RESPIRATORY

SYSTEM

Romel M. Durante, RN, MAN ( C )

Clinical Instructor
 LEARNING OUTCOMES
At the end of this lecture, you should be able to:
1. Describe the functions of the respiratory system.
2. Describe the anatomy of the respiratory passages, beginning at the nose and
ending with the alveoli.
3. Describe the structure of the lungs, and define respiratory membrane.
4. Describe the changes in alveolar pressure that are responsible for moving air
into and out of the lungs.
5. Explain how surfactant and pleural pressure prevent the lungs from collapsing
and how changes in pleural pressure cause alveolar volume to change.
6. List the respiratory volumes and capacities, and define each of them.
7. Explain how O2 and CO2 are transported in the blood.
8. Describe the respiratory areas of the brainstem and how they produce a
rhythmic pattern of ventilation.
 Functions
1. Regulation of blood pH - The respiratory system can
alter blood pH by changing blood CO2 levels.
2. Voice production - Air movement past the vocal
cords makes sound and speech possible.
3. Olfaction - The sensation of smell occurs when
airborne molecules are drawn into the nasal cavity.
4. Innate immunity - The respiratory system protects
against some microorganisms and other pathogens,
such as viruses, by preventing them from entering the
body and by removing them from respiratory surfaces.

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RESPIRATORY SYSTEM

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 Nose
A. External nose
▪ composed of mainly of hyaline cartilage
B. Nasal cavity
▪ Extends from the nares or nostrils ( external openings of the
nose ) to the choanae ( openings into the pharynx )
❑ nasal septum - partition dividing the nasal cavity into right and
left parts
❑ deviated nasal septum - occurs when the septum bulges to one
side
❑ hard palate - forms the floor of the nasal cavity, separating the
nasal cavity from the oral cavity.
❑ conchae - Three prominent bony ridges ; increase the surface
area of the nasal cavity; help in cleaning, humidifying, warming of
air
Air can flow through the nasal cavity when the oral cavity is closed or full of
food.
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Paranasal sinuses:
o air filled spaces within bone
o include the maxillary, frontal, ethmoidal, and sphenoidal
sinuses
o open into nasal cavity and are lined with mucous membrane
o reduce the weight of the skull, produce mucus, and influence
the quality of the voice by acting as resonating chambers.
Nasolacrimal ducts:
o carry tears from eyes, also open into nasal cavity
❖ sneeze reflex dislodges foreign substances from the nasal cavity
❖ photic sneeze reflex
➢ stimulated by exposure to bright light, such as the sun
➢ fancifully called ACHOO, which stands for autosomal-dominant-
compelling-helio-ophthalmic-outburst.
❖ pupillary reflex - causes the pupils to constrict in response to
bright light

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 Functions of Nose
• Filters
• Airway for respiration
• Involved in speech
• Olfactory receptors
• Warms air
• Sneezing dislodges materials from nose

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 Pharynx
❑ Throat
❑ Common passageway for respiratory and the digestive systems
❑ Air from the nasal cavity and air, food, and water from the mouth
pass through the pharynx.
❑ Three regions:
1. Nasopharynx
➢ superior part of the pharynx
➢ located posterior to the choanae and superior to the soft palate
( incomplete muscle and connective tissue partition separating
the nasopharynx from the oropharynx ).
❖ uvula - posterior extension of the soft palate.
➢ posterior part of the nasopharynx contains the pharyngeal
tonsil (which helps defend the body against infection)
soft palate is elevated during swallowing; this movement closes the
nasopharynx and prevents food from passing from the oral cavity into the
nasopharynx.
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 10
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 Pharynx
❑ Three regions:
2. Oropharynx
➢ extends from the uvula to the epiglottis, and the oral cavity opens
into the oropharynx
➢ food, drink, and air all pass through the oropharynx
➢ Two sets of tonsils, the palatine tonsils and the lingual tonsil, are
located near the opening between the mouth and the oropharynx
❑ palatine tonsils - located in the lateral walls near the border of
the oral cavity and the oropharynx.
❑ lingual tonsil - located on the surface of the posterior part of the
tongue.
3. Laryngopharynx
➢ Food and drink pass through the laryngopharynx to the
esophagus
➢ small amount of air is usually swallowed with the food and drink
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 12
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Lower Respiratory Tract
• Larynx

• Trachea

• Bronchi

• Lungs

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 Figure 15.1

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 Larynx
• In front of throat
• Consists of cartilage
• Thyroid cartilage:
✓ largest piece of cartilage
✓ called Adam’s apple
• Cricoid cartilage ( ring-shaped)
✓ forms the base of the larynx on
which the other cartilages rest

❑ The thyroid and cricoid cartilages maintain an open

passageway for air movement.

