Respiratory System

Dr. Thontowi Djauhari NS, MKes

ProgramStudi Farmasi
Universitas Muhammadiyah Malang
 Respiratory System: Functions

1. Provides extensive surface area within the

lungs in the alveoli for gas exchange between
outside air & blood.
2. Moves air to & from exchange surfaces of
lung.
3. Purifies, warms, and humidifies the incoming
air in passageways to the lungs
4. Defends against invading microorganisms.
5. Produces sounds involved in speech.
 Organs of the Respiratory system
Conducting portion
• Nose
• Pharynx
• Larynx
• Trachea
• Bronchi
Respiratory
portion

• Lungs –
alveoli
Figure 13.1
 Paranasal Sinuses
 Functions of paranasal sinuses
 Lighten the skull
 Give resonance and amplification to voice

Figure 5.10

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

 Upper vs. Lower Respiratory System
Upper respiratory system – Nose to pharynx.
Functions:
Filters air
Warms air
Humidifies air
Lower respiratory system – larynx to smallest
structures of lungs.
Functions:
Same as above
Gas exchange
Upper
Respiratory
System

Lower
Respiratory
System
Upper Respiratory Tract

NC

OC

Figure 13.2
 Larynx (Voice Box)
• Routes air and food into proper channels
• Plays a role in speech
• Made of eight rigid hyaline cartilages and a spoon-
shaped flap of elastic cartilage (epiglottis)
• Thyroid cartilage
– Largest hyaline cartilage
– Protrudes anteriorly (Adam’s apple)
• Epiglottis
– Superior opening of the larynx
– Routes air to the trachea & food to the esophagus.
• Vocal cords (vocal folds)
– Vibrate with expelled air to create sound (speech)
• Glottis – opening between vocal cords
Anatomy E
epiglottis
of the
larynx

Thyroid
 Anatomy of
the larynx:
Vocal fold epiglottis,
E
glottis, and
vocal folds
Trachea (Windpipe)
Trachea

The
trachea
(windpipe)
connects
larynx
with
bronchi.
Trachea
Walls reinforced
with C-shaped
hyaline cartilage
which prevent
collapse of the
trachea.

Trachea lined
with ciliated
mucosa that beat
continuously;
trachea expels
mucus loaded
with dust & other
debris away from
lungs.
Coverings of the Lungs (Serous Membrane)
• Pulmonary (visceral) pleura covers the lung surface
• Parietal pleura lines the walls of the thoracic cavity
• Pleural (serous) fluid fills the area between layers of
pleura to allow gliding
 Each lung is divided into lobes by fissures
Lungs oblique
fissure
lobe
lobe

hilus lobe
lobe

Left lung – two lobes Right lung – three lobes

Primary Bronchi
• Formed by division of
the trachea
• Enters the lung at the
hilus
• Bronchi subdivide into
smaller
and smaller branches
Respiratory Tree
Divisions
• Primary bronchi
• Secondary bronchi
• Tertiary bronchi
• Bronchioles
• Terminal bronchioles
 The trachea
primary bronchus and primary
bronchi have
cartilage
rings.
secondary bronchus
Secondary
and tertiary
bronchi have
cartilage
plates
arranged
around
lumen.
L
tertiary
bronchi
Bronchioles
lack
cartilage.
 Bronchioles

• Smallest branches of
the bronchi
• All but the smallest
branches have
reinforcing cartilage
• Terminal bronchioles
end in alveoli

Figure 13.5a
 Respiratory Zone
• Respiratory
bronchioles
• Alveoli
– Alveolar duct
– Alveolar sac
– Alveolus
(Alveoli)
• Gas exchange
takes place
within the alveoli
• Sites of gas
exchange
• Pulmonary
capillaries cover
external
surfaces of
alveoli
Respiratory Membrane (Air-Blood Barrier)
•Thin flat epithelial layer lining alveolar walls
•Macrophages add protection
•Surfactant coats gas-exposed alveolar surface

Figure 13.6
Events of
Respiration
• Respiratory gas
transport –
transport of
oxygen and carbon
dioxide via the
bloodstream
• Internal
respiration – gas
exchange between
blood and tissue
cells in systemic
capillaries
 Neural Regulation of Respiration

