RESPIRATORY SYSTEM

Clarence L. Nuval, RMT, MD

RESPIRATORY SYSTEM
Consists of the following: Functions:
• Nose • Gas exchange
• Pharynx (throat) • Blood pH regulation
• Larynx (voice box) • Phonation
• Trachea (windpipe) • Contain receptors for
olfaction
• Bronchi
• Filters inspired air
• Lungs
• Rids the body of some water
and heat in exhaled air
RESPIRATION
• Process of supplying the
body with oxygen and
removing carbon dioxide

• Three basic steps:

• Pulmonary ventilation
• External respiration
• Internal respiration
RESPIRATORY SYSTEM
Structurally
• Upper respiratory system
• Lower respiratory system

Functionally
• Conducting zone
• Respiratory zone
RESPIRATORY SYSTEM (STRUCTURAL)
Upper respiratory system Lower respiratory system
• Nose • Larynx
• Nasal cavity • Trachea
• Pharynx and associated • Bronchi
structures • Lungs
RESPIRATORY SYSTEM (FUNCTIONAL)
Conducting zone Respiratory zone
• Nose • Respiratory bronchioles
• Nasal cavity • Alveolar ducts
• Pharynx • Alveolar sacs
• Larynx • Alveoli
• Trachea
• Bronchi
• Bronchioles
• Terminal bronchioles
Nose
Nasal cavity
Pharynx

THE UPPER RESPIRATORY SYSTEM

NOSE
NOSE
• A specialised organ at the entrance of the respiratory system
• Consists of the following:
• External nose
• Portion that is visible on the face
• Internal nose (nasal cavity)
• Portion inside the skull
NOSE
EXTERNAL NOSE
• Bony framework:
• Frontal bone
• Nasal bones
• Maxillae

• Cartilaginous framework:
• Septal nasal cartilage – anterior portion of nasal septum
• Lateral nasal cartilage – inferior to nasal bones
• Alar cartilage – form a portion of the wall of the nostrils
NOSE
EXTERNAL NOSE
• External nares (nostrils)
• Two openings of the
external nose
• Lead into cavities called
NASAL VESTIBULES
NOSE
INTERNAL NOSE
• Refers to the NASAL CAVITY
• A large space in the anterior aspect of the skull
• Lies inferior to the nasal bone
• Lies superior to the oral cavity
• Lined with muscle and mucous membrane

• Anteriorly merges with external nose

• Posteriorly communicates with the pharynx through the internal
nares or choanae
NASAL CAVITY
NASAL CAVITY
Functions:
• Warming, moistening and filtering incoming air
• Detecting olfactory stimuli
• Modifying speech vibrations

Framework:
• Roof: ethmoid bone
• Lateral walls: ethmoid, maxillae, lacrimal, palatine and inferior
nasal conchae bones
• Floor: maxillae and palatine bones
NASAL CAVITY
Respiratory region Olfactory region
• Larger and inferior • Smaller and superior
• Lined with respiratory • Lined with olfactory
epithelium epithelium
• Ciliated pseudostratified • Olfactory receptor cells,
columnar epithelium with supporting cells and
numerous goblet cells basal cells
• Contains cilia but without
goblet cells
NASAL CAVITY
NASAL SEPTUM
• A vertical partition that • Three components:
divides the nasal cavity into • Vomer
left and right sides
• Septal cartilage
• Perpendicular plate of the
ethmoid
NASAL CAVITY
PARANASAL SINUSES
• Cavities in frontal, sphenoid, ethmoid and maxillae that are
continuous with the lining of the nasal cavity

• Functions:
• Mucus production
• Resonating chambers
PHARYNX
PHARYNX (THROAT)
• A 13-cm, funnel-shaped tube that starts at the internal nares and
extends to the level of the cricoid cartilage
• Lies posterior to the nasal and oral cavities
• Lies superior to the larynx
• Lies anterior to the cervical vertebrae
PHARYNX (THROAT)
Functions:
• Passageway for air and food
• Resonating chamber for speech sounds
• Houses the tonsils

Three anatomical regions:

