Chapter 44

Functional Organization of Respiratory System

CO,
LearningObjectives Ventilation
phase
chapter:
study ofthis
Dn completionof (must know):
able to
Thestudentwillbe respiration and understand their significance.
diferenttphhases of functions
1 Name tract give their
and
Name the parts of respiratory significance of their modifications.
thedivision of airways
and
3 Leam the reflections and Ifunctions of pleura and pleural cavity.
Comprehend
segment.
Comprehend the concept of a bronchopulmonary system.
the respiratory Lungs
AList the functions of lungs and
Name the non-respiratory functions of lungs O, CO,
(desirable to know):
The student mayalso be able to tract
Describe the functions of upper and lower respiratory Transport
phase
zone
Describe the modifications in respiratory zone and conducting

Respiration is defined as the process by which oxygen

from atmosphere is delivered to the tissue and carbon
dioxide from the tissue is removed into the atmosphere.
Phages of Respiration: Respiration takes place in four Circulation
phases (Fig. 44.1). phaseExchange
Tissue CO,
Ventilation phase: Exchange of gases between the phase
amosphere and pulmonary capillary blood occurs due to Interstitial
pulmonary ventilation. fluid Co,
Iran_port phase: Gasses are transported between the
lungs and the tissues.
Lchange phase: Gases are exchanged between the CO,
systemic blood and the tissue. Cell
ue phase: Oxygen delivered to the tissue is
by the utilized
mitochondrial enzymes for metabolism (cellular
Tespiration). Tissue
PY6.1
COMPONENTS OF RESPIRATORY Fig. 44.1: Phases of respiration. Entire process of respiration takes place in four stages.

SYSTEM In ventilation stage, gases (0, and CO) are exchanged with pulmonary capillary
blood through lungs. In transport stage, gases are transported between lungs and

TeRessppiriraattoorryy t tractsystemand lowerdivided

tissues via circulation. In exchange stage, exchange of O, and CO, takes between
is into two parts: upper systemic circulation and tissues. In tissue stage,O, is taken up by cells and utilized by
mitochondria (MC) for oxídation during which CO, is produced and released into tissue
respiratory tract (Fig. 44.2). capillary blood.

