Académique Documents
Professionnel Documents
Culture Documents
22-1
Respiration
Respiration has three meanings:
1. ventilation of the lungs (breathing)
2. the exchange of gases between the air and
blood, and between blood and the tissue
fluid
3. the use of oxygen in cellular metabolism
22-2
sense of smell
22-4
Nasal
cavity
Posterior
nasal
aperture
Hard
palate
Soft palate
Epiglottis
Nostril
Pharynx
Larynx
Esophagus
Trachea
Left lung
Right lung
Left main
bronchus
Lobar
bronchus
Segmental
bronchus
Pleural
cavity
Pleura
(cut)
Diaphragm
Figure 22.1
22-5
The Nose
functions of the nose
warms, cleanses, and humidifies inhaled air
detects odors in the airstream
serves as a resonating chamber that amplifies the voice
Root
Bridge
Dorsum nasi
Nasofacial angle
Apex
Ala nasi
Naris (nostril)
Nasal septum
Philtrum
Alar nasal sulcus
(a)
The McGraw-Hill Companies/Rebecca Gray, photographer/Don Kincaid, dissections
Figure 22.2a
22-7
Nasal bone
Lateral cartilage
Septal nasal
cartilage
Minor alar
cartilages
Major alar
cartilages
Dense connective
tissue
(b)
The McGraw-Hill Companies/Joe DeGrandis, photographer
Figure 22.2b
22-8
Nasal Cavity
nasal fossae right and left halves of the nasal cavity
nasal septum divides nasal cavity
22-9
Nasal Cavity
vestibule beginning of nasal cavity small dilated chamber just
inside nostrils
lined with stratified squamous epithelium
vibrissae stiff guard hairs that block insects and debris from entering nose
posteriorly the nasal cavity expands into a larger chamber with not
much open space.
occupied by three folds of tissue nasal conchae
superior, middle, and inferior nasal conchae (turbinates)
Nasal Cavity
Tongue
Lower lip
Meatuses:
Superior
Middle
Inferior
Sphenoid sinus
Posterior nasal
aperture
Pharyngeal
tonsil
Auditory
tube
Soft palate
Uvula
Palatine tonsil
Lingual tonsil
Mandible
Epiglottis
Frontal
sinus
Nasal conchae:
Superior
Middle
Inferior
Vestibule
Guard hairs
Naris (nostril)
Hard palate
Upper lip
Vestibular fold
Vocal cord
Larynx
Trachea
Esophagus
(b)
Figure 22.3b
22-12
Frontal sinus
Cribriform plate
Nasal conchae:
Superior
Middle
Inferior
Auditory tube
Sites of respiratory control nuclei:
Pons
Medulla oblongata
Meatuses
Nasopharynx
Uvula
Hard palate
Oropharynx
Tongue
Laryngopharynx
Larynx:
Epiglottis
Vestibular fold
Vocal cord
Vertebral column
Trachea
Esophagus
(a)
The McGraw-Hill Companies/Joe DeGrandis, photographer
Figure 22.3a
22-13
Regions of Pharynx
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Nasal septum:
Perpendicular plate
Septal cartilage
Vomer
Pharynx:
Nasopharynx
Oropharynx
Laryngopharynx
(c)
Figure 22.3c
22-14
Pharynx
oropharynx
space between soft palate and epiglottis
contains palatine tonsils
laryngopharynx
epiglottis to cricoid cartilage
esophagus begins at that point
oropharynx and laryngopharynx pass air, food, and drink and are lined by
stratified squamous epithelium
22-15
Larynx
larynx (voice box) cartilaginous chamber about 4 cm
(1.5 in.)
