The Respiratory System

Introduction
At the cellular level, cellular respiration produces energy in the form of ATP. Oxidative
phosphorylation requires oxygen as a reactant and produces carbon dioxide as a waste
product. Carbon dioxide and oxygen are exhaled through the functions of the respiratory
system.

Organs and Structures of the Respiratory System

1. Conducting Zone – organs and structures not involved directly in gas exchange
a. The Nose and its Adjacent Structures
i. Major entrance and exit for respiratory system
ii. External nose – surface and skeletal structures that result in outward
appearance and contribute to functions
1. Root = between eyebrows
2. Bridge = connects root to rest of nose
3. Dorsum nasi = length of nose; formed from septal cartilage
(hyaline)
4. Apex = tip of nose
5. Ala = cartilaginous structure that forms lateral naris (plural =
nares), or nostril openings
6. Philtrum = concave surface connecting apex to upper lip
7. Nasal bone – underlies root and bridge
8. Alar cartilage – consists of apex; surrounds nares

iii. Internal nose, or nasal cavity

1. Nasal septum – formed anteriorly by septal cartilage and
posteriorly by the perpendicular plate of ethmoid bone and
vomer bones
a. Lateral walls have conchae – upper, middle, and lower,
which increase surface area of nasal cavity and disrupt
air flow and causing turbulence against nasal
epithelium, cleaning, warming, and moisturizing the air
b. Conchae and meatuses (spaces between conchae) also
conserve water and prevent dehydration of nasal
epithelium by trapping exhaled water
2. Floor of nasal cavity is the palate – hard palate (bone)
anteriorly and soft palate (muscle) posteriorly
3. Paranasal sinuses – spaces within bones forming walls of
nasal cavity; named for associated bones: frontal sinus,
maxillary sinus, sphenoidal sinus, ethmoidal sinus
 a. Sinuses produce mucus and lighten weight of skull
4. Lined with respiratory epithelium – pseudostratified ciliated
columnar epithelial tissue with goblet cells (produce mucus to
trap debris)
iv. Pharynx – continuous with the nasal cavity; tube formed from
skeletal muscle and lined with mucous membranes; divided into three
regions:
1. Nasopharynx – the superior portion of the pharynx located
between the soft palate and the internal nares; lined with
pseudostratified columnar epithelium and houses the
pharyngeal tonsils (adenoids)
2. Oropharynx – extends between the soft palate and the base of
the tongue at the level of the hyoid bone; epithelial tissue
changes from pseudostratified columnar to stratified
squamous epithelium to accommodate the movement of food
through this region and protects against abrasion; houses the
palatine tonsils on either side of the fauces (archways formed
by the soft palate and uvula) and the lingual tonsils attached
to the back of the tongue
3. Laryngopharynx – inferior to the oropharynx and posterior to
the larynx; continuous common route for ingested materials
and air until it diverges into respiratory and digestive
openings; lined with stratified squamous epithelium
v. Larynx - cartilaginous structure inferior to the laryngopharynx;
surrounds and protects the glottis; commonly called the “voice box”;
lined with pseudostratified columnar epithelium
1. Glottis – narrow opening through which inhaled air leaves the
pharynx and enters the larynx
2. Paired and unpaired cartilages of the larynx:
a. Epiglottis –flexible flap of elastic cartilage that covers
the glottis during swallowing to prevent food from
entering respiratory passageways
b. Thyroid cartilage – large single piece of hyaline
cartilage forming the anterior and lateral walls of the
larynx
i. Laryngeal prominence, also “Adam’s Apple” -
prominent anterior surface of thyroid cartilage
ii. Superior portion of thyroid cartilage is
connected to the hyoid bone by the thyrohyoid
membrane
c. Cricoid cartilage – a single piece of hyaline cartilage
with an expanded posterior portion to provide support;
together the cricoid and thyroid cartilages protect the
glottis and the entrance to the trachea; their broad
surfaces provide muscle and ligament attachment sites
 d. Arytenoid cartilages – two small pieces of hyaline
cartilage which articulate with the superior surface of
the cricoid cartilage; help anchor the vocal cords
e. Cuneiform cartilages – two long, curved pieces of
hyaline cartilage; lie within the folds of tissue that
extend between the lateral surface of each arytenoid
cartilage and the epiglottis
f. Corniculate cartilages – two small pieces of hyaline
cartilage that articulate with the arytenoid cartilages to
function in the opening and closing of the glottis and the
production of sound
3. Vestibular and Vocal Ligaments – bands of connective tissue
that extend between the thyroid cartilage and arytenoid
cartilages
a. Vocal folds – house the vocal ligaments; inferior to the
vestibular folds; vocal folds vibrate as air passes over
them - involved in production of sound; also known as
vocal cords
4. Vestibular folds – house an inelastic pair of vestibular
ligaments that are not associated with sound production; help
prevent foreign objects from entering the glottis and
contacting the more delicate vocal folds; also known as false
vocal cords
vi. Trachea, also windpipe – tough flexible tube connecting larynx to
bronchi of lungs
1. 16-20 stacked, C-shaped hyaline cartilage rings connected by
dense connective tissue keep airway open
2. Trachealis muscle and elastic connective tissue form the
fibroelastic membrane that connects C-shaped rings at the
posterior of trachea
3. Lined with pseudostratified ciliated columnar epithelium
4. Esophagus borders posteriorly

