Respiratory Physiology

RESPIRATORYPHYSIOLOGY
Guest Lecture to Biomed Dept.

Prathyusha Engineering College
by
Dr. R.V.S.N. Sarma.,
M.D., M.Sc., (Canada)
Consultant Physician & Chest Specialist

Mobile: 93805 21221 or 98940 60593
Visitourwebsite:www.drsarma.in
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Lecture map
Physiology of respiration
Definitions and structures
Mechanics of breathing
Measurements of pulmonary function
Cellular Respiration, Pulmonary disorders
Blood gases - Diffusion
Neural control of respiration
Hemoglobin (and disorders)
Transport of C02
Acid/base balance
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Anatomy of Respiratory Tree
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Longitudinal Section
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The Thorax and its contents
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What is Respiration ?
Goals:
What
is the respiratory system?
What
is respiration?
What
are the structural features?
What
are their functions?
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Respiration
Ventilation:
Action of breathing with muscles and lungs
Gas
exchange:
Between air and capillaries in the lungs.

Between systemic capillaries and tissues of
the body
02
utilization:
Cellular respiration in mitochondria
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The Vocal Chords (Voice Box)
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Functions of the Respiratory System

Gas Exchange
O2, CO2
Acid-base balance
CO2 +H2O H2CO3 H+ + HCO3-
Phonation
Pulmonary defense
Pulmonary metabolism and handling of
bioactive materials
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Inspiratory Movements
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Thoracic Cavity
Diaphragm:
Sheets of striated muscle divides anterior body cavity
into 2 parts.
Above diaphragm: thoracic cavity:
Contains heart, large blood vessels, trachea,
esophagus, thymus, and lungs.
Below diaphragm: abdominopelvic cavity:
Contains liver, pancreas, GI tract, spleen, and
genitourinary tract.
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Gas: the more volume, the less pressure (Boyles)
Inspiration:
lung volume increases ->
decrease
in intrapulmonary pressure,
to just below atmospheric pressure ->
air
goes in!
Expiration: viceversa
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Intrapleural space:
Space between visceral & parietal pleurae.
Visceral and parietal pleurae (membranes) are
flush against each other.

Lungs normally remain in contact with the chest
wall.
Lungs expand and contract along with the
thoracic cavity.
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Pleural Layers Cross Section
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Compliance:
This the ability of the lungs to stretch during

inspiration
lungs can stretch when under tension.
Elasticity:
It is the ability of the lungs to recoil to their

original collapsed shape during expiration
Elastin in the lungs helps recoil
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Inspiration
Inspiration Active process
Diaphragm contracts -> increased thoracic
volume vertically.
Intercostals contract, expanding rib cage ->
increased thoracic volume laterally.

More volume -> lowered pressure -> air in.
Negative pressure breathing
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Expiration
Expiration Passive
Due to recoil of elastic lungs.
Less volume -> pressure within alveoli is just

above atmospheric pressure -> air leaves
lungs.
Note: Residual volume of air is always left

behind, so alveoli do not collapse.
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During Quiet breath:
+/- 3 mmHg intrapulmonary pressure.
During Forced breath:
Extra muscles, including abdominals

+/- 20-30 mm Hg intrapulmonary pressure
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Dynamics of Respiration
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The Pressures
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X-Ray of Chest
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Respiration
It is the process by which the body takes in
oxygen and utilizes and removes CO2 from the
tissues into the expired air
It comprises of
Ventilation by the lungs

inspiration and expiration
Gas exchange across alveolar membrane
Diffusion in the alveoli, Ficks law
Transport of gases by blood (haemoglobin)
Uptake of O2 and release of CO2 by tissues
Diffusion at the cellular level
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Conducting Zone
Conducting zone:
Includes all the
structures that air

passes through
before reaching the
respiratory zone.
Mouth, nose, pharynx,
glottis, larynx, trachea,
bronchi.
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Conducting Zone
Conducting zone
Warms and humidifies until inspired air
becomes:
37 degrees
Saturated with water vapor
Filters and cleans:
Mucus secreted to trap particles
Mucus/particles moved by cilia to be

