Pulmonary ventilation

MODULE 10: RESPIRATORY • Respiration (gas exchange) steps

Monday, May 3, 2021 03:01 AM 1. Pulmonary ventilation/ breathing
▪ Inhalation and exhalation
Respiratory System Anatomy ▪ Exchange of air between atmosphere and alveoli
Structurally □ Occur in the lungs
• Upper respiratory system 2. External (pulmonary) respiration
○ Nose, pharynx and associated structures ▪ Exchange of gases between alveoli and blood
○ Boundary: pharyngeal area ▪ Alveolus, alveoli and blood capillaries
• Lower respiratory system 3. Internal (tissue) respiration
○ Larynx, trachea, bronchi and lungs ▪ Exchange of gases between systemic capillaries and tissue cells
○ Boundary: larynx to inside of lungs ▪ Supplies cellular respiration (makes ATP)
Functionally
Inhalation/ inspiration
• Conducting zone – conducts air only to lungs
• Pressure inside alveoli must become lower than atmospheric pressure for air to flow into lungs
○ Area seen by the naked eye
○ 760 millimeters of mercury (mmHg) or 1 atmosphere (1 atm)
○ Nose, pharynx, larynx, trachea, bronchi, bronchioles and terminal bronchioles
• Achieved by increasing size of lungs
• Respiratory zone – main site of gas exchange
○ Boyle’s Law – pressure of a gas in a closed container is inversely proportional to the volume of the
○ Microscopic structures container
○ Respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli • Inhalation – lungs must expand, increasing lung volume, decreasing pressure below atmospheric pressure
Structures of the Respiratory System Boyle’s Law

Inhalation
• Inhalation is active – Contraction of
○ Diaphragm – most important muscle of inhalation
▪ Flattens, lowering dome when contracted
▪ Responsible for 75% of air entering lungs during normal quiet breathing
○ External intercostals
Nose ▪ From Superior rib inserting in the inferior rib
• External nose – portion visible on face ▪ Contraction elevates ribs
• Internal nose – large cavity beyond nasal vestibule ▪ 25% of air entering lungs during normal quiet breathing
○ Also known as Internal nares or choanae ○ Accessory muscles for deep, forceful inhalation
○ Ducts from paranasal sinuses and nasolacrimal ducts open into internal nose • When thorax expands, parietal and visceral pleurae adhere tightly due to subatmospheric pressure and surface
○ Nasal cavity divided by nasal septum tension – pulled along with expanding thorax
○ Nasal conchae subdivide cavity into meatuses • As lung volume increases, alveolar (intrapulmonic) pressure drops
▪ Increase surface are and prevents dehydration w/in the nose
○ Olfactory receptors in olfactory epithelium
▪ Smell and appetite
□ When having colds you can only taste what is detected by the tongue (salty,
sweet, sour) but not the essence of the food
Epiglottis helps to
food from entering
the trachea w/c is
unlikely due to
sneeze reflex

Pharynx
• Starts at internal nares and extends to cricoid cartilage of larynx
• Contraction of skeletal muscles assists in deglutition
Functions 3 anatomical regions
○ Passageway for air ○ Nasopharynx
and food ○ Superior portion of the pharynx
○ Resonating ○ Receives air from nasal cavity
chamber ○ Exchanges small amounts of air from auditory tubes to
○ Houses tonsils release/equalize pressure
○ Oropharynx
○ Intermediate portion
○ Has respiratory and digestive function
○ Serves as a common passageway for air, food, and Exhalation/ expiration
drinks • Pressure in lungs greater than atmospheric pressure
○ Where palatine and lingual tonsils are found • Normally passive – muscle relax instead of contract
○ Laryngopharynx ○ Based on elastic recoil of chest wall and lungs from elastic fibers and surface tension of alveolar fluid
○ Also called hypopharynx ○ Diaphragm relaxes and become dome shaped
○ Inferior portion ○ External intercostals relax and ribs drop down
○ Begins at the level of the hyoid bone • Exhalation only active during forceful breathing
▪ Bone located in the neck that does not any
communication with the skeletal system

