Anatomy & Physiology Bio 2402 Lecture. Instructor: Daryl Beatty Chapter 22 Respiratory System

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1 Anatomy & Physiology Bio 2402 Lecture Instructor: Daryl Beatty Chapter 22 Respiratory System

2 Functions of the Respiratory System Exchange of oxygen and carbon dioxide Voice production Regulation of plasma ph Olfactory Infection prevention

3 Respiratory System Consists of the respiratory and conducting zones Respiratory zone: Site of gas exchange Consists of bronchioles, alveolar ducts, and alveoli

4 Respiratory System Conducting zone: Conduits for air to reach the sites of gas exchange Includes all other respiratory structures (e.g., nose, nasal cavity, pharynx, trachea) Respiratory muscles diaphragm and other muscles that promote ventilation PLAY InterActive Physiology : Anatomy Review: Respiratory Structures, page 3

5 Respiratory System Figure 22.1

6 Major Functions of the Respiratory System Respiration four distinct processes must happen Pulmonary ventilation moving air into and out of the lungs External respiration gas exchange between the lungs and the blood Transport transport of oxygen and carbon dioxide between the lungs and tissues Internal respiration gas exchange between systemic blood vessels and tissues

7 Pulmonary Ventilation Exchange of air between the lungs and the atmosphere. What must exist for air to move? When breathing in, where is pressure higher? When breathing out, where is pressure higher?

8 External Respiration Is the Exchange of carbon dioxide and oxygen between the blood and lungs Always follows the pressure gradient Where is O2 pressure higher? Where is CO2 pressure higher?

9 Internal Respiration Is the Exchange of carbon dioxide and oxygen between the blood and tissues Always follows the pressure gradient Where is O2 pressure higher? Where is CO2 pressure higher?

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11 Cellular Respiration NOT directly a part of the respiratory system Sum of all metabolic activity in the cell Where does it occur? What gas is used? What gas is produced?

12 Breathing Breathing, or pulmonary ventilation, consists of two phases Inspiration air flows into the lungs Expiration gases exit the lungs

13 Respiratory Tract Divided into upper tract and lower tract: 1.Upper Respiratory Tract Nose, pharynx and larynx 2.Lower Respiratory Tract Trachea, bronchi, and lungs

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15 Two Zones of the Respiratory System Conducting zone Where gases are physically transported Respiratory zone Where O2 and CO2 are exchanged between air and blood

16 Conducting Zone Structures Nasal cavity, nasopharynx, oropharynx, laryngopharynx, larynx, trachea, bronchi, and all bronchioles except respiratory bronchioles. Functions Transport of air to respiratory zone Filtering, humidifying, and warming

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18 Conducting Zone Structures Nose and nasal cavity Nasopharynx Oropharynx Laryngopharynx Larynx Trachea Bronchi Most bronchioles

19 Nose Roof Frontal, sphenoid & ethmoid Walls Maxillae Palatines Conchae Floor is the hard palate

20 Nasal Conchae Functions? How do they affect surface area? How do they affect airflow? This helps with what 3 processes?

21 Conducting Zone Continued

22 Pharynx Nasopharynx Oropharynx Laryngopharynx

23 Nasopharynx Contains 2 auditory tubes openings (Eustacian Tubes) Allows the middle ear to equalize pressure

24 Oropharynx Bottom of the uvula to top of the epiglottis

25 Laryngopharynx Top of the epiglottis to the division between larynx and esophagus

26 Larynx Routes food and air Tube composed of 9 cartilage members

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28 Vocal Folds or Cords Vocal folds paired folds of laryngeal mucosa just deep to the thyroid cartilage. They contain the elastic vocal ligaments. They re also known as the true vocal cords. Function?

29 Glottis Glottis space between the vocal folds

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31 Trachea Runs from larynx to the 2 primary bronchi Ends at the carina

32 Trachea on dissection

33 Trachea and Esophagus

34 Hyaline Cartilage in Trachea

35 What happens to air in the conducting zone? Humidity will? Temperature goes (up or down)? Bacteria & particles will? O2 and CO2 content will?

36 Lung Anatomy Left lung has 2 lobes superior and inferior, separated by an oblique fissure. Right lung has 3 lobes superior, middle, and inferior, separated by the oblique and horizontal fissures.