vii. Bronchial tree - highly branching pattern of bronchi and bronchioles

as they approach and travel through the lungs; rings of cartilage
provide support and prevent collapse
1. Primary bronchi – trachea branches at site of Carina to form
a right and left primary bronchus; transport air to right and
left lung
2. Secondary bronchi – right primary bronchus branches to
form three secondary bronchi; left primary bronchus branches
to form two secondary bronchi
3. Tertiary bronchi – each secondary bronchus branches to form
tertiary bronchi; cartilage begins to shrink forming cartilage
plates rather than C-shaped rings
 a. Each tertiary bronchus branches repeatedly to give rise to
microscopic passageways called bronchioles (1 mm in diameter)
b. Terminal bronchioles (> 1000 per lung) are the LAST branch of the
conducting zone
2. Respiratory Zone – gas exchange occurs
a. Respiratory bronchiole – smallest bronchioles; lead to alveolar duct which
opens to cluster of alveoli
b. Alveoli – small, grape-like sacs at ends of alveolar ducts; responsible for gas
exchange
i. ~200 µL in diameter with elastic walls; connected to neighboring
alveoli by alveolar pores to maintain equal air pressure throughout
lung
ii. 3 types of cells make up alveolar walls:
1. Type I alveolar cells - simple squamous cells that make up
97% of alveolar surface area; highly permeable to gases
a. Attached to thin elastic basement membrane; borders
endothelium of pulmonary capillaries to form
respiratory membrane – exchange of oxygen and
carbon dioxide with blood occurs across this membrane
2. Type II alveolar cells – interspersed among type I cells;
secrete pulmonary surfactant – substance composed of
phospholipids and proteins that reduce surface tension in
alveoli
3. Alveolar macrophages – phagocytic immune cell specific to
alveoli

The Lungs
1. Gross Anatomy of the Lungs
a. pyramid-shaped, paired organs connected to trachea by right and left
bronchi
b. bordered inferiorly by the diaphragm – a dome-shaped muscle at the base of
the thoracic cavity
c. Apex and base – the apex of the lungs is the narrow pointed region at the top
while the base is the wide region at the bottom in contact with the diaphragm
i. Right lung – shorter and wider than left lung; composed of three
lobes: superior, middle and inferior lobe divided by two fissures
1. Horizontal fissure divides superior from middle lobe and the
oblique fissure divides middle lobe from the inferior lobe
ii. Left lung – occupies smaller volume than right lung; composed of two
lobes: superior and inferior lobe divided by the oblique fissure
1. Cardiac notch – indentation in surface of left lung which
allows space for the heart
d. Lobes are subdivided into bronchopulmonary segments, each with its own
tertiary bronchus and its own artery
 e. Segments further subdivide into lobules, each with its own large bronchiole
with multiple branches
f. Pulmonary hilum – an indention in each lung where primary bronchi,
pulmonary blood vessels, nerves, and lymphatics enter into and exit out of
the lungs

2. Blood Supply and Innervation of the Lungs

a. Blood Supply
i. Pulmonary arteries and veins – the pulmonary arteries (often
shown in blue) exit the right atrium of the heart and transport
deoxygenated blood to the lungs; the pulmonary veins (often shown
in red) leave the lungs and transport oxygenated blood to the left
atrium
ii. As pulmonary arteries and arterioles branch and approach alveoli,
they become the pulmonary capillary network; wraps around
respiratory bronchioles and alveoli, where they contribute to the
respiratory membrane
iii. Oxygenated blood drains into pulmonary veins which exit through
the hilum to return to systemic circulation via the left atrium of the
heart
b. Nervous Innervation
i. Sympathetic and parasympathetic systems control dilation and
constriction of the airway
1. Bronchoconstriction = parasympathetic
2. Bronchodilation = sympathetic
ii. Reflexes like coughing and regulation of oxygen and carbon dioxide
are also under autonomic control
iii. Pulmonary plexus = nerves enter lungs at the hilum, then follow
bronchi to branch for innervation of muscle, glands, and blood vessels
3. Pleura of the Lungs
a. serous membrane surrounding each lung; composed of two distinct layers:
i. Visceral pleura – lines external surface of lungs, extending into
fissures
ii. Parietal pleura – lines the interior of the thoracic cavity and extends
over the diaphragm and mediastinum
iii. Pleural cavity and pleural fluid – the space between the parietal
and visceral pleura; contains a small volume of pleural fluid that
coats the pleural surfaces and reduces friction

