The Respiratory System

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The Respiratory System

Humans can live without water for days and without food for weeks, but they cannot live without
oxygen for even a few minutes. Breathing is our most urgent need. The trillions of cells in the
body need a continuous supply of oxygen to produce the energy needed to carry out their
vital functions. Furthermore, as the cells use oxygen, they produce carbon dioxide, a waste
product the body must eliminate. The major function of the respiratory system is to fulfill these
needs that is, to supply the body with oxygen and dispose of carbon dioxide (CO2). To
accomplish this, the following processes, collectively called respiration, must occur:

1. Pulmonary ventilation. Air must be moved into and out of the lungs so that the gases in the
air sacs (alveoli) of the lungs are continuously replaced. This movement is commonly called
ventilation, or breathing.

2. External respiration. Gas exchange must occur between the blood and air at the lung alveoli.
Oxygen in the air sacs diffuses into the blood; CO2 in blood diffuses into the air sacs.

3. Transport of respiratory gases. Oxygen and carbon dioxide must be transported between
the lungs and the cells of the body. This is accomplished by the cardiovascular system, with
blood serving as the transporting fluid.

4. Internal respiration. At the systemic capillaries, gases must be exchanged between the blood
and the tissue cells.

Oxygen is used by the cells and carbon dioxide is produced as a waste product during the
chemical process that converts glucose to cellular energy (ATP). This process is called
cellular respiration ( ). The respiratory
processes described above ensure that cellular respiration can occur in virtually all body cells.
Unless gas transport and internal respiration also occur, the respiratory system cannot
accomplish its main goal of supplying oxygen to the cells and removing carbon dioxide. Thus,
the respiratory and cardiovascular systems are closely coupled, and if either system fails, the
body’s cells begin to die from oxygen starvation. Because it moves air into and out of the body,
the respiratory system is also involved in the sense of smell and with the
vocalizations(vibration of vocal folds) of speech.
FUNCTIONAL ANATOMY OF THE RESPIRATORY SYSTEM

The organs of the respiratory system include the nose, nasal cavity, and paranasal sinuses; the
pharynx; the larynx; the trachea; the bronchi and their smaller branches; and the lungs, which
contain the terminal air sacs, or alveoli. Functionally, these respiratory structures are
divided into conducting and respiratory zones. The conducting zone includes the respiratory
passageways that carry air to the sites of gas exchange. The structures of the conducting zone
also filter, humidify, and warm the incoming air. Thus, the air reaching the lungs contains
much less dust than it did when it entered the nose and is warm and damp. The respiratory
zone, the actual site of gas exchange in the lungs, is composed of the terminal respiratory
passageways and alveoli—namely, the respiratory bronchioles, alveolar ducts, and alveolar
sacs.
The Nose and the Paranasal Sinuses

The Nose

The nose is the only externally visible part of the respiratory system. The nose (1) provides an
airway for respiration, (2) moistens and warms entering air, (3) filters inhaled air to
cleanse it of foreign particles, (4) serves as a resonating chamber for speech, and (5) houses
the olfactory (smell) receptors. The structures of the nose are divided into the external nose and
the internal nasal cavity. The skeletal framework of the external nose, consists of the frontal
and nasal bones superiorly (forming the root and bridge, respectively), the maxillary bones
laterally, and flexible plates of hyaline cartilage inferiorly (the lateral, septal, and alar
cartilages).

The Nasal Cavity


The nasal cavity lies in and posterior to the external nose. During breathing, air enters this
cavity by passing through the external nares, or nostrils. The nasal cavity is divided into right
and left halves by the nasal septum in the midline. Posteriorly, the nasal cavity is continuous
with the nasal part of the pharynx (nasopharynx) through the posterior nasal apertures, also
called the choanae or internal nares.

The nose hairs, or vibrissae (vi-brise) (vibro to quiver), filter large particles, such as insects and
lint, from the inspired air. The rest of the nasal cavity is lined with two types of mucous
membrane: (1) the small patch of olfactory mucosa near the roof of the nasal cavity, which
houses the receptors for smell, and (2) the respiratory mucosa, a mucous membrane that lines
the vast majority of the nasal cavity.

