RESPIRATORY

SYSTEM
DR. CHESSA BELANDRES
DR. ISMAEL MAMINGGEN

Reference: MARIEB 11TH ED CH13

 RESPIRATORY SYSTEM

CONDUCTIVE ZONE RESPIRATORY ZONE

 ● only externally visible part of
NOSE the respiratory system
● air enters the nose by passing
through the NOSTRILS OR
NARES
● OLFACTORY RECEPTORS for the
sense of smell are located in
the mucosa in the slitlike
superior part of the nasal
cavity, just beneath the
ethmoid bone.
● NASAL CAVITY
● NASAL SEPTUM
● RESPIRATORY MUCOSA, rests
on a rich network of thin-
walled veins that warms the air
as it flows past
NOSE ● RESPIRATORY MUCOSA:
warms the air, moistens
the air and traps incoming
bacteria and other foreign
debris
NOSE
● CONCHAE
○ three mucosa-covered
projections, or lobes
○ increase the surface area
of the mucosa exposed to
the air
○ increase the air
turbulence in the nasal
cavity

○ The nasal cavity is

separated from the oral
cavity below by a
partition, the palate
NOSE
● PARANASAL SINUSES
○ frontal, sphenoidal,
ethmoid, and maxillary
bones.
○ lighten the skull, and they
act as resonance
chambers for speech.
○ produce mucus, which
drains into the nasal
cavities
 ● muscular passageway about 13 cm (5 inches)
● serves as a common passageway for food and
PHARYNX air

● 3 DIVISIONS: NASOPHARYNX,
OROPHARYNX, LARYNGOPHARYNX
● pharyngotympanic tubes drains to the
nasopharynx

● Tonsils also play a role in protecting the

body from infection
○ Pharyngeal tonsil, or adenoid -
nasopharynx
○ Palatine tonsils - end of the soft
palate (OROPHARYNX)
○ Lingual tonsils - base of the tongue
(OROPHARYNX)
 ● Located inferior to the pharynx
● it is formed by eight rigid hyaline
LARYNX cartilages and a spoon-shaped flap
of elastic cartilage, the epiglottis.
○ the epiglottis protects the
superior opening of the
larynx.
○ “COUGH REFLEX”

● The largest of the hyaline

cartilages is the shield-shaped
thyroid cartilage, which protrudes
anteriorly and is commonly called
the Adam’s apple.
LARYNX
● Part of the mucous membrane
of the larynx forms a pair of
folds, called the vocal folds, or
true vocal cords, which vibrate
with expelled air.

● The vocal folds and the slit like

passageway between them are
called the glottis.
 ● the trachea, or windpipe
TRACHEA ● 10–12 cm, or about 4 inches to
the level of the fifth thoracic
vertebra
● its walls are reinforced with C-
shaped rings of hyaline
cartilage.
○ The open parts of the rings
abut the esophagus and
allow it to expand
anteriorly.
○ The solid portions support
the trachea walls and keep
RESPIRATORY
PHSYIOLOGY
 RESPIRATORY PHYSIOLOGY
1. PULMONARY VENTILATION - Air movement into and out of the lungs;
“BREATHING”

2. EXTERNAL RESPIRATION - gas exchanges are being made between the blood
and the body exterior; pulmonary blood and alveoli
• O2 loading and CO2 unloading

3. RESPIRATORY GAS TRANSPORT - Oxygen and carbon dioxide must be

transported to and from the lungs and tissue cells of the body

4. INTERNAL RESPIRATION - gas exchanges are occurring between the blood

and cells inside the body; all systemic capillaries
MECHANICS OF
BREATHING
 KEEP THIS RULE IN MIND!

Volume changes lead to pressure

changes, which lead to the flow of
gases to equalize the pressure.
in a large volume, the gas molecules
will be far apart, and the pressure will
be low. If the volume is reduced, the
gas molecules will be closer together,
and the pressure will rise.
 ● diaphragm contracts, it
moves inferiorly and flattens
INSPIRATION ●
out (is depressed)
Contraction of the external
intercostals lifts the rib cage
and thrusts the sternum
forward
● intrapulmonary volume (the
volume within the lungs)
increases, the gases within
the lungs spread out to fill
the larger space
● decrease in the gas pressure
in the lungs produces a
partial vacuum (pressure less
than atmospheric pressure),
which sucks air into the lung
 ● As the inspiratory muscles relax and
EXPIRATORY resume their initial resting length,
the rib cage descends and the lungs
recoil
● both the thoracic and
intrapulmonary volumes decrease

● the gases inside the lungs are

forced more closely together, and
the intrapulmonary pressure rises
● This causes the gases to flow out to
equalize the pressure inside and
outside the lungs.
RESPIRATORY
VOLUMES AND
CAPACITY
Normal quiet breathing moves
approximately 500 ml of air
(about a pint) into and out of
the lungs with each breath.
This respiratory volume is
referred to as the tidal volume
(TV)
The amount of air that can be
taken in forcibly over the tidal
volume is the inspiratory
reserve volume (IRV).

