Respiratory System

Respiratory System
• Dr. Surekha Kamath
• Prof & Coordinator
• Division of Physiology
• DBMS, MAHE, Manipal
• [email protected]
Absorption of O2
and removal of External
CO2 from the respiration
body

Internal
Utilization of O2 Respiration
and production of
CO2
Functional Anatomy of Respiratory System
Respiratory
Passage
Nose /nasal cavities
↓
pharynx
↓
larynx
↓
trachea
↓
bronchi
↓
bronchioles
↓
alveolar duct
↓
alveoli
 Functional Anatomy Respiratory System
• What is the function of the
upper respiratory tract?
1. Warm and humidify the
inspired air
2. Filtration of dust particles
• What is the function of
the lower respiratory
tract?
1. Exchange of gases
2. secretes surfactant
 Surfactant
• Mixture of lipids and proteins
• Lowers alveolar surface tension
• ↑Lung compliance
• Easier to expand the lungs
1.Conducting Zone
• First 16 division
• Trachea to terminal
bronchioles
• Transport of gas

• Anatomical dead
space - 150mL
• 2. Respiratory Zone

• Last 7 generations
• Respiratory
bronchioles,
alveolar ducts,
alveoli
• Exchange of gases
 Pulmonary circulation- features
1. Circulation of blood between heart and lungs
Starts from-The right ventricle and ends in left
atrium
2. It is low pressure, low resistance and high
capacitance system (Pulmonary arteries are thin
walled & distensible)
3. Purpose is to oxygenate the blood and
remove carbon dioxide –ensures that body
receives oxygen rich blood.
Mechanics of breathing
• Inspiration
• air is taken from the
atmosphere into
alveoli
• Inspiration is active
process
• Expiration
• air is expelled out of
the lungs
• Expiration is normally
passive process
Mechanism of Inspiration
 Mechanism of Inspiration
• Size of the thoracic cavity is increased by
1. Movement of ribs
2. Descent of diaphragm
 1. Movement of ribs
• Contraction of external intercostal muscles
• ↑ in Anteroposterior diameter of thorax
• Lateral dimensions
2. Descent of diaphragm
• Descends down by 1.5cm in eupnoea
and more during deep inspiration
• ↑vertical diameter of thoracic cage
 Intrapleural Pressure (IPP)
• Pressure within the pleural
cavity
• Normally subatmospheric
pressure

• Intralveolar Pressure (IAP)

• Pressure within the lungs
 Sequence of events during inspiration
• ↑Neural input →
• Inspiratory muscles contract →
• Thorax expand →
• IPP becomes more negative →
• Lungs expand →
• IAP becomes subatmospheric →
• Air flows into alveoli
Sequence of events during expiration
• Relaxation of inspiratory muscles →
• Recoil of chest wall →
• IPP back toward preinspiration value →
• Lungs recoil →
• Air in alveoli becomes compressed →
• IAP > Atm.Pressure →
• Air flows out of lungs
 Spirogram
• Spirometer is the instrument; lung volume
and lung capacities are measured
• The graph obtained is spirogram
• Lung volumes
1. Tidal volume; 500ml
• Volume of air inspired or expired during
normal breathing at rest
2. Inspiratory reserve volume
3. Expiratory reserve volume
4. Residual volume
 Lung capacities
1. Vital capacity ;TV+IRV+ERV ; 4.6L
• Maximum amount of air expired from
lungs after a deep inspiration
2. Total lung capacity 5 to 6L
3. Functional residual capacity
 Pulmonary Ventilation
 Amount of air breathed in or out by
lungs in one minute

PV= TV x RR
= 500ml x 12/min
= 6L/min
 Alveolar Ventilation
 Amount of air reaching the alveoli
/minute

AV= TV- Anatomical DS x RR

= 500ml-150ml x 12/min
= 4.2L/min
 Anatomical dead space
• Air in conducting zone, does not
involve in gaseous exchange
• 150ml (Adult, 70Kg)
Gas Exchange
Factors affecting rate of gas
diffusion
Vgas  P . SA
T
• Passively by diffusion
• Pressure gradients
• Surface area
• Thickness of RM
 Oxygen Transport

• Dissolved in the plasma (<2%)

• Combined with haemoglobin (Hb) (>98%)
Oxygen-Hemoglobin Dissociation Curve
 Significance of sigmoid curve
• Flat portion
• O2 Carrying capacity of the blood not
affected much if PO2 falls from 100mmHg
to 60mmHg

• Example: High altitude PO2 is about 60

mmHg, the saturation is still close to 90%
 Significance of sigmoid curve
• Steep Portion
• A small fall in tissue PO2 results in
considerable increase in oxygen delivery
• As ↓PO2 Hb has lower affinity for O2 and
releases more O2
:
Factors shifting the curve to
right
 PCO2
  temperature
  pH ( ↑ H ions)
:
Factors shifting the curve to
Left
PCO2
temperature
pH ( ↓ H ions)
Shifting of the curve to left
 CO2 Transport
1. Dissolved in the plasma - 10%
2. Carbaminohemoglobin - 20%
CO2 combines with hemoglobin
3. Bicarbonate (HCO3) - 70%
 Bicarbonate form-Chloride shift
Carbonic Anhydrase  
CO 2  H 2 O       
 H 2 CO 3  H  HCO 3

• CO2 reacts with H2O forms carbonic acid

• Carbonic acid dissociates to H+ and
HCO3-
•
 Bicarbonate form-Chloride shift
 H   HCO 3 
Carbonic Anhydrase
CO 2  H 2 O       
 H 2 CO 3 

 Newly formed HCO3- passes out of RBC

 Cl- diffuses into RBC to maintain electroneutrality
 Regulation of respiration
 Theprocess of inspiration and
expiration are controlled by-

 Neural control of respiration

 Chemical control of respiration

 Neural control of respiration
 Voluntary control
• Centre is in Cerebral cortex (CC)
• CC sends impulse to respiratory
muscles
 Automatic Control
Pons and medulla
 Respiratory Centers
 Pontine Areas
 Pneumotaxic Center

 Apneustic center.