Each day, the nasal glands and the epithelial goblet cells secrete about a quart of mucus
containing lysozyme, an enzyme that digests and destroys bacteria. The sticky mucus forms a
sheet that covers the surface of the mucosa and traps inhaled dust, bacteria, pollen, viruses, and
other debris from the air. Thus, an important function of the respiratory mucosa is to filter the
inhaled air. The ciliated cells in the epithelial lining create a gentle current that moves the sheet
of contaminated mucus posteriorly to the pharynx, where it is swallowed. In this way, particles
filtered from the air are ultimately destroyed by digestive juices in the stomach. In addition,
the sheet of mucus is a wet film that moistens the inhaled air.

The Paranasal Sinuses

The nasal cavity is surrounded by a ring of air-filled cavities called Paranasal sinuses located in
the frontal, sphenoid, ethmoid, and maxillary bones. These sinuses open into the nasal cavity,
are lined by the same mucosa, and perform the same air-processing functions as does that
cavity. Their mucus drains into the nasal cavities, and the suctioning effect caused by nose
blowing helps to drain them. Inflammation of the Paranasal sinuses, a condition called
sinusitis, is caused by viral, bacterial, or fungal infections. When the passages that connect
the Paranasal sinuses to the nasal cavity become blocked by swelling of the inflamed nasal
mucosa, air in the sinus cavities is absorbed into the blood vessels of the mucosal lining,
resulting in a partial vacuum and a sinus headache localized over the inflamed areas. Serious
cases of sinusitis are treated by promoting drainage and with antibiotics.
The Pharynx

The pharynx is the funnel-shaped passageway that connects the nasal cavity and mouth
superiorly to the larynx and esophagus inferiorly. It descends from the base of the skull to the
level of the sixth cervical vertebra and serves as a common passageway for both food and air.
In the context of the digestive tract, the pharynx is commonly called the throat. On the basis of
location and function, the pharynx is divided into (from superior to inferior) the nasopharynx,
oropharynx, and laryngopharynx. The muscular wall of the pharynx consists of skeletal
muscle throughout its length, but the nature of the mucosal lining varies among the three
pharyngeal regions.

The Larynx

The larynx, or voice box, has three functions: (1) producing vocalizations, (2) providing an open
airway, and (3) acting as a switching mechanism to route air and food into the proper channels.
For the latter purposes, the inlet (superior opening) to the larynx is closed during swallowing and
open during breathing.

The framework of the larynx is composed of intricate or complex arrangement of nine


cartilages connected by membranes and ligaments: thyroid cartilage, cricoid cartilage,
arytenoid cartilages (2), corniculate cartilages (2), cuneiform cartilages (2) and the epiglottis.
The thyroid cartilage which externally known as Adam’s apple is larger in men than in women,
because male sex hormones stimulate its growth during puberty.

Air exhaled from the lungs causes vocal folds to vibrate in a wave motion and to clap
together, producing the basic sounds of speech . Generally, speech involves the intermittent
release of exhaled air and the opening and closing of the glottis. Loudness of the voice depends
on the force with which air rushes across the vocal folds. The greater the force, the stronger
the vibrations and the louder the sound. The vocal folds do not move at all when we whisper,
but they vibrate vigorously when we yell.

Although the vocal folds produce the basic speech sounds, the entire length of the pharynx or
throat acts as a resonating chamber to amplify the quality of sound. The oral cavity, nasal
cavity, and Paranasal sinuses also contribute to vocal resonance. In addition, normal speech
and good enunciation depend on the “shaping” of sounds into recognizable consonants and
vowels by the pharynx, tongue, soft palate, and lips.