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 ○ Laryngopharynx ○ Based on elastic recoil of chest wall and lungs from elastic fibers and surface tension of alveolar fluid
○ Also called hypopharynx ○ Diaphragm relaxes and become dome shaped
○ Inferior portion ○ External intercostals relax and ribs drop down
○ Begins at the level of the hyoid bone • Exhalation only active during forceful breathing
▪ Bone located in the neck that does not any
communication with the skeletal system
▪ Free floating
▪ Support the tongue and serves as attachment for
the neck musculature

Larynx
• Short passageway connecting laryngopharynx with trachea
• Composed of 9 pieces of cartilage
○ Thyroid cartilage or Adam’s apple
○ Cricoid cartilage - hallmark for tracheotomy
▪ Surgical procedure wherein a hole is punched in the throat which will allow
passageway of air
▪ Done when there is a collapse of the upper airway
• Epiglottis – closes off glottis during swallowing; flap
• Glottis – pair of folds of mucous membranes or vocal folds
 true vocal cords
 Vibrate; creating sound
 rima glottidis (space)/false vocal chords
 For support only

• Cilia
○ upper respiratory tract
▪ move mucous and trapped particles down toward pharynx
○ lower respiratory tract
▪ move them up toward pharynx

Airflow
• Air pressure differences drive airflow
• 3 other factors affect rate of airflow and ease of pulmonary ventilation
○ Surface tension of alveolar fluid
▪ Causes alveoli to assume smallest possible diameter
▪ Accounts for 2/3 of lung elastic recoil
Tracheal cartilages
• Protect trachea ▪ Prevents collapse of alveoli at exhalation
• Maintain the ○ Lung compliance
opening of the ▪ High compliance means lungs and chest wall expand easily
trachea ▪ Related to elasticity and surface tension
• Protect the
○ Airway resistance
trachea
▪ Larger diameter airway has less resistance
▪ Regulated by diameter of bronchioles & smooth muscle tone
▪ e.g. asthma (smaller diameter, higher sound)

Lung volumes and capacities

• Minute ventilation (MV) = total volume of air inhaled and exhaled each minute
○ Observed by spirometer
• Normal healthy adult averages 12 breaths per minute
• moving about 500 ml of air in and out of lungs (tidal volume)
• MV = 12 breaths/min x 500 ml/ breath
= 6 liters/ min

Spirogram of Lung Volumes and Capacities

Structures of Voice Production

• Mucous membrane of larynx forms
○ Ventricular folds (false vocal cords) – superior pair
▪ Function in holding breath against pressure in thoracic cavity
▪ Valsalva maneuver
□ Reaction of an individual to a situation
□ Constipation; expel waste out of body with the help of pressure; ire
□ Increase of thoracic pressure because of breath holding
○ Vocal folds (true vocal cords) – inferior pair
▪ Muscle contraction pulls elastic ligaments which stretch vocal folds out into airway
▪ Vibrate and produce sound with air
▪ Folds can move apart or together, elongate or shorten, tighter or looser
• Androgens (testosterone) make folds thicker and longer – slower vibration and lower pitch
○ Causes Adam's apple to be more prominent in males VOLUMES: CAPACITIES:
▪ Found in epiglottis
Tidal Volume Functional residual capacity = ERV + RV
○ Thyroid cartilage - composed of two vertical blades that join in front
• Amount of air that goes in and out of the lungs during normal Vital capacity = TV + ERV + IRV
respiration Inspiratory capacity = IRV + TV
Creation of sound due to the vibration of the vocal chords is caused by air coming from inside
• Normally 500 ml Total lung capacity = IRV + TV + ERV + RV
the thoracic region going outside
Inspiratory Reserve volume
• Maximum amount of air that can be inhaled after a normal
inspiration

Expiratory Reserve volume

• Maximum amount of air that can be exhaled after a normal
inspiration

Residual volume
• Amount of air left in the lungs after maximal exhalation
• Prevent collapse of lungs

Lung Volumes
• Only about 70% of tidal volume reaches respiratory zone
• Other 30% remains in conducting zone
○ When other volumes of air this 30% will be mobilized and then go to the respiratory zone
• Anatomic (respiratory) dead space – conducting airways with air that does not undergo respiratory gas
exchange

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 Lung Volumes
• Only about 70% of tidal volume reaches respiratory zone
• Other 30% remains in conducting zone
○ When other volumes of air this 30% will be mobilized and then go to the respiratory zone
• Anatomic (respiratory) dead space – conducting airways with air that does not undergo respiratory gas
exchange
• Alveolar ventilation rate – volume of air per minute that actually reaches respiratory zone
• Inspiratory reserve volume – taking a very deep breath

