The Respiratory System

(Revision)
Respiration is the process by which all
metabolically active cells in the body:
 are supplied with oxygen
 and carbon dioxide is removed
The respiratory system consists of a
number of respiratory passageways and
the lower respiratory tract
UPPER RESPIRATOY TRACT
The upper respiratory tract consists of the:

 Nose
 Nasal cavity
 Pharynx

Air entering and leaving the lungs

communicates with the external environment
through this region
 Alveoli
 Within each lobule of the lung, the terminal
bronchioles divide into respiratory
bronchioles
which contain several alveolar ducts
the ends of which contain numerous little
pockets or sacs called alveoli
 An alveolus is the structure through which
external respiration actually takes place
It is only one cell thick, which allows rapid
gas exchange
 There are special cells associated with the
alveolus called septa cells
 These cells produce pulmonary surfactant,
which is important in reducing surface
tension of the fluids lining the alveoli
 There are also macrophages present, which
remove dust particles and other foreign
substances
 Each alveolus is surrounded by a dense
network of capillaries to allow gas exchange
 There are about 300 million alveoli
a respiratory surface of 70 m2
 VENTILATION
 Ventilation is the movement of air into
and out of the lungs
 that is, inhalation and exhalation

 It depends on the pressure differences

between the air outside the body and the
air in the lungs
 Inhalation
 This is breathing in
 It is initiated by contraction of the diaphragm
and the intercostal muscles between the ribs
 When relaxed, the diaphragm is dome shaped
 When contracted, it flattens
 When the external intercostal muscles contract
the ribcage moves upwards and outwards
 Together, these contractions cause the volume
of the thorax to increase
which will decrease the pressure inside the
lungs

 This in turn causes a pressure gradient between

the lungs and the air outside the body
therefore air will move into the lungs until the
pressures are again equal

 As the contraction of muscles requires energy,

inspiration is an active process
 Exhalation
 This is breathing out
 It is a passive process resulting from the
relaxation of the diaphragm and intercostal
muscles
 When these muscles relax, the volume of the
thoracic cavity decreases
which increases the pressure inside the lungs
 Air moves out of the lungs until the pressure
inside equals the pressure outside
 The amount of air inspired and expired as
well as the rate of ventilation are important
clinical measurements that can be used to
identify a number of disorders
The Respiratory System
Physiology
The Respiratory System
Topics to be covered:
External Respiration
- gas transport (O2 & CO2)
Control of Respiration
- local & extrinsic factors
Respiratory regulation in exercise
Internal Respiration
 External Respiration
 Alveolar walls - extremely thin with almost solid network
of connecting capillaries
 Diameter of a pulmonary capillary = app. 8 μm so
erythrocytes (7.5 μm diameter) touches capillary wall
 Most gases highly soluble in respiratory membrane, but
differences do occur between gases
 Eg. rate of CO2 diffusion is 20 times rate of O2 diffusion
 Many factors may affect diffusion
 These include thickness of the membrane (increased by
oedema) and surface area of the lung (reduced in
emphysema)
 Gas Transport
 Gases move by diffusion, which relates to concentration
(pressure) difference
 O2 moves from alveoli into pulmonary capillary blood as
the O2 pressure (PO2) in alveoli is greater than PO2 in the
pulmonary blood
 In the periphery, where PO2 is lower than in arterial
blood, O2 diffuses out of capillary to tissues

 When O2 is metabolised to form CO2, the CO2 pressure

(PCO2) in cells rises
 This causes CO2 to diffuse into blood, from where it is
carried to the lungs
 In alveoli, the PCO2 is lower than in blood, so CO2
moves from blood to alveoli
Actual Gas Concentrations
 Oxygen Transport
 O2 is not very soluble in plasma, very little carried this way
 More than 98% of O2 in blood is found bound to a large
protein molecule in the red blood cells called haemoglobin
 A haemoglobin molecule has four sub-units, each
containing a haem group and a protein group
 The haem group contains an iron atom that can combine
with a molecule of O2.
 Each haemoglobin molecule is therefore capable of
carrying four molecules of O2
 If PO2 is high, the haemoglobin has a greater affinity for it,
and will become saturated
 If PO2 is low, haemoglobin will only become partially
saturated and will give it up more easily
 So during internal respiration, PO2 at the tissues is low, so
haemoglobin will give up O2 easily
 Carbon Dioxide Transport
CO2 is transported in the blood in three ways:

1. Dissolved in plasma (about 7%)

2. Attached to a haemoglobin molecule as
carbamino haemoglobin (about 23%)
CO2 forms a loose reversible bond with the
globin part of haemoglobin molecules, once
haemoglobin has given up its O2
3. As the bicarbonate ion
CO2 is readily dissolved in plasma, and so does not need
haemoglobin for its transport

In the presence of the enzyme carbonic anhydrase:

carbon dioxide + water <–> bicarbonate ion <-> hydrogen ion +carbonic acid

In the lungs, the carbonic acid once again dissociates into

CO2 and water, and is released into the alveoli
 The reaction catalysed by carbonic anhydrase is
an equilibrium reaction:

