Respiratory

Introduction to the Respiratory System

lungs

The lungs flank the heart and great vessels in the chest cavity. (Source: Gray’s Anatomy of the Human Body, 20th ed. 1918.)

The Respiratory System is crucial to every human being. Without it, we would cease to live outside of the womb. Let us begin by taking a look at the structure of the respiratory system and how vital it is to life. During inhalation or exhalation air is pulled towards or away from the lungs, by several cavities, tubes, and openings. The organs of the respiratory system make sure that oxygen enters our bodies and carbon dioxide leaves our bodies. The respiratory tract is the path of air from the nose to the lungs. It is divided into two sections: Upper Respiratory Tract and the Lower Respiratory Tract. Included in the upper respiratory tract are the Nostrils, Nasal Cavities, Pharynx, Epiglottis, and the Larynx. The lower respiratory tract consists of the Trachea, Bronchi, Bronchioles,
and the Lungs. As air moves along the respiratory tract it is warmed, moistened and filtered.

Functions
In this chapter we will discuss the four processes of respiration. They are:
1. BREATHING or ventilation
2. EXTERNAL RESPIRATION, which is the exchange of gases (oxygen and carbon
dioxide) between inhaled air and the blood.
3. INTERNAL RESPIRATION, which is the exchange of gases between the blood
and tissue fluids.
4. CELLULAR RESPIRATION
In addition to these main processes, the respiratory system serves for:
• REGULATION OF BLOOD pH, which occurs in coordination with the kidneys,
and as a
• DEFENSE AGAINST MICROBES
• Control of body temperature due to loss of evaporate during expiration

Breathing and Lung Mechanics
Ventilation is the exchange of air between the external environment and the alveoli. Air moves by bulk flow from an area of high pressure to low pressure. All pressures in the respiratory system are relative to atmospheric pressure (760mmHg at sea level). Air will move in or out of the lungs depending on the pressure in the alveoli. The body changes the pressure in the alveoli by changing the volume of the lungs. As volume increases pressure decreases and as volume decreases pressure increases. There are two phases of ventilation; inspiration and expiration. During each phase the body changes the lung dimensions to produce a flow of air either in or out of the lungs. The body is able to stay at the dimensions of the lungs because of the relationship of the lungs to the thoracic wall. Each lung is completely enclosed in a sac called the pleural sac. Two structures contribute to the formation of this sac. The parietal pleura is attached to the thoracic wall where as the visceral pleura is attached to the lung itself. In-between these two membranes is a thin layer of intrapleural fluid. The intrapleural fluid completely surrounds the lungs and lubricates the two surfaces so that they can slide across each other. Changing
the pressure of this fluid also allows the lungs and the thoracic wall to move together during normal breathing. Much the way two glass slides with water in-between them are difficult to pull apart, such is the relationship of the lungs to the thoracic wall. The rhythm of ventilation is also controlled by the “Respiratory Center” which is located largely in the medulla oblongata of the brain stem. This is part of the autonomic system and as such is not controlled voluntarily (one can increase or decrease breathing rate voluntarily, but that involves a different part of the brain). While resting, the respiratory center sends out action potentials that travel along the phrenic nerves into the diaphragm and the external intercostal muscles of the rib cage, causing inhalation. Relaxed exhalation occurs between impulses when the muscles relax. Normal adults have a breathing rate of 12-20 respirations per minute.

The Pathway of Air
When one breathes air in at sea level, the inhalation is composed of different gases. These gases and their quantities are Oxygen which makes up 21%, Nitrogen which is 78%, Carbon Dioxide with 0.04% and others with significantly smaller portions.

Phary Gray994

Diagram of the Pharynx

In the process of breathing, air enters into the nasal cavity through the nostrils and is filtered by coarse hairs (vibrissae) and mucous that are found there. The vibrissae filter macroparticles, which are particles of large size. Dust, pollen, smoke, and fine particles are trapped in the mucous that lines the nasal cavities (hollow spaces within the bones of the skull that warm, moisten, and filter the air). There are three bony projections inside the
nasal cavity. The superior, middle, and inferior nasal conchae. Air passes between these conchae via the nasal meatuses. Air then travels past the nasopharynx, oropharynx, and laryngopharynx, which are the three portions that make up the pharynx. The pharynx (1 ) is a funnel-shaped tube that connects our nasal and oral cavities to the larynx. The tonsils which are part of the lymphatic system, form a ring at the connection of the oral cavity and the pharynx. Here, they protect against foreign invasion of antigens. Therefore the respiratory tract aids the immune system through this protection. Then the air travels through the larynx. The larynx closes at the epiglottis to prevent the passage of food or drink as a protection to our trachea and lungs.

