Chapter 23

The Respiratory System

Lecture Outline

Principles of Human Anatomy and Physiology, 11e 1

 INTRODUCTION

• The two systems that cooperate to supply O2 and eliminate

CO2 are the cardiovascular and the respiratory system.
• The respiratory system provides for gas exchange.
• The cardiovascular system transports the respiratory gases.
• Failure of either system has the same effect on the body:
disruption of homeostasis and rapid death of cells from
oxygen starvation and buildup of waste products.
• Respiration is the exchange of gases between the
atmosphere, blood, and cells. It takes place in three basic
steps: ventilation (breathing), external (pulmonary)
respiration, and internal (tissue) respiration.

Principles of Human Anatomy and Physiology, 11e 2

Chapter 23 The Respiratory System

• Cells continually use O2 &

release CO2
• Respiratory system designed for
gas exchange
• Cardiovascular system
transports gases in blood
• Failure of either system
– rapid cell death from O2
starvation

Principles of Human Anatomy and Physiology, 11e 3

 Respiratory System Anatomy (Figure 23.1).
• Nose
• Pharynx = throat
• Larynx = voicebox
• Trachea = windpipe
• Bronchi = airways
• Lungs

• Locations of infections
– upper respiratory tract is above vocal cords
– lower respiratory tract is below vocal cords
• The conducting system consists of a series of cavities and
tubes - nose, pharynx, larynx, trachea, bronchi, bronchiole,
and terminal bronchioles - that conduct air into the lungs. The
respiratory portion consists of the area where gas exchange
occurs - respiratory bronchioles, alveolar ducts, alveolar sacs,
and alveoli.

Principles of Human Anatomy and Physiology, 11e 4

 External Nasal Structures

• Skin, nasal bones, & cartilage lined with mucous membrane

• Openings called external nares or nostrils

Principles of Human Anatomy and Physiology, 11e 5

 External Anatomy

• The external portion of the nose is made of cartilage and

skin and is lined with mucous membrane. Openings to the
exterior are the external nares.
• The external portion of the nose is made of cartilage and
skin and is lined with mucous membrane (Figure 23.2a).
• The bony framework of the nose is formed by the frontal
bone, nasal bones, and maxillae (Figure 23.2).

Principles of Human Anatomy and Physiology, 11e 6

 Internal Anatomy
• The interior structures of the nose are specialized for warming,
moistening, and filtering incoming air; receiving olfactory stimuli;
and serving as large, hollow resonating chambers to modify
speech sounds.
• The internal portion communicates with the paranasal sinuses
and nasopharynx through the internal nares.
• The inside of both the external and internal nose is called the
nasal cavity. It is divided into right and left sides by the nasal
septum. The anterior portion of the cavity is called the vestibule
(Figure 7.14a).
• The surface anatomy of the nose is shown in Figure 23.3.
• Nasal polyps are outgrowths of the mucous membranes which
are usually found around the openings of the paranasal sinuses.

Principles of Human Anatomy and Physiology, 11e 7

 Nose --
Internal
Structures

• Large chamber within the skull

• Roof is made up of ethmoid and floor is hard palate
• Internal nares (choanae) are openings to pharynx
• Nasal septum is composed of bone & cartilage
• Bony swelling or conchae on lateral walls

Principles of Human Anatomy and Physiology, 11e 8

 Functions of the Nasal Structures

• Olfactory epithelium for sense of smell

• Pseudostratified ciliated columnar with goblet cells lines
nasal cavity
– warms air due to high vascularity
– mucous moistens air & traps dust
– cilia move mucous towards pharynx
• Paranasal sinuses open into nasal cavity
– found in ethmoid, sphenoid, frontal & maxillary
– lighten skull & resonate voice

Principles of Human Anatomy and Physiology, 11e 9

 Rhinoplasty

• Rhinoplasty (“nose job”) is a surgical procedure in which the

structure of the external nose is altered for cosmetic or
functional reasons (fracture or septal repair)
• Procedure
– local and general anesthetic
– nasal cartilage is reshaped through nostrils
– bones fractured and repositioned
– internal packing & splint while healing

Principles of Human Anatomy and Physiology, 11e 10

 Pharynx - Overview

• The pharynx (throat) is a muscular tube lined by a mucous

membrane (Figure 23.4).
• The anatomic regions are the nasopharynx, oropharynx,
and laryngopharynx.
• The nasopharynx functions in respiration. Both the
oropharynx and laryngopharynx function in digestion and in
respiration (serving as a passageway for both air and food).

Principles of Human Anatomy and Physiology, 11e 11

 Pharynx

Principles of Human Anatomy and Physiology, 11e 12

 Pharynx
• Muscular tube (5 inch long) hanging from skull
– skeletal muscle & mucous membrane
• Extends from internal nares to cricoid cartilage
• Functions
– passageway for food and air
– resonating chamber for speech production
– tonsil (lymphatic tissue) in the walls
protects entryway into body
• Distinct regions -- nasopharynx, oropharynx
and laryngopharynx

Principles of Human Anatomy and Physiology, 11e 13

 Nasopharynx

• From choanae to soft palate

– openings of auditory (Eustachian) tubes from middle ear cavity
– adenoids or pharyngeal tonsil in roof
• Passageway for air only
– pseudostratified ciliated columnar epithelium with goblet
Principles of Human Anatomy and Physiology, 11e 14
 Oropharynx

• From soft palate to epiglottis

– fauces is opening from mouth into oropharynx
– palatine tonsils found in side walls, lingual tonsil in tongue
• Common passageway for food & air
– stratified squamous epithelium

Principles of Human Anatomy and Physiology, 11e 15

 Laryngopharynx

• Extends from epiglottis to cricoid cartilage

• Common passageway for food & air & ends as esophagus inferiorly
– stratified squamous epithelium

Principles of Human Anatomy and Physiology, 11e 16

 Larynx - Overview
• The larynx (voice box) is a passageway that connects the
pharynx with the trachea.
• It contains the thyroid cartilage (Adam’s apple); the
epiglottis, which prevents food from entering the larynx; the
cricoid cartilage, which connects the larynx and trachea; and
the paired arytenoid, corniculate, and cuneiform cartilages
(Figure 23.5).
• Voice Production
– The larynx contains vocal folds (true vocal cords), which
produce sound. Taunt vocal folds produce high pitches,
and relaxed vocal folds produce low pitches (Figure
23.6). Other structures modify the sound.

