RESPIRATORY PHYSIOLOGY  Anteriorly- ribs and sternum

Rodina Gorospe MD, MPH | 13-Nov-2019  Laterally- ribs

 Posteriorly- ribs and vertebral
column
OUTLINE  Inferiorly- diaphragm
I. Introduction  Diaphragm separates the thoracic cavity from
II. Functional Anatomy the abdominal cavity
III. Gas Laws  The heart and the mediastinum is found
IV. External Respiration between the lungs
V. Internal Respiration B. Lungs
VI. Pulmonary volumes and capacities  The total organ-
VII. Alveolar ventilation Is divided into :
VIII. Nervous and Chemical Control of Respiration  Right has 3 lobes
 Left has 2 lobes

I. Introduction
>Respiration is the gaseous interchange between an
organism and its environment
Functions:
 Provides oxygen
 Eliminates carbon dioxide
 Regulates the blood hydrogen ion
concentration (pH)
 Forms speech sounds (phonation)
 Defends speech sounds (phonation)
 Influences arterial concentration of chemical
messengers by removing some pulmonary
capillary blood and producing and adding
others to this blood- acts as a circulatory filter
 Traps and dissolve blood clots
4 major components of respiration:
1. Pulmonary ventilation – inflow and outflow o
air between the atmosphere and the lungs
2. Diffusion of oxygen and carbon dioxide
between the alveoli and the blood
3. Transport of oxygen and carbon dioxide in the
blood and body fluids to and from the body’s
tissue cells
4. Regulation of ventilation and other facets of
respiration
II. Functional Anatomy
A. Organizational Set-up
 Thorax and the Thoracic Cavity
 Lungs, right and left lobes, are contained in the
thoracic cavity
 The thoracic cavity is bounded by
 The lungs and the chest wall – elastic tissues
 Consist mainly of tiny sac containing air –
alveoli (150M/lung)- site of gas exchange with
the blood
 The outer surface of the lungs – visceral pleura
 Thoracic cavity innermost covering – parietal
pleura
 The pleura are separated from each other by a
thin film of fluid – pleural fluid
 Potential space between the pleura – pleural
cavity (NCBI)
 Also note that pleura fluid lubricates
movement of lungs within the cavity
 The lungs are in close apposition with the
thoracic wall (it floats in the thoracic cavity
surrounded by a thin layer of pleural fluid)
 Since the size of the lungs are smaller
than that of the thoracic cavity, the
lungs are always stretched.
 At relaxation, the lungs are slightly pulled out
(expanded) while the chest wall is slightly
pulled in (retracted)
 The hilum, which is medially located, is part of
the lungs where all structures (veins, artery,
nerves, lymphatic vessels, and respiratory
passages) enter and leave the lungs
 The lungs communicate directly with the
outside through the respiratory passages
 It can be expanded in 2 ways :
 Downward and upward movement f
the diaphragm to lengthen or shorten
the chest cavity (Normal Quiet
Breathing)
 Elevation and depression of the ribs to
increase and decrease the

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  Bronchi
 Bronchioles
 Respiratory Zone
 Alveoli

1. Nasal Cavity
 External nares are lined with skin, inward it is
lined with ciliated columnar epithelium and
some goblet cells
 The nasal lining is very vascular
 The nasal cavity is provided with hairs
 Functions:
 It warms air as it passes through the
surface of the septum and turbinates
 It moistens the air
 It filters off air impurities

anteroposterior diameter of the chest

cavity

C. Respiratory Passages
 These extend from the nostrils to the
respiratory bronchioles
 No gas exchange takes place across its walls
 The epithelial surface of the airways, to the
end of the respiratory bronchioles, contains
cilia, they also contain glands

 Conducting Zone/Dead space

 Nose – nostril
 Pharynx
 Larynx
 Trachea 2. Pharynx
 It is a common pathway for air and food
 Branches into two tubes, one (the esophagus)
through which food passes through the
stomach and one (the larynx), which is part of
the airway which houses the vocal chords, the
two strong bands of elastic tissue stretched
horizontally across the lumen

3. Tracheobronchial Tree
 A system of tubes that branch and rebranch as
they near the periphery of the lungs
 It conducts air from the outside into the lung
alveoli/the flow of air past the vocal cords (in
the larynx) cause them to vibrate, producing
sound

