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Chapter 22

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Title: Chapter 22


1
Chapter 22 The Respiratory System
2
Ch. 22 (Respiratory Sys.) Study Guide
  • Critically read Chapter 22 pp. 864-886 right
    before 22.3 Gas Exchange and Transport section
  • Comprehend Terminology (those in bold)
  • Study-- Figure questions, Think About It
    questions, and Before You Go On (section-ending)
    questions
  • Do end-of-the-chapter questions
  • Testing Your Recall 1-5, 7, 10, 11-18
  • True or False 1, 2, 4-6, 8
  • Testing Your Comprehension 1, 4, 5

2
3
Breathe/Breath (1 or 2)
  • Fear less, hope more
  • Whine less, breathe more
  • Talk less, say more
  • Hate less, love more
  • And all good things are yours.
  • --Swedish proverb

4
Breathe/Breath (2 of 2)
  • Every day brings a chance
  • for you to draw in a breath,
  • kick off your shoes,
  • and dance.
  • --Oprah Winfrey

5
I. Anatomical Consideration
  • Self-Check Question As we breathe in, what
    respiratory organs, in order, does air pass
    through?
  • Answer Nose (mouth) . . .
  • Fig. 22.1

6
Organs of Respiratory System
1
2
3
4
5
6
7
General Aspects
  • Airflow in lungs
  • bronchi ? bronchioles ? alveoli
  • Conducting Rspiratory (C/R) divisions--
  • (C) passages ONLY for airflow, nostrils to
    bronchioles
  • (R) distal gas-exchange regions and ________
  • Upper/lower (U/L) respiratory tracts
  • (U) organs in head and neck, nose through larynx
  • (L) organs of trachea through lungs

8
1. Nose
  • Bony and cartilaginous supported by
  • superior half nasal bones medially and maxillae
    laterally
  • inferior half lateral and alar cartilages
  • ala nasi flared portion shaped by alar
    cartilages and dense CT forms lateral wall of
    each nostril
  • Fig. 22.2 ab

9
Conn. tissues shape the nose
(Ala nasi)
10
External Anatomy of Nasal Region
11
Nasal Cavity (1)
  • Extends from nostrils to posterior nares
  • Vestibule dilated chamber inside ala nasi (just
    inside the nostril)
  • stratified squamous epithelium and vibrissae
    (guard hairs)
  • Nasal septum divides cavity into right and left
    chambers called nasal fossae
  • Makes up of Perpendicular plate of ethmoid bone
    . . .

12
Nasal Cavity (2) - Conchae and Meatuses
  • Superior, middle and inferior nasal conchae
  • 3 folds of tissue on lateral wall of nasal fossa
  • mucous membranes lines the cavity
  • Meatuses
  • narrow air passages beneath each conchae
  • narrowness and turbulence ensures most air
    contact the mucous membrane.
  • Fig. 22.3

13
?
?
?
14
Figure 8.4b
Skull--
1
2
5
6
3
7
4
8
10
9
11
15
?
?
?
?
?
?
?
?
Palatine bones
16
Functions of the nose
  • Nose (mouth)air enters the body through here
  • Functions
  • Warm and moisten air
  • Produce nasal mucus how much each day? By epi.
    cells
  • Cilia push particles toward the throat

17
2. Pharynx (throat)
  • Functions
  • Common entryway of . . .
  • Food and air diverge into two separate branches
  • Air ? which organ next?
  • Food ? which organ next?
  • Which passage way (air or food) is at the
    anterior?
  • Figure 22.3 bc

22-17
18
Lower respiratory tract
22-18
19
Three Regions of Pharynx
Hyoid bone
Cricoid cartilage
22-19
20
2. Pharynx (continued)
  • Nasopharynx (pseudostratified epithelium)
  • posterior to choanae, dorsal to soft palate
  • receives auditory tubes houses _____ tonsil
  • 90? downward turn traps large particles (gt10?m)
  • Oropharynx (stratified squamous epithelium)
  • space between soft palate and root of tongue,
    inferiorly as far as hyoid bone, contains
    palatine and lingual tonsils
  • Laryngopharynx (stratified squamous epi.)
  • hyoid bone to level of cricoid cartilage

21
3. Larynx (Voice box)
  • Anatomyanterior protrusion called ?
  • Functions
  • Air passageway with cilia
  • Epiglottis superior opening of larynx
  • Voice production by ____________
  • LaryngitisInflammation of the vocal cords
    symptoms? Three major causes?