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38 Lungs on Dissection

39 Pleurae and Pleural Cavity Double layered serosa that covers each lung. Parietal pleura lines the thoracic wall, the superior surface of the diaphragm, and the mediastinum. Visceral pleura covers the lungs themselves. Between the visceral and parietal layers is the pleural cavity. What does it contain? Why?

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42 Bronchi Trachea splits to yield 2 primary bronchi. Right primary bronchus is wider, shorter, and more vertical than the left primary bronchus. Why? Primary bronchi split to yield secondary bronchi. 3 bronchi on the right, 2 on the left. One secondary bronchus per lobe of the lung. Secondary bronchi yield tertiary bronchi, then quaternary bronchi, and so on until the tubes have a diameter of <1mm. Smaller ones are known as bronchioles.

43 Bronchial Tree

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45 As you go to smaller bronchi: The amount of cartilage present will: The relative amount of smooth muscle present will: The number of cilia will: The available surface area will: The thickness of the epithelium will:

46 Bronchioles Airways with a diameter of <1mm. Lack cartilage Last airways without alveoli (exchange sites) are terminal bronchioles First airways with alveoli are respiratory bronchioles

47 Exchange Zone Structures Respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli. Functions GAS EXCHANGE between alveolar air and blood. What type of epithelium would you expect to find in the respiratory zone? WHY?

48 Exchange zone Respiratory bronchioles Are the beginning of the exchange zone. Give rise to alveolar ducts Alveolar ducts Tubes consisting of side-by-side alveoli Give rise to alveolar sacs dead ends consisting of nothing but alveoli.

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53 Alveoli Sites of external respiration 300 million Why so many? Simple squamous epithelium Made up of 2 cell types Type I alveolar cells Simple squamous. Sites of exchange Type II alveolar cells Produce surfactant Also contain alveolar macrophages (dust cells)

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55 Role of Capillaries and Elastic Fibers

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57 Emphysema What effect does the reduced number of alveoli have?

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59 Showing Capillary Alveoli An RBC in the capillary

60 Pressure Relationships in the Thoracic Cavity Respiratory pressure is always described relative to atmospheric pressure Atmospheric pressure (P atm ) Intrapulmonary pressure (P pul ) pressure within the alveoli - Intrapleural pressure (P ip ) pressure within the pleural cavity - -2 to -8 relative to atmosphere.

61 Pressure Relationships Two forces act to pull the lungs away from the thoracic wall, promoting lung collapse Elasticity of lungs causes them to assume smallest possible size Surface tension of alveolar fluid draws alveoli to their smallest possible size Opposing force elasticity of the chest wall pulls the thorax outward to enlarge the lungs

62 Pressure Relationships Figure 22.12

63 Lung Collapse Caused by equalization of the intrapleural pressure with the intrapulmonary pressure Transpulmonary pressure keeps the airways open Transpulmonary pressure difference between the intrapulmonary and intrapleural pressures (P pul P ip )

64 Pneumothorax

65 Pulmonary Ventilation A mechanical process that depends on volume changes in the thoracic cavity Volume changes lead to pressure changes, which lead to the flow of gases to equalize pressure

66 Boyle s Law Boyle s law the relationship between the pressure and volume of gases P 1 V 1 = P 2 V 2 P = pressure of a gas in mm Hg V = volume of a gas in cubic millimeters Subscripts 1 and 2 represent the initial and resulting conditions, respectively

67 Boyle s Law Pressure and volume move in opposite directions

68 Mechanics of Breathing

69 Inspiration Figure

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71 Inspiratory Muscles Diaphragm External Intercostals

72 Diaphragm

73 Factors That Diminish Lung Compliance Scar tissue or fibrosis that reduces the natural resilience of the lungs Blockage of the smaller respiratory passages with mucus or fluid Reduced production of surfactant Decreased flexibility of the thoracic cage or its decreased ability to expand

74 Expiration Figure

75 Pulmonary Pressures Figure 22.14

76 Clinical Applications Atelectasis lung collapse air entering pleural cavity, or from plugged bronchioles. Pneumothorax penetration wound Tension pneumothorax worsening of simple pneumothorax Hemothorax blood in pleural cavity IRDS Infant Respiratory Distress Syndrome

77 Respiratory volumes (See figure 22.16) Tidal volume (TV) air that moves into and out of the lungs with each breath (approximately 500 ml) Inspiratory reserve volume (IRV) air that can be inspired forcibly beyond the tidal volume ( ml) Expiratory reserve volume (ERV) air that can be evacuated from the lungs after a tidal expiration ( ml) Residual volume (RV) air left in the lungs after strenuous expiration (1200 ml)

78 Respiratory Capacities Vital capacity (VC) the total amount of exchangeable air (TV + IRV + ERV) Total lung capacity (TLC) sum of all lung volumes (approximately 6000 ml in males) Dead Space The amount of air inhaled into the airways that does not reach the alveoli. (Hose illustration diving).

