cardiovascular and respiratory systems - Lobes that increase the surface area of the mucosa

- share responsibility for supplying the body with exposed to the Air
oxygen and disposing of carbon dioxide. - Increase the air turbulence in the nasal cavity - to
deflext inhaled particles onto the mucus-coated
respiratory system organs surfaces
- Oversee the gas exchanges that occur between the Palate
blood and the - Separates the nasal cavity and oral cavity
external environment - Hard palate- supported by a bone, anterior part
- pharynx, larynx, trachea, bronchi and their - Soft palate- unsupported, posterior part
smaller branches, and the lungs, which contain the
alveoli - or terminal air sacs Pharynx
- where gas exchange with the blood happens - The throat
- the other respiratory system - Muscular passageway Taht serves a passageway for
structures are really just conducting passageways food and air
- Continuous with that nasal cavity anteriorly via the
that carry air through the lungs
posterior nasal aperture
- Has three regions
upper respiratory tract - from the nose to the larynx - Nasopharynx - superior portion
lower respiratory tract - from the trachea to the alveoli - Oropharynx
- Laryngopharynx
conducting passageways - purify, humidify, and warm - Food travels from the mouth, with air travels through
incoming air along the oropharynx and laryngopharynx.
- Food is directed to the esophagus, by the epiglottis.
- Pharyngotympanic tubes - drain middle ears, open
Nose
into the nasopharynx
- Button and hooked in shape
- Tonsils - cluster of lymphatic tissue, protects the body form
- Only external visible part of the respiratory system
infection
Pharyngeal tissue -
Nostrils
- single,
- Also called nares - adenoid
- where air enters the nose - Located high in the nasopharynx
Palatine tonsils
Interior of the nose - nasal cavity, divided by a midline, nasal - A pair
septum - In the oropharynx ate the end of the soft palate
Lingual tonsils
Olfactory receptors - located in the mucosain the slitlike - Lies at the base of the tongue
superior part of the nasal cavity, beneath the ethmoid bone
Larynx
Respiratory Mucosa - The voice box
- Routes air and food into the proper channels
- the rest of the mucosa lining the nasal cavity
- Plays a role in speech
- warms the air
- Inferior to the pharynx, formed by the eight rigid
- the mucosa’s glands produce sticky mucus that
hyaline cartilages and a spoon-shaped flap of elastic
moistens the airs, and traps incoming bacteria and
cartilage, the epiglottis
other foreign debris
- Thyroid cartilage
- has lysozyme enzymes that destroy bacteria
- Largest hyaline cartilage
chemically - Protrudes anteriorly
- ciliated cells of nasal mucosa, create a gentle current - The adam’s apple
that moves the sheet of contaminated mucus - Epiglottis
- Referred to as the “guardian of the airway”
Cilia - protects the superior opeing of the larynx
- when cold, they become sluggish, allowing micks to - Allows the passage of air into the lower
accumulate in the nasal cavity respiratory pasaages
- Smoking inhibits and ultimately destroys the cilia - Closes during food intakes, and forms a lid
over the larynx's opening
Conchae - Cough reflex
- Mucosa-covered projections - if anything, aside form air, enters the larynx
- To prevent the substance from continuing
into the lungs
 - Vocal folds
- Or true vocal cords
- Vibrate with expelled air, which allows us to
speak
- Glottis - the vocal folds and the slitlike
passageway between them
Trachea
- Or windpipe
- Lined with ciliated mucosa, surrounded by goblet
called that produce mucus
- Cilia beat continuously, in an opposite direction of
the incoming air
- Rigid, reinforced with c-shaped rings of hyaline
cartilage
- Open rings - abut the esophagus, and allows
it expand anteriorly when we swallow a
large piece of food
- Solid portions - support the trachea walls
- Keep it patent or open in spite of pressure
changes
- Trachealis muscle - lies next to the esophagus
- Completes the wall of the trachea posteriorly
Main (primary) Bronchi
- Formed by the division of the trachea
- Each bronchus runs obliquely and plunges into the
medial depression (hillum)
Right main bronchus
- wider, shorter and straighter than the left
- Most common site for an inhaled foreign
object to become lodged
When inhaled air reaches the Bronchi, it is warm, cleansed of
most impurities, and humid.
