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III. ANATOMY AND PHYSIOLOGY

Respiratory System
The upper respiratory tract and the lower respiratory tract comprise the respiratory
system. The larynx, trachea, bronchi, and lungs are parts of the lower respiratory tract; the
external nose, nasal cavity, pharynx, and related structures are parts of the upper respiratory tract.
(Seeley’s, 2019)

The organs and other body parts involved in breathing, which involves exchanging
carbon dioxide and oxygen, make up your respiratory system. For your body to function, every
cell needs oxygen. They emit carbon dioxide, also known as a "waste gas," when they take in
oxygen. This gas enters your circulation and travels to your lungs. When you exhale, it leaves
your body. Your body is designed to perform "gas exchange," a vital function, automatically.
(Seed, 2024)

Anatomy and Physiology Respiratory System

Upper Airways
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The upper respiratory tract (upper airway) consists of the nose, mouth, sinuses, pharynx
(upper section of the throat), and larynx (voice box). (Respiratory System, n.d.)

Nasal Cavity
The nasal cavity extends from the nares to the choanae, which are the openings into the
pharynx. The nasal septum divides the cavity into right and left parts. The floor of the nasal
cavity is formed by the hard palate, separating it from the oral cavity. Three bony ridges called
conchae increase the surface area and cause the air to churn, allowing it to be cleansed,
humidified, and warmed. The paranasal sinuses, including the maxillary, frontal, ethmoidal, and
sphenoidal sinuses, open into the nasal cavity, reducing the weight of the skull and influencing
the voice's quality by acting as resonating chambers. The nasal cavity also contains sensory
receptors for smell in its superior part. Air enters the nasal cavity, where it is filtered by coarse
hairs and mucus produced by goblet cells. Cilia sweep the mucus posteriorly to the pharynx,
where it is swallowed. (Seeley's, 2019).

Pharynx
The pharynx is a common passageway for both the respiratory and digestive systems, leading to
the larynx and esophagus. It is divided into three regions:
⦁ Nasopharynx: Located posterior to the choanae and superior to the soft palate, it is

lined with pseudostratified ciliated columnar epithelium and contains the pharyngeal tonsil.

The auditory tubes from the middle ears open into the nasopharynx.

⦁ Oropharynx: Extends from the uvula to the epiglottis, it allows passage for air, food,

and drink. It is lined with stratified squamous epithelium and houses the palatine and lingual

tonsils.

⦁ Laryngopharynx: Passes posterior to the larynx and extends from the tip of the

epiglottis to the esophagus, allowing food, drink, and air to pass through (Seeley's, 2019).

Larynx
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The larynx, located in the anterior throat, extends from the base of the tongue to the trachea and
serves as a passageway for air. It consists of nine cartilages: three unpaired (thyroid, cricoid, and
epiglottis) and six paired (cuneiform, corniculate, and arytenoid). The thyroid cartilage is the
largest and forms the Adam's apple, while the cricoid cartilage forms the base. The epiglottis,
made of elastic cartilage, covers the laryngeal opening during swallowing. The vocal folds, or
true vocal cords, produce sound when air moves past them, and their tension controls the pitch of
the voice. Inflammation of the vocal folds, known as laryngitis, inhibits voice production
(Seeley's, 2019).

Lower Airways
The lower respiratory tract consists of the trachea (windpipe), bronchial tubes, and lungs.
The bronchial tubes carry air into the lungs and branch into smaller and smaller bronchioles.
These end in alveoli (air sacs). (Respiratory System, n.d.)

Trachea
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The trachea, or windpipe, is a membranous tube attached to the larynx, consisting of

connective tissue and smooth muscle reinforced with 16-20 C-shaped pieces of hyaline cartilage.
It extends from the cricoid cartilage to the fifth thoracic vertebra, where it divides into the right
and left primary bronchi. The trachea's posterior wall lacks cartilage and consists of a
ligamentous membrane and smooth muscle, allowing it to change diameter during coughing to
expel mucus and foreign substances. The trachea is lined with pseudostratified columnar
epithelium with cilia and goblet cells, which propel mucus out of the trachea. (Seeley's, 2019).