79 Respiratory Capacities FVC Forced vital capacity measures amount of gas expelled from a deep breath spirometry FEV1 Amount expelled in first second. Low FEV1 indicates obstructive pulmonary disease. Should be about 80% of FVC.

80 Application of volumes Increases of TLC (Total Lung capacity), RV(Residual Volume) indicate Obstructive disease. Decreases indicate restrictive diseases, which limit lung expansion.

81 Minute Ventilation At rest, about 6 L/ minute (12 breaths times 500 ml) With exercise, up to 200 L/Min

82 Basic Properties of Gases: Dalton s Law of Partial Pressures Total pressure exerted by a mixture of gases is the sum of the pressures exerted independently by each gas in the mixture The partial pressure of each gas is directly proportional to its percentage in the mixture Atmospheric Air Oxygen Carbon Dioxide Nitrogen

83 Table 22.4

84 Basic Properties of Gases: Henry s Law When a mixture of gases is in contact with a liquid, each gas will dissolve in the liquid in proportion to its partial pressure The amount of gas that will dissolve in a liquid also depends upon its solubility: Carbon dioxide is the most soluble Oxygen is 1/20 th as soluble as carbon dioxide Nitrogen is practically insoluble in plasma

85 Respiratory Membrane Figure 22.9.c, d

86 External Respiration: Pulmonary Gas Exchange Factors influencing the movement of oxygen and carbon dioxide across the respiratory membrane Partial pressure gradients and gas solubilities Matching of alveolar ventilation and pulmonary blood perfusion Structural characteristics of the respiratory membrane

87 Ventilation-Perfusion Coupling Ventilation the amount of gas reaching the alveoli (V) in g/min Perfusion the blood flow reaching the alveoli (Q) in l/min Ventilation and perfusion must be tightly regulated for efficient gas exchange Changes in P CO2 in the alveoli cause changes in the diameters of the bronchioles Passageways servicing areas where alveolar carbon dioxide is high dilate Those serving areas where alveolar carbon dioxide is low constrict

88 Ventilation-Perfusion Coupling P O2 P CO2 in alveoli Reduced alveolar ventilation; excessive perfusion Pulmonary arterioles serving these alveoli constrict Reduced alveolar ventilation; reduced perfusion P O2 P CO2 in alveoli Enhanced alveolar ventilation; inadequate perfusion Pulmonary arterioles serving these alveoli dilate Enhanced alveolar ventilation; enhanced perfusion Figure 22.19

89 Internal Respiration The factors promoting gas exchange between systemic capillaries and tissue cells are the same as those acting in the lungs The partial pressures and diffusion gradients are reversed P O2 in tissue is always lower than in systemic arterial blood P O2 of venous blood draining tissues is 40 mm Hg and P CO2 is 45 mm Hg PLAY InterActive Physiology : Respiratory System: Gas Exchange, page 3 17

90 Figure 22.17

91 Oxygen Transport Molecular oxygen is carried in the blood: Bound to hemoglobin (Hb) within red blood cells Dissolved in plasma Each Hb molecule binds four oxygen atoms in a rapid and reversible process The hemoglobin-oxygen combination is called oxyhemoglobin (HbO 2 ) Hemoglobin that has released oxygen is called reduced hemoglobin (HHb)

92 Hemoglobin (Hb) Saturated hemoglobin when all four hemes of the molecule are bound to oxygen Partially saturated hemoglobin when one to three hemes are bound to oxygen The rate that hemoglobin binds and releases oxygen is regulated by: P O2, temperature, blood ph, and P CO2 These factors ensure adequate delivery of oxygen to tissue cells

93 Carbon Monoxide Poisoning CO competes with O2 Hemoglobin has higher affinity for CO Treatment 100% O2 Cyanosis Skin has bluish color due to increased concentration of deoxyhemoglobin (HHb)

