Functions:

1. Gas exchange
2. Regulation of blood ph
3. Voice phonation
4. Olfaction
5. Innate immunity

Anatomy
Upper Respiratory tract
Nose, nasal cavity,
pharynx and associated
structures

Lower Respiratory tract

Larynx, trachea,
bronchi, and lungs

Nose and Nasal cavity

Epithelial lining:
stratified squamous
epithelium with coarse
hair, traps dust particles
and humidifies air.
Pseudostratified ciliated
epithelium with goblet
cells

Nares (nostrils), external opening

Choane, openings into the pharynx
Nasal septum, divides the cavity in to left and right halves
Hard palate, floor of the nasal cavity
Conchae, prominent bony ridges on the lateral wall of each nasal cavity
• Increase surface area
Paranasal sinuses, air filled spaces with in the bone (skull)
• Maxillary, frontal, ethmoidal and sphenoidal
o Open into the nasal cavity
o Reduce weight, produce mucus and act as resonating chambers
o Susceptible to infection and inflammation
Nasolacrimal duct

Pharynx
Common passageway for air and solid particles. Leads to the respiratory and digestive
systems. 3 regions: nasopharynx, oropharynx and laryngopharynx

Nasopharynx
Superior part of the pharynx, from the choane to the level of the uvula.
Soft palate, floor of the nasopharynx
Auditory tubes opens into the nasopharynx
Pharyngeal tonsils

Oropharynx
From the uvula to the epiglottis
Palatine tonsils, lateral walls near the border oral cavity and oropharynx
Lingual tonsils, surface on the posterior part of the tongue

Laryngopharynx
Posterior to the larynx and extend from the tip of the epiglottis to the esophagus

Larynx
Connected superiorly to the pharynx and inferiorly to the trachea. Consist of 3 unpaired
and 6 pair cartilages

Unpaired cartilages
Thyroid cartilage (Adams apple), superiorly attached to the hyoid bone
Cricoid cartilage, base of the larynx
Epiglottis, made of elastic cartilage. Its inferior margin is attached to the thyroid cartilage
anteriorly and it superior part projects freely toward the tongue.
During swallowing, the larynx elevates and the epiglottis moves posteriorly to
cover the opening of the pharynx

Paired cartilages (posterior side of the pharynx)

Cuneiform cartilage, superiorly located
Corniculate cartilage, middle
Arythenoid cartilage, inferiorly located and articulated with the cricoid cartilage

Ligaments
Vestibular folds (false vocal cords)
Vocal cords (true vocal cords)

Function
Open passageway, prevent swallowed material from the larynx, primary source of sound
production.
Air moving past vocal cords causes vibration. The greater the amplitude (greater force of
air) of vibrations the louder the sound. The frequency of vibrations determines pitch.
Higher pitched tones are produced only when the anterior portions vibrate and
progressively lower tones as the length of the involved cords increases

Trachea
Membranous tube that consists of dense connective tissue and smooth muscle reinforced
with “C” shaped cartilage.

Trachealis muscle – contraction of this smooth muscle narrows the diameter of the
trachea. During coughing this action of narrowing causes air to forcefully move out of the
respiratory system. Mucus membranes with ciliated cells line the trachea. Cilia propel
mucus and foreign material toward the larynx where the mucus enters the pharynx to be
swallowed.

Primary bronchi – trachea divides to form two smaller tubes.

Carina – the most inferior tracheal cartilage, which separates the opening into the two
primary bronchi. It is very sensitive to mechanical stimulation and foreign objects
reaching it will produce a powerful cough.

Tracheobronchial tree
Beginning with the trachea, all respiratory passageways
Main bronchi → lobar bronchi (2 left, 3 right) → segmental bronchi (bronchopulmonary
segments) → bronchioles → terminal bronchiole → respiratory bronchioles → alveolar
duct → alveoli

Conducting zone: From the trachea to the terminal bronchioles

Respiratory zone: Extends from terminal bronchioles to alveoli

The tissue surrounding the alveoli contain elastic fibers that allow the alveoli to expand
and recoil.

Type I pneumocytes – form 90% of alveolar wall, gas exchange

Type II pneumocytes – secretory cells that produce surfactant

Respiratory membrane – of the lungs is where gas exchange between air and blood takes
place.
To facilitate the diffusion of gases;
1. Thin layer of fluid lining the alveolus
2. Alveolar epithelium simple squamous epithelium
3. Basement membrane of the alveolar epithelium
4. Thin interstitial space
5. Basement membrane of capillary endothelium
6. Capillary endothelium simple squamous epithelium

Lungs
Principal organs of respiration
Right lung larger than left.
Hilum – region on the medial surface for entry and exit of blood vessels, lymphatic
vessels, nerves, and primary bronchus
Root of the lung – all structures passing through the hilum
Right lung has three lobes.
Left lung has 2 lobes.

Muscles of respiration
Diaphragm – dome shaped, attaches to the inner circumference of the inferior thoracic
wall.
Inspiration – diaphragm, external intercostals pectoralis minor, and scalenes.
Expiration – diaphragm, abdominal muscles and internal intercostals.