Principles of Human Anatomy and Physiology, 11e 17

 Cartilages of
the Larynx

• Thyroid cartilage forms Adam’s apple

• Epiglottis---leaf-shaped piece of elastic cartilage
– during swallowing, larynx moves upward
– epiglottis bends to cover glottis
• Cricoid cartilage---ring of cartilage attached to top of trachea
• Pair of arytenoid cartilages sit upon cricoid
– many muscles responsible for their movement
– partially buried in vocal folds (true vocal cords)

Principles of Human Anatomy and Physiology, 11e 18

 Larynx

• Cartilage & connective tissue tube

• Anterior to C4 to C6
• Constructed of 3 single & 3 paired cartilages

Principles of Human Anatomy and Physiology, 11e 19

 Vocal Cords

• False vocal cords (ventricular folds) found above vocal folds

(true vocal cords)
• True vocal cords attach to arytenoid cartilages

Principles of Human Anatomy and Physiology, 11e 20

 The Structures of Voice Production

• True vocal cord contains both skeletal muscle and an

elastic ligament (vocal ligament)
• When 10 intrinsic muscles of the larynx contract, move
cartilages & stretch vocal cord tight
• When air is pushed past tight ligament, sound is
produced (the longer & thicker vocal cord in male
produces a lower pitch of sound)
• The tighter the ligament, the higher the pitch
• To increase volume of sound, push air harder

Principles of Human Anatomy and Physiology, 11e 21

 Movement of Vocal
Cords

• Opening and closing of the

vocal folds occurs during
breathing and speech

Principles of Human Anatomy and Physiology, 11e 22

 Speech and Whispering

• Speech is modified sound made by the larynx.

• Speech requires pharynx, mouth, nasal cavity & sinuses to
resonate that sound
• Tongue & lips form words
• Pitch is controlled by tension on vocal folds
– pulled tight produces higher pitch
– male vocal folds are thicker & longer so vibrate more
slowly producing a lower pitch
• Whispering is forcing air through almost closed rima
glottidis -- oral cavity alone forms speech

Principles of Human Anatomy and Physiology, 11e 23

 Application

• Laryngitis is an inflammation of the larynx that is usually

caused by respiratory infection or irritants. Cancer of the
larynx is almost exclusively found in smokers.

Principles of Human Anatomy and Physiology, 11e 24

 Trachea

• The trachea (windpipe) extends from the larynx to the

primary bronchi (Figure 23.7).
• It is composed of smooth muscle and C-shaped rings of
cartilage and is lined with pseudostratified ciliated columnar
epithelium.
• The cartilage rings keep the airway open.
• The cilia of the epithelium sweep debris away from the lungs
and back to the throat to be swallowed.

Principles of Human Anatomy and Physiology, 11e 25

 Trachea
• Size is 5 in long & 1in diameter
• Extends from larynx to T5 anterior to the esophagus and then
splits into bronchi
• Layers
– mucosa = pseudostratified columnar with cilia & goblet
– submucosa = loose connective tissue & seromucous
glands
– hyaline cartilage = 16 to 20 incomplete rings
• open side facing esophagus contains trachealis m.
(smooth)
• internal ridge on last ring called carina
– adventitia binds it to other organs
Principles of Human Anatomy and Physiology, 11e 26
 Trachea and Bronchial Tree

• Full extent of airways is visible starting at the larynx and trachea

Principles of Human Anatomy and Physiology, 11e 27

 Histology of the Trachea

• Ciliated pseudostratified columnar epithelium

• Hyaline cartilage as C-shaped structure closed by trachealis muscle

Principles of Human Anatomy and Physiology, 11e 28

 Airway Epithelium

• Ciliated pseudostratified columnar epithelium with goblet cells

produce a moving mass of mucus.
Principles of Human Anatomy and Physiology, 11e 29
 Tracheostomy and Intubation

• Reestablishing airflow past an airway obstruction

– crushing injury to larynx or chest
– swelling that closes airway
– vomit or foreign object
• Tracheostomy is incision in trachea below cricoid cartilage if
larynx is obstructed
• Intubation is passing a tube from mouth or nose through
larynx and trachea

Principles of Human Anatomy and Physiology, 11e 30

 Bronchi

• The trachea divides into the right and left pulmonary bronchi
(Figure 23.8).
• The bronchial tree consists of the trachea, primary bronchi,
secondary bronchi, tertiary bronchi, bronchioles, and
terminal bronchioles.
• Walls of bronchi contain rings of cartilage.
• Walls of bronchioles contain smooth muscle.

