UNIT 7

The Respiratory System

Learning Outcomes

At the end of this lesson, you will be able to:

 name the organs forming the respiratory passageway;

 describe the functions of the respiratory organs;
 describe the process of gas exchange in the lungs and tissues;
 describe how oxygen and carbon dioxide are transported in the blood; and
 discuss measures on the care of respiratory organs.

Pretest

Circle the term that does not belong in each of the following groupings.
1. Sphenoidal Maxillary Mandibular Ethmoidal Frontal

2. Nasal cavity Trachea Alveolus Larynx Bronchus

3. Apex Base Hilum Larynx Pleura

4. Sinusitis Peritonitis Pleurisy Tonsillitis Laryngitis

5. Laryngopharynx Oropharynx Transports air and food Nasopharynx

6. Alveoli Respiratory zone Alveolar sac Main bronchus

Content

When the respiratory system is mentioned, people generally think of breathing, but breathing is
only one of the activities of the respiratory system. The body cells need a continuous supply of
oxygen for the metabolic processes that are necessary to maintain life. The respiratory system
works with the circulatory system to provide this oxygen and to remove the waste products of
metabolism. It also helps to regulate pH of the blood.

Respiration is the sequence of events that results in the exchange of oxygen and carbon dioxide
between the atmosphere and the body cells. Every 3 to 5 seconds, nerve impulses stimulate the
breathing process, or ventilation, which moves air through a series of passages into and out of the
lungs. After this, there is an exchange of gases between the lungs and the blood. This is called
external respiration. The blood transports the gases to and from the tissue cells. The exchange of
gases between the blood and tissue cells is internal respiration. Finally, the cells utilize the oxygen
for their specific activities: this is called cellular metabolism, or cellular respiration. Together, these
activities constitute respiration.

Mechanics of Ventilation
Ventilation, or breathing, is the movement of air through the conducting passages between the
atmosphere and the lungs. The air moves through the passages because of pressure gradients that
are produced by contraction of the diaphragm and thoracic muscles.

Pulmonary ventilation
Pulmonary ventilation is commonly referred to as breathing. It is the process of air flowing into the
lungs during inspiration (inhalation) and out of the lungs during expiration (exhalation). Air flows
because of pressure differences between the atmosphere and the gases inside the lungs.

Air, like other gases, flows from a region with higher pressure to a region with lower pressure.
Muscular breathing movements and recoil of elastic tissues create the changes in pressure that
result in ventilation. Pulmonary ventilation involves three different pressures:

Atmospheric pressure
Intraalveolar (intrapulmonary) pressure
Intrapleural pressure

Atmospheric pressure is the pressure of the air outside the body. Intraalveolar pressure is the
pressure inside the alveoli of the lungs. Intrapleural pressure is the pressure within the pleural
cavity. These three pressures are responsible for pulmonary ventilation.

Inspiration
Inspiration (inhalation) is the process of taking air into the lungs. It is the active phase of ventilation
because it is the result of muscle contraction. During inspiration, the diaphragm contracts and the
thoracic cavity increases in volume. This decreases the intraalveolar pressure so that air flows into
the lungs. Inspiration draws air into the lungs.

Expiration
Expiration (exhalation) is the process of letting air out of the lungs during the breathing cycle.
During expiration, the relaxation of the diaphragm and elastic recoil of tissue decreases the thoracic
volume and increases the intraalveolar pressure. Expiration pushes air out of the lungs.

Respiratory Volumes and Capacities

Under normal conditions, the average adult takes 12 to 15 breaths a minute. A breath is one
complete respiratory cycle that consists of one inspiration and one expiration.

An instrument called a spirometer is used to measure the volume of air that moves into and out of
the lungs, and the process of taking the measurements is called spirometry. Respiratory
(pulmonary) volumes are an important aspect of pulmonary function testing because they can
provide information about the physical condition of the lungs.

Respiratory capacity (pulmonary capacity) is the sum of two or more volumes.

Factors such as age, sex, body build, and physical conditioning have an influence on lung volumes
and capacities. Lungs usually reach their maximumin capacity in early adulthood and decline with
age after that.

Conducting Passages
Illustration of the conducting passages of the upper and lower respiratory tracts
The respiratory conducting passages are divided into the upper respiratory tract and the lower
respiratory tract. The upper respiratory tract includes the nose, pharynx, and larynx. The lower
respiratory tract consists of the trachea, bronchial tree, and lungs. These tracts open to the outside
and are lined with mucous membranes. In some regions, the membrane has hairs that help filter the
air. Other regions may have cilia to propel mucus.

Nose, Nasal Cavities, & Paranasal Sinuses

Nose & Nasal Cavities
The framework of the nose consists of bone and cartilage. Two small nasal bones and extensions
of the maxillae form the bridge of the nose, which is the bony portion. The remainder of the
framework is cartilage and is the flexible portion. Connective tissue and skin cover the framework.

Air enters the nasal cavity from the outside through two openings: the nostrils or external nares.
The openings from the nasal cavity into the pharynx are the internal nares. Nose hairs at the
entrance to the nose trap large inhaled particles.