94 Carbon Dioxide Transport Carbon dioxide is transported in the blood in three forms Dissolved in plasma 7 to 10% Chemically bound to hemoglobin (the globin, not the heme) 20% is carried in RBCs as carbaminohemoglobin Bicarbonate ion in plasma 70% is transported as bicarbonate (HCO 3 )

95 Haldane Effect The amount of carbon dioxide transported is markedly affected by the P O2 Haldane effect the lower the P O2 and hemoglobin saturation with oxygen, the more carbon dioxide can be carried in the blood At the tissues, as more carbon dioxide enters the blood: More oxygen dissociates from hemoglobin (Bohr effect) More carbon dioxide combines with hemoglobin, and more bicarbonate ions are formed This situation is reversed in pulmonary circulation

96 Transport and Exchange of Carbon Dioxide Carbon dioxide diffuses into RBCs and combines with water to form carbonic acid (H 2 CO 3 ), which quickly dissociates into hydrogen ions and bicarbonate ions CO 2 + H 2 O H 2 CO 3 H + + HCO 3 Carbon dioxide Water Carbonic acid Hydrogen ion In RBCs, carbonic anhydrase reversibly catalyzes the conversion of carbon dioxide and water to carbonic acid Bicarbonate ion

97 Transport and Exchange of Carbon Dioxide At the tissues: Bicarbonate quickly diffuses from RBCs into the plasma The chloride shift to counterbalance the outrush of negative bicarbonate ions from the RBCs, chloride ions (Cl ) move from the plasma into the erythrocytes

98 Transport and Exchange of Carbon Dioxide Figure 22.22a

99 Transport and Exchange of Carbon Dioxide At the lungs, these processes are reversed Bicarbonate ions move into the RBCs and bind with hydrogen ions to form carbonic acid Carbonic acid is then split by carbonic anhydrase to release carbon dioxide and water Carbon dioxide then diffuses from the blood into the alveoli

100 Transport and Exchange of Carbon Dioxide Figure 22.22b

101 Influence of Carbon Dioxide on Blood ph The carbonic acid bicarbonate buffer system resists blood ph changes If hydrogen ion concentrations in blood begin to rise, excess H + is removed by combining with HCO 3 If hydrogen ion concentrations begin to drop, carbonic acid dissociates, releasing H + Changes in respiratory rate can also: Alter blood ph Provide a fast-acting system to adjust ph when it is disturbed by metabolic factors

102 Control of Respiration: Medullary Respiratory Centers The dorsal respiratory group (DRG), or inspiratory center: Appears to be the pacesetting respiratory center Excites the inspiratory muscles and sets eupnea (12-15 breaths/minute) Becomes dormant during expiration The ventral respiratory group (VRG) is involved in forced inspiration and expiration

103 Figure 22.24

104 Hyperventilation - Compensatory Hyperventilation increased depth and rate of breathing that: Quickly flushes carbon dioxide from the blood Occurs in response to hypercapnia (high CO 2 ) Though a rise CO 2 acts as the original stimulus, control of breathing at rest is regulated by the hydrogen ion concentration in the brain Exercise Drugs affecting CNS

105 Hyperventilation Noncompensatory Rapid or extra deep breathing leads to hypocapnia -(low CO 2 ) Can lead to alkalosis with cramps and spasms Causes acute anxiety or emotional tension CO 2 is vasodilator low P CO2 results in LOCAL vasoconstrictions = ischemia/hypoxia How do you fix it?

106 Hypoventilation Noncompensatory Hypoventilation slow and shallow breathing due to abnormally low P CO2 levels (initially) Apnea (breathing cessation) may occur until P CO2 levels rise Leads to too much CO 2 which leads to drop in ph = acidosis

107 Depth and Rate of Breathing: Higher Brain Centers Hypothalamic controls act through the limbic system to modify rate and depth of respiration Example: breath holding that occurs in anger A rise in body temperature acts to increase respiratory rate (----Dog?) Cortical controls are direct signals from the cerebral motor cortex that bypass medullary controls Examples: voluntary breath holding, taking a deep breath

108 Depth and Rate of Breathing: P CO2 Changing P CO2 levels are monitored by chemoreceptors of the brain stem Carbon dioxide in the blood diffuses into the cerebrospinal fluid where it is hydrated Resulting carbonic acid dissociates, releasing hydrogen ions P CO2 levels rise (hypercapnia) resulting in increased depth and rate of breathing

