OVERVIEW OF THE
RESPIRATORY SYSTEM
dr I Nyoman Widajadnja, M.Kes
(Fisiologi Olahraga dan Cedera)
TUJUAN PEMBELAJARAN APAKAH
YANG INGIN DICAPAI?
• Memahami & menjelaskan struktur sistem pernapasan
• Memahami & menjelaskan fungsi sistem pernapasan
• Memahami & menjelaskan mekanisme fungsi sistem
pernapasan
• Memahami & menjelaskan regulasi fungsi sistem
pernapasan
• Memahami & menjelaskan hubungan fungsi sistem
pernapasan dengan sistem lain
• Memahami & menjelaskan kepentingannya dengan
(calon) sarjana kedokteran (S.Ked) dan dokter
Klasifikasi : Structurally and Functionally
Structurally : 2 parts
1. Upper Respiratory system : nasal,
pharynx
2. Lower respiratory system : larynx,
trachea, bronchi, and lungs
Functionally : 2 parts
1. Conducting Zone
2. Respiratory zone
• System Conducting Zone: consist a series
of interconecting cavity and tubes,
functioned as to filters, warm, moisten air
and conduct to lungs: nasal, pharynx,
larynx, trachea, bronchi, bronchiolus,
bronchiolus terminalis
• The Respiratory Zone : lungs tissue  the
gas exchange occurs: Bronchiolus
respiratorius, ductus alveolus, saccus
alveolus, alveoli. (main set of the gas
exchange between air ~ blood)
• Ruang lingkup THT : Ears, Nose,
Larynx (ENT)
= othorhinolaryngology
• Pulmonologist is a specialist in
diagnosis and treatment of desease
of the lungs
Chapter 9
Respiratory System
Points to Ponder
• What are the parts and function of the upper and lower
respiratory system?
• What is the mechanism for expiration and inspiration?
• How is breathing controlled by the nervous system and
through chemicals?
• Where and how is exchange of gases accomplished?
• What are some common respiratory infections and
disorders?
• What do you know about tobacco and health?
• What is your opinion about bans and legislation on
smoking?
9.1 The respiratory system
Overview of the respiratory system
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Nasal cavity
filters, warms, and moistens air
Upper
Respiratory
Tract
Pharynx
passageway where pathway
for air and food cross
Glottis
space between the vocal chords;
opening to larynx
Larynx
(voice box); produces sound
Trachea
(windpipe); passage of air
to bronchi
Bronchus
passage of air to lungs
Lower
Respiratory
Tract
Bronchioles
passage of air to alveoli
Lung
contains alveoli (air sacs);
carries out gas exchange
Diaphragm
skeletal muscle; functions
in ventilation
What is the pathway that air follows?
nose
pharynx
larynx
trachea
bronchus
bronchioles
alveoli
What constitutes the upper respiratory tract?
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• Nose
• Pharynx
• Larynx
sinus
nasal cavity
hard
palate
nares
sinus
tonsil
pharynx
nasopharynx
uvula
mouth
tongue
oropharynx
tonsils
epiglottis
glottis
larynx
trachea
laryngopharynx
esophagus
The nose
• Opens at the nostrils/nares and leads into the nasal
cavities
• Hairs and mucus in the nose filters the air
• The nasal cavity has lot of capillaries that warm and
moisten the air
• Specialized cells act as odor receptors
• Tear glands drain into the nasal cavities that can lead to
a runny nose
9.2 The upper respiratory tract
The pharynx
• Funnel-shaped cavity commonly called the
“throat”
• 3 portions based on location: nasopharynx,
oropharynx and laryngopharynx
• Tonsils provide a lymphatic defense during
breathing at the junction of the oral cavity
and pharynx
9.2 The upper respiratory tract
The larynx
• Triangular, cartilaginous
structure that passes air
between the pharynx and
trachea
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• Called the voice box and
houses vocal cords
base of
tongue
Epiglottis
Vocal
cords
glottis
© CNRI/ Phototake
• There are 2 mucosal folds
that make up the vocal
cords with an opening in the
middle called the glottis
9.3 The lower respiratory tract
What constitutes the lower respiratory tract?