expectorated.
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Conducting Airways
Includes:FromTrachea>Terminalbronchioles
Trachea>rightandleftmainstembronchi.
Rightmainstemvulnerabletoforeignparticles
Mainstembronchi>lobarbronchi.
Dichotomousbranching:~16generationsof
airways
ConvectionFlow
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Conducting Zone
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Respiratory Zone
Respiratory zone
Region of gas exchange between air and blood
- Respiratory bronchioles
- Alveolar ducts, Alveolar Sacs and
- Alveoli
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Respiratory Zone
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Respiratory Zone
Airduct
AirSac
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Respiratory Zone
Alveoli
Air sacs
Honeycomb-like clusters
~ 300 million.
Large surface area (6080 m2).
Each alveolus: only 1 thin cell layer.
Total air barrier is 2 cells across (2 m)

(alveolar cell and capillary endothelial cell).
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Respiratory Zone
Alveolar cells
Alveolar type I: structural cells.
Alveolar type II: secrete surfactant.
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Branching of Airways
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Respiratory Zone
RespiratoryZone:Respiratorybronchioles,
Alveoli(300million),Alveolarducts,Alveolarsacs
GasExchange:respiratorymembrane
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Respiratory Zone
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Ventilation
Mechanical process that
moves air in and out of

the lungs.
Diffusion of
O2: air to blood.
Insert 16.1
C02: blood to air.

Rapid:
large surface area

small diffusion
distance.
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Bronchial Section - microscopic
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Higher magnification of Bronchus
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Terminal Bronchioles - bifurcation
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Alveoli under microscope
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Alveoli - higher magnification
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EM of the alveoli
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Alveoli
8 million alveolar ducts
300 million alveoli (diameter 70-300 m)
Total alveolar surface area ~ 70 m2
Alveolar membrane thickness < 1 m.
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Cross Section of Alveolus
Netter FH, CIBA Collection of

Medical Illustrations 2nd ed. 1980
vol.7, p. 29.
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Secretion of Surfactant by Alveoli
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Section of Bronchus - schematic
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The large surface area of alveoli
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Bronchoscopy
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Blood Vessels of the Lung

PulmonaryArtery:
Deoxygenated(venous)cardiacoutput.
Pulmonarycapillaries
extremelydense
undergroundparkinggarage
PulmonaryVeins:
Oxygenated(arterial)cardiacoutput.
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Alveolar capillary interface
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Alveolar capillary interface - schematic
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Alveolar capillary interface
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Surface tension
Surfactant
produced by alveolar type II cells.
Interspersed among water molecules.
Lowers surface tension.
RDS, respiratory distress syndrome, in
preemies.
First breath: big effort to inflate lungs!
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Surface tension
Insert fig. 16.12
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Pulmonary Function
Spirometry
Breathe into a closed system, with air, water, moveable
bell
Insert fig. 16.16
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Lung Volumes
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Lung Volumes
Tidal volume (TV): in/out with quiet breath (500 ml)
Total minute volume: tidal x breaths/min
500 x 12 = 6 L/min
Exercise: even 200 L/min!
Anatomical dead space:
Conducting zone
Dilutes tidal volume, by a constant amount.
Deeper breaths -> more fresh air to alveoli.
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Lung Volumes
Inspiratory reserve volume (IRV): extra
(beyond TV) in with forced inspiration.
Expiratory reserve volume (ERV): extra
(beyond TV) out with forced expiration.
Residual volume: always left in lungs, even
with forced expiration.

Not measured with spirometer
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Lung Capacities
Vital capacity (VC): the most you can actually
ever expire, with forced inspiration and

expiration.
VC= IRV + TV + ERV
Total lung capacity: VC plus residual volume
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Pulmonary disorders
Restrictive disorder:
Vital
capacity is reduced.
Less air in lungs.
Obstructive disorder:
Rate
of expiration is reduced.
Lungs are fine, but bronchi are
obstructed.
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Disorders
Air/ Fluid in the pleural space
Pneumothorax
Hydrothorax
Pyothorax
Hydropneumothorax
Restrictive disorder:
Black lung from coal mines.