 Medullary Areas
 Dorsal Respiratory Group
(DRG)
 Ventral Respiratory Group
(VRG)
 Pneumotaxic centre
• Group of neurons in upper pons
• Function: Fine tuning of respiration but not
essential mainly inhibits inspiration
 Apneustic Centre
 Group of neurons in lower pons
 Tonically active and activate I-
neurons
 Medulla oblongata
 Dorsal Respiratory Group
Active during normal
breathing
It has Inspiratory neurons
Stimulate the inspiratory
muscles
 Medulla oblongata
 Ventral Respiratory Group
 Has both inspiratory and expiratory
neurons
 Silent during quiet breathing
 stimulated during forceful breathing
 Generation of respiratory rhythm
 The rhythmicity of DRG of neurons is by
pre – Botzinger complex
 Network of neurons display pacemaker
activity
 Located on medulla
 Chemical regulation of respiration

 Spontaneous rhythm of respiration is also

regulated by chemical changes in the
blood
 PO2, PCO2, H+

 Central Chemoreceptors
 Peripheral Chemoreceptors
 Central chemoreceptors
• Chemosensitive area (CSA) on the ventral
surface of medulla
 Primary stimulus PCO2
Sequence of events during regulation of
respiration by central chemoreceptors
• Increase in PCO2 of blood
• CO2 diffuses to CSF (cerebrospinal fluid)
• CO2 reacts with H2O to form carbonic acid
• Dissociates into H+ and HCO3-
• H+ stimulates the central chemoreceptors (CC)
• CC stimulates the respiratory center (DRG)
• ↑Ventilation (rate and depth of respiration)
 Peripheral Chemoreceptors
 Carotid body & aortic body
 Afferent nerves are IX and X cranial nerves
 Blood flow is very high
 Dissolved O2

 PO2 ,CO2 ,H+

 Most potent stimulus PO2

 Sequence of events during regulation of
respiration by peripheral chemoreceptors

• Fall in PO2
• Stimulates the peripheral chemoreceptors
• ↑ impulse discharge by afferent nerves
• Respiratory center (DRG)stimulation
• ↑Ventilation (rate and depth of respiration)
 Hypoxia -Classification
• Hypoxia
• O2 deficiency at the tissue level

1. Hypoxic hypoxia
2. Anemic hypoxia
3. Stagnant / ischemic hypoxia
4. Histotoxic hypoxia
 1. Hypoxic hypoxia
• PO2 of arterial blood is reduced
• Seen in ;High altitude & hypoventilation

2. Anemic hypoxia
• Normal arterial PO2
• Amount of Hb to carry oxygen is reduced
Seen in : CO poisoning
3. Stagnant / ischemic hypoxia
Blood flow to tissue is sluggish
• Seen in :Cardiac failure
• Hemorrhage
4. Histotoxic hypoxia
• Tissue cannot utilize oxygen supplied to
them
• Seen in :Cyanide poisoning
 CYANOSIS
• Bluish discoloration of skin and
mucous membrane
• Deoxy/reduced hemoglobin more
than 5 gm/ dl in capillaries
 Dyspnoea

• Difficulty in (labored) breathing

• Respiratory disorders affecting ventilation

 Asphyxia
• Hypoxia (↓PO2) is combined with hypercapnea
(↑ PCO2)
1. Strangulation
2. Drowning
 Apnoea
• Temporary cessation of breathing
• Types of apnoea
• 1. Voluntary apnoea
• Voluntarily one can hold breath for sometime
• (40 sec) breath holding time
• 2. Deglutition apnoea
• To prevent entry of food into the trachea
1.Describe the mechanism of quiet
inspiration and expiration.
2.Name the muscles of inspiration and
explain the mechanism of inspiration
3.Write a note on surfactant.
4.Name any ONE lung volumes and lung
capacities give its normal value.
5.Write two features of pulmonary
circulation
1.Describe the mechanism of oxygen and carbon
dioxide transport in the blood
2.Describe the oxygen transport.
3.Draw and label oxygen dissociation curve and
list 2 factors shifting the curve to right.
4.Describe the CO2 transport.
5.Define and give its normal value.
a. Pulmonary ventilation
b. Alveolar ventilation
c. Anatomical dead space
d. Compliance
e. Tidal volume
1. Name the respiratory centers in pons and
medulla.
2. Describe the neural regulation of respiration
3. Describe the chemical regulation of respiration
4. Name the central chemoreceptors. Describe their
role in regulation of respiration.
5. Name the peripheral chemoreceptors. Describe
their role in regulation of respiration.
• 1. Define
• a. Cyanosis b. Hypoxia c. Apnea
• d. Dyspnea e. Asphyxia
• 2. Define and classify hypoxia.
• 3. Classify hypoxia and describe the features
and examples of each type of hypoxia.
• Describe periodic breathing with example.