Anatomy & Physiology of the Respiratory System

The respiratory system is situated in

the thorax, and is responsible for
gaseous exchange between the
circulatory system and the outside
world. Air is taken in via the upper
airways (the nasal cavity, pharynx
and larynx) through the lower
airways (trachea, primary bronchi
and bronchial tree) and into the
small bronchioles and alveoli within
the lung tissue.
Move the pointer over the coloured
regions of the diagram; the names will
appear at the bottom of the screen)
The lungs are divided into lobes;
The left lung is composed of
the upper lobe, the lower
lobe and thelingula (a small
remnant next to the apex of the heart), the right lung is composed of
the upper, themiddle and the lower lobes.
Mechanics of Breathing
To take a breath in, the external intercostal muscles contract, moving the
ribcage up and out. Thediaphragm 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.
CO
2
moves into the alveolus as the concentration is much lower in the alveolus
than in the blood, and O
2
moves out of the alveolus as the continuous flow of
blood through the capillaries prevents saturation of the blood with O
2
and allows
maximal transfer across the membrane.
Respiratory physiology Pulmonary ventilation - movement of air into and out of
lungs External respiration - The process by which gases are exchanged between
the lungs and the pulmonary vasculature. O2 diffuses from the alveoli into the
blood, and CO2 diffuses from the blood to the alveoli. Diffusion is a passive
process in which gases move across a membrane from an area of higher to lower
concentration. In the lungs the membrane is the alveolar-capillary network
Internal respiration - The process by which gases are exchanged between the
pulmonary vasculature and the body's tissues. Oxygen from the lungs diffuses
from the blood into the body tissue. CO2 diffuses from the tissues into the blood.
This blood in then carried back to the right side of the heart for re-oxygenation
Hypoxia - reduced oxygenation of cells in tissues Hypoxemia - reduced
oxygenation of arterial blood (PaO2). Hypoxemia can lead to tissue hypoxia,
however tissue hypoxia has other causes and can occur in light of normal arterial
oxygenation (low CO or cyanide poisoning) Cyanosis, a bluish coloring of the skin,
caused by an unusually high percentage of deoxygenated hemoglobin in the
blood. Deoxygenated hemoglobin is purplish, in contrast to the bright red
oxyhemoglobin Anoxia - when O2 supply completely shut off, anoxia and tissue
death may result .Pulmonary Ventilation Boyles Law - as pressure of gas
decreases it volume expands; as pressure increases its volume decreases.
Intrapulmonary pressure drives air exchange - decreased pressure, air in.
Diaphragm and external and internal intercostals - used for normal quite breathing
Accessory muscles - active during active inspiratory and expiratory movements of
forced breathing hyperventilation is defined as increased alveolar ventilation. This
leads to a decrease in PaCo2. There are many causes of hyperventilation including
hypoxemia, head injury, and anxiety or panic attack. hypoventilation is defined as
a decreased alveolar ventilation. This leads to a increased PaCo2. Some common
causes of hypovetilation include chest wall restriction, altered neurologic control of
breathing, and obstructed airway. Gas exchange Daltons Law - In a mixed gas the
individual gases exert a pressure proportional to their abundance in the mixture.
Partial pressure - the pressure contributed by a single gas is the partial pressure
Alveolar ventilation - the amount of air reaching the alveoli each minute. O2 and
CO2 exchange ooccurs at the interface of the alveolus and pulmonary capillaries
(respiratory membrane) Diffusion of these gases depends on several factors. Two
important factors are the thickness and surface area of the respiratory membrane.
Interstitial edema and fibrotic changes cause the respiratory membrane to change
in thickness. The surface area of the respiratory membrane becomes smaller with
emphysema as alveoli are destroyed. If the surface area is decreased more than
25% then the patient can have diffusion problems and shortness of breath even at
rest Blood entering peripheral capillaries delivers oxygen and absorbs CO2 at the
tissues Po2 - over the range of O2 pressures normally present in the body, a small
change in plasma Po2 will mean a large change in the amount of O2 bound or
released. At alveolar Po2 the hemoglobin are almost fully saturatted; at the
peripheral tissues it retains a substantial O2 reserve When low plasma Po2
continues for an extended period of time, red blood cells generate more 2,3 (BPG)
bisphosphoglycerate, which reduces hemoglobins affinity for oxygen. CO2
production - aerobic metabolism in the peripheral tissues generates CO2. About 7
percent of the CO2 transported in the blood is dissolved in the plasma; 23 percent
is bound as carbaminohemoglobin; the rest is converted to cardbonic acid which
dissociates into H+ and HCO3-