primary function is to keep food and drink out of the airway
has evolved to additional role phonation production of sound
Views of Larynx
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Epiglottis
Epiglottis
Hyoid bone
Hyoid bone
Epiglottic cartilage
Thyrohyoid ligament
Fat pad
Thyroid cartilage
Thyroid cartilage
Laryngeal prominence
Cuneiform cartilage
Corniculate cartilage
Arytenoid cartilage
Vestibular fold
Cricoid cartilage
Vocal cord
Cricotracheal
ligament
Arytenoid cartilage
Arytenoid muscle
Cricoid cartilage
Trachea
(a) Anterior
Tracheal cartilage
(b) Posterior
(c) Median
Larynx
nine cartilages that make up framework of larynx
first three are solitary and relatively large
epiglottic cartilage spoon-shaped supportive plate in epiglottis
most superior one
thyroid cartilage largest, laryngeal prominence (Adams apple)
shield-shaped
testosterone stimulated growth, larger in males
22-18
Walls of Larynx
walls of larynx are quite muscular
deep intrinsic muscles operate the vocal cords
superior extrinsic muscles connect the larynx to hyoid bone
elevate the larynx during swallowing
infrahyoid group
interior wall has two folds on each side that extend from
thyroid cartilage in front to arytenoid cartilages in the back
superior vestibular folds
play no role in speech
close the larynx during swallowing
22-19
Anterior
Epiglottis
Glottis
Vestibular fold
Vocal cord
Trachea
Corniculate
cartilage
Posterior
(a)
Phototake
Figure 22.5a
22-20
Anterior
Vocal cord
Lateral
cricoarytenoid muscle
Posterior
Arytenoid cartilage
Corniculate cartilage
(a)
Posterior
cricoarytenoid muscle
(c)
Base of tongue
Epiglottis
Vestibular fold
Vocal cord
Glottis
Corniculate
cartilage
(b)
(d)
22-21
Trachea
trachea (windpipe) a rigid tube about 12 cm (4.5
in.) long and 2.5 cm (1 in.) in diameter
found anterior to esophagus
supported by 16 to 20 C-shaped rings of hyaline
cartilage
reinforces the trachea and keeps it from collapsing when
you inhale
opening in rings faces posteriorly towards esophagus
trachealis muscle spans opening in rings
gap in C allows room for the esophagus to expand as swallowed
food passes by
contracts or relaxes to adjust air flow
22-23
Trachea
inner lining of trachea is a ciliated pseudostratified columnar
epithelium
composed mainly of mucus-secreting cells, ciliated cells, and stem cells
mucociliary escalator mechanism for debris removal
mucus traps inhaled particles
upward beating cilia drives mucus toward pharynx where it is swallowed
22-24
Tracheal Epithelium
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Cilia
Goblet cell
Figure 22.8
Custom Medical Stock Photo, Inc.
4 m
22-25
Tracheostomy
tracheostomy to make a temporary opening in the
trachea inferior to the larynx and insert a tube to
allow airflow
prevents asphyxiation due to upper airway obstruction
inhaled air bypasses the nasal cavity and is hot humidified
if left for long will dry out the mucous membranes of the
respiratory tract
become encrusted and interfere with clearance of mucus
from tract
promoting infection
22-26
Mucus
Larynx
Thyroid
cartilage
Mucociliary
escalator
Particles
of debris
Cricoid
cartilage
Epithelium:
Goblet cell
Ciliated cell
Mucous gland
Trachea
Cartilage
Chondrocytes
(b)
Carina
Trachealis
muscle
Lobar
bronchi
Hyaline
cartilage ring
Main
bronchi
Mucosa
Segmental
bronchi
(a)
Lumen
Mucous gland
Perichondrium
(c)
22-27
Larynx:
Thyroid cartilage
Cricoid cartilage
Trachea
Apex of lung
Main bronchi
Superior lobe
Superior lobar
bronchus
Costal
surface
Horizontal fissure
Middle lobar
bronchus
Superior
lobe
Middle lobe
Inferior lobar
bronchus
Oblique fissure
Mediastinal
surfaces
Inferior lobe
Base of lung
Cardiac
impression
Inferior lobe
Oblique
fissure
Apex
Superior lobe
Lobar bronchi
Pulmonary
arteries
Pulmonary
veins
Hilum
Middle lobe
Pulmonary
ligament
Inferior lobe
Diaphragmatic
surface
(b) Mediastinal surface, right lung
Figure 22.9
22-28
Anterior
Breast
Sternum
Ribs
Pericardial
cavity
Heart
Left lung
Right lung
Visceral
pleura
Aorta
Pleural cavity
Vertebra
Parietal
pleura
Spinal cord
Posterior
Ralph Hutchings/Visuals Unlimited
Figure 22.10
22-29
Lungs
lungs are crowded by adjacent organs, neither fill the entire ribcage,
nor are they symmetrical.