Principles of Human Anatomy and Physiology, 11e 31

 Bronchi and Bronchioles

• Primary bronchi supply each lung

• Secondary bronchi supply each lobe of the lungs (3 right + 2 left)
• Tertiary bronchi supply each bronchopulmonary segment
• Repeated branchings called bronchioles form a bronchial tree
Principles of Human Anatomy and Physiology, 11e 32
 Histology of Bronchial Tree
• Epithelium changes from pseudostratified ciliated columnar
to nonciliated simple cuboidal as pass deeper into lungs
• Incomplete rings of cartilage replaced by rings of smooth
muscle & then connective tissue
– sympathetic NS & adrenal gland release epinephrine that
relaxes smooth muscle & dilates airways
– asthma attack or allergic reactions constrict distal
bronchiole smooth muscle
– nebulization therapy = inhale mist with chemicals that
relax muscle & reduce thickness of mucus

Principles of Human Anatomy and Physiology, 11e 33

 Pleural Membranes & Pleural Cavity

• Visceral pleura covers lungs --- parietal pleura lines ribcage & covers
upper surface of diaphragm
• Pleural cavity is potential space between ribs & lungs

Principles of Human Anatomy and Physiology, 11e 34

 Lungs - Overview

• Lungs are paired organs in the thoracic cavity; they are enclosed and
protected by the pleural membrane (Figure 23.9).
• The parietal pleura is the outer layer which is attached to the wall of the
thoracic cavity.
• The visceral pleura is the inner layer, covering the lungs themselves.
• Between the pleurae is a small potential space, the pleural cavity, which
contains a lubricating fluid secreted by the membranes.
• The pleural cavities may fill with air (pneumothorax) or blood
(hemothorax).
• A pneumorthorax may cause a partial or complete collapse of the lung.
• The lungs extend from the diaphragm to just slightly superior to the
clavicles and lie against the ribs anteriorly and posteriorly (Figure
23.10).

Principles of Human Anatomy and Physiology, 11e 35

 Lungs - Overview

• The lungs almost totally fill the thorax (Figure 23.10).

• The right lung has three lobes separated by two fissures;
the left lung has two lobes separated by one fissure and a
depression, the cardiac notch (Figure 23.10).
• The secondary bronchi give rise to branches called tertiary
(segmental) bronchi, which supply segments of lung tissue
called bronchopulmonary segments.
• Each bronchopulmonary segment consists of many small
compartments called lobules, which contain lymphatics,
arterioles, venules, terminal bronchioles, respiratory
bronchioles, alveolar ducts, alveolar sacs, and alveoli
(Figure 23.11).

Principles of Human Anatomy and Physiology, 11e 36

 Gross Anatomy of Lungs

• Base, apex (cupula), costal surface, cardiac notch

• Oblique & horizontal fissure in right lung results in 3 lobes
• Oblique fissure only in left lung produces 2 lobes

Principles of Human Anatomy and Physiology, 11e 37

 Mediastinal Surface of Lungs

• Blood vessels & airways enter lungs at hilus

• Forms root of lungs
• Covered with pleura (parietal becomes visceral)

Principles of Human Anatomy and Physiology, 11e 38

 Structures within a
Lobule of Lung

• Branchings of single arteriole, venule & bronchiole are wrapped by elastic CT

• Respiratory bronchiole
– simple squamous
• Alveolar ducts surrounded by alveolar sacs & alveoli
– sac is 2 or more alveoli sharing a common opening

Principles of Human Anatomy and Physiology, 11e 39

 Alveoli

• Alveolar walls consist of type I alveolar (squamous

pulmonary epithelial) cells, type II alveolar (septal) cells, and
alveolar macrophages (dust cells) (Figure 23.12).
• Type II alveolar cells secrete alveolar fluid, which keeps the
alveolar cells moist and which contains a component called
surfactant. Surfactant lowers the surface tension of alveolar
fluid, preventing the collapse of alveoli with each expiration.
• Respiratory Distress Syndrome is a disorder of premature
infants in which the alveoli do not have sufficient surfactant
to remain open.
• Gas exchange occurs across the alveolar-capillary
membrane (Figure 23.12).

Principles of Human Anatomy and Physiology, 11e 40

 Histology of Lung Tissue

Photomicrograph of
lung tissue showing
bronchioles, alveoli
and alveolar ducts.

Principles of Human Anatomy and Physiology, 11e 41

 Details of
Respiratory
Membrane

Principles of Human Anatomy and Physiology, 11e 42

 Cells Types of the Alveoli

• Type I alveolar cells

– simple squamous cells where gas exchange occurs
• Type II alveolar cells (septal cells)
– free surface has microvilli
– secrete alveolar fluid containing surfactant
• Alveolar dust cells
– wandering macrophages remove debris

Principles of Human Anatomy and Physiology, 11e 43

 Alveolar-Capillary Membrane

• Respiratory membrane = 1/2 micron thick

• Exchange of gas from alveoli to blood
• 4 Layers of membrane to cross
– alveolar epithelial wall of type I cells
– alveolar epithelial basement membrane
– capillary basement membrane
– endothelial cells of capillary
• Vast surface area = handball court

Principles of Human Anatomy and Physiology, 11e 44

 Details of
Respiratory
Membrane

• Find the 4 layers that comprise the respiratory membrane

Principles of Human Anatomy and Physiology, 11e 45

 Double Blood Supply to the Lungs

• Deoxygenated blood arrives through pulmonary trunk

from the right ventricle
• Bronchial arteries branch off of the aorta to supply
oxygenated blood to lung tissue
• Venous drainage returns all blood to heart
• Less pressure in venous system
• Pulmonary blood vessels constrict in response to low O2
levels so as not to pick up CO2 on there way through the
lungs

Principles of Human Anatomy and Physiology, 11e 46

 Clinical Applications

• Nebulization, a procedure for administering medication as

small droplets suspended in air into the respiratory tract, is
used to treat many different types of respiratory disorders.

• In the lungs vasoconstriction in response to hypoxia diverts

pulmonary blood from poorly ventilated areas to well
ventilated areas. This phenomenon is known as ventilation
– perfusion coupling.

Principles of Human Anatomy and Physiology, 11e 47

 PULMONARY VENTILATION

• Respiration occurs in three basic steps: pulmonary

ventilation, external respiration, and internal respiration.
• Inspiration (inhalation) is the process of bringing air into the
lungs.
• The movement of air into and out of the lungs depends on
pressure changes governed in part by Boyle’s law, which
states that the volume of a gas varies inversely with
pressure, assuming that temperature is constant (Figure
23.13).