Pulmonary fibrosis: Tuberculosis
too much connective tissue.
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Pneumothorax collapse lung
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Obstructive Sleep Apnea

OSA
Normal
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Pulmonary Disorders
COPD (chronic obstructive pulmonary
disease):
Smoking is the main cause for COPD
Asthma
Emphysema
Chronic bronchitis
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Disorders
Asthma:
Obstructive
Inflammation, mucus secretion, bronchial
constriction.
Provoked by: allergic, exercise, cold and

dry air
Anti-inflammatories, including inhaled
epenephrine (specific for non-heart
adrenergic receptors), anti-leukotrienes,
anti-histamines.
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Disorders
Emphysema:
Alveolar tissue is destroyed.

Chronic progressive condition
Cigarette smoking stimulates

macrophages and WBC to secrete
enzymes which digest proteins.
Or: genetic inability to stop trypsin
(which digests proteins).
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Blood Gases
Barometers use mercury (Hg) as convenience to
measure total atmospheric pressure.

Sea level: 760 mm Hg (torr)
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Blood Gases
Total pressure of a gas mixture is = to the sum
of the independent, partial pressures of each

gas (Daltons Law).
In sea level atmosphere:
PSTP = 760 mm Hg = PN + P0 + PC0 + PH 0
2
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Blood Gases
Partial pressures: % of that gas x total
pressure.
In atmosphere:
02 is 21%, so (.21 x 760) = 159 mm Hg =
P0
Note: atmospheric P0 decreases on a
mountain, increases as one dives into the
ocean.
2
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Blood Gases
But inside you, the air is saturated with water
vapor.
PH20 = 47 mm Hg at 37 degrees
P0 :
P0 = 105 mm Hg in alveoli.
In constrast, alveolar air is enriched in
CO2, as compared to inspired air.
PCO = 40 mm Hg in alveoli.
So, inside you, there is less
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Blood Gases
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Blood Gases
Gas and fluid in contact:
Gas dissolved in a fluid depends directly on
its partial pressure in the gas mixture.

With
a set solubility, non changing temp.

(Henrys law)
So
P0
in alveolar air ~ = P0 in blood.
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Blood Gases
electrodes can measure dissolved O2 in
a fluid. (also CO2 electrodes)
O2
Good index of lung function.

Arterial P0 is only slightly below alveolar P0
2
Arterial P0 = 100 mm Hg
2
Alveolar P0 = 105 mm Hg
2
P0 in the systemic veins is about 40 mm Hg.

2
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Lung Perfusion and Ventilation
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Ventilation Perfusion Matching
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System Overview
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Circulation Overview
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Ventilation and Perfusion
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Perfusion
Geometry of vascular tree
R = /r4
Passive factors affecting PVR
PA pressure
LA pressure
effect of lung volume on PVR
Local factors regulating Q and matching V/Q
HPV
pH/pCO2
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Capillary Sheet
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Capillary Recruitment
Normal
Recruitme
nt
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Dilatatio
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Tissue Respiration
OxygenreleaseandCO
pickupatthetissuelevel.
2
87
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Cellular Respiration
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Blood gases
Most O2 is in hemoglobin
0.3 ml dissolved in plasma +

19.7 ml in hemoglobin
20 ml O2 in 100 ml blood!
But: O2 in hemoglobin-> dissolved ->
tissues.
Breathing pure O2 increases only the
dissolved portion.
- insignificant effect on total O2
- increased O2 delivery to tissues
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Pulmonary Circulation
Left ventricle pumps to entire body,
Right ventricle only to lungs.
Both ventricles pump 5.5 L/min!
Pulmonary circulation: various adaptations.
- Low pressure, low resistance.
- Prevents pulmonary edema.
- Pulmonary arteries dilate if P02 is low (opposite of
systemic)
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Neural control
Respiratory centers
In hindbrain
- medulla oblongata
- pons
Automatic breathing
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Neural control
I neurons = inspiration
E neurons = expiration
I neurons -> spinal motor neurons ->
respiratory muscles.
E neurons inhibit I neurons.
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Neural control
Also
voluntary breathing controlled by the
cerebral cortex.
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Chemoreceptors
Oxygen: large reservoir attached to
hemoglobin.
So chemoreceptors are more sensitive to
changes in PC02 (as sensed through changes
in pH).
Ventilation is adjusted to maintain arterial
PC02 of 40 mm Hg.
Chemoreceptors are located throughout the