right lung
shorter than left because the liver rises higher on the right
has three lobes superior, middle, and inferior separated by horizontal and
oblique fissure
left lung
taller and narrower because the heart tilts toward the left and occupies more
space on this side of mediastinum
has indentation cardiac impression
has two lobes superior and inferior separated by a single oblique fissure 22-30
Bronchial Tree
Bronchial Tree
pulmonary artery branches closely follow the bronchial tree on their way to
the alveoli
bronchial artery services bronchial tree with systemic blood
arises from the aorta
22-32
Bronchial Tree
bronchioles
lack cartilage
1 mm or less in diameter
pulmonary lobule - portion of lung ventilated by one bronchiole
have ciliated cuboidal epithelium
well developed layer of smooth muscle
divides into 50 - 80 terminal bronchioles
respiratory bronchioles
have alveoli budding from their walls
considered the beginning of the respiratory division since alveoli participate
in gas exchange
divide into 2-10 alveolar ducts
end in alveolar sacs grape-like clusters of alveoli arrayed around a central
22-33
space called the atrium
22-34
Lung Tissue
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Bronchiole:
Epithelium
Smooth muscle
Alveoli
Terminal bronchiole
Pulmonary arteriole
Respiratory bronchiole
Branch of
pulmonary artery
Alveolar duct
Alveoli
Alveolar duct
(a)
1 mm
(b)
1 mm
Figure 22.11
22-35
Bronchiole
Pulmonary arteriole
Pulmonary venule
Alveoli
Alveolar sac
Terminal
bronchiole
Capillary
networks
around
alveoli
Respiratory
bronchiole
Figure 22.12a
(a)
22-36
Alveoli
150 million alveoli in each lung, providing about 70 m 2 of
surface for gas exchange
cells of the alveolus
squamous (type I) alveolar cells
thin, broad cells that allow for rapid gas diffusion between alveolus and bloodstream
cover 95% of alveolus surface area
Respiratory Membrane
each alveolus surrounded by a basket of blood capillaries supplied by the
pulmonary artery
respiratory membrane the barrier between the alveolar air and blood
respiratory membrane consists of:
squamous alveolar cells
endothelial cells of blood capillary
their shared basement membrane
in
22-38
Alveolus
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Respiratory membrane
Capillary endothelial cell
Fluid with surfactant
Squamous alveolar cell
Lymphocyte
(b)
Great
alveolar
cell
Alveolar
macrophage
Air
Respiratory membrane:
Squamous alveolar cell
Shared basement membrane
Capillary endothelial cell
CO2
O2
Blood
(c)
22-39
compartmentalization
prevents spread of infection from one organ in the mediastinum to others
22-40
Pulmonary Ventilation
breathing (pulmonary ventilation) consists of a repetitive
cycle one cycle of inspiration (inhaling) and expiration
(exhaling)
respiratory cycle one complete inspiration and expiration
quiet respiration while at rest, effortless, and automatic
forced respiration deep rapid breathing, such as during exercise
Respiratory Muscles
diaphragm
prime mover of respiration
contraction flattens diaphragm and enlarging thoracic cavity and pulling air
into lungs
relaxation allows diaphragm to bulge upward again, compressing the lungs
and expelling air
accounts for two-thirds of airflow
synergist to diaphragm
between ribs
stiffen the thoracic cage during respiration
prevents it from caving inward when diaphragm descends
contribute to enlargement and contraction of thoracic cage
adds about one-third of the air that ventilates the lungs
scalenes
synergist to diaphragm
quiet respiration holds ribs 1 and 2 stationary
22-42
forced inspiration
erector spinae, sternocleidomastoid, pectoralis major, pectoralis minor, and
serratus anterior muscles and scalenes
greatly increase thoracic volume
forced expiration
rectus abdominis, internal intercostals, other lumbar, abdominal, and pelvic
muscles
greatly increased abdominal pressure pushes viscera up against diaphragm
22-43
increasing thoracic pressure, forcing air out
22-44
Respiratory Muscles
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Inspiration
Sternocleidomastoid
(elevates sternum)
Scalenes
(fix or elevate ribs 12)
External intercostals
(elevate ribs 212,
widen thoracic cavity)
Forced expiration
Internal intercostals,
interosseous part
(depress ribs 111,
narrow thoracic cavity)
Internal intercostals,
intercartilaginous part
(aid in elevating ribs)
Diaphragm
(ascends and
reduces depth
of thoracic cavity)
Diaphragm
(descends and
increases depth
of thoracic cavity)
Rectus abdominis
(depresses lower ribs,
pushes diaphragm upward
by compressing
abdominal organs)
External abdominal oblique
(same effects as
rectus abdominis)
Figure 22.13
22-45
innervation
fibers of phrenic nerve supply diaphragm
intercostal nerves supply intercostal muscles
22-46
pons
pontine respiratory group (PRG)
modifies rhythm of the VRG by outputs to both the VRG and DRG
adapts breathing to special circumstances such as sleep, exercise, vocalization,
22-47
and emotional responses
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Key
Inputs to respiratory
centers of medulla
Outputs to spinal centers
and respiratory muscles
Respiratory
Control
Centers
Output from
hypothalamus,
limbic system, and
higher brain centers
Pons
Pontine respiratory
group (PRG)
Dorsal respiratory
group (DRG)
Central chemoreceptors
Glossopharyngeal n.
