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Respiratory System Function – Supply cells with oxygen – Get rid of waste; carbon dioxide Respiration Five Stages – Pulmonary Ventilation Inhaling and exhaling – Gas Exchange Between respiratory cells and blood – Transport Of gases throughout the body by the blood Respiration Five Stages (cont.) – Exchange Of gases between blood and tissue cells (internal respiration) – Cellular Respiration Use of oxygen by body cells to break down glucose and release energy (ATP) and carbon dioxide Upper Respiratory Tract Nose – External nose structures lateral cartilage – External nares lesser alar cartilages greater alar cartilage dense fibrous connective tissue Upper Respiratory Tract Nasal Cavity superior concha ethmoid – Septum – Roof – Floor middle sphenoid concha nasal bone septal cartilage Nasal conchae Internal nares (choanae) Mucosa vomer palatine inferior bone concha palatine process internal nares Upper Respiratory Tract Paranasal Sinuses frontal sinus – 4 pair maxillary sinus sphenoid sinus ethmoid sinus Upper Respiratory Tract Pharynx – Nasopharynx – Oropharynx – Laryngopharynx nasopharynx oropharynx laryngopharynx Lower Respiratory Tract epiglottis Larynx – Cartilages Thyroid Laryngeal prominence Cricoid Arytenoid Corniculate Cuneiform Epiglottic cuneiform cartilage thyroid cartilage corniculate cartilage laryngeal arytenoid prominence cartilage cricoid cartilage Lower Respiratory Tract Internal Structures epiglottis – Auditus – Vestibule – Vestibular folds – Ventricles vestibular folds vocal folds – Vocal folds – Glottis glottis Lower Respiratory Tract Laryngeal Muscles – Cricothyroid Posterior cricoarytenoideus Lateral cricoarytenoideus Thyroarytenoideus Vocalis Aryepiglottic thyroarytenoideus aryepiglottic vocalis lateral cricothyroid posterior cricoarytenoideus cricoarytenoideus Lower Respiratory Tract Sound Production – Pitch – Volume Lower Respiratory Tract Trachea – Tracheal cartilages and carina – Lined with pseudostratified ciliated columnar epithelium – Goblet cells – Horseshoe shaped hyaline cartilage – Trachealis muscle posterior esophagus trachealis muscle hyaline cartilage Pseudostratified ciliated columnar epithelium adventitia Bronchial Tree Primary Bronchi – Rt. Bronchus is shorter, wider and steeper than the left – Same wall structure as trachea – Cartilage in plates in smaller passageways – Branch into secondary and tertiary bronchi (R) primary bronchus (L) primary bronchus Bronchial Tree Trachea (R) and (L) primary bronchi secondary (lobar) bronchi tertiary (segmental) bronchi smaller bronchi bronchioles terminal (R) primary bronchus bronchioles respiratory bronchioles alveolar duct alveolar sac alveolus (L) primary bronchus trachea Bronchial Tree Bronchioles – No cartilage – No cilia or mucous producing cells – Epithelium changes to simple columnar Terminal Bronchioles – Simple cuboidal epithelium – Lead into respiratory bronchioles terminal bronchiole Bronchial Tree Respiratory Bronchioles alveoli – Lead into alveolar ducts Alveoli – Simple squamous epithelium – May open into an alveolar sac – Where gas exchange takes place capillaries alveolar sac respiratory bronchiole Alveoli Septal Cells (type II alveolar cells) – Produce pulmonary surfactant Dust Cells – Macrophages in alveoli – Phagocytize bacteria, dirt, foreign particles Respiratory Membrane= – Squamous alveoli epithelium + alveolar basement membrane + endothelium of capillary walls – Gas on one side, blood on other – Gas diffuses easily The Lungs Fill pleural cavities lateral to mediastinum apex Anatomical Structures Apex Hilus Base Costal surface Pleura Serous membranes Parietal Visceral Pleural cavity Pleural fluid base Right Lung The Lungs SUPERIO R LOBE – 3 lobes Superior, middle, inferior – Oblique and horizontal fissures SUPERIOR LOBE oblique fissure horizontal fissure Left Lung 2 lobes Superior, inferior Oblique fissure Cardiac notch Lingula MIDDLE LOBE cardiac INFERIOR notch LOBE oblique INFERIOR fissure LOBE Bronchopulmonary Segments Each lung has 10 segments (some list only 8 in the left lung) Each segment is served by a tertiary (segmental) bronchus, an artery and vein Help to reduce spread of disease or infection ANTERIOR VIEW Blood Supply Bronchial Circulation (to lungs) – Bronchial Arteries Arise from aorta Run with bronchi – Bronchial Veins Drain blood from lung tissue Empty into the azygos and hemiazygos veins Pulmonary circulation (to circulation) Pulmonary trunk pulmonary arteries branch within lungs, travel with bronchi pulmonary capillaries surround alveoli gas exchange pulmonary veins (L) atrium of heart GasATMOSPHERIC Pressures PRESSURE Intrapleural pressure 756 mm Hg (-4 mm Hg) parietal pleura Collapsing force of lungs (4 mm Hg) pleural