The Trachea

The flexible trachea, or windpipe, descends from the larynx through the neck and into the
mediastinum; it ends by dividing into the two main bronchi (primary bronchi) in the
midthorax. The tracheal wall contains 16 to 20 C-shaped rings of hyaline cartilage joined to
one another by intervening membranes of fibro-elastic connective tissue. The microscopic
structure of the wall of the trachea consists of several layers common to many tubular organs of
the body: the mucosa, submucosa, and adventitia. The mucosa, a mucous membrane, as usual,
consists of an inner epithelium and a lamina propria. The epithelium is the same air-filtering
pseudo-stratified epithelium that occurs throughout most of the respiratory tract; its cilia
continuously propel dust-laden sheets of mucus superiorly toward the pharynx.
The Bronchial Tree

Bronchi in the Conducting Zone

The right and left main bronchi, also called primary bronchi, are the largest conduits in the
bronchial tree, a system of respiratory passages that branches extensively within the lungs. The
two main bronchi are branches of the trachea in the mediastinum. Because the right main
bronchus is wider, shorter, and more vertical than the left, an accidentally inhaled object, such
as a button or marble, is more likely to lodge in the right main bronchus. As they approach and
enter the lungs, the main bronchi divide into secondary or lobar bronchi—three on the right
and two on the left—each of which supplies one lung lobe.

The lobar bronchi branch into tertiary or segmental bronchi, which in turn divide repeatedly
into smaller bronchi: fourth-order, fifth-order, and so on. Overall, there are about 23 orders of air
tubes in the lungs, the tiniest almost too small to be seen without a microscope. The tubes
smaller than 1 mm in diameter are called bronchioles (“little bronchi”), and the smallest of these,
the terminal bronchioles, are less than 0.5 mm in diameter.
The Respiratory Zone

The respiratory zone consists of structures that contain air-exchange chambers called
alveoli. The first respiratory zone structures, which branch from the terminal bronchioles of
the conducting zone, are respiratory bronchioles. These can be recognized by the scattered
alveoli protruding from their walls. The respiratory bronchioles lead into alveolar ducts, straight
ducts whose walls consist almost entirely of alveoli. The alveolar ducts then lead into terminal
clusters of alveoli called alveolar sacs. Note that alveoli and alveolar sacs are not the same
things: An alveolar sac is analogous to a bunch of grapes, in which the individual grapes are the
alveoli. About 300 million air-filled alveoli crowd together within the lungs, accounting for
most of the lung volume and providing a tremendous surface area for gas exchange.
The Lungs and Pleurae

Gross Anatomy of the Lungs

The paired lungs and their pleural sacs occupy the entire thoracic cavity lateral to the
mediastinum. Each lung is roughly cone-shaped. The anterior, lateral, and posterior surfaces of a
lung contact the ribs and form a continuously curving costal surface. Just deep to the clavicle is
the apex, the rounded, superior tip of the lung. The concave inferior surface that rests on
the diaphragm is the base. On the medial surface of each lung is an indentation, the hilum,
through which blood vessels, bronchi, lymphatic vessels, and nerves enter and exit the lung.
Collectively, these structures attach the lung to the mediastinum and are called the root of the
lung. The largest components of this root are the pulmonary artery and veins and the main
(primary) bronchus.

Because the heart is tilted slightly to the left of the median plane of the thorax, the left and right
lungs differ slightly in shape and size. The left lung is somewhat smaller than the right and
has a cardiac notch, a deviation in its anterior border that accommodates the heart. Several
deep fissures divide the two lungs into different patterns of lobes. The left lung is divided into
two lobes, the superior lobe and the inferior lobe, by the oblique fissure. The right lung is
partitioned into three lobes, the superior, middle, and inferior lobes, by the oblique and
horizontal fissures.
The Pleurae

Around each lung is a flattened sac whose walls consist of a serous membrane called pleura.
The outer layer of this sac is the parietal pleura, whereas the inner layer, directly on the lung, is
the visceral pleura. The space between the parietal and visceral pleurae is the pleural cavity.
The pleural cavity is filled with a thin film of pleural fluid. This fluid is secreted by the pleurae
and it allows the lungs to glide without friction over the thoracic wall during breathing
movements.

VENTILATION

Breathing, or pulmonary ventilation, consists of two phases: inspiration (inhalation), the


period when air flows into the lungs, and expiration (exhalation), the period when gases exit the
lungs.

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