The Respiratory System

Learning Outcomes

Identify the main structures of the respiratory

system.

State the role of the respiratory system.

Define the following - Internal Respiration,
External Respiration, Respiratory Gas
Transport.

Learning Outcomes
With reference to pressure and volume changes,
describe the mechanism of air movement in and out
of the lungs.
Define Tidal Volume (TV) and Respiratory Rate (RR)
& state the average amounts in a healthy adult.
Describe how tidal volume and respiratory rate can
be measured and how Pulmonary Ventilation Rate
(PVR) and Alveolar Ventilation Rate (AVR) can be
calculated.

Learning Outcomes
Explain why breathing is more efficient when the
depth of breathing (tidal volume) is increased as
opposed to the rate of breathing.
Explain briefly how oxygen and carbon dioxide
are transported in the blood.
State briefly what physiological parameters a
pulse oximeter measures.

Function of the respiratory system

The respiratory system contributes to homeostasis
by:
supplying the cells of the body with oxygen.
removing carbon dioxide from the body
it also helps to adjust the blood pH.

Write down the

names of the key
structures/organs
associated with the
process of
breathing.

Structures of the Respiratory System

The upper respiratory system includes the nose,
nasal cavity, pharynx.

The lower respiratory system includes the

larynx, trachea, bronchi, and the lungs.

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Structural organization

Fig. 23.1a
Nose
Nasal cavity

Upper
respiratory
tract

Pharynx
Larynx
Trachea
Bronchus

Bronchiole

Lower
respiratory
tract

Terminal bronchiole

Lungs

Respiratory System Anatomy

The respiratory system act with the
cardiovascular system to supply oxygen and
remove carbon dioxide.
The nose, made of cartilage and skin, warms,
moistens, and filters air and functions in olfaction
and speech.

Respiratory System Anatomy

The pharynx (throat) is a muscular tube lined by
a mucous membrane. The anatomical regions
are the nasopharynx (functions in respiration);
oropharynx and larynopharynx function in both
breathing and digestion.
The larynx (voice box) is a passageway that
connects the pharynx with the trachea. It
contains epiglottis which prevents food from
entering the larynx.

Respiratory System Anatomy

The trachea (windpipe) extends from he larynx to
the main bronchi. It is composed of C-shaped
rings of cartilage and smooth muscle lined with
ciliated columnar epithelium.
The bronchial tree consists of the trachea, main
bronchi, lobar bronchi, segmental bronchi,
bronchioles, and terminal bronchioles.
Lungs are paired organs in the thoracic cavity
enclosed by the pleural membrane.

Respiratory System Anatomy

The right lung has three lobes separated by two
fissures.
The left lung has two lobes separated by one
fissure.
Lobar bronchi consists of lobules-which contain
lymphatics, arterioles, venules, terminal
bronchioles, respiratory bronchioles, alveolar
ducts, alveolar sacs, and alveoli.

Respiratory System Anatomy

Functionally, the respiratory system is divided into the
conducting zone and the respiratory zone.
The conducting zone is involved with bringing air to
the site of external respiration and consists of the
nose, pharynx, larynx, trachea, bronchi, bronchioles
and terminal bronchioles.
The respiratory zone is the main site of gas
exchange and consists of the respiratory bronchioles,
alveolar ducts, alveolar sacs, and alveoli.

Regions of gas exchange

Respiratory System Anatomy

Alveoli are delicate structures composed of:
type I alveolar cells, which allow for exchange of
gases with the pulmonary capillaries.
Type II cells secrete a substance called
surfactant that prevents collapse of the
alveoli during exhalation and
Alveolar macrophages destroy foreign materials

Respiratory System Anatomy

The processes of respiration

Pulmonary ventilation (breathing) -the

movement of air into and out of the lungs.

It involves inhalation and exhalation.
External respiration -the exchange of
gases between the alveoli and the blood in
the pulmonary circulation.

Gas exchange - Alveoli

O2 diffuses from alveoli to the blood in

pulmonary capillaries.
CO2 diffuses from the blood in pulmonary
capillaries to alveoli.

