Sunday, 2 October 2016

Respiratory System


The primary organ of respiration in humans are lungs  . Their function in the respiratory system is to extract oxygen from the atmosphere and transfer it into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere, in a process of gas exchange. In humans, the primary muscle that drives breathing is the diaphragm. The lungs also provide airflow that makes vocal sounds including human speech possible.
Functionally, the respiratory system can be divided into two zones
·         conducting zone
·         respiratory zone
Conducting Zone
The conducting zone of the respiratory system includes the organs and structures not directly involved in gas exchange. The gas exchange occurs in the respiratory zone.The major functions of the conducting zone are to provide a route for incoming and outgoing air, remove debris and pathogens from the incoming air, and warm and humidify the incoming air. Several structures within the conducting zone perform other functions as well. The epithelium of the nasal passages, for example, is essential to sensing odors, and the bronchial epithelium that lines the lungs can metabolize some airborne carcinogens.
The Nose and its Adjacent Structures

The major entrance and exit for the respiratory system is through the nose. When discussing the nose, it is helpful to divide it into two major sections: the external nose, and the nasal cavity or internal nose.
The external nose consists of the surface and skeletal structures that result in the outward appearance of the nose and contribute to its numerous functions . The root is the region of the nose located between the eyebrows. The bridge is the part of the nose that connects the root to the rest of the nose. The dorsum nasi is the length of the nose.The apex is the tip of the nose. On either side of the apex, the nostrils are formed by the alae (singular = ala). An ala is a cartilaginous structure that forms the lateral side of each naris (plural = nares), or nostril opening. The philtrum is the concave surface that connects the apex of the nose to the upper lip.
Underneath the thin skin of the nose are its skeletal features . While the root and bridge of the nose consist of bone, the protruding portion of the nose is composed of cartilage. As a result, when looking at a skull, the nose is missing. The nasal bone is one of a pair of bones that lies under the root and bridge of the nose. The nasal bone articulates superiorly with the frontal bone and laterally with the maxillary bones. Septal cartilage is flexible hyaline cartilage connected to the nasal bone, forming the dorsum nasi. The alar cartilage consists of the apex of the nose; it surrounds the naris.The nares open into the nasal cavity, which is separated into left and right sections by the nasal septum .The nasal septum is formed anteriorly by a portion of the septal cartilage (the flexible portion you can touch with your fingers) and posteriorly by the perpendicular plate of the ethmoid bone (a cranial bone located just posterior to the nasal bones) and the thin vomer bones (whose name refers to its plough shape). Each lateral wall of the nasal cavity has three bony projections, called the superior, middle, and inferior nasal conchae. The inferior conchae are separate bones, whereas the superior and middle conchae are portions of the ethmoid bone. Conchae serve to increase the surface area of the nasal cavity and to disrupt the flow of air as it enters the nose, causing air to bounce along the epithelium, where it is cleaned and warmed. The conchae and meatuses also conserve water and prevent dehydration of the nasal epithelium by trapping water during exhalation. The floor of the nasal cavity is composed of the palate. The hard palate at the anterior region of the nasal cavity is composed of bone. The soft palate at the posterior portion of the nasal cavity consists of muscle tissue. Air exits the nasal cavities via the internal nares and moves into the pharynx.
Several bones that help form the walls of the nasal cavity have air-containing spaces called the paranasal sinuses, which serve to warm and humidify incoming air. Sinuses are lined with a mucosa. Each paranasal sinus is named for its associated bone: frontal sinus, maxillary sinus, sphenoidal sinus, and ethmoidal sinus. The sinuses produce mucus and lighten the weight of the skull.The nares and anterior portion of the nasal cavities are lined with mucous membranes, containing sebaceous glands and hair follicles that serve to prevent the passage of large debris, such as dirt, through the nasal cavity. An olfactory epithelium used to detect odors is found deeper in the nasal cavity.
Pharynx
In humans the pharynx is part of the digestive system and also of the conducting zone of the respiratory system. (The conducting zone also includes the nose, larynx, trachea, bronchi, and bronchioles, and their function is to filter, warm, and moisten air and conduct it into the lungs. The pharynx makes up the part of the throat situated immediately behind the nasal cavity, behind the mouth and above the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx, the oropharynx and the laryngopharynx. It is also important in vocalization.In humans there are two sets of pharyngeal muscles that form the pharynx, determining the shape of its lumen. These are arranged as an inner layer of longitudinal muscles and an outer circular layer.

The nasopharynx is flanked by the conchae of the nasal cavity, and it serves only as an airway. At the top of the nasopharynx are the pharyngeal tonsils. A pharyngeal tonsil, also called an adenoid, is an aggregate of lymphoid reticular tissue similar to a lymph node that lies at the superior portion of the nasopharynx. The function of the pharyngeal tonsil is not well understood, but it contains a rich supply of lymphocytes and is covered with ciliated epithelium that traps and destroys invading pathogens that enter during inhalation. The pharyngeal tonsils are large in children, but interestingly, tend to regress with age and may even disappear. The uvula is a small bulbous, teardrop-shaped structure located at the apex of the soft palate. Both the uvula and soft palate move like a pendulum during swallowing, swinging upward to close off the nasopharynx to prevent ingested materials from entering the nasal cavity. In addition, auditory (Eustachian) tubes that connect to each middle ear cavity open into the nasopharynx. This connection is why colds often lead to ear infections. The oropharynx is a passageway for both air and food. The oropharynx is bordered superiorly by the nasopharynx and anteriorly by the oral cavity. The fauces is the opening at the connection between the oral cavity and the oropharynx. As the nasopharynx becomes the oropharynx, the epithelium changes from pseudostratified ciliated columnar epithelium to stratified squamous epithelium. The oropharynx contains two distinct sets of tonsils, the palatine and lingual tonsils. A palatine tonsil is one of a pair of structures located laterally in the oropharynx in the area of the fauces. The lingual tonsil is located at the base of the tongue. Similar to the pharyngeal tonsil, the palatine and lingual tonsils are composed of lymphoid tissue, and trap and destroy pathogens entering the body through the oral or nasal cavities. The laryngopharynx is inferior to the oropharynx and posterior to the larynx. It continues the route for ingested material and air until its inferior end, where the digestive and respiratory systems diverge. The stratified squamous epithelium of the oropharynx is continuous with the laryngopharynx. Anteriorly, the laryngopharynx opens into the larynx, whereas posteriorly, it enters the esophagus.
Larynx
The larynx is a cartilaginous structure inferior to the laryngopharynx that connects the pharynx to the trachea and helps regulate the volume of air that enters and leaves the lungs. The structure of the larynx is formed by several pieces of cartilage. Three large cartilage pieces—the thyroid cartilage (anterior), epiglottis (superior), and cricoid cartilage (inferior)—form the major structure of the larynx. The thyroid cartilage is the largest piece of cartilage that makes up the larynx. The thyroid cartilage consists of the laryngeal prominence, or “Adam’s apple,” which tends to be more prominent in males. The thick cricoid cartilage forms a ring, with a wide posterior region and a thinner anterior region. Three smaller,paired cartilages—the arytenoids, corniculates, and cuneiforms—attach to the epiglottis and the vocal cords and muscle that help move the vocal cords to produce speech.
epiglottis
The epiglottis is a flap made of elastic cartilage tissue covered with a mucous membrane, attached to the entrance of the larynx. It projects obliquely upwards behind the tongue and the hyoid bone, pointing dorsally. It stands open during breathing, allowing air into the larynx. During swallowing, it closes to prevent aspiration, forcing the swallowed liquids or food to go down the esophagus instead. It is thus the valve that diverts passage to either the trachea or the esophagus.The epiglottis gets its name from being above the glottis (epi- + glottis). There are taste buds on the epiglottis.