Lungs
- Occupies the entire thoracic cavity
- Mediastinum
- Houses the heart, blood vessels, bronchi,
esophagus
- Apex
- Narrow superior portion of each lung
- Base
- The broad lunch area resting on the
diaphragm
- Divided into two lobes by fissures
- Left lung has two lobes
- Right lung has three lobes
- Visceral pleura or pulmonary pleura - Visceral
serosa that covers the surface area of each lung
- Pleural fluid
- produced by pleural membrane, allows the
lungs to glide easily over the thorax wall
during breathing
- Causes the two pleural layers to cling
together, for normal breaching
- Bronchial tree
- Respiratory tree
- main bronchi subdivided into smaller
branches after entering the lungs, broncioles
- Because of the branching and rebranching of
the respiratory passageways
Respiratory zone structures and the respiratory
membrane
- Terminal bronchioles lead into respiratory zone
structures - smaller conduits that eventually
terminate in alveoli, or air sacs
Respiratory zone
- Respiratory bronchioles, alveolar ducts, alveolar sacs,
alveoli
- Only site of gas exchange
Conducting zone structures
- Other respiratory pasagges
- Serve as conduits to and from the respiratory zone
● Millions of clustered alveoli make up the bulk of the
lungs
Stroma
- balance of lung tissue
- Mainly elastic connective tissue that allows the lungs
to stretch and recoil
Alveolar Walls
- made of single thin layer of squamous epithelial cells
- Provide a total gas exchange of 50 to 70 square
meters
- Formed by cuboidal surfactant-secreting cells
produces surfactants
Surfactants - lipid (fat) molecule, coats the gas exposed
alveolar surfaces
Alveolar pores
- connect neighboring air sacs and provide alternative
routes for air to reach alveoli whose feeder
bronchioles have been clogged by mucus or
otherwise blocked
Respiratory membrane
- made of occasional elastic fibers
Simple diffusion
- manner of gas exchange, through the respiratory
membrane
- movement occurs toward the area of lower
concentration of the diffusing substance
 Alveolar macrophages Inspiration
- Also called “dust cells” - Inspiratory muscles, diaphragm and external
- Final line of defense for respiratory system in the thoracic intercostals, contract, size of thoracic
alveoli cavity increases
- Wander in and out of the alveoli picking up bacteria, - Series of events:
carbon particles and other debris - As the diaphragm contracts inferiorly, the height of
the toxic cavity increase
RESPIRATORY PHYSIOLOGY - As the external intercostal contracts, it lifts the rib
cage and thrusts the sternum forward, increases the
Respiratory anteroposterior and lateral dimensions of the thorax
- Major function of the respiratory system is to - Lungs adhere tightly to the thorax walls, so they are
supplement the body with oxygen and to dispose stretched to the new, largely size of the thorax.
- Intrapulmonary volume
carbon dioxide
- Volume within the lungs
- Four distinct events
- As it increases, the gases within the lungs
spread out to fill the larger space
1. Pulmonary ventilation. - The resulting decrease in gas pressure in the lungs,
- Air moves into and out of the lungs
produces a partial vacuum, which causes air to flow
- Causes the alveoli or the lungs continuously
into the lungs
refreshed
- Partial vacuum - pressure less than
- Commonly called as breathing
atmospheric pressure outside the body
- Air continues to move into the lungs until the
2. External respiration.
intrapulmonary pressure equals atmospheric pressure
- Gas exchange between the pulmonary blood and
alveoli
Expiration
- Gas exchanges are being made between the blood
- Exhalation
and the body exterior
- A passive process that depends more on the natural
elasticity if the lungs
3. Respiratory gas transport - Series of events
- Oxygen and carbon dioxide transported to and from - As the inspiratory muscles relax and resume their
the lungs and tissue cells of the body initial resting length, the rib cages descend, recoil,
- via the bloodstream both thoracic and intrapulmonary volume decrease,
- As the intrapulmonary volume decreases, gases
4. Internal respiration inside the lungs are forced more closely together,
- Gas exchange occurs between the blood and cells intrapulmonary pressure rises to a point higher than
inside the body atmospheric pressure.