cavity visceral pleura Intrapulmonary pressure 760 mm Hg (0 mm Hg) Ventilation And Pressure Ventilation – Taking air in and out of lungs – Inspiration, expiration – Dependant upon difference in pressures in alveoli and outside atmosphere Intrapulmonary Pressure – Within alveoli – Changes during breathing – Always equalizes with atmospheric pressure (760 mm hg at sea level) Ventilation And Pressure Intrapleural Pressure – Within the pleural cavity – Fluctuates – Maintains 4 mm less pressure than in alveoli (negative compared to atmospheric or intrapulmonary pressures) – Created by the thorax expanding faster than the lungs in fetal development ***Any condition that equalizes intrapleural pressure with intrapulmonary pressure will cause lung collapse (atelectasis) Forces Acting On Lungs Forces pushing lungs out, towards the thorax wall: 1. Greater pressure inside the lungs (intrapulmonary pressure) than in the surrounding pleural cavities (intrapleural pressure) 2. Adhesive force created by the fluid in the pleural cavity 3. Atmospheric pressure pushing in on the thorax Forces Acting On Lungs Forces pulling lungs in, away from the thorax wall 1. Tendency of elastic fibers in lungs to recoil 2. Surface tension within alveoli draw them back to their smallest dimension Inspiration And Expiration Dependant upon the relationship between change in volume or pressure Boyle’s Law – Pressure of gas varies inversely with its volume (when temp. Is constant) Inspiration Expiration Forced Expirations Abdominal and internal intercostal muscles contract (not used in normal expiration) Reduction in volume of thoracic cavity More air expelled Pulmonary Surfactant Lipoprotein Reduces surface tension (cohesive force between water molecules) within alveoli Produced by septal cells (type II alveolar cells) Produced during last two months of fetal development Reduces energy required to stretch lungs Helps prevent lung collapse Resistance And Compliance Airway Resistance – Larger diameter = less resistance – Any factor that decreases airway diameter will increase energy needed to breath – Mucus, infections, tumors, asthma Compliance – Ease in which lungs will distend – Amount of change in lung volume that occurs with change in intrapulmonary pressure – High compliance = lungs and thorax easily expandable – Surfactant increases compliance Respiratory Volumes Can be measured by a respirometer or spirometer Tidal Volume (TV) – Amount of air inspired and expired during normal breathing (usually 500 ml) Residual Volume (RV) – 1200 ml air remaining in lungs to prevent collapse Respiratory Capacities Vital Capacity (VC) – Maximum inspiration + maximum expiration (4700 ml) Reduced in restrictive disorders (fibrosis), but rate of expiration is normal Normal in obstructive disorders (asthma), but rate of expiration is reduced Dead Space Anatomical Dead Space – Air found in airways not undergoing gas exchange (150 ml) Physiological Dead Space – Air available in alveoli but not used (due to lack of blood, etc.) Respiratory Volumes Minute Respiratory Volume (MRV) – Breathing rate/min. X tidal volume – 12 breaths x 500 = 6000 ml Alveolar Ventilation Rate (AVR) – Measurement of incoming air actually used for respiration – Breathing rate x (tidal volume - dead space) Gas Exchange Dalton’s Law – Each gas in a mixture will exert its own pressure on a container equal to the amount of pressure it would exert on its own – Partial Pressure Amt. of pressure exerted by each individual gas in a mixture Total pressure in a mixture = sum of all partial pressures – PN2 + PO2 + PCO2 Gas Exchange Henry’s Law – When a mixture of gases is in contact with a liquid, each gas will dissolve into the liquid in proportion to its partial pressure – The higher the partial pressure of a gas, the faster it will go into solution Gas Solubility – Also influences how readily gas will go into solution – Carbon dioxide is more soluble than oxygen – Nitrogen is the least soluble gas in air Gas Exchange External Respiration – Between alveoli and pulmonary capillaries – Partial pressure of O2 is greater in the alveoli O2 diffuses into capillaries – Partial pressure of CO2 is greater in capillaries CO2 diffuses out of capillaries into the alveoli Gas Exchange Internal Respiration – Between blood and body cells – Partial pressure of O2 is higher in blood O2 diffuses into body cells – CO2 partial pressure greater in body cells CO2 diffuses into blood Gas Transport 98% of oxygen in blood is associated with hemoglobin The affinity of hemoglobin to O2 is dependant upon the partial pressure of O2 In Body Tissues – Oxygen partial pressure is low – Hemoglobin loses affinity for oxygen – Releases oxygen In Lungs – High oxygen partial pressure – Hemoglobin has a high affinity