Physiology
Ventilation
The process of moving air into and out of the lungs. The flow of air into the lungs
requires a pressure gradient from the outside of the body to the alveoli. Airflow from the
lungs requires a pressure gradient in the opposite direction. Movement of air into and out
of the lungs results from changes in thoracic volume, which causes changes in alveolar
pressure
Lung recoil - causes the alveoli to collapse and it results from
1. Elastic recoil caused by the elastic fibers in alveolar walls.
2. Surface tension of the film of fluid that lines the alveoli.

Surfactant - mixture of lipoprotein molecules form a layer over the surface of the fluid
within the alveoli to reduce surface tension. Significantly reduces the tendency of the
lungs to collapse.

Pulmonary Volume and Capacities

Spirometry - the process of measuring volumes of air into and out of lungs.
Spirometer - device used to measure pulmonary volumes.
1. Tidal volume - the volume of air inspired or expired during normal inspiration
and expiration.
 2. Inspiratory reserve volume - the amount of air that can be inspired forcefully
after inspiration of the normal tidal volume.
3. Expiratory reserve volume - the amount of air that can be forcefully expired
after normal tidal volume.
4. Residual volume - the volume of air still remaining in the respiratory passages
after the most forceful expiration.

Respiratory capacities - the sum of two or more pulmonary volumes

1. Inspiratory capacity - the tidal volume plus the inspiratory reserve volume.
Maximum inspiration following normal expiration.
2. Functional residual capacity - expiratory reserve volume plus the residual
volume, amount of air remaining in lungs at the end of normal expiration.
3. Vital capacity - the sum of inspiratory reserve volume, the tidal volume, and
the expiratory reserve volume. Maximum volume of air that a person can
expel from the respiratory tract after maximum inspiration.
4. Forced expiratory vital capacity - pulmonary test that measures a person's vital
capacity.

Gas Exchange
The factors that influence the rate of gas diffusion across the respiratory membrane
include.
1. Thickness of the membrane.
a. Increasing membrane thickness decreases diffusion
Ex. Pulmonary edema, TB, Pneumonia
2. Surface area
a. Healthy normal individuals 70 square meters
b. Decreases in area caused by diseases ex. Emphysema, lung ca.
3. Partial pressure difference
 a. The difference between the partial pressure of the gas in the alveoli and
the partial pressure of gas in the blood of the pulmonary capillaries.
b. Pressure gradient diffuses from high to low.

Gas Transport

1. Molecular oxygen is carried in blood, 98.5% bound to hemoglobin, and 1.5% in

plasma.
a. Binds in a reversible fashion.
2. Carbon dioxide is transported in three major ways.
a. 7% is transported dissolved in plasma.
b. 23% transported in combination with blood proteins.
c. 70% transported in the bicarbonate form.
d. Binds in a reversible fashion.
3. Haldane effect – hemoglobin that has released its oxygen binds more readily to
carbon dioxide than hemoglobin that has oxygen bound to it.
4. Chloride shift – Bicarbonate ion concentration inside RBC’s are lowered by
exchanging them for chloride ions. As bicarbonate ions are produced, carrier
molecules in RBC membranes move bicarbonate ions out of the RBC’s and
chloride ions into the cell.

Regulation of Respiration
1. CNS
a. Medullary respiratory system – dorsal portion of medulla oblongota, and
ventral portion.
 Although the dorsal and ventral respiratory groups are bilateral,
cross communication does exist, so that respiratory movements
are symmetrical.
b. Dorsal respiratory system is most active during inspiration but is
responsible for stimulation of the diaphragm.
c. Ventral respiratory group is active during both inspiration and expiration.
Stimulate the external and internal intercostals, and abdominal muscles.
d. Pontine Respiratory group – neurons in the pons, some are active in
expiration or inspiration and/or both.

2. Cerebral and Limbic System Control

a. Possible to voluntarily or involuntarily to control rate of breathing through
the cerebral cortex.
b. Apnea – absence of breathing.
c. Voluntary apnea increases a greater and greater urge to breathe due to
increasing PCO2 levels.

3. Chemical Control of Ventilation

a. The Chemoreceptors involved with the regulation of respiration responds
to changes in hydrogen ion concentration and PO2, or both.
b. Chemosensitive areas are located in the medulla oblongota.
c. Peripheral Chemoreceptors are found in the carotid and aortic bodies.

4. Effect of pH
a. Chemosensitive area of the medulla oblongota is bathed in cerebrospinal
fluid and is sensitive to changes in pH.
b. The chemosensitive area reacts indirectly to change in blood pH.
 c. Carbon dioxide levels change pH.
d. Respiratory system plays an important role in acid-base balance.

5. Effect of Carbon Dioxide

a. The major regulator of respiration.

6. Effect of Carbon Dioxide

a. The major regulator of respiration.
b. Hypercapnia – greater than normal levels of carbon dioxide in the blood.
c. Hypocapnia – lower than normal carbon dioxide levels.

7. Effect of Oxygen
a. Hypoxia – decrease in oxygen levels below normal levels.
b. The effect of oxygen concentration in the blood has a small role in
regulation of respiration.

O2-Hemoglobin Dissociation Curve

Describes the percentage of hemoglobin saturated with oxygen at any given PO2.