ANAPHY 101: Anatomy and Physiology

LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

Organs of the Respiratory System - Bronchioles

- Alveoli (air sacs)
• Nose
• Oversees gas exchange between the
• Pharynx
blood and external environment
• Larynx
• Alveoli: where exchanging of gases
• Trachea occur
• Bronchi • Passageway of the lungs purify, warm,
• Lungs – alveoli and humidify the incoming air

The Nose

• The only externally visible part of the

respiratory system
• Air enters the nose through the
external nares (nostrils)
• The interior of the nose consists of a
nasal cavity divided by a nasal septum

Main Functions of the Respiratory System

• Oxygenation and Ventilation of tissues

• Air pass through:
o Nose
- Nostrils
o Pharynx
- Nasopharynx
- Oropharynx
- Laryngopharynx
Note:
o Larynx (voice box)
o Trachea (windpipe) The External Nares is provided with hair like
o Bronchi structures called cilia
- Primary/Main Stem: from
-Cilia: filters the air that enters the nasal cavity
the trachea
▪ Left and Right Main
Stem
- Secondary Bronchi
- Tertiary Bronchi
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

Anatomy of the Nasal Cavity o Oropharynx: middle region

behind mouth
• Olfactory receptors are located in the
o Laryngopharynx: inferior region
mucosa on the superior surface where
attached to larynx
the cribriform plates of the ethmoid
• The oropharynx and laryngopharynx are
bone are found
common passageways for air and food
• The rest of the cavity is lined with
• The nasopharynx serves only as
respiratory mucosa:
passageway for air
o Moistens air
o Entraps incoming foreign Structures of the Pharynx
particles
• Auditory tubes enter the nasopharynx
• Lateral walls have projections called
• Tonsils of the pharynx
conchae
o Pharyngeal Tonsil (adenoids): in
o Increase surface area exposed
the nasopharynx
to air
o Palatine Tonsils: in oropharynx
o Increase air turbulence within
o Lingual Tonsils: at base of the
the nasal cavity
tongue
• The nasal cavity is separated from the
oral cavity by the palate Note:
o Anterior Hard Palate (bone)
o Posterior Soft Palate (muscle) Tonsils form the Waldeyer’s Ring that protects
the upper respiratory tract from invasion by
Paranasal Sinuses bacteria
• Cavities within bones surrounding the
nasal cavity
Larynx (Voice Box)
o Frontal Bone
o Sphenoid Bone • Made of eight rigid hyaline cartilages
o Ethmoid Bone and a spoon-shaped flap of elastic
o Maxillary Bone cartilage (epiglottis: guardian of the
• Functions of the sinuses: airways)
o Lighten the skull • Routed air (respiratory tract) and food
o Act as resonance chambers for (esophagus) into proper channels
speech • Plays a role in speech
o Produce mucus that drains into • Voice Box: Vocal Cords
the nasal cavity
Structures of the Larynx
Pharynx (Throat)
• Thyroid Cartilage
• Muscular passage from the nasal cavity o Larges hyaline cartilage
to the larynx o Protrudes anteriorly (Adam’s
• Three regions: apple)
o Nasopharynx: superior region • Epiglottis
behind nasal cavity
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

o Superior opening of the larynx Lungs

o Routes food to the larynx and
• Occupy most of the thoracic cavity
air toward the trachea
o Apex is near the clavicle
o Made up of elastic cartilage
(superior portion)
• Vocal cords (vocal folds)
o Base rests on the diaphragm
o Vibrate with expelled air to
(inferior portion)
create sound (speech)
• Each lung is divided into lobes by
• Glottis (Rima Glottidis)
fissures:
o Opening between vocal cords
o Left lung: two lobes divided by
Trachea (Windpipe) an oblique fissure
o Right lung: three lobes (upper,
• Connects larynx with bronchi
middle, lower lobe) divided by
• Pseudostratified Ciliated Columnar transverse and oblique fissure
Epithelium
• Lined with ciliated mucosa:
o Beat continuously in the
opposite direction of incoming
air
o Expel mucus loaded with dust
and other debris away from the
lungs
• Walls are reinforced with C-shaped
hyaline cartilage

