RESPIRATORY PHYSIOLOGY Part Ia Objectives To understand the physiologic anatomy of the respiratory system List the passages through

gh which air passes from the exterior to the alveoli List the major muscles in respiration and state the role of each Describe the chemical composition and function of surfactant Describe the pulmonary circulation and differentiate with systemic circulation Describe basic lung defense and metabolic functions RESPIRATION Ventilation: Movement of air into and out of lungs External respiration: - Gas exchange between air in lungs and blood - Transport of oxygen and carbon dioxide in the blood - Gas exchange between the blood and tissues Internal respiration: (Cellular) - The use of O2 to produce ATP via Glycolysis, TCA cycle, & ETS, and production of CO2 wthin the tissue cells RESPIRATORY SYSTEM FUNCTIONS Gas exchange: Oxygen enters blood and carbon dioxide leaves Regulation of blood pH: Altered by changing blood carbon dioxide levels Carbonic acid Buffer system Sound production: Movement of air past vocal folds makes sound and speech Olfaction: Smell occurs when airborne molecules drawn into nasal cavity Thermoregulation: Heating and cooling of body Protection: Against microorganisms by preventing entry and removing them Metabolic Role

Lungs Two lungs: Principal organs of respiration Right lung: Three lobes Left lung: Two lobes Divisions Lobes, bronchopulmonary segments, lobules Pleura Pleural fluid produced by pleural membranes Acts as lubricant (produces 15 ml) Helps hold parietal and visceral pleural membranes together Pleura Pneumothorax- a collection of air or gas in the pleural cavity of the chest between the lung and the chest wall Pleural effusion- is excess fluid that accumulates in the pleura Empyema- a collection of pus within the cavity RESPIRATORY SYSTEM DIVISIONS Upper airway Nose, pharynx and associated structures Lower airway Larynx, trachea bronchi, lungs Respiratory Passages Nasal Cavity - ciliated columnar epithelium/ goblet cells - highly vascular - warms/ moistens the air

- nasal hair filters off impurities - mucosal lining traps particles and bacteria, large particles up to 6 um - sedimentation in larynx 1- 5 um Pharynx - nasopharynx - oropharynx - laryngopharynx Trachea Windpipe Divides to form Primary bronchi Carina: Cough reflex

Conducting Zone Trachea to terminal bronchioles which is ciliated for removal of debris, mucus lined Passageway for air movement controlled by smooth muscle at end of terminal bronchioles Cartilage holds tube system open and smooth muscle controls tube diameter Warms and humidifies until inspired air becomes: 37 degrees Saturated with water vapor Filters and cleans: Mucus secreted to trap particles Mucus/particles moved by cilia to be expectorated.

Respiratory Zone Region of gas exchange between air and blood.

Respiratory bronchiole 5 or 6 alveolar ducts 3 to 6 air sacs alveoli Respiratory unit - respiratory bronchiole - alveolar ducts - alveolar sacs ALVEOLI Air sacs Honeycomb-like clusters ~ 300 million. Large surface area (6080 m2). Each alveolus: only 1 thin cell layer.

Alveolus and Respiratory Membrane CELLS OF THE AIRWAY CILIATED CELLS - line the respiratory tract to bronhioles - propel mucus and waste materials towards the pharynx CELLS OF THE AIRWAY CELL PRODUCING MUCUS 1. surface secretory cells (goblet cells) 2. submucosal glands - present wherever there is cartilage 3. Clara cells

- at the level of bronchioles - main secretory cell type in the distal conducting airways - plays a role in epithelial regeneration after an injury DUST CELLS (PHAGOCYTES) - alveolar macrophages - phagocytize inhaled particles and bacteria(< 1 um) - impaired by cigarette smoking ALVEOLAR CELLS type I - thin squamous epithelial cells - forms 90% of alveolar surface - gas exchange occurs ALVEOLAR CELLS type II - produces surfactant - regenerative capacity Surfactant Thin film lining the alveolar surface Phospholipid produced by alveolar type II cells Main component: dipalmitoylphosphatidylcholine (DPPC) Production starts at 24 weeks AOG Functions: 1. lowers surface tension anti-stick property 2. promotes stability among alveoli of different sizes by decreasing tendency of small alveoli to collapse (interdepence) 3. Reduces capillary filtration forces Formation and metabolism of surfactant

Force exerted by fluid in alveoli to resist distension. Lungs secrete and absorb fluid, leaving a very thin film of fluid. This film of fluid causes surface tension. Fluid absorption is driven (osmosis) by Na+ active transport. Fluid secretion is driven by the active transport of Cl- out of the alveolar epithelial cells. H20 molecules at the surface are attracted to other H20 molecules by attractive forces. Force is directed inward, raising pressure in alveoli. Law of Laplace: Pressure in alveoli is directly proportional to surface tension; and inversely proportional to radius of alveoli. Pressure in smaller alveolus would be greater than in larger alveolus, if surface tension were the same in both. Abnormalities: Respiratory distress syndrome (IRDS) of newborn - also known as hyaline membrane disease - due to abnormal formation of surfactant because of immaturity of lungs - babies have inadequate gas exchange Atelectasis - alveolar collapse Adult respiratory distress syndrome (ARDS) - abnormal surfactant function caused by schock, infection and trauma BLOOD SUPPLY 1. Pulmonary Circulation - deoxygenated blood from the RV passes via the pulmonary artery to the pulmonary capillary bed, where it is oxygenated and returned to the left atrium via the pulmonary veins 2. Bronchial Circulation - blood supply to the conducting airways, also supplies the pleura and hilar lymph nodes

