Respiratory Physiology Part 1, Revised 2020

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Human Respiratory

Physiology
Part 1
DR. RITCHE M. AGCAOILI, MHA
LEARNING OBJECTIVES
1. Discuss the basics of the Respiratory System
– Functions & functional anatomy

2. Discuss and differentiate the Gas Laws

3. Discuss Mechanics of ventilation


Basics of the Respiratory System
General Functions

• Exchange of gases
• Directionality depends on gradients!
– Atmosphere to blood
– Blood to tissues
• Regulation of pH
– Dependent on rate of CO2 release
• Protection
• Vocalization
• Synthesis
Basics of the Respiratory System
Respiration

• What is respiration?
– Respiration = the series of exchanges that leads to
the uptake of oxygen by the cells, and the release of
carbon dioxide to the lungs
Step 1 = ventilation
– Inspiration & expiration
Step 2 = exchange between alveoli (lungs) and pulmonary
capillaries (blood)
– Referred to as External Respiration
Step 3 = transport of gases in blood
Step 4 = exchange between blood and cells
– Referred to as Internal Respiration
– Cellular respiration = use of oxygen in ATP
synthesis
Schematic View of Respiration

External Respiration

Internal Respiration
Basics of the Respiratory System
Functional Anatomy

• What structural aspects must be considered in the


process of respiration?
– The conduction portion
– The exchange portion
– The structures involved with
ventilation
• Skeletal & musculature
• Pleural membranes
• Neural pathways
• All divided into
– Upper respiratory tract
• Entrance to larynx
– Lower respiratory tract
• Larynx to alveoli (trachea
to lungs)
Basics of the Respiratory System
Functional Anatomy

• Bones, Muscles & Membranes


Basics of the Respiratory System
Functional Anatomy

• Function of these Bones, Muscles & Membranes


– Create and transmit a pressure gradient
• Relying on
– the attachments of the
muscles to the ribs
(and overlying tissues)
– The attachment of the
diaphragm to the base
of the lungs and associated
pleural membranes
– The cohesion of the parietal
pleural membrane to the
visceral pleural membrane
– Expansion & recoil of the lung
and therefore alveoli with the
movement of the overlying
structures
Basics of the Respiratory System
Functional Anatomy

• The Respiratory Tree


– connecting the external environment to the
exchange portion of the lungs
– similar to the vascular component
– larger airway = higher flow & velocity
• small cross-sectional area
– smaller airway = lower flow & velocity
• large cross-sectional area
Basics of the Respiratory System
Functional Anatomy

• The Respiratory Tree


– Upper respiratory tract is for all intensive purposes a single large
conductive tube
– The lower respiratory tract starts after the larynx and divides
again and again…and again to eventually get to the smallest
regions which form the exchange membranes
• Trachea
• Primary bronchi
• Secondary bronchi
• Tertiary bronchi conductive portion
• Bronchioles
• Terminal bronchioles
• Respiratory bronchioles with
start of alveoli outpouches
exchange portion
• Alveolar ducts with outpouchings
of alveoli
Basics of the Respiratory System
Functional Anatomy

• What is the function of the upper


respiratory tract? Raises
incoming air to
– Warm 37 Celsius Forms
mucociliary
– Humidify Raises escalator
incoming air to
– Filter 100% humidity
– Vocalize
Basics of the Respiratory System
Functional Anatomy

• What is the function of the lower respiratory


tract?
– Exchange of gases …. Due to
• Huge surface area = 1x105 m2 of type I alveolar cells (simple
squamous epithelium)
• Associated network of pulmonary capillaries
– 80-90% of the space between alveoli is filled with blood in
pulmonary capillary networks
• Exchange distance is approx 1 um from alveoli to blood!
– Protection
• Free alveolar macrophages (dust cells)
• Surfactant produced by type II alveolar cells (septal cells)
Basics of the Respiratory System
Functional Anatomy

• Characteristics of exchange membrane


– High volume of blood through huge capillary
network results in
• Fast circulation through lungs
– Pulmonary circulation = 5L/min through lungs….
– Systemic circulation = 5L/min through entire body!
• Blood pressure is low…
– Means
» Filtration is not a main theme here, we do not want a
net loss of fluid into the lungs as rapidly as the
systemic tissues
» Any excess fluid is still returned via lymphatic system
Basics of the Respiratory System
Functional Anatomy

• Sum-up of functional anatomy


– Ventilation?
– Exchange?
– Vocalization?
– Protection?
Respiratory Physiology
Gas Laws

• Basic Atmospheric conditions


– Pressure is typically measured in mm Hg
– Atmospheric pressure is 760 mm Hg
– Atmospheric components
• Nitrogen = 78% of our atmosphere
• Oxygen = 21% of our atmosphere
• Carbon Dioxide = .033% of our atmosphere
• Water vapor, krypton, argon, …. Make up the rest
• A few laws to remember
– Dalton’s law
– Fick’s Laws of Diffusion
– Boyle’s Law
– Ideal Gas Law
Respiratory Physiology
Gas Laws