Exchange of Oxygen and Carbon Dioxide

Dalton’s Law
• Each gas in a mixture of gases exerts its own pressure as if no other gases were present
• questionable
• Pressure of a specific gas is partial pressure P x
• Total pressure is the sum of all the partial pressures
• Atmospheric pressure (760 mmHg) = P N2 + PO2 + PH2O + PCO2 + Pother gases
• Each gas diffuses across a permeable membrane from the area where its partial pressure is greater to the area
where its partial pressure is less
○ The greater the difference, the faster the rate of diffusion

Partial Pressures of Gases in Inhaled Air

PN2 =0.786 x 760mm Hg = 597.4 mmHg Nitrogen may have a larger PP however it is has low
solubility (cannot dissolve in the blood flow), while
PO2 =0.209 x 760mm Hg = 158.8 mmHg Oxygen is soluble which is why it is what is absorbed by
PH2O =0.004 x 760mm Hg = 3.0 mmHg our body
PCO2 =0.0004 x 760mm Hg = 0.3 mmHg
Trachea Pother gases =0.0006 x 760mm Hg = 0.5 mmHg
• Extends from larynx to superior border of T5 TOTAL = 760.0 mmHg
○ Divides into right and left primary bronchi
• 4 layers
○ Mucosa ○ Hyaline cartilage Henry’s law
• Quantity of a gas that will dissolve in a liquid is proportional to the partial pressures of the gas and its solubility
○ Submucosa ○ Adventitia
• Higher partial pressure of a gas over a liquid and higher solubility, more of the gas will stay in solution
• 16-20 C-shaped rings of hyaline cartilage • Much more C O2 is dissolved in blood than O 2 because CO2 is 24 times more soluble
○ Function is to maintain the opening of the trachea • Even though the air we breathe is mostly N 2, very little dissolves in blood due to low solubility
○ Open part faces esophagus ○ Decompression sickness (bends)
▪ Faces posteriorly ▪ When divers in deep sea don't gradually come out of the ocean, this causes an increase in the solubility
of nitrogen in the blood, causing bubbles which is dangerous; deadly
▪ Increase solution of nitrogen in the blood which creates bubbles
▪ Symptoms
□ Joint pain (esp arms and legs) □ Extreme fatigue
□ Dizziness □ Paralysis
□ Shortness of breath □ Unconsciousness

External Respiration in Lungs

Oxygen Carbon dioxide
• Oxygen diffuses from alveolar air (P O2 105 mmHg) into ○ Carbon dioxide diffuses from deoxygenated blood
blood of pulmonary capillaries (P O2 40 mmHg) in pulmonary capillaries (PCO2 45 mmHg) into
• Diffusion continues until P O2 of pulmonary capillary alveolar air (PCO2 40 mmHg)
blood matches P O2 of alveolar air ○ Continues until PCO2 blood reaches 40 mmHg
• Small amount of mixing with blood from conducting
Bronchi portion of respiratory system drops P O2 of blood in
• Right and left primary bronchus goes to right and left lung pulmonary veins to 100 mmHg
• Carina – internal ridge
○ Where the trachea divides to form the primary bronchi Internal Respiration
○ Most sensitive area for triggering cough reflex • Internal respiration – in tissues throughout body
• Divide to form bronchial tree Oxygen Carbon dioxide
○ Secondary lobar bronchi (one for each lobe), tertiary (segmental) bronchi, bronchioles, • Oxygen diffuses from systemic capillary blood (P O2 • Carbon dioxide diffuses from tissue cells (PCO2 45
terminal bronchioles 100 mmHg) into tissue cells (P O2 40 mmHg) – cells mmHg) into systemic capillaries (PCO2 40 mmHg) –
• Structural changes with branching constantly use oxygen to make ATP cells constantly make carbon dioxide
○ Mucous membrane changes • Blood drops to 40 mmHg by the time blood exits the • PCO2 blood reaches 45 mmHg
○ Incomplete rings become plates and then disappear systemic capillaries
○ As cartilage decreases, smooth muscle increases • At rest, only about 25% of the available oxygen is used
▪ Sympathetic ANS – relaxation/ dilation ○ Deoxygenated blood would retain 75% of its oxygen capacity
□ When it's hard to breath; asthma attack/irritants
▪ Parasympathetic ANS – contraction/ constriction Rate of Pulmonary and Systemic Gas Exchange
Depends on
• Partial pressures of gases
○ Alveolar PO2 must be higher than blood PO2 for diffusion to occur – problem with increasing altitude
• Surface area available for gas exchange
• Diffusion distance
○ Problems occur when substances that are present in the lungs (fibrosis in lungs-increases distance)
• Molecular weight and solubility of gases
○ O2 has a lower molecular weight and should diffuse faster than CO2 except for its low solubility - when
diffusion is slow, hypoxia occurs before hypercapnia