Structure
The epiglottis is shaped somewhat like a leaf of purslane, with the stem attached to the anterior part of the thyroid cartilage.The epiglottis is one of nine cartilaginous structures that make up the larynx (voice box). During breathing, it lies completely within the larynx. During swallowing, it serves as part of the anterior of the pharynx.
Histology
In a direct section of the epiglottis it can be seen that the body consists of elastic cartilage. The epiglottis has two surfaces, a lingual and a laryngeal surface, related to the oral cavity and the larynx respectively.The entire lingual surface and the apical portion of the laryngeal surface (since it is vulnerable to abrasion due to its relation to the digestive tract) are covered by stratified squamous non-keratinized epithelium. The rest of the laryngeal surface on the other hand, which is in relation to the respiratory system, has respiratory epithelium: pseudostratified, ciliated columnar cells and mucus secreting goblet cells.
Development
The epiglottis arises from the fourth pharyngeal arch. It can be seen as a distinct structure later than the other cartilage of the pharynx, visible around the fifth month of development.
Function
The epiglottis is normally pointed upward during breathing with its underside functioning as part of the pharynx. During swallowing, elevation of the hyoid bone draws the larynx upward; as a result, the epiglottis folds down to a more horizontal position, with its superior side functioning as part of the pharynx. In this manner, the epiglottis prevents food from going into the trachea and instead directs it to the esophagus, which is at the back. Should food or liquid enter the windpipe due to the epiglottis failing to close properly, the gag reflex is induced to protect the respiratory system.
Gag reflex
The glossopharyngeal nerve (CN IX) sends fibers to the upper epiglottis that contribute to the afferent limb of the gag reflex. (The gag reflex is variable in people from a limited to a hypersensitive response.) The superior laryngeal branch of the vagus nerve (CN X) sends fibers to the lower epiglottis that contribute to the efferent limb of the cough reflex.This initiates an attempt to try to dislodge the food or liquid from the windpipe.
The trachea, colloquially called the windpipe, is a cartilaginous tube that connects the pharynx and larynx to the lungs, allowing the passage of air, and so is present in almost all air-breathing animals with lungs. Only in the lungfish, where the lung is connected to the pharynx and the larynx, is it absent.The trachea extends from the larynx and branches into the two primary bronchi. At the top of the trachea the cricoid cartilage attaches it to the larynx. This is the only complete ring, the others being incomplete rings of reinforcing cartilage. The trachealis muscle joins the ends of the rings and these are joined vertically by bands of fibrous connective tissue – the annular ligaments of trachea. The epiglottis closes the opening to the larynx during swallowing.
trachea
The trachea develops in the second month of development. It is lined with an epithelium that has goblet cells which produce protective mucins. An inflammatory condition, also involving the larynx and bronchi, called croup can result in a barking cough. A tracheotomy is often performed for ventilation in surgical operations where needed. Intubation is also carried out for the same reason by the inserting of a tube into the trachea. From 2008, operations have transplanted a windpipe grown by stem cells, and synthetic windpipes; their success is however doubtful.
The human trachea has an inner diameter of about 25 millimetres (1 in) and a length of about 10 to 16 centimetres (4 to 6 in). It commences at the lower border of the larynx, level with the sixth cervical vertebra. Inside the trachea at the level of the fifth thoracic vertebra (T5) there is a cartilaginous ridge known as the carina of trachea which runs across from the front to the back of the trachea and marks the point of bifurcation into the right and left primary bronchi. The carina is opposite the sternal angle and can be positioned up to two vertebrae lower or higher, depending on breathing.A ring of hyaline cartilage called the cricoid cartilage forms the inferior wall of the larynx and is attached to the top of the trachea. The cricoid cartilage is the only complete ring of cartilage in the trachea. Below this there are from fifteen to twenty incomplete C-shaped tracheal rings or tracheal cartilages, also of hyaline, that reinforce the front and sides of the trachea to protect and maintain the airway. This leaves a membranous wall at the back, (about a third of the ring's diameter) without cartilage. The cartilages (around 4 mm deep and 1 mm thick) are placed horizontally above each other, separated by narrow intervals. The outer surfaces are directed vertically and the inner surfaces are convex due to the cartilages being thicker in the middle than at the margins.The first tracheal ring is broader than the rest, and often divided at one end; it is connected by the cricotracheal ligament with the lower border of the cricoid cartilage, and is sometimes blended with the next cartilage down. The last cartilage is thick and broad in the middle, due to its lower border being prolonged into a triangular hook-shaped (uncinate) process, which curves downward and backward between the two bronchi. It ends on each side in an imperfect ring, which encloses the commencement of the bronchus. The cartilage above the last is somewhat broader than the others at its center.Two or more of the cartilages often unite, partially or completely, and they are sometimes bifurcated at their extremities. The rings are generally highly elastic but they may calcify with age.The trachealis muscle connects the ends of the incomplete rings and contracts during coughing, reducing the size of the lumen of the trachea to increase the rate of air flow. The esophagus lies posteriorly to the trachea, adjoining along the tracheoesophageal stripe. Circular horizontal bands of fibrous tissue called the annular ligaments of trachea join the tracheal rings together. The cartilaginous rings are incomplete to allow the trachea to collapse slightly so that food can pass down the esophagus. A flap-like epiglottis closes the opening to the larynx during swallowing to prevent swallowed matter from entering the trachea.
Development
In the fourth week of embryogenesis as the respiratory bud grows, the trachea separates from the foregut through the formation of tracheoesophageal ridges which fuse to form the tracheoesophageal septum and this separates the future trachea from the oesophagus and divides the foregut tube into the laryngotracheal tube. Before the end of the fifth week, the trachea begins to develop from the laryngotracheal tube which develops from the laryngotracheal groove. The first part of the cephalic region of the tube forms the larynx, and the next part forms the trachea.
Histology
The trachea is lined with a layer of pseudostratified columnar epithelium. The epithelium contains goblet cells, which are glandular, modified simple columnar epithelial cells that produce mucins, the main component of mucus. Mucus helps to moisten and protect the airways. Mucus lines the ciliated cells of the trachea to trap inhaled foreign particles that the cilia then waft upward toward the larynx and then the pharynx where it can be either swallowed into the stomach or expelled as phlegm. This self-clearing mechanism is termed mucociliary clearance.
