Fatty pad
Vestibular fold
(false vocal cord)
Thyroid cartilage
Vocal fold
(true vocal cord)
Cricothyroid ligament
Tracheal cartilages
Photograph of cartilaginous framework of the larynx,
posterior view
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Body of hyoid bone
Cricotracheal ligament
Sagittal section (anterior on the right)
Figure 21.5b The larynx.
Epiglottis
Thyrohyoid
membrane
Body of hyoid bone
Thyroid cartilage
Laryngeal prominence
(Adam’s apple)
Cricothyroid ligament
Cricoid cartilage
Cricotracheal ligament
Tracheal
cartilages
Anterior view
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Figure 21.5c The larynx.
Epiglottis
Hyoid
bone
Thyrohyoid
membrane
Corniculate cartilage
Thyroid
cartilage
Arytenoid cartilage
Cricoid cartilage
Glottis
Tracheal cartilages
Photograph of cartilaginous framework of the larynx,
posterior view
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Figure 21.5d The larynx.
Epiglottis
Body of hyoid bone
Thyrohyoid
membrane
Thyrohyoid membrane
Cuneiform cartilage
Corniculate cartilage
Fatty pad
Arytenoid cartilage
Vestibular fold
(false vocal cord)
Arytenoid muscle
Thyroid cartilage
Cricoid cartilage
Vocal fold
(true vocal cord)
Cricothyroid ligament
Tracheal cartilages
Cricotracheal ligament
Sagittal section (anterior on the right)
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Figure 21.6 Movements of the vocal folds.
Epiglottis
Vestibular fold (false vocal cord)
Vocal fold (true vocal cord)
Glottis
Inner lining of trachea
Cuneiform cartilage
Corniculate cartilage
Vocal folds in closed position;
closed glottis
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Vocal folds in open position;
open glottis
Figure 21.7a Tissue composition of the tracheal wall.
Posterior
Esophagus
Trachealis
Mucosa
Submucosa
Lumen of
trachea
Seromucous gland
in submucosa
Hyaline cartilage
Adventitia
Anterior
Cross section
of the trachea
and esophagus
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Figure 21.7b Tissue composition of the tracheal wall.
Goblet cell
Mucosa
• Pseudostratified
ciliated columnar
epithelium
• Lamina propria
(connective tissue)
Submucosa
Seromucous gland
in submucosa
Hyaline cartilage
Photomicrograph of the
tracheal wall (320 )
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Figure 21.7c Tissue composition of the tracheal wall.
Scanning electron micrograph of cilia
in the trachea (2500)
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Hyaline Cartilage forms C-rings stabilizing the Trachea
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Figure 21.8 Conducting zone passages.
Trachea
Superior lobe
of left lung
Left main
(primary)
bronchus
Superior lobe
of right lung
Lobar (secondary)
bronchus
Middle lobe
of right lung
Segmental
(tertiary)
bronchus
Inferior lobe
of right lung
Inferior lobe
of left lung
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Figure 21.12 A cast of the bronchial tree.
Right lung
Right
superior
lobe (3
segments)
Left lung
Left superior
lobe
(4 segments)
Right
middle
lobe (2
segments)
Right
inferior lobe
(5 segments)
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Left inferior
lobe
(5 segments)
Figure 21.9a Respiratory zone structures.
Alveoli
Alveolar duct
Respiratory
bronchioles
Terminal
bronchiole
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Alveolar duct
Alveolar
sac
Figure 21.9b Respiratory zone structures.
Respiratory
bronchiole
Alveolar
duct
Alveoli
Alveolar
sac
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Alveolar
pores
Figure 21.10 Alveoli and the respiratory membrane.
Terminal bronchiole
Respiratory bronchiole
Smooth
muscle
Elastic
fibers
Alveolus
Capillaries
Diagrammatic view of capillary-alveoli relationships
Scanning electron micrograph of pulmonary
capillary casts (300)
Red blood cell
Nucleus of type I
alveolar cell
Alveolar pores
Capillary
O2
Capillary
CO2
Macrophage
Alveolus
Alveolus
Endothelial cell nucleus
Alveolar epithelium
Respiratory
membrane
Fused basement membranes
of alveolar epithelium and
capillary endothelium
Capillary endothelium
Alveoli (gas-filled
air spaces)
Red blood cell
in capillary
Type II alveolar cell
(secretes surfactant)
Detailed anatomy of the respiratory membrane
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Type I
alveolar cell
Surfactant is secreted by Type II Alveolar Cells and lubricates the alveolar surface
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Figure 21.10a Alveoli and the respiratory membrane.