- At systemic capillaries - This causes the gases to passively flow out to
equalize the pressure with the outside.
● First two processes are the special responsibility of - If respiratory passageways are narrowed by spams of
the respiratory system the bronchioles, or clogged with mucus or fluid,
expiration becomes an active process
Cellular respiration
- the use of oxygen to produce ATP and carbon dioxide - Forced expiration
- Cornerstone of all energy-producing chemical - The internal intercostal muscles are
reactions and occurs in all cells activated to help depress the rib cage, and
the abdominal muscles contract
MECHANICS OF BREATHING - and help to force air from the lungs by
squeezing the abdominal organs upward
Breathing against the diaphragm.
- Pulmonary ventilation - Intrapleural pressure -
- A mechanical process that depends on volume - pressure within the space
- Always negative
changes occurring in the thoracic cavity
- Major factor preventing lung collapse
- Volume changes leat to pressure changes, which lead
- If equal with the atmospheric pressure, lungs
to the flow of gases to equalize the pressure.
collapse and recoil
- Two phases of breathing
- Inspiration - flowing of air into the lungs
- Expiration - air leaving the lungs RESPIRATORY VOLUMES AND CAPACITY

Factors that affect respiratory capacity
- A person’s: Size, sex, age and physical condition
tidal volume (TV)
- respiratory volume
- a person is capable of inhaling much more air than is
taken in during a tidal breath
- Normal quiet breathing
- approximately 500 ml of air into and out of the lungs
with each breath
inspiratory reserve volume (IRV)
- the amount of air that can be taken in forcibly above
the tidal volume
- around 3,100 ml.
the expiratory reserve volume (ERV)
- after a normal expiration, more air can be exhaled.
- the amount of air that can be forcibly exhaled beyond
tidal expiration
- approximately 1,200 ml.
residual volume
- about 1,200 ml of air still remains in the lungs and
cannot voluntarily be expelled.
- allows gas exchange to go on continuously even
between breaths and helps to keep the alveoli open
(inflated).
vital capacity (VC)
- total amount of exchangeable air
- around 4,800 ml in healthy young men
- 3,100 ml in healthy young women
- the sum of the tidal volume plus the inspiratory and
expiratory reserve volumes.
dead space volume
- some of the air that enters the respiratory tract
remains in the conducting zone passageways and
never reaches the alveoli
- during a normal tidal breath is about 150 ml
functional volume
- air that actually reaches the respiratory zone and
contributes to gas exchange
- is about 350 ml
spirometer
– measures respiratory capacities
– me inside the apparatus. Spirometer testing is useful
for evaluating losses in respiratory functioning and in
following the course of some respiratory diseases
Nonrespiratory Air Movements
– Coughs and sneezes clear the air passages of debris
or collected mucus.
– Laughing and crying reflect our emotions.
– nonrespiratory air movements are a result of reflex
activity, but some may be produced voluntarily
Respiratory Sounds
– Bronchial sounds
– produced by air rushing through the large
respiratory passageways (trachea and bronchi).
– Vesicular breathing sounds
– occur as air fills the alveoli.
– soft murmurs that resemble a muffled breeze
External Respiration, Gas Transport, and Internal Respiration
– external respiration - the actual exchange of gases
between the alveoli and the blood (pulmonary gas
exchange)
– internal respiration - the gas exchange process that
occurs between the blood and the tissue cells (systemic
capillary gas exchange)
EXTERNAL RESPIRATION
– dark red blood flowing through the pulmonary circuit
is transformed into the scarlet river that is returned to
the heart for distribution to the systemic circuit.
– carbon dioxide is being unloaded from the blood
equally fast.
– Because body cells continually remove oxygen from
blood, there is always more oxygen in the alveoli
than in the blood.
– oxygen tends to diffuse from the air of the alveoli
through the respiratory membrane into the more
oxygen-poor blood of the pulmonary capillaries
– as tissue cells remove oxygen from the blood in the
systemic circulation, they release carbon dioxide into
the blood.
– Because the concentration of carbon dioxide is much
higher in the pulmonary capillaries than it is in the
alveolar air, it will diffuse from the blood into the
alveoli and be flushed out of the lungs during
expiration.
