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Respiration: 1. The Respiratory Tract A. The Upper Respiratory Tract

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RESPIRATION

1. The Respiratory Tract


A. The upper respiratory tract
• Nose
 lined by ciliated columnar
epithelium
 mucus secreting cells
 dense vascular network in
submucosa
 filtering air
 warming air
 humidifying air
 sneezing reflex
• Pharynx
 Epiglottis
• Larynx
 vocal cords
 glottis
B. The lower respiratory tract
• Trachea
• Bronchi
• Bronchioles
• Respiratory bronchioles
• Alveolar ducts and alveoli
• Conducting zone
 to warm and humidify the air
 to distribute the gas
 to serve as part of body defense system
• Respiratory zone
• Respiratory tract defense system
 Mucocilliary transport system: mucus escalator
 Cough reflex
 Macrophages
2. The Lung Mechanics
A. Lung pressures and ventilation
• The thorax and respiratory
muscles
 thoracic cage: ribs (12),
sternum, diaphragm
 pleural space

 respiratory muscles during


inspiration:
- diaphragm
- external intercostal muscles
- accessory muscles
 respiratory muscles during
expiration:
- Diaphragm
- internal intercostal muscles
-
• Lung pressures
 Air flows because of pressure
gradients
 pleural pressure (Ppl)
 alveolar pressure (PA)
 Pressure changes during
respiratory cycle
 pneumothorax
• Lung volumes and capacities
 Spirometry
 tidal volume (VT)
 inspiratory reserve volume (IRV)
 expiratory reserve volume (ERV)
 residual volume (RV)
 inspiratory capacity (IC)
 functional residual capacity (FRC)
 vital capacity (VC)
 total lung capacity (TLC)
 forced vital capacity (FVC)
 FEV1: timed forced expiratory
volume in one second
 FEV1/FVC = 80%: more
useful for detecting obstructive
vs restrictive lung diseases
• Minute respiratory volume (V, minute ventilation)
V = VT * f (respiratory rate)
• Dead space volume (VD)
• Alveolar ventilation (VA): VA = (VT - VD) * f
B. Mechanical Properties of the lung
• Lung Distensibility
• Pressure-volume curve
• Compliance (CL= DV/DP)
• Pulmonary surfactant
 surface tension

 Laplace Law: P = 2T/r

 atelectasis
• Work of breathing
W = force X distance
Factors that affect the amount of work:
 lung compliance
 surface tension
 airway resistance
- R  L  /r4
- diameter of the airways
Bronchoconstriction: histamine
Broncodilation: CO2, EP (2 receptors)
3. Pulmonary Circulation
A. Vascular pressure and blood flow
• Pulmonary circulation is a low-pressure system
 pulmonary arterial systemic pressure: 25
mmHg
 pulmonary arterial diastolic pressure: 10
mmHg
 mean pulmonary arterial pressure: 15 mmHg
 effect of the special gravity of blood on
distribution of blood flow in the lung:
- poor perfusion in the upper lung (functional
dead space volume)
• Hypoxic vasoconstriction
balances blood flow with
ventilation
 regional
hypoxia/hypoxemia
 hypoxic vasoconstriction -
a mechanism that
balances the perfusion of
blood with the availability
of regional ventilation
 effect of hypoxic
vasoconstriction at the
high altitude
• Exercise recruits capillaries
and decreases transit time
4. Gas Uptake and Transport
A. Gases diffuse through respiratory membrane

• Dalton’s law: PB = PO2 + PCO2 + PN2 + PH2O +


PHe…
 barometric pressure: PB at the sea level = 760
mmHg
 partial pressures
 PO2 = PB X F O2 = 760 X 0.21 = 160 mmHg
 vapor pressure of water
 PO2 in alveolar gas and venous blood: 100/40
mmHg
Gas exchange:alveoli and cells
• Factors that affect the rate of gas diffusion through the
respiratory membrane
 thickness of respiratory membrane (alveolar-capillary
membrane): normally 0.1 - 0.5 µm
 pulmonary edema
 fibrosis of the lung
 surface area of the respiratory membrane: 70 m2 in
the normal adult
 emphysema (dissolution of alveolar walls)
 diffusion coefficient
 solubility in water
 molecular weight
 carbon dioxide diffuses 20 times as rapidly as
oxygen
 pressure difference across the respiratory membrane
Respiratory membrane
• Pulmonary pathologies
B. Transport of oxygen
• Transport of oxygen in the dissolved state
 only 2% of oxygen transported in the dissolved
state in the water of the plasma and cells
• Transport of oxygen by hemoglobin
 98% oxygen is carried to the tissues by reversible
combination with hemoglobin
 oxygen carrying capacity: 20 ml/100ml blood
 oxygen saturation: percent O2 saturation = O2
content/O2 capacity x 100
 oxyhemoglobin dissociation curve
 factors that affect the oxyhemoglobin curve
Oxygen-hemoglobin dissociation

"2,3-DPG and oxygen/Hb binding"

• Factors that
affect the
oxyhemoglobin
curve
• Factors contributing to the total oxygen content
of arterial blood
C. Transport of carbon dioxide
• Dissolved in plasma: (7-10%)
• Carbaminohemoglobin: (15-30%)
• As bicarbonate: (60-70%)
 CO2 + H2O H2CO3 H+ + HCO3-
catalyzed carbonic anhydrase
 H+ + Hb- HHb
 chloride shift
D. Control of Breathing
• Neural mechanisms
 Medullary respiratory centers
inspiratory neurons: set the rhythm
expiratory neurons
 receive synaptic inputs from the cortex and
pons
 effects of pulmonary stretch receptors
(proprioreceptors)
 failure of the respiratory center
by physical damages (concussions, cerebral
edema)
by overdose of chemical substances
(barbiturate, anesthetics)
• Reflex control of ventilation
 Chemoreceptors monitor blood gases and pH
 Control centers in the brain stem regulate activity
to respiratory muscles
• Chemical mechanisms
 chemoreceptors
central chemoreceptors (in the medulla): monitor
only H+ in CSF
peripheral chemoreceptors (aortic bodies and
carotid bodies)
 control of the alveolar ventilation by the arterial CO2
 control of the alveolar ventilation by the arterial H+:
exclusively by peripheral chemoreceptors
 control of the alveolar ventilation by the hypoxia:
relatively insensitive to hypoxia
Carotid body oxygen sensor Central chemoreceptor
Chemoreceptor reflex

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