The pulmonary arteries branch into increasingly smaller arteries and travel with the bronchi toward the respiratory zones. The smallest arteries divide into arterioles and then into pulmonary capillaries, which form dense networks (capillary baskets) around the alveoli there are anastomoses between the bronchial capillaries and the pulmonary capillaries and veins, and although some of the bronchial blood enters the bronchial veins, some enters the pulmonary capillaries and veins, bypassing the right ventricle Pulmonary Circulation Rate of blood flow through the pulmonary circulation is = flow rate through the systemic circulation Driving pressure is about 10 mm Hg. Pulmonary vascular resistance is low Low pressure pathway produces less net filtration than produced in the systemic capillaries. Avoids pulmonary edema. In a fetus: Pulmonary circulation has a higher vascular resistance, because the lungs are partially collapsed After birth, vascular resistance decreases: Opening the vessels as a result of subatmospheric intrapulmonary pressure Physical stretching of the lungs Dilation of pulmonary arterioles in response to increased alveolar P02. Pulmonary Blood Flow On standing, blood flow is lowest at the apex of the lungs and highest at the base. (Gravitational effect) In supine position, the gravitational effects disappear Regulation of Pulmonary Blood Flow Regulated by altering the resistance of pulmonary arterioles Changes in in pulmonary arteriolar resistance are controlled by local factors in PaO2 causes hypoxic vasoconstriction Matches ventilation/ perfusion ratio Pulmonary and systemic circulation differences:

Thinned wall arteries Contain less elastin and smooth muscle than systemic vessels, making pulmonary circulation highly compliant Capillaries form a dense capillary bed, each alveoli sits on a capillary basket. High flow, high compliance Low resistance, low pressure system Pulmonary lymphatics Supplied by the superficial and deep lymphatic vessels which exits from the hilus No lymphatics drain the alveoli Remove plasma filtrate, particular matter absorbed from alveoli, and escaped protien from the vascular system Help maintain negative interstitial pressure which pulls alveolar epithelium against capillary epithelium Innervation of the Respiratory System 1. Autonomic nervous control - sympathetic control - activation of B2 adrenergic receptors bronchodilatation; bronchial secretion - parasymphatetic control - activation of muscarinic receptors bronchoconstriction Vasoactive intestinal peptide (VIP) - a noncholinergic, nonadrenergic innervation of bronchioles 2. Local control - exerted by substances released in the lungs by mast cells: Histamine: binds to H1 receptor constriction bronchodilatation

binds to H2 receptor SRS- A: allergic response to pollen constriction Prostaglandin E Prostaglandin F Thoracic Walls Muscles of Respiration Muscles of Inspiration Diaphragm dilatation constriction

dilatation

Movement of the diaphragm accounts for 75% of the change in intrathoracic volume during quiet inspiration Innervated by phrenic nerve (C3, C4, C5) The distance it moves ranges from 1.5 cm to as much as 7 cm with deep inspiration During inspiration - contraction of the diaphragm pulls the lower surfaces of the lungs downward During expiration - by relaxation of the diaphragm and elastic recoil of the lungs, chest wall, and abdominal structures compresses the lungs External intercostals - lifts 2nd to 6th rib - ribs move like a bucket handle - sternum moves like a water pump Muscle of Expiration In quiet respiration - expiration is purely passive - accomplished when muscles of inspiration relax and by lung recoil In forced expiration

- Expiratory muscles are used during exercise or when airway resistance is increased because of disease (asthma) 1. Abdominal muscles (rectus abdominus)- compress the abdominal cavity, push the diaphragm up, and push air out of the lungs. 2. Internal intercostal muscles- pull the ribs downward and inward. PROTECTIVE MECHANISMS Mucociliary clearance system - also known as mucociliary elevator - Mucus continually secreted by goblet cells that traps particles and debris - IgA protects against bacteria and viruses - impaired by toxins from cigarette smoking Sneeze reflex - function to dislodge foreign substances from nasal cavity - Afferent impulses pass in CN V to the medulla - during the reflex, uvula and soft palate are depressed so that rapidly flowing air from lungs is directed through the nasal passages Cough Reflex - afferent impulses pass in CN X to the medulla - Steps: 1. about 2.5 L of air is inspired 2. epiglottis closes and vocal cords shut tightly 3. muscles of expiration contract forcefully which causes pressure in lungs to rise to 100 mmHg 4. vocal cords and epiglottis suddenly open widely explosive outpouring of air at speed of 75 to 100 miles/hour THANK YOU FOR LISTENING