Bronchial Tree
The trachea branches into the right and left primary bronchi at the carina. These bronchi are also lined by pseudostratified ciliated columnar epithelium containing mucus-producing goblet cells. The carina is a raised structure thatcontains specialized nervous tissue that induces violent coughing if a foreign body, such as food, is present. Rings ofcartilage, similar to those of the trachea, support the structure of the bronchi and prevent their collapse. The primary bronchienter the lungs at the hilum, a concave region where blood vessels, lymphatic vessels, and nerves also enter the lungs.The bronchi continue to branch into bronchial a tree. A bronchial tree (or respiratory tree) is the collective term used forthese multiple-branched bronchi. The main function of the bronchi, like other conducting zone structures, is to provide apassageway for air to move into and out of each lung. In addition, the mucous membrane traps debris and pathogens.A bronchiole branches from the tertiary bronchi. Bronchioles, which are about 1 mm in diameter, further branch until theybecome the tiny terminal bronchioles, which lead to the structures of gas exchange. There are more than 1000 terminalbronchioles in each lung. The muscular walls of the bronchioles do not contain cartilage like those of the bronchi. Thismuscular wall can change the size of the tubing to increase or decrease airflow through the tube.
Respiratory Zone
In contrast to the conducting zone, the respiratory zone includes structures that are directly involved in gas exchange.The respiratory zone begins where the terminal bronchioles join a respiratory bronchiole, the smallest type of bronchiole, which then leads to an alveolar duct, opening into a cluster of alveoli. Respiratory Zone Bronchioles lead to alveolar sacs in the respiratory zone, where gas exchange occurs.
Alveoli
An alveolar duct is a tube composed of smooth muscle and connective tissue, which opens into a cluster of alveoli. An alveolus is one of the many small, grape-like sacs that are attached to the alveolar ducts.An alveolar sac is a cluster of many individual alveoli that are responsible for gas exchange. An alveolus is approximately 200 mm in diameter with elastic walls that allow the alveolus to stretch during air intake, which greatly increases the surface area available for gas exchange. Alveoli are connected to their neighbors by alveolar pores, which help maintain equal air pressure throughout the alveoli and lung.
The alveolar wall consists of three major cell types: type I alveolar cells, type II alveolar cells, and alveolar macrophages. A type I alveolar cell is a squamous epithelial cell of the alveoli, which constitute up to 97 percent of the alveolar surface area.These cells are about 25 nm thick and are highly permeable to gases. A type II alveolar cell is interspersed among the type I cells and secretes pulmonary surfactant, a substance composed of phospholipids and proteins that reduces the surface tension of the alveoli. Roaming around the alveolar wall is the alveolar macrophage, a phagocytic cell of the immune system that removes debris and pathogens that have reached the alveoli. The simple squamous epithelium formed by type I alveolar cells is attached to a thin, elastic basement membrane. This epithelium is extremely thin and borders the endothelial membrane of capillaries. Taken together, the alveoli and capillary membranes form a respiratory membrane that is approximately 0.5 mm thick. The respiratory membrane allows gases to cross by simple diffusion, allowing oxygen to be picked up by the blood for transport and CO2 to be released into the air of the alveoli.
Anatomy of the Lungs
The lungs are pyramid-shaped, paired organs that are connected to the trachea by the right and left bronchi; on the inferior surface, the lungs are bordered by the diaphragm. The diaphragm is the flat, dome-shaped muscle located at the base of the lungs and thoracic cavity. The lungs are enclosed by the pleurae, which are attached to the mediastinum. The right lung is shorter and wider than the left lung, and the left lung occupies a smaller volume than the right. The cardiac notch is an indentation on the surface of the left lung, and it allows space for the heart . The apex of the lung is the superior region, whereas the base is the opposite region near the diaphragm. The costal surface of the lung borders the ribs.The mediastinal surface faces the midline.



 Each lung is composed of smaller units called lobes. Fissures separate these lobes from each other. The right lung consists of three lobes: the superior, middle, and inferior lobes. The left lung consists of two lobes: the superior and inferior lobes.A bronchopulmonary segment is a division of a lobe, and each lobe houses multiple bronchopulmonary segments. Each segment receives air from its own tertiary bronchus and is supplied with blood by its own artery. Some diseases of the lungs typically affect one or more bronchopulmonary segments, and in some cases, the diseased segments can be surgically removed with little influence on neighboring segments. A pulmonary lobule is a subdivision formed as the bronchi branch into bronchioles. Each lobule receives its own large bronchiole that has multiple branches. An interlobular septum is a wall, composed of connective tissue, which separates lobules from one another.

Blood Supply and Nervous Innervation of the Lungs
The blood supply of the lungs plays an important role in gas exchange and serves as a transport system for gases throughout the body. In addition, innervation by the both the parasympathetic and sympathetic nervous systems provides an important level of control through dilation and constriction of the airway.
Blood Supply
The major function of the lungs is to perform gas exchange, which requires blood from the pulmonary circulation. This blood supply contains deoxygenated blood and travels to the lungs where erythrocytes, also known as red blood cells, pick up oxygen to be transported to tissues throughout the body. The pulmonary artery is an artery that arises from the pulmonary trunk and carries deoxygenated, arterial blood to the alveoli. The pulmonary artery branches multiple times as it follows the bronchi, and each branch becomes progressively smaller in diameter. One arteriole and an accompanying venule supply and drain one pulmonary lobule. As they near the alveoli, the pulmonary arteries become the pulmonary capillary network. The pulmonary capillary network consists of tiny vessels with very thin walls that lack smooth muscle fibers. The capillaries branch and follow the bronchioles and structure of the alveoli. It is at this point that the capillary wall meets the alveolar wall, creating the respiratory membrane. Once the blood is oxygenated, it drains from the alveoli by way of multiple pulmonary veins, which exit the lungs through the hilum.
Nervous Innervation
Dilation and constriction of the airway are achieved through nervous control by the parasympathetic and sympathetic nervous systems. The parasympathetic system causes bronchoconstriction, whereas the sympathetic nervous system stimulates bronchodilation. Reflexes such as coughing, and the ability of the lungs to regulate oxygen and carbon dioxide levels, also result from this autonomic nervous system control. Sensory nerve fibers arise from the vagus nerve, and from the second to fifth thoracic ganglia. The pulmonary plexus is a region on the lung root formed by the entrance of the nerves at the hilum. The nerves then follow the bronchi in the lungs and branch to innervate muscle fibers, glands, and bloodvessels.
Pleura of the Lungs
Each lung is enclosed within a cavity that is surrounded by the pleura. The pleura (plural = pleurae) is a serous membrane that surrounds the lung. The right and left pleurae, which enclose the right and left lungs, respectively, are separated by the mediastinum. The pleurae consist of two layers. The visceral pleura is the layer that is superficial to the lungs, and extends into and lines the lung fissures . In contrast, the parietal pleura is the outer layer that connects to the thoracic wall, the mediastinum, and the diaphragm. The visceral and parietal pleurae connect to each other at the hilum. The pleural cavity is the space between the visceral and parietal layers.
