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Conducting zone organs cleanse, humidify, and warm incoming air. Air reaching the lungs has
fewer irritants (dust, bacteria) then when it entered the system
External Nose:
Root (area between the eyebrows), bridge, and dorsum nasi (anterior margin), the latter
terminating in the apex (tip of the nose), philtrum, external openings (nostrils/nares).
Supporting framework of bone and cartilage; covered with skin and lined with mucous
membrane
Internal Nose:
Paranasal sinuses
Pharynx (throat)
Connects the nasal cavity and mouth superiorly to the larynx and esophagus inferiorly
Funnel-shaped tube (13cm or 5in) (from the base of the skull to the 6th cervical vertebra)
Divide into: nasopharynx, oropharynx, and laryngopharynx
Composed of skeletal muscle and lined with mucous membrane
Functions as passageway for food and air
1) Nasopharynx: serves only as air passageway
Posterior to nasal cavity, inferior to sphenoid bone, superior to the level of soft palate (from
sphenoid bone to soft palate)
Four openings in its wall
Two from internal nares (pharyngeal tonsils or adenoids) which, if swollen, can cut off
air supply from nose (traps and destroys pathogens entering nasopharynx in air)
Two from the pharyngtoympanic tubes (auditory and Eustachian) that drain the middle
ear); allow middle ear pressure to equalize with atmospheric pressure (Surrounded by
tubal tonsils-help protect the middle ear against infections
Pseudostratified ciliated columnar epithelium lining (moves contaminated mucous
towards the throat to be swallowed or spit out); continuous with the nasal mucosa
Oropharynx
lies posterior to the oral cavity and is continuous with it through an archway called isthmus of
the fauces (opening of the posterior of the mouth) (both food and air pass through it)
pseudostratified ciliated columnar changes to stratified squamous epithelium (more
protective epithelium- accommodates the increased friction and greater chemical trauma
accompanying food passage)
two pairs of tonsils:
palatine (lie embedded in the oropharnygeal mucosa of the lateral walls of the feuces)
lingual tonsil (covers the posterior surface of the tounge)
Laryngopharynx
between the (superiorly attached to hyoid bone) and opens into laryngopharynx and (inferiorly
continuous) with trachea (short passageway 5cm or 2in)
from the level of the third to the sixth cervical vertebrae
Three functions:
To provide a patent (open) airway
To act as a switching mechanism to route air and food into the proper channels (uses
epiglottis as a lid)
To voice production (houses vocal folds (vocal cords))
Associated structures: (nine cartilages) (all hyaline except epiglottis)
1) Thyroid cartilage:
Formed by the fusion of two cartilage plates
Laryngeal prominence: marks the fusion point (externally Adams apple)
2) Cricoid cartilage: inferior to thyroid cartilage; ring-shaped; perched atop and
anchored to the trachea inferiorly
Three pairs of small cartilage: (arytenoid, cuneiform, & corniculate)Arytenoid (hyaline CT) (most important-pyramid shaped) anchors the true
vocal cords (folds) and pharyngeal muscles, their action moves (push/pull
on) the vocal cords
The cuneiform and corniculate (rod shape cartilages, made of elastic CT)
and their membranes connect the epiglottis to arytenoid cartilage
3) Epiglottis:
Composed of elastic cartilage, covered by taste bud-containing mucosa
Attached to the thyroid cartilage anteriorly; posteriorly it is unattached and
open
Works like a trap door (larynx can be closed off to liquid and foods, only
allowing air through)
Forms a lid over rima glottis (space between the parallel vocal folds)
4) Vocal ligaments:
Attach arytenoid cartilages to the thyroid cartilage
Composed largely of elastic fibers into TWO pairs
Lower Pair: vocal folds or true vocal cords
Form the core of mucosal folds called vocal folds, or true vocal cords-appear
white because they lack blood vessels
Vocal fold vibrate , producing sounds as air rushes up from lungs
Vocal folds and medial opening between them through which air passes are
called glottis
Upper Pair: vestibular folds or false vocal cords
No part in sound production
Help close the glottis when we swallow (sphincter, when holding breath)
Superior portion subjected to food contact-is lined with stratified squamous epithelium
Below the vocal folds-epithelium is pseudostratified ciliated columnar-that act as dust filter
Power stroke of cilia is directed upward toward the pharynx so that mucus is continually moved
away from the lungs
Voice production:
Skeletal muscles of larynx attach to arytenoid cartilage and the vocal folds themselves
Muscles contract, pulling the strings (increase tension) of elastic ligaments and
stretching the vocal folds, narrowing the glottis
Passing air (from the lungs) over them-> they vibrate setting up sound waves
Increased air pressure -> there is increased sound
