Mechanical & Physiological Aspect

of External Respiration
Auliyani Andam Suri

Department of Physiology, Medical Faculty, UIN Jakarta

April 27, 2022
 Respiratory: Function

● Obtaining oxygen used by cells’ body and eliminating the carbon dioxide from
cells’ product (Sherwood, 2016)
● Providing oxygen to the tissues and removing carbon dioxide (Guyton, 2019)
● Four primary function of respiratory system (Silverthorn, 2019):
1. Exchange of gases between the atmosphere and the blood
2. Homeostatic regulation of body pH
3. Protection (from inhaled pathogens & irritating substances)
4. Vocalization
 Upper respiratory tract

• Mouth, nasal cavity, pharynx, larynx

Respiratory
Tract
Lower respiratory tract (thoracic portion)

• Trachea, bronchi/bronchus & lungs

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 448. 9th Ed. 2016 Barret KE, et al. Ganong’s Review of Medical
Physiology. Chapter 34, p.622. 25 th Ed. 2016
 Beta-2 adrenergic receptors à

Respiratory Tract:
● The trachea and larger bronchi:
bronchodilation, bronchial secretions;
fairly rigid, nonmuscular tubes
Cellular transition
Alfa-1 adrenergic à inhibit secretions
encircled by a series of
cartilaginous rings à prevent
compressing
● Bronchiolus: contain smooth
muscle, innervated by the
autonomic nervous system,
sensitive to certain hormones and
local chemicals
● Epithelial cells secretes IgA,
surfactant protein, other peptides,
chemockines, cytokines à act as
antimicrobials agent

Barret KE, et al. Ganong’s Review of Medical Physiology. Chapter 34, p.623. 25 th Ed. 2016
 Pulmonary ventilation

Diffusion of O2 and CO2

Respiration between alveoli and
blood
In physiology has several
meaning (Silverthorn)

Transport O2 and CO2 in

the blood and body fluids

Regulation of ventilation

Guyton & Hall. Textbook of Medical Physiology, 14th Ed. 2021, p.491
Internal respiration

Sherwood L. Human Physiology: From Cells to System. 9th Ed.

2016, p.500
 During ventilation à air flows into and out of the lungs
Important pressure by moving down alternately reversing pressure
during ventilation gradients established between the alveoli and the
atmosphere by cyclic respiratory muscle activity
Ventilation: Bulk flow exchange of air
between the atmosphere (breathing)

Sherwood L. Human Physiology From Cell To

Atmosphere pressure: 760 mmHg System. Chapter 13, p. 451. 9th Ed. 2016

Intra-aveolar/intra-pulmonary pressure

Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter Intrapleural pressure: 756 mmHg
22, p. 817. 9th Ed. 2013
Pressure during ventilation:
Transmural pressure gradient

Transmural pressure gradient = 4 mmHg

pushes out on the lungs, stretching lungs to
fill the larger thoracic cavity

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 451. 9th Ed. 2016
Pneumothorax
The abnormal condition of air in the
pleural cavity

Intrapleural and intra-alveolar

pressure = atmospheric pressure

transmural pressure gradient

collapsed lung

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 452. 9th Ed. 2016
Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.547. 8th Ed. 2019
 Ventilation: Basic mechanism
● Air flows down the pressure gradient

● Inspiration : the intra-alveolar pressure

must be less than atmospheric pressure

● Expiration: the intra-alveolar pressure must

be greater than atmospheric pressure

Altering the volume of the lungs à

change intra-alveolar pressure

Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. Chapter 23,

Boyle’s Law: p.871. 15th Ed. 2017
P1V1 = P2 V2
If the volume of a gas is reduced, the pressure increases
If the volume increases, the pressure decreases changes in the volume of the chest cavity à
respiratory muscle activity
Respiratory muscles

Sherwood L. Human Physiology From Cell To System. Chapter

13, p. 453. 9th Ed. 2016

Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. Chapter 23,

Phrenic nerve (from C3-C5), innervating diaphragm p.870. 15th Ed. 2017

Intercostal nerve (from T1-T11), innervating intercostal muscles

Inspiration &
Expiration Mechanism

Barret KE, et al. Ganong’s Review of Medical Physiology.