The inspiratory reserve volume

is around 3,100 ml
The amount of air that can be
forcibly exhaled after a tidal
expiration, the expiratory
reserve volume (ERV), is
approximately 1,200 ml.
about 1,200 ml of air still
remains in the lungs, and it
cannot be voluntarily expelled.
This is the residual volume.
The total amount of
exchangeable air (around 4,800
ml in healthy young men and
3,100 ml in healthy young
women) is the vital capacity
(VC).

The vital capacity is the sum of

the TV + IRV + ERV
Note that much of the air that
enters the respiratory tract remains
in the conducting zone
passageways and never reaches the
alveoli. This is called the dead space
volume.

150 ml - Deadspace zone

350 ml - reaches the alveoli

 NON RESPIRATORY AIR MOVEMENT
Nonrespiratory air movements are a result of reflex activity, but some may be produced
voluntarily.
COUGH Taking a deep breath, closing glottis, and forcing air superiorly from lungs
against glottis. Then, the glottis opens suddenly, and a blast of air rushes
upward. Coughs act to clear the lower respiratory passageways.
SNEEZE Similar to a cough, except that expelled air is directed through nasal cavities
instead of through oral cavity. Sneezes clear upper respiratory passages.
CRYING Inspiration followed by release of air in a number of short expirations
LAUGHING Essentially same as crying
HICCUPS Sudden inspirations resulting from spasms of diaphragm
YAWN Very deep inspiration
 RESPIRATORY SOUNDS
BRONCHIAL SOUNDS

produced by air rushing through the

large respiratory passageways
(trachea and bronchi).

VESICULAR SOUNDS

occur as air fills the alveoli

EXTERNAL RESPIRATION, GAS
TRANSPORT AND INTERNAL
RESPIRATION
 It is important to remember that all gas
exchanges are made according to the laws of
diffusion; that is, movement occurs toward
the area of lower concentration of the
diffusing substance
EXTERNAL RESPIRATION

ALVEOLUS
GAS TRANSPORT IN THE BLOOD
 GAS TRANSPORT IN THE BLOOD
● Oxygen is transported in the blood in two ways. Most attaches to
hemoglobin molecules inside the RBCs to form oxyhemoglobin
● Most carbon dioxide is transported in plasma as the bicarbonate
ion (HCO3 −)
● Before carbon dioxide can diffuse out of the blood into the alveoli,
it must first be released from its bicarbonate ion form.
● bicarbonate ions must enter the red blood cells where they
combine with hydrogen ions (H+) to form carbonic acid (H2CO3).
Carbonic acid quickly splits to form water and carbon dioxide, and
carbon dioxide then diffuses from the blood and enters the alveoli.
INTERNAL RESPIRATION

TISSUES
 INTERNAL RESPIRATION
● Internal respiration, the exchange of gases that takes place between the blood
and the tissue cells, is the opposite of what occurs in the lungs. In this process,
oxygen is unloaded and carbon dioxide is loaded into the blood
● Carbon dioxide diffusing out of tissue cells enters the blood.
● In the blood, it combines with water to form carbonic acid (H2CO3), which
quickly releases the bicarbonate ions. As previously mentioned, most conversion
of carbon dioxide to bicarbonate ions actually occurs inside the RBCs, where a
special enzyme (carbonic anhydrase) is available to speed up this reaction. Then
the bicarbonate ions diffuse out into plasma, where they are transported. At the
same time, oxygen is released from hemoglobin, and the oxygen diffuses quickly
out of the blood to enter the tissue cells. A
CONTROL OF
RESPIRATION
 NEURAL REGULATION
● Neural centers that control respiratory rhythm and depth are located
mainly in the medulla and pons
● The medulla, contains a pacemaker, or self-exciting inspiratory center,
called the ventral respiratory group, or VRG
● The medulla also contains a center that modifies the activity of the
pacemaker in a rhythmic way.
● The activity of the respiratory muscles, the diaphragm and external
intercostals - phrenic and intercostal nerves.
● Pons centers appear to smooth out the basic rhythm of inspiration and
expiration set by the medulla.
● Bronchioles and alveoli (stretch receptors) → inspiration ends and
expiration occurs
 Non-neural Factors Influencing
Respiratory Rate and Depth
● PHYSICAL FACTORS

talking, coughing, and exercising; Increased body temperature

● VOLITION

singing and swallowing; swim underwater

● EMOTIONAL FACTORS

reflexes initiated by emotional stimuli acting through centers in the hypothalamus

● CHEMICAL FACTORS

the levels of carbon dioxide and oxygen in the blood