The Respiratory System ANATOMY OF THE RESPIRATORY SYSTEM TABLE OF CONTENT The Respiratory Tract: The Lungs Alveoli THE RESPIRATORY SYSTEM CONSISTS OF: 1) Respiratory Tract: Nose through bronchi 2) The lungs. The respiratory tract further divided into the upper and lower respiratory tract The upper respiratory tract from the nose through the pharynx The lower respiratory tract (The Bronchial Tree) from the larynx to tertiary bronchi The Bronchial Tree The Bronchial Tree Extends to Bronchioles and Alveoli Alveoli Bronchioles and Alveoli Cartilage Ring asthma attack Cartilage Plates Bronchioles No Cartilage but Smooth Muscles Ciliary Lining of the Lower Respiratory Tract Cilia Cross Section Longitudinal Section Electron Micrograph of Cilia The cilia beat upward and drive the debris-laden mucus to the pharynx, where it is swallowed. THE LUNGS The Lungs overlap with the respiratory tract. Inside Lungs Primary Bronchi Secondary Bronchi Tertiary Bronchi Bronchioles Alveoli THE LUNGS - consist of the left and the right lungs - The left lung is divided into two lobes; the right into three. - receives the bronchus, blood and lymphatic vessels, and nerves through its hilum. - The bronchi extend into alveoli ALVEOLI ~700 SF surface area Alveoli consists of : 1) type I alveolar cells (95%), thin 2) type II alveolar cells (5%), secrete surfactant. 3) macrophages (dust cells), defense - Each alveolus is surrounded with a basket of capillaries. surrounded with capillaries The respiratory membrane: 1) the wall of the alveolus 2) the endothelial wall of the capillary 3) their fused basement membranes Alveoli contain elastic fibers which helps expiration. Low blood pressure keeps alveoli dry. Gas exchange occurs only in alveoli. Dead Space - starts from nose to terminal bronchiole - where there is no gas exchange - ~ 150 ml terminal bronchiole SUMMARY ANATOMY OF THE RESPIRATORY SYSTEM The Respiratory Tract: The Lungs Alveoli ventilation gas exchange transport by blood gas exchange MECHANICS OF VENTILATION TABLE OF CONTENTS Driving Force for Air Flow Resistance to Airflow Measurements of Ventilation Alveolar Ventilation Terms: inspiration or inhalation: breathing in expiration or exhalation: breathing out Driving Force for Air Flow Airflow driven by the pressure difference between atmosphere (barometric pressure) and inside the lungs (intrapulmonary pressure). 760 mmHg atmospheric pressure = 760 mmHg Before inspiration atmospheric pressure = 760 mmHg atmospheric pressure = 760 mmHg atmospheric pressure = 760 mmHg Mechanism for the Change in Intrapulmonary pressure Boyle’s Law: Volume x Pressure = Constant P V gas Inspiration: Volume Pressure Expiration: Volume Pressure Inspiration: Volume Pressure Expiration: Volume Pressure Can the lungs expand/shrink by themselves? Major Respiratory Muscles 1) The Diaphragm 1) 1) The TheDiaphragm Diaphragm - the principal muscleMuscles of 2) External Intercostal 2) External 2) External Intercostal IntercostalMuscles Muscles inspiration 3) Internal Intercostal Muscles 3) The Muscles 3) TheAbdominal Abdominal Muscles pulls the diaphragm down, - Inspiration muscles 4) The Abdominal Muscles increasing all three - increases 4) Internalthe Intercostal Muscles dimensions of the thoracic - Expiration muscles anteroposterior and cage. -transverse pulls the diaphragm up, dimensions of the - Extra Expiration muscles reducing chest. the vertical dimension of the thoracic cage. Coupling Between Lungs and Thoracic Cage - The lungs and thoracic cage are coupled by the pleurae. Visceral pleura covers the surface of each lung; parietal pleura lines the chest cavity. - The two pleurae form the pleural cavity. - The