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• Trachea
• Bronchial tree
• Lungs
Nasal cavity
filters, warms, and moistens air
Pharynx
passageway where pathway
for air and food cross
Upper
Glottis
Respiratory
space between the vocal chords;
Tract
opening to larynx
Larynx
(voice box); produces sound
Trachea
(windpipe); passage of air
to bronchi
Bronchus
passage of air to lungs
Bronchioles
passage of air to alveoli
Lower
Respiratory
Lung
Tract
contains alveoli (air sacs);
carries out gas exchange
Diaphragm
skeletal muscle; functions
in ventilation
9.3 The lower respiratory tract
The trachea
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cilia
goblet cell
• A tube, often called the
windpipe, that connects
the larynx with the 1°
bronchi
• Made of connective
tissue, smooth muscle
and cartilaginous rings
• Lined with cilia and
mucus that help to keep
the lungs clean
© Dr. Kessel & Dr. Kardon/Tissues & Organs/Visuals Unlimited
2,865
X
9.3 The lower respiratory tract
The bronchial tree
• Starts with two main bronchi that lead from
the trachea into the lungs
• The bronchi continue to branch until they
are small bronchioles about 1mm in
diameter with thinner walls
• Bronchioles eventually lead to elongated
sacs called alveoli
The Bronchial Tree
9.3 The lower respiratory tract
The lungs
• The bronchi, bronchioles and alveoli
beyond the 1° bronchi make up the lungs
• The right lung has 3 lobes while the left
lung has 2 lobes that divide into lobules
• Each lung is enclosed by membranes
called pleura
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9.3 The lower respiratory tract
The alveoli
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Pulmonary
vein
• 300 million in the lungs that
greatly increase surface area
blood flow
blood flow
pulmonary arteriole
contains much CO2,
little O2
• Alveoli are enveloped by blood
capillaries
• The alveoli and capillaries are
one layer of epithelium to allow
exchange of gases
Pulmonary
artery
bronchiole
pulmonary venule
contains much O2,
little CO2
lobule
• Alveoli are lined with surfactant
that act as a film to keep
alveoli open
capillary
network
alveoli
9.4 Mechanism of breathing
Two phases of breathing/ventilation
1. Inspiration – an active process of
inhalation that brings air into the lungs
2. Expiration – usually a passive process of
exhalation that expels air from the lungs
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Hukum Fisika yang berperan
1.
2.
3.
4.
5.
Boyle` low
Dalton`s law
Henry`s law
La Place law
Hukum kekekal masa % Hb saturation (dari plasma ke SDM Hb)
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Hukum Boyle`s
• Udara mengalir dari tekanan tinggi ke
tekanan yang rendah
• Inspirasi  membuat tekanan di dalam
rongga dada lebih rendah dari atmosfer
udara atmosfer masuk ke dalam rongga
dada
• Ekspirasi  membuat tekanan di dalam
dada lebih tinggi dari atmosfer udara
dlm dada dikeluarkan ke atmosfer
Boyle` law
• P1 x V1 = P2 x V2
• Persamaan gas ideal... PV = nRT......P =
tekanan, V = volume, n = mol gas, T=
suhu, R = konstanta gas universal
8,3145j/mol x K
• Pd Manusia jmlh mol dan suhu nilainya
konstan....... V = 1/P..... Jadi bila Vol ↑
maka tekanan P ↓
9.4 Mechanism of breathing
Inspiration
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• The diaphragm and intercostal
muscles contract
trachea
Rib cage
moves
up and out.
• The diaphragm flattens and the
rib cage moves upward and
outward
External intercostal muscles
pull the ribs outward.
lungs
Diaphragm contracts
and moves down.
• Volume of the thoracic cavity
and lungs increase
air in
• The air pressure within the
lungs decrease
lung
rib cage
• Air flows into the lungs
a. Inspiration
When
Pressure
in lungs
decreases,
air comes
rushing in.
9.4 Mechanism of breathing
Expiration
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•
The diaphragm and intercostal
muscles relax
•
The diaphragm moves upward
and becomes dome-shape
•
The rib cage moves downward
and inward
•
Rib cage
moves
down and in.
Internal intercostal muscles
pull the ribs inward during
forced expiration.
Diaphragm relaxes
and moves up.
Volume of the thoracic cavity and
lungs decrease
air out
•
•
The air pressure within the lungs
increases
When
Pressure
in lungs
increases,
air is
pushed out.
Air flows out of the lungs
b. Expiration
9.4 Mechanism of breathing
Different volumes of air during breathing
• Tidal volume – the small amount of air that usually
moves in and out with each breath
• Vital capacity – the maximum volume of air that can be
moved in plus the maximum amount that can be moved
out during one breath
• Inspiratory and expiratory reserve volume – the
increased volume of air moving in or out of the body
• Residual volume – the air remaining in the lungs after
exhalation
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9.4 Mechanism of breathing
Visualizing the vital capacity
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Average Lung Volume (ml)
5,800
4,800
maximum
expiration
maximum
inspiration
inspiratory
reserve
volume
vital
capacity
3,600
2,900
2,400
tidal
volume
expiratory
reserve
volume
1,200
residual
volume
residual
volume
0
© Burger/Photo Researchers, Inc.
total
Lung
capacity
9.5 Control of ventilation
How is breathing controlled by the
nervous system?
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• Nervous control:
brain
– Respiratory control center respiratory center
region of the brain that
in the brain (medulla
automatically regulates
breathing
oblongata) sends out
nerve impulses to
contract muscle for
intercostal nerves
stimulate the intercostal
inspiration
muscles to contract
– Sudden infant death
syndrome (SIDS) is
thought to occur when
this center stops sending
out nerve signals
external intercostal muscles
help expand the thoracic
cavity by contracting
phrenic nerve
stimulates the diaphragm
to contract
diaphragm
helps expand the thoracic
cavity by flattening when
it contracts
9.5 Control of ventilation
How is breathing chemically controlled?