Ventral respiratory
group (VRG)
Vagus n.
Medulla oblongata
Intercostal
nn.
Spinal integrating
centers
Phrenic n.
Figure 22.14
Accessory muscles
of respiration
22-48
22-49
irritant receptors nerve endings amid the epithelial cells of the airway
respond to smoke, dust, pollen, chemical fumes, cold air, and excess mucus
trigger protective reflexes such as bronchoconstriction, shallower breathing,
breath-holding (apnea), or coughing
22-50
Peripheral Chemoreceptors
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Carotid body
Aortic bodies
Aorta
Heart
Figure 22.15
22-51
22-53
Inspiration
the two pleural layers, their cohesive attraction to each other, and their
connections to the lungs and their lining of the rib cage bring about inspiration
when the ribs swing upward and outward during inspiration, the
parietal
pleura follows them
the visceral pleura clings to it by the cohesion of water and it follows the parietal
pleura
it stretches the alveoli within the lungs
the entire lung expands along the thoracic cage
as it increases in volume, its internal pressure drops, and air flows in
intrapleural pressure the slight vacuum that exists between the two pleural
layers
about -4 mm Hg
drops to -6 mm Hg during inspiration as parietal pleura pulls away
some of this pressure change transfers to the interior of the lungs
intrapulmonary pressure the pressure in the alveoli drops -3 mm Hg
pressure gradient from 760 mm Hg atmosphere to 757 mm Hg in alveoli
to flow into the lungs
allows air
22-54
Inspiration
another force that expands the lungs is Charless Law
Charless Law the given quantity of a gas is directly
proportional to its absolute temperature
on a cool day, 16C (60F) air will increase its temperature by 21C
(39F) during inspiration
inhaled air is warmed to 37C (99 F) by the time it reaches the alveoli
inhaled volume of 500 mL will expand to 536 mL and this thermal
expansion will contribute to the inflation of the lungs
Respiratory Cycle
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
No airflow
Atmospheric pressure 760 mm Hg
Pleural cavity
Diaphragm
2 Inspiration
4 Pause
Airflow
Airflow
Intrapleural
pressure 4 mm Hg
Intrapleural
pressure 6 mm Hg
Intrapulmonary
pressure +3 mm Hg
Intrapulmonary
pressure 3 mm Hg
Diaphragm rises
3 Expiration
Diaphragm flattens
Rib
Rib
Rib
Rib
Sternum
Ribs elevated, thoracic
cavity expands laterally
Sternum
Sternum
Sternum swings up,
thoracic cavity expands
anteriorly
Sternum
Sternum swings down,
thoracic cavity contracts
posteriorly
Figure 22.16
22-56
Expiration
relaxed breathing
passive process achieved mainly by the elastic recoil of the
thoracic cage
recoil compresses the lungs
volume of thoracic cavity decreases
raises intrapulmonary pressure to about +3 mm Hg
air flows down the pressure gradient and out of the lungs
forced breathing
accessory muscles raise intrapulmonary pressure as high as
+30 mmHg
massive amounts of air moves out of the lungs
22-57
Pneumothorax
pneumothorax - presence of air in pleural cavity
thoracic wall is punctured
inspiration sucks air through the wound into the pleural
cavity
potential space becomes an air filled cavity
loss of negative intrapleural pressure allows lungs to
recoil and collapse
Resistance to Airflow
pressure is one determinant of airflow - resistance is the other
the greater the resistance the slower the flow
pulmonary compliance the ease with which the lungs can expand
the change in lung volume relative to a given pressure change
compliance reduced by degenerative lung diseases in which the lungs are
stiffened by scar tissue
22-59
Alveolar Ventilation
only air that enters the alveoli is available for gas exchange
not all inhaled air gets there
about 150 mL fills the conducting division of the airway
anatomic dead space
conducting division of airway where there is no gas exchange
can be altered somewhat by sympathetic and parasympathetic stimulation
22-61
Measurements of Ventilation
spirometer a device that recaptures expired breath and records such
variables such as rate and depth of breathing, speed of expiration, and
rate of oxygen consumption
respiratory volumes
tidal volume - volume of air inhaled and exhaled in one cycle during quiet
breathing (500 mL)
6,000
5,000
4,000
Inspiratory
reserve volume
Vital capacity
Inspiratory
capacity
Tidal
volume
3,000
Total lung capacity
Expiratory
reserve volume
2,000
1,000
Maximum voluntary
expiration
Residual
volume
Functional residual
capacity
22-63
Respiratory Capacities
vital capacity - total amount of air that can be inhaled and
then exhaled with maximum effort
IC = TV + IRV
(3500 mL)
FRC = RV + ERV
(2500 mL)
TLC = RV + VC
(6000 mL)
22-64
Respiratory Capacities
spirometry the measurement of pulmonary function
aid in diagnosis and assessment of restrictive and obstructive lung
disorders
Respiratory Capacities
forced expiratory volume (FEV)
percentage of the vital capacity that can be exhaled in a given time
interval
healthy adult reading is 75 - 85% in 1 sec
peak flow
maximum speed of expiration
blowing into a handheld meter
22-66
22-67
760 mmHg
22-68
2.