Paranasal Sinuses
Paranasal sinuses are air-filled cavities in the frontal, maxilae, ethmoid, and sphenoid bones. These
sinuses, which have the same names as the bones in which they are located, surround the nasal
cavity and open into it. They function to reduce the weight of the skull, to produce mucus, and to
influence voice quality by acting as resonating chambers.

Pharynx
The pharynx, commonly called the throat, is a passageway that extends from the base of the skull
to the level of the sixth cervical vertebra. It serves both the respiratory and digestive systems by
receiving air from the nasal cavity and air, food, and water from the oral cavity. Inferiorly, it opens
into the larynx and esophagus. The pharynx is divided into three regions according to location: the
nasopharynx, the oropharynx, and the laryngopharynx (hypopharynx).

The nasopharynx is the portion of the pharynx that is posterior to the nasal cavity and extends
inferiorly to the uvula. The oropharynx is the portion of the pharynx that is posterior to the oral
cavity. The most inferior portion of the pharynx is the laryngopharynx that extends from the hyoid
bone down to the lower margin of the larynx.

The upper part of the pharynx (throat) lets only air pass through. Lower parts permit air, foods, and
fluids to pass.

The pharyngeal, palatine, and lingual tonsils are located in the pharynx. They are also called
Waldereyer's Ring.

The retromolar trigone is the small area behind the wisdom teeth.

Larynx & Trachea

Larynx
The larynx, commonly called the voice box or glottis, is the passageway for air between the pharynx
above and the trachea below. It extends from the fourth to the sixth vertebral levels. The larynx is
often divided into three sections: sublarynx, larynx, and supralarynx. It is formed by nine cartilages
that are connected to each other by muscles and ligaments.
The larynx plays an essential role in human speech. During sound production, the vocal cords close
together and vibrate as air expelled from the lungs passes between them. The false vocal cords
have no role in sound production, but help close off the larynx when food is swallowed.

The thyroid cartilage is the Adam's apple. The epiglottis acts like a trap door to keep food and other
particles from entering the larynx.

Trachea
The trachea, commonly called the windpipe, is the main airway to the lungs. It divides into the right
and left bronchi at the level of the fifth thoracic vertebra, channeling air to the right or left lung.

The hyaline cartilage in the tracheal wall provides support and keeps the trachea from collapsing.
The posterior soft tissue allows for expansion of the esophagus, which is immediately posterior to
the trachea.

The mucous membrane that lines the trachea is ciliated pseudostratified columnar epithelium
similar to that in the nasal cavity and nasopharynx. Goblet cells produce mucus that traps airborne
particles and microorganisms, and the cilia propel the mucus upward, where it is either swallowed
or expelled.

Bronchi, Bronchial Tree, & Lungs

Bronchi and Bronchial Tree

In the mediastinum, at the level of the fifth thoracic vertebra, the trachea divides into the right and
left primary bronchi. The bronchi branch into smaller and smaller passageways until they terminate
in tiny air sacs called alveoli.

The cartilage and mucous membrane of the primary bronchi are similar to that in the trachea. As
the branching continues through the bronchial tree, the amount of hyaline cartilage in the walls
decreases until it is absent in the smallest bronchioles. As the cartilage decreases, the amount of
smooth muscle increases. The mucous membrane also undergoes a transition from ciliated
pseudostratified columnar epithelium to simple cuboidal epithelium to simple squamous epithelium.

The alveolar ducts and alveoli consist primarily of simple squamous epithelium, which permits rapid
diffusion of oxygen and carbon dioxide. Exchange of gases between the air in the lungs and the
blood in the capillaries occurs across the walls of the alveolar ducts and alveoli.
Lungs
The two lungs, which contain all the components of the bronchial tree beyond the primary bronchi,
occupy most of the space in the thoracic cavity. The lungs are soft and spongy because they are
mostly air spaces surrounded by the alveolar cells and elastic connective tissue. They are
separated from each other by the mediastinum, which contains the heart. The only point of
attachment for each lung is at the hilum, or root, on the medial side. This is where the bronchi,
blood vessels, lymphatics, and nerves enter the lungs.

The right lung is shorter, broader, and has a greater volume than the left lung. It is divided into three
lobes and each lobe is supplied by one of the secondary bronchi. The left lung is longer and
narrower than the right lung. It has an indentation, called the cardiac notch, on its medial surface for
the apex of the heart. The left lung has two lobes.

Each lung is enclosed by a double-layered serous membrane, called the pleura. The visceral pleura
is firmly attached to the surface of the lung. At the hilum, the visceral pleura is continuous with the
parietal pleura that lines the wall of the thorax. The small space between the visceral and parietal
pleurae is the pleural cavity. It contains a thin film of serous fluid that is produced by the pleura. The
fluid acts as a lubricant to reduce friction as the two layers slide against each other, and it helps to
hold the two layers together as the lungs inflate and deflate.

Learning Activities

I.
Using the key choices, select the terms identified in the following descriptions by inserting the
appropriate term or letter in the answer blanks.
Key Choices:

A. Alveoli D. Epiglottis G. Palate J. Main bronchi M. Vocal cords

B. Bronchioles E. Esophagus H. Parietal pleura K. Trachea
C. Conchae F. Glottis I. Phrenic L. Visceral pleura

_________________________ 1. Smallest conducting respiratory passageways

_________________________ 2. Separates the oral and nasal cavities
_________________________ 3. Major nerve, stimulating the diaphragm
_________________________ 4. Food passageway posterior to the trachea
_________________________ 5. Closes off the larynx during swallowing
_________________________ 6. Windpipe
_________________________ 7. Actual site of gas exchanges
_________________________ 8. Pleural layer covering the thorax walls
_________________________ 9. Pleural layer covering the lungs
_________________________ 10. Opening between vocal folds
_________________________ 11. Fleshy lobes in the nasal cavity which increase its surface area
_________________________ 12. Vibrate with expired air

II.
Using the key choices, select the terms identified in the following descriptions by inserting the
appropriate term or letter in the answer blanks.

Key Choices:
A. Atmospheric pressure B. Intrapulmonary pressure C. Intrapleural pressure
_________________________ 1. In healthy lungs, it is always lower than atmospheric pressure
(that is, it is negative pressure)
_________________________ 2. Pressure of air outside the body
_________________________ 3. As it decreases, air flows into the passageways of the lungs
_________________________ 4. As it increases over atmospheric pressure, air flows out
of the lungs
_________________________ 5. If this pressure becomes equal to the atmospheric pressure,
the lungs collapse
_________________________ 6. Rises well over atmospheric pressure during a forceful cough
_________________________ 7. Also known as intra-alveolar pressure

III.
Use the key choices to respond to the following descriptions. Insert the correct term or letter in the
answer blanks.

Key Choices:
A. External respiration C. Inspiration E. Ventilation (breathing)
B. Expiration D. Internal respiration

_________________________ 1. Period of breathing when air enters the lungs

_________________________ 2. Exchange of gases between the systemic capillary blood
and body cells
_________________________ 3. Alternate flushing of air into and out of the lungs
_________________________ 4. Exchange of gases between alveolar air and pulmonary
capillary blood
_________________________ 5. Period of breathing when air leaves the lungs

Mastery Test

___1. Structures that are part of the respiratory zone include:

A. terminal bronchioles
B. respiratory bronchioles
C. tertiary bronchi
D. alveolar ducts
___2. Which structures are associated with the production of speech?
A. Cricoid cartilage
C. Arytenoid cartilage
B. Glottis
D. Pharynx
___3. The skeleton of the external nose consists of:
A. cartilage and bone
B. bone only
C. hyaline cartilage only
D. elastic cartilage only
___4. The respiratory zone function is:
A. conduction
B. moistening of air
C. gaseous exchange
D. warming of air
___5. Where does the pharyngotympanic tube drain into?
A. Oropharynx C. Nasopharynx
B. Larynx D. Laryngopharynx
___6. The function of the cuboid cells of the alveolar walls is:
A. to produce surfactant
B. to propel mucous sheets
C. phagocytosis of dust particles
D. to allow rapid diffusion of respiratory gases
___7. An examination of a lobe of the lung reveals many branches off the main passageway.
These branches are:
A. main bronchi C. tertiary bronchi
B. lobar bronchi D. segmental bronchi
___8. What feature can be used to allow alternate routes for air if bronchioles become
blocked?
A. Alveolar ducts
B. Alveolar sacs
C. Alveolar pores
D. Terminal bronchioles
___9. The respiratory membrane (air-blood barrier) consists of:
A. squamous cells, basal membranes, endothelial cells
B. air, connective tissue, lung
C. squamous and cuboidal epithelial cells and macrophages
D. pseudostratified epithelium, lamina pro- pria, capillaries
___10. Carbon dioxide is largely transported in the blood as:
A. bicarbonate ions
B. carbon monoxide
C. carbonic acid
D. free gas
___11. The basic rate of breathing is set by the:
A. ventral respiratory group
B. cerebellum
C. dorsal respiratory group
D. diaphragm
___12. Emphysema is characterized by:
A. excess mucus
B. destruction of alveolar walls
C. increased elasticity
D. chronic cough
___13. When the inspiratory muscles contract,
A. the size of the thoracic cavity increases in diameter
B. the size of the thoracic cavity increases in length
C. the volume of the thoracic cavity decreases
D. the size of the thoracic cavity increases in both length and diameter
___14. Lung collapse is prevented by:
A. high surface tension of alveolar fluid
B. high surface tension of pleural fluid
C. high pressure in the pleural cavities
D. high elasticity of lung tissue
___15. Resistance is increased by:
A. epinephrine
B. parasympathetic stimulation
C. inflammatory chemicals
D. contraction of the trachealis muscle
___16. Which of the following changes accompanies the loss of elasticity associated with aging?
A. Increase in tidal volume
B. Increase in inspiratory reserve volume
C. Increase in residual volume
D. Increase in vital capacity