The pleurae perform two major functions: They produce pleural fluid and create cavities that separate the major organs.Pleural fluid is secreted by mesothelial cells from both pleural layers and acts to lubricate their surfaces. This lubrication reduces friction between the two layers to prevent trauma during breathing, and creates surface tension that helps maintain the position of the lungs against the thoracic wall. This adhesive characteristic of the pleural fluid causes the lungs to enlarge when the thoracic wall expands during ventilation, allowing the lungs to fill with air. The pleurae also create a division between major organs that prevents interference due to the movement of the organs, while preventing the spread of infection.
Pulmonary ventilation is the act of breathing, which can be described as the movement of air into and out of the lungs.The major mechanisms that drive pulmonary ventilation are atmospheric pressure (Patm); the air pressure within the alveoli,called alveolar pressure (Palv); and the pressure within the pleural cavity, called intrapleural pressure (Pip).
Mechanisms of Breathing
The alveolar and intrapleural pressures are dependent on certain physical features of the lung. However, the ability to breathe—to have air enter the lungs during inspiration and air leave the lungs during expiration—is dependent on the air pressure of the atmosphere and the air pressure within the lungs.
Pressure Relationships
Inspiration (or inhalation) and expiration (or exhalation) are dependent on the differences in pressure between the atmosphere and the lungs. In a gas, pressure is a force created by the movement of gas molecules that are confined. For example, a certain number of gas molecules in a two-liter container has more room than the same number of gas molecules in a one-liter container. In this case, the force exerted by the movement of the gas molecules against the walls of the two-liter container is lower than the force exerted by the gas molecules in the one-liter container. Therefore, the pressure is lower in the two-liter container and higher in the one-liter container. At a constant temperature, changing the volume occupied by the gas changes the pressure, as does changing the number of gas molecules. Boyle’s law describes the relationship between volume and pressure in a gas at a constant temperature. Boyle discovered that the pressure of a gas is inversely proportional to its volume: If volume increases, pressure decreases. Likewise, if volume decreases, pressure increases. Pressure and volume are inversely related (P = k/V). Therefore, the pressure in the one-liter container (one-half the volume of the two-liter container) would be twice the pressure in the two-liter container. Boyle’s law is expressed by the following formula:
P1 V1 = P2 V2
In this formula, P1 represents the initial pressure and V1 represents the initial volume, whereas the final pressure and volume are represented by P2 and V2, respectively. If the two- and one-liter containers were connected by a tube and the volume of one of the containers were changed, then the gases would move from higher pressure (lower volume) to lower pressure (higher volume).

Pulmonary ventilation is dependent on three types of pressure: atmospheric, intra-alveolar, and interpleural. Atmospheric pressure is the amount of force that is exerted by gases in the air surrounding any given surface, such as the body. Atmospheric pressure can be expressed in terms of the unit atmosphere, abbreviated atm, or in millimeters of mercury (mm Hg). One atm is equal to 760 mm Hg, which is the atmospheric pressure at sea level. Typically, for respiration, other pressure values are discussed in relation to atmospheric pressure. Therefore, negative pressure is pressure lower than the atmospheric pressure, whereas positive pressure is pressure that it is greater than the atmospheric pressure. A pressure that is equal to the atmospheric pressure is expressed as zero. Intra-alveolar pressure is the pressure of the air within the alveoli, which changes during the different phases of breathing. Because the alveoli are connected to the atmosphere via the tubing of the airways (similar to the two- and one-liter containers in the example above), the interpulmonary pressure of the alveoli always equalizes with the atmospheric pressure.
Intrapleural pressure is the pressure of the air within the pleural cavity, between the visceral and parietal pleurae. Similar to intra-alveolar pressure, intrapleural pressure also changes during the different phases of breathing. However, due to certain characteristics of the lungs, the intrapleural pressure is always lower than, or negative to, the intra-alveolar pressure (and therefore also to atmospheric pressure). Although it fluctuates during inspiration and expiration, intrapleural pressure remains approximately –4 mm Hg throughout the breathing cycle. Competing forces within the thorax cause the formation of the negative intrapleural pressure. One of these forces relates to the elasticity of the lungs themselves—elastic tissue pulls the lungs inward, away from the thoracic wall. Surface tension of alveolar fluid, which is mostly water, also creates an inward pull of the lung tissue. This inward tension from the lungs is countered by opposing forces from the pleural fluid and thoracic wall. Surface tension within the pleural cavity pulls the lungs outward. Too much or too little pleural fluid would hinder the creation of the negative intrapleural pressure; therefore, the level must be closely monitored by the mesothelial cells and drained by the lymphatic system. Since the parietal pleura is attached to the thoracic wall, the natural elasticity of the chest wall opposes the inward pull of the lungs. Ultimately, the outward pull is slightly greater than the inward pull, creating the –4 mm Hg intrapleural pressure relative to the intraalveolar pressure. Transpulmonary pressure is the difference between the intrapleural and intra-alveolar pressures, and it determines the size of the lungs. A higher transpulmonary pressure corresponds to a larger lung.
Physical Factors Affecting Ventilation
In addition to the differences in pressures, breathing is also dependent upon the contraction and relaxation of muscle fibers of both the diaphragm and thorax. The lungs themselves are passive during breathing, meaning they are not involved in creating the movement that helps inspiration and expiration. This is because of the adhesive nature of the pleural fluid, which allows the lungs to be pulled outward when the thoracic wall moves during inspiration. The recoil of the thoracic wall during expiration causes compression of the lungs. Contraction and relaxation of the diaphragm and intercostals muscles (found between the ribs) cause most of the pressure changes that result in inspiration and expiration. These muscle movements and subsequent pressure changes cause air to either rush in or be forced out of the lungs. Other characteristics of the lungs influence the effort that must be expended to ventilate. Resistance is a force that slows motion, in this case, the flow of gases. The size of the airway is the primary factor affecting resistance. A small tubular diameter forces air through a smaller space, causing more collisions of air molecules with the walls of the airways. The following formula helps to describe the relationship between airway resistance and pressure changes:
F = Δ P / R
As noted earlier, there is surface tension within the alveoli caused by water present in the lining of the alveoli. This surface tension tends to inhibit expansion of the alveoli. However, pulmonary surfactant secreted by type II alveolar cells mixes with that water and helps reduce this surface tension. Without pulmonary surfactant, the alveoli would collapse during expiration. Thoracic wall compliance is the ability of the thoracic wall to stretch while under pressure. This can also affect the effort expended in the process of breathing. In order for inspiration to occur, the thoracic cavity must expand. The expansion of the thoracic cavity directly influences the capacity of the lungs to expand. If the tissues of the thoracic wall are not very compliant, it will be difficult to expand the thorax to increase the size of the lungs.