pleural fluid serves to reduce friction during chest expansion. - Intrapleural pressure: The pressure in the pleural cavity is negative. pleural cavity Parietal pleura visceral pleura lung Potential pleural cavity (negative intrapleural pressure) Generation of the negative intrapleural pressure The thoracic cage is larger than the natural size of the lungs. Parietal pleura visceral pleura lung Potential pleural cavity (negative intrapleural pressure) pneumathorax air air Conclusion Lungs pleurae - pressure Thoracic Cage Inspiration Contraction of 1) diaphragm 2) external intercostal muscles The lungs are carried along. Lung volume pressure Air flows in. active Resting Expiration Relaxation of 1) diaphragm 2) external intercostal muscles The lungs shrink. Lung volume pressure Air flows out. passive Forced Expiration Relaxation of 1) diaphragm 2) external intercostal muscles and Contraction of abdominal, internal intercostal and other accessory respiratory muscles. Lung volume pressure Air flows out. active SUMMARY Driving Force for Air Flow Atmosphere-lung pressure gradient Major respiratory muscles Coupling between lungs and thoracic cage Resistance to Airflow TABLE OF CONTENTS Resistance 1) Alveolar Surface Tension 2) Elastic Resistance 3) Airway Resistance Compliance 1) Alveolar Surface Tension - generated by a thin film of liquid over the surface of alveolar epithelium, - tends to cause a collapse of the alveoli, - Resists against inspiration. Alveolar surface tension is a resistance against inspiration. Alveoli - Surface tension is reduced by surfactant. ( type II alveolar epithelial cells) Pre-term infants don't have enough surfactant. type II surfactant Resistance 1) Alveolar Surface Tension 2) Elastic Resistance 3) Airway Resistance - Against inspiration due to elastic fibers in the lungs and chest wall, - Increases in pulmonary fibrosis. Resistance 1) Alveolar Surface Tension 2) Elastic Resistance 3) Airway Resistance - Due to friction, affected by airway caliber. - Against inspiration and expiration! - Increases during asthma attack (smooth muscle contraction in bronchiole. Resistance 1) Alveolar Surface Tension 2) Elastic Resistance 3) Airway Resistance Compliance - The reciprocal of resistance, - An indicator of ease with which the lungs expand. Measurements of Ventilation using Spirometer Alveolar ventilation rate = (tidal volume – dead space) x resp freq (/min) Dead Space inspiration expiration Changes in Spirometric Measures Restrictive disorders - (pulmonary fibrosis) compliance & vital capacity. Changes in Spirometric Measures Obstructive disorders - No change in respiratory volumes - FEV1. one-second forced expiratory volume SUMMARY MECHANICS OF VENTILATION Driving Force for Air Flow Resistance to Airflow Measurements of Ventilation Alveolar Ventilation NEURAL CONTROL OF VENTILATION Rhythm? Center in the medulla oblongata 1) inspiratory center - stimulates inspiration muscles. 2) expiratory center - inhibits the inspiratory center, - stimulates expiration muscles. The pons fine-tunes ventilation. Afferent Connections to the Respiratory Centers the limbic system Hypothalamus Chemoreceptors the lungs Chemoreceptor-initiated Reflexes Peripheral chemoreceptors - aortic and carotid bodies, - monitor O2, CO2 and pH of the blood. Central chemoreceptors - close to the surface of the medulla oblongata, - monitor the pH of the cerebrospinal fluid. CHEMORECEPTOR-MEDIATED REFLEX O2, CO2, or pH stimulate chemoreceptors reflex frequency and depth of respiration Voluntary Control - the motor cortex, - bypass the brainstem respiratory centers, - limited voluntary control. GAS EXCHANGE in the LUNGS