body (in brain and arteries).
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Chemoreceptors (CTZ)
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Hemoglobin
Each hemoglobin has 4 polypeptide chains
(2 alpha, 2 beta) and 4 hemes (colored

pigments).
In the center of each heme group is 1 atom
of iron that can combine with 1 molecule 02.
(so there are four 02 molecules per
hemoglobin molecule.)
280 million hemoglobin molecules per RBC!
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Hemoglobin
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Hemoglobin
Oxyhemoglobin:
Ferrous iron (Fe2+) plus 02.
Deoxyhemoglobin:
Still ferrous iron (reduced).

No 02.
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Hemoglobin
Carboxyhemoglobin:
Carbon
monoxide (CO) binds to heme

instead of 02
Smokers
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Hemoglobin
Loading:
Load 02 into the RBC.
Deoxyhemoglobin plus 02 -> Oxyhemoglobin.
Unloading:
Unload 02 into the tissues.
Oxyhemoglobin -> deoxyhemoglobin plus 02.
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Hemoglobin
Loading/unloading depends on:
P02
Affinity between hemoglobin and 02
pH
temperature
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Hemoglobin
Dissociation curve: % oxyhemoglobin saturation
at different values of P0 .
2
Describes effect of P0 on loading/unloading.

Sigmoidal
At low P0 small changes produce large differences
in % saturation and unloading.
2
Exercise: P0 drops, much more unloading from

veins.
2
At high P0 slow to change.
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Oxyhemoglobin Dissociation Curve
Insert fig.16.34
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Hemoglobin
Affinity between hemoglobin and 0 2:
pH falls -> less affinity -> more unloading
(and vice versa if pH increases)

temp rises -> less affinity -> more
unloading
exercise, fever
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Hemoglobin
Arteries: 97% saturated (i.e. oxyhemoglobin)
Veins: 75% saturated.
Arteries: 20 ml 02 /100 ml blood.
Veins: ~ 5 ml less
Only 22% was unloaded!
Reservoir of oxygen in case:
dont breathe for ~5 min

exercise (can unload up to 80%!)
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Hemoglobin
Fetal hemoglobin (F):
Gamma chains (instead of beta)
More affinity than adult (A) hemoglobin
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Hemoglobin
Anemia:
Hemoglobin below normal.
Polycythemia
Hemoglobin above normal.
Altitude adjustment.
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Disorders
Sickle-cell anemia:
fragile, inflexible RBC
inherited change: one base pair in DNA -> one
aa in beta chains
hemoglobin S
protects vs. malaria; african-americans
Thalassemia:
defects in hemoglobin
type of anemia
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RBC
RBC
no nucleus
no mitochondria
Cannot use the 02 they carry!!!
Respire glucose, anaerobically.
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C02 Transport
C02 transported in the blood:
-
most as bicarbonate ion (HC03-)
dissolved C02
C02 attached to hemoglobin

(Carbaminohemoglobin)
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C02 Transport
Carbonic
anhydrase in RBC
promotes
useful changes in blood PC02
CA
H20 + C02 -> H2C03 -> HC03high PC0
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H20 + C02 <- H2C03 <HC03www.drsarma.in
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C02 Transport
Chloride shift:
Chloride ions help maintain electroneutrality.
HC03- from RBC diffuses out into plasma.
RBC becomes more +.
Cl- attracted in (Cl- shift).