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 Anatomy of the Larynx

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 Larynx

• Epiglottis:
✓ consists of elastic cartilage
rather than hyaline cartilage
✓ helps prevent swallowed
materials from entering the
larynx
✓ As the larynx elevates during
swallowing, the epiglottis tips
posteriorly to cover the opening
of the larynx.

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• Vocal folds/cords:
- primary source of voice production
- air moves past them, they vibrate, and
sound is produced
- force of air determine loudness
- tension of the vocal folds control the pitch

• Laryngitis:
- inflammation of vocal folds
- caused by overuse, dry air, infection
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 Vestibular and Vocal Folds

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 Trachea
• Windpipe
• Consists of 16-20 C shaped pieces of hyaline cartilage
• adult trachea is about 1.4–1.6 centimeters (cm) in diameter and
about 10–11 cm long
• Coughing dislodges materials from trachea
• Divides into right and left primary bronchi (lungs)
• Sensory receptors detect the foreign substance, and action
potentials travel along the vagus nerves to the medulla oblongata,
where the cough reflex is triggered.
• During coughing, the smooth muscle of the trachea contracts,
decreasing the trachea’s diameter so air moves rapidly through
the trachea, which helps expel mucus and foreign substances.
• uvula and soft palate are elevated, so that air passes primarily
through the oral cavity.

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 Bronchi
• Divide from trachea
• trachea divides into the left and right main bronchi or
primary bronchi
• Connect to lungs
• The left main bronchus is more horizontal than the right
main bronchus because it is displaced by the heart
• Lined with cilia
• Contain C shaped pieces of cartilage

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 Lungs
• Primary organ of respiration
• Cone shaped
• base resting on the diaphragm and its apex extending
superiorly to a point about 2.5 cm above the clavicle
• Right lung has 3 lobes (superior, middle, and inferior lobes)
• Left lung has 2 lobes (superior and inferior lobes)
• Contains many air passageways (divisions)
• Each lobe is divided into bronchopulmonary segments (
nine in the left lung and ten in the right lung) separated from
one another by connective tissue septa

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 Lungs, Lung Lobes, and Bronchi

Superior lobe

Pulmonary arteries
Hilum Hilum
Primary bronchi
Horizontal fissure
Pulmonary Cardiac impression
veins
Middle lobe Cardiac notch

Inferior lobe Oblique fissure

Oblique fissure

Right lung Left lung

Medial views

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 Air Passageways of Lungs
1. Primary bronchi
2. Lobar (secondary) bronchi
3. Segmental (tertiary) bronchi
4. Bronchioles
5. Terminal bronchioles
6. Respiratory bronchioles
7. Alveolar ducts
8. Alveoli

• Structures become smaller and more numerous from

primary bronchi to alveoli
• There are about 300 million alveoli in the lungs

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 Lungs
• Alveoli:
- small air sacs
- where gas exchange occurs
- surrounded by capillaries
- 300 million in lungs

• Asthma attack:
contraction of terminal bronchioles leads to
reduced air flow

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 Bronchioles and Alveoli

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 Respiratory Membrane
• In lungs where gas exchange between air
and blood occurs
• Formed by walls of alveoli and capillaries
• Alveolar ducts and respiratory bronchioles
also contribute
• very thin to facilitate the diffusion of gases.

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Alveolus and the Respiratory Membrane

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Layers of Respiratory Membrane
1. Thin layer of fluid from alveolus
2. Alveolar epithelium (simple squamous)
3. Basement membrane of alveolar
epithelium
4. Thin interstitial space
5. Basement membrane of capillary
endothelium
6. Capillary endothelium (simple
squamous)
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Pleural Membranes and Cavities
• Pleura:
double-layered membrane around lungs
• Parietal pleura:
membrane that lines thoracic cavity
• Visceral pleura:
membrane that covers lung’s surface
• Pleural cavity:
space around each lung
33
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 Ventilation
• What is it?
- breathing
- process of moving air in and out of lungs
- uses diaphragm: skeletal muscle that
separates thoracic and abdominal cavities

35
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Effect of the Muscles of Respiration on Thoracic Volume

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 Phases of Ventilation
• Inspiration:
- breathe in
- uses external intercostal muscles

• Expiration:
- breathe out
- uses internal intercostal muscles

37
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Pressure Changes and Air Flow
• When thoracic cavity volume increases
pressure decreases.