22
Larynx
  • Glottis vocal cords and opening between them
  • Epiglottis
  • flap of tissue that guards glottis, directs food
    and drink to esophagus
  • Infant larynx epiglottis touches soft palate
  • higher in throat, forms a continuous airway from
    nasal cavity to the larynx that allows breathing
    while swallowing
  • by age 2, more muscular tongue, forces larynx
    down to lower position

23
Nine Cartilages of Larynx
  • The superior three (large)
  • Epiglottic cartilage (1)- most superior
  • Thyroid cartilage (1) largest laryngeal
    prominence is the Adams apple
  • Cricoid cartilage (1)- connects larynx to trachea
  • Fig. 22.4

24
Views of Larynx
1
2
4
5-6
3
25
Nine Cartilages of Larynx
  • The other 3 small pairs of cartilages
  • Arytenoid cartilages (2) - posterior to thyroid
    cartilage
  • Corniculate cartilages (2) - attached to
    arytenoid cartilages like a pair of little horns
  • The above two pairs of cartilages function in
    speech
  • Cuneiform cartilages (2) - support soft tissue
    between arytenoids and epiglottis

26
Walls of Larynx
  • Interior wall has 2 muscular folds on each side,
    from thyroid to arytenoid cartilages
  • Vestibular folds (superior pair) and vocal
    cords/folds (inferior) (produce sound)
  • Intrinsic muscles (deep)- rotate corniculate and
    arytenoid cartilages (Fig. 22.6)
  • adducts (tightens high pitch sound) or abducts
    (loosens low pitch sound) vocal cords
  • Extrinsic muscles (superficial)- connect larynx
    to hyoid bone, elevate larynx during swallowing

27
low pitch
High pitch
28
4.Trachea (windpipe)
  • Anatomy/Histology Beginning of lower respiratory
    tract (Fig. 22.7 a-c x)
  • Rigid tube 5 in. long and 1 in. diameter,
    anterior/posterior (?) to the esophagus
  • Supported by 16 to 20 C-shaped rings openings
    facing anterior/posterior (?)
  • The lowermost cartilage called ________
  • A smooth m. (trachealis) spans opening in rings,
    adjusts airflow facing (ant./post.?)
  • (Histology) Larynx and trachea lined with
    ciliated pseudostratified columnar epi. which
    functions as mucociliary escalator

29
Larynx
See next three slides
Trachea
Carina
30
(No Transcript)
31
Ciliated Pseudostratified Epi.
32
Mucosa
33
ID structures Practice at home
A
B
C
D
E
34
4. Trachea (continued)
  • Functions
  • Air passageway
  • Warm and moisten air
  • Remove particles debris
  • Clinical applications
  • Trachea obstruction and Heimlich Maneuver
  • Tracheostomy (Insight 22.1) when the obstruction
    is superior to the level of the larynx pitfall?

35
5. Bronchi (supported by cartilages)
  • Primary bronchi (2) with C-shaped rings
  • from trachea after 2-3 cm enter hilum of lungs
  • right bronchus slightly wider and more vertical
  • Secondary (lobar) bronchi (2 L. lung 3 R. lung)
    one secondary bronchus for each lobe of lung
    cartilage plates
  • Tertiary (segmental) bronchi (8 L. lung 10 R.
    lung) cartilage plates
  • bronchopulmonary segment portion of lung
    supplied by each tertiary bronchus
  • Fig. 22.7