for oxygen – Attaches to oxygen Oxygen Transport Factors affecting the affinity of hemoglobin to oxygen 1. pH Affinity decreases with decrease in pH High CO2 can decrease pH More oxygen released to body cells when CO2 levels are high 2. Temperature Increased temperature causes a decreased affinity Increase in cellular metabolism causes an increase temp., Partial pressure of CO2 and decrease in pH Decreased affinity more O2 released to body cells Oxygen Transport 3. DPG (2,3-diphosphoglyceric acid) Released by RBC’s when O2 supply to body tissues is low DPG reversibly binds to hemoglobin decreasing its affinity to O2 Oxygen released to body tissues – Fetal hemoglobin has a much higher affinity for oxygen than maternal hemoglobin Maternal hemoglobin releases O2 to fetal hemoglobin Carbon Dioxide Transport 3 Methods of CO2 Transport 1. Dissolved in plasma 7 to 10% 2. Attached to hemoglobin 20 to 30% Forms carbaminohemoglobin 3. As a bicarbonate ion (HCO3-) 60 to 70% Catalyzed by carbonic anhydrase Control Of Respiration The brain and local factors in the lung work together to regulate and coordinate respiration Local Factors – Bronchiole smooth muscle is sensitive to changes in CO2 concentration Increased CO2 relaxes smooth muscle in bronchioles dilate more CO2 released from lungs Opposite if CO2 levels decrease Control of Respiration Local Factors (cont.) – Pulmonary arterioles are sensitive to changes in O2 and H+ ions Decrease in O2 or increase in H+ pulmonary arterioles contract blood shunted towards alveoli with more O2 Just the opposite if O2 levels are high Brain Control Of Respiration Basic breathing pattern is set by the reticular formation in the medulla and pons Medulla Rhythmicity Center – Inspiratory Neurons Cause contraction of inspiratory muscles via phrenic nerve and intercostal nerves Fire for 2 sec (inspiration) Cease for 3 sec (expiration) Brain Control Of Respiration Medulla Rhythmicity Center (cont.) – Expiratory Neurons Inactive during normal breathing Activated with increased ventilation to cause contraction of expiratory muscles Brain Control Of Respiration The Pons – Pneumotaxic Center Sends inhibitory signals to inspiratory area in medulla Shortens and quickens breathing Prevents over inflation of lungs – Apneustic Center Continuously stimulates the inspiratory area in medulla Prolongs inspiration Deep and slow breathing pneumotaxic center apneustic center Factors Influencing Ventilation The Hering-Breuer Reflex – Stretch receptors in lungs Cause inhibition of inspiratory and apneustic centers Prevents over inflation or over deflation of lungs Cortical Input – From cerebrum allows some voluntary control of breathing Factors Influencing Ventilation Chemical Influences – CO2, O2 and H+ ion concentrations in body fluids can affect ventilation – Chemoreceptors in the aortic arch and carotid bodies send input to respiratory centers carotid body aortic body Chemical Influences CO2 and H+ Ions – Changes picked up by chemosensitive areas in medulla – Excite respiratory center when increased increased ventilation more CO2 eliminated from blood H+ levels drop – Small changes in H+ levels in the CSF can drastically effect the medulla O2 Levels – Drop detected by aortic and carotid bodies – Causes increased ventilation Chemical Influences pH Levels – As pH falls, picked up by peripheral chemoreceptors – Cause increase in ventilation – Elimination of CO2 Other Influences Exercise – Causes increased ventilation – Not related to partial pressures or shortage of O2 – May be caused by input from proprioceptors or cerebrum Other Influences Altitude Changes – Higher altitudes = lower partial pressure of gases – Ventilation increases – Oxygen released to tissues more readily Respiratory Disorders Atelectasis – Partial or complete lung collapse – Can be caused by: Obstructed bronchus Any injury affecting thoracic pressures Pneumothorax – Pleural cavity becomes filled with air or gas – Causes lung collapse Respiratory Disorders IRDS (Infant Respiratory Distress Syndrome) – Usually the result of insufficient surfactant – Alveoli collapse RESPIRATORY DISORDERS SIDS (Sudden Infant Distress Syndrome) – Infants stop breathing during sleep – Most common cause of death in infants under 1 year – Possible causes Viral or bacterial infection Allergic response? Malfunction of respiratory centers Respiratory Disorders COPD (Chronic Obstructive Pulmonary Disease) – Collection of diseases that cause chronic difficulty in breathing and cough – Often includes chronic bronchitis and emphhysema RESPIRATORY DISORDERS Lung Cancer – 1/3 of deaths in U.S. – 90% are smokers – Low cure rate Pleurisy – Inflammation of the pleura – Friction and stabbing pains with breathing – Can be caused by decreased pleural fluid