Chapter 34, p.628. 25 th Ed. 2016 Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 818. 9th Ed. 2013
 Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.546. 8th Ed. 2019

Volume &
Pressure Change
During Quite
Breathing

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 452. 9th Ed. 2016
Other Factors Affecting Pulmonary Ventilation

1. Airway resistance
2. Compliance and Elastic Recoil of Lung
3. Alveolar surface tension
 Airway Resistance
● Airflow obstruction in airways, determined by radius of conducting
airway
● The radius of the conducting system is large enough that resistance
remains extremely low
● The airways normally offer such low resistance that only small pressure
gradients of 1 to 2 mm Hg are needed to achieve adequate rates of
airflow into and out of the lungs

Relationship between gas flow (F), pressure (P), and resistance (R):

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 456. 9th Ed. 2016
 Airway Resistance

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 456. 9th Ed. 2016
 Airway resistance is abnormally increased
with chronic obstructive pulmonary disease

● Chronic Bronchitis à long-term inflammatory condition of

the lower respiratory airways due to frequent exposure to
irritating cigarette smoke, polluted air, or allergens causes
lining of airway thickening, mucus à narrowed airways
● Asthma, due to (1) thickening of airway walls à
inflammation and histamine-induced edema; (2) plugging of
the airways by excessive secretion of thick mucus; (3) airway
hyperresponsiveness à constriction of the smaller airways
caused by trigger-induced spasm of the smooth muscle in
the walls of these airways.
● Emphysema à (1) collapse of the smaller airways and (2)
breakdown of alveolar walls. Excessive trypsin à destroy
not only foreign materials but lung tissue
 Lung Compliance & Elasticity

● Compliance à how much effort is required to stretch ● Elasticity/ elastance (elastic recoil) à The ability to resist
the lungs and chest wall being deformed, the ability of a body to return to its original
○ High compliance : lungs and chest wall expand shape when a deforming force is removed.
easily
○ Low compliance: resist expansion
Δ𝑃
● In the lung, compliance can defined as the change of
Δ𝑉
volume (V) that results from a given force or pressure
(P) exerted on the lung:

Δ𝑉 A low-compliance lung requires more force from

the inspiratory muscles to stretch it, vice versa
Δ𝑃

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.548-549. 8th Ed. 2019
 Lung Compliance & Elastic Recoil
Depends on

Changes on lung’s Airway Resistance Surface tension

elasticity

• Pulmonary fibrosis: normal lung

tissue is replaced with scar-
forming fibrous connective • Related to alveolar surfactant
tissue à (compliance ↓, • Airway congestion & • Increasing of surface tension:
elasticity ↑) pulmonary edema will compliance ↓, elasticity ↑
• Emphysema: destruction of decrease compliance • Decreasing of surface tension:
elastic fibers in alveolar walls compliance ↑, elasticity ↓
à (compliance ↑, elasticity ↓)

Other factors
• Neuromuscular disorder in respiratory muscles: compliance ↓
• Pneumothorax: ↑ P interpleura, ↓ lung volume à compliance ↓, elasticity ↑

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 458. 9th Ed. 2016
 Surface Tension & Surfactant
● Surface tension created by the thin fluid layer In alveoli:
between the alveolar cells and the air. ↑ surface tension, collapsing pressure ↑, ↓ alveoli diameter
● The water molecules on the fluid’s surface are
attracted to other water molecules beside
and beneath them but are not attracted to
gases in the air at the air-fluid interface.
● The surface tension created by the thin film of
fluid is directed toward the center of the
bubble and creates pressure in the interior of
the bubble.
● The fluid lining all the alveoli creates surface
tension

Silverthorn DU. Human Physiology An Intergrated Approach.