Principles of Human Anatomy and Physiology, 11e 48

 Breathing or Pulmonary Ventilation

• Air moves into lungs when pressure inside lungs is less

than atmospheric pressure
– How is this accomplished?
• Air moves out of the lungs when pressure inside lungs
is greater than atmospheric pressure
– How is this accomplished?
• Atmospheric pressure = 1 atm or 760mm Hg

Principles of Human Anatomy and Physiology, 11e 49

 Boyle’s Law

• As the size of closed container decreases, pressure inside is

increased
• The molecules have less wall area to strike so the pressure on each
inch of area increases.
Principles of Human Anatomy and Physiology, 11e 50
 Dimensions of the Chest Cavity

• Breathing in requires muscular activity & chest size changes

• Contraction of the diaphragm flattens the dome and increases the vertical
dimension of the chest
Principles of Human Anatomy and Physiology, 11e 51
 Inspiration
• The first step in expanding the lungs involves contraction of the
main inspiratory muscle, the diaphragm (Figure 23.14).
• Inhalation occurs when alveolar (intrapulmonic) pressure falls
below atmospheric pressure. Contraction of the diaphragm and
external intercostal muscles increases the size of the thorax,
thus decreasing the intrapleural (intrathoracic) pressure so that
the lungs expand. Expansion of the lungs decreases alveolar
pressure so that air moves along the pressure gradient from
the atmosphere into the lungs (Figure 23.15).
• During forced inhalation, accessory muscles of inspiration
(sternocleidomastoids, scalenes, and pectoralis minor) are
also used.
• A summary of inhalation is presented in Figure 23.16a.

Principles of Human Anatomy and Physiology, 11e 52

 Quiet Inspiration

• Diaphragm moves 1 cm & ribs lifted by muscles

• Intrathoracic pressure falls and 2-3 liters inhaled

Principles of Human Anatomy and Physiology, 11e 53

 Expiration
• Expiration (exhalation) is the movement of air out of the lungs.
• Exhalation occurs when alveolar pressure is higher than
atmospheric pressure. Relaxation of the diaphragm and
external intercostal muscles results in elastic recoil of the chest
wall and lungs, which increases intrapleural pressure,
decreases lung volume, and increases alveolar pressure so
that air moves from the lungs to the atmosphere. There is also
an inward pull of surface tension due to the film of alveolar fluid.
• Exhalation becomes active during labored breathing and when
air movement out of the lungs is impeded. Forced expiration
employs contraction of the internal intercostals and abdominal
muscles (Figure 23.15).
• A summary of expiration is presented in Figure 23.16b.

Principles of Human Anatomy and Physiology, 11e 54

 Quiet Expiration

• Passive process with no muscle action

• Elastic recoil & surface tension in alveoli pulls inward
• Alveolar pressure increases & air is pushed out
Principles of Human Anatomy and Physiology, 11e 55
 Labored Breathing

• Forced expiration
– abdominal mm force
diaphragm up
– internal intercostals
depress ribs
• Forced inspiration
– sternocleidomastoid,
scalenes & pectoralis
minor lift chest upwards
as you gasp for air

Principles of Human Anatomy and Physiology, 11e 56

 Intrapleural
Pressures
• Always subatmospheric
(756 mm Hg)
• As diaphragm contracts
intrathoracic pressure
decreases even more
(754 mm Hg)
• Helps keep parietal &
visceral pleura stick
together

Principles of Human Anatomy and Physiology, 11e 57

 Summary of Breathing

• Alveolar pressure decreases & air rushes in

• Alveolar pressure increases & air rushes out
Principles of Human Anatomy and Physiology, 11e 58
 Alveolar Surface Tension
• Thin layer of fluid in alveoli causes inwardly directed
force = surface tension
– water molecules strongly attracted to each other
• Causes alveoli to remain as small as possible
• Detergent-like substance called surfactant produced
by Type II alveolar cells
– lowers alveolar surface tension
– insufficient in premature babies so that alveoli
collapse at end of each exhalation

Principles of Human Anatomy and Physiology, 11e 59

 Compliance of the Lungs

• Ease with which lungs & chest wall expand depends upon
elasticity of lungs & surface tension
• Some diseases reduce compliance
– tuberculosis forms scar tissue
– pulmonary edema --- fluid in lungs & reduced surfactant
– paralysis

Principles of Human Anatomy and Physiology, 11e 60

 Airway Resistance

• Resistance to airflow depends upon airway size

– increase size of chest
• airways increase in diameter
– contract smooth muscles in airways
• decreases in diameter

Principles of Human Anatomy and Physiology, 11e 61

 Breathing Patterns

• Eupnea is normal variation in breathing rate and depth.

• Apnea refers to breath holding.
• Dyspnea relates to painful or difficult breathing.
• Tachypnea involves rapid breathing rate.
• Costal breathing requires combinations of various patterns of
intercostal and extracostal muscles, usually during need for
increased ventilation, as with exercise.
• Diaphragmatic breathing is the usual mode of operation to move
air by contracting and relaxing the diaphragm to change the
lung volume (Figure 23.14).
• Modified respiratory movements are used to express emotions
and to clear air passageways. Table 23.1 lists some of the
modified respiratory movements.

Principles of Human Anatomy and Physiology, 11e 62

 Modified Respiratory Movements

• Coughing
– deep inspiration, closure of rima glottidis & strong
expiration blasts air out to clear respiratory passages
• Hiccuping
– spasmodic contraction of diaphragm & quick closure of
rima glottidis produce sharp inspiratory sound
• Chart of others on page 794

Principles of Human Anatomy and Physiology, 11e 63

 LUNG VOLUMES AND CAPACITIES

• Air volumes exchanged during breathing and rate of ventilation are

measured with a spiromometer, or respirometer, and the record is called
a spirogram (Figure 23.17)
• Among the pulmonary air volumes exchanged in ventilation are tidal
(500 ml), inspiratory reserve (3100 ml), expiratory reserve (1200 ml),
residual (1200 ml) and minimal volumes. Only about 350 ml of the tidal
volume actually reaches the alveoli, the other 150 ml remains in the
airways as anatomic dead space.
• Pulmonary lung capacities, the sum of two or more volumes, include
inspiratory (3600 ml), functional residual (2400 ml), vital (4800 ml), and
total lung (6000 ml) capacities (Figure 23.17).
• The minute volume of respiration is the total volume of air taken in
during one minute (tidal volume x 12 respirations per minute = 6000
ml/min).