freshly inspired air mixes with residual air left from the previous
respiratory cycle
3.
22-69
22-71
Air
Air
Time
Blood
Blood
Initial state
Equilibrium state
(a) Oxygen
Air
Air
Time
Blood
Blood
Figure 22.18
Initial state
Equilibrium state
22-72
(b) Carbon dioxide
O2 is twice as soluble as N2
22-73
thickening of
gas
perfusion of
the capillaries
ventilation-perfusion ratio of 0.8 a flow of 4.2 L of air and 5.5 L of
per minute at rest
blood
22-74
Inspired air
Expired air
PO2 159 mm Hg
PO2 116 mm Hg
PCO2 32 mm Hg
PCO2 0.3 mm Hg
Alveolar
gas exchange
Alveolar air
O2 loading
PO2 104 mm Hg
CO2 unloading
PCO2 40 mm Hg
CO2
Gas transport
O2
Pulmonary circuit
O2 carried
from alveoli
to systemic
tissues
CO2 carried
from systemic
tissues to
alveoli
Deoxygenated
blood
Oxygenated blood
PO2 40 mm Hg
PCO2 46 mm Hg
PO2 95 mm Hg
PCO2 40 mm Hg
Systemic circuit
Systemic
gas exchange
CO2
O2
O2 unloading
CO2 loading
Tissue fluid
PO2 40 mm Hg
PCO2 46 mm Hg
Figure 22.19
22-75
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
p
ee
St
id
ap
,r
40
Redu
ced
al g
r
n
io
us
110
Nor
m
ff
di
158
O2
nt
ie
ad
gr
adie
nt a
n
gradie
nt, slo
w
dO
diff
usi
on
er O
2 diffu
sio
Air at 3,000 m
(10,000 ft)
Figure 22.20
Atmosphere
Venous blood
arriving at
alveoli
Pressure gradient of O2
22-76
(a) Normal
Fluid and
blood cells
in alveoli
Alveolar
walls
thickened
by edema
(b) Pneumonia
Confluent
alveoli
Figure 22.21
(c) Emphysema
22-77
Perfusion Adjustments
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Decreased
airflow
Reduced PO2 in
blood vessels
Response
to reduced
ventilation
Result:
Blood flow
matches airflow
Increased
airflow
Elevated PO2 in
blood vessels
Response
to increased
ventilation
Vasodilation of
pulmonary vessels
Vasoconstriction of
pulmonary vessels
Decreased
blood flow
Increased
blood flow
Figure 22.22a
22-78
Ventilation Adjustments
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Reduced PCO2
in alveoli
Response
to reduced
perfusion
Decreased
blood flow
Result:
Airflow matches
blood flow
Increased
blood flow
Elevated PCO2
in alveoli
Response
to increased
perfusion
Constriction of
bronchioles
Dilation of
bronchioles
Decreased
airflow
Increased
airflow
Figure 22.22b
22-79
Gas Transport
gas transport - the process of carrying gases from
the alveoli to the systemic tissues and vise versa
oxygen transport
98.5% bound to hemoglobin
1.5% dissolved in plasma
Oxygen Transport
arterial blood carries about 20 mL of O2 per
deciliter
95% bound to hemoglobin in RBC
1.5% dissolved in plasma
22-81
22-82
20
O2 unloaded
to systemic
tissues
80
15
60
10
40
mL O2 /dL of blood
100
5
20
0
0
20
40
60
80
Systemic tissues
Partial pressure of O2 (PO2) in mm Hg
100
Alveoli
Figure 22.23
22-83
22-84
chloride shift
keeps reaction proceeding, exchanges HCO 3- for Cl H+ binds to hemoglobin
O2 unloading
H+ binding to HbO2 reduces its affinity for O 2
tends to make hemoglobin release oxygen
22-85
Respiring tissue
Capillary blood
7%
CO2
Carbamino compounds
23%
CO2
HbCO2
CO2 + Hb
70%
CO2
CO2 + H2O
CAH
H2CO3
Chloride shift
Cl
HCO3 + H+
98.5%
O2
O2
O2 + HHb
1.5%
Dissolved O2 gas
Figure 22.24