109 Depth and Rate of Breathing: P CO2 Arterial oxygen levels are monitored by the aortic and carotid bodies Substantial drops in arterial P O2 (to 60 mm Hg) are needed before oxygen levels become a major stimulus for increased ventilation(hypoxic drive) If carbon dioxide is not removed (e.g., as in emphysema and chronic bronchitis), chemoreceptors become unresponsive to P CO2 chemical stimuli In such cases, P O2 levels become the principal respiratory stimulus (hypoxic drive)

110 Depth and Rate of Breathing: Arterial ph Changes in arterial ph can modify respiratory rate even if carbon dioxide and oxygen levels are normal Increased ventilation in response to falling ph is mediated by peripheral chemoreceptors

111 Depth and Rate of Breathing: Arterial ph Acidosis may reflect: Carbon dioxide retention Accumulation of lactic acid Excess fatty acids in patients with diabetes mellitus Respiratory system controls will attempt to raise the ph by increasing respiratory rate and depth (respiratory compensation for acidosis)

112 Factors Influencing Rate and Depth

113 Respiratory Adjustments: Exercise Respiratory adjustments are geared to both the intensity and duration of exercise During vigorous exercise: Ventilation can increase 20 fold Breathing becomes deeper and more vigorous, but respiratory rate may not be significantly changed (hyperpnea) Exercise-enhanced breathing is not prompted by an increase in P CO2 or a decrease in P O2 or ph These levels remain surprisingly constant during exercise

114 Respiratory Adjustments: Exercise As exercise begins: Ventilation increases abruptly, rises slowly, and reaches a steady state When exercise stops: Ventilation declines suddenly, then gradually decreases to normal

115 Respiratory Adjustments: Exercise Neural factors bring about the above changes, including: Psychic stimuli Cortical motor activation Excitatory impulses from proprioceptors in muscles PLAY InterActive Physiology : Control of Respiration, pages 3 15

116 Respiratory Adjustments: High Altitude The body responds to quick movement to high altitude (above 8000 ft) with symptoms of acute mountain sickness headache, shortness of breath, nausea, and dizziness

117 Respiratory Adjustments: High Altitude Acclimatization respiratory and hematopoietic adjustments to altitude include: Increased ventilation 2-3 L/min higher than at sea level Chemoreceptors become more responsive to P CO2 Substantial decline in P O2 stimulates peripheral chemoreceptors

118 Chronic Obstructive Pulmonary Disease (COPD) Includes: chronic bronchitis and obstructive emphysema Patients have a history of: Smoking Dyspnea, where labored breathing occurs and gets progressively worse Coughing and frequent pulmonary infections COPD victims develop respiratory failure accompanied by hypoxemia, carbon dioxide retention, and respiratory acidosis

119 Chronic Bronchitis Role of cigarette smoke Mucus collection Ventilation impared Blue bloaters

120 Pathogenesis of COPD Figure 22.28

121 Asthma Characterized by dyspnea, wheezing, and chest tightness Active inflammation of the airways precedes bronchospasms Airway inflammation is an immune response caused by release of IL-4 and IL-5, which stimulate IgE and recruit inflammatory cells Airways thickened with inflammatory exudates increase the effect of bronchospasms

122 Tuberculosis Infectious disease caused by the bacterium Mycobacterium tuberculosis Symptoms include fever, night sweats, weight loss, a racking cough, and splitting headache Treatment entails a 12-month course of antibiotics

123 Lung Cancer Accounts for 1/3 of all cancer deaths in the U.S. 90% of all patients with lung cancer were smokers The three most common types are: Squamous cell carcinoma (20-40% of cases) arises in bronchial epithelium Adenocarcinoma (25-35% of cases) originates in peripheral lung area Small cell carcinoma (20-25% of cases) contains lymphocyte-like cells that originate in the primary bronchi and subsequently metastasize

124 What if???? Alveolar P O2 is 100, alveolar P co2 is 38 and alveolar P CO is 1 A child eats 20 aspirin tablets (aspirin is acetylsalicylic acid. How will respiratory rate be affected? A few hours after surgery I am experiencing lots of pain, so I take a dose of my narcotic pain killer 5 minutes later it still hurts so I take another.how will RR be affected?

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