The tighter the cords and narrower the glottis, the higher the pitch
The looser the cords and wider the glottis, the lower the pitch
Sound originates from vibration of vocal folds, but other structures are needed to convert sound
into recognizable speech (pharynx, mouth, nasal cavity and sinuses)
Constriction and relaxation or pharyngeal muscles will produce vowel sounds
The muscles of the face, tongue, and lips help enunciation
Inflammation of the vocal fold-laryngitis-causes swelling of vocal folds
A site where conducting zone structures give way to respiratory zone structures
1) Conducting Zone structures:
Trachea divides to form the right and left main (primary bronchi at the T7)
Right main bronchus is more wider, shorter and more vertical then left (more
commonly obstructed by foreign objects)
Primary bronchi contain incomplete cartilage rings and are lined with pseudostratified
ciliated columnar epithelium (like the trachea)
2) Inside the lungs each main bronchus subdivides into lobar (secondary) bronchi-three on the
right and two on the left-each supply one lung lobe
3) The lobar bronchi branch into third-order segmental (tertiary) bronchi, which divide
repeatedly into smaller and smaller bronchi (supply bronchopulmonary segments)
Passages smaller than 1mm in diameter are called bronchioles and the tiniest-terminal
bronchioles (less than 0.5mm in diameter) (lined with simple cuboidal epithelium)
As branching increases several changes occur:
Cartilage rings are replaced by cartilage plates (elastic fibers found in tube walls
throughout bronchial tree)
Paired lungs occupy the entire thoracic cavity except the mediastinum. Lungs have an apex,
base, hilus (through which pulmonary, systemic BV, bronchi, lymphatic V. enter and leave the
lung) and cardiac notch, the last of which is only in the left lung. Right lung is shorter than left
Left Lung: subdivided into superior and inferior lobes by the oblique fissure
Right Lung: partitioned into superior, middle, and inferior lobes by the oblique and horizontal
fissures
Lobes: contain a number of pyramid-shaped bronchopulmonary segments
Separated by one another by CT septa.
Each segment is served by its own artery and vein (own vascular system)
Receives air from individual segmental (tertiary) bronchus
Each lung contains 10 bronchopulonary segments (left lung can be 8 or 9 segments)
Blood supply and innervation
1) Pulmonary Circulation
Pulmonary arteries deliver deoxygenated blood to the lung
In the lungs, pulmonary arteries branch profusely along with bronchi and feed into
the pulmonary capillary networks surrounding the alveoli
Pulmonary veins deliver oxygenated blood to the heart
2) Bronchial arteries and veins:
Bronchial arteries provide oxygenated system blood to lung tissue-except alveoli
Arise from aorta, enter hilum and run along branching bronchi
One artery on the right and two on the left (from aorta); drained by bronchial veins
3) Innervated by parasympathetic and sympathetic motor fibers (visceral sensory)
These nerve fibers enter each lung through pulmonary plexus on the lung root
Parasympathetic fibers constrict air tubes, sympathetic fibers dilate them
Pleura:
Mechanics of Breathing:
A. Respiratory pressures are always described relative to Atmospheric pressures
(760mmHg=1atm, at sea level)
Atmospheric pressure is pressure exerted by the air (gases) surrounding the body.
Intrapulmonary pressure (intra-alevolar) (Ppul)=atmospheric pressure
Pressure in the alveoli.
Rises and falls with phases of breathing
Always equalizes with atmospheric pressure
Intrapleural pressure (interthoracis)(Pip)
Pressure between the parietal and visceral pleura (in the pleural cavity)
a decrease in the thoracic cage size (dec. volume -> inc. intrapulmonary
pressure)
when inspiratory muscles relax thoracic cage goes back to its normal size
(smaller) -> this leads to compression of the lungs -> Ppul rises to about 1mmHg
above atmospheric pressure
when Ppul > Patm, the pressure gradient forces gases to flow out of the lungs
intrapulmonary pressure 763mmHg
Forced Expiration: an active process causing contraction of internal intercostal
& abdominal muscles, these contractions
1) Increase intra-abdominal pressure, which forces the abdominal organs
superiorly against the diaphragm
2) Depress the rib cage. Internal costal muscles also help depress the rib cage
and decrease thoracic volume
Lung collapse (atelectasis) would occur if intrapleural pressure was not
maintained (at negative pressure)
REVIEW:
Intrapulmonary pressure: Pressure inside lung decreases as lung volume increases during inspiration;
pressure increases during expiration
Anytime intrapulmonary pressure is less than the atmospheric pressure, air rushes into the
lungs along the pressure gradient. Inspiration ends when Ppul= P atm.
Intrapleural pressure: Pleural cavity pressure becomes more negative as chest wall expands during
inspiration. Returns to initial value as chest wall recoils.