HbO2+ H+
Key
Hb
Hemoglobin
HbCO2
HbO2
HHb
CAH
Carbaminohemoglobin
Oxyhemoglobin
Deoxyhemoglobin
Carbonic anhydrase
22-86
Alveolar air
CO2
Respiratory membrane
7%
Capillary blood
Dissolved CO2 gas
CO2 + plasma protein
Carbamino compounds
23%
CO2
CO2 + Hb
70%
CO2
CO2 + H2O
CAH
Chloride shift
Cl
HbCO2
H2 CO3
HCO3 + H+
98.5%
O2 + HHb
O2
O2
1.5%
Dissolved O2 gas
Key
Hb
Figure 22.25
HbO2 + H+
HbCO2
HbO2
HHb
CAH
Hemoglobin
Carbaminohemoglobin
Oxyhemoglobin
Deoxyhemoglobin
Carbonic anhydrase
22-88
the tissues
four factors that adjust the rate of oxygen unloading
ambient PO2
temperature
Bohr effect
bisphosphoglycerate (BPG)
Haldane effect rate of CO2 loading is also adjusted to varying needs of the tissues, low
level of oxyhemoglobin enables the blood to transport more CO 2
body temp (fever), thyroxine, growth hormone, testosterone, and epinephrine all raise BPG
and cause O2 unloading
metabolic rate requires oxygen
22-89
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
100
10C
20C
90
38C
80
43C
70
60
Normal body
temperature
50
40
30
20
10
0
0
20
40
60
80
100
120
140
Figure 22.26a
22-90
100
90
pH 7.60
80
pH 7.40
(normal blood pH)
70
60
pH 7.20
50
40
30
20
10
0
0
(b) Effect of pH
20
40
60
80
100
120
140
Figure 22.26b
22-91
7.35 7.45
PCO2
40 mm Hg
P O2
95 mm Hg
Hydrogen Ions
pulmonary ventilation is adjusted to maintain the pH
of the brain
central chemoreceptors in the medulla oblongata
produce about 75% of the change in respiration induced
by pH shift
yet H+ does not cross the blood-brain barrier very easily
CO2 does and in CSF reacts with water and produces
carbonic acid
dissociates into bicarbonate and hydrogen ions
most H+ remains free and greatly stimulates the central chemoreceptors
Hydrogen Ions
acidosis blood pH lower than 7.35
alkalosis blood pH higher than 7.45
hypocapnia PCO2 less than 37 mm Hg
(normal 37 43 mm Hg)
most common cause of alkalosis
22-94
Carbon Dioxide
indirect effects on respiration
through pH as seen previously
direct effects
CO2 at beginning of exercise may directly
stimulate peripheral chemoreceptors and trigger
ventilation more quickly than central
chemoreceptors
22-97
Effects of Oxygen
PO2 usually has little effect on respiration
chronic hypoxemia, PO2 less than 60 mm Hg, can
significantly stimulate ventilation
hypoxic drive respiration driven more by low PO2
than by CO2 or pH
emphysema, pneumonia
high elevations after several days
22-98
22-99
Respiratory Disorders
Oxygen Imbalances
22-100
Oxygen Excess
oxygen toxicity - pure O2 breathed at 2.5 atm or
greater
hyperbaric oxygen
formerly used to treat premature infants, caused retinal
damage, was discontinued
22-101
Effects of COPD
reduces pulmonary compliance and vital
capacity
hypoxemia, hypercapnia, respiratory acidosis
hypoxemia stimulates erythropoietin release from
kidneys - leads to polycythemia
cor pulmonale
hypertrophy and potential failure of right heart due
to obstruction of pulmonary circulation
22-105
Lung Cancer
adenocarcinoma
originates in mucous glands of lamina propria
22-108
Effect of Smoking
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Tumors
22-109