Figure 13.12
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
Mechanics
of
Breathing
(Pulmonary
Ventilation)

• Completely mechanical process

• Depends on volume changes in the thoracic cavity
• Volume changes lead to pressure changes, which lead to the flow of
gases to equalize pressure
• Two phases
– Inspiration – flow of air into lung
– Expiration – air leaving lung
 Inspiration

•Diaphragm and intercostal muscles contract

•The size (volume) of the thoracic cavity increases.
•The pressure inside the thoracic caivity decreases and draws
external air into the lungs down the pressure gradient. Figure 13.7a
 Expiration

• Largely a passive process which depends on natural lung

elasticity
• As muscles relax, air is pushed out of the lungs
• Forced expiration can occur mostly by contracting internal
intercostal muscles to depress the rib cage
Pressure
Differences
in the
lungs:
Thoracic intrapulmonary
pressure
Cavity
pleural cavity:
intrapleural
pressure

• Normal pressure within the pleural space (cavity) is always negative

(intrapleural pressure)
• Pressure differences between the lungs (intrapulmonary) and pleural
spaces keep the lungs from collapsing
 Respiratory Volumes and Capacities

Respiratory
capacities
are
measured
with a
spirometer

• Normal breathing moves about 500 ml of air with each breath (tidal
volume [TV])
• Many factors that affect respiratory capacity
– A person’s Size; Sex; Age; Physical condition
• Residual volume of air – after exhalation, about 1200 ml of air remains in
the lungs
Respiratory Volumes and Capacities

• Inspiratory reserve volume (IRV)

– Amount of air that can be taken in forcibly over the tidal volume
– Usually between 2100 and 3200 ml
• Expiratory reserve volume (ERV)
– Amount of air that can be forcibly exhaled
– Approximately 1200 ml
Respiratory Volumes and Capacities

Vital capacity
– The total amount of exchangeable air
– Vital capacity = TV + IRV + ERV
Respiratory Volumes and Capacities

• Dead space volume (about 150 ml)

Air that remains in conducting zone and never reaches alveoli
• Functional volume (about 350 ml)
– Air that actually reaches the respiratory zone
 The Cardiovascular System:
Program Studi Farmasi
Fakultas Ilmu Kesehatan
Universitas Muhammadiyah Malang
 Heart
• Anatomy
– 4 chambers
– AV valves
• Tricuspid
• Bicuspid - mitral
– Semilunar valves
• Right - pulmonary
• Left - aortic

Inferior view of valves

Heart Anatomy
• Approximately the size of your fist
• Location
– Superior surface of diaphragm
– Left of the midline
– Anterior to the vertebral column, posterior to
the sternum
Heart Anatomy

Figure 18.1
Coverings of the Heart: Anatomy
• Pericardium – a double-walled sac around the
heart composed of:
– A superficial fibrous pericardium
– A deep two-layer serous pericardium
• The parietal layer lines the internal surface
of the fibrous pericardium
• The visceral layer or epicardium lines the
surface of the heart
• They are separated by the fluid-filled
pericardial cavity
Coverings of the Heart: Physiology
• The pericardium:
– Protects and anchors the heart
– Prevents overfilling of the heart with blood
– Allows for the heart to work in a relatively
friction-free environment
Pericardial Layers of the Heart

Figure 18.2
Heart Wall
• Epicardium – visceral layer of the serous
pericardium
• Myocardium – cardiac muscle layer forming the
bulk of the heart
• Fibrous skeleton of the heart – crisscrossing,
interlacing layer of connective tissue
• Endocardium – endothelial layer of the inner
myocardial surface
External Heart: Major Vessels of the
Heart (Anterior
• Vessels View)
returning blood to the heart include:
– Superior and inferior venae cavae
– Right and left pulmonary veins
• Vessels conveying blood away from the heart
include:
– Pulmonary trunk, which splits into right and
left pulmonary arteries
– Ascending aorta (three branches) –
brachiocephalic, left common carotid, and
subclavian arteries
External Heart: Vessels that
Supply/Drain the Heart (Anterior View)
• Arteries – right and left coronary (in
atrioventricular groove), marginal, circumflex, and
anterior interventricular arteries
• Veins – small cardiac, anterior cardiac, and great
cardiac veins
External Heart: Anterior View