– blood draining from the lungs into the pulmonary
veins is rich in oxygen and poor in carbon dioxide
Gas Transport in the Blood O
– Oxygen is transported in the blood in two ways.
1. Most attaches to hemoglobin molecules inside
the red blood cells (RBCs) to form
oxyhemoglobin —HbO2
2. A very small amount of oxygen is carried
dissolved in the plasma.
 – Carbon dioxide is twenty times more soluble in
plasma compared to oxygen.
– As a result, most carbon dioxide is transported in
plasma as bicarbonate ion (HCO3−), which plays a
very important role in buffering blood pH.
– Carbon dioxide is enzymatically converted to
bicarbonate ion within red blood cells; then the newly
formed bicarbonate ions diffuse into the plasma.
– A smaller amount of the transported CO2 (between
20 and 30 percent) is carried inside the RBCs bound
to hemoglobin.
– Carbon dioxide binds to hemoglobin at a different site
from oxygen, so it does not interfere with oxygen
transport.
– Before carbon dioxide can diffuse out of the blood
into the alveoli, it must first be released from its
bicarbonate ion form.
– For this to occur, bicarbonate ions (HCO3–) must
enter the red blood cells, where they combine with
hydrogen ions (H+) to form carbonic acid (H2CO3).
Carbonic acid quickly splits to form water and carbon
dioxide, and carbon dioxide then diffuses from the
blood into the alveoli.
 most of the conversion of carbon dioxide to bicarbonate
ions occurs inside the RBCs, where a special enzyme
(carbonic anhydrase) speeds up this reaction.
INTERNAL RESPIRATION
- opposite of what occurs in the lungs
- oxygen leaves and carbon dioxide enters the blood
- In the blood, carbon dioxide combines with water to
form carbonic acid (H2CO3), which quickly releases
bicarbonate ions.
- Then the bicarbonate ions diffuse out into plasma,
where they are transported.
- At the same time, oxygen is released from
hemoglobin, and the oxygen diffuses quickly out of
the blood to enter the cells.
- As a result of these exchanges, venous blood in the
systemic circulation is much poorer in oxygen and
richer in carbon dioxide than blood leaving the lungs
CONTROL OF RESPIRATION
Neural Regulation: Setting the Basic Rhythm
 phrenic nerves and intercostal nerves
– transmit nerve impulses from the brain for the activity
of the respiratory muscles, the diaphragm
Neural centers that control respiratory rhythm and depth are
located mainly in the medulla and pons
medulla contains two respiratory centers:
1. the ventral respiratory group (VRG)
- contains both inspiratory and expiratory neurons that
alternately send impulses to control the rhythm of
breathing.
- The inspiratory neurons stimulate the diaphragm and
external intercostal muscles via the phrenic and
intercostal nerves, respectively, during quiet
breathing.
- Impulses from the expiratory neurons stop the
stimulation of the diaphragm and external intercostal
muscles, allowing passive exhalation to occur.
- Impulses from the VRG maintain eupnea
Eupnea - a normal quiet breathing rate of 12 to 15
respirations/minute, a rate called
2. the dorsal respiratory group (DRG)
- integrates sensory information from chemoreceptors
and peripheral stretch receptors.
- communicates this information to the VRG to help
modify breathing rhythms
pons respiratory centers
- communicate with the VRG, help to smooth the
transitions (modify timing) between inhalation and
exhalation during activities such as singing, sleeping
or exercising
Stretch receptors
- espond to extreme overinflation (of bronchioles and
alveoli) by initiating protective reflexes
- In the case of overinflation, the vagus nerves send
impulses from the stretch receptors to the medulla;
soon thereafter, inspiration ends and expiration
occurs. (one example of DRG integration during
respiratory control)
Hyperpnea - we breathing more vigorously and deeply
because the brain centers send more impulses to the
respiratory muscles
NONNEURAL FACTORS INFLUENCING
RESPIRATORY RATE AND DEPTH
Physical Factors
Volition (Conscious Control)
- voluntary control of breathing is limited, and the
respiratory centers will simply ignore messages from
the cortex when the oxygen supply in the blood is
getting low or blood pH is falling.