Principles of Human Anatomy and Physiology, 11e 64

 Lung Volumes and Capacities

• Tidal volume = amount air moved during quiet breathing

• MVR= minute ventilation is amount of air moved in a minute
• Reserve volumes ---- amount you can breathe either in or out above
that amount of tidal volume
• Residual volume = 1200 mL permanently trapped air in system
• Vital capacity & total lung capacity are sums of the other volumes
Principles of Human Anatomy and Physiology, 11e 65
 EXCHANGE OF OXYGEN AND CARBON DIOXIDE

• To understand the exchange of oxygen and carbon dioxide

between the blood and alveoli, it is useful to know some gas
laws.
• According to Dalton’s law, each gas in a mixture of gases
exerts its own pressure as if all the other gases were not
present.

Principles of Human Anatomy and Physiology, 11e 66

 Dalton’s Law

• Each gas in a mixture of gases exerts its own

pressure
– as if all other gases were not present
– partial pressures denoted as p
• Total pressure is sum of all partial pressures
– atmospheric pressure (760 mm Hg) = pO2 +
pCO2 + pN2 + pH2O
– to determine partial pressure of O2-- multiply 760
by % of air that is O2 (21%) = 160 mm Hg

Principles of Human Anatomy and Physiology, 11e 67

 What is Composition of Air?

• Air = 21% O2, 79% N2 and .04% CO2

• Alveolar air = 14% O2, 79% N2 and 5.2% CO2
• Expired air = 16% O2, 79% N2 and 4.5% CO2
• Observations
– alveolar air has less O2 since absorbed by blood
– mystery-----expired air has more O2 & less CO2 than
alveolar air?
– Anatomical dead space = 150 ml of 500 ml of tidal
volume

Principles of Human Anatomy and Physiology, 11e 68

 EXCHANGE OF OXYGEN AND CARBON DIOXIDE

• The partial pressure of a gas is the pressure exerted by that

gas in a mixture of gases. The total pressure of a mixture is
calculated by simply adding all the partial pressures. It is
symbolized by P.
• The partial pressures of the respiratory gases in the
atmosphere, alveoli, blood, and tissues cells are shown in
the text.
• The amounts of O2 and CO2 vary in inspired (atmospheric),
alveolar, and expired air.

Principles of Human Anatomy and Physiology, 11e 69

 Henry’s Law

• Henry’s law states that the quantity of a gas that will

dissolve in a liquid is proportional to the partial pressure of
the gas and its solubility coefficient (its physical or chemical
attraction for water), when the temperature remains
constant.
• Nitrogen narcosis and decompression sickness (caisson
disease, or bends) are conditions explained by Henry’s law.

Principles of Human Anatomy and Physiology, 11e 70

 Henry’s Law

• Quantity of a gas that will dissolve in a liquid depends upon

the amount of gas present and its solubility coefficient
– explains why you can breathe compressed air while scuba
diving despite 79% Nitrogen
• N2 has very low solubility unlike CO2 (soda cans)
• dive deep & increased pressure forces more N2 to
dissolve in the blood (nitrogen narcosis)
• decompression sickness if come back to surface too
fast or stay deep too long
• Breathing O2 under pressure dissolves more O2 in blood

Principles of Human Anatomy and Physiology, 11e 71

 Hyperbaric Oxygenation
• A major clinical application of Henry’s law is hyperbaric
oxygenation.
– Use of pressure to dissolve more O2 in the blood
– treatment for patients with anaerobic bacterial infections
(tetanus and gangrene)
– anaerobic bacteria die in the presence of O2
• Hyperbaric chamber pressure raised to 3 to 4 atmospheres
so that tissues absorb more O2
• Used to treat heart disorders, carbon monoxide poisoning,
cerebral edema, bone infections, gas embolisms & crush
injuries

Principles of Human Anatomy and Physiology, 11e 72

 Respiration

Principles of Human Anatomy and Physiology, 11e 73

 External Respiration

• O2 and CO2 diffuse from

areas of their higher partial
pressures to areas of their
lower partial pressures
(Figure 23.18)
• Diffusion depends on partial
pressure differences
• Compare gas movements in
pulmonary capillaries to
tissue capillaries

Principles of Human Anatomy and Physiology, 11e 74

 Rate of Diffusion of Gases

• Depends upon partial pressure of gases in air

– p O2 at sea level is 160 mm Hg
– 10,000 feet is 110 mm Hg / 50,000 feet is 18 mm Hg
• Large surface area of our alveoli
• Diffusion distance (membrane thickness) is very small
• Solubility & molecular weight of gases
– O2 smaller molecule diffuses somewhat faster
– CO2 dissolves 24X more easily in water so net outward
diffusion of CO2 is much faster
– disease produces hypoxia before hypercapnia
– lack of O2 before too much CO2

Principles of Human Anatomy and Physiology, 11e 75

 Internal Respiration
• Exchange of gases between
blood & tissues
• Conversion of oxygenated blood
into deoxygenated
• Observe diffusion of O2 inward
– at rest 25% of available O2
enters cells
– during exercise more O2 is
absorbed
• Observe diffusion of CO2
outward

Principles of Human Anatomy and Physiology, 11e 76

 TRANSPORT OF OXYGEN AND CARBON DIOXIDE
IN THE BLOOD

Principles of Human Anatomy and Physiology, 11e 77

 Oxygen Transport

• In each 100 ml of oxygenated blood, 1.5% of the O2 is

dissolved in the plasma and 98.5% is carried with
hemoglobin (Hb) inside red blood cells as oxyhemglobin
(HbO2) (Figure 23.19).
• Hemoglobin consists of a protein portion called globin and a
pigment called heme.
• The heme portion contains 4 atoms of iron, each capable of
combining with a molecule of oxygen.