Primary Bronchi

• Distal end of trachea

Note:
• Formed by the division of the trachea
• Enters the lung at the hilus (medial -R and L Main Stem Brochi sundivides to
depression) secondary, tertiary, and smaller stem bronchi
• Right bronchus is wider, shorter, and
straighter than left
• Bronchi subdivide into smaller and Coverings of the Lungs
smaller branches
• Pulmonary (visceral) pleura covers the
lung surface
Note: o Inner layer
• Parietal pleura lines the walls of the
Primary stem of Bronchi, right and left are
thoracic cavity
found in Carina
o Outer layer
• Pleura fluid fills the area between layers
of pleura to allow gliding
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

Respiratory Tree Divisions • Gas exchange takes place within alveoli

in the respiratory membrane
• Primary Bronchi
• Structure of Alveoli
• Secondary Bronchi
o Alveolar Duct
• Tertiary Bronchi
o Alveolar Sac
• Bronchiole o Alveolus
• Terminal Bronchiole
Respiratory Membrane (Air-Blood Barrier)
Bronchioles
• Thin squamous epithelial layer lining
• Smallest branches of the bronchi alveolar walls
• All but the smallest branches have • Pulmonary capillaries cover external
reinforcing cartilages surfaces of alveoli
• Terminal bronchioles end in alveoli

Note:

The Pulmonary capillary blood unloads carbon

Note: Respiratory Zone dioxide in favor of oxygen

Attached to Terminal Bronchioles

-Respiratory Bronchiole Gas Exchange

-Alveolar Duct • Gas crosses the respiratory membrane

by diffusion (passive transport)
-Alveolar Sac o Oxygen enters the blood
o Carbon dioxide enters the
-Alveoli
alveoli
Respiratory Zone serves as site of gas exchange
Events of Respiration

• Pulmonary Ventilation (breathing):

Alveoli moving air in and out of the lungs
• External Respiration: gas exchange
between pulmonary blood and alveoli
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

• Respiratory gas transport: transport of o Expiration: air leaving the lungs

oxygen and carbon dioxide via the - Largely a passive process
bloodstream which depends on natural
• Internal respiration: gas exchange lung elasticity
between blood and tissue cells in - As muscles (diaphragm)
systemic capillaries relax, air is pushed out of
the lungs
Mechanics of Breathing (Pulmonary Ventilation) - Forced expiration can occur
• Completely a mechanical process mostly by contracting
• Depends on volume changes in the internal intercoastal
thoracic cavity muscles to depress the rib
• Volume changes lead to pressure cage
changes, which lead to the flow of gases - Diaphragm Relax: move
to equalize pressure superiorly
• Two phases: - External intercoastal
o Inspiration: flow of air into the muscles: ribs and sternum
lungs are depressed
- Diaphragm and intercoastal ▪ There is generalized
muscles contract decrease in the
- The size of the thoracic intrathoracic
cavity increases volume while
- External air is pulled into elevating the
the lungs due to an increase intrathoracic
in intrapulmonary volume pressure
- Diaphragm contracts: move
inferiorly
- External intercostal muscles
contract: move forward,
widening the ribcage
▪ There is generalized
increase in the
intrathoracic
volume

Pressure Differences in the Thoracic Cavity

• Normal pressure within the pleura

space is always negative (intrapleural
pressure)
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

