Chapter 22: The Respiratory System

1. Chapter 22: The Respiratory System

2. Alexander Graham Bell – invented the respiratory jacket in 1882. This device was the precursor to the IRON LUNG developed by Philip Drinker in the 1920s.

3. Figure 22.1: The major respiratory organs in relation to surrounding structures, p. 832. Nasal cavity Nostril Pharynx Oral cavity Trachea Larynx Carina of trachea Right main (primary) bronchus Left main (primary) bronchus Right lung Left lung Diaphragm

4. Figure 22.2: The external nose, p. 833. Frontal bone Epicranius, frontal belly Nasal bone Septal cartilage Root and bridge of nose Maxillary bone (frontal process) Dorsum nasi Ala of nose Lateral process of septal cartilage Minor alar cartilages Dense fibrous connective tissue Apex of nose Philtrum Major alar cartilages Naris (nostril) (a) (b)

5. Figure 22.3a: The upper respiratory tract, p. 834. Olfactory nerves Olfactory epithelium Superior nasal concha and superior nasal meatus Middle nasal concha and middle nasal meatus Mucosa of pharynx Tubal tonsil Inferior nasal concha and inferior nasal meatus Pharyngo- tympanic (auditory) tube Hard palate Soft palate Nasopharynx Uvula (a)

6. Figure 22.3b: The upper respiratory tract, p. 834. Sphenoidal sinus Frontal sinus Nasal meatuses (superior, middle, and inferior) Cribriform plate of ethmoid bone Nasal conchae (superior, middle and inferior) Pharyngeal tonsil Opening of pharyngotympanic (auditory) tube Nasal vestibule Nostril Nasopharynx Posterior nasal aperture Hard palate Soft palate Tongue Uvula Palatine tonsil Lingual tonsil Isthmus of the fauces Epiglottis Oropharynx Hyoid bone Laryngopharynx Thyroid cartilage Vestibular fold Laryngeal cartilages Cricoid cartilage Vocal fold Esophagus Thyroid gland Trachea (b)

7. Figure 22.4a-b: The larynx, p. 836. Epiglottis Body of hyoid bone Thyrohyoid membrane Body of hyoid bone Thyrohyoid membrane Cuneiform cartilage Fatty pad Thyroid cartilage Corniculate cartilage Vestibular fold (false vocal cord) Laryngeal prominence (Adam’s apple) Arytenoid cartilage Thyroid cartilage Vocal fold (true vocal cord) Arytenoid muscles Cricothyroid ligament Cricothyroid ligament Cricoid cartilage Cricotracheal ligament Cricotracheal ligament Tracheal cartilages (a) (b)

8. Figure 22.5: Movements of the vocal cords, p. 837. Base of tongue Epiglottis False vocal cord True vocal cord Glottis Inner lining of trachea Corniculate cartilage (a) (b)

9. Figure 22.6: Tissue composition of the tracheal wall, p. 839. Posterior Pseudostratified ciliated columnar epithelium Esophagus Trachealis muscle Seromucous glands in submucosa Lumen of trachea Mucous membrane Hyaline cartilage Submucosa Adventitia Anterior (a) (b) (c)

10. Figure 22.7: Conducting zone passages, p. 840. Trachea Superior lobe of right lung Superior lobe of left lung Right main (primary) bronchus Lobar (secondary) bronchus Segmental (tertiary) bronchus Middle lobe of right lung Inferior lobe of right lung Inferior lobe of left lung

11. Figure 22.8: Respiratory zone structures, p. 841. Alveoli Alveolar duct Alveolar duct Respiratory bronchioles Terminal bronchiole Alveolar sac (a) Respiratory bronchiole Alveolar pores Alveolar duct Alveoli Alveolar sac (b)

12. Figure 22.9a-b: The respiratory membrane, p. 843. Capillaries Smooth muscle Elastic fibers Alveolus (a) (b)

13. Figure 22.9c-d: The respiratory membrane, p. 843. Type II (surfactant- secreting) cell Type I cell of alveolar wall Red blood cell Epithelial cell nucleus Capillary Endothelial cell nucleus Capillary O2 CO2 Alveolus Nucleus of type I (squamous epithelial) cell Alveolus Macrophage (d) Alveolar epithelium Respiratory membrane Fused basement membranes of the alveolar epithelium and the capillary endothelium Capillary endothelium Alveoli (gas-filled air spaces) Alveolar pores Red blood cell in capillary (c)

14. Figure 22.10a: Anatomical relationships of organs in the thoracic cavity, p. 844. Parietal pleura Apex of lung Rib Trachea Lung Thymus Intercostal muscle Pleural cavity Visceral pleura Right superior lobe Left superior lobe Horizontal fissure Right middle lobe Cardiac notch Oblique fissure Oblique fissure Right inferior lobe Left inferior lobe Heart (in mediastinum) Diaphragm Base of lung (a)

15. Figure 22.16a: Respiratory volumes and capacities, p. 852. 6000 5000 Inspiratory reserve volume 3100 ml Inspiratory capacity 3600 ml 4000 Vital capacity 4800 ml Total lung capacity 6000 ml 3000 Milliliters (ml) Tidal volume 500 ml Expiratory reserve volume 1200 ml 2000 Functional residual capacity 2400 ml 1000 Residual volume 1200 ml 0 (a) Spirographic record for a male