——————
1 http://en.wikipedia.org/wiki/pharynx

The larynx is also our voicebox; it contains vocal cords, in which it produces sound. Sound is produced from the vibration of the vocal cords when air passes through them. The trachea, which is also known as our windpipe, has ciliated cells and mucous secreting cells lining it, and is held open by C-shaped cartilage rings. One of its functions is similar to the larynx and nasal cavity, by way of protection from dust and other particles. The dust will adhere to the sticky mucous and the cilia helps propel it back up the trachea, to where it is either swallowed or coughed up. The mucociliary escalator extends from the top of the trachea all the way down to the bronchioles, which we will discuss later. Through the trachea, the air is now able to pass into the bronchi.

Inspiration
Inspiration is initiated by contraction of the diaphragm and in some cases the intercostals muscles when they receive nervous impulses. During normal quiet breathing, the phrenic nerves stimulate the diaphragm to contract and move downward into the abdomen. This downward movement of the diaphragm enlarges the thorax.
When necessary, the intercostal muscles also increase the thorax by contacting and drawing the ribs upward and outward. As the diaphragm contracts inferiorly and thoracic muscles pull the chest wall outwardly, the volume of the thoracic cavity increases. The lungs are held to the thoracic wall by negative pressure in the pleural cavity, a very thin space filled with a few milliliters of lubricating pleural fluid. The negative pressure in the pleural cavity is enough to hold the lungs open in spite of the inherent elasticity of the tissue. Hence, as the thoracic cavity increases in volume the lungs are pulled from all sides to expand, causing a drop in the pressure (a partial vacuum) within the lung itself (but note that this negative pressure is still not as great as the negative pressure within the pleural cavity–otherwise the lungs would pull away from the chest wall). Assuming the airway is open, air from the external environment then follows its pressure gradient down and expands the alveoli of the lungs, where gas exchange with the blood takes place. As long as pressure within the alveoli is lower than atmospheric pressure air will continue to move inwardly, but as soon as the pressure is stabilized air movement stops.

Expiration
During quiet breathing, expiration is normally a passive process and does not require muscles to work (rather it is the result of the muscles relaxing). When the lungs are stretched and expanded, stretch receptors within the alveoli send inhibitory nerve impulses to the medulla oblongata, causing it to stop sending signals to the rib cage and diaphragm to contract. The muscles of respiration and the lungs themselves are elastic, so when the diaphragm and intercostal muscles relax there is an elastic recoil, which creates a positive pressure (pressure in the lungs becomes greater than atmospheric pressure), and air moves out of the lungs by flowing down its pressure gradient. Although the respiratory system is primarily under involuntary control, and regulated by the medulla oblongata, we have some voluntary control over it also. This is due to the higher brain function of the cerebral cortex. When under physical or emotional stress, more frequent and deep breathing is needed, and
both inspiration and expiration will work as active processes. Additional muscles in the rib cage forcefully contract and push air quickly out of the lungs. In addition to deeper breathing, when coughing or sneezing we exhale forcibly. Our abdominal muscles will contract suddenly (when there is an urge to cough or sneeze), raising the abdominal pressure. The rapid increase in pressure pushes the relaxed diaphragm up against the pleural cavity. This causes air to be forced out of the lungs. Another function of the respiratory system is to sing and to speak. By exerting conscious control over our breathing and regulating flow of air across the vocal cords we are able to create and modify sounds.

Lung Compliance
Lung Compliance is the magnitude of the change in lung volume produced by a change in pulmonary pressure. Compliance can be considered the opposite of stiffness. A low lung compliance would mean that the lungs would need a greater than average change in intrapleural pressure to change the volume of the lungs. A high lung compliance would indicate that little pressure difference in intrapleural pressure is needed to change the
volume of the lungs. More energy is required to breathe normally in a person with low lung compliance. Persons with low lung compliance due to disease therefore tend to take shallow breaths and breathe more frequently.
Determination of Lung Compliance: Two major things determine lung compliance. The first is the elasticity of the lung tissue. Any thickening of lung tissues due to disease will decrease lung compliance. The second is surface tensions at air water interfaces in the alveoli. The surface of the alveoli cells is moist. The attractive force, between the water cells on the alveoli, is called surface tension. Thus, energy is required not only to expand the tissues of the lung but also to overcome the surface tension of the water that lines the alveoli. To overcome the forces of surface tension, certain alveoli cells (Type II pneumocytes) secrete a protein and lipid complex called “Surfactant”, which acts like a detergent by disrupting the hydrogen bonding of water that lines the alveoli, hence decreasing surface tension.
 Control of respiration
central control
Peripheral control
CO2 is converted to HCO3; most CO2 produced at the tissue cells is carried to lungs in the
form of HCO3
• CO2 & H2O form carbonic acid (H2CO3)
• changes to H CO3 & H+ ions
• result is H+ ions are buffered by plasma proteins

Source: Cray MI,  Ch. 9 The Respiratory System ,Textbook of Human Physiology and Biophysics, V#1. Atlanta Ga: IVMS 2014:240-43

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