Pulmonary Ventilation
The difference in pressures drives pulmonary ventilation because air flows down a pressure gradient, that is, air flows from an area of higher pressure to an area of lower pressure. Air flows into the lungs largely due to a difference in pressure; atmospheric pressure is greater than intra-alveolar pressure, and intra-alveolar pressure is greater than intrapleural pressure. Air flows out of the lungs during expiration based on the same principle; pressure within the lungs becomes greater than the atmospheric pressure. Pulmonary ventilation comprises two major steps: inspiration and expiration. Inspiration is the process that causes air to enter the lungs, and expiration is the process that causes air to leave the lungs . A respiratory cycle is one sequence of inspiration and expiration. In general, two muscle groups are used during normal inspiration: the diaphragm and the external intercostal muscles. Additional muscles can be used if a bigger breath is required. When the diaphragm contracts, it moves inferiorly toward the abdominal cavity, creating a larger thoracic cavity and more space for the lungs. Contraction of the external intercostal muscles moves the ribs upward and outward, causing the rib cage to expand, which increases the volume of the thoracic cavity. Due to the adhesive force of the pleural fluid, the expansion of the thoracic cavity forces the lungs to stretch and expand as well. This increase in volume leads to a decrease in intra-alveolar pressure, creating a pressure lower than atmospheric pressure. As a result, a pressure gradient is created that drives air into the lungs.
The process of normal expiration is passive, meaning that energy is not required to push air out of the lungs. Instead, the elasticity of the lung tissue causes the lung to recoil, as the diaphragm and intercostal muscles relax following inspiration. In turn, the thoracic cavity and lungs decrease in volume, causing an increase in interpulmonary pressure. The interpulmonary pressure rises above atmospheric pressure, creating a pressure gradient that causes air to leave the lungs. There are different types, or modes, of breathing that require a slightly different process to allow inspiration and expiration. Quiet breathing, also known as eupnea, is a mode of breathing that occurs at rest and does not require the cognitive thought of the individual. During quiet breathing, the diaphragm and external intercostals must contract.
A deep breath, called diaphragmatic breathing, requires the diaphragm to contract. As the diaphragm relaxes, air passively leaves the lungs. A shallow breath, called costal breathing, requires contraction of the intercostal muscles. As the intercostals muscles relax, air passively leaves the lungs. In contrast, forced breathing, also known as hyperpnea, is a mode of breathing that can occur during exercise or actions that require the active manipulation of breathing, such as singing. During forced breathing, inspiration and expiration both occur due to muscle contractions. In addition to the contraction of the diaphragm and intercostal muscles, other accessory muscles must also contract. During forced inspiration, muscles of the neck, including the scalenes, contract and lift the thoracic wall, increasing lung volume. During forced expiration, accessory muscles of the abdomen, including the obliques, contract, forcing abdominal organs upward against the diaphragm. This helps to push the diaphragm further into the thorax, pushing more air out. In addition, accessory muscles (primarily the internal intercostals) help to compress the rib cage, which also reduces the volume of the thoracic cavity.
Respiratory Volumes and Capacities
Respiratory volume is the term used for various volumes of air moved by or associated with the lungs at a given point in the respiratory cycle. There are four major types of respiratory volumes: tidal, residual, inspiratory reserve, and expiratory reserve . Tidal volume (TV) is the amount of air that normally enters the lungs during quiet breathing, which is about 500 milliliters. Expiratory reserve volume (ERV) is the amount of air you can forcefully exhale past a normal tidal expiration, up to 1200 milliliters for men. Inspiratory reserve volume (IRV) is produced by a deep inhalation, past a tidal inspiration. This is the extra volume that can be brought into the lungs during a forced inspiration. Residual volume (RV) is the air left in the lungs if you exhale as much air as possible. The residual volume makes breathing easier by preventing the alveoli from collapsing. Respiratory volume is dependent on a variety of factors, and measuring the different types of respiratory volumes can provide important clues about a person’s respiratory health.
Respiratory capacity is the combination of two or more selected volumes, which further describes the amount of air in the lungs during a given time. For example, total lung capacity (TLC) is the sum of all of the lung volumes (TV, ERV, IRV, and RV), which represents the total amount of air a person can hold in the lungs after a forceful inhalation. TLC is about 6000 mL air for men, and about 4200 mL for women. Vital capacity (VC) is the amount of air a person can move into or out of his or her lungs, and is the sum of all of the volumes except residual volume (TV, ERV, and IRV), which is between 4000 and 5000 milliliters. Inspiratory capacity (IC) is the maximum amount of air that can be inhaled past a normal tidal expiration, is the sum of the tidal volume and inspiratory reserve volume. On the other hand, the functional residual capacity (FRC) is the amount of air that remains in the lung after a normal tidal expiration; it is the sum of expiratory reserve volume and residual volume.
In addition to the air that creates respiratory volumes, the respiratory system also contains anatomical dead space, which is air that is present in the airway that never reaches the alveoli and therefore never participates in gas exchange. Alveolar dead space involves air found within alveoli that are unable to function, such as those affected by disease or abnormal blood flow. Total dead space is the anatomical dead space and alveolar dead space together, and represents all of the air in the respiratory system that is not being used in the gas exchange process.
Respiratory Rate and Control of Ventilation
Breathing usually occurs without thought, although at times you can consciously control it, such as when you swim under water, sing a song, or blow bubbles. The respiratory rate is the total number of breaths, or respiratory cycles, that occur each minute. Respiratory rate can be an important indicator of disease, as the rate may increase or decrease during an illness or in a disease condition. The respiratory rate is controlled by the respiratory center located within the medulla oblongata in the brain, which responds primarily to changes in carbon dioxide, oxygen, and pH levels in the blood. The normal respiratory rate of a child decreases from birth to adolescence. A child under 1 year of age has a normal respiratory rate between 30 and 60 breaths per minute, but by the time a child is about 10 years old, the normal rate is closer to 18 to 30. By adolescence, the normal respiratory rate is similar to that of adults, 12 to 18 breaths per minute.