• Nasopharynx
• Oropharynx
• Laryngopharynx
PHARYNX (THROAT)
NASOPHARYNX
• Superior portion of the pharynx
• Lined with ciliated pseudostratified columnar epithelium
• Lies posterior to the nasal cavity
• Extends to the soft palate
• An arch-shaped muscular partition between the nasopharynx and
oropharynx
• Five openings:
• Two internal nares
• Two eustachian tubes
• The opening into the oropharynx
PHARYNX (THROAT)
NASOPHARYNX
• Functions:
• Receives air from the nasal cavity
• Exchanges air with the eustachian tubes to equalise air pressure
between middle ear and atmosphere
• Also contains the pharyngeal tonsil or adenoid
PHARYNX (THROAT)
OROPHARYNX
• Intermediate portion of the pharynx
• Lined with nonkeratinised stratified squamous epithelium
• Lies posterior to the oral cavity
• Extends from the soft palate to the level of the hyoid bone
• Has only one opening called fauces
PHARYNX (THROAT)
OROPHARYNX
• Has both respiratory and digestive functions
• Also contains the palatine and lingual tonsils
PHARYNX (THROAT)
LARYNGOPHARYNX (HYPOPHARYNX)
• Inferior portion of the pharynx
• Lined by nonkeratinised stratified squamous epithelium
• Begins at the level of the hyoid bone
• At its inferior end:
• Opens into the larynx anteriorly
• Opens into the esophagus posteriorly

• Has both respiratory and digestive functions

Larynx
Trachea
Bronchi
Lungs

THE LOWER RESPIRATORY SYSTEM

LARYNX
LARYNX (VOICE BOX)
• A short passageway that connects the laryngopharynx with the
trachea
• Lies in the midline of the neck
• Lies anterior to the esophagus and C4-C6 vertebrae
LARYNX (VOICE BOX)
Nine pieces of cartilage making
up the wall:
• Singly:
• Epiglottis
• Thyroid cartilage
• Cricoid cartilage

• In pairs:
• Arytenoid cartilage
• Cuneiform cartilage
• Corniculate cartilage
LARYNX (VOICE BOX)
CAVITY OF THE LARYNX
• The space that extends from the entrance into the larynx down to the
inferior border of the cricoid

LARYNGEAL VESTIBULE
• The portion of the cavity above the vestibular folds

INFRAGLOTTIC CAVITY
• The portion of the cavity below the vestibular folds
*EPIGLOTTIS
• A large, leaf-shaped piece of
elastic cartilage covered with
epithelium

• “Stem” – the tapered inferior

portion attached to the
anterior rim of the thyroid
cartilage

• “Leaf” – the broad superior

portion that is unattached
and is freely movable
*EPIGLOTTIS
• During swallowing, the pharynx and larynx rise.
• Elevation of the pharynx widens it.
• Elevation of the larynx causes the epiglottis to move down and
form a lid over the glottis, closing it off.

• Lining of the larynx

• Superior to the vocal folds
• Nonkeratinised stratified squamous epithelium
• Inferior to the vocal folds
• Ciliated pseudostratified columnar epithelium
*THYROID CARTILAGE
• Adam’s apple

• Two fused plate of hyaline

cartilage that form the
anterior wall of the larynx
*CRICOID CARTILAGE
• A ring of hyaline cartilage that forms the inferior wall of the larynx
• The landmark for tracheotomy
• Attached to the trachea via the cricotracheal ligament
• Attached to the thyroid cartilage via the cricothyroid ligament
*CRICOID CARTILAGE
*ARYTENOID CARTILAGE
• Triangular pieces of mostly
hyaline cartilage

• Located at the posterior,

superior border of the cricoid
cartilage

• Form synovial joints with the

cricoid cartilage
*CUNEIFORM CARTILAGE
• Club-shaped elastic
cartilages

• Located anterior to the

corniculate cartilages

• Support the vocal folds and

lateral aspect of the epiglottis
*STRUCTURES OF VOICE
PRODUCTION
*STRUCTURES OF VOICE PRODUCTION
Vestibular folds Vocal folds
• False vocal cords • True vocal cords
• Located superiorly • Located inferiorly
• With a space between the
folds called RIMA VESTIBULI
• Function in holding the
breath against pressure in the
thoracic cavity (i.e. valsalva
maneuver)
MOVEMENT OF VOCAL FOLDS
• The vocal folds are the principal structures of voice production.
• Mucous membrane composed of nonkeratinised stratified
squamous epithelium
• Elastic ligaments stretched between cartilages of the larynx

• Intrinsic laryngeal muscles attach to cartilages and vocal folds.