Emotional factors
 - result from reflexes initiated by emotional stimuli
acting through centers in the hypothalamus
Chemical Factors
- the levels of carbon dioxide and oxygen in the blood
- An increased level of carbon dioxide and a decreased
blood pH are the most important stimuli leading to
an increase in the rate and depth of breathing.
- An increase in the carbon dioxide level can cause a
decreased blood pH because high CO2 results in
more carbonic acid, which lowers blood pH.
- However, a low blood pH could also result from
metabolic activities independent of breathing.
- Changes in the carbon dioxide concentration or H+
ion concentration (which affects pH) in brain tissue
seem to act directly on the medulla centers by
influencing the pH of local tissues in the brain stem
peripheral chemoreceptor
- detect changes in oxygen concentration in the blood
from the regions in the aorta (aortic body in the aortic
arch) and in the fork of the common carotid artery
(the carotid body).
- send impulses to the medulla when the blood oxygen
level is dropping.
- When oxygen levels are low, these same
chemoreceptors are also able to detect high carbon
dioxide levels.
- the body’s need to rid itself of carbon dioxide that
is the most important stimulus for breathing.
- A decrease in the oxygen level becomes an important
stimulus only when the level is dangerously low
HOMEOSTATIC IMBALANCES
cleft palate
- a genetic defect
- failure of the bones forming the palate to fuse
medially
- results in breathing difficulty as well as problems
with oral cavity functions, such as nursing and
speaking
rhinitis
- inflammation of the nasal mucosa
- Caused by cold viruses and various allergens
- excessive mucus produced results in nasal congestion
and postnasal drip
Sinusitis
- sinus inflammation,
- difficult to treat and can cause marked changes in
voice quality
sinus headache
- results when the passageways connecting the sinuses
to the nasal cavity are blocked with mucus or
infectious matter, the air in the sinus cavities is
absorbed.
pharyngeal tonsil becomes inflamed and swollen
- (as during a bacterial infection)
- it obstructs the nasopharynx and forces the person to
breathe through the mouth.
- In mouth breathing, air is not properly moistened,
warmed, or filtered before reaching the lungs.
tracheal obstruction
- Heimlich maneuver, a procedure in which the air in
a person’s own lungs is used to “pop out,” or expel,
an obstructing piece of food, has saved many people
from becoming victims of choking.
- Tracheostomy - surgical opening of the trachea,
done to provide an alternative route for air to reach
the lungs. Individuals with tracheostomy tubes in
place form huge amounts of mucus the first few days
because of irritation to the trachea
Pleurisy (
- inflammation of the pleurae,
- can be caused by insufficient secretion of pleural
fluid. The pleural surfaces become dry and rough,
resulting in friction and stabbing pain with each
breath.
- Conversely, the pleurae may produce excessive
amounts of fluid, which exerts pressure on the lungs.
- This type of pleurisy hinders breathing movements,
but it is much less painful than the dry rubbing type
atelectasis
- lung collapse
- the lung is useless for ventilation.
- occurs when air enters the pleural space through a
chest wound, but it may also result from a rupture of
the visceral pleura, which allows air to enter the
pleural space from the respiratory tract.
pneumothorax
- The presence of air in the intrapleural space, which
disrupts the fluid bond between the pleurae
- reversed by drawing air out of the intrapleural space
with a chest tube, which allows the lung to reinflate
and resume its normal function
crackle (a bubbling sound, wheezing (a whistling sound),
rales
 - abnormal sounds produced by diseased respiratory
tissue, mucus, or pus
Rales - abnormal bronchial sounds produced by the presence
of mucus or exudate in the lung passages or by thickening of
the bronchial walls
hypoxia
- due to impaired oxygen transport:
- inadequate oxygen delivery to body tissues
- easy to recognize in light-skinned people because
their skin and mucosae take on a bluish cast (become
cyanotic)
- In dark-skinned individuals, this color change can be
observed only in the mucosae and nailbeds
- may be the result of anemia, pulmonary disease, or
impaired or blocked blood circulation.
Carbon monoxide poisoning
- represents a unique type of hypoxia.