• Dalton’s Law
– Law of Partial Pressures
• “each gas in a mixture of gases will exert a pressure
independent of other gases present”
Or
• The total pressure of a mixture of gases is equal to the sum
of the individual gas pressures.
– What does this mean in practical application?
• If we know the total atmospheric pressure (760 mm Hg) and
the relative abundances of gases (% of gases)
– We can calculate individual gas effects!
– Patm x % of gas in atmosphere = Partial pressure of any
atmospheric gas
» PO2 = 760mmHg x 21% (.21) = 160 mm Hg
• Now that we know the partial pressures we know the
gradients that will drive diffusion!
Respiratory Physiology
Gas Laws

• Fick’s Laws of Diffusion


– Things that affect rates of diffusion
• Distance to diffuse P
• Gradient sizes
• Diffusing molecule sizes P
• Temperature P
– What is constant & therefore out of our realm
of concern? P
• So it all comes down to partial pressure gradients
of gases… determined by Dalton’s Law!
Respiratory Physiology
Gas Laws

• Boyle’s Law
– Describes the relationship between pressure
and volume
• “the pressure and volume of a gas in a system are
inversely related”
• P1V1 = P2V2
Respiratory Physiology
Gas Laws

• How does Boyle’s Law work in us?


– As the thoracic cavity (container) expands the volume must go
up and pressure goes down
• If it goes below 760 mm Hg what happens?
– As the thoracic cavity shrinks the volume must go down and
pressure goes up
• If it goes above 760 mm Hg what happens
Boyle’s Law
• Changes in intrapulmonary pressure occur as a
result of changes in lung volume.
– Pressure of gas is inversely proportional to its
volume.
• Increase in lung volume decreases
intrapulmonary pressure.
– Air goes in.
• Decrease in lung volume, raises intrapulmonary
pressure above atmosphere.
– Air goes out.
Respiratory Physiology
Gas Laws

• Ideal Gas law


– The pressure and volume of a container of
gas is directly related to the temperature of
the gas and the number of molecules in the
container
– PV = nRT
• n = moles of gas
• T = absolute temp
• R = universal gas constant @ 8.3145 J/K·mol
– Do we care?
Respiratory Physiology
Gas Laws

• Can’t forget about poor Charles and his law or


Henry and his law
– Aptly named … Charles’s Law & Henry’s Law

As the temp goes up


in a volume of gas the
volume rises At a constant temperature, the amount of a given gas
proportionately dissolved in a given type and volume of liquid is
VµT directly proportional to the partial pressure of that gas
in equilibrium with that liquid.
OR
the solubility of a gas in a liquid at a particular
temperature is proportional to the pressure of that gas
above the liquid.
*also has a constant which is different for each gas
Physical Properties of the Lungs
• Ventilation occurs as a result of pressure
differences induced by changes in lung
volume.
• Physical properties that affect lung
function:
• Compliance
• Elasticity
• Surface tension
Compliance
• Distensibility (stretchability):
• Ease with which the lungs can expand.

• Change in lung volume per change in transpulmonary


pressure.
DV/DP

• 100 x more distensible than a balloon.


– Compliance is reduced by factors that
produce resistance to distension.
Elasticity
• Tendency to return to initial size after
distension.
• High content of elastin proteins.
– Very elastic and resist distension.
• Recoil ability.
• Elastic tension increases during inspiration
and is reduced by recoil during expiration.
Surface Tension
• Force exerted by fluid in alveoli to resist
distension.
• Lungs secrete and absorb fluid, leaving a very thin film of
fluid.
– This film of fluid causes surface tension.
– Fluid absorption is driven (osmosis) by Na+ active
transport.
– Fluid secretion is driven by the active transport of Cl-
out of the alveolar epithelial cells.
• H20 molecules at the surface are attracted to
other H20 molecules by attractive forces.
– Force is directed inward, raising pressure in alveoli.
Surface Tension (continued)