• Differences in lung and pleural space • Dead space volume (150ml) vs

pressures keep lungs from collapsing Functional volume (350ml)
o Air that remains in conducting
Respiratory Volumes and Capacities
zone and never reaches alveoli
• Normal breathing moves about 500ml
Spirometer
of air with each breath (tidal volume –
TV)
• Many factors affect respiratory capacity
o Body mass
o Sex
o Age
o Physical condition
• Inspiratory Reserve Volume (IRV)
o Amount of air that can be taken
in forcibly over the tidal volume
o Usually between 2100 and 3200
ml
• Expiratory Reserve Volume (ERV)
o Amount of air that can be
forcibly exhales Note:
o Approximately 1200 ml Tidal Volume: volume of air that moves in and
• Residual Volume (RV) out of the lungs during regular breathing
o Air remaining in lung after the
expiration IRV: allowance of air that can still be inhaled
o About 1200 ml after tidal breathing
• Vital Capacity (VC) ERV: volume of air that can still be expelled
o Total amount of exchangeable from the lungs after tidal breathing
air
o Vital Capacity = TV + IRV + ERV RV: volume of air that remain in the lungs to
• Inspiratory Capacity (IC) keep alveoli inflated at all times
o Maximum volume of air that
can be inspired after reaching
the end of a normal quiet External Respiration
expiration
• Oxygen movement into the body
o TV + IRV
o The alveoli have more oxygen
• Functional Residual Capacity (FRC)
than the blood
o The volume remaining in the
o Oxygen moves by diffusion
lungs after a normal, passive
towards the area of lower
exhalation
concentration (toward blood)
o 3L in normal individual
o Pulmonary capillary blood gains
o ERV + RV
oxygen
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

Note: Internal Respiration

Movement of oxygen and carbon dioxide • Exchange of gases between systemic

between the alveoli of the lungs and the capillary blood and body cells (tissues)
pulmonary capillary blood • An opposite reaction to what occurs in
the lungs (external respiration)
• Carbon dioxide movement out of the
o Carbon dioxide diffuses out of
blood
tissue to blood
o Blood returning from tissues
o Oxygen diffuses from blood into
has higher concentrations of
the tissue
carbon dioxide than air in the
alveoli
o Pulmonary capillary blood gives
up carbon dioxide
• Blood leaving the lungs is oxygen-rich
and carbon dioxide-poor

Note:

As pulmonary capillary blood gains oxygen, its

carbon dioxide is unloaded in favor of the
alveoli in the lungs

Gas Transport in the Blood

• Means of oxygen transport in the

blood:
o Inside red blood cells attached
to hemoglobin (as
oxyhemoglobin [HbO2])
o A small amount is carried
dissolved in the plasma
• Means of carbon dioxide transport in
the blood:
o Most is transported in the
plasma as bicarbonate ion
(HCO3-)
o A small amount is carried inside
RBC on hemoglobin, but at
different binding sites than
those of oxygen
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

Neural Regulation of Respiration Note:

• Activity of respiratory muscles in Elevated levels of carbon dioxide in the blood

transmitted to the brain by the phrenic acts directly to stimulate the neural centers
(nerve supply to diaphragm) and located in the brain (pons and medulla
intercoastal nerves (nerve supply to oblongata)
external intercoastal muscles)
Drop in the oxygen level in the blood would first
• Neural centers that control rate and
stimulate the autosensors located in the aortic
depth are located in the medulla
arch
oblongata
• The pons appears to smooth out Neurocenters in the pons and medulla
respiratory rate oblangata once stimulated should send nerve
• Normal respiratory rate (eupnea) is 12- impulses via phrenic nerve and intercoastal
15 respirations per minute nerves
• Hyperpnea is increased respiratory rate
-to stimulate the diaphragm and external
often due to heightened oxygen needs
intercoastal muscles respectively to undergo
contraction