The Process of Breathing

1. Mechanisms of Breathing
a. Major mechanisms driving pulmonary ventilation are atmospheric pressure
(Patm), intra-alveolar pressure (Palv), and intrapleural pressure (Pip)
 b. Pressure differential of 0 mmHg exists when atmospheric and alveolar
pressures are equal; positive Palv will push air out of the lungs while negative
Palv will pull air into the lungs
c. Air flows from an area of higher pressure to an area of lower pressure
d. Pressure Relationships
i. Atmospheric pressure (Patm) - the force exerted by the mixture of air
surrounding the body; normal atmospheric pressure at sea level is
760 mmHg (1 atm)
ii. Intra-alveolar pressure (Palv) – also, intrapulmonary pressure; the
force exerted by the air within the alveoli of the lungs; this pressure
rises and falls as the phases of breathing progress; equalizes with Patm
iii. Intrapleural pressure (Pip) –pressure within the pleural cavity;
always 4 mmHg lower than the alveolar pressure so the alveoli will be
able to inflate
iv. Boyle’s Law – P1V1 = P2V2; volume is inversely proportional to
pressure; as volume increase, pressure decreases, and as volume
decreases, pressure increases
1. If the volume of the thoracic cavity is reduced by half, pressure
within the thoracic cavity will double; if the volume of the
thoracic cavity is doubled, pressure within will decrease by
half

e. Physical Factors Affecting Ventilation

i. Changes in intra-alveolar pressure are the result of variations in lung
and thoracic volume; contraction and relaxation of respiratory
muscles alter the volume of the thoracic cavity; lungs are passive
ii. Resistance – force that slows the flow of gases; primarily impacted by
size of airway; regulated by bronchodilation and bronchoconstriction
iii. Surface tension – water present in respiratory membrane is
cohesive; surface tension inhibits expansion of alveoli; type II
alveolar cells (pneumocytes) secrete surfactant which reduces
surface tension
iv. Thoracic wall compliance – ability of thoracic wall to stretch while
under pressure; directly influences capacity of lungs to expand

2. Pulmonary Ventilation
a. Differences in pressures drives pulmonary ventilation (movement of air
into and out of the lungs)
b. Inspiration – also, inhalation; as the diaphragm contracts, it moves
downward which increases the volume of the thoracic cavity; intra-alveolar
pressure decreases [758 mm Hg], which causes atmospheric air to be pulled
into the lung spaces
c. Expiration – also, exhalation; as the diaphragm relaxes, it moves upward
which decreases the volume of the thoracic cavity; intra-alveolar pressure
 increases [762 mm Hg], which causes air to be squeezed out of the lung
spaces and out into the atmosphere
3. Respiratory Volumes and Capacities
a. Respiratory Volume – air moved by or associated with the lungs at a given
point in the respiratory cycle
i. Tidal volume (TV) – the amount of air moved into the lungs during
inhalation and out of the lungs during exhalation (quiet breathing);
tidal volume is approximately 500 mL
ii. Inspiratory reserve volume (IRV) – the amount of air that can be
forcibly inhaled after a normal tidal volume inhalation; IRV ranges
from 1900 to 3300 mL
iii. Expiratory reserve volume (ERV) – the amount of air that can be
forcibly exhaled after a normal tidal volume exhalation; ERV is up to
1200 mL in males
iv. Residual volume (RV) – the amount of air that remains in your lungs
even after a forcible exhalation; prevents alveoli from collapsing; RV
ranges from 1100 to 1200 mL
b. Respiratory Capacity – the combination of two or more selected volumes,
which further describes the amount of air in the lungs at a given time
i. Total Lung Capacity (TLC) – the volume of your lungs, the sum of all
four respiratory volumes; TLC = IRV + TV + ERV + RV; TLC averages
around 6000 mL in males and 4200 mL in females
ii. Vital Capacity (VC) = the maximum amount of air that you can move
into or out of your lungs in a single respiratory cycle; VC = IRV + TV +
ERV; VC ranges from 4000 to 5000 mL
iii. Inspiratory Capacity (IC) – maximum amount of air that can be
inspired after a normal expiration; IC = IRV + TV
iv. Functional Residual Capacity (FRC) – the amount of air remaining in
your lungs after you have completed a quiet respiratory cycle; FRC =
ERV + RV
c. Dead space
i. Anatomical dead space – air that never reaches the alveoli so never
participates in gas exchange
ii. Alveolar dead space – air within non-functional alveoli, such as those
affected by disease or abnormal blood flow
iii. Total dead space = anatomical + alveolar dead space

