RESPIRATORY SYSTEM

A. Anatomy Respiration
The primary function of the respiratory system is to supply the blood with oxygen in
order for the blood to deliver oxygen to all parts of the body. The respiratory system does
this through breathing. When we breathe, we inhale oxygen and exhale carbon dioxide.
This exchange of gases is the respiratory system's means of getting oxygen to the blood.
Respiration is the act of breathing:
 Inhaling (inspiration)--taking in oxygen
 Exhaling (expiration)--giving off carbon dioxide
The respiratory system is made up of the organs involved in the interchanges of gases,
and consists of the:
 Nose
 Mouth (oral cavity)
 Pharynx (throat)
 Larynx (voice box)
 Trachea (windpipe)
 Bronchi
 Lungs
The upper respiratory tract includes the:
 Nose
 Nasal cavity
 Ethmoidal air cells
 Frontal sinuses
 Maxillary sinus
 Sphenoidal sinus
 Larynx
The lower respiratory tract includes the:
 Trachea
 Lungs
 Airways (bronchi and bronchioles)
 Air sacs (alveoli)
 Nose and Nasal Cavity
The nose and nasal cavity form the main external opening for the respiratory
system and are the first section of the body’s airway—the respiratory tract through
which air moves. The nose is a structure of the face made of cartilage, bone,
muscle, and skin that supports and protects the anterior portion of the nasal cavity.
The nasal cavity is a hollow space within the nose and skull that is lined with
hairs and mucus membrane. The function of the nasal cavity is to warm,
moisturize, and filter air entering the body before it reaches the lungs. Hairs and
mucus lining the nasal cavity help to trap dust, mold, pollen and other
environmental contaminants before they can reach the inner portions of the body.
Air exiting the body through the nose returns moisture and heat to the nasal cavity
before being exhaled into the environment.
 Mouth
The mouth, also known as the oral cavity, is the secondary external opening for
the respiratory tract. Most normal breathing takes place through the nasal cavity,
but the oral cavity can be used to supplement or replace the nasal cavity’s
functions when needed. Because the pathway of air entering the body from the
mouth is shorter than the pathway for air entering from the nose, the mouth does
not warm and moisturize the air entering the lungs as well as the nose performs
this function. The mouth also lacks the hairs and sticky mucus that filter air
passing through the nasal cavity. The one advantage of breathing through the
mouth is that its shorter distance and larger diameter allows more air to quickly
enter the body.
 Pharynx
The pharynx, also known as the throat, is a muscular funnel that extends from the
posterior end of the nasal cavity to the superior end of the esophagus and larynx.
The pharynx is divided into 3 regions: the nasopharynx, oropharynx, and
laryngopharynx. The nasopharynx is the superior region of the pharynx found in
the posterior of the nasal cavity. Inhaled air from the nasal cavity passes into the
nasopharynx and descends through the oropharynx, located in the posterior of the
 oral cavity. Air inhaled through the oral cavity enters the pharynx at the
oropharynx. The inhaled air then descends into the laryngopharynx, where it is
diverted into the opening of the larynx by the epiglottis. The epiglottis is a flap of
elastic cartilage that acts as a switch between the trachea and the esophagus.
Because the pharynx is also used to swallow food, the epiglottis ensures that air
passes into the trachea by covering the opening to the esophagus. During the
process of swallowing, the epiglottis moves to cover the trachea to ensure that
food enters the esophagus and to prevent choking.
 Larynx
The larynx, also known as the voice box, is a short section of the airway that
connects the laryngopharynx and the trachea. The larynx is located in the anterior
portion of the neck, just inferior to the hyoid bone and superior to the trachea.
Several cartilage structures make up the larynx and give it its structure. The
epiglottis is one of the cartilage pieces of the larynx and serves as the cover of the
larynx during swallowing. Inferior to the epiglottis is the thyroid cartilage, which
is often referred to as the Adam’s apple as it is most commonly enlarged and
visible in adult males. The thyroid holds open the anterior end of the larynx and
protects the vocal folds. Inferior to the thyroid cartilage is the ring-shaped cricoid
cartilage which holds the larynx open and supports its posterior end. In addition to
cartilage, the larynx contains special structures known as vocal folds, which allow
the body to produce the sounds of speech and singing. The vocal folds are folds of
mucous membrane that vibrate to produce vocal sounds. The tension and vibration
speed of the vocal folds can be changed to change the pitch that they produce.