Factors Influencing Respiratory Rate and Depth

• Physical Factors:
o Increased body temperature
o Exercise
o Talking
o Coughing
• Volition (conscious control)
• Emotional Factors
• Chemical Factors:
o Carbon dioxide levels
- Level of carbon dioxide in
the blood is the main
regulatory chemical for
respiration
- Increased carbon dioxide
inreases respiration
- Changes in carbon dioxide
act directly on the medulla
oblongata
o Oxygen levels
- Changes in oxygen
concentration in the blood
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

are detected by the Chronic Bronchitis

chemoreceptors in the
• Mucosa of the lower respiratory
aorta and carotid artery
passages becomes severely inflamed
- Information is sent to the
medulla oblongata • Mucus production increases
• Pooled mucus impairs ventilation and
Respiratory Disorders: Chronic Obstructive gas exchange
Pulmonary Disease (COPD) • Risk of lung infection increases
• Pneumonia is common
• Exemplified by chronic bronchitis and
emphysema • Hypoxia and cyanosis occur early
• Features of COPD: • Chronic Bronchitis patients are called
o Patients almost always have a “blue bloater”
history of smoking
o Labored breathing (dyspnea)
becomes progressively more
severe
o Coughing and frequent
pulmonary infectios are
common
o Most victims retain carbon
dioxide, are hypoxic and have
respiratory acidosis
o Ultimately leads to respiratpry
failure

Emphysema

• Alveoli enlarge as adjacent chambers

break through
• Chronic inflammation promotes lung
fibrosis
• Airways collapse during expiration
• Patients use a large amount of energy Lung Cancer
to exhale
• Increased incidence associated with
• Overinflation of the lungs leads to a
smoking
permanently expanded barrel chest
• 2 main types of lung cancer:
• Cyanosis apperas late in the disease
o Small cell lung cancer (SCLC)
• Emphysema patient are called “pink
- Starts in the bronchi, then
puffers”
quickly grows and spread to
other parts of the body
including the lymph nodes
 ANAPHY 101: Anatomy and Physiology
LECTURE 10: The Respiratory System

BACHELOR OF SCIENCE IN NURSING – MENDES, ANGELA ALIZON

1ST SEMESTER A.Y. 2022 – 2023

- Represent fewer than 20% of Sudden Infant Death Syndrome (SIDS)

lung cancers
- Typically caused by tobacco • Apparently healthy infant stops breathing
smoking and dies during sleep
- Oat-cell cancer • Problem of the neural respiratory control
o Non-small cell lung cancer (NSCLC) center (?)
- Most common type of lung • One third of the cases appear to be due to
cancer heart rhythm abnormalities
- Accounts for nearly 9/10 cases Asthma
- Usually grows at a slower rate
than SCLC • Chronically inflamed hypersensitive
- Most often develops slowly bronchiole passages
and causes few or no • Dyspnea, coughing, and wheezing
symptoms until it has • Airway inflammation, intermittent airflow
advanced obstruction, and bronchiole hyper
responsiveness
3 Main Types of NCLC
Developmental Aspects of Respiratory System
1. Adenocarcinoma of the Lung
o Most common form of lung cancer • Lungs are filled with fluid in the fetus
o 30% of all cases overall, 40% of • Lungs are not fully inflated with air until
non-small cell cancer occurrences two weeks after birth
o Found in several common cancers, • Surfactant that lowers alveolar surface
including breast, prostate, and tension is not present until late in fetal
colorectal development and may not be present in
o Adenocarcinomas of the lung are premature babies
found in the outer region of the
lung, in glans that secrete mucus Aging Effects
and help us breathe
• Elasticity of lungs decreases
o Symptoms:
• Vital capacity decreases
- Coughing
• Blood oxygen levels decrease
- Hoarseness
• Stimulating effects of carbon dioxide
- Weight loss
decreases
- Weakness
• Increased risk for respiratory tract
2. Squamous Cell CA
infections
o Found centrally in the lung, where
the larger bronchi join the trachea Respiratory Rate Changes Throughout Life
to the lung, or in one of the main
airway branches • Newborns: 40-80 respirations/min
o Responsible for about 30% of all • Infants: 30 respirations/min
non-small cell lung cancers • Age 5: 25 respirations/min
o Generally linked to smoking • Adults: 12-18 respiration/min
3. Large-cell Undifferentiated Carcinoma • Rate often increases with old age
o Grows and spreads quickly
o Can be found anywhere in the lung
o Accounts for 10-15% of all cases of
NSCLC