36
All bronchi are supported by cartilages
37
6. Bronchioles
  • Bronchioles (lack cartilage 1 mm or less in
    diameter ciliated simple columnar to ciliated
    simple cuboidal epi.)
  • Each divides into 50 - 80 terminal bronchioles
  • Mostly nonciliated simple cuboidal end of
    conducting division
  • Each terminal bronchiole branches into
    respiratory bronchioles (respiratory div. now)
    smallest ones are nonciliated epi.
  • Each divides into 2-10 alveolar ducts
    (nonciliated simple squamous epi.) end in
    alveolar sacs
  • Fig. 22.11

38
Bronchial tree
  • Def. --Highly branched system of air tubes from
    the primary bronchi to about 65,000 terminal
    bronchioles
  • Resemble inverted trees
  • Fig. 22.0 X

39
CO 22
Left lung 8 segments
Right lung 10 segments
Each broncho-pulmonary segment by a different
color of resin
40
Right lung 10 broncho-pulmonary segments
Left lung 8 broncho-pulmonary segments
41
7. Lungs (Fig. 22.9 a b)
  • Concave base and blunt apex
  • Costal surface--
  • Concave mediastinal surface
  • The hilum (hilus) slits/depression where
    bronchi, blood vessels, nerves entering/leaving
  • The right lung shorter the left lung narrower,
    with cardiac impression
  • L 2 lobes separated by a fissure
  • R 3 lobes separated by two fissures

42
(No Transcript)
43
(No Transcript)
44
8. Alveoli meaning hollow
  • Def. tiny air sacs where . . .
  • Anatomy/physiology
  • Each alveolus single layer of epithelium
    surrounded by ____________________
  • Numerous alveoli (150 million) in each lung
  • Figure 22.12

45
Alveolar Blood Supply
46
AlveoliPore of Kohn
  • Pore of Kohn
  • Location?
  • Function?
  • Analogy
  • Fig. x

47
Smooth muscle
1.Terminal bronchiole
A. Branch of pulmonary artery
C. Branch of pulmonary vein
2. Respiratory Bronchiole (beginning of
respiratory division)
B. Pulmonary capillaries
3. Alveolus
Alveolar sac
Pores of Kohn
48
AlveoliThree types of cells
  • Squamous (Type I) alveolar cells
  • Location?
  • Function--Gas exchange through these sites What
    type of epi.?
  • Respiratory membrane 0.5 micrometer the barrier
    between alveolar air and _____
  • Great (Type II) alveolar cells
  • Location? Embed within alveolar walls
  • Functions secretes surfactant repairs
  • Figure 22.12

49
Fluid lining With surfactant
C. Alveolar macrophage
B. Great alveolar cell
Alveolus
Pulmonary capillary
O2
A. Squamous alveolar cell
Respiratory mem.
RBC
50
AlveoliThree types of cells
  • Alveolar macrophages (dust cells)
  • Most numerous of all cells in the lung
  • Large tissue-bound phagocytes
  • Location within the alveolar lumen
  • Function-- Phagocytosis

51
Practice at home
D
A
What is respiratory membrane?
C
B.
Fig. 22.11 b and c
Identify A, B, C, and D.
Respiratory mem.
52
Questions (muddiest points)?
53
II. Pulmonary Ventilation
  • Respiratory cycle One complete cycle of
    inspiration and expiration
  • Breathing (pulmonary ventilation) repeated
    cycles above
  • Quiet respiration vs. forced respiration
  • Basic requirement of respiration
  • Flow of air in and out of lung requires a
    ______________ between air pressure within lungs
    and outside body why? (next slide)

54
Breathing- mechanical steps
  • Why flow of air into and out of the lungs during
    the breathing?
  • A rule of thumb
  • PV K (Boyles law) with Temp. is constant
  • For example, during inspiration lung volume
    increases? lung pressure decreases ? therefore,
    air flow (from where to where? ___________________
    __)
  • Figure x (Boyles Law explained)