• Chemical control:
– 2 sets of chemoreceptors sense the drop in
pH: one set is in the brain and the other in the
circulatory system
– Both are sensitive to carbon dioxide levels
that change blood pH due to metabolism
Dalton`s Law
• Hukum Gas: hukum yang mengatur
kelarutan gas ke dalam larutan
• Tekanan atmosfer normal = 760 mmHg
• Udara atmosfer satuannya: mmHg yi
1mmHg = 1,36 cm H2O
• 760 mmHg = 101,325 kPa
Dalton`s Law
• Hk dalton : tekanan total dari campuran
gas = jumlah dari tekanan masing-2 gas
• Atmosfer 760 mmHg 78% N2, 21% O2,
0,04% CO2...dst
• Dalam Fisiologi bukan hanya oleh Hk
Dalton, tapi juga oleh masing-2 tekanan
partill O2 dan CO2 ikut menentukan
Henry`s law
• Kwantitas gas yg akan terlarut berbanding
lurus dg tekanan partiil gas dan daya
kelarutan gas
• Semakin ↑ tek partiil dan semakin ↑ daya
kelarutan  semakin kuat gas tertahan
dalam larutan
• Contoh: soft drink
9.6 Gas exchanges in the body
Exchange of gases in the body
• Oxygen and carbon dioxide are exchanged
• The exchange of gases is dependent on diffusion
• Partial pressure is the amount of pressure each
gas exerts (PCO2 or PO2)
• Oxygen and carbon dioxide will diffuse from the
area of higher to the area of lower partial pressure
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9.6 Gas exchanges in the body
External respiration
• Exchange of gases between the lung alveoli and the
blood capillaries
• PCO2 is higher in the lung capillaries than the air thus
CO2 diffuses out of the plasma into the lungs (Henry`s
law)
• The partial pressure pattern for O2 is just the opposite,
so O2 diffuses to the red blood cells in the lungs
Carbon dioxide transport: carbonic
H+ + HCO3H2CO3 anhydrase H2O + CO2
Oxygen transport:
Hb + O2
HbO2
9.6 Gas exchanges in the body
Internal respiration
• The exchange of gases between the blood and the
tissue fluid in the capillaries outside of the lungs
• PO2 is higher in the capillaries than the tissue fluid thus
O2 diffuses out of the blood into the tissues
Oxyhemoglobin gives up oxygen:
HbO2
Hb + O2
Most CO2 is carried as a bicarbonate ion:
CO2 + H2O
carbonic
anhydrase
H2CO3
H3 + HCO3-
9.6 Gas exchanges in the body
The movement of oxygen and carbon
dioxide in the body
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alveolus
plasma
Hb H+
CO2
pulmonary
capillary
HCO3 H+ + HCO3-
External respiration
RBC
H2CO3
CO2
Hb O2
H2O
RBC
O2
O2
Hb CO2
Pulmonary
capillary
alveolus
CO2 exits blood
CO2
a.
plasma
O2 enters blood
O2
lung
pulmonary artery
pulmonary vein
heart
systemic vein
tissue cells
systemic artery
HCO3-
plasma
plasma
H+ + HCO3-
systemic
capillary
RBC
Hb H+
CO2
O2
RBC
systemic
capillary
H2CO3
CO2
H2O
Hb
Internal respiration
Hb CO2
Tissue
fluid
CO2 enters blood
b.
Tissue
cell
Tissue
cell
Tissue
fluid
O2 exits blood
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9.7 Respiration and health
Upper respiratory tract infections
• Sinusitis – blockage of sinuses
• Otitis media – infection of the middle ear
• Tonsillitis – inflammation of the tonsils
• Laryngitis – infection of the larynx that
leads to loss of voice
9.7 Respiration and health
Lower respiratory tract disorders
• Pneumonia – infection of the lungs with thick, fluid build up
• Tuberculosis – bacterial infection that leads to tubercles (capsules)
• Pulmonary fibrosis – lungs lose elasticity because fibrous
connective tissue builds up in the lungs usually because of inhaled
particles
• Emphysema – chronic, incurable disorder in which alveoli are
damaged and thus the surface area for gas exchange is reduced
• Asthma – bronchial tree becomes irritated causing breathlessness,
wheezing and coughing
• Lung cancer – uncontrolled cell division in the lungs that is often
caused by smoking and can lead to death
9.7 Respiration and health
Health focus: Things you should know about
tobacco and health
• All forms of tobacco can cause damage
• Smoking increases a person’s chance of lung, mouth, larynx,
esophagus, bladder, kidney, pancreas, stomach and cervix
• The 5-year survival rate for people with lung cancer is only
13%
• Smoking also increases the chance of chronic bronchitis
emphysema, heart disease, stillbirths and harm to an unborn
child
• Passive smoke can increase a nonsmokers chance of
pneumonia, bronchitis and lung cancer
9.7 Respiration and health
Bioethical focus: What do you think?
• Is it ethical to ban smoking?
• Does restricting the freedom to smoke segregate people
based on habit?
• Are nonsmokers infringing upon smokers or are smokers
infringing upon nonsmokers? Is it both?
• Will this legislation help smokers quit?
• Should smoking be banned in bars and casinos?
• Do smoking bans hurt the economy?