The processes of respiration

Internal respiration -the exchange of gases
between the blood in systemic capillaries
and cells of the body.
In internal and external respiration, O2 and
CO2 diffuse from areas of higher partial
pressures to areas of lower partial pressures.

Gas exchange - tissues

O2 diffuses from the blood in systemic

capillaries to body tissues/cells.
CO2 diffuses from the body tissues/cells to
the blood in systemic capillaries.

The processes of respiration

Respiratory gas transport

Respiratory gas transport- is the transport of O2
and CO2 to and from the lungs and tissues.
The blood transports gases between the lungs
and body tissues.
When O2 and CO2 enter the blood, certain
chemical reactions occur that aid in gas
transport and gas exchange.

Respiratory gas transport

O2 transport
O2 is not very soluble in water. Once O2 enters
the blood , the majority of it binds to haemoglobin.
In each 100ml of oxygenated blood; 98.5% is
transported by haemoglobin as oxy haemoglobin
(Hb-O2) within red blood cells. 1.5% dissolves in
the plasma.
Hb + O2 HbO2
Deoxyhaemoglobin + oxygen oxyhaemoglobin
Can be affected by sickle cell, carbon monoxide

Respiratory gas transport

In an acidic environment, haemoglobins affinity
to O2 is lower, and O2 dissociates more readily
from it (Bohr effect).
In the presence of O2, less CO2 binds to
haemoglobin (Haldane effect).

Structure of Haemoglobin
Haemoglobin is a globulin protein with four heme
groups within its structure.
2 polypeptide chains
2 polypeptide chains
Each heme group contains an atom of iron, to
which the O2 binds.
1 Hb binds with 4 O2 molecules oxyhaemoglobin.

Structure of Haemoglobin

Pulse oximetry
Pulse oximetry is a
simple, non-invasive
method of monitoring
the percentage (%) of
haemoglobin (Hb)
which is saturated
with oxygen.

Respiratory gas transport

CO2 transport
CO2 can be transported in the blood in a
variety of ways.
In each 100ml of deoxygenated blood: 10%
dissolve in the plasma; 20-30% binds to
Haemoglobin and 60-70% is transported in
blood plasma as bicarbonate ions (HCO3-).

Respiratory gas transport

CO2 transport
As CO2 moves out of tissues it reacts with
water within the blood to produce carbonic
acid. Carbonic acid then dissociates into
hydrogen and bicarbonate ions.
The enzyme carbonic anhdrase speeds this
reaction.
CO2 + HO2 H2 CO3 H+ + HCO3-

CO2 is the most powerful respiratory stimulant

Understanding Gases
Boyles law applies to containers with flexible
walls like our thoracic cage.
It says that volume and pressure are inversely
related.
If there is a decrease in
volume; there will be an
increase in pressure.
V 1/P

Pressure changes in Pulmonary Ventilation

Air moves into lungs when alveolar pressure is
less than atmospheric pressure, and out of the
lungs when alveolar pressure is greater than
atmospheric pressure.
During inhalation, the diaphram and external
intercostals contact, the lungs expand and air
moves into the lungs; during exhalation, the
diaphram and external intercostals relax and the
lungs recoil, forcing air out of the lungs.

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Ventilation and Respiration

Mechanics of inspiration
Inspiratory muscles contract Intercostals/Diaphragm
Increased thoracic cavity volume
Lungs stretched - pleura
Increased intrapulmonary volume
(Boyles Law)
Decreased intrapulmonary pressure (-1 mmHg)
Air flows into lungs from atmosphere
to equalise pressure (0 mm Hg)

Movement of the rib cage during inspiration

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 How many times per

minute do we
breathe?

Pulmonary Ventilation

Tidal Volume (TV)

The amount of air
moved in or out of
the lungs with each
breath, in normal
quiet breathing =
500ml.