55
Figure 13.10Page 467
Piston
Each container with the same number of gas
molecules
Piston
Piston
Pressure gauge
A. Volume 1/2 Pressure 2
B. Volume 1 Pressure 1
C. Volume 2 Pressure 1/2
PV K
56
Breathing- mechanical steps
  • Mechanism of Inspiration (resting)
  • Diaphragm contracts and move ______?
  • External intercostals muscles contract ? the ribs
    move __________?
  • ? Chest volume _________?
  • ? Air pressure is _________? (Boyles law)
  • ? Air flows inward
  • Deeper Inspiration
  • Neck muscles (among others) are also involved
  • 5 Figures

57
Diaphragm
A 2-dimentional figure
58
Quiet Inspiration
2. Contraction of external intercostal muscles
1. Contraction of diaphragm
increases side-to-side dimension (x)
increases vertical dimension of (z)
increases front-to-back Dimension (y)
A 3-dimentional figure
59
Equilibrated no net movement of air
Before inspiration
760 mmHg
Preinspiratory size of thorax
760 mmHg
Preinspiratory size of lungs
60
760 mm Hg
During inspiration
Size of thorax ? on contraction of inspiratory
muscles
Size of lungs ? as they are stretched to fill the
expanded thorax pressure ?
757-759 mm Hg (from 760)
Demonstrationlung model
61
Muscles of active/forced expiration
Muscles of deeper inspiration
1. Sternocleidomastoid
Internal intercostal muscles
2. Scalenus
1. External intercostal muscles
2. Diaphragm
Abdominal muscles
Major muscles of inspiration
62
Breathing- mechanical steps (students practice
on this KEY on next slide)
  • Mechanism of Expiration
  • Diaphragm ________ and becomes ______
  • External intercostal muscles ____ ? the ribs move
    ______
  • ? Chest volume _________?
  • ? Air pressure is _________? (Boyle law)
  • ? Air flows outward
  • Forced expiration abdominal and internal
    intercostal muscles are involved
  • Figures 22.13

63
Relaxation of external intercostal muscles
Contraction of internal intercostal muscles
Contraction of internal intercostal muscles
flattens ribs and sternum, further
reducing side-to-side and front-to-back
dimensions of thoracic cavity
A review slide on expiration
Contraction of abdominal muscles
Position of relaxed abdominal muscles
Relaxation of diaphragm
Contractions of abdominal muscles cause diaphragm
to be pushed upward, further reducing vertical
dimension of thoracic cavity
Passive expiration
Return of diaphragm, ribs, and sternum to
resting position on relaxation of inspiratory
muscles restores thoracic cavity to
preinspiratory size
Active expiration
64
During expiration
760 mm Hg
Size of thorax on relaxation of inspiratory
muscles
761 mm Hg (from 760)
Size of lungs as they recoil
65
Summary of respiratory muscles (This slide for
review with Fig. x next)
  • Diaphragm (dome shaped)
  • contraction flattens diaphragm
  • External intercostals
  • increases XY diameter stiffen thoracic cage
  • Scalenes - hold first 2 pair of ribs stationary
  • Pectoralis minor, sternocleidomastoid and erector
    spinae muscles
  • used in forced inspiration
  • Abdominals, internal intercostals, and latissimus
    dorsi
  • forced expiration (to sing, cough, sneeze)
  • Valsalva maneuver raise abdominal pressure . . .

66
Forced Expiration
Forced Inspiration
Quiet Inspiration
67
III. Neural Control of Breathing
68
Neural Control of Breathing (1)
  • Breathing depends on repetitive stimuli from the
    braincontrolled at two levels (A B below)
  • Neurons in medulla oblongata and pons control
    unconscious breathing
  • Ondines curse brainstem damage
  • Causes Poliomyelitis etc.
  • Symptoms disabled automatic respiratory
    functions
  • Cure--
  • Voluntary control provided by motor cortex is
    cerebral and consciously controlled

69
Neural Control of Breathing (2)
  • Unconscious breathing
  • Inspiratory neurons fire during inspiration
  • Expiratory neurons fire during forced expiration
  • Fibers of phrenic nerve go to diaphragm
    intercostal nerves to intercostal muscles

70
Three Respiratory Control Centersin the
brainstem (Fig. 14.4)
  • Ventral respiratory group (VRG) in medulla
  • Primary generator of respiratory rhythm
  • Having both inspiratory and expiratory neurons,
    taking turns to fire ? spinal integrating centers
  • Dorsal respiratory group (DRG) in medulla
  • An integrating center inputs from . . . (Fig.
    22.4)
  • Output to the VRG modifying respiratory rhythm
  • Pontine respiratory group (PRG) in pons
  • Modifies the rhythm of the VRG
  • Making each breath shorter/shallower OR longer/
    deeper during sleep, exercise, etc.