Principles of Human Anatomy and Physiology, 11e 78

 Hemoglobin and Oxygen Partial Pressure

• The most important factor that determines how much

oxygen combines with hemoglobin is PO2.
• The relationship between the percent saturation of
hemoglobin and PO2 is illustrated in Figure 23.20, the
oxygen-hemoglobin dissociation curve.
• The greater the PO2, the more oxygen will combine with
hemoglobin, until the available hemoglobin molecules are
saturated.

Principles of Human Anatomy and Physiology, 11e 79

 Hemoglobin and Oxygen Partial Pressure

• Blood is almost fully saturated at

pO2 of 60mm
– people OK at high altitudes
& with some disease
• Between 40 & 20 mm Hg, large
amounts of O2 are released as
in areas of need like contracting
muscle

Principles of Human Anatomy and Physiology, 11e 80

 Oxygen Transport in the Blood

• Oxyhemoglobin contains 98.5% chemically combined

oxygen and hemoglobin
– inside red blood cells
• Does not dissolve easily in water
– only 1.5% transported dissolved in blood
• Only the dissolved O2 can diffuse into tissues
• Factors affecting dissociation of O2 from hemoglobin are
important
• Oxygen dissociation curve shows levels of saturation and
oxygen partial pressures

Principles of Human Anatomy and Physiology, 11e 81

 Hemoglobin and Oxygen Partial Pressure

• Blood is almost fully saturated at

pO2 of 60mm
– people OK at high altitudes
& with some disease
• Between 40 & 20 mm Hg, large
amounts of O2 are released as
in areas of need like contracting
muscle

Principles of Human Anatomy and Physiology, 11e 82

 Other Factors Affecting Hemoglobin Affinity for
Oxygen
• In an acid (low pH) environment, O2 splits more readily from
hemoglobin (Figure 23.21). This is referred to as the Bohr
effect.
• Low blood pH (acidic conditions) results from high P CO2.
• Within limits, as temperature increases, so does the amount
of oxygen released from hemoglobin (Figure 23.22). Active
cells require more oxygen, and active cells (such as
contracting muscle cells) liberate more acid and heat. The
acid and heat, in turn, stimulate the oxyhemoglobin to release
its oxygen.
• BPG (2, 3-biphosphoglycerate) is a substance formed in red
blood cells during glycolysis. The greater the level of BPG,
the more oxygen is released from hemoglobin.
Principles of Human Anatomy and Physiology, 11e 83
 Acidity & Oxygen Affinity for Hb

• As acidity
increases, O2
affinity for Hb
decreases
• Bohr effect
• H+ binds to
hemoglobin &
alters it
• O2 left behind in
needy tissues

Principles of Human Anatomy and Physiology, 11e 84

 pCO2 & Oxygen Release

• As pCO2 rises with

exercise, O2 is
released more
easily
• CO2 converts to
carbonic acid &
becomes H+ and
bicarbonate ions &
lowers pH.

Principles of Human Anatomy and Physiology, 11e 85

 Temperature & Oxygen Release

• As temperature
increases, more O2 is
released
• Metabolic activity &
heat
• More BPG, more O2
released
– RBC activity
– hormones like
thyroxine & growth
hormone

Principles of Human Anatomy and Physiology, 11e 86

 Oxygen Affinity & Fetal Hemoglobin

• Differs from adult in

structure & affinity for
O2
• When pO2 is low, can
carry more O2
• Maternal blood in
placenta has less O2

Principles of Human Anatomy and Physiology, 11e 87

 Review

Principles of Human Anatomy and Physiology, 11e 88

 Fetal Hemoglobin

• Fetal hemoglobin has a higher affinity for oxygen because it

binds BPG less strongly and can carry more oxygen to
offset the low oxygen saturation in maternal blood in the
placenta (Figure 23.23).
• Because of the strong attraction of carbon monoxide (CO) to
hemoglobin, even small concentrations of CO will reduce
the oxygen carrying capacity leading to hypoxia and carbon
monoxide poisoning. (Clinical Application)

Principles of Human Anatomy and Physiology, 11e 89

 Carbon Monoxide Poisoning

• CO from car exhaust & tobacco smoke

• Binds to Hb heme group more successfully than O2
• CO poisoning
• Treat by administering pure O2

Principles of Human Anatomy and Physiology, 11e 90

 Carbon Dioxide Transport

• CO2 is carried in blood in the form of dissolved CO2 (7%),

carbaminohemoglobin (23%), and bicarbonate ions (70%).
• The conversion of CO2 to bicarbonate ions and the related
chloride shift maintains the ionic balance between plasma
and red blood cells (Figure 23.24).

Principles of Human Anatomy and Physiology, 11e 91

 Carbon Dioxide Transport
• 100 ml of blood carries 55 ml of
CO2
• Is carried by the blood in 3 ways
– dissolved in plasma
– combined with the globin part
of Hb molecule forming
carbaminohemoglobin
– as part of bicarbonate ion
• CO2 + H2O combine to
form carbonic acid that
dissociates into H+ and
bicarbonate ion

Principles of Human Anatomy and Physiology, 11e 92

 Summary of Gas Exchange and Transport in Lungs
and Tissues
• CO2 in blood causes O2 to split from hemoglobin.
• Similarly, the binding of O2 to hemoglobin causes a release
of CO2 from blood.