 In the periphery, the equilibrium concentration of

CO2 is higher than H2CO3, so that the reaction
produces H2CO3. In contrast, in the lungs, the
equilibrium concentration of H2CO3 is higher
than CO2, so that the reaction produces CO2
 This process maximises the rate of movement of
CO2
 Clinical Note: Acidosis
 An abnormal increase in hydrogen ion concentration in the
body resulting from an accumulation of an acid or the loss of a
base
 It is indicated by a blood pH below 7.4
 Various forms of acidosis are named for the cause of the
condition:
Respiratory acidosis results from respiratory retention of CO2
Renal tubular acidosis results from failure of the kidneys to
secrete hydrogen ions or reabsorb bicarbonate ions
Diabetic acidosis results from an accumulation of ketones
(containing Carbonyl group, C+O+H) associated with poorly controlled
diabetes mellitus
 Respiratory Acidosis
 Respiratory acidosis occurs due to alveolar
hypoventilation
 Production of CO2 occurs rapidly, and failure of ventilation
to meet demands increases the level of PCO2.
 Alveolar hypoventilation -> increased PCO2
 The increase in PCO2 decreases the HCO3-/PCO2 and
decreases pH.
 Hypercapnia and respiratory acidosis occur when
ventilation is impaired or demands increase, so the
removal of CO2 by the lungs is less than the production of
CO2 in the tissues
 Control of Respiration

Both internal and external respiration are

controlled by intrinsic and extrinsic factors
 Local Factors (in respiratory control)
 Smooth muscles of the bronchioles are sensitive to
changes in CO2 levels
 An increase in CO2 causes muscles to relax, increasing
the diameter of the bronchioles, allowing more CO2 to be
expired
 A decrease in CO2 levels causes bronchoconstriction
(tightening of the bronchi), therefore decreasing the
amount of expired air
 The smooth muscle of pulmonary arterioles is sensitive
to changes in O2 and H+ levels
 If some alveoli have low levels of O2, the pulmonary
arteriole contracts, allowing less blood to flow to these
alveoli and more blood to flow to other alveoli
 High amounts of O2 results in vasodilation, therefore
more blood flow and more efficient gas exchange
 Local Factors (continued)

 Pulmonary arterioles are also sensitive to H+ ion

concentration
 Changes in H+ levels are mainly due to the PCO2
 Increased H+ levels cause arteriolar vasoconstriction
 Decreased H+ levels cause arteriolar vasodilation
 Higher PCO2 levels will increase the concentration of H+
as more carbonic acid will be formed
Extrinsic Factors
(in control of respiration)
1. Respiratory Centres in the Brain
 Ventilation depends on the stimulation of the
inspiratory muscles (expiration - passive process)
 This stimulation originates in the medulla and the
pons, which contain the respiratory centres of the
brain
 The medulla inspiratory area receives input from
many sources including chemoreceptors,
baroreceptors, and stretch receptors throughout
the body and higher brain centres
 This information (from receptors) is integrated by
the medulla, and impulses are produced in the
medullary inspiratory neurons, which affect the
inspiratory muscles, causing them to contract
 They are usually active for about two seconds
and inactive for three, producing a cyclical
alternation of inspiration and expiration
 The neurons in the expiratory area are normally
inactive during quiet respiration, but with
increased ventilation, the inspiratory area
stimulates the expiratory area so that more CO2
is released
 The respiratory centres in the pons control the
transition from inspiration to expiration by
sending inhibitory impulses from the
pneumotaxic centre to the medulla inspiratory
area and the apneustic centre of the pons

 This limits the length of inspiration and prevents

over-inflation
 2. Stretch Receptors

 As the lungs fills with the air, they stretch

 This stimulates the stretch receptors in the
lungs, which send inhibitory messages to the
respiratory centres in the brain
 This causes expiration
 Expiration produces decreased stimulation from
the stretch receptors and so inspiration starts
 3. Chemoreceptors
 These receptors are sensitive to changes in PO2
and PCO2 levels

 Increases in PCO2 have an excitatory effect on

the respiratory centres of the brain

 Decreases in PO2 causes a small increase in

ventilation
 4. Exercise
 Heavy exercise causes breathing to
increase up to 20 times normal due to O2
usage and CO2 production

 The higher centres in the brain are also

thought to stimulate the respiratory
centres, as are the joint proprioceptors
 5. Altitude
 As altitude increases, the PO2 of the air
decreases
 To compensate for a lower PO2 in the
alveoli, alveolar ventilation and cardiac
output increase immediately
 If a person remains at the high altitude,
they can become acclimatised to the lower
O2 levels by increasing their haemoglobin
levels
Respiratory Regulation in Exercise
 During strenuous exercise, O2 utilisation and CO2
formation can increase up to 20 times
 The respiratory changes occur in parallel with
cardiovascular responses
 The motor cortex sends impulses to the muscles and
also sends collaterals to respiratory centres, which
increase respiratory output
 Body movements lead to an increase in pulmonary
ventilation by exciting joint proprioceptors
 These in turn excite the respiratory centre
 Blood factors, primarily arterial PCO2, also influence
respiratory activity
 Body movement and muscular activity are more
important than the humoral factors
 Internal Respiration
 Metabolism describes the sum of the processes by which
cells extract energy from their environment and synthesise
the molecules they require
 These processes are carried out by an integrated system of
chemical reactions, and metabolism
 Metabolism involves many different reactions, but only a few
kinds of reactions
 For these reactions, a group of about one hundred
molecules are usually important
 Metabolism also involves enzymes, enzyme regulation and
cellular compartmentalisation
 The movement of O2 into and out of the body cells is known
as internal respiration
 The presence of O2 is required for many of the cellular
metabolic processes of energy production
 Notes on Respiration Rate
 Respiratory rate is highest in newborn infants, about 40
to 80 r/m and continues to drop through life:
 In the infant it is around 30/minute
 At 5 years It is around 25/minute
 In adults it is 12-18/minute
 However, the rate often increases again in old age
 The lungs continue to mature throughout childhood, and
more alveoli are formed until young adulthood
 But when smoking is begun during the early teens, the
lungs never completely mature, and those additional
alveoli are lost forever
 Key Points
 External Respiration
 gas transport (O2 & CO2)
 acidosis
 Control of Respiration
 local & extrinsic factors
 Respiratory regulation in exercise
 Principles of Internal Respiration
 Respiration Rate