71
(No Transcript)
72
Anterior
1. from higher brain centers
2. PRG
Pons
DRG
3. Central Chemoreceptors
Medulla
4. CN IX and X
VRG
Spinal integrating centers
22-72
73
Input to the respiratory centers
  • Central chemoreceptors (in medulla)
  • primarily monitor pH (and CO2) of CSF
  • Peripheral chemoreceptors (Fig. 22.15)
  • Monitor pH, O2 and CO2 and fibers synapse to the
    DRG
  • Stretch receptors (bronchi and bronchioles)
  • Excessive inflation triggers inflation reflex and
    stops inspiration
  • Irritant receptors (epithelial cells of the
    airway)
  • Respond to particles and trigger coughing etc.

74
(No Transcript)
75
Voluntary Control of breathing
  • Neural pathways
  • motor cortex of frontal lobe of cerebrum sends
    impulses down corticospinal tracts to respiratory
    neurons in spinal cord, bypassing brainstem
  • Limitations on voluntary control
  • blood CO2 and O2 limits cause automatic
    respiration overrides ones will
  • Voluntary control is important in singing,
    speaking, breath-holding

76
Check Point Questions
  • Q--Where exactly are the medulla oblongata and
    the pons located, respectively?
  • Answer medulla oblongata is the most caudal part
    of the brainstem (stalklike lower portion of the
    brain), immediately superior to the spinal cord
  • The pons is a part of the brainstem located
    immediately superior to the medulla oblongata and
    ventral to the cerebellum

77
Next section--IV. Pressure, Resistance, and
Airflow
Q-- Is it possible that temperamental children
may hold their breath until they die?
78
Pressure and Airflow (1)
  • Introduction (Mostly we have talked about)
  • Atmospheric (barometric) pressure--
  • 1 atmosphere (atm) 760 mmHg
  • Intrapulmonary pressure and lung volume
  • pressure is inversely proportional to volume
  • for a given amount of gas, as volume ?, pressure
    ? and as volume ?, pressure ?
  • Pressure gradients matters to airflow--
  • difference between atmospheric and intrapulmonary
    pressure
  • Airflow (F) ?P (pressure gradient)

79
Pressure and Airflow (2)
  • During inspiration how lungs are expanded?
  • Ribs swing upward and outward ? lungs expand with
    thoracic cage
  • ? intrapulmonary pressure (-3 mm Hg 3 mm Hg
    below atmospheric pressure)
  • 500 ml of air flows into the lungs (tidal volume)
  • Another force expands the lungs warming of the
    inhaled air. Inhaled air expands, it helps to
    inflate the lungs. (Charless law)
  • Charless law volume of given quantity of gas is
    directly proportional to its absolute temperature

80
Pressure and Airflow (3)
  • Recoiling mechanisms during expiration
  • During quiet breathing, expiration achieved by
    elasticity of lungs and thoracic cage etc.
  • As volume of thoracic cavity ?, intrapulmonary
    pressure ? (3 mm Hg) and air is expelled
  • Pulmonary elasticity related disorders
  • Atelectasis The collapse of a lung
  • Causes A) Pneumothorax (air in the pleural
    cavity see next slide), B) airway obstruction
    (that part of lung collapses b/c it cannot be
    reventilated, for example inadequate surfactant,
    aspirated object etc.