More work would be needed to expand smaller alveoli à prevented by
Chapter 17, p.549-50. 8th Ed. 2019 surfactant (Surface Active Agent)
Surfactant

● Complex mixture of lipids and

proteins secreted by Type II
alveolar cells
● Intersperses between the water
molecules in the fluid lining the
alveoli and lowers alveolar
surface tension by decreasing
extent of hydrogen bonding
between molecules at the alveolar
air–water interface.

Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 813. 9th Ed. 2013
 Surfactant function & Law of LaPlace

Pulmonary surfactant’s role in reducing the tendency of alveoli

to recoil à stabilize the sizes of the alveoli and helps keep
them open and available to participate in gas exchange.
Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 459. 9th Ed. 2016
 Surfactant Deficiency: Newborn Respiratory Distress
Syndrome
● In period of gestation normally, surfactant synthesis begins about the 25th week reaches
adequate levels by the 34th week (about 6 weeks before normal delivery).
● Babies who are born prematurely without adequate concentrations of surfactant in their
alveoli develop newborn respiratory distress syndrome (NRDS).

↓ Surfactant ↑ Surface tension

↓ Lung Compliance, ↑ Energy to
↑ Elasticity expand the lung

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 460. 9th Ed. 2016

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.550. 8th Ed. 2019
 ● Normally, the lungs are highly compliant and
airway resistance is low, so only about 3% of
the total energy expended by the body is used
for quiet breathing.
● During strenuous exercise, the amount of
energy required to power pulmonary
ventilation may increase 25x
● In patients with poorly compliant lungs or
obstructive lung disease, the energy required
for breathing even at rest may be as much as
30% of total energy expenditure à breathing
itself becomes exhausting.

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 460. 9th Ed. 2016
 The work of breathing may be increased in four
different situations:

When pulmonary compliance is decreased

(pulmonary fibrosis)

When airway resistance is increased (COPD)

When elastic recoil is decreased, as with emphysema

When there is a need for increased ventilation, such as

during exercise (↑ depth breathing & rate breathing)

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 460. 9th Ed. 2016
 Lung Volumes
and Capacities
● Lung volumes, which can be measured
directly by use of a spirometer
● Lungs capacities, which are combinations
of different lung volumes
Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.543. 8th Ed. 2019

Sherwood L. Human Physiology From Cell To System.

Chapter 13, p. 461. 9th Ed. 2016
Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. Chapter 23, p.874. 15th Ed. 2017
Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 822. 9th Ed. 2013
 The FEV1 to FVC ratio (FEV1/FVC) is a useful
tool in the recognizing classes of airway
disease
● Forced Vital Capacity (FVC): the largest amount of air that
can be expired after a maximal inspiratory effort.
● FEV1 à forced expiratory volume in the first second

FEV1/FVC x 100%
Normal ratio:
4 L/5L x 100 % = 80%

!"#$↓
Obstructive à % !#&
= < 80%

!"#$
Restrictive à % = > 80%
↓ !#&
Barret KE, et al. Ganong’s Review of Medical Physiology. Chapter 34, p.629. 25 th Ed. 2016
 Pulmonary and Alveolar Ventilation

= 500 x 12
= 6000 ml/min

● Not all the inspired air gets down to the site of gas exchange in the alveoli
● Every breath remains in the conducting airways, such as the trachea and
bronchi
● Known as the anatomic dead space, averages about 150 mL.
● In effect, even though 500 mL of air are moved in and out with each breath, only
350 mL are actually exchanged between the atmosphere and the alveoli
Anatomic
Dead Space

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.552. 8th Ed. 2019
Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 464. 9th Ed. 2016
External respiration: Ventilation & Perfusion

● Blood flow (perfusion) past the alveoli must be high enough to pick up the available oxygen
from ventilation

(alveolar) Ventilation = 4200 ml/min

Perfusion (total blood volume in pulmonary arteriole, depends on cardiac output) = 5000
ml/min
Ideally:
Ventilation : Perfusion = 4200 ml/min : 5000 ml/min = ~ 0,8
V/Q = 0,8

● Matching the ventilation rate into groups of alveoli with blood flow past those alveoli is a two
part process involving local regulation of both air flow and blood flow.
Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.555. 8th Ed. 2019
Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 466. 9th Ed. 2016
 Differences in ventilation, perfusion, and ventilation-perfusion ratios at
the top and bottom of the lungs as a result of gravitational effects