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  Larynx open into a long tube, the trachea,
which in turn branches into two bronchi, one
of each enters each lung
 Within the lungs there are more than 20
generations of branching, each resulting into
narrower, shorter, and more numerous tubes
 Tracheal walls contain cartilage
 The first airway branches that no longer
contain cartilage are called respiratory
bronchioles
4. Alveoli
 Air sacs
 Approximately 300M with total surface area of
70 m2
 Are lined by 2 types of epithelial cells
 Type I- flat cells, primary lining cells
 Type II- granular pneumocytes, thicker, secrete
surfactant (dipalmitoylphosphatidylcholine) by
exocytosis
 Alveolar tissue contains elastin and collagen,
the fluid lining its surface is the surfactant
 Removed by pulmonary macrophages
 Physiologic advantage of Pulmonary Surfactant
1. Decrease surface tension of the liquid
lining layer
2. Improve stability of the lung by decreasing
surface tension in smaller alveoli
3. Helps to keep the alveoli dry
BAGWAN
D. Muscles involved in respiration
Muscles of inspiration (elevates rib cage)
1. External intercostals – most important
muscles that raises the rib cage
- contracts during inspiration
2.Sternocleidomastoid – lifts sternum
upward
3. Anterior Serratius – lift many ribs
4. Scalenes – lift first 2 ribs
Muscles of expiration (depress rib cage)
1. Abdominal rectus – pulls the lower ribs
downward (together with abdominal
muscles compresses abdominal contents
against diaphragm
2. Internal intercostals – elongated foward
and downward
E. Pressures for air movement in lungs
 Pleural Pressure – pressure of fluid in thin
space between the lung pleura and the chest
wall pleura
- Slightly negative pressure
- Normal pleura pressure at beginning of
inspiration : -5 cm H2O
 Alveolar pressure – air pressure inside the
lung alveoli
- Inspiration : -1 cm (enough to pull 0.5 L
of air into the lungs in 2 seconds
- Expiration : +1 cm (forces 0.5 L of
inspired air out of lungs during 2-3
seconds of expiration
 Transpulmonary pressure – difference
between alveolar and pleural pressure
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 Recoil pressure: Measures of elastic alveolar- epithelial cells (10%
forces in lungs that tend to collapse the surface area)
lungs at each instant of respiration. - Mixture of :
 Phospholipid (dipalmitoyl
F. Compliance posphatidylcholine) –
 Lung compliance – extent to which the lungs reduces surface tension by
will expand or each unit increase in dissolving partly the
transpulmonary pressure alveolar lining
 Average Total compliance: 200 ML of air / cm  Proteins
of water transpulmonary pressure (both lungs)  Ions (calcium)
 Distensibility or expansibility of a structure
 Expressed as volume increase in lung 2. Elastic forces caused by surface tension of
area for each unit increase in alveolar the fluid that lines the inside walls of the
pressure alveoli and other lung air spaces
C=VL/Pa - 2/3 of total lung elasticity
 Ratio of change in volume to the lung pressure
 Normal compliance = 0.20 L/cmH2O Surface tension – elastic contractile of lungs
 For every 1cmH2O increase = volume due to alveolar collapse
increase by 0.20L or 200 ml
 In order to inspire 500 ml ITP must Pure water 72 dynes/ cm
decrease by 2.3 cmH2O Normal fluids lining 50 dynes/ cm
 Compliance = size alveoli w/o surfuctant
 ½ normal compliance = ½ lung Normal fluids lining 5 and 30 dynes/ cm
 Factors responsible for the elasticity of the alveoli with normal
lung amounts of surfuctant
 Elastic components of the lung tissue=
nylon stocking elasticity Pressure in occluded alveoli caused by surface
 Surface tension of the liquid film lining tension :
the alveoli
- Role of surfactant
 Reduction in compliance
1. Destruction of lung tissue produces edema
fibrosis
2. Blocked alveoli G. Pulmonary Vessels
3. Deformities of the chest wall (eg. Paralysis  Bronchial vessels receive 1 to 2% of the CO,
of the muscle of the thoracic wall, fibrotic supplies lung tissues, its blood drains to the
pleurisy) pulmonary vein into the left ventricle. This
 Elastic forces that determines compliance: makes the LV output greater than the right
1. Elastic forces of the lung tissue ventricle.
- represents 1/3 of total lung elasticity
- tends to collapse of the air- filled lung
- determined by elastin and collagen
fibers
- increases when there is no available
surfactant

Surfactant- surface active agent in water that

reduces its surface tension
- Secreted by a granular, lipid
containing cell called type 2

