Chapter 14. Respiratory System
Higher category : 【Biology】 Biology Index
7. Lung disease
1. Overview of Breathing
⑴ Stage of breathing
① Exhalation : Gas exchange between the atmosphere and the respiratory tract (ventilation)
② Diffusion : Gas exchange between respiratory tract and blood
③ Mass transport : Carrying of blood
④ Breathing : Gas exchange between blood and tissue cells
⑤ (Note) cell respiration : Receives O2 to oxidize organic matter and produces CO2 and ATP
⑵ Insect breathing : Direct air to the engine only
① Air flow : Institutions → Institutions → Air capillaries
○ 1st. Atmospheric O2 flows into the trachea (the thickest air duct) through the gate on the side of the abdomen
○ 2nd. Air entering the trachea is the trachea (a.K.a bronchiole)
○ 3rd. Air pockets exist due to the presence of expanded sites near tissues with high oxygen demand
○ 4th. O2 in the bronchus moves through the diffusion into the air capillary
② The shape of the organ is retained by the ring-shaped chitin
③ The end of the bronchus is filled with a dark blue liquid. → As the momentum increases, oxygen consumption increases, and most of this liquid is absorbed into the body fluid, which increases the volume of the bronchial tube containing air.
④ Diving Insect : Using Bubbles to Absorb Oxygen
⑶ Fish breathing : Using gills as a respiratory tract
① Located on both sides of the fish
② Four gill bows located between the mouth and the gill lids
③ Hundreds of gill filaments, lamellar up and down
○ Lamella : Practical gas exchange surface
④ Blood vessels passing through the gill : Afferent vessels, centrifugal vessels
○ Afferent blood vessels : Carries blood to the gills
○ Efferent vessels : Withdrawing blood from gills
⑤ Increased gas exchange efficiency by ventilation and backflow exchange
○ Backflow Exchange : Blood flow inside the lamellae and water flow in opposite directions
⑷ Amphibian breathing
① Using gills during larval period, then lungs when adult
○ Reptiles, birds and mammals breathe using their lungs
② Ventilate with positive pressure breathing
○ Breathe positively : Breathing, swallowing air, increasing the pressure near the breathing surface to allow oxygen in the air to dissolve in capillaries across the breathing surface
○ Breathing negative pressure. mammalia) : A breath that lowers the pressure near the breathing surface so that oxygen in the air dissolves in capillaries that cross the breathing surface.
③ Skin respiration : 50% of gas exchanges through the skin
⑸ Bird breathing
① Envelope : Lungs and space inside some bones
② flow of air : Trachea → Bronchus → Lateral Bronchus → Air Capillary, two inhales and exhalations
○ Back air bag → Lung → Front air bag
○ 1st. First breath : Air fills the rear pockets
○ 2nd. First exhalation : The back airbag contracts and sends air to the lungs
○ 3rd. Second inhale : Air flows out of the lungs into the front airbag
○ 4th. Second exhalation : The anterior lung contracts and releases the air that entered the body by the first inhale
③ Advantages of bird breathing
○ Algae lungs are not blocked at the end → residual amount × → gas exchange efficiency ↑
○ Less contraction and relaxation than mammals
⑹ Mammal Breathing (See. 2, 3)
2. Lung Structure (Mammals)
⑴ Air flow : Mouth or nose → nasal cavity → pharynx → larynx → airway → bronchus → tracheobronchial (bronchial) → alveoli
① Air is filtered, warmed and humidified through the nasal passages
② Air from the nasal passages moves to the pharynx (inlet of the esophagus and larynx), where it meets food from the mouth.
③