363
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palate,
extends intg bone
nasopharyongjitis epiglotis, particlesinfectione
the wide adducor
during of
entry the stridorproduces
In incomplete and Ine broncn. manyinwhich
trauma. open
frOmhyoid
cord
laryoy
Howees,
and
in cOrd
contract patients:enter tree tree. branches
bronchi,
and
soft below. food
infeciongduring fibers vocal of prevents
tract. particles produces
and airway airway two
nasopharynx, is mouth
nasopharynx of consistsof
vocal
(sinusts) contraction patients,
branching.
facial noseof nares
larynx unconscious stridor) intoand
bonelevel
aacute
viralsinuses
(
of
aspiration
vagal
flow.
enlarge
pulls which respiratory
food pneumonia.
larynx Lower
Respiratory
Tract of constitute
branches smallercalled
level the Clinical
Note
44.2
during the posterior hyoidesophagus.anself-limiting the lung
behind
the behindthe 0S
(URT) to treatment. COver air by thethat
innervatedglottis.reflex
glottis, and
anesthetized
(inspiratory consists
each
is
progressively
aentersbronchioles.
form
turn
into fronm Larynx to
spread arytenoids in inspiration the of at airway tubes
brain of of prevents
arytenoids obstruction
muscles in fluid tract tubes
dividedlocated
to Infection level infection
a antibiotic cords, tract.
theswallowing,into adductors
aspiration aspiration
pneumonia diameter
ynx
and tubessand
laryngopharynx, locatedstarts usually
may the IMPORTANT pneumonia
to nares into
Glottis: respiratory open NOTE allows inspiration
materials
respiratory branching Each ofsystem
mainbronchus
protection (Clinical
Note
44.2). the tract infection vocal areabductor close
Laryngopharynx
opens respiratory
and warrants
is is is to and
that children, larynxof andglottisof Tree in the into
Pharynx posterior
Nasopharynx
nasopharynx. cold, cause partand cause decrease
above
Oropharynx bacterial and deglutition muscles
During Paralysis Trachea,
Eustachian and which and Epiglottis early apart food unconscious
Aspiration of times This
as arytenoids the andof The of and during lower Airway
Provide Upper
manifesting In closure series
Pharynx: from palate above (laryngitis),
secondary Larynx into Muscles lungs lungs. tubes
URTI: The
A
3. 1. 2. 3. "
They becomes
paranasal body
inspired and cross-sectional like sinus,
of offered have that
theirsinuses
cavity
Nasal >
Bronchioles 50% infections They throughinuses
bronchus lung
Left sinus.
Nostril LarynxTrachea
> attains immunoglobulins maxillary of
Left Main the About
turbinates.is posture ostia
the
> > nose, um. system 44.1) turbinates
thein
’ Diaphragm trachea. viral frontal
process 10 secretions
mucosa,
it the resistance: are Note upright
Tract
Respiratory
Upperconsists
of and than
organisms.
butnasal
respiratory
during sinuses Clinical
Note
44.1 nasal
and(Clinical
to reaches nasalof
is humidified
greater ml, which the retention
by airway increases sinus voice intoof
(URT) URT contains 20 Paranasal edema
larynx. ittime open
particletheonlyincreasedthe
system.
ethmoid thefor
turbinates in
System of
in resistance and results
sinuses
respiratory tract getsthe
andfunction kill IMPORTANT
NOTEof airflow to skull, inflammation
secretion is Thissinusitis.
Respiratory respiratory
pharynxit by filters thatnosegreatly50% Sinuses: resonance
sinus,three the
functions:
nasal Paranasal blocked.
Pharynx of
Components thattemperatureinterferons
of to Thecommon
cold.
bronchus
maiRignht main Nose Volume
offers Lighten During causes
so is resistance into Offer easier. Sinusitis:
Paranasal
sphenoid readily
sinuses, Nasal area nose.
VI: The
Section 44.2: Upper air Nose: Nose
by
open ostia. turn
are 364
¬
Right
Fig. 1. 2. in
lung e
 COnducting
Conducting
Zone airways).
Airways of The 6. 5.The 4.The 3.The 2.The 1.
Branching
Airways OCCur:
bronchiTracheaairways ion .There
the As Generat and bronchi
The bronchial
calledis , ,
trachea zone). cOnducting
(respiratory
Tespiratory he Ihey The constri c maxi
tion mum Bronchodilation
stimulation.
ctimulation cvtokines, onchial Bronchial Carbronchi
influence,brThough airway.
the
tilatgeserminoalle. smo th smo th
wallthicknessBromusnchclieoslesbronchreioslpeisr,atoreysglperiaotrhusnedslic.uomnTrtaaihncahtsea musIracchlebearonacdhtire .
gas generation %
of
quantity
amount
quantitynumberamount
airways are isare and bronchioles
terminaland In
zone and exchange progressively are the the is
a
hormones
zeroNumbers:
designated circadian adenosine, it aid s Tone: are
(Fig. first airways airways that
broadly of of of ofbecome
cartilage
smooth
submucosal
of
mucus cilia number
first occurringdilation and is in
and and
44.3). 16 areas
branch decreases.
generation.
generation. oCcurring Considerably
is
such tone.This Tone
patency
respiration. absent
and
terminal bu t tract, content
th at smaller, inthe | bronchi
generations divided
of muscle secreting increases, bybronchoconstriction
The atrhythm substance as tone of from glands
participate lungs move in 6 produced smooth respiratory cilia is
times
23 the
glands narrower progressively
The
their AM. inflammatory is
contributes tobronchioles
quantity
bronchioles relativelylecontain
ss.
(conducting aiby r intwto increases,airway cells at for influencedmainly are arenumerOus are
of the generationleft 6 P, present
becomes bronchial
PM histamine tract of absent lined by
a
cartilages,
airway in intogenerations(23of
convection waldecreases,
l following and by muscles
bronchi of
smooth
gas and and due in
is
categories: decreases. sympathetic by downwardmaxinmum have in il
formthe exchange zone) less. shorter. right
bifurcating
numbers. maximum tone bymodulators, to bronchioles
respiratory
mucOus
changes andchemicals muscle
adequate and
ciliated
and main with vagal VIP. neural
their
in and
of as
2. ANS. by
1.Nerve " " asStructural
conducting of conducting Fig. Respiratory zone
epithelium
mediated available
Sympathetic mediatedVagal does there
isnoAs bronchioles.airways bronchi. Some they cartilage
and The generation, 44.3: Alveolar
Conducting zone Zone

