The Respiratory System

The Respiratory System
B. Pimentel, M.D.
University Of Makati – College of Nursing
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
Upper Respiratory Tract
Anatomy
Nose and Nasal Cavity
Epithelial lining
♦ Stratified squamous epithelium with coarse hair,
traps dust particles and humidifies air.
♦ Pseudostratified ciliated columnar 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
♦ Paranasal sinuses, air filled spaces with in the

bone (skull)
♦ Maxillary, frontal, ethmoidal and sphenoidal
– Open into the nasal cavity
– Reduce weight, produce mucus and act as resonating
chambers
– Susceptible to infection and inflammation
♦ Nasolacrimal duct
Paranasal Sinuses
Paranasal Sinuses
Paranasal Sinuses
1.Sinus frontalis
2.Cellulae ethmoidales
3.Septum nasi
4.Concha nasalis inferior
5.Processus alveolaris
mandibulae with teeth
6.Sinus maxillaris
7.Margo infraorbitalis
8.Linea innominata
9.Lamina orbitalis ossis
ethmoidalis
10.Margo supraorbitalis
Pharynx
Common passageway for air and solid particles.

Leads to the respiratory and digestive systems.
3 regions:
1. Nasopharynx
2. Oropharynx
3. Laryngopharynx
Pharynx
Pharynx (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
Pharynx
Pharynx (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
Pharynx
Pharynx (Laryngopharynx)
Posterior to the larynx and
extend from the tip of the
epiglottis to the esophagus
Lower Respiratory Tract
Larynx
♦ Connected superiorly to
the pharynx and inferiorly
to the trachea.
♦ Consist of 3 unpaired and
6 pair cartilages
Larynx (Function)
♦ Open passageway, prevent swallowed material

from the larynx
♦ Primary source of sound production.
Larynx (Function)
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
Larynx (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
Larynx (Unpaired Cartilages)
Larynx
Larynx (Epiglottis)
♦ During swallowing, the larynx elevates and the

epiglottis moves posteriorly to cover the opening
of the pharynx
Larynx (Epiglottis)
Larynx (Paired Cartilages)
Posterior side of the pharynx

♦ Cuneiform cartilage, superiorly located
♦ Corniculate cartilage, middle
♦ Arythenoid cartilage, inferiorly located and
articulated with the cricoid cartilage
Larynx
Larynx (Vocal Cords)
Ligaments
♦ Vestibular folds (false
vocal cords)
♦ Vocal cords (true vocal
cords)
Larynx (Vocal Cords)
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
Trachea
♦ 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.
Trachea
Trachea
Trachea
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
Tracheobronchial Tree (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

– Thin layer of fluid lining the alveolus
– Alveolar epithelium simple squamous epithelium
– Basement membrane of the alveolar epithelium
– Thin interstitial space
– Basement membrane of capillary endothelium
– Capillary endothelium simple squamous epithelium
a = alveoli, with thin
interalveolar septa
between them
b = smooth muscle in its
wall
c = blood vessel, filled
with r.b.c.'s
d = bronchiole
Lungs
Principal organs of respiration

♦ 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.
Lungs
Lungs
Lungs
Lungs
Lungs
Lungs
Lungs
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.
Respiratory 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
♦ Atmospheric Pressure (Patm) - pressure exerted by

the air surrounding the body. At sea level its equal
to 760mmHg. For our purposes, we'll assume it to
be constant and assign it a value of 0mmHg.
♦ Intrapulmonary Pressure (Palv) - pressure exerted

by the air within the alveoli. It rises and falls
during inspiration and expiration, but it always
equalizes with atmospheric pressure.
♦ Intrapleural Pressure (Pip) - pressure within the

pleural cavity. It is always lower than both
atmopsheric pressure and intrapulmonary
pressure.
Respiratory Physiology
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.
Respiratory Physiology
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.
Respiratory Physiology (Gas Exchange)
The factors that influence the rate of gas diffusion

across the respiratory membrane include
1. Thickness of the membrane.

♦ Increasing membrane thickness decreases
diffusion
– Ex. Pulmonary edema, TB, Pneumonia
Pulmonary edema
Pulmonary edema
Pulmonary edema
CXR
♦ 51 year old male with
shortness of breath.
♦ bilateral parahilar
infiltrates
2. Surface area
♦ Healthy normal individuals 70 square meters
♦ Decreases in area caused by diseases
– Ex. Emphysema, lung ca.
Emphysema
CXR
♦ 65 y/o female with a
120 pack year history
of tobacco use.
– hyperaerated lungs
– flattened diaphragms
– narrow heart shadow
– widened rib spaces
– decreased vascular
markings
3. Partial pressure difference

