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Respiratory physiology Functions of respiratory system Respiratory function. Protective functions. Functions of the Respiratory System: Exchange O2 Air to blood Blood to cells Exchange CO2 Cells to blood Blood to air Regulate blood pH Vocalizations Protect alveoli Figure 17-1: Overview of external and cellular respiration Protective functions A. Air conditioning. B. Trapping & elimination of foreign particles. C. Protective reflexes: Cough reflex . Sneeze reflex. Respiration & Ventilation Four Stages: 1. Pulmonary ventilation; air into lungs 2. External respiration; gas exchange from lungs to blood 3. Internal respiration; exchange of gas from blood to cells 4. Cellular respiration; utilization of oxygen by cells to produce energy Respiratory System Divisions Airways Respiratory Airways (Respiratory tract or Air passages) Anatomically: Upper respiratory tract. Lower respiratory tract. Functionally: Conducting zone (no gas exchange = dead space). Respiratory zone (Gas exchange). Nasal Cavity and Pharynx Nose and Pharynx Nose External nose Nasal cavity Functions Passageway for air Cleans the air Humidifies, warms air Smell Along with paranasal sinuses are resonating chambers for speech Pharynx Common opening for digestive and respiratory systems Three regions Nasopharynx Oropharynx Laryngopharynx Larynx Functions Maintain an open passageway for air movement Epiglottis and vestibular folds prevent swallowed material from moving into larynx Vocal folds are primary source of sound production Respiratory zone Respiratory bronchioles, alveolar ducts, atria, alveolar sacs & alveoli. Gas exchange. Conducting zone Nose, pharynx, larynx, trachea, bronchi, bronchioles & terminal bronchioles. Cartilaginous rings, smooth muscles, columnar ciliated epithelium (escalator) & mucous glands. Warms and humidifies inspired air. Filters and cleans: Mucus secreted to trap particles in the inspired air. Mucus moved by cilia to be expectorated Pleura 2 layers (visceral & parietal). Thin layer of fluid (lubricant). Pressure difference across the wall of the lung to expand lung Positive air pressure = MORE than 760 mmHg Intrapleural pressure is the pressure within the pleural sac which surrounds the lung Intrapulmonary pressure is the pressure within the alveoli of the lung itself Pleura Pleural fluid produced by pleural membranes Acts as lubricant Helps hold parietal and visceral pleural membranes together Ventilation Mechanical process that moves air in and out of the lungs. [O2] of air is higher in the lungs than in the blood, O2 diffuses from air to the blood. C02 moves from the blood to the air by diffusing down its concentration gradient. Gas exchange occurs entirely by diffusion: Diffusion is rapid because of the large surface area Breathing rate is 10-16 breaths / minute at rest, 40 45 at maximum exercise in adults Ventilation Movement of air into and out of alveoli Inhalation: The lungs inflate with air, bringing oxygen into the body Exhalation: The lungs let go of air, releasing carbon dioxide out into the environment Movement of air into and out of lungs Air moves from area of higher pressure to area of lower pressure Pressure is inversely related to volume Inspiration Active process. Contraction of the inspiratory muscles. Diaphragm (75%) & External intercostal muscles. Inspiration Mechanism of inspiration 1. Contraction of the inspiratory muscles. 2. .snoisnemid tsehC 3. PPI. 4. Lungs expansion. 5. 6. Intrapulmonary pressure. Rush of 500 ml air into the lungs (Inflation). Expiration Expiration A passive process No muscle contraction Only relaxation of inspiratory muscles Mechanism of Expiration 1. Relaxation of the inspiratory muscles. 2. snoisnemid tsehC. 3. PPI. 4. Lungs recoil. 5. 