secretion
Activation Supply:
anatomic
space.
dead from
Therefore, sacs Alveolar
ducts
expiration.
notespecially
during
However,
suspended Though the
cartilage 44.3).Right
below are Diand visions
Bronchioles
(no cartilage) Bronchi
(cartilage) Chapter
lu ng amount
bystimulation
and bronchial
in by nose occur in side subjected zone. is
Specialization: respiratory bronchioles
Respiratory) bronchiTerminal
ole divisions
Name of
and B, The tissue of 44:
stimulation
of muscarinic the alveoli bronchioles the the upto present ai rways Mainstem
bronchi
receptors
smooth to bronchioles
in by is mai n This airways. Functional
a, bronchi Trachea
receptors B, the
volume the elastic conducting levelabsent
maintains which of to and Alveolus m
receptors tree. generation-16 conducting upto bronchus cartilage prevents
changes in th ei r
muscle.
that receptorscauses and
of 16 tissue lack bronchioles.
of
the first characteristics. Organization
bronchioles totally The
inhibits arcauses generation, are of 23 22 21 20 19 18 17 16 15 14 genera No.of
e respiratory their zone airways in
collapse four 13 12 11 10 2 1 0 tion the
zone. susceptible thcartilage,
is
increases present
bronchoconstriction e wider thoracic
is considerable Term
respiratory uni
bronchodilation,
secretion. that airways patency
lung in present Not e
are are generations Alveoli Structure
division the of of
are the of the
Respiratory
in are tract gasparenchyma.elasticity the The (Clinical referred pressures. these differences bronchiTerminal
ole
bronchialbronchial innervated to as bronchioles Cartlage
plentily isexchange
starting th ey terminal
smallest upto
365 called/ collapse airways amount
Note to of between 5x10 6x10 díivisiontubesNo.inof System
are of
as10" the 8x10 32 16 4
 Section VI: Respiratory System

3. Also, there is noncholinergic-nonadrenergic innerva 1. The parietal pleura is theeouter

layer of
tion of bronchiole that causes bronchodilation, which
is most likely mediated by VIP,
contains blood vessels.
2. The visceral pleura lies pleural sac that
3. Normally, about 10-20 directly
on
ml of fluidthe lung.
Clinical Note 44.3 pleural cavity, the space between is
paripresent
the4) in
Infection of right lung is commonf: The right side of the main bronchus
has more diameter than the left side. Moreover, it is present in parallel
with trachea. Therefore, inhaled foreign bodies lodge easily in the right
and visceral pleura (Clinical Note 44
Pleural Fluid: The viscous pleural flujd etal pleuthera
lungs than the left. Thus, infection of right lung is common than that of left about 10 um thick between the forms alining of
functions as alubricant so thattwo layers of
lung.
chest wall. lungs can sliipdleeura, which
Respiratory Zone
The last seven gernerations of airway form the respiratory
Thus, pleural fluid facilitates
the change in
shape of lungs during respiration
against the
zone. Respiratory zone is the site for gas exchange It also protects Size
lungs from external damage and
Arrangement: The respiratory zone consists of respiratory
bronchioles, alveolar ducts and alveoli. Clinical Note 44.4
Alveoli start budding off bronchioles from 17Bh generations. Pleural effusion: Accumulation of pleural
Bronchioles from 17h to 19th generations are called cavity is called as pleural effusion. fluid in excess in
respiratory bronchioles. lung expansion and decreases gas Signifcant
pleural the pleural
With each descending generation, number of cavity that occurs either due to exchange. Entry of air eftusion
imits
trauma or rupture of into the pleura
alveoli increases. pneumothorax, and entry of blo0d is called hemothorax.alveoli results in
Generations 20-22 are the alveolar ducts that finally
terminate in the alveolar sac (generation 23).
Alveolus: Alveolus is the functional unit of gas exchange. Lobes of Lungs
There areabout 300 million of alveoli present in both the Lungs are divided into lobes. There are
right lung and twolobes in left lung.
lungs in adults (Application Box 44.1). Diameter of alveoli " The three lobes in
ranges from 75 to 300 um. right lung constitutes about 55%
mass and function. ,of the total lung
The total surface area of all alveoli of both lungs is
between 50 to 100 m², which is roughly the size of a Lungs consist of vascular tree and
are embedded in elastic airway tree that
tennis court.
parenchyma. connective tissue, the luna
Thus, alveoli are amongst the largest biological
membranes in the body.
The alveoli are surrounded by capillaries that remain Bronchopulmonary Segments
in close contact with each other forming
alveolar-
Bronchopulmonary segment is the part of the lungs
supplied by a segmental bronchus.
capillary membrane through which gas exchange 1. There are 10 bronchopulmonary segments in right
takes place. lung and nine segments in left lung.
Alveolar epithelium is lined by epithelial cells that are of
These are apical, posterior, anterior, lateral, meil
two types: Type I and Type I (inferior), superior, medial-basal, anterior-basa,
Type I epithelial cells are present in more numbers lateral-basal, and posterior-basal.
and cover 95% of epithelial surface area of alveoli.
Type II cells secrete surfactant and play important
role in alveolar repair./
Application Box 44.1 Pleural caty

Alveolar damage should be checked: Alveoli increase in number ánd ’ Thoracic wal
size during childhood. However, after adolescence, alveoli increase
only in size,but not in number. Therefore, destruction of alveoli results in
’ Parietalpleu
permanent damage to lungs as they have limited ability to repair themselves
in adults. > Lung
’ Visceralplera
The Lungs
Heart
Pleura
Pleura is the covering of lungs. There are two layers of
pleura: parietal pleura and visceral pleura (Fig. 44.4). Fig. 44.4: Layers of pleura, and pleural cavity.
366)