Principles of Human Anatomy and Physiology, 11e 93

 Summary of Gas Exchange & Transport

Principles of Human Anatomy and Physiology, 11e 94

 CONTROL OF RESPIRATION

Principles of Human Anatomy and Physiology, 11e 95

 Respiratory Center

• The area of the brain from which nerve impulses are sent to
respiratory muscles is located bilaterally in the reticular
formation of the brain stem. This respiratory center consists
of a medullary rhythmicity area (inspiratory and expiratory
areas), pneumotaxic area, and apneustic area (Figure
23.15).

Principles of Human Anatomy and Physiology, 11e 96

 Role of the Respiratory Center

• Respiratory mm.
controlled by neurons
in pons & medulla
• 3 groups of neurons
– medullary
rhythmicity
– pneumotaxic
– apneustic centers

Principles of Human Anatomy and Physiology, 11e 97

 Medullary Rhythmicity Area

• The function of the medullary rhythmicity area is to control

the basic rhythm of respiration.
• The inspiratory area has an intrinsic excitability of
autorhythmic neurons that sets the basic rhythm of
respiration.
• The expiratory area neurons remain inactive during most
quiet respiration but are probably activated during high
levels of ventilation to cause contraction of muscles used in
forced (labored) expiration (Figure 23.26).

Principles of Human Anatomy and Physiology, 11e 98

 Medullary Rhythmicity Area
• Controls basic rhythm of respiration
• Inspiration for 2 seconds, expiration for 3
• Autorhythmic cells active for 2 seconds then inactive
• Expiratory neurons inactive during most quiet breathing only active
during high ventilation rates

Principles of Human Anatomy and Physiology, 11e 99

 Pneumotaxic Area

• The pneumotaxic area in the upper pons helps coordinate

the transition between inspiration and expiration (Figure
23.25).
• The apneustic area sends impulses to the inspiratory area
that activate it and prolong inspiration, inhibiting expiration.

Principles of Human Anatomy and Physiology, 11e 100

 Regulation of Respiratory Center

• Cortical Influences
– voluntarily alter breathing patterns
– Cortical influences allow conscious control of respiration
that may be needed to avoid inhaling noxious gasses or
water.
– Voluntary breath holding is limited by the overriding
stimuli of increased [H+] and [CO2].
• inspiratory center is stimulated by increase in either
• if you hold breathe until you faint----breathing will
resume

Principles of Human Anatomy and Physiology, 11e 101

 Chemoreceptor Regulation of Respiration

• A slight increase in PCO2 (and thus H+), a condition called

hypercapnia, stimulates central chemoreceptors (Figure
23.26).
• As a response to increased PCO2, increased H+ and decreased
PO2, the inspiratory area is activated and hyperventilation,
rapid and deep breathing, occurs (Figure 23.28).
• If arterial PCO2 is lower than 40 mm Hg, a condition called
hypocapnia, the chemoreceptors are not stimulated and the
inspiratory area sets its own pace until CO2 accumulates and
PCO2 rises to 40 mm Hg.
• Severe deficiency of O2 depresses activity of the central
chemoreceptors and respiratory center (Figure 23.29).

Principles of Human Anatomy and Physiology, 11e 102

 Chemical Regulation of Respiration

• Central chemoreceptors in medulla

– respond to changes in H+ or pCO2
– hypercapnia = slight increase in
pCO2 is noticed
• Peripheral chemoreceptors
– respond to changes in H+ , pO2 or
PCO2
– aortic body---in wall of aorta
• nerves join vagus
– carotid bodies--in walls of common
carotid arteries
• nerves join glossopharyngeal
nerve

Principles of Human Anatomy and Physiology, 11e 103

 Negative Feedback Regulation of
Breathing

• Negative feedback control of

breathing
• Increase in arterial pCO2
• Stimulates receptors
• Inspiratory center
• Muscles of respiration contract
more frequently & forcefully
• pCO2 Decreases

Principles of Human Anatomy and Physiology, 11e 104

 Control of Respiratory Rate

• Proprioceptors of joints and muscles activate the inspiratory

center to increase ventilation prior to exercise induced
oxygen need.
• The inflation (Hering-Breuer) reflex detects lung expansion
with stretch receptors and limits it depending on ventilatory
need and prevention of damage.
• Other influences include blood pressure, limbic system,
temperature, pain, stretching the anal sphincter, and
irritation to the respiratory mucosa.
• Table 23.2 summarizes the changes that increase or
decrease ventilation rate and depth.

Principles of Human Anatomy and Physiology, 11e 105

 Regulation of Ventilation Rate and Depth

Principles of Human Anatomy and Physiology, 11e 106

 Hypoxia

• Hypoxia refers to oxygen deficiency at the tissue level and is

classified in several ways (Clinical Application).
– Hypoxic hypoxia is caused by a low PO2 in arterial blood
(high altitude, airway obstruction, fluid in lungs).
– In anemic hypoxia, there is too little functioning hemoglobin
in the blood (hemorrhage, anemia, carbon monoxide
poisoning).
– Stagnant hypoxia results from the inability of blood to carry
oxygen to tissues fast enough to sustain their needs (heart
failure, circulatory shock).
– In histotoxic hypoxia, the blood delivers adequate oxygen
to the tissues, but the tissues are unable to use it properly
(cyanide poisoning).
Principles of Human Anatomy and Physiology, 11e 107
 EXERCISE AND THE RESPIRATORY SYSTEM

• The respiratory system works with the cardiovascular system to make

appropriate adjustments for different exercise intensities and durations.
• As blood flow increases with a lower O2 and higher CO2 content, the
amount passing through the lung (pulmonary perfusion) increases and
is matched by increased ventilation and oxygen diffusion capacity as
more pulmonary capillaries open.
• Ventilatory modifications can increase 30 times above resting levels, in
an initial rapid rate due to neural influences and then more gradually due
to chemical stimulation from changes in cell metabolism. A similar, but
reversed, effect occurs with cessation of exercise.
• Smokers have difficulty breathing for a number of reasons, including
nicotine, mucous, irritants, and that fact that scar tissue replaces elastic
fibers.