Ventilation Control Centers

The control of ventilation is a complex interplay of multiple regions in the brain that signal the muscles used in pulmonary ventilation to contract . The result is typically a rhythmic, consistent ventilation rate that provides the body with sufficient amounts of oxygen, while adequately removing carbon dioxide.The medulla oblongata contains the dorsal respiratory group (DRG) and the ventral respiratory group (VRG). The DRG is involved in maintaining a constant breathing rhythm by stimulating the diaphragm and intercostal muscles to contract, resulting in inspiration. When activity in the DRG ceases, it no longer stimulates the diaphragm and intercostals to contract, allowing them to relax, resulting in expiration. The VRG is involved in forced breathing, as the neurons in the VRG stimulate the accessory muscles involved in forced breathing to contract, resulting in forced inspiration. The VRG also stimulates the accessory muscles involved in forced expiration to contract. The second respiratory center of the brain is located within the pons, called the pontine respiratory group, and consists of the apneustic and pneumotaxic centers. The apneustic center is a double cluster of neuronal cell bodies that stimulate neurons in the DRG, controlling the depth of inspiration, particularly for deep breathing. The pneumotaxic center is a network of neurons that inhibits the activity of neurons in the DRG, allowing relaxation after inspiration, and thus controlling the overall rate. Factors That Affect the Rate and Depth of Respiration The respiratory rate and the depth of inspiration are regulated by the medulla oblongata and pons; however, these regions of the brain do so in response to systemic stimuli. It is a dose-response, positive-feedback relationship in which the greater the stimulus, the greater the response. Thus, increasing stimuli results in forced breathing. Multiple systemic factors are involved in stimulating the brain to produce pulmonary ventilation. The major factor that stimulates the medulla oblongata and pons to produce respiration is surprisingly not oxygen concentration, but rather the concentration of carbon dioxide in the blood. As you recall, carbon dioxide is a waste product of cellular respiration and can be toxic. Concentrations of chemicals are sensed by chemoreceptors. A central chemoreceptor is one of the specialized receptors that are located in the brain and brainstem, whereas a peripheral chemoreceptor is one of the specialized receptors located in the carotid arteries and aortic arch. Concentration changes in certain substances, such as carbon dioxide or hydrogen ions, stimulate these receptors, which in turn signal the respiration centers of the brain. In the case of carbon dioxide, as the concentration of CO2 in the blood increases, it readily diffuses across the blood-brain barrier, where it collects in the extracellular fluid. As will be explained in more detail later, increased carbon dioxide levels lead to increased levels of hydrogen ions, decreasing pH. The increase in hydrogen ions in the brain triggers the central chemoreceptors to stimulate the respiratory centers to initiate contraction of the diaphragm and intercostal muscles. As a result, the rate and depth of respiration increase, allowing more carbon dioxide to be expelled, which brings more air into and out of the lungs promoting a reduction in the blood levels of carbon dioxide, and therefore hydrogen ions, in the blood. In contrast, low levels of carbon dioxide in the blood cause low levels of hydrogen ions in the brain, leading to a decrease in the rate and depth of pulmonary ventilation, producing shallow, slow breathing. Another factor involved in influencing the respiratory activity of the brain is systemic arterial concentrations of hydrogen ions. Increasing carbon dioxide levels can lead to increased H+ levels, as mentioned above, as well as other metabolic activities, such as lactic acid accumulation after strenuous exercise. Peripheral chemoreceptors of the aortic arch and carotid arteries sense arterial levels of hydrogen ions. When peripheral chemoreceptors sense decreasing, or more acidic, pH levels, they stimulate an increase in ventilation to remove carbon dioxide from the blood at a quicker rate. Removal of carbon dioxide from the blood helps to reduce hydrogen ions, thus increasing systemic pH.Blood levels of oxygen are also important in influencing respiratory rate. The peripheral chemoreceptors are responsible for sensing large changes in blood oxygen levels. If blood oxygen levels become quite low—about 60 mm Hg or less—then peripheral chemoreceptors stimulate an increase in respiratory activity. The chemoreceptors are only able to sense dissolved oxygen molecules, not the oxygen that is bound to hemoglobin. As you recall, the majority of oxygen is bound by hemoglobin; when dissolved levels of oxygen drop, hemoglobin releases oxygen. Therefore, a large drop in oxygen levels is required to stimulate the chemoreceptors of the aortic arch and carotid arteries. The hypothalamus and other brain regions associated with the limbic system also play roles in influencing the regulation of breathing by interacting with the respiratory centers. The hypothalamus and other regions associated with the limbic system are involved in regulating respiration in response to emotions, pain, and temperature. For example, an increase in body temperature causes an increase in respiratory rate. Feeling excited or the fight-or-flight response will also result in an increase in respiratory rate.
Transporting the Gases
The gas exchange process necessary for cells to function properly could not occur without the blood transporting oxygen and carbon dioxide throughout the body. This transportation depends on the gases’ distinct properties and on a blood component called hemoglobin, an oxygen carrying protein found in red blood cells called erythrocytes.
O2 Transport
Compared to carbon dioxide, oxygen is not very soluble. As a result, only about 0.01 fluid ounces (0.3 milliliters) of oxygen will dissolve in every 3.4 fluid ounces (100 milliliters) of blood plasma, which is not enough to carry sufficient oxygen to the body’s tissues and cells. The majority of oxygen in the human body is carried via hemoglobin, which is the respiratory pigment in humans and also gives blood its red color. Because of the affinity of oxygen to hemoglobin, the oxygen-carrying capacity of blood is boosted nearly 70-fold to about 0.7 fluid ounces (20.8 milliliters) per 3.4 fluid ounces (100 milliliters) of blood. Hemoglobin’s unique molecular characteristics make it an excellent transport molecule for oxygen. Each hemoglobin molecule includes four hemes, which are iron-containing porphyrin compounds, combined with the protein globin. Porphyrins are a group of organic pigments characterized by a ringed group of four linked nitrogen-containing molecular rings (called a tetrapyrrole nucleus). In a heme, each porphyrin ring has an atom of iron (Fe) at its center. Each iron atom can unite with one molecule of oxygen. As a result, each hemoglobin molecule can carry four oxygen molecules. Furthermore, when one oxygen molecule binds to one of the four heme groups, the other heme groups change shape ever so slightly so that their affinity increases for the binding of each subsequent oxygen molecule. In other words, after the first oxygen molecule is attached, the next three oxygen molecules attach even more rapidly to form oxyhemoglobin (the bright red hemoglobin that is a combination of hemoglobin and oxygen from the lungs), thus providing rapid transfer of oxygen throughout the blood. Conversely, when it comes time for hemoglobin to “unload” its oxygen content into cells and tissues, once one heme group releases its oxygen, the other three rapidly follow.
Oxygen’s affinity for hemoglobin is also affected by the partial pressure of carbon dioxide and the blood’s pH level. This is known as the Bohr effect, named after its discoverer Christian Bohr (1855–1911). A high concentration, or partial pressure, of carbon dioxide makes the blood more acidic, which causes hemoglobin to have less affinity for oxygen. As a result, in tissues in which the concentration of carbon dioxide in the blood is high because of its release as a waste product from cells, hemoglobin easily releases oxygen. In the lungs, where blood carbon dioxide levels are low because of its diffusion into the alveoli, hemoglobin readily accepts oxygen. The Bohr effect or shift, which relates to a mathematically plotted curve called the oxygen dissociation curve, serves an extremely useful purpose. During exercise, cells are working harder—more actively respiring—to produce more energy. As a result, they release much higher levels of carbon dioxide into the blood than when the body is at rest. The higher carbon dioxide levels, in turn, reduce the blood’s pH level, thus acidifying the blood and signaling hemoglobin to release more rapidly the oxygen needed to replenish cells and tissues. In other words, the Bohr effect informs the body that its metabolism has increased due to exercise and that it must compensate for the increased need to absorb oxygen and release carbon dioxide.
CO2 Transport
Carbon dioxide enters the blood as a waste product of cell metabolism and cellular respiration. Unlike oxygen, carbon dioxide readily dissolves in blood. Carbon dioxide is transported by the blood to the alveoli in three ways:
1. As soluble CO2 in blood (5–10 percent)
2. Bound by hemoglobin (20–30 percent)
3. As a bicarbonate (60–70 percent)
Although carbon dioxide is more soluble than oxygen and dissolves directly into the blood after it diffuses out of cells, the amount that dissolves is not enough to perform the essential function of ridding the body of carbon dioxide. In the second mode of transport, approximately a quarter of the carbon dioxide eliminated from cells reacts with hemoglobin.