 Trachea
The trachea, or windpipe, is a 5-inch long tube made of C-shaped hyaline cartilage
rings lined with pseudostratified ciliated columnar epithelium. The trachea
connects the larynx to the bronchi and allows air to pass through the neck and into
the thorax. The rings of cartilage making up the trachea allow it to remain open to
air at all times. The open end of the cartilage rings faces posteriorly toward the
esophagus, allowing the esophagus to expand into the space occupied by the
trachea to accommodate masses of food moving through the esophagus.
 The main function of the trachea is to provide a clear airway for air to enter and
exit the lungs. In addition, the epithelium lining the trachea produces mucus that
traps dust and other contaminants and prevents it from reaching the lungs. Cilia on
the surface of the epithelial cells move the mucus superiorly toward the pharynx
where it can be swallowed and digested in the gastrointestinal tract.
 Bronchi and Bronchioles
At the inferior end of the trachea, the airway splits into left and right branches
known as the primary bronchi. The left and right bronchi run into each lung before
branching off into smaller secondary bronchi. The secondary bronchi carry air
into the lobes of the lungs—2 in the left lung and 3 in the right lung. The
secondary bronchi in turn split into many smaller tertiary bronchi within each
lobe. The tertiary bronchi split into many smaller bronchioles that spread
throughout the lungs. Each bronchiole further splits into many smaller branches
less than a millimeter in diameter called terminal bronchioles. Finally, the millions
of tiny terminal bronchioles conduct air to the alveoli of the lungs.
As the airway splits into the tree-like branches of the bronchi and bronchioles, the
structure of the walls of the airway begins to change. The primary bronchi contain
many C-shaped cartilage rings that firmly hold the airway open and give the
bronchi a cross-sectional shape like a flattened circle or a letter D. As the bronchi
branch into secondary and tertiary bronchi, the cartilage becomes more widely
spaced and more smooth muscle and elastin protein is found in the walls. The
bronchioles differ from the structure of the bronchi in that they do not contain any
cartilage at all. The presence of smooth muscles and elastin allow the smaller
bronchi and bronchioles to be more flexible and contractile.
The main function of the bronchi and bronchioles is to carry air from the trachea
into the lungs. Smooth muscle tissue in their walls helps to regulate airflow into
the lungs. When greater volumes of air are required by the body, such as during
exercise, the smooth muscle relaxes to dilate the bronchi and bronchioles. The
dilated airway provides less resistance to airflow and allows more air to pass into
and out of the lungs. The smooth muscle fibers are able to contract during rest to
prevent hyperventilation. The bronchi and bronchioles also use the mucus and
 cilia of their epithelial lining to trap and move dust and other contaminants away
from the lungs.
 Lungs
The lungs are a pair of large, spongy organs found in the thorax lateral to the
heart and superior to the diaphragm. Each lung is surrounded by a pleural
membrane that provides the lung with space to expand as well as a negative
pressure space relative to the body’s exterior. The negative pressure allows the
lungs to passively fill with air as they relax. The left and right lungs are slightly
different in size and shape due to the heart pointing to the left side of the body.
The left lung is therefore slightly smaller than the right lung and is made up of 2
lobes while the right lung has 3 lobes.
The interior of the lungs is made up of spongy tissues containing many capillaries
and around 30 million tiny sacs known as alveoli. The alveoli are cup-shaped
structures found at the end of the terminal bronchioles and surrounded by
capillaries. The alveoli are lined with thin simple squamous epithelium that allows
air entering the alveoli to exchange its gases with the blood passing through the
capillaries.

B. The Muscle of Respiration

The Muscles of respiration can be divided into those used during inspiration and
expiration.