ventilation gas exchange transport by blood gas exchange - The gas exchange between alveolar air and the blood is via diffusion of O2 and CO2. - Diffusion of a gas is driven by O2 and CO2 partial pressure gradient. PO2 = 40 mmHg PCO2 = 46 mmHg PO2 = 104 mmHg PCO2 = 40 mmHg The partial pressure of a gas refers to the share of the total pressure generated by a mixture of gases. H 2O 104 mmHg 13.6% O2 N2 Total = 760 mmHg 40 mmHg CO2 5.3% Oxygen and carbon dioxide cross the respiratory membrane and the air-water interface easily. PO2 = 40 mmHg PCO2 = 46 mmHg PO2 = 104 mmHg PCO2 = 40 mmHg Overview of Gas Exchange in the Lungs Factors That Affect the Efficiency of Alveolar Gas Exchange 1. partial pressure 2. solubility 3. respiratory membrane thickness/area 4. ventilation-perfusion coupling 1) Partial pressure PO2104 mmHg PCO2 40 mmHg a) High altitude b) Hyperbaric chamber c) Obstructive disease H 2O O2 O2 CO2 Air N2 Total = 760 mmHg CO2 N2 Total = 760 mmHg 1) Partial pressure PO2 40 mmHg PCO2 46 mmHg 2) Solubility PO2104 mmHg PCO2 40 mmHg CO2 has a higher solubility than O2. CO2 Pressure Gradient 6 mmHg O2 64 mmHg 1) Partial pressure 2) Solubility 3) Respiratory membrane thickness/area 1) Partial pressure 2) Solubility 3) Respiratory membrane thickness/area 4) Ventilation-perfusion Coupling - average V-P ratio = 0.8 - autoregulated by: PO2 and PCO2 causes: 1) vasoconstriction of pulmonary arterioles 2) dilation of bronchioles summary 1) Driving force for gas exchange 2) Factors that affect the efficiency of alveolar gas exchange Gas transport by the blood TABLE OF CONTENT 1) Carbon Dioxide Transport 2) Oxygen Transport Carbon Dioxide Transport 7% dissolved in the blood as a gas, 23% as carbaminohemoglobin, 70% as carbonic acid in the plasma. Oxygen Transport - About 98.5% of O2 in the blood are carried by hemoglobin. - The rest is physically dissolved in plasma. Hypoxemia Blood Oxygen Content - average 20 ml/dL - determined by: 1) saturation of hemoglobin Hypoventilation CO poisoning 2) content of hemoglobin anemia Carbon monoxide competes with oxygen for heme binding with a much higher affinity. Problem: deoxygenate hemoglobin Treatment: hyperbaric oxygen chamber GAS EXCHANGE in the TISSUES How to dissociate? O2 1. Carbon Dioxide Loading 2. Oxygen Unloading Dissociation of O2 from hemoglobin (HB) is affected by: PO2 dissociation PCO2 dissociation pH dissociation DPG dissociation (2,3-diphosphoglycerate) Temperature dissociation O2 In Lungs High PO2, low PCO2 O2 association with HG favor the loading of O2 100% saturated In tissues High PCO2, low PO2, low pH, DPG dissociation of O2 from HG favor the unloading O2 In tissues High PCO2, low PO2, low pH, DPG dissociation of O2 from HG favor the unloading O2 Utilization Coefficient - The amount of oxygen uptake by tissue versus the arterial blood oxygen content 20 ml O2/dL 15.6 ml O2/dL blood 4.4 ml O2/dL cell cell cell cell cell Utilization Coefficient = 4.4 ml / 20 ml = 22% Function of Oxygen ? glucose without oxygen 2 ATP with oxygen 38 ATP Can human beings produce oxygen? Oxygen Toxicity - Excessive oxygen generates hydrogen peroxide and free radicals, which destroy enzymes and damage nervous tissue. - Oxidative toxicity with aging. Hypercapnia - PCO2 > 43 mmHg caused by hypoventilation (respiratory diseases) Hypocapnia - PCO2 < 37 mmHg caused by hyperventilation Summary of the Respiratory System ventilation gas exchange transport by blood gas exchange Oxyhemoglobin Dissociation Curve Oxygen Dissociation & Temperature Active tissue - more O2 released PO2 (mmHg) Oxygen Dissociation & pH Active tissue - more O2 released Bohr effect: release of O2 in response to low pH