Principles of Human Anatomy and Physiology, 11e 108

 Smokers Lowered Respiratory Efficiency

• Smoker is easily “winded” with moderate exercise

– nicotine constricts terminal bronchioles
– carbon monoxide in smoke binds to hemoglobin
– irritants in smoke cause excess mucus secretion
– irritants inhibit movements of cilia
– in time destroys elastic fibers in lungs & leads to
emphysema
• trapping of air in alveoli & reduced gas exchange

Principles of Human Anatomy and Physiology, 11e 109

 DEVELOPMENT OF THE RESPIRATORY SYSTEM

• The respiratory system begins as an outgrowth of the

foregut called the respiratory diverticulum (Figure 23.29).
• The endoderm of the diverticulum gives rise to the
epithelium and glands of the trachea, bronchi, and alveoli.
• The mesoderm of the diverticulum produces the connective
tissue, cartilage, smooth muscle, and pleural sacs.
• Epithelium of the larynx develops from the endoderm of the
respiratory diverticulum while pharyngeal arches 4 and 6
produce the cartilage and muscle of the structure.
• Distal ends of the respiratory diverticulum develop into the
tracheal buds and a little later the bronchial buds

Principles of Human Anatomy and Physiology, 11e 110

 The time line for development of the respiratory
system
• 6 – 16 weeks the basic structures are formed
• 16 – 26 weeks vascularization and the development of
respiratory bronchioles, alveolar ducts and some alveoli
begins
• 26 weeks to birth many more alveoli develop
• By 26 – 28 weeks there is sufficient surfactant for survival.

Principles of Human Anatomy and Physiology, 11e 111

 Developmental Anatomy of Respiratory System

• 4 weeks endoderm of foregut

gives rise to lung bud
• Differentiates into epithelial lining
of airways
• 6 months closed-tubes swell into
alveoli of lungs

Principles of Human Anatomy and Physiology, 11e 112

 Aging & the Respiratory System

• Respiratory tissues & chest wall become more rigid

• Vital capacity decreases to 35% by age 70.
• Decreases in macrophage activity
• Diminished ciliary action
• Decrease in blood levels of O2
• Result is an age-related susceptibility to pneumonia or
bronchitis

Principles of Human Anatomy and Physiology, 11e 113

 Disorders of the Respiratory System
• Asthma
• Chronic obstructive pulmonary disease
– Emphysema
– Chronic bronchitis
– Lung cancer
• Pneumonia
• Tuberculosis
• Coryza and Influenza
• Pulmonary Edema
• Cystic fibrosis

Principles of Human Anatomy and Physiology, 11e 114

 Pneumothorax

• Pleural cavities are sealed cavities not open to the outside

• Injuries to the chest wall that let air enter the intrapleural
space
– causes a pneumothorax
– collapsed lung on same side as injury
– surface tension and recoil of elastic fibers causes the
lung to collapse

Principles of Human Anatomy and Physiology, 11e 115

 DISORDERS: HOMEOSTATIC IMBALANCES
• Asthma is characterized by the following: spasms of smooth muscle in
bronchial tubes that result in partial or complete closure of air
passageways; inflammation; inflated alveoli; and excess mucus
production. A common triggering factor is allergy, but other factors
include emotional upset, aspirin, exercise, and breathing cold air or
cigarette smoke.
• Chronic obstructive pulmonary disease (COPD) is a type of respiratory
disorder characterized by chronic and recurrent obstruction of air flow,
which increases airway resistance.
– The principal types of COPD are emphysema and chronic bronchitis.
– Bronchitis is an inflammation of the bronchial tubes, the main
symptom of which is a productive (raising mucus or sputum) cough.

Principles of Human Anatomy and Physiology, 11e 116

 DISORDERS: HOMEOSTATIC IMBALANCES
• In bronchogenic carcinoma (lung cancer), bronchial epithelial cells are
replaced by cancer cells after constant irritation has disrupted the
normal growth, division, and function of the epithelial cells. Airways are
often blocked and metastasis is very common. It is most commonly
associated with smoking.
• Pneumonia is an acute infection of the alveoli. The most common
cause in the pneumococcal bacteria but other microbes may be
involved. Treatment involves antibiotics, bronchodilators, oxygen
therapy, and chest physiotherapy.
• Tuberculosis (TB) is an inflammation of pleurae and lungs produced by
the organism Mycobacterium tuberculosis. It is communicable and
destroys lung tissue, leaving nonfunctional fibrous tissue behind.
• Coryza (common cold) is caused by viruses and usually is not
accompanied by a fever, whereas influenza (flu) is usually accompanied
by a fever greater than 101oF.

Principles of Human Anatomy and Physiology, 11e 117

 DISORDERS: HOMEOSTATIC IMBALANCES
• Pulmonary edema refers to an abnormal accumulation of interstitial fluid
in the interstitial spaces and alveoli of the lungs. It may be pulmonary or
cardiac in origin.
• Cystic fibrosis is an inherited disease of secretory epithelia that affects
the respiratory passageways, pancreas, salivary glands, and sweat
glands.
• Asbestos related diseases develop as a result of inhaling asbestos
particles. Diseases such as asbestosis, diffuse pleural thickening, and
mesothelioma may result.
• Sudden infant death syndrome (SIDS) is the sudden unexpected death
of an apparently healthy infant. Peak incidence is ages two to four
months. The exact cause is unknown.
• Severe acute respiratory syndrome (SARS) is an emerging infectious
disease.

Principles of Human Anatomy and Physiology, 11e 118

 end

Principles of Human Anatomy and Physiology, 11e 119