Respiratory
physiology
Chapter 13
• Organization of the Respiratory System
• I. The respiratory system comprises the lungs, the airways
leading to them, and the chest structures responsible for
moving air into and out of them.
a. The conducting zone of the airways consists of the trachea,
bronchi, and terminal bronchioles.
b. The respiratory zone of the airways consists of the alveoli,
which are the sites of gas exchange, and those airways to
which alveoli are attached (respiratory bronchioles).
• c. The alveoli are lined by type I cells and some type II cells,
which produce surfactant (Surfactant stabilizes alveoli by
decreasing surface tension in smaller alveoli)
d. The lungs and interior of the thorax are covered by pleura;
between the two pleural layers is an extremely thin layer of
intrapleural fluid.
• II. The lungs are elastic structures whose volume
depends upon the pressure difference across the lungs
—the transpulmonary pressure—and how stretchable
the lungs are.
• III. The steps involved in respiration are summarized in
Figure 13.6. In the steady state, the net volumes of
oxygen and carbon dioxide exchanged in the lungs per
unit time are equal to the net volumes exchanged in the
tissues
• Ventilation and Lung Mechanics
• I. Bulk flow of air between the atmosphere and alveoli is
proportional to the difference between the alveolar and
atmospheric pressures and inversely proportional to the
airway resistance: F =(Palv - Patm)/R.
• II. Between breaths at the end of an unforced expiration, Patm
= Palv, no air is flowing, and the dimensions of the lungs and
thoracic cage are stable as the result of opposing elastic
forces. The lungs are stretched and are attempting to recoil,
whereas the chest wall is compressed and attempting to
move outward. This creates a subatmospheric intrapleural
pressure and hence a transpulmonary pressure that opposes
the forces of elastic recoil.
• III. During inspiration, the contractions of the diaphragm and
inspiratory intercostal muscles increase the volume of the
thoracic cage.
a. This makes intrapleural pressure more subatmospheric,
increases transpulmonary pressure, and causes the lungs to
expand to a greater degree than they do between breaths.
b. This expansion initially makes alveolar pressure
subatmospheric, which creates the pressure difference between
the atmosphere and alveoli to drive airflow into the lungs.
• IV. During expiration, the inspiratory muscles cease contracting,
allowing the elastic recoil of the lungs to return them to their
original between-breaths size.
a. This initially compresses the alveolar air, raising alveolar
pressure above atmospheric pressure and driving air out of the
lungs.
b. In forced expirations, the contraction of expiratory intercostal
• IV. The vital capacity is the sum of resting tidal volume,
inspiratory reserve volume, and expiratory reserve
volume. The volume expired during the first second of a
forced vital capacity measurement is the FEV and
1
normally averages 80% of forced vital capacity.
• V. Minute ventilation is the product of tidal volume and
respiratory rate. Alveolar ventilation = (Tidal volume -
Anatomical dead space) X Respiratory rate.
• VI. Inadequate gas exchange between alveoli and
pulmonary capillaries may occur when
[Link] alveolar-capillary surface area is decreased
2. when the alveolar walls thicken
3. or when there are ventilation–perfusion inequalities
• VII. In the tissues, net diffusion of oxygen occurs from
blood to cells and net diffusion of carbon dioxide from
cells to blood.
• II. The major determinant of the degree to which hemoglobin is saturated with
oxygen is blood PO2.
a. Hemoglobin is almost 100% saturated at the normal systemic arterial PO2 of
100 mmHg. The fact that saturation is already more than 90% at a PO2 of 60
mmHg permits relatively normal uptake of oxygen by the blood even when
alveolar PO2 is moderately reduced.
b. Hemoglobin is 75% saturated at the normal systemic mixed venous PO2 of 40
mmHg. Thus, only 25% of the oxygen has dissociated from hemoglobin and
diffused into the tissues.
• III. The affinity of hemoglobin for oxygen is decreased by an increase in PCO2,
H+ concentration, and temperature. All these conditions exist in the tissues
and facilitate the dissociation of oxygen from hemoglobin. Fetal hemoglobin
has a higher affinity for oxygen allowing adequate uptake of oxygen in the
placenta and delivery to the tissues.
• IV. The affinity of hemoglobin for oxygen is also decreased by binding DPG(,
which is synthesized by the erythrocytes. DPG increases in situations
associated with inadequate oxygen supply and helps maintain oxygen release
in the tissues.
• Acclimatization to High Altitude
• Atmospheric pressure progressively decreases as
altitude increases.
• Hypoxia
I. The causes of hypoxic hypoxia are listed in Table 13.10.
• II. During exposure to hypoxia, as at high altitude,
oxygen supply to the tissues is maintained by the five
responses listed in Table 13.11.
• Nonrespiratory Functions of the Lungs
• I. The lungs influence arterial blood concentrations of
biologically active substances by removing some from
systemic venous blood and adding others to systemic
arterial blood.
• II. The lungs also act as sieves that trap and dissolve
small clots formed in the systemic tissues.