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 467. 9th Ed. 2016
 External respiration: Alveolus & Blood Gas Exchange

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.556. 8th Ed. 2019
External respiration: Alveolus & Blood Gas Exchange

Pathological changes that adversely

affect gas exchange:
1. a decrease in the amount of
alveolar surface area available
for gas exchange,
2. an increase in the thickness of
the alveolar-capillary exchange
Barrier
3. an increase in the diffusion
Gas Exchange à Diffusion
distance between the alveolar air
space and the blood.

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.556. 8th Ed. 2019
 Pathologies that cause hypoxia
hypoxia à a state of too little oxygen

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 17, p.556. 8th Ed. 2019
 Alveolus & Blood Gas Exchange:
Gas Partial Pressure & Solubility
● Diffusion à Partial pressure gradient
● Dalton’s law à each gas in a mixture of gases exerts its own
pressure as if no other gases were present

● Partial pressures determine the movement of O2 and CO2

between the atmosphere and lungs, between the lungs and
blood and between the blood and body cells
● The greater the diff erence in partial pressure, the faster the rate
Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 467.
of diffusion 9th Ed. 2016
Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. Chapter 23, p.875. 15th Ed. 2017
 Alveolar PO2 and PCO2
● Alveolar air is not of the same composition as inspired atmospheric air:
1. Humidification of inspired air in effect “dilutes” the partial pressure of the
inspired gases by 47 mm Hg
2. Fresh inspired air (average equals 350 mL out of a tidal is mixed with the large
volume of old air that remained in the lungs at the end of the preceding
expiration. At the end of inspiration, only about 13% of the air in the alveoli is
fresh air.

Alveolar PO2 is 100 mm Hg, compared to the atmospheric PO2 of 160 mm Hg

Alveolar PCO2 remains fairly constant throughout the respiratory cycle but at a lower value of
40 mm Hg

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 468. 9th Ed. 2016
Gases dissolve
● Henry’s law à quantity of a gas that will dissolve in a liquid is proportional to the
partial pressure of the gas and its solubility.

S (solubility) = K x P (Pressure)

● The solubility of CO2 is 24 times greater than O2.

● The air contains mostly N2, but it has no known effect on bodily functions à very
little of it dissolves in blood plasma because its solubility is very low
● Partial pressure of nitrogen is higher in a mixture of compressed air than in air
at sea level pressure, a considerable amount of nitrogen dissolves in plasma
and interstitial fluid. Excessive amounts of dissolved nitrogen may produce
giddiness and other symptoms similar to alcohol intoxication, called nitrogen
narcosis or “rapture of the deep.”
Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 470. 9th Ed. 2016
O2 and CO2 exchange across
pulmonary and systemic
capillaries

Sherwood L. Human Physiology From Cell To System. Chapter

13, p. 469. 9th Ed. 2016
 ● T-state hemoglobin (high affinity of CO2 & H+, low affinity of O2)
Oxygen unloading ●
●
O2 à tissues; CO2 à blood
Bohr effect

2-10%
↑ PCO2 46 mmHg

70%

20%

↓ PO2 40 mmHg

Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 833. 9th Ed. 2013
 ● R-state hemoglobin (high affinity of O2, low affinity of CO2, H+)
Oxygen loading ● O2 à blood; CO2 à alveoli
● Haldane Effect

Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 833. 9th Ed. 2013
 Regulation of Respiration
● Breathing must occur in a continuous, cyclic pattern to sustain life
● Inspiratory muscles must rhythmically contract and relax to alternately
fill the lungs with air and empty them

Breathing

Involuntary Voluntary

Pons & Medulla Cortex cerebri

Rhythmic & Modified voluntary

spontaneous breathing (singing,
breathing pattern talking, whistling,
holding breath)
Silverthorn DU. Human Physiology An
Intergrated Approach. Chapter 18,
p.604. 8th Ed. 2019
 Respiratory Center

● Respiratory neurons in the medulla control inspiratory and

expiratory muscles.
● Neurons in the pons integrate sensory information and
interact with medullary neurons to influence ventilation.
● The rhythmic pattern of breathing arises from a brainstem
neural network with spontaneously discharging neurons.
● Ventilation is subject to continuous modulation by various
chemoreceptor- and mechanoreceptor-linked reflexes and by
higher brain centers.