MOVEMENT OF VOCAL FOLDS
• Contraction of posterior cricoarytenoid muscles  abducts vocal
folds  rima glottidis opens
MOVEMENT OF VOCAL FOLDS
• Contraction of lateral cricoarytenoid muscles  adducts vocal folds
 rima glottidis closes
TRACHEA
TRACHEA (WINDPIPE)
• A tubular passageway for air
• 12 cm long, 2.5 cm in diameter
• Located anterior to the esophagus
• Extends from the larynx (at the inferior border of the cricoid cartilage)
to the superior border of T5 vertebra, where it divides into right and left
primary bronchi

• Layers of the tracheal wall

• Mucosa
• Submucosa
• Hyaline cartilage
• Adventitia
TRACHEA (WINDPIPE)
MUCOSA
• Ciliated pseudostratified columnar epithelium
• Underlying lamina propria (elastic and reticular fibers)

SUBMUCOSA
• Areolar connective tissue containing seromucous glands and
ducts

ADVENTITIA
• Areolar connective tissue
• Joins the trachea to surrounding tissues
TRACHEA (WINDPIPE)
HYALINE CARTILAGE
• Dense connective tissue
• 16-20 incomplete, horizontal rings resembling the letter C
• Spanned by a fibromuscular membrane, consisting the trachealis
muscle and elastic connective tissue
• Prevents the trachea from collapsing
BRONCHI
BRONCHI
• The airways that lead from the trachea into the lungs
• Division of the trachea into right and left at the superior border of T5
vertebra
• Contains incomplete rings of cartilage
• Lined by ciliated pseudostratified columnar epithelium

• Rule of thumb: the right main bronchus is shorter, wider and more
vertical than the left main bronchus.
BRONCHI
LOBAR BRONCHI
• Division of the main bronchi,
one for each lobe of the lung

SEGMENTAL BRONCHI
• Supply the specific
bronchopulmonary segments
within the lobes

BRONCHIOLES
• Division of the segmental
bronchi
BRONCHI
TERMINAL BRONCHIOLES
• Represent the end of the
conducting zone of the
respiratory system
• Contain Clara cells
• Columnar, nonciliated cell
interspersed among
epithelial cells
LUNGS
LUNGS
• Paired cone-shaped organs in the thoracic cavity
• Separated from each other by the heart and other structures of the
mediastinum
• Extend from the diaphragm to just slightly superior to the clavicles
• Lie against the ribs anteriorly and posteriorly
LUNGS
• Enclosed and protected by a double-layered serous membrane called
pleural membrane or pleura
• The parietal pleura lines the thoracic cavity.
• The visceral pleura lines the lungs themselves.
• In between these two structures is a space called pleural cavity,
which contains pleural fluid.
LUNGS
APEX
• The narrow superior portion
of the lungs

BASE
• The broad inferior portion of
the lungs
• Concave and fits over the
convex area of the diaphragm
LUNGS
COSTAL SURFACE
• The surface of the lung lying
against the ribs
• Matches the rounded
curvature of the ribs

MEDIASTINAL SURFACE
• Contains a region called the
hilum, through which
bronchi, pulmonary blood
vessels, lymphatic vessels
and nerves enter and exit
LUNGS
COSTAL SURFACE
• The surface of the lung lying
against the ribs
• Matches the rounded
curvature of the ribs

MEDIASTINAL SURFACE
• Contains a region called the
hilum, through which
bronchi, pulmonary blood
vessels, lymphatic vessels
and nerves enter and exit
LUNGS
CARDIAC NOTCH
• A concavity in the left lung in
which the apex of the heart
lies

Hence, the left lung is 10%

smaller than the right,

The right lung is also thicker and

broader, but shorter than the left
lung, because the diaphragm is
higher on the right side where it
accommodates the liver.
LUNGS
• Fissures divide each lung into sections called lobes.
• Both lungs have an oblique fissure, which extends inferiorly and
anteriorly.
• In the left lung, it separates the superior lobe from the inferior
lobe.
• In the right lung:
• The superior part separates the superior lobe from the
inferior lobe.
• The inferior part separates the inferior lobe from the middle
lobe.
LUNG
Each lobe receives its own lobar bronchus.
• Right main bronchus
• Superior, middle and inferior lobar bronchi
• Left main bronchus
• Superior and inferior lobar bronchi

Within the lung, the lobar bronchi give rise to segmental bronchi.
• 10 in each lung
• The portion being supplied by the segmental bronchi is called
the bronchopulmonary segment.
LUNG
Each bronchopulmonary segment has compartments called lobules.
• Each wrapped in elastic connective tissue
• Contain lymphatic vessels, an arteriole, a venule, and a branch
from a terminal bronchiole
• Subdivide to become respiratory bronchioles