Transport of Oxygen and Carbon Dioxide

Oxygen transport
• Only about 1.5% dissolved in plasma
• 98.5% bound to hemoglobin in red blood cells
○ Heme portion of hemoglobin contains 4 iron atoms – each can bind one O2 molecule
○ Oxyhemoglobin
▪ Hemoglobin + oxygen
○ Only dissolved portion can diffuse out of blood into cells
○ Oxygen must be able to bind and dissociate from heme

Relationship between Hemoglobin and Oxygen Partial Pressure

• Higher the PO2, More O2 combines with Hb
• Fully saturated – completely converted to oxyhemoglobin
• Percent saturation expresses average saturation of hemoglobin with oxygen
• Oxygen-hemoglobin dissociation curve
○ In pulmonary capillaries, O2 loads onto Hb
○ In tissues, O2 is not held and unloaded
▪ 75% may still remain in deoxygenated blood (reserve)

Oxygen-hemoglobin Dissociation Curve

Lungs
• Separated from each other by the heart and
other structures in the mediastinum
• portions
○ Right lung

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Lungs
• Separated from each other by the heart and
other structures in the mediastinum
• portions
○ Right lung
○ 3 lobes (superior, middle and
inferior)
○ Horizontal and oblique fissure

○ Left lung
○ 2 lobes (superior and inferior)
○ Oblique fissure
• Each lung enclosed by double-layered pleural
membrane
○ Parietal pleura – lines wall of thoracic
cavity
○ Visceral pleura – covers lungs
themselves
• Pleural cavity is space between layers
○ Pleural fluid reduces friction, produces
surface tension (stick together)
• Cardiac notch
○ heart makes left lung 10% smaller than
right
○ Accommodates the heart Hemoglobin and Oxygen
• Other factors affecting affinity of Hemoglobin for oxygen
• Each makes sense if you keep in mind that metabolically active tissues need O2, and produce acids, CO 2, and
heat as wastes
○ Acidity
▪ Related to PCO2
▪ Decrease in PH
○ PCO2
▪ Increase in PCO2, increase in acidity
○ Temperature

Bohr Effect
○ As acidity increases (pH decreases), affinity of Hb for O2 decreases
○ Increasing acidity enhances unloading
○ Shifts curve to right
• PCO2
○ Also shifts curve to right
○ As PCO2 rises, Hb unloads oxygen more easily
○ Low blood pH can result from high PCO2

Anatomy of Lungs
• Lobes – each lung divides by 1 or 2 fissures
○ Each lobe receives its own secondary (lobar) bronchus that branch into tertiary
(segmental) bronchi
• Lobules wrapped in elastic connective tissue and contains a lymphatic vessel, arteriole, venule
and branch from terminal bronchiole
• Terminal bronchioles branch into respiratory bronchioles which divide into alveolar ducts
• About 25 orders of branching
• Lungs receive blood from
○ Pulmonary artery
▪ deoxygenated blood; to be oxygenated
○ Bronchial arteries
▪ oxygenated blood to perfuse muscular walls of bronchi and bronchioles
▪ Blood supply of the lungs for its metabolism

Alveoli
• Cup-shaped outpouching
• Alveolar sac – 2 or more alveoli sharing a common opening
• 2 types of alveolar epithelial cells
○ Type I alveolar cells
▪ form nearly continuous lining, more numerous than type II
▪ main site of gas exchange
○ Type II alveolar cells (septal cells)
▪ free surfaces contain microvilli
▪ secrete alveolar fluid w/c serve as surfactant
□ reduces tendency to collapse
□ Made up of phospholipid ang glycoproteins thereby reducing surface tension
of alveolar fluid

Components of Alveolus

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