Bronchi and Bronchioles

The trachea divides into the left and right main bronchi, which enter the lungs. The right
main bronchus is wider, shorter, and more vertical than the left, making it more prone to foreign
object lodging. The bronchi continue to branch into secondary (lobar) bronchi, tertiary
(segmental) bronchi, and finally bronchioles. The bronchioles subdivide into terminal
bronchioles and then into respiratory bronchioles, alveolar ducts, and alveoli. The structure of the
walls changes with decreasing passageway size, with less cartilage and more smooth muscle.
The ciliated epithelium in the larger airways functions as a mucus-cilia escalator, while the
thinner walls of the smaller airways facilitate gas exchange where gas exchange between the air
and blood takes place.

The respiratory membrane, composed of six layers, facilitates gas diffusion:

● A thin layer of fluid lining the alveolus
● The alveolar epithelium (simple squamous epithelium's, 2019).

Alveoli
The alveoli are small air sacs where gas exchange between the air and blood takes place.
The respiratory membrane, composed of six layers, facilitates gas diffusion:
● The basement membrane of the alveolar epithelium
● A thin interstitial space
● The basement membrane of the capillary endothelium
● The capillary endothelium (simple squamous epithelium)
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Elastic fibers surrounding the alveoli allow them to expand during inspiration and recoil
during expiration. Specialized cells secrete surfactant, reducing the tendency of alveoli to
collapse (Seeley's, 2018).

Pleura
The lungs are contained within the thoracic cavity, each surrounded by a pleural cavity
lined with a serous membrane called the pleura. The parietal pleura lines the thorax, diaphragm,
and mediastinum, while the visceral pleura covers the lung surface. The pleural cavity, filled
with pleural fluid, acts as a lubricant and helps hold the pleural membranes together (Seeley's,
2019).

Lungs
The lungs are the principal organs of respiration. The right lung has three lobes (superior,
middle, and inferior), while the left lung has two lobes (superior and inferior). Each lung lobe is
divided into bronchopulmonary segments. The tracheobronchial tree branches into progressively
smaller airways, ending in the alveoli. The lungs are highly elastic and capable of returning to
their original state after inflation. The lymphatic system, with superficial and deep vessels, drains
lymph from the lungs and helps remove foreign particles and debris (Seeley's, 2018).

Diaphragm
The diaphragm is a large dome of skeletal muscle that separates the thoracic cavity from
the abdominal cavity and plays a crucial role in ventilation. During quiet inspiration, the
diaphragm contracts, increasing thoracic volume and allowing air to flow into the lungs.
Relaxation of the diaphragm and elastic recoil of the lungs result in expiration. During labored
breathing, additional muscles are recruited to increase thoracic volume further (Seeley's, 2019).

Respiratory centers
● Medullary Respiratory Center (Medulla Oblongata): Situated in the medulla oblongata,
the medullary respiratory center acts as the central command for regulating breathing
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patterns (Seeley's, 2019). It consists of two main groups: the dorsal respiratory group
(DRG) and the ventral respiratory group (VRG). The DRG primarily controls the
contraction of the diaphragm, the main muscle involved in breathing, while the VRG
oversees the activation of various respiratory muscles, including those in the chest and
abdomen. Together, these groups coordinate the rhythmic pattern of breathing, ensuring a
balance between inhalation and exhalation.
● Pontine Respiratory Group (Pons): Located in the pons, the pontine respiratory group
serves as an interface between the medullary respiratory center and higher brain centers
(Seeley's, 2019). It contributes to the regulation of breathing by influencing the timing
and coordination of respiratory muscle activity, particularly the transition between
inhalation and exhalation. Through its connections with the medulla, the pontine
respiratory group helps fine-tune respiratory patterns in response to changes in metabolic
demands and environmental conditions.
● Carotid and Aortic Bodies: Positioned in the carotid arteries and aorta, respectively, the
carotid and aortic bodies are peripheral chemoreceptors that play a crucial role in
monitoring the levels of oxygen, carbon dioxide, and pH in the blood (Seeley's, 2019).
When these receptors detect deviations from normal blood gas concentrations, they send
signals to the respiratory centers in the brainstem, prompting adjustments in breathing
rate and depth to restore equilibrium. This feedback loop ensures that the body receives
an adequate supply of oxygen and maintains proper acid-base balance.
● Muscles and Joints: Sensory receptors located in muscles and joints provide valuable
feedback to the respiratory centers regarding the body's activity level and energy
requirements (Seeley's, 2019). As physical activity increases, these receptors relay signals
indicating the need for enhanced ventilation to meet the heightened oxygen demand and
facilitate the removal of carbon dioxide produced during exercise. Consequently, the
respiratory centers adjust breathing rate and depth accordingly, ensuring efficient gas
exchange and metabolic homeostasis.