16. Figure 22.16b: Respiratory volumes and capacities, p. 852. Adult male Adult female average average Measurement Description value value Amount of air inhaled or exhaled with each breath under resting conditions Tidal volume (TV) 500 ml 500 ml Inspiratory reserve volume (IRV) Amount of air that can be forcefully inhaled after a normal tidal volume inhalation 3100 ml 1900 ml Respiratory volumes Expiratory reserve volume (ERV) Amount of air that can be forcefully exhaled after a normal tidal volume exhalation 1200 ml 700 ml Residual volume (RV) 1200 ml 1100 ml Amount of air remaining in the lungs after a forced exhalation Maximum amount of air contained in lungs after a maximum inspiratory effort: TLC = TV + IRV + ERV + RV Total lung capacity (TLC) 6000 ml 4200 ml Maximum amount of air that can be expired after a maximum inspiratory effort: VC = TV + IRV + ERV (should be 80% TLC) Vital capacity (VC) 4800 ml 3100 ml Respiratory capacities Maximum amount of air that can be inspired after a normal expiration: IC = TV + IRV Inspiratory capacity (IC) 3600 ml 2400 ml Functional residual capacity (FRC) Volume of air remaining in the lungs after a normal tidal volume expiration: FRC = ERV + RV 2400 ml 1800 ml (b) Summary of respiratory volumes and capacities for males and females

17. Figure 22.17: Partial pressure gradients promoting gas movements in the body, p. 856. Expired air: PO2 120 mm Hg PCO2 27 mm Hg Inspired air: PO2 160 mm Hg PCO2 0.3 mm Hg Alveoli of lungs: PO2 104 mm Hg PCO2 40 mm Hg O2 CO2 O2 CO2 External respiration O2 CO2 Blood leaving alveolar capillaries: PO2 104 mm Hg PCO2 40 mm Hg Blood entering alveolar capillaries: PO2 40 mm Hg PCO2 45 mm Hg CO2 O2 O2 CO2 O2 CO2 Pulmonary veins (PO2 100 mm Hg) Pulmonary arteries Systemic arteries Systemic veins Heart O2 CO2 Blood entering tissue capillaries: PO2 100 mm Hg PCO2 40 mm Hg Blood leaving tissue capillaries: PO2 40 mm Hg PCO2 45 mm Hg O2 CO2 O2 CO2 Internal respiration Tissues: PO2 less than 40 mm Hg PCO2 greater than 45 mm Hg O2 CO2

18. Figure 22.28: The pathogenesis of COPD, p. 871. • Tobacco smoke • Air pollution a-1 antitrypsin deficiency Continual bronchial irritation and inflammation Breakdown of elastin in connective tissue of lungs Chronic bronchitis Bronchial edema, chronic productive cough, bronchospasm Emphysema Destruction of alveolar walls, loss of lung elasticity, air trapping • Airway obstruction or air trapping • Dyspnea • Frequent infections • Abnormal ventilation- perfusion ratio • Hypoxemia • Hypoventilation

19. Additional Items to Review About the Lymphatic System

20. Figure 20.1: Distribution and special structural features of lymphatic capillaries, p. 774. Loose connective tissue around capillaries Venous system Arterial system Venule Arteriole Heart Lymph duct Lymph trunk Lymph node Lymphatic system Lymphatic collecting vessels, with valves Lymphatic capillary Tissue fluid Blood capillaries Lymphatic capillary Tissue cell (a) Filaments anchored to connective tissue Blood capillaries Endothelial cell Flaplike minivalve Fibroblast in loose connective tissue (b)

21. Figure 20.2a: The lymphatic system, p. 776. Regional lymph nodes: Entrance of right lymphatic duct into right subclavian vein Cervical nodes Internal jugular vein Entrance of thoracic duct into left subclavian vein Axillary nodes Thoracic duct Aorta Cisterna chyli Lymphatic collecting vessels Inguinal nodes (a)

22. Please remember that the overall design of the lymphatic system is a slightly modified replication of the arterial and venous systems. Namely, the lymphatic vessels include the larger “lymphatic vessels” the “lymphatuoles” and the “lymphatic capillaries”. • From the lymphatic system, the fluids that are collected will be transported back into circulation via the veins in the blood vascular system. One specific entry point is the subclavian vein. • Peyer’s patches are significantly involved with aspects of immune response associated with the digestive system and last during our entire lifetime. • The way in which the lymphatic capillaries draws fluid into them is via the movment of the slit-like flaps through their attachment with filaments to the sidewalls of other tissues. • Lymphatic vessels have valves like seen in veins. • The cisterna chyli is a dialated part of the thorascic duct in the lymphatic system.

23. Figure 20.4: Lymph node, p. 778. Afferent lymphatic vessels Cortex: • Lymphoid follicle • Germinal center • Subcapsular sinus Efferent lymphatic vessels Follicles Trabecula Subcapsular sinus Hilum Medulla: Capsule • Medullary cord • Medullary sinus Medullary cords Medullary sinuses Trabeculae Capsule (a) (b)

24. Figure 20.5: Lymphoid organs, p. 779. Tonsils (in pharyngeal region) Thymus (in thorax; most active during youth) Spleen (curves around left side of stomach) Peyer’s patches (in intestine) Appendix