Respiratory Rate (RR)

The number of
inspirations per
minute.
12-18 breaths per
minute (adults)
40-50bpm (newborns)

Measuring Ventilation
Only about 70% of the tidal volume reaches the respiratory zone
the other 30% remains in the conducting zone (called the anatomic
dead space).
If a single VT breath = 500 ml, only 350 ml will exchange gases
at the alveoli.
In this example, with a respiratory rate of 12, the Pulmonary
ventilation rate = 12 x 500 = 6000 ml.
The alveolar ventilation rate (volume of air/min that
actually reaches the alveoli) = 12 x 350 = 4200ml.

12

Calculation of Pulmonary Ventilation Rate

(PVR)
Tidal volume x respiratory rate
500ml x 12 bpm = 6000ml/minute
= 6L/min

Alveolar Ventilation Rate (AVR)

The amount of air that reaches the alveoli
per minute
Need to consider dead space

Dead Space

Inspired air that fills the conducting

airways and does not contribute to gas
exchange.
Dead space = 150ml

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Calculation of Alveolar Ventilation Rate (AVR)

(TV DS) x RR = AVR
(500 150) x 12 =
350 x 12 = 4200ml/minute
= 4.2L/min

Effect of breathing rate and depth on

alveolar ventilation rate
Breathing
Pattern

Dead space
volume

Tidal volume

Respiratory
rate

Pulmonary
ventilation
rate

Alveolar
ventilation
rate

% of TV =
dead space
volume

Normal
rate and
depth

150 ml

500ml

20/min

10L/min

7L/min

30%

Slow, deep
breathing

150 ml

1000ml

10/min

10L/min

8.5/min

15%

Rapid,
shallow
breathing

150 ml

250ml

40/min

10L/min

4L/min

60%

TV and DS in children & adults

Age/circumstances

Tidal volume (VT)

Respiratory rate (RR)

Neonates

9ml/Kg

40-60/60-80

5 years

18ml/Kg

25-30

8 years

35ml/Kg

20-25

Adult

250-500ml

12-18/20

Pregnancy

700ml

No change in
frequency, but increase
in depth

DS is age/size dependent, of great importance is compliance of the

trachea in children

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Lung Compliance
High lung compliance means the lungs and
chest wall expand easily.
Diminished by any factor that:
Reduces natural resilience of lungs.
Blocks the bronchi or smaller passageways.
Impairs flexibility of thoracic cage.
broken rib, or by diseases such
as pneumonia or emphysema.

Lung Volumes & Capacities

Residual Volume the volume of air remaining in
the lungs after a maximum expiration.
Inspiratory Reserve Volume (IRV) amount of air
that can be forcefully inhaled after a normal
inspiration.
Expiratory Reserve Volume (ERV) amount of air
that can be forcefully exhaled after a normal
expiration.
Vital Capacity the maximum volume of air that
can be expelled after a maximum inspiration.

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

6000

Lung volume (mL)

5000

4000

Inspiratory
capacity

Inspiratory
reserve
volume
Vital
capacity

Tidal
volume

Total
lung
capacity

3000

2000
Expiratory
reserve
volume

Functional
residual
capacity

1000

Residual
volume

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Measuring Ventilation
Ventilation can be measured using spirometry.

Tidal Volume (VT) is the volume of air inspired (or

expired) during normal quiet breathing (500 ml).

Inspiratory Reserve Volume (IRV) is the volume

inspired during a very deep inhalation (3100 ml
height and gender dependent).

Measuring Ventilation
Lung capacities are the sum of two or more
lung volumes.

Residual Volume (RV) is the air still present in

the lungs after a force exhalation (1200 ml).
The RV is a reserve for mixing of gases but
is not available to move in or out of the
lungs.

Measuring Forced Expiratory Volume in 1 second

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Peak Expiratory Flow Rate

The speed at which air is moved out of the lungs
Usually impaired in the presence of diffuse airway
obstruction. However is a useful measurement to
take due to:
Reproducibility
Speed
Simplicity & convenience

PEF cannot differentiate between obstructive and

restrictive diseases.
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