As the respiratory bronchioles penetrate more deeply into the lungs, the
epithelial lining changes from simple cuboidal to simple squamous.
Respiratory bronchioles subdivide into several alveolar ducts, which
consist of simple squamous epithelium.
LUNGS
ALVEOLAR SAC
• The terminal dilation of an alveolar duct
• Analogous to cluster of grapes
• Composed of outpouchings called alveoli

ALVEOLI
• The wall consists of two types of alveolar epithelial cell
• Type I pneumocyte (alveolar cell)
• For gas exchange
• Type II pneumocyte (alveolar cell)
• For surfactant production
BREATHING
BREATHING
• The flow of air into and out of the lungs
• Between the atmosphere and the alveoli of the lungs

• Air moves into the lungs when the air pressure inside the lungs is
less than the air pressure in the atmosphere.

• Air moves out of the lungs when the air pressure inside the lungs is
greater than the air pressure in the atmosphere.
BREATHING
During inspiration
• Pressure inside the alveoli is lower than atmospheric pressure.
• Achieved by increasing the size of the lungs through lung
expansion. Remember Boyle’s law.
• Diaphragm and external intercostals contract.
• Air continues to flow into the lungs as long as pressure differences
exist.
BREATHING
During expiration
• Pressure in the lungs is greater than atmospheric pressure.
• Inspiratory muscles relax.
• No muscular contractions involved.
• Air flows from the area of higher pressure (in the alveoli) to the area
lower pressure (in the atmosphere).
FACTORS AFFECTING BREATHING
• Air pressure
• Surface tension of alveolar fluid
• Lung compliance
• Airway resistance
LUNG VOLUMES AND CAPACITIES
LUNG VOLUMES AND CAPACITIES
LUNG VOLUMES
• Can be measured directly by use of a spirometry
• I.e. tidal volume, residual volume, inspiratory reserve volume,
expiratory reserve volume

LUNG CAPACITIES
• Combinations of different lung volumes
• I.e. vital capacity, inspiratory capacity, functional residual
capacity, total lung capacity
LUNG VOLUMES
Tidal volume (TV)
• Volume inspired/expired with each normal breath
• 500 mL
• 350 mL reaches the respiratory zone
• 150 mL remains in the conducting airways

Residual volume (RV)

• Volume that remains in the lungs after maximal expiration
• Cannot be measured by spirometry
• ~1200 mL in an average adult male
• ~1100 mL in an average adult female
LUNG VOLUMES
Inspiratory reserve volume (IRV)
• Volume that can be inspired over and above the tidal volume
• Additional inhaled air
• ~3100 mL in an average adult male
• ~1900 mL in an average adult female

Expiratory reserve volume (ERV)

• Volume that can be expired after the expiration of the tidal volume
• Volume exhaled forcibly
• 1200 mL in an average adult male
• 700 mL in an average adult female
LUNG CAPACITIES
Functional residual capacity (FRC)
• ERV + RV
• Volume remaining in the lungs after a tidal volume is expired

Inspiratory capacity (IC)

• IRV + TV
LUNG CAPACITIES
Vital capacity (VC)
• IRV + ERV + TV
• Volume of air that can be forcibly expired after a maximal
expiration

Total lung capacity (TLC)

• IRV + ERV + TV + IC
• Volume in the lungs after a maximal inspiration
EXCHANGE OF OXYGEN AND
CARBON DIOXIDE
GAS LAWS
Boyle’s law
• An increase in lung volume will decrease pressure, and vice versa.

Dalton’s law
• Law for mixed gases
• The total pressure of a mixture of gases is equal to the sum of the
partial pressures of the component gases.
GAS LAWS
Henry’s law
• Law for gases dissolved in solution
• The amount of dissolved gas in a liquid is proportional to its partial
pressure above the liquid.