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 18, p.605. 8th Ed. 2019
 Respiratory Center
● Establish a rhythmic breathing pattern
● Consist of 3 main parts:
1. the pneumotaxic center
pontine respiratory groups
2. the apneustic center
3. medullary respiratory center
1. DRG (Dorsal respiratory group)
2. VRG (Ventral respiratory group)

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 479. 9th Ed. 2016
 Medullary respiratory center
DRG (Dorsal Respiratory Group)
- Located on nucleus tractus solitarius (NTS)
- consists mostly of inspiratory neurons, generate
impulses to the diaphragm via the phrenic nerves and
the external intercostal muscles via the intercostal
nerves
- receives sensory information from peripheral chemo-
and mechanoreceptors through the vagus and
glossopharyngeal nerves (cranial nerves X and IX)
- Inactivated DRG (after 2’s) à expiration process
(inspiratory muscle relax about 3’s)

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 479. 9th Ed. 2016
Medullary respiratory center
DRG (Dorsal Respiratory Group)
- Located on nucleus tractus solitarius (NTS)
- consists mostly of inspiratory neurons, generate
impulses to the diaphragm via the phrenic nerves and
the external intercostal muscles via the intercostal
nerves
- receives sensory information from peripheral chemo-
and mechanoreceptors through the vagus and
glossopharyngeal nerves (cranial nerves X and IX)
- Inactivated DRG (after 2’s) à expiration process
(inspiratory muscle relax about 3’s)

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 18, p.605. 8th Ed. 2019
 Medullary respiratory center

VRG (Ventral Respiratory Group)

- almost totally inactive during normal quiet respiration
- contributes extra respiratory drive (active ventilation),
stimulates VRG
- Has one area known as the pre-Bötzinger complex act
as the basic pacemaker for the respiratory rhythm
● innervate muscles of the larynx, pharynx, and tongue to
keep the upper airways open during breathing

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 479. 9th Ed. 2016
Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. Chapter 23, p.885. 15th Ed. 2017
 Pons respiratory center
● The neurons are active during inhalation and exhalation.
● Transmits nerve impulses to the DRG in the medulla.
● May play a role in both inhalation and exhalation by
modifying the basic rhythm of breathing generated by the
VRG, as when exercising, speaking, or sleeping.

Pneumotaxic center Apneustic center

● sends impulses to the DRG ● prevents the inspiratory
that help “switch off” the neurons from being
inspiratory neurons, limiting switched off, thus
the duration of inspiration providing an extra boost
● dominates over the apneustic to the inspiratory drive.
center, helping halt
inspiration and letting
expiration occur normally

produce normal, smooth

inspirations and expirations

Sherwood L. Human Physiology From Cell To System. Chapter 13, p. 479. 9th Ed. 2016
Neural and chemical influences on brain
stem respiratory centers.

Carotid body

Medulla oblongata

Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 835. 9th Ed. 2013
Chemical Control of
Respiration: Chemo-sensitive
area of Respiratory Center
● the central chemoreceptors
monitor CO2, actually respond to
pH changes in the cerebrospinal
fluid (CSF), strongly by increasing
ventilation
● If PCO2 remains elevated for
several days, ventilation falls back
toward normal rates as the
chemoreceptor response adapt &
renal adjustment of H+
concentration

↑PCO2 à ↑ H+ à ↓ pH

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 18,

p.608. 8th Ed. 2019 Hall JE. Guyton and Hall Textbook of Medical Physiology. Chapter 42, p.532. 13th Ed. 2016
Hypercapnia (PCO2 ↑)