Terminal bronchiole
Respiratory bronchiole
Smooth
muscle
Elastic
fibers
Alveolus
Capillaries
Diagrammatic view of capillary-alveoli relationships
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Figure 21.10c Alveoli and the respiratory membrane.
Red blood cell
Nucleus of type I
alveolar cell
Alveolar pores
Capillary
O2
Capillary
CO2
Macrophage
Alveolus
Alveolus
Endothelial cell nucleus
Alveolar epithelium
Respiratory
membrane
Fused basement membranes
of alveolar epithelium and
capillary endothelium
Capillary endothelium
Alveoli (gas-filled
air spaces)
Red blood cell
in capillary
Type II alveolar cell
(secretes surfactant)
Detailed anatomy of the respiratory membrane
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Type I
alveolar cell
Acute Respiratory Distress Syndrome (ARDS)
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Figure 21.11a Anatomical relationships of organs in the thoracic cavity.
Intercostal muscle
Rib
Parietal pleura
Pleural cavity
Visceral pleura
Lung
Trachea
Thymus
Apex of lung
Right superior lobe
Horizontal fissure
Right middle lobe
Oblique fissure
Left
superior lobe
Oblique
fissure
Left inferior
lobe
Right inferior lobe
Heart
(in mediastinum)
Diaphragm
Base of lung
Cardiac notch
Anterior view. The lungs flank mediastinal structures laterally.
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Figure 21.11b Anatomical relationships of organs in the thoracic cavity.
Apex of lung
Pulmonary
artery
Left
superior lobe
Oblique
fissure
Left inferior
lobe
Hilum of lung
Aortic
impression
Left main
bronchus
Pulmonary
vein
Cardiac
impression
Oblique
fissure
Lobules
Photograph of medial view of the left lung.
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Figure 21.11c Anatomical relationships of organs in the thoracic cavity.
Vertebra
Posterior
Esophagus
(in mediastinum)
Root of lung
at hilum
• Left main bronchus
Right lung
• Left pulmonary artery
Parietal pleura
• Left pulmonary vein
Visceral pleura
Left lung
Pleural cavity
Thoracic wall
Pulmonary trunk
Pericardial
membranes
Heart (in mediastinum)
Anterior mediastinum
Sternum
Anterior
Transverse section through the thorax, viewed from above. Lungs, pleural
membranes, and major organs in the mediastinum are shown.
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Figure 21.12 A cast of the bronchial tree.
Right lung
Right
superior
lobe (3
segments)
Left lung
Left superior
lobe
(4 segments)
Right
middle
lobe (2
segments)
Right
inferior lobe
(5 segments)
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Left inferior
lobe
(5 segments)
Figure 21.13 Intrapulmonary and intrapleural pressure relationships.
Atmospheric pressure (Patm)
0 mm Hg (760 mm Hg)
Parietal pleura
Thoracic
wall
Visceral pleura
Pleural cavity
4
Transpulmonary
pressure
4 mm Hg
(the difference
between 0 mm Hg
and 4 mm Hg)
0
Lung
Diaphragm
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Intrapulmonary
pressure (Ppul)
0 mm Hg
(760 mm Hg)
Intrapleural
pressure (Pip)
4 mm Hg
(756 mm Hg)
Figure 21.14 Pneumothorax.
Ruptured visceral pleura
(often spontaneous)
Punctured parietal pleura
(e.g., knife wound)
Parietal pleura
Visceral pleura
Pleural cavity
(Intrapleural pressure
 4 mm Hg)
0
4
0
Intrapulmonary
pressure (0 mm Hg)
4
0
4
0
4
Atmospheric pressure
0 mm Hg (760 mm Hg)
Pneumothorax (air
in pleural cavity):
intrapleural pressure
becomes equal to
atmospheric pressure
Intrapleural
pressure
(4 mm Hg)
0
0
0
Collapsed lung
(atelectasis)
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4
Intrapulmonary
pressure (0 mm Hg)