81
Pneumothorax
  • Def.abnormal condition of air entering the
    pleural sac
  • Causes (see fig. x)
  • Consequences transmural pressure gradient no
    longer exists and . . .
  • Figure x

82
760
Atelectasis (pneumothorax)
A
760
B
C
760 intra-pulmonary pressure
760
760
760
756 intrapleural pressure
Collapsed lung
A Parietal pleura Bpleural cavity (pleural
fluid) C Visceral pleura
83
Pulmonary surfactant (1)
  • A potential problem of breathing
  • In alveolitiny sacs . . . why?
  • b/c surface tension of water Fig. z
  • Solution-- pulmonary surfactant
  • What is it? Phospholipoproteins
  • Where does it from? By what cell type?
  • Functions?

84
Demonstration
H2O molecules
An alveolus
85
Pulmonary surfactant (2)
  • (Newborn/Infant) respiratory distress syndrome
    (IRDS)
  • What is lacking in premature infants?
  • What are the problems?
  • When surfactant is produced?
  • Alveoli collapsed completely
  • Newborns muscles--
  • Cure--

86
Check Point Questions
  • What types of cells make up the wall of an
    alveolus? Function?
  • What type of cell in the lungs secrete pulmonary
    surfactant? Function?

87
V. Alveolar Ventilation
88
Alveolar Ventilation (1)
  • Does all inhaled air enter the alveoli?
  • Dead air (150 ml per breath)
  • fills conducting division of airway, cannot
    exchange gases with the blood
  • Where is the dead air? In anatomic dead space
  • It exists in conducting division of airway
  • Normally about _______mL
  • Physiological (total) dead space
  • sum of anatomic dead space and any pathological
    alveolar dead space

89
Alveolar ventilation (2)
  • Alveolar ventilation rate (AVR) bodys ability
    to get oxygen to the tissues per minute
  • alveolar ventilation rate (AVR) (Tidal volume -
    dead space volume) x respiratory rate
  • AVR (500-150mL) x 12 breaths/min 4,200 mL/min

90
Measurements of Ventilation (1)
  • Spirometer measures ventilation specifically
    respiratory volumes and capacities
  • Fig. x

91
Floating drum
Air
Recording paper advancing with time
Water
Expired air
Spirogram
Inspired air
92
Measurements of Ventilation (2)
  • Respiratory volumes
  • Tidal volume (TV) - The air entering or leaving
    the lungs in a single breath.
  • Inspiratory reserve volume (IRV) - The extra air
    that can be maximally inspired over the typical
    resting TV.
  • Expiratory reserve volume (ERV) - The maximal
    volume of air that can be actively expired beyond
    a tidal volume.
  • Residual volume (RV) - air remaining in lungs
    after maximum expiration
  • Fig. 22.17

93
a capacity is the sum of more than two volumes
2
?
?
?
1
3
?
4
94
Measurements of Ventilation (3)
  • Respiratory capacities
  • Inspiratory capacity (IC) - The maximum volume of
    air that can be inspired at the end of a normal
    quiet expiration. TV IRV
  • Functional residual capacity (FRC) Amount of
    air remaining in the lungs after a normal tidal
    expiration RV ERV
  • Vital capacity (VC) - The maximum volume of air
    that can be expired following a maximal
    inspiration. TV IRV ERV
  • Total lung capacity (TLC) - maximum amount of air
    lungs can hold VC RV

95
ID the following respiratory volumes/capacities
D
A
F
H
G
B
E
C
Work on this figure at home.
96
Check Point Question
  • If you breathe in as deeply as possible and then
    exhale as much air as you can, which lung volume
    or capacity have you demonstrated?

97
Lung disorders and spirometry
  • Restrictive disorders Those having reduce
    pulmonary compliance, limiting the amount to
    which the lungs can be inflated
  • Disorders- black lung disease, tuberculosis
  • Spirometry- reduced IC, VC, TLC
  • Obstructive disorders (COPD Chronic Obstructive
    Pulmonary Disease) those that interfere with
    airflow by narrowing or blocking the airway
  • Disorders asthma, emphysema etc.
  • Detection Forced expiratory volume (FEV)-- of
    vital capacity exhaled/time healthy adult -
    ___________ of VC in 1 sec (Fig. Y)

98
FEV1.0
1 sec interval
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