Fick’s law
• Law for transfer of gases through simple diffusion in cell membranes
or capillary walls
• The driving force for diffusion is the difference in partial pressure,
not concentration of gases.
• Substances will move from an area of higher partial pressure to an
area of lower partial pressure.
EXTERNAL RESPIRATION
• Pulmonary gas exchange
• The diffusion of oxygen from air in the alveoli to blood in the
pulmonary capillaries
• The diffusion of CO2 in the opposite direction
• Converts deoxygenated blood (from the right side of the heart) into
oxygenated blood
• Gases diffuse independently from an area of higher partial pressure
to an area of lower partial pressure.
INTERNAL RESPIRATION
• Systemic gas exchange
• The exchange of O2 and CO2 between systemic capillaries and
tissue cells
• CO2 still diffuses in the opposite direction
EXCHANGE OF OXYGEN AND CARBON
DIOXIDE
Factors that affect the rate of pulmonary and
systemic gas exchange:
• Partial pressure differences of the gases
• Surface area available for gas exchange
• Diffusion distance
• Molecular weight and solubility of the
gases
TRANSPORT OF OXYGEN AND
CARBON DIOXIDE
OXYGEN TRANSPORT
• 1.5% of inhaled O2 is dissolved in blood plasma
• 98.5% of blood O2 is bound to hemoglobin
• Each 100 mL of oxygenated blood contains ~20 mL of gaseous O2
• 0.3 mL dissolved in plasma
• 19.7 mL bound to hemoglobin
THE RELATIONSHIP BETWEEN HEMOGLOBIN AND
OXYGEN PARTIAL PRESSURE
• The most important factor that determines how much O2 binds to
hemoglobin is the PO2.
• The higher the PO2, the more O2 combines with hemoglobin. The
binding of the first O2 molecule increases affinity for the second
O2 molecule and so forth. This is called positive cooperativity.

• Oxygen normally binds with Fe2+ (ferrous form) and not Fe3+ (ferric
form).
THE RELATIONSHIP BETWEEN HEMOGLOBIN AND
OXYGEN PARTIAL PRESSURE
• Fully saturated hemoglobin
• Hemoglobin completely converted to oxyhemoglobin
• Four O2 bound to hemoglobin
• Remember that the heme portion of hemoglobin contains 4
atoms of iron which has the capacity to bind 1 molecule of O2.

• Partially saturated hemoglobin

• Hemoglobin + oxyhemoglobin
THE RELATIONSHIP BETWEEN HEMOGLOBIN AND
OXYGEN PARTIAL PRESSURE
• At 60-100 mmHg (i.e. in the
lungs), hemoglobin is 90-
100% saturated with O2. This
is seen in arterial blood.

• At 40 mmHg (i.e. at a state of

rest), hemoglobin is 75%
saturated with O2. This is
seen in mixed venous blood.
THE RELATIONSHIP BETWEEN HEMOGLOBIN AND
OXYGEN PARTIAL PRESSURE
• At 25 mmHg, hemoglobin is
50% saturated with O2. Also
called P50. Meaning, 2 of 4
heme groups have O2 bound
to them.

• At 20 mmHg (i.e. contracting

skeletal muscles),
hemoglobin is only 35%
saturated with O2.
FACTORS AFFECTING THE AFFINITY OF
HEMOGLOBIN FOR OXYGEN
• PO2
• Acidity
• PCO2
• Temperature
• BPG (2,3-bisphosphoglycerate)
OXYGEN-HEMOGLOBIN DISSOCIATION
CURVE
Shift to the right, or shift to the left?
• “What’s LEFT will STAY. What’s RIGHT is RELEASED.”
• “Shift to the RIGHT, won’t hold tight.”

• Factors that shift the oxygen-hemoglobin dissociation

curve to the RIGHT promote release of oxygen from
hemoglobin.
• Factors that shift the oxygen-hemoglobin dissociation
curve to the LEFT promote further binding of oxygen to
hemoglobin.
FACTORS AFFECTING THE AFFINITY OF
HEMOGLOBIN FOR OXYGEN
ACIDITY
• The higher the acidity (or the
lower the pH), the lower the
affinity of hemoglobin for O2,
hence O2 is readily unloaded.

• Higher acidity  shift to the

RIGHT  O2 RELEASED
• Lower acidity  shfit to the
LEFT  O2 BOUND to Hb
FACTORS AFFECTING THE AFFINITY OF
HEMOGLOBIN FOR OXYGEN
PCO2
• As PCO2 rises, hemoglobin
releases O2 more readily.

• Higher PCO2  shift to the

RIGHT  O2 RELEASED
• Lower PCO2  shift to the
LEFT  O2 BOUND to Hb
FACTORS AFFECTING THE AFFINITY OF
HEMOGLOBIN FOR OXYGEN
TEMPERATURE
• As temperature rises,
hemoglobin releases O2 more
readily.

• Higher temperature  shift to

the RIGHT  O2 RELEASED
• Lower temperature  shift to
the LEFT  O2 BOUND to Hb
FACTORS AFFECTING THE AFFINITY OF
HEMOGLOBIN FOR OXYGEN
BPG
• BPG decreases the affinity of
hemoglobin for O2, hence
release O2 more readily.