Blood PCO2 ↑ ⛔

CO2↑ in
cerebrospinal fluid
↑PO2, ↓PCO2, ↑ Ventilation
↑pH ↑ RR, depth breathing

External
T1-T11 n. intercostalis intercostalis
muscle
Medulla spinalis

C3-C5 n. phrenicus Diaphgram

muscle
DRG

Central
pneumotaxic
 Peripheral
chemoreceptors
● Located in the aortic bodies, clusters of chemoreceptors located in the wall of
the arch of the aorta, and in the carotid bodies
● important for detecting changes in O2 in the blood, also respond to a lesser
extent to changes in CO2 and H+ concentrations.
● Not sensitive to modest reductions in arterial PO2 à must fall < 60 mm Hg (.40%
reduction)

PO2 < 60 mmHg à only in the unusual

circumstances of severe pulmonary disease
or reduced atmospheric PO2

Tortora GJ, Derrickson B. Principles of Anatomy and

Physiology. Chapter 23, p.886. 15th Ed. 2017
Hall JE. Guyton and Hall Textbook of Medical Physiology. Chapter 42, p.535. 13th Ed. 2016
Basic Mechanism of Stimulation of
the Chemoreceptors by O2
Deficiency
Glomus cells have O2-sensitive potassium channels that are
inactivated when blood PO2 decreases markedly

N IX (Glossopharyngeal nerve)
N X (Vagus nerve)

DRG

Inspiration muscle contraction

↑ Ventilation

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 18, p.607. 8th Ed. 2019
Increased CO2 and
H+ Concentration
Stimulates the
Chemoreceptors
• the direct effects of ↑ CO2 and
H+ in the respiratory center are
much more powerful (7x) than
through the pheriperal
chemoreceptors
• the stimulation via the
peripheral chemoreceptors five
times rapidly than thru central
stimulation
• Important in increasing the
rapidity of response to CO2 at
the onset of exercise

Silverthorn DU. Human Physiology An Intergrated Approach. Chapter 18, p.608. 8th Ed. 2019
Regulation of breathing in
response to changes in blood PCO2,
PO2, and pH (H+) via negative
feedback control.

Marieb EN, Hoehn K. Human Anatomy &

Physiology. Chapter 22, p. 836. 9th Ed. 2013
 Non chemical stimulus
● ↑ body temperature à ↑
ventilation à heat loss
mechanism
● Exercise à ↑ Epinephrine à
sympathetic nerve à ↑
ventilation

Hering Breurer Reflex, ↑

expiration

Movement à DRG à ↑ ↑ expiration à coughing

ventilation à RR & sneezing mechanism

Marieb EN, Hoehn K. Human Anatomy & Physiology. Chapter 22, p. 835. 9th Ed. 2013
Hering Breurer Reflex
a protective mechanism for preventing excess lung inflation

Inspiration muscle
>≈1.5 L/breath
contracton
air during inspiration
⛔ Expiration

Overstretched ⛔ VRG VRG

lung Inspiratory neuron Expiratory neuron

⛔ ➕
Visceral pleura Bronchi & bronchiole
stretch receptors stretch receptors
DRG

⛔ ⛔
NV
PRG
(Vagus nerves)
Voluntary Control Breathing:
Breaking Point

Breaking point à when you can no longer hold your breath

● ↑ PCO2
● ↑ H+
● ↑ Stimulus in central chemoreceptor
● ↑ Inspiration
References

1. Silverthorn DU. Human Physiology An

Intergrated Approach. Chapter 17-18. 8th Ed.
2019
2. Sherwood L. Human Physiology From Cell To
System. Chapter 13. 9th Ed. 2016
3. Hall JE. Guyton and Hall Textbook of Medical
Physiology. Chapter 38-42. 13th Ed. 2016
4. Tortora GJ, Derrickson B. Principles of Anatomy
and Physiology. Chapter 23. 15th Ed. 2017
5. Barret KE, et al. Ganong’s Review of Medical
Physiology. Chapter 34-36. 25 th Ed. 2016
6. Marieb EN, Hoehn K. Human Anatomy &
Physiology. Chapter 22, p. 817. 9th Ed. 2013
Thank you.

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