4. Respiratory Rate and Control of Ventilation

a. Respiratory rate = total number of respiratory cycles (breaths) per minute
i. Infants = 30-60 breaths/min
ii. Child ~ 10 years = 18-30 breaths/min
iii. Adolescent – adult = 12-18 breaths/min
b. Ventilation Control Centers
i. Medulla oblongata
 1. Dorsal respiratory group (DRG) – the “pacemaker”;
functions in every respiratory cycle; contains the neurons that
control lower motor neurons innervating the primary
inspiratory muscles
2. Ventral respiratory group (VRG) – inspiratory and expiratory
centers function only when ventilation demands increase and
accessory respiratory muscles are needed (forced breathing)
ii. Pontine respiratory group
1. Apneustic center - promotes inhalation by stimulating the
DRG; controls depth of inspiration, especially during deep
breathing,
2. Pneumotaxic center - inhibits the neurons of the DRG; allows
for passive or active exhalation
c. Factors that Affect the Rate and Depth of Respiration
i. Carbon dioxide concentration is the major factor driving respiration
ii. Oxygen concentrations are also a factor
1. Chemoreceptors sensitive to the pH, PO2, or PCO2 of the blood
or cerebrospinal fluid alter the activities of the respiratory
centers
iii. Emotions, pain, and temperature also influence respiratory rate;
regulated by hypothalamus and limbic system

Gas Exchange
1. Gas Exchange
a. Gas Laws and Air Composition – Gas diffusion across the respiratory
membrane depends on partial pressures and solubility of gases
i. Partial pressure - the pressure contributed by a single gas in a
mixture of gases; represented as PO2 or PCO2
ii. Total pressure – sum of all the partial pressures in a gaseous mixture
iii. Dalton’s Law - the sum of all partial pressures equals the total
pressure exerted by a gas mixture
iv. Partial pressure predicts movement of gases; gases move from areas
of high to low concentration; greater partial pressure difference
results in more rapid diffusion of gases
b. Solubility of Gases in Liquids
i. Henry’s Law - the concentration of a gas in solution is directly
proportional to the solubility and partial pressure of that gas
1. Greater partial pressure of a gas results in greater number of
molecules of that gas that dissolve in solution
2. Concentration of gas in solution is also dependent on
solubility (the ability to be dissolved) of that gas
a. Ex. solubility of nitrogen in blood is very low; solubility
of carbon dioxide is higher
c. Ventilation and Perfusion
 i. Ventilation (movement of air into and out of the lungs) and
perfusion (flow of blood in pulmonary capillaries) need to be
balanced for efficient gas exchange
ii. Ventilation is regulated by diameter of airways; perfusion is regulated
by diameter of blood vessels
2. Gas Exchange
a. External Respiration – in the lungs, the PO2 is high (104 mmHg) and the PCO2
is low (40 mmHg); in the blood, the PO2 is low (40 mmHg) and PCO2 is high (45
mmHg)
i. Oxygen is forced into the blood from the lungs; carbon dioxide is
forced from the blood into the lungs
b. Internal Respiration - in the blood, the PO2 is high (100 mmHg) and the PCO2
is low (45 mmHg); in the tissues, the PO2 is low (40 mmHg) and PCO2 is high
(45 mmHg)
i. Oxygen is forced out of the blood and into the tissues; carbon dioxide
is forced from the tissues into the blood

Transport of Gases
1. Oxygen Transport in Blood
a. Oxygen solubility in blood is low; only about 1.5% of total oxygen is dissolved
in blood; the rest is bound to RBCs with hemoglobin
i. Each hemoglobin molecule contains 4 heme units which contain iron
and bind O2
ii. Oxygen bound to hemoglobin = oxyhemoglobin (bright red molecule
that contributes to bright red color of oxygenated blood)
b. Function of Hemoglobin
i. Protein with quaternary structure – each of the four subunits contains
a heme
ii. Hemoglobin saturation = percent of total heme units bound to oxygen
1. Normal = 95-99%
c. Oxygen Dissociation from Hemoglobin
i. Oxygen-hemoglobin dissociation curve – graph describing
relationship between partial pressure of O2 to binding and subsequent
dissociation from heme.
ii. Temperature, certain hormones, and pH of blood can also influence
the oxygen-hemoglobin association curve
1. Bohr effect – lower (more acidic) pH promotes oxygen
dissociation from heme; higher (more basic) pH inhibits
oxygen dissociation from heme