Inspiration
 Diaphragm - Thin, dome-shaped sheet of muscle inserted at the lower ribs. Contraction
of the diaphragm moves the abdomen downward and forward increasing the vertical
dimensions of the chest cavity. The ribs are also lifted outward increasing the diameter of
the thorax. In normal tidal breathing, the diaphragm moves about 1cm (may move up to
10cm during forced expiration. Paralysis of the diaphragm causes paradoxical movement
in which it moves up rather than down with inspiration. This occurs when a person sniffs.
 External Intercostal Muscles - Connect adjacent ribs and under contraction, the ribs
move upward and forward. Paralysis of the intercostal muscles does not seriously affect
breathing because the diahragm is so effective.
  Accessory Muscles of Inspiration
o scalen muscles - Elevate the first two ribs
o sternomastoids - Raise the sternum (may contract vigorously during exercise)
o alae nasi - Flare the nostrils
o Other small muscles in the neck and head
Expiration (Non-Passive Only)
 Muscles in the Abdominal Wall - Contract forcefully during coughing, vomiting, and
defecation.
o rectus abdominus
o internal and external obliques
o transversus abdominus
 Internal Intercostal Muscles - Pull ribs downward and inward (opposite to external
intercostal muscles)
It is crucially important that these muscles work together in a coordination

C. Mechanism of Breathing
To take a breath in, the external intercostal muscles contract, moving the ribcage up and
out. The diaphragm moves down at the same time, creating negative pressure within the
thorax. The lungs are held to the thoracic wall by the pleural membranes, and so expand
 outwards as well. This creates negative pressure within the lungs, and so air rushes in
through the upper and lower airways.
Expiration is mainly due to the natural elasticity of the lungs, which tend to collapse if
they are not held against the thoracic wall. This is the mechanism behind lung collapse if
there is air in the pleural space (pneumothorax).
Physiology of Gas Exchange
Each branch of the bronchial tree eventually sub-divides to form very narrow terminal
bronchioles, which terminate in the alveoli. There are many millions of alveloi in each lung, and
these are the areas responsible for gaseous exchange, presenting a massive surface area for
exchange to occur over.
Each alveolus is very closely associated with a network of capillaries containing deoxygenated
blood from the pulmonary artery. The capillary and alveolar walls are very thin, allowing rapid
exchange of gases by passive diffusion along concentration gradients.
CO2 moves into the alveolus as the concentration is much lower in the alveolus than in the blood,
and O2 moves out of the alveolus as the continuous flow of blood through the capillaries prevents
saturation of the blood with O2 and allows maximal transfer across the membrane.
Pulmonary Circulation
Pulmonary circulation is the movement of blood from the heart, to the lungs, and back to the
heart again. This is just one phase of the overall circulatory system.
The veins bring waste-rich blood back to the heart, entering the right atrium throughout two large
veins called vena cavae. The right atrium fills with the waste-rich blood and then contracts,
pushing the blood through a one-way valve into the right ventricle. The right ventricle fills and
then contracts, pushing the blood into the pulmonary artery which leads to the lungs. In the lung
capillaries, the exchange of carbon dioxide and oxygen takes place. The fresh, oxygen-rich blood
enters the pulmonary veins and then returns to the heart, re-entering through the left atrium. The
oxygen-rich blood then passes through a one-way valve into the left ventricle where it will exit
the heart through the main artery, called the aorta. The left ventricle's contraction forces the
blood into the aorta and the blood begins its journey throughout the body.
The one-way valves are important for preventing any backward flow of blood. The circulatory
system is a network of one-way streets. If blood started flowing the wrong way, the blood gases
(oxygen and carbon dioxide) might mix, causing a serious threat to your body.
You can use a stethoscope to hear pulmonary circulation. The two sounds you hear, "lub" and
"dub," are the ventricles contracting and the valves closing.
D. Basic Regulatory Patterns of Respiration.
(a) Quiet breathing. (b) Forced breathing.
Central nervous system stimulants, such as cocaine, amphetamines, ecstacy, or even
caffeine, increase your respiratory rate by facilitating the respiratory centers. These
actions can be opposed by CNS depressants, such as ethyl alcohol, barbiturates or
opiates. A mixture of these stimulants and depressants is often fatal.