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  The blood vessels supplying the lungs generally  At constant temperature, the volume is
accompany the airway and also undergo directly proportional to the absolut
numerous branching. The smallest of these temperature or
branches into network of capillaries.  **Absolute temperature = 273 (kelvin temp) +
37 (Celsius temp)= 310
H. Important Structures  At constant volume, the pressure is
 Cilia- ciliated cells line the larynx, trachea, and directly proportional to the absolute
bronchi temperature
 FXN: propel mucus and waste materials  Avogadro’s Law
towards the pharynx  Equal volumes of different gases at the
 Elastic tissue- plenty in the tracheobronchial same temperature and pressure contain
tree, elastic membrane is responsible for the the same number of molecules
recoil of bronchial tree during expiration  Ideal Gas Law
 Cartilaginous rings- ensures patency of the  Combines all the three laws – Boyle’s law,
tubes Charle’s law, Avogadro’s law
 Smooth muscles- changes the diameter of the
lumen of the tube  Dalton’s law
 Nerve supply- bronchoconstrictor are derived  Each gas in a mixture exerts a pressure
from the vagus according to its own concentration,
independent of the other gases present
III. Gas Laws  Each component behaves as though it
were present alone
1. Kinetic Theory of Gases  The pressure of each gas is referred to as
 The molecule of a gas are in constant random partial pressure or tension
motion and are detached from their course  Pp = conc. x total pressure
only by collision with other molecules or with
the walls of the container  Partial Pressure
 Pressure depends on:
 Gas molecules are in constant rapid
 Number of molecules present motion causing them to strike each other
 Mass the walls or surface – because of this
 Speed/velocity constant bombardment pressure is
 Boyle’s law produced
 At a constant temperature, the
pressure of a given mass of a gas is 2. Composition of Air
inversely proportional to its volume a. Solubility Coefficient of gases at
 Gay Lussac’s Law bodytemperature
 If the pressure of a given quantity of  N2 0.012
gas remains constant but the  O2 0.024
temperature varies – the volume of  Water vapor
the gas increases directly in proportion  Negligible CO2 0.53
to the increase in temperature Inert Gases
 V=T x K  Helium 0.008
 Gas Law b. Dry atmosphere
 Boyle’s Law + Gay Lussac’s Law  1. N2 - 79%
 Graham’s Law  2. O2 - 21%
 The rate of diffusion of a gas is inversely
proportional to the square root of its IV. External Respiration
density - A passive process by Elastic recoil
 Charle’s Law of lungs and chest cage
Steps of Respiration

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  Ventilation- exchange of air between
atmosphere and alveoli by bulk flow
 Exchange of O2 and CO2 between alveolar air and
blood in lung capillaries by diffusion
 Transport of O2 and CO2 through pulmonary and
systemic circulation by bulk flow
 Exchange of O2 and CO2 between blood in tissue
capillaries and cells in tissue by diffusion
 Cellular utilization of O2 and production of CO2
1. Process involved in respiration
 Ventilation- the process of moving air from
atmosphere into the alveoli( and carbon dioxide
in opposite direction)
 Diffusion- movement of gas across the gas blood
barrier
 Matching ventilation and blood flow
 Pulmonary blood flow- to move oxygen out of
the lung and carbon dioxide in the lung
 Blood gas transport- carriage of oxygen and
carbon dioxide in the blood
 Transfer of gases from the peripheral capillaries
and the cells
 Utilization of oxygen
A. Ventilation (Breathing)
 Inspiration- expiration
 Requires 3-5 % of total energy
 Reasons why there are differences between
atmospheric and alveoli air
1. Alveolar air is partially replaced by
atmospheric air with each breath
2. Oxygen is constantly being absorbed from
the alveolar gas
3. Carbon dioxide is constantly diffusing from
the pulmonary blood into the alveoli
4. Dry atmosphere air enters the respiratory
passage is humidified even before it
reaches the alveoli
V. Internal respiration
- Respiratory muscle contraction
3 fractions :
1. To expand the lungs against lung and chest
elastic forces
2. To overcome the viscosity of the lung and
chest wall structures- Tissue resistance work
3. To overcome airway resistance to movement
of air into lungs- airway resistance work
VI. Pulmonary volumes and capacities
BAGWAN
Pulmonary volumes
1. Tidal volumes – volume of air inspired and
expired
2. Inspiratory reserve volume – extra volume of
air that can be inspired over and above the tidal
volume when the person inspires full force
3. Expiratory reserve volume – max extra volume
of air that can be expired by forceful expiration
4. Residual volume – volume of air remaining in
lungs after the most forceful expiration
Pulmonary Capacity
1. Inspiratory capacity
2. Functional Residual Capacity
3. Vital Capacity
4. Total Lung Capacity
VI. Alveolar Ventilation
- the ultimate importance of pulmonary
ventilation : continually renew the air in gas
exchange areas of lungs
- rate at which new air reaches alveoli, alveolar
sacs & ducts and respiratory bronchioles
Dead Space Air – not useful for gas exchange
since it never reaches gas exchange areas
- Only fills respiratory passages like
nose pharynx and trachea where
no gas exchange occurs.
- One of the major factors that
determine concentrations of
oxygen and carbon dioxide in
alveoli.
VIII. Nervous and Chemical control of Respiration
 Sympathetic – bronchodilation
- Epinephrine stimulates beta-
adrenergic receptors- dilation of
the bronchial tree
 Parasympathetic – bronchoconstriction
 Also causes bronchoconstriction :
- Histamine and slow reactive
substances of anaphylaxis
- Smoke, dust, sulphur dioxide and
some of acidic elements in smog
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 Abbreviation and Symbols
VC = IRV + VT + ERV
VC = IC + ERV
TLC = VC + RV
TLC = IC + FRC
FRC = ERV + RV

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