- Carbon monoxide competes vigorously with oxygen
for the same binding sites on hemoglobin. Moreover,
because hemoglobin binds to CO more readily than
to oxygen, carbon monoxide is a very successful
competitor
- leading cause of death from fire
- victim becomes confused and has a throbbing
headache
- In rare cases, the skin becomes cherry red (the color
of the hemoglobin CO complex), which is often
interpreted as a healthy “blush.”
Hyperventilation - often brought on by anxiety attacks,
frequently leads to brief periods of apnea, until the carbon
dioxide builds up in the blood again
Apnea - cessation of breathing
chronic obstructive pulmonary disease (COPD)
- the group of diseases collectively referred to as
- chronic bronchitis and emphysema
certain features in common:
(1) Patients almost always have a history of smoking;
(2) dyspnea, difficult or labored breathing, often referred to as
“air hunger,” occurs and becomes progressively worse;
(3) coughing and frequent pulmonary infections are common;
(4) most COPD victims are hypoxic, retain carbon dioxide and
have respiratory acidosis, and ultimately develop respiratory
failure
chronic bronchitis
- the mucosa of the lower respiratory passages
becomes severely inflamed and produces excessive
mucus.
- The pooled mucus impairs ventilation and gas
exchange and dramatically increases the risk of lung
infections, including pneumonias.
- patients are sometimes called “blue bloaters” because
hypoxia and carbon dioxide retention occur early in
the disease and cyanosis is common
emphysema
- the walls of some alveoli are destroyed, causing the
remaining alveoli to be enlarged.
- chronic inflammation promotes fibrosis of the lungs.
- As the lungs become less elastic, the airways collapse
during expiration and obstruct outflow of air.
- As a result, these patients use an incredible amount of
energy to exhale, and they are always exhausted.
- Because air is retained in the lungs, oxygen exchange
is surprisingly efficient, and cyanosis does not
usually appear until late in the disease.
- sufferers are sometimes referred to as “pink puffers.”
- overinflation of the lungs leads to a permanently
expanded barrel chest
Lung Cancer
- nearly 90 percent of lung cancers result from
smoking.
- aggressive and metastasizes rapidly and widely, so
most cases are not diagnosed until they are well
advanced.
- The cure rate for lung cancer is notoriously low; most
victims die within 1 year of diagnosis.
- The overall 5-year survival of people with lung
cancer is about 17 percent.
- Ordinarily, nasal hairs, sticky mucus, and the action
of cilia do a fine job of protecting the lungs from
irritants, but smoking overwhelms these cleansing
devices, and they eventually stop functioning.
- Continuous irritation prompts the production of more
mucus, but smoking slows the movements of cilia
that clear this mucus and depresses lung
macrophages.
- One result is a pooling of mucus in the lower
respiratory tract and an increased frequency of
pulmonary infections, including pneumonia and
COPD.
- However, it is the irritating effects of the “cocktail”
of toxic chemicals in tobacco smoke that ultimately
lead to lung cancer. The three most common types of
lung cancer are (1) adenocarcinoma (40 percent of
cases), which originates as solitary nodules in
peripheral lung areas and develops from bronchial
glands and alveolar cells; (2) squamous cell
carcinoma (25–30 percent), which arises in the
 epithelium of the larger bronchi and tends to form
masses that hollow out and bleed; and (3) small cell
carcinoma (about 20 percent), which contains
lymphocytelike cells that originate in the main
bronchi and grow aggressively in small grapelike
clusters within the mediastinum, a site from which
metastasis is especially rapid. The most effective
treatment for lung cancer is complete removal of the
diseased lung lobes in an attempt to halt metastasis.
However, removal is an option only if metastasis has
not already occurred. In most cases, radiation therapy
and chemotherapy are the only options, but most lung
cancers are resistant to these treatments. Fortunately,
there are several new therapies on the horizon. These
include (1) antibodies that target specific molecules
required by the tumor or that deliver toxic agents
directly to the tumor,
- (2) cancer vaccines to stimulate the immune system,
and (3) various forms of gene therapy to replace the
defective genes that make tumor cells divide
continuously. As clinical trials progress, we will learn
about the effectiveness of these approaches.
However, prevention is worth a pound of cure.
Quitting smoking is a valuable goal.