1. Chapter 24 Physiology of the Respiratory System

2. Respiratory Physiology
complex processes that help maintain homeostasis
Respiratory function includes the following:
External respiration
Pulmonary ventilation (breathing)
Pulmonary gas exchange
Transport of gases by the blood
Internal respiration
Systemic tissue gas exchange
Cellular respiration
Regulation of respiration

3. Pulmonary Ventilation (breathing)
Respiratory cycle
Inspiration— moves air into the lungs
Expiration— moves air out of the lungs
Mechanism of pulmonary ventilation
Pulmonary ventilation mechanism must establish two gas pressure gradients:
pressure within alveoli of lungs is lower than atmospheric pressure to produce inspiration
pressure in alveoli of lungs is higher than atmospheric pressure to produce expiration
Pressure gradients are established by changes in size of thoracic cavity

4. Pulmonary Ventilation (breathing)
Inspiration— contraction of diaphragm produces inspiration— as it contracts, it makes thoracic cavity larger
Expansion of thorax results in decreased intrapleural pressure (Pip), leading to a decreased alveolar pressure (Pa)
Air moves into lungs when alveolar pressure (Pa) drops below atmospheric pressure (Pb)
Compliance— ability of pulmonary tissues to stretch, making inspiration possible
Intrapleural is the space surrounding the lungs

5. Pulmonary Ventilation (breathing)
Expiration— a passive process that begins when inspiratory muscles are relaxed, decreasing size of thorax
Decreasing thoracic volume increases intrapleural pressure (Pip) and thus increases alveolar pressure (Pa) above atmospheric pressure (Pb)
Air moves out of lungs when Pa > Pb

7. Pulmonary Volumes
Pulmonary volumes— the amounts of air moved in and out and remaining are important to the normal exchange of oxygen and carbon dioxide
FYI:
Spirometer— instrument used to measure volume of air (Figure 24-10)
Tidal volume (TV)— amount of air exhaled after normal inspiration
Expiratory reserve volume (ERV)— largest volume of additional air that can be forcibly exhaled (between 1.0 and 1.2 liters is normal ERV)
Inspiratory reserve volume (IRV)— amount of air that can be forcibly inhaled after normal inspiration (normal IRV is 3.3 liters)

8. Pulmonary Volumes
Residual volume (RV)— amount of air that CANNOT be forcibly exhaled (1.2 liters)
“wind knocked out of you” = your residual volume (along with your expiratory reserve) is forced out of your airways  alveoli collapse
Between breaths, an exchange of O2 and CO2 occurs between this trapped air in the alveoli and the blood.

9. Pulmonary Capacities
Pulmonary capacities— the sum of two or more pulmonary volumes
Vital capacity— the sum of IRV + TV + ERV
Represents the largest volume of air one can move in and out of lungs
A person’s vital capacity depends on many factors, including the size of the thoracic cavity and posture
Larger person has larger vital capacity
Excess fluid in abdominal cavities
Emphysema: alveolar walls stretched too much and unable to recoil  increased RV (air trapped)
Functional residual capacity— amount of air
at the end of a normal respiration

10. Pulmonary Capacities
Alveolar ventilation— volume of inspired air that reaches the alveoli
Only this volume of air takes part in exchange of gases
Anatomical dead space— “dead” air in passageways that do not participate in gas exchange (nose, pharynx, larynx, trachea, bronchi)
Physiological dead space— anatomical dead space plus the volume of any nonfunctioning alveoli (caused by disease)
Alveoli must be properly ventilated for adequate gas exchange
Chronic obstructive pulmonary disease (COPD): chronic bronchitis and emphysema

11. Pulmonary Gas Exchange
Partial pressure of gases— pressure exerted by a gas in a mixture of gases
Dalton’s law of partial pressures— the partial pressure of a gas in a mixture of gases is directly related to the concentration of that gas in the mixture and to the total pressure of the mixture
Arterial blood Po2 + Pco2 = Alveolar Po2 + Pco2

13. Pulmonary Gas Exchange
Exchange of gases in the lungs takes place between alveolar air and blood flowing through lung capillaries
Four factors determine the amount of oxygen that diffuses into blood:
The oxygen pressure gradient between alveolar air and blood
The total functional surface area of the respiratory membrane
The respiratory volume
Alveolar ventilation

14. Pulmonary Gas Exchange
Structural factors that facilitate oxygen diffusion from alveolar air to blood:
Walls of the alveoli and capillaries form only a very thin barrier for gases to cross
Alveolar and capillary surfaces are large
Blood is distributed through the capillaries in a thin layer so each red blood cell comes close to alveolar air
Alveolar blood supply. rich blood supply to alveoli (which have been removed). The numerous, narrow branches ensure that each red blood cell is exposed to the alveolar air.