♦ 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.
♦ Pressure gradient diffuses from high to low.
Partial Pressure Difference
Respiratory Physiology (Gas Transport)
1. Molecular oxygen is carried in blood

– 98.5% bound to hemoglobin
– 1.5% in plasma.
♦ Binds in a reversible fashion.
2. Carbon dioxide is transported in three major ways

– 7% is transported dissolved in plasma.
– 23% transported in combination with blood proteins.
– 70% transported in the bicarbonate form.
♦ 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.
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 (CNS)
CNS
♦ 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
♦ Dorsal respiratory system is most active during

inspiration but is responsible for stimulation of the
diaphragm.
♦ Ventral respiratory group is active during both
inspiration and expiration. Stimulate the external
and internal intercostals, and abdominal muscles.
♦ Pontine Respiratory group – neurons in the pons,
some are active in expiration or inspiration and/or
both.
Regulation of Respiration
(Cerebral and Limbic System Control)
♦ Possible to voluntarily or involuntarily to control
rate of breathing through the cerebral cortex.
♦ Apnea – absence of breathing.
♦ Voluntary apnea increases a greater and greater

urge to breathe due to increasing PCO2 levels.
(Chemical Control of Ventilation)
♦ The Chemoreceptors involved with the regulation

of respiration responds to changes in hydrogen ion
concentration and PO2, or both.
♦ Chemosensitive areas are located in the medulla

oblongota.
♦ Peripheral Chemoreceptors are found in the

carotid and aortic bodies.
Regulation of Respiration (Effect of pH)
♦ Chemosensitive area of the medulla oblongota is

bathed in cerebrospinal fluid and is sensitive to
changes in pH.
♦ The chemosensitive area reacts indirectly to
change in blood pH.
♦ Carbon dioxide levels change pH.
♦ Respiratory system plays an important role in
acid-base balance.
(Effect of Carbon Dioxide)
♦ The major regulator of respiration.
♦ Hypercapnia – greater than normal levels of

carbon dioxide in the blood.
♦ Hypocapnia – lower than normal carbon dioxide

levels.
(Effect of Carbon Dioxide)
Regulation of Respiration (Effect of Oxygen)
♦ Hypoxia – decrease in oxygen levels below

normal levels.
♦ 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
Revised Schedule
May June
Sat 20 - Respiratory System Sat 3 Pre-final Review
- Digestive and GI System
Sun 4 Finals!!!
Sun 21 - Urinary System & Acid
Base Balance
All schedules are subject to
changes
Sat 27 Midterms!!!
- Reproductive System
(Male and Female)
- Endocrine System
Sun 28 - Nervous Systems

Preceptorials 2

The Respiratory System

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The Respiratory System

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The Respiratory System

Upper Respiratory tract

Lower Respiratory tract

♦ Pseudostratified ciliated columnar epithelium with

♦ Nares (nostrils), external opening

♦ Paranasal sinuses, air filled spaces with in the

Common passageway for air and solid particles.

♦ Open passageway, prevent swallowed material

Air moving past vocal cords causes vibration.

♦ Thyroid cartilage (Adams apple), superiorly

♦ During swallowing, the larynx elevates and the

Posterior side of the pharynx

♦ Primary bronchi – trachea divides to form two

♦ Beginning with the trachea, all respiratory

♦ The tissue surrounding the alveoli contain elastic

To facilitate the diffusion of gases

Principal organs of respiration

♦ Diaphragm – dome shaped, attaches to the inner

The process of moving air into and out of the lungs.

♦ Atmospheric Pressure (Patm) - pressure exerted by

♦ Intrapulmonary Pressure (Palv) - pressure exerted

♦ Intrapleural Pressure (Pip) - pressure within the

Lung recoil - causes the alveoli to collapse and it

Surfactant - mixture of lipoprotein molecules form a

The factors that influence the rate of gas diffusion

1. Thickness of the membrane.

3. Partial pressure difference

1. Molecular oxygen is carried in blood

2. Carbon dioxide is transported in three major ways

3.Haldane effect – hemoglobin that has released its

4. Chloride shift – Bicarbonate ion concentration

♦ Dorsal respiratory system is most active during

♦ Apnea – absence of breathing.

♦ Voluntary apnea increases a greater and greater

♦ The Chemoreceptors involved with the regulation

♦ Chemosensitive areas are located in the medulla

♦ Peripheral Chemoreceptors are found in the

♦ Chemosensitive area of the medulla oblongota is

♦ The major regulator of respiration.

♦ Hypercapnia – greater than normal levels of

♦ Hypocapnia – lower than normal carbon dioxide

♦ Hypoxia – decrease in oxygen levels below

♦ The effect of oxygen concentration in the blood

Sun 28 - Nervous Systems

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