Figure 18.4b
External Heart: Major Vessels of the
Heart (Posterior
• Vessels View)
returning blood to the heart include:
– Right and left pulmonary veins
– Superior and inferior venae cavae
• Vessels conveying blood away from the heart
include:
– Aorta
– Right and left pulmonary arteries
External Heart: Vessels that
Supply/Drain the Heart (Posterior View)
• Arteries – right coronary artery (in
atrioventricular groove) and the posterior
interventricular artery (in interventricular
groove)
• Veins – great cardiac vein, posterior vein to left
ventricle, coronary sinus, and middle cardiac vein
Pathway of Blood Through the Heart and
Lungs

Figure 18.5
 Left
Arteries
Right common
carotid common
carotid
Right
subclavian
Brachiocephalic Left
subclavian

Aortic
arch

Descending
aorta
Arteries

Right external
carotid
Right internal
carotid
Right common
carotid

Right
subclavian
Brachiocephalic
 Major Arteries of Systemic Circulation

Figure 11.11

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 11.30
Veins

Superior
vena cava

Pulmonary
veins
Coronary
Cardiac sinus
veins

Inferior
vena cava
Veins

Right external
jugular

Right internal
jugular Right
subclavian
Axillary

Brachiocephalic
 Major Veins of Systemic Circulation

Figure 11.12

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 11.31
 Circulation to the Fetus

Figure 11.15

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 11.34
Fetal Circulation
Coronary Circulation
• Coronary circulation is the functional blood supply
to the heart muscle itself
• Collateral routes ensure blood delivery to heart
even if major vessels are occluded
Coronary Circuit

Aorta

Coronary
arteries
Coronary
sinus
Cardiac
veins
Coronary Vessels – Anterior
---LAC RPM---
Coronary Vessels – Posterior
---LAC RPM---
Heart
• HeartValves
valves ensure unidirectional blood flow
through the heart
• Atrioventricular (AV) valves lie between the
atria and the ventricles
• AV valves prevent backflow into the atria when
ventricles contract
• Chordae tendineae anchor AV valves to papillary
muscles
Heart Valves
• Aortic semilunar valve lies between the left
ventricle and the aorta
• Pulmonary semilunar valve lies between the right
ventricle and pulmonary trunk
• Semilunar valves prevent backflow of blood into
the ventricles
Heart Valves

Figure 18.8a, b
Heart Valves
Valve Anatomy
• The AV valves, the
tricuspid and bicuspid
(mitral) valves
AV Valve Mechanics
• Ventricles relax, pressure drops, semilunar valves
close, AV valves open, blood flows from atria to
ventricles
• Ventricles contract, AV valves close (papillary m.
contract and pull on chordae tendineae to prevent
prolapse), pressure rises, semilunar valves open,
blood flows into great vessels
Operation of Atrioventricular Valves
Operation of Semilunar Valves
Blood Flow Through Heart
Pathway of Blood Through the Heart and
Lungs
• Right atrium  tricuspid valve  right ventricle
• Right ventricle  pulmonary semilunar valve 
pulmonary arteries  lungs
• Lungs  pulmonary veins  left atrium
• Left atrium  bicuspid valve  left ventricle
• Left ventricle  aortic semilunar valve  aorta
• Aorta  systemic circulation
 Conduction pathway

• Heart rate fluctuations

• Sympathetic
– Cardiac nerve
– Norepinephrine
– (Na+, Ca++ influx)
• Parasympathetic
– Vagus nerve
– Acetycholine (K+ efflux)
Intrinsic Cardiac Conduction System
Approximately 1% of cardiac muscle cells are
autorhythmic rather than contractile

75/min

40-60/min

30/min
Intrinsic Conduction
Function: initiate & distributeSystem
impulses so heart
depolarizes & contracts in orderly manner from
atria to ventricles.

SA node

AV node
Bundle of His

Bundle Branches

Purkinje fibers
 Pulse

 Pulse –
pressure wave
of blood
 Monitored at
“pressure
points” where
pulse is easily
palpated
Figure 11.16
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 11.35
TERIMA KASIH