15. How Blood Transports Oxygen
Hemoglobin
made up of four polypeptide chains, each with an iron-containing heme group
Some CO2 can bind to amino acids in the chains
O2 can bind to iron in the heme groups
Oxygenated blood contains about 0.3 ml of dissolved O2 per 100 ml of blood

16. How Blood Transports CO2
A small amount of CO2 dissolves in plasma and is transported as a solute (10%)
< 1/4 of blood CO2 combines with amino groups of hemoglobin (20%)
CO2 association with hemoglobin is accelerated by an increase in blood Pco2
> 2/3 of blood CO2 is carried in plasma as bicarbonate ions (70%)

18. Systemic Gas Exchange
Exchange of gases takes place between capillaries and cells
Oxygen diffuses out of arterial blood because the oxygen pressure gradient favors its outward diffusion
As oxygen diffuses out of blood, blood Po2 decreases, which accelerates oxyhemoglobin dissociation to release more oxygen to plasma for diffusion to cells

19. Oxygen-hemoglobin dissociation curve
Oxygen-hemoglobin dissociation curve. The graph represents the relationship between PO2 and O2 saturation of hemoglobin (Hb-O2 affinity). The inset shows how the graphed curve relates to oxygen transport by the blood. Notice that at high plasma PO2 values (point A), hemoglobin (Hb) is fully loaded with oxygen. At low plasma PO2 values (point B), Hb is only partially loaded with oxygen.

20. Systemic Gas Exchange
Carbon dioxide exchange between tissues and blood takes place in the opposite direction from oxygen exchange
Bohr effect— increased Pco2 decreases the affinity between oxygen and hemoglobin
Haldane effect— increased carbon dioxide loading caused by a decrease in Po2

21. The increased PCO2 in systemic tissues decreases the affinity between Hb and O2, shown as a right shift of the oxygen-hemoglobin dissociation curve. This phenomenon is known as the Bohr effect. A right shift can also be caused by a decrease in plasma pH.

22. At the same time, the decreased PO2 commonly observed in systemic tissues increases the CO2 content of the blood, shown as a left shift of the CO2 dissociation curve. This phenomenon is known as the Haldane effect.

23. Regulation of Pulmonary Function
Respiratory control centers— the main integrators that control the nerves that affect inspiratory and expiratory muscles are located in the brainstem
Medullary rhythmicity center— generates the basic rhythm of respiratory cycle
Basic breathing rhythm can be altered by different inputs to medullary rhythmicity center

24. Regulation of Pulmonary Function
Factors that influence breathing— sensors from the nervous system provide feedback to medullary rhythmicity center
Changes in the Po2, Pco2 and pH of arterial blood influence medullary rhythmicity area
Pco2 acts on central chemoreceptors in medulla
if it increases, result is faster breathing
if it decreases, result is slower breathing
Arterial blood pressure controls breathing through respiratory pressoreflex mechanism
Hering-Breuer reflexes help control respirations by regulating depth of respirations and volume of tidal air
Cerebral cortex influences breathing by increasing or decreasing rate and strength of respirations

25. Regulation of Pulmonary Function
Ventilation and perfusion
Alveolar ventilation— air flow to the alveoli
Alveolar perfusion— blood flow to the alveoli
Efficiency of gas exchange can be maintained by limited ability to match perfusion to ventilation— for example, vasoconstricting arterioles that supply poorly ventilated alveoli and allow full blood flow to well-ventilated alveoli

26. The Big Picture
The internal system must continually get new oxygen and rid itself of carbon dioxide because each cell requires oxygen and produces carbon dioxide as a result of cell respiration
Specific mechanisms involved in respiratory function:
Blood gases need blood and the cardiovascular system to be transported between gas exchange tissues of lungs and various systemic tissues of body
Regulation by the nervous system adjusts ventilation to compensate for changes in oxygen or carbon dioxide levels in internal environment
Skeletal muscles of the thorax aid airways in maintaining flow of fresh air
Skeleton houses the lungs, and the arrangement of bones facilitates the expansion and recoil of the thorax
Immune system prevents pathogens from colonizing the respiratory tract and causing infection