Tidal volume (TV):air moving into and out of lungs during normal quite breathing (500ml)
Inspiratory reserve volume (IRV): the amount of air that can be inspired forcibly beyond the
tidal volume (2100 to 3100 ml)
Expiratory reserve volume (ERV): the amount of air-normally (1000-1200ml) that can be
evacuated from the lungs after a dial expiration.
Residual volume (RV): the amount of air remaining in the lungs (1200); prevents lung collapse
Inspiratory capacity (IC): is the total amount of air that can be inspired after a tidal expiration
(sum of TV and IRV)
Functional residual capacity (FRC): represents the amount of air remaining in the lungs after a
tidal expiration and is the combined RV and ERV
Vital capacity (VC): total amount of exchangeable air. Sum of TV, IRV, and ERV. (4800ml)
Total lung capacity (TLC): the sum of all lung volumes (6000ml)
Dead Space:
Volume of air that remains in the conducting zone (nose, pharynx, larynx, trachea & bronchi)
Accounts for about 150ml of the 500ml of tidal volume (leaving approx.. 350 ml in respiratory
zone (bronchioles alveolar ducts, alveolar sacs and alveoli)
Alveolar Ventilation Rate (AVR): AVR (ml/mm) =frequency (breath/mm) x TV - dead space
ml/breath. Alveolar dead space (if alveoli cease to act in gas exchange) is added to anatomical
dead space- total dead space (no useful volumes)
AVR takes into account the volume of air wasted in the dead space and measures the flow of
fresh gases in and out of the alveoli during a particular time interval. Usually 12 breaths per min.
times the difference of 500-150ml per breath, or 4200ml/min.
External respiration: exchange of O2 and CO2 between the alveoli of the lungs and pulmonary
capillaries. Atmospheric pressure; the sum of all partial pressures in a specific gas (air)
pO2 in alveoli is 104mmHg, and pO2 in capillaries is 40mmHg, therefore O2 diffuses from
alveoli to deoxygenated blood until equilibrium is reached. Blood now has pO2 of 104mmHg.
Arriving at the lungs pCO2 in the blood is at 45mmHg. And that of the alveoli is 40mmHg. This
difference will cause diffusion of the CO2 into the alveoli, which will be eliminated during
expiration.
The reason equal amount of O2 and CO2 are exchanged equally is because CO2 is 20
times more soluble in plasma and alveolar fluid than O2
Internal respiration: (at tissues): exchange of oxygen and carbon dioxide between blood and tissues
pO2 in capillary blood is 104mmHg, and pO2 in tissue cells is 40mmHg. Due to gradient
difference, O2 will diffuse out of capillaries through interstitial fluid into tissue cell leaving pO2
in capillary at 40mmHg.
pCO2 in tissue cells is 45mmHg, while in tissue capillaries it is only 40mmHg. As a result, CO2
diffuses from tissue out through interstitium to tissue capillary, increasing pOC2 to 45mmHg.
Then blood is pumped back to the heart, and the cycle begins again.
Partial pressure: each gas in the mixture of gases exerts its own pressure as if all other gases
were not present (Daltons Law)
Partial pressure gradients: during inspiration; atmospheric air containing oxygen enters the
alveoli as deoxygenated blood flows through the pulmonary capillaries that overlie the alveoli
Factors that assist in diffusion:
Gas solubilities: CO2 is 20x more soluble in plasma than O2 is. This helps diffusion of
CO2 in spite of the very small partial pressure gradient difference is only 5mmHg.
Surface are for gas exchange: total surface area is about 90-140m2. Many more times
the surface area of the skin (40x)
The greater the surface are of the respiratory membrane, the more gas can diffuse
across it in a given time period.
Ventilation-perfusion coupling: lying over the alveoli are countless capillaries (1L of
blood can participate in gas exchange at any time)
Amount of gas (air) reaching lungs and blood flow through them must be matched. This
is extremely important; timing becomes essential, making this local auto-regulation
system extremely important.
When ventilation is inadequate, Po2 is low, high Pco2; terminal arterioles constrict and
blood is redirected to respiratory areas where Po2 is high.
When ventilation is maximal, PO2 is high/PCO2 is low, pulmonary arteriole dilate,
increasing blood flow into the associated pulmonary capillaries.