In essence, carbon dioxide is able to hitch a ride with hemoglobin because, at this point, hemoglobin is not carrying much oxygen and has an increased affinity for carbon dioxide. This is known as the Haldane effect and occurs as blood passes through the lungs. Blood proteins that bind to carbon dioxide are called carbamino compounds. When carbon dioxide binds to the hemoglobin’s protein, the combination is called carbaminohemoglobin. The first two methods of transporting carbon dioxide are relatively slow and inefficient compared to the third method of transporting the gas. Because carbon dioxide is highly soluble, it reacts readily with water (H2O) molecules to form carbonic acid (H2CO3) in red blood cells. This reaction would also be too slow for efficient carbon dioxide transport if not for an enzyme called carbonic anhydrase (CA), which is highly concentrated in red blood cells and acts as a catalyst to help produce carbonic acid. The carbonic acid then ionizes (or disassociates) to form a positively charged hydrogen ion (H+) and a negatively charged bicarbonate ion (HCO3−). The chemical process can be viewed as follows:
CO2 + H2O !! H2CO3 !! H+ + HCO3
Because the concentration of the negatively charged bicarbonate ions in the red blood cells is at a higher level than outside of these cells, these ions readily diffuse into the surrounding blood plasma for transport to the alveoli. To compensate for the negatively charged bicarbonate ions moving out of a red blood cell, a negatively charge chloride (Cl) ion enters the cell from the plasma to maintain the electrical balance in both the erythrocyte and the plasma. This exchange is called a chloride shift.
Cellular Respiration
Cellular respiration is the process by which cells use the oxygen delivered by the respiratory and circulatory systems to manufacture and release the chemical energy stored in food, primarily in the form of carbohydrates. As such, it is called an exergonic reaction, meaning that it produces energy. Cellular respiration produces energy via a catabolic process, that is, by making smaller things out of larger things. In cellular respiration, it refers to the breaking down of polymers (large molecules formed by the chemical linking of many smaller molecules) into smaller and more manageable molecules. The catabolic process within cells involves breaking down glucose, a simple sugar in carbohydrates that stores energy, into smaller molecules called pyruvic acid. These smallermolecules are ultimately used to produce adenosine triphosphate (ATP). ATP is the primary “energy currency” of the cell, the human body, and nearly all forms of life. Energy via ATP in cells is used to:
• Manufacture proteins
• Construct new organelles (subcellular structures that perform a role within each cell)
• Replicate DNA
• Synthesize fats and polysaccharides
• Pump water through cell membranes
• Contract muscles
• Conduct nerve impulses
Cellular respiration is the most efficient catabolic process known to exist in nature. Although it occurs in every cell in the body, cellular respiration does not take place simultaneously in the exact same phases throughout all the cells. If the energy produced though cellular respiration was released simultaneously, the body would not be able to process all the energy efficiently, which would result in wasted energy. In addition, the impact of such a large amount of energy being released all at once could overload and damage cells. As a result, cellular respiration occurs at different stages in the body’s various cells, even in cells that are close neighbors or side by side. ATP molecules act like time-release capsules; they release small amounts of energy to fuel various functions within the body at different times. Overall, two primary processes occur in cellular respiration. The first is the breakdown of glucose into carbon dioxide and hydrogen, known as the carbon pathway. The second is the transfer of hydrogen from sugar molecules to oxygen, resulting in the creation of water and energy. The entire process of cellular respiration occurs in three primary stages:
1. Glycolysis
2. Krebs cycle (citric acid cycle)
3. Electron transport system
Glycolysis
Glycolysis, which comes from the Greek words glykos (“sugar” or “sweet”) and lysis (“splitting”), is the initial harvester of chemical energy within the body. It occurs in the cell’s cytoplasm and converts glucose molecules into molecules of pyruvate, or pyruvic acid. Unlike the other processes in cellular respiration, glycolysis does not require oxygen and is the only metabolic pathway shared by all living organisms. Scientists believe that this biological approach to producing life-giving energy existed before oxygen developed in the Earth’s atmosphere. It is the first step in both aerobic (oxygen) and anaerobic (oxygen-free) energyproducing processes .Glycolysis is a multistep process, with each step being catalyzed by a specific enzyme dissolved in the fluid portion of the cytoplasm called the cytosol. As with all biological processes, energy is needed to begin the process, and two ATP energy molecules initiate the reactions. This initial input of energy is called the energy investment phase, and occurs when ATP is used to phosphorylate, or add a phosphate to, the six-carbon glucose molecule. However, the process also yields energy in that further breaking down the six-carbon glucose molecule into two three-carbon pyruvic acid molecules ultimately results in a net gain of ATP molecules, as well as other energy molecules such as reduced nicotinamide adenine dinucleotide (NADH). However, glycolysis is extremely inefficient. The entire process captures only about 2 percent of the energy that is available in glucose for use by the body. Much more energy is available in the two molecules of pyruvic acid and NADH produced during glycolysis. It is this potential energy that goes on to the next step, called the Krebs cycle.
Anaerobic Respiration
When we exercise, our bodies produce more energy and require more oxygen. However, our blood cannot always supply enough of the oxygen via respiration that the cells in our muscles need. Under these circumstances, our muscle cells can respire anaerobically, that is, without oxygen, like some fungi and bacteria are able to do. Anaerobic respiration is also referred to as fermentation. However, cells in the human body can only respire without oxygen for a short period of time. Like normal aerobic cellular respiration, anaerobic respiration begins with glucose in the cell, but takes place completely in the cell’s cytoplasm. Although ATP energy molecules are also produced this way, the process is extremely inefficient compared to aerobic respiration. In the human body, the anaerobic process results in pyruvic acid being turned into the waste product lactic acid, as opposed to entering the mitochondria for further oxidation as it does in aerobic cellular respiration. It is the lactic acid in muscles that makes them stiff and sore after intense aerobic exercise, such as running.
The Krebs Cycle (Citric Acid Cycle)
Discovered by Hans Krebs (1900–1981), the Krebs cycle, also known as the citric acid cycle, is a cyclic series of molecular reactions that require oxygen to function. The cycle is mediated by enzymes that help create the molecules for the final harvesting of cellular energy in the third and final phase of the cellular respiration process. The Krebs cycle occurs in the matrix of the mitochondria, which are the powerhouses of cells. Although the mitochondrion is the second largest organelle in a cell after the nucleus, some cells may contain thousands of mitochondria from 0.5 to 1 micrometer in diameter. Unlike the energy-harvesting process of glycolysis in the cytoplasm, mitochondria are extremely efficient in taking energy from sugar (and other nutrients) and converting it into ATP. In fact, compared to the typical automobile engine, which only harvests about 25 percent of the energy available in gasoline to propel a car, the mitochondrion is more than twice as efficient—it converts 54 percent of the energy available in sugar into ATP. After glycolysis is completed, the two pyruvate molecules that were formed enter the mitochondria for complete oxidization by a series of reactions mediated by various enzymes. As the pyruvate leaves the cytoplasm and enters a mitochondrion, acetyl coenzyme A (CoA) is produced when an enzyme removes carbon and oxygen molecules from each pyruvate molecule. This step is known as the transition reaction. The Krebs cycle begins as oxygen within the cells is used to completely oxidize the acetyl CoA molecules. The process is initiated when each of the acetyl CoA molecules combines with oxaloacetic acid to produce a six-carbon citric acid molecule. Further oxidation eventually produces a four-carbon compound and carbon dioxide. The four-carbon compound is ultimately transformed back in oxaloacetic acid so that the cycle can begin again. Because two pyruvate molecules are transferred into the mitochondria for each glucose molecule, the cycle must be completed twice, once for each pyruvate molecule. Each cycle results in one molecule of ATP, two molecules of carbon dioxide, and eight hydrogen molecules. The ATP molecules produced during this cycle can be used as energy. But it is through the cycle’s creation of the electron “carrier” coenzyme molecules NADH and reduced flavin adenine dinucleotide (FADH2)—which are created when the coenzymes nicotine adenine dinucleotide (NAD) and flavin adenine dinucleotide (FAD) “pick up” the hydrogen molecules—that the abundance of ATP is produced in the next stage of cellular respiration, the electron transport system.