• Increased BPG levels  shift

to the RIGHT  O2
RELEASED
• Decreased BPG levels  shift
to the LEFT  O2 BOUND to
Hb
SHIFT TO THE LEFT OR SHIFT TO THE
RIGHT?

SHIFT TO THE LEFT SHIFT TO THE RIGHT

• Increased PO2 • Decreased PO2
• Decreased PCO2 • Increased PCO2
• Increased pH / lower acidity • Decreased pH / higher acidity
• Lower temperature • Higher temperature
• Decreased BPG • Increased BPG
SHIFT TO THE LEFT OR SHIFT TO THE
RIGHT?
“CABET, DO THE right
SHIFT TO THE RIGHT thing, LET GO.”
• Decreased PO2 • CO2 (increased)
• Increased PCO2 • ACIDOSIS
• Decreased pH / higher acidity • BPG (increased)
• Higher temperature • EXERCISE
• Increased BPG • TEMPERATURE (Increased)
CARBON DIOXIDE TRANSPORT
• Per 100 mL of deoxygenated blood, 53 mL is gaseous CO2.
• Transported in the blood in 3 main forms:
• Dissolved CO2 (7%)
• Carbamino compounds (23%)
• Bicarbonate ions (70%)
CARBON DIOXIDE TRANSPORT
• CO2 is generated in the tissues and diffuses freely into the venous
plasma, then into the RBCs:

• In the RBCs:

• Bicarbonates ions leave RBCs in exchange for chloride ions and is

transported to the lungs in the plasma. This is called the chloride
shift.
CONTROL OF BREATHING
CONTROL OF BREATHING
• Sensory information (PCO2, lung stretch, irritants, muscle spindles,
tendons and joints) is coordinated in the brainstem.
• The output of the brainstem controls the respiratory muscles and the
breathing cycle.
CENTRAL CONTROL OF BREATHING
• Medullary respiratory center
• Dorsal respiratory group
• Ventral respiratory group
• Apneustic center
• Pneumotaxic center
• Cerebral cortex
CENTRAL CONTROL OF BREATHING
MEDULLARY RESPIRATORY CENTER
• Dorsal respiratory group
• Responsible for inspiration
• Generates the basic rhythm for breathing
• Input from the vagus (from peripheral chemoreceptors and
mechanoreceptors of the lungs) and glossopharyngeal nerves (from
peripheral chemoreceptors)
• Output to the diaphragm via the phrenic nerve

• Ventral respiratory group

• Responsible for expiration
• Not active during normal, quiet breathing
CENTRAL CONTROL OF BREATHING
APNEUSTIC CENTER
• Located in the lower pons
• Stimulates inspiration

PNEUMOTAXIC CENTER
• Located in the upper pons
• Inhibits inspiration
• Regulates inspiratory volume and respiratory rate
CENTRAL CONTROL OF BREATHING
CEREBRAL CORTEX
• Breathing can be under voluntary control.
• Hypoventilation (or breath-holding) is limited by resulting increase in
PCO2 and decrease in PO2.
• A previous period of hyperventilation extends the period of
hypoventilation.
CHEMORECEPTORS
CENTRAL CHEMORECEPTORS PERIPHERAL
CHEMORECEPTORS
• Located in the medulla
• Located in the carotid and
• Stimuli that increase
aortic bodies
respiratory rate:
• Stimuli that increase
• Decreased pH
respiratory rate:
• Increased PCO2
• Decreased pH
• Particularly sensitive to CSF
• Increased PCO2
pH
• Decreased O2
OTHER RECEPTORS FOR CONTROL OF
BREATHING
Lung stretch receptors
• Stimulated by distention of the lungs

Irritant receptors
• Stimulated by noxious substances

J (juxtacapillary) receptors
• Stimulated by engorgement of pulmonary capillaries

Joint and muscle receptors

• Stimulated by limb movement
ADAPTATION TO HIGH ALTITUDE
ADAPTATION TO HIGH ALTITUDE
Decreased alveolar PO2
= HYPOXEMIA

Hypoxemia stimulates the peripheral chemoreceptors

= HYPERVENTILATION  RESPIRATORY ALKALOSIS
• More CO2 is exhaled as you hyperventilate, hence blood
becomes less acidic, leading to alkalosis.
ADAPTATION TO HIGH ALTITUDE
Hypoxemia stimulates renal production of erythropoietin.
= Increased RBC production  increased hemoglobin concentration

Increased 2,3-BPG
• SHIFT TO THE RIGHT  O2 RELEASED

Pulmonary vasoconstriction
• Due to hypoxic vasoconstriction