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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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. Uvula Soft palate Hard palate Nasal vestibule Figure 21.4a The pharynx, larynx, and upper trachea. Nasopharynx Oropharynx Laryngopharynx Regions of the pharynx © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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) © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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 ) © 2017 Pearson Education, Inc. Figure 21.7c Tissue composition of the tracheal wall. Scanning electron micrograph of cilia in the trachea (2500) © 2017 Pearson Education, Inc. Hyaline Cartilage forms C-rings stabilizing the Trachea © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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) © 2017 Pearson Education, Inc. Left inferior lobe (5 segments) Figure 21.9a Respiratory zone structures. Alveoli Alveolar duct Respiratory bronchioles Terminal bronchiole © 2017 Pearson Education, Inc. Alveolar duct Alveolar sac Figure 21.9b Respiratory zone structures. Respiratory bronchiole Alveolar duct Alveoli Alveolar sac © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. Type I alveolar cell Surfactant is secreted by Type II Alveolar Cells and lubricates the alveolar surface © 2017 Pearson Education, Inc. Figure 21.10a Alveoli and the respiratory membrane. Terminal bronchiole Respiratory bronchiole Smooth muscle Elastic fibers Alveolus Capillaries Diagrammatic view of capillary-alveoli relationships © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. Type I alveolar cell Acute Respiratory Distress Syndrome (ARDS) © 2017 Pearson Education, Inc. 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. © 2017 Pearson Education, Inc. 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. © 2017 Pearson Education, Inc. 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. © 2017 Pearson Education, Inc. 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) © 2017 Pearson Education, Inc. 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 © 2017 Pearson Education, Inc. 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) © 2017 Pearson Education, Inc. 4 Intrapulmonary pressure (0 mm Hg)