Electron Transport System
Overall, the first two processes in cellular respiration, glycolysis and the Krebs cycle, have produced relatively little energy for the body’s cells to use. Although both of these processes produce some ATP directly, the energy currency of ATP is created and cashed in for the big payoff during the electron transport system, also known as the electron transport chain. This process takes place across the inner membrane of the mitochondria called the cristae. A chain of electron receptors are embedded in the cristae, which are folded to create numerous inward, parallel, regularly spaced projections or ridges. This design results in an extremely high density of receptors, thus increasing the electron transport chain’s efficiency. The receptors are actually a network of proteins that can carry electrons and transfer them on down a protein chain. The process works like a snowball gaining speed as it rolls down a hill. As the NADH and FADH2 molecules produced during glycolysis and the Krebs cycle pass down the chain, they release electrons to the first molecule in the chain and so on. Because each successive carrier in the chain is higher in electronegativity (that is, has a higher tendency to attract electrons) than the previous carrier, the electrons are “pulled downhill.” During the process, hydrogen protons (H+) or ions from NADH and FADH2 are transferred along a group of closely related protein receptors that include flavoproteins, iron-sulfur proteins, quinones, and a group of proteins called cytochromes. The cytochrome proteins in the electron transport system will only accept the electron from each hydrogen and not the entire atom. The final cytochrome carrier in the chain transfers the electrons, which by this time have lost all their energy, to oxygen in the matrix to create the hydrogen-oxygen bond of water. This bond is another reason why oxygen is so important to the life of the cell. Without it, the molecules in the chain would remain stuck with electrons, and ATP would not be produced. Because of the second law of thermodynamics, the electrons passed down the chain lose some of their energy with every transfer from cytochrome to cytochrome. Some of the energy lost helps to “pump” hydrogen ions out of the mitochondria’s matrix into a confined intermembrane space between the mitochondria’s inner and outer membranes. This energy for pumping the hydrogen ions is a result of a process called the oxidationreduction reaction, or redox reaction. The reaction results in the molecules within the electron transport system alternately being reduced (gaining an electron) and then oxidized (losing an electron). The entire process establishes a buildup of hydrogen ions, resulting in a concentration, or diffusion, gradient—more hydrogen ions are pumped inside the confined space between the mitochondria’s membranes than exist in the mitochondria’s matrix. As the concentration gradient increases, the ions begin to diffuse back through the membrane into the matrix to equalize the hydrogen ion gradient. Hydrogen ion diffusion occurs through ATP synthase, an enzyme within the inner membrane of the mitochondrion. ATP synthase uses the potential energy of the proton gradient to synthesize the abundance of ATP out of the adenosine diphosphate (ADP) molecule and phosphate. This process is referred to as chemiosmosis. The formation of ATP is an energy storage process, and the energy is released when ATP is converted via the ATPase enzyme back into ADP (adenose bound to two phosphate groups) or to adenosine monophosphate (AMP—adenose bound to one phosphate group). All of these conversions are known as ATP phosphorylation. ADP and the separate phosphates produced by the breakdown are then recycled into cellular respiration for the recreation of ATP. At the same time, the waste products carbon dioxide and water are eliminated via diffusion from the cell into the bloodstream and on through the organismal respiratory process .
Synthesis of ATP.
The buildup of hydrogen ions into the mitochondria’s intermembrane space via electron transport and the eventual transport of these ions back through the membrane, where they are used by ATP synthase to make ATP (the major source of energy for cellular reactions) out of ADP and phosphate. (Sandy Windelspecht/ Ricochet Productions)
Respiratory System Defense Mechanisms
The respiratory systemhas several features that help protect it from the possible harmful effects of environmental particles and pathogens (viruses, bacteria, etc.) that can enter the system when we breathe. In the upper respiratory tract, the mucociliary (mucus and ciliary) lining of the nasal cavity is the respiratory system’s first line of defense. Composed of tiny hairs lining the nose, this defense mechanism filters out the particles inhaled from the environment. The second line of defense is the mucus that lines the turbinate bones (scrolled spongy bones of the nasal passages) in the sinuses and collects particles that get past the nose. These defense mechanisms together trap larger particles from 5 to 10 micrometers in diameter.
As the air we breathe passes through the nose and nasal cavity, it enters the pharynx, where many particles also stick to the mucus on the back of the throat and tonsils. These captured particles can then be eliminated via coughing and sneezing. In addition, the adenoids and tonsils in the back of the throat help trap pathogens for elimination. These lymphoid tissues (tissue from the lymphatic system) also play an important role in developing an immune system response, such as the production of antibodies to fight off germs. The lower portion of the respiratory tract also has ciliated cells and mucus-secreting cells that cover it with a layer of mucus. These features work together with the mucus-trapping particles and pathogens, which are then driven upwards by the sweeping ciliary action to the back of the throat where they can be expelled. Most of the upper respiratory tract surfaces (including the nasal and oral passages, the pharynx, and the trachea) are colonized by a variety of naturally occurring organisms called flora. These organisms (primarily of the staphylococcus group) can help to combat infections and maintain a healthy respiratory system by preventing infectious microorganisms or pathogens from getting a foothold. This phenomenon is known as colonization resistance or inhibition, and occurs because the normal flora compete for space and nutrients in the body. Some flora also produce toxins that are harmful to other pathogenic microorganisms. In rare instances, normal flora can help cause disease if outside factors cause them to become pathogenic or they are introduced into normally sterile sites in the body.Despite these defense mechanisms, pathogens and particles from 2 to 0.2micrometers oftenmake their way to the lungs and the alveoli. For example, most bacteria and all viruses are 2 micrometers or smaller. The alveoli, however, also have defense mechanisms to protect against microscopic invaders. In the case of the lungs, these mechanisms are primarily cellular in nature. For example, alveolar macrophages are a type of leukocyte that ingest and destroy invading organisms as part of the immune system’s response to infection. The fluid lining the alveoli contains many components, such as surfactant, phospholipids, and other unidentified agents, thatmay be important in activating alveolar macrophages. Lymphoid tissue associated with the lungs also plays a role in defending against infections by initiating immune responses. For example, immune system cells, such as B and T cells, represent a local immune response to fight off infections by producing antibodies or activating macrophages.

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