• When thoracic cavity volume decreases

pressure increases.

• Air flows from areas of high to low pressure.

38
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 Inspiration
• Diaphragm descends and rib cage expands

• Thoracic cavity volume increases, pressure

decreases

• Atmospheric pressure is greater than

(high) alveolar pressure (low)

• Air moves into alveoli (lungs)

39
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 Expiration
• Diaphragm relaxes and rib cage recoils

• Thoracic cavity volume decreases, pressure

increases

• Alveolar pressure is greater than (high)

atmospheric pressure (low)

• Air moves out of lungs

40
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 Lung Recoil
• What is it?
- tendency for an expanded lung to
decrease in size
- occurs during quiet expiration
- due to elastic fibers and thin film of fluid
lining alveoli

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 Surfactant
• What is it?
- mixture of lipoproteins
- produced by secretory cells of alveoli
- surfactant molecules form a single layer
on the surface of the thin fluid layer lining
the alveoli, reducing surface tension
- keeps lungs from collapsing

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Alveolus and the Respiratory Membrane

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 Pleural Pressure
• What is it?
- pressure in pleural cavity
- less than alveolar pressure
- keep alveoli from collapsing

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 Factors that Influence
Pulmonary Ventilation
• Lung elasticity:
- lungs need to recoil between ventilations
- decreased by emphysema
• Lung compliance:
- expansion of thoracic cavity
- affected if rib cage is damaged
• Respiratory passageway resistance:
occurs during an asthma attack, infection,
tumor 46
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 Pulmonary Volumes
Spirometer
➢ device that measures pulmonary volumes
Spirometry
➢ is the process of measuring volumes of air that move into and
out of the respiratory system
Tidal volume (TV)
➢ volume of air inspired and expired with each breath
➢ At rest, quiet breathing results in a tidal volume of about 500
milliliters (mL).
Inspiratory reserve volume (IRV):
➢ volume of air that can be inspired forcefully after a normal
inspiration
➢ about 3000 mL
47
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 Spirometer

48
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Expiratory reserve volume (ERV):
➢ volume of air that can be expired forcefully after a
normal expiration
➢ about 1100 mL

Residual volume (RV):

➢ volume of air still remaining in the respiratory
passages and lungs after maximum expiration
➢ about 1200 mL

49
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 Figure 15.12b

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Functional residual capacity
➢ ERV + RV
➢ This is the amount of air remaining in the lungs at the end
of a normal expiration (about 2300 mL at rest).
Inspiratory capacity
➢ TV + IRV
➢ This is the amount of air a person can inspire maximally
after a normal expiration (about 3500 mL at rest).
Vital Capacity (VC):
➢ VC = IRV + ERV + TV
➢ It is the maximum volume of air that a person can expel
from the respiratory tract after a maximum inspiration
(about 4600 mL).
Total lung capacity (TLC):
➢ TLC = VC + RV
➢ about 5800 mL
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 Figure 15.12b

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Factors that Influence Pulmonary Volumes

• Gender

• Age

• Height

• Weight

53
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Factors that Influence Pulmonary Volumes
• vital capacity of adult females is usually 20–25% less than
that of adult males.
• The vital capacity reaches its maximum amount in young
adults and gradually decreases in the elderly.
• Tall people usually have a greater vital capacity than short
people, and thin people have a greater vital capacity than
obese people.
• Well-trained athletes can have a vital capacity 30–40%
above that of untrained people.
• In patients whose respiratory muscles are paralyzed by
spinal cord injury or diseases such as poliomyelitis or
muscular dystrophy, the vital capacity can be reduced to
values not consistent with survival (less than 500–1000 mL).
54
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 Gas Exchange
o Respiratory membrane: where gas exchange
between blood and air occurs
o primarily in alveoli
o some in respiratory bronchioles and alveolar
ducts
o does NOT occur in bronchioles, bronchi,
trachea ( the volume is called anatomical dead
space )
o influenced by thickness of membrane, total area
of membrane, partial pressure of gases

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Respiratory Membrane Thickness
• Increased thickness decreases rate of diffusion
• Pulmonary edema (fluid accumulates in the
alveoli) decreases diffusion
• Rate of gas exchange is decreased
• O2 exchange is affected before CO2 because CO2
diffuse more easily than O2 (O2 diffuses through
the respiratory membrane about 20 times less
easily than does CO2).