Same thing for carbon dioxide in bronchioles except its affected by PCO2
Transporting Oxygen (O2)
Oxygen is carried in blood in two ways:
1) Bound to hemoglobin (98.5)
2) Dissolved in plasma (1.5)
Hemoglobin consists of: globin (protein) and heme (pigment)
Heme contains four atoms of iron, each can combine with one molecule of O2
Oxyhemoglobin: (saturated hemoglobin) O2 attached to it
Deoxyhemoglobin: (reduced) without O2 attached to it
Hemoglobin and pO2
With high pO2 hemoglobin may only be partially saturated
The affinity (attraction) of hemoglobin for O2 varies with the degree of saturation (increase
saturation -> increase affinity)
Pulmonary capillaries: pO2 is high; lots of O2 binds with hemoglobin. In tissues where the pO2 is
lower, hemoglobin will release O2 and it will diffuse into the cells
Hemoglobin and temperature:
With inc. temperature (within limits), oxygen releases from hemoglobin (dec. affinity);
enhancing oxygen unloading from the blood.
Inc. work -> inc. metabolic reaction -> inc. heat production -> inc. unloading of O2 from
hemoglobin to supply the active cells
Hemoglobin and pH
With an incr. acidity, O2 is released more readily from hemoglobin (dec. affinity)
The Bohr effect, hydrogen ion (H+) bind to hemoglobin and alter its structure causing the
release of O2 (dec. affinity)
The Haldane effect, as more O2 bind to hemoglobin and alter its structure, then hydrogen ion
(H+) are released (decr. Affinity) and ultimately incr. CO2 can be made and expelled from the
body
High CO2: (C02+H20<-> H2CO3 <-> H+ + HCO)
Muscle contractions increase lactic acid which decreases pH; both cause acidic conditions due to
an increase in free H+
Hemoglobin and 2-3 BPG (biphosphoglycerate)
An intermediate compound formed in RBCs during glycolysis (in ATP production)
BPG combines with hemoglobin altering its structures to release O2 (dec. affinity)
Transporting Carbon Dioxide
1) Dissolves in plasma: approx. 7-10% of CO2 at the lung; it simply diffuses back into alveoli
2) Chemically bound: to hemoglobin
20-30% combines with the globin of hemoglobin to form carbanihemoglobin
loading and unloading of C02 is a direct result of the Pco2 and oxygenation of
hemoglobin
3) as a bicarbonate ion in the plasma
70% AKA: carbonic acid-bicarbonate blood buffer system ( allows CO2 to get to the
lung as a bicarbonate ion) also acts as a buffer system
Carbon dioxide (CO2) enters RBCs, reacts with water in the presence of carbonic
anhydrase to form carbonic acid (H2CO3). It then dissociates into a hydrogen ion (H+)
and a bicarbonate ion (HC03). This is a reversible reaction.
(CO2+H20<->H2CO3<->H+HCO3)
HCO3 leaves RBCs and enter plasma in exchange for a Cl- (negative ions exchange
maintains ionic balance) -> chloride shift via facilitated diffusion.
Cl- enters RBCs and combines with a K+ (potassium ion) forming KCl (potassium chloride
salt). HC03 (bicarbonate ion) combines with NA+ (sodium ion) forming NaHCO3 (sodium
bicarbonate)
as CO2 arrives at the lungs all 3 forms simply revers the actions to release CO2 into
alveoli
Control of Respiration:
A. Medullary (rhythmicity area) respiration centers to control basic respiratory rhythm.
Eupnea, 12-15 breaths/min, with inspiration -2 seconds and expiration -3 sec.
Inspiration center:
Dorsal respiratory group (DRG)
o Located dorsally near the root of cranial nerve IX
o Only to integrate input from peripheral stretch and chemoreceptors and
sends it to VRG
Ventral respiratory group (VRG)
A network of neurons that extends in the ventral brain stem from the
spinal cord to the pons-medulla junctions
o A rhythm-generation and integrative center
o Has neurons for both inspiration and expiration
o When inspiratory neurons fire, a burst of impulse travels along the
phrenic nerve (innervating diaphragm) and the intercostal nerve
(innervating external intercostal muscles) contract and increase the size
of the thoracic cage, leading to inspiration
o When the expiratory neurons fire the output stops and expiration
occurs passively as the muscles relax and lungs recoil
hypothesis: respiratory rhythm is most likely due to reciprocal inhibition of
interconnecting neurons in the medulla, rather than due to pacemaker cells
Forced breathing: (during high levels of ventilation) impulses from inspiratory area
activate the expiratory area or ventral respiratory group (VRG) causing internal
intercostal and abdominal muscles to contract
Pons respiratory centers:
Pontine respiratory group (pneumotaxic center): upper pons
influence and modify the activity of medullary neurons
ongoing transmission of impulses in inspiratory area to turn off the impulses before
lungs overfill and facilitate expiration smoothing out the transitions from inspiration to
expiration
apneustic center (functional concept): lower pons: sends impulses to inspiratory area to
prolong inspiration. It is usually inhibited by pneumotaxic center.