Anatomy of the Respiratory System (pp. 796-806)

1. Conducting and respiratory divisions
2. Upper and lower respiratory tract
3. The nose
   1.   Structure
   • Bone and cartilage framework
   • Anterior and posterior nares
   • Vestibule and vibrissae
   • Nasal septum and fossae
   • Conchae and meatuses
   2.   Functional aspects
   • Olfaction
   • Entrapment of inhaled debris
   • Ciliary movement of mucus
   • Erectile tissues of inferior concha
4. The pharynx
   1.   Naso-, oro-, and laryngopharynx
   2.   Passage of air, food, and drink
5. The larynx
   1.   Epiglottis and glottis
   2.   Unpaired cartilages
   • Epiglottic cartilage
   • Thyroid cartilage
   • Cricoid cartilage
   3.   Paired cartilages
   • Arytenoid cartilages
   • Corniculate cartilages
   • Cuneiform cartilages
   4.   Muscles
   • Extrinsic–elevate larynx
   • Intrinsic–speech
   5.   Vocal cords and speech mechanism
6. The trachea
   1.   Cartilage rings and trachealis muscle
   2.   Mucociliary escalator
7. The lungs
   1.   Four surfaces of lung
   2.   Left lung: two lobes and cardiac notch
   3.   Right lung: three lobes
8. The bronchial tree
   1.   Primary bronchi
   2.   Secondary bronchi
   3.   Tertiary bronchi
   4.   Bronchioles
   • Diameter 1 mm or less
   • Lack of cartilage
   • Well-developed smooth muscle
   • Major point of air resistance
   5.   Terminal bronchioles
   • Diameter of 0.5 mm or less
   • Lack of mucous glands and goblet cells
   6.   Respiratory bronchioles
   • Beginning of respiratory division
   • Smallest ones unciliated
   • Give off some alveoli
   7.   Alveolar ducts and sacs
9. Alveoli
   1.   Pouches 0.2 to 0.5 mm diameter
   2.   Squamous alveolar cells
   • Gas diffusion role
   3.   Great alveolar cells
   • Secrete pulmonary surfactant
   4.   Alveolar macrophages
   5.   Respiratory membrane
   • Squamous alveolar cells
   • Capillary endothelium
   • Fused basement membranes
10. The pleurae
    1.   Visceral and parietal pleurae
    2.   Pleural cavity and fluid
    3.   Functions
    • Reduce friction
    • Create pressure gradient
    • Compartmentalize thoracic organs

1. Pressure and flow
   1.   Atmospheric pressure
   2.   Boyle's law and intrapulmonary pressure
2. Inspiration
   1.   Action of thoracic muscles
   2.   Role of intrapleural pressure
   3.   Transpulmonary pressure and airflow
   4.   Charles' law and thermal expansion
   5.   Effects on abdominal pressure
3. Expiration
   1.   Usually passive
   2.   Importance of elasticity
   3.   Forced expiration
   4.   Pneumothorax and atelectasis
4. Resistance to airflow
   1.   Importance of compliance
   2.   Bronchoconstriction
   3.   Bronchodilation
5. Alveolar surface tension
   1.   Law of Laplace
   2.   Role of pulmonary surfactant
6. Alveolar ventilation
   1.   Dead space
   2.   Alveolar ventilation rate
7. Nonrespiratory air movements
8. Measurements of ventilation
   1.   Respiratory volumes and capacities (table 22.1)
   2.   Restrictive and obstructive disorders
   3.   Forced expiratory volume
   4.   Minute respiratory volume
   5.   Maximum voluntary ventilation
9. Patterns of breathing (table 22.2)

1. Control centers in the medulla oblongata
   1.   I neurons and E neurons
   2.   Inspiratory center
   3.   Expiratory center
2. Control centers in the pons
   1.   Pneumotaxic center
   2.   Apneustic center
3. Afferent connections to brainstem nuclei
   1.   Limbic system and hypothalamus
   2.   Chemoreceptors
   3.   Inflation reflex
4. Voluntary control of ventilation

1. Composition of air
   1.   Partial pressures and Dalton's law
   2.   Inspired and alveolar air
   3.   Henry's law and the gas-liquid interface
2. Factors in alveolar gas exchange
   1.   Speed of RBC travel
   2.   Concentration gradients
   3.   Gas solubility
   4.   Membrane thickness
   5.   Membrane area
   6.   Ventilation-perfusion coupling
3. Gas transport
   1.   Oxygen
   • Binding to hemoglobin
   • Oxyhemoglobin dissociation curve
   2.   Carbon dioxide
   • Carbonic acid reaction
   • Carbamino compounds
   • Dissolved gas
4. Systemic gas exchange
   1.   Carbon dioxide loading
   • Hydration of CO₂
   • Chloride shift
   2.   Oxygen unloading
   • Oxyhemoglobin dissociation
   • Utilization coefficient
   3.   Reverse chloride shift
   4.   Adjustment to metabolic needs of tissues
   • Ambient ^Po₂
   • Effects of temperature
   • The Bohr effect of pH
   • Effects of DPG
   • Haldane effect

1. Chemoreceptors
2. Hydrogen ions
   1.   Acidosis and alkalosis
   2.   Hypercapnia and hypocapnia
3. Carbon dioxide
4. Oxygen

1. Oxygen deficiency and excess
   1.   Forms of hypoxia
   2.   Oxygen toxicity
2. Chronic obstructive pulmonary diseases
   1.   Chronic bronchitis
   2.   Emphysema
3. Smoking and lung cancer
4. Infectious diseases

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