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 Surface Area
• Total surface area of the respiratory
membrane is about 70 square meters

• Decreased due to removal of lung tissue,

destruction from cancer, emphysema

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 Partial Pressure
What is it?
❑pressure exerted by a specific gas in a
mixture of gases, such as air.
❑Ex. Total pressure of all gases is 760 mm
Hg (atmospheric pressure at sea level) and
21% of mixture is O2 then partial pressure
for O2 is 160 mm Hg
❑symbol is P and gas (Po2)

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 Diffusion of Gases in Lungs
• Cells in body use O2 and produce CO2.
• Blood returning from tissues and entering
lungs has a decreased Po2 and increased
Pco2
• O2 diffuses from alveoli into pulmonary
capillaries (blood)
• CO2 diffuses from capillaries into alveoli

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Diffusion of Gases in Tissues
• Blood flow from lungs through left side of heart
to tissue capillaries
• Oxygen diffuses from capillaries into interstitial
fluid because Po2 in interstitial fluid is lower than
capillary
• Oxygen diffuses from the interstitial fluid into
cells, in which the Po2 is less than in the
interstitial fluid.
• Within the cells, O2 is used in cellular respiration

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Gas Exchange in the Tissues and in the Lungs

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 Oxygen Transport
▪ After O2 diffuses through the respiratory
membrane into the blood, about 98.5% of the O2
transported in the blood combines reversibly with
the iron-containing heme groups of hemoglobin.
▪ About 1.5% of the O2 remains dissolved in the
plasma.
▪ Hemoglobin with O2 bound to its heme groups is
called oxyhemoglobin.
▪ At rest, approximately 23% of the O2 picked up by
hemoglobin in the lungs is released to the tissues.

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 Oxygen Transport
The amount of O2 released from oxyhemoglobin is
influenced by four factors. More O2 is released from
hemoglobin if:
1.the Po2 is low
2.the Pco2 is high
3.the pH is low
4.the temperature is high.
Increased muscular activity results in a decreased Po2, an
increased Pco2, a reduced pH, and an increased
temperature. Consequently, during physical exercise, as
much as 73% of the O2 picked up by hemoglobin in the lungs
is released into skeletal muscles.
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Carbon Dioxide Transport and Blood pH
• CO2 diffuses from cells into tissue capillaries
• After CO2 enters the blood, it is transported in three ways:
1. About 7% is transported as CO2 dissolved in the plasma;
2. 23% is transported in combination with blood proteins, primarily
hemoglobin
3. 70% is transported in the form of bicarbonate ions.
• CO2 reacts with water to form carbonic acid (H2CO3) which
then dissociate to form H+ + bicarbonate ions (HCO3)
• Enzyme Carbonic anhydrase (inside RBC) increases rate
of CO2 reacting with water to form H+ and HCO3 in the
tissue capillaries --- carbonic anhydrase promotes the
uptake of CO2 by RBC
• As CO2 levels increase, blood pH decreases ( acidic )

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 Rhythmic Ventilation
• Normal respiration rate ( adult ) - 12-20
breaths per minute
• In children, the rates are higher and may
vary from 20 to 40 per minute.
• Controlled by neurons in medulla oblongata
• Rate is determined by number of times
respiratory muscles are stimulated

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 Respiratory Areas in the Brainstem
• Neurons involved with respiration are located in
the brainstem.
• dorsal respiratory group - primarily responsible
for stimulating contraction of the diaphragm.
• ventral respiratory group - primarily responsible
for stimulating the external intercostal, internal
intercostal, and abdominal muscles.
• pre-Botzinger complex - is now known to
establish the basic rhythm of breathing.

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 Nervous Control of Breathing
• Higher brain centers allow voluntary breathing
• Emotions and speech affect breathing
• Hering-Breuer Reflex:
inhibits respiratory center when lungs are
stretched during inspiration
• Touch, thermal, and pain receptors in the skin
also stimulate the respiratory center, which
explains why we gasp in response to being
splashed with cold water or being pinched

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Nervous and Chemical Mechanisms of Breathing

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 Chemical Control of Breathing
• Chemoreceptors in medulla oblongata respond to
changes in blood pH
• Blood pH are produced by changes in blood CO2
levels
• An increase in CO2 causes decreased pH, result
is increased breathing
• Low blood levels of O2 stimulate chemoreceptors
in carotid and aortic bodies, increased breathing

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