H+ released buffered by combining with
deoxyhemoglobin.
Reverse in pulmonary capillaries
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Acid-Base Balance
Normal blood pH: 7.40 (7.35- 7.45)
Alkalosis: pH up
Acidosis: pH down
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Acid-Base Balance
H20 + C02
H2C03
H+ + HC03-
Hypoventilation:
PC0 rises, pH falls (acidosis).
Hyperventilation:
2
PC0 falls, pH rises (alkalosis).

2
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Acid-Base Balance
Ventilation is normally adjusted to keep
pace with metabolic rate, so homeostasis

of blood pH is maintained.
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Acid-Base Balance
Hyperventilation -> PC02 down -> pH of CSF
up -> vasoconstriction -> dizziness.

If hyperventilating, should you breath into
paper bag? Yes! It increases PC02!

Metabolic acidosis can trigger hyperventilation.
Diarrhea -> acidosis.
Vomit -> alkalosis.
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Other Functions of the Respiratory System

BEHAVIORAL- talking, laughing, singing, reading
DEFENSE- humidification, particle expulsion
(coughing, sneezing), particle trapping (clots),
immunoglobulins from tonsils and adenoids, a-1
antitrypsin, lysozyme, interferon, complement system
SECRETIONS- mucus (goblet cells, mucus
glands)
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Other Functions: cont

METABOLIC- forms angiotensin II, prostacyclin,
bradykinin, serotonin and histamine
ACID - BASE BALANCE- changes in ventilation
e.g., acute acidosis of exercise

MISCELLANAEOUS- lose heat and water, liquid
reservoir for blood,force generation for lifting,
vomiting, defaecation and childbirth
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Best of Luck to all of you !!!

CD of my lectures is made available
Contact us for any clarifications or needs
Dr R.V.S.N.Sarma., M.D., M.Sc.,(Canada)
Web site: www.drsarma.in
E-mail: sarma.rvsn@gamail.com
Mobile: 93605 21221 or 98949 60593
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Respiratory Physiology

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RESPIRATORYPHYSIOLOGY

Guest Lecture to Biomed Dept.

M.D., M.Sc., (Canada)

Consultant Physician & Chest Specialist

Definitions and structures

Measurements of pulmonary function

Cellular Respiration, Pulmonary disorders

Blood gases - Diffusion

Neural control of respiration

Hemoglobin (and disorders)

Anatomy of Respiratory Tree

The Thorax and its contents

is the respiratory system?

are the structural features?

are their functions?

Action of breathing with muscles and lungs

Between air and capillaries in the lungs.

The Vocal Chords (Voice Box)

Functions of the Respiratory System

CO2 +H2O H2CO3 H+ + HCO3-

Space between visceral & parietal pleurae.

Visceral and parietal pleurae (membranes) are

flush against each other.

Pleural Layers Cross Section

This the ability of the lungs to stretch during

lungs can stretch when under tension.

It is the ability of the lungs to recoil to their

Elastin in the lungs helps recoil

increased thoracic volume laterally.

Due to recoil of elastic lungs.

Less volume -> pressure within alveoli is just

Note: Residual volume of air is always left

+/- 3 mmHg intrapulmonary pressure.

During Forced breath:

Extra muscles, including abdominals

Ventilation by the lungs

structures that air

Saturated with water vapor

Filters and cleans:

Mucus secreted to trap particles

Mucus/particles moved by cilia to be

Large surface area (6080 m2).

Each alveolus: only 1 thin cell layer.

Total air barrier is 2 cells across (2 m)

Alveolar type I: structural cells.

Alveolar type II: secrete surfactant.

moves air in and out of

C02: blood to air.

large surface area

Bronchial Section - microscopic

Higher magnification of Bronchus

Terminal Bronchioles - bifurcation

Alveoli under microscope

Alveoli - higher magnification

Cross Section of Alveolus

Netter FH, CIBA Collection of

Secretion of Surfactant by Alveoli

Section of Bronchus - schematic

The large surface area of alveoli

Blood Vessels of the Lung

Alveolar capillary interface

Alveolar capillary interface - schematic

Alveolar capillary interface

Insert fig. 16.16