The Apneustic and Pneumotaxic Centers
The apneustic centers and the pneumotaxic centers of the pons are paired nuclei that
adjust the output of the respiratory rhythmicity centers. Their activities regulate the
respiratory rate and the depth of respiration in response to sensory stimuli or input from
other centers in the brain.
Each apneustic center provides continuous stimulation to the DRG on that side of the
brain stem. During quiet breathing, stimulation from the apneustic center helps increase
the intensity of inhalation over the next 2 seconds. Under normal conditions, after 2
seconds the apneustic center is inhibited by signals from the pneumotaxic center on that
side. During forced breathing, the apneustic centers also respond to sensory input from
the vagus nerves regarding the amount of lung inflation.
The pneumotaxic centers inhibit the apneustic centers and promote passive or active
exhalation. Centers in the hypothalamus and cerebrum can alter the activity of the
pneumotaxic centers, as well as the respiratory rate and depth. However, essentially
normal respiratory cycles continue even if the brain stem superior to the pons has been
severely damaged. If the inhibitory output of the pneumotaxic centers is cut off by a
stroke or other damage to the brain stem, and if sensory innervation from the lungs is
eliminated by cutting the vagus nerves, the person inhales to maximum capacity and
maintains that state for 10–20 seconds at a time. Intervening exhalations are brief,
and little pulmonary ventilation occurs.
 Respiratory Reflexes
The activities of the respiratory centers are modified by sensory information from several
sources:
1. Chemoreceptors sensitive to the pH, or of the blood or cerebrospinal fluid.
2. Changes in blood pressure in the aortic or carotid sinuses.
3. Stretch receptors that respond to changes in the volume of the lungs.
4. Irritating physical or chemical stimuli in the nasal cavity, larynx, or bronchial tree.
5. Other sensations, including pain, changes in body temperature, and abnormal visceral
sensations.
E. Respiratory Volumes and Capacities
 The resting tidal volume is the amount of air you move into or out of your lungs during a
single respiratory cycle under resting conditions. The resting tidal volume averages about
500 ml in both males and females.
 The expiratory reserve volume (ERV) is the amount of air that you can voluntarily expel
after you have completed a normal, quiet respiratory cycle. As an example, if, with
maximum use of the accessory muscles, you can expel an additional 1000 ml of air, your
expiratory reserve volume is 1000 ml.
 The residual volume is the amount of air that remains in your lungs even after a maximal
exhalation–typically, about 1200 ml in males and 1100 ml in females.
  The minimal volume , a component of the residual volume, is the amount of air that
would remain in your lungs if they were allowed to collapse. The minimal volume ranges
from 30 to 120 ml, but, unlike other volumes, it cannot be measured in a healthy person.
You would have to squeeze out the lungs like a sponge to measure it.
 The inspiratory reserve volume (IRV) is the amount of air that you can take in over and
above the tidal volume. Inspiratory reserve volumes differ significantly by gender,
because, on average, the lungs of males are larger than those of females. The inspiratory
reserve volume of males averages 3300 ml, compared with 1900 ml in females.
We can determine respiratory capacities by adding the values of various volumes. Examples
include the following:
 The inspiratory capacity is the amount of air that you can draw into your lungs after you
have completed a quiet respiratory cycle. The inspiratory capacity is the sum of the tidal
volume and the inspiratory reserve volume.
 The functional residual capacity (FRC) is the amount of air remaining in your lungs after
you have completed a quiet respiratory cycle. The FRC is the sum of the expiratory
reserve volume and the residual volume.
 The vital capacity is the maximum amount of air that you can move into or out of your
lungs in a single respiratory cycle. The vital capacity is the sum of the expiratory reserve,
the tidal volume, and the inspiratory reserve and averages around 4800 ml in males and
3400 ml in females.
 The total lung capacity is the total volume of your lungs. The sum of the vital capacity
and the residual volume, the total lung capacity averages around 6000 ml in males and
4500 ml in females.