6. Intrapulmonary pressure. Rush of 500 ml air outside the lungs (Deflation). Inspiration Inspirato ry muscles contract Thoraci c cavity size increase I.Pulm on volume increas e Thoracic cavity size Decrease I.Pulmon volume decrease I.P Decreas e than atmosph ric Air Rush into lung Expiration Inspiratory muscles Relax expiratory muscles Contract I.P inecrease than atmosphri c Air Rush out the lung W Paul Segars Johns Hopkins W Paul Segars Johns Hopkins Alveoli 300 million. 80 - 100 m2. 0.2 micron. Single layer of flat epithelium cells (Type I). Granular pneumocytes (Type II) → Surfactant. Lined by thin film of fluid (surface tension ). Surfactant decreases the surface tension of alveolar fluid Pulmonary Alveolar macrophages. Pulmonary Interstitial tissue (elastin & collagen). Surrounded by extensive network of capillaries. Alveolar structure Type I cells gas exchange Type II cells secrete surfactant (lipoproteins) decrease surface tension allowing for easier alveoli inflation Surfactants start to be secreted by the 7th month of pregnancy risk of lung disease in premature babies Presence of macrophages in alveoli Anatomical Dead Space No gas exchange (dead space). Not all of the inspired air reached the alveoli. As fresh air is inhaled it is mixed with air in anatomical dead space. Conducting zone and alveoli where [02] is lower than normal and [C02] is higher than normal. Alveolar ventilation = F x (TV- DS). F = frequency (breaths/min.). TV = tidal volume. DS = dead space. HOW THE BODY GET OXYGEN AND GET RIDE OF CO2 DURING RESPIRATION Gas exchange at Tissue levels Gas exchange at Lung levels Pulmonary Capillary Co2 transport Some fraction of carbon dioxide is dissolved and carried in blood. Some reacts reversibly with Hb to form carbamino Hb. CO2 + Hb ↔ HbC02 Some carbon dioxide is converted to bicarbonate. Carbonic CO2 + H2O ↔ H2CO3 ↔ HCO3- + H+ anhydrase The enzyme, carbonic anyhydrase, is present in erythrocytes where the reaction takes place after which the bicarbonate moves out into the plasma. Minute and Alveolar Ventilation 1. Tidal volume:Volume of air inspired or expired during a normal inspiration or expiration=500 mL 2. Respiratory rate or frequency: Number of breaths taken per minute= 12-16 3. Minute ventilation: Total amount of air moved into and out of respiratory system per minute =500x12=6 L 4. Anatomic dead space: Part of respiratory system where gas exchange does not take place=150 mL 5. Alveolar ventilation: How much air per minute enters the parts of the respiratory system in which gas exchange takes place= Hypoxia O2 deficiency at the tissue level Deficiency in either the delivery or utilization of oxygen at the tissue level, which can lead to changes in function, metabolism and even structure of the body 1) Hypoxic hypoxia 2) Anemic hypoxia 3) Stagnant hypoxia 4) Histotoxic hypoxia Hypoxia 1. Shortness of breath 2. Restlessness 3. Headache 4. Nausea 5. Fatigue 6. Tachycardia 7. Tachypnea and Hyperpnea 8. Cyanosis 9. Coma 10. Death types of hypoxia I. 1. Hypoxic hypoxia II. Anemic hypoxia III. 3. Stagnant hypoxia IV. 4. Histotoxic hypoxia Hypoxic hypoxia: It is the hypoxia in which arterial PO2 is reduced Causes: 1. Decreased O2 tension in the atmosphere: high altitude. 2. Defective pulmonary ventilation 3. Defective gas exchange 4. Venous-to-arterial shunts. Anemic hypoxia This is due to reduction of the amount of hemoglobin available to carry O2. Causes: 1. All types of anemia 2. Carbon monoxide (CO) poisoning Stagnant hypoxia: This is the hypoxia in which the blood flow to the tissues is slow, O2 delivered to the tissues is not adequate despite a normal PO2 and hemoglobin concentration Causes: 1. Hypotension 2. Polycythemia. (localized). 2. Heart failure. 3. V.C. on exposure to cold Histotoxic hypoxia This is the hypoxia in which tissue is unable to use O2 due to inhibition of enzyme responsible for internal respiration. Causes: 1. Cyanide poisoning: the most common cause 2. Alcohol and barbiturate which prevent dehydrogenase enzyme.