• Law of Laplace:
– Pressure in alveoli is
directly proportional to
surface tension; and
inversely proportional
to radius of alveoli.
– Pressure in smaller
alveolus would be
greater than in larger
alveolus, if surface
tension were the same
in both.
Ventilation
• Terminology
– Inspiration = the movement of air into the respiratory tracts
(upper & lower)
– Expiration = movement of air out of the respiratory tracts
– Respiratory cycle is one inspiration followed by an expiration
• Cause of Inspiration?
– Biological answer
• Contraction of the inspiratory muscles causes an increase in the
thoracic cavity size, thus allowing air to enter the respiratory tract
– Physics answer
• As the volume in the thoracic cavity increases (due to inspiratory
muscle action) the pressure within the respiratory tract drops below
atmospheric pressure, creating a pressure gradient which causes
molecular movement to favor moving into the respiratory tract
– Cause of Expiration?
Ventilation
• What are the different respiratory
patterns?
– Quiet breathing (relaxed)
– Forced inspirations & expirations
• Respiratory volumes follow these
respiratory patterns…
Quiet Inspiration
• Active process:
– Contraction of diaphragm, increases thoracic volume
vertically.
• Parasternal and external intercostals contract,
raising the ribs; increasing thoracic volume
laterally.
• Pressure changes:
– Alveolar changes from 0 to –3 mm Hg.
– Intrapleural changes from –4 to –6 mm Hg.
– Transpulmonary pressure = +3 mm Hg.
Expiration
• Quiet expiration is a passive process.
– After being stretched by contractions of the
diaphragm and thoracic muscles; the diaphragm,
thoracic muscles, thorax, and lungs recoil.
– Decrease in lung volume raises the pressure within
alveoli above atmosphere, and pushes air out.
• Pressure changes:
– Intrapulmonary pressure changes from –3 to +3 mm
Hg.
– Intrapleural pressure changes from –6 to –3 mm Hg.
– Transpulmonary pressure = +6 mm Hg.
Pulmonary Ventilation
Terms Used to Describe Lung
Volumes and Capacities
Ventilation
Pulmonary Function Tests
• Assessed by spirometry.
• Subject breathes into a closed system in which
air is trapped within a bell floating in H20.
• The bell moves up when the subject exhales
and down when the subject inhales.
Ventilation
• Inspiration
– Occurs as alveolar pressure drops below atmospheric
pressure
• For convenience atmospheric pressure = 0 mm Hg
– A (-) value then indicates pressure below atmospheric P
– A (+) value indicates pressure above atmospheric P
• At the start of inspiration (time = 0),
– atmospheric pressure = alveolar pressure
» No net movement of gases!
• At time 0 to 2 seconds
– Expansion of thoracic cage and corresponding pleural
membranes and lung tissue causes alveolar pressure to drop to
-1 mm Hg
– Air enters the lungs down the partial pressure gradient
Ventilation
• Expiration
– Occurs as alveolar pressure elevates above
atmospheric pressure due to a shrinking
thoracic cage
• At time 2-4 seconds
– Inspiratory muscles relax, elastic tissue of corresponding
structures initiates a recoil back to resting state
– This decreases volume and correspondingly increases
alveolar pressure to 1 mm Hg
» This is above atmospheric pressure, causing…?
• At time 4 seconds
– Atmospheric pressure once again equals alveolar
pressure and there is no net movement
Ventilation
• Both inspiration and expiration can be
modified
– Forced or active inspiration
– Forced or active expiration

– The larger and quicker the expansion of the


thoracic cavity, the larger the gradient and
• The faster air moves down its pressure gradient
Ventilation
• Things to consider
– surfactant effect

– airway diameter

– Minute volume respiration (ventilation rate times tidal


volume) & anatomical dead space
• Leading to a more accurate idea of alveolar ventilation rates

– Changes in ventilation patterns


Ventilation
• Surfactant is produced by the septal cells
– Disrupts the surface tension & cohesion of water molecules
– Impact?
• prevents alveoli from sticking together during expiration
Surfactant
• Phospholipid produced
by alveolar type II cells.
• Lowers surface tension.
– Reduces attractive forces of
hydrogen bonding by
becoming interspersed
between H20 molecules.
• Surface tension in alveoli
is reduced.
• As alveoli radius
decreases, surfactant’s
ability to lower surface
tension increases.
• Disorders:
– RDS.
– ARDS.
Ventilation

Airway
diameter &
other factors
that affect
airway
resistance?
Next Time…
• Diffusion and Solubility
– Gas composition in the alveoli
• Gas exchange
• Gas transport in blood
• Regulation of pulmonary function
References
• Boron, Walter F. (2017) Medical Physiology,
International Edition, 3rd edition, USA: Berkeley, CA
94704, Elsevier publisher
• Costanzo, Linda S.(2018). BRS Physiology, 7th edition.
USA: Baltimore, MD, Wolters Kluwer Health..
• Costanzo, Linda S. (2017). Physiology, 6th edition. USA:
Elsevier publisher
• Fox, Stuart Ira. (2015). Human Physiology, 14th Edition.
USA: McGraw-Hill Education publisher.
References
• Guyton, Arthur & Hall, John. (2016). Medical Physiology,
13th edition. USA: Elsevier, publisher
• Koeppen, Bruce M. & Stanton, Bruce A.(2017). Berne &
Levy Physiology, 7th International Edition. USA:
Elsevier publisher
• Preston, Robin R. & Wilson, Thad E. (2020). Physiology,
2nd edition.USA: Philadelphia, Wolters Kluwer
Health; Series: Lippincott’s Illustrated Reviews
• Yuan, Jason, Barrett, Kim, Barman,Susan & Brooks,
Heddwen.(2019). Ganong’s Review of Medical
Physiology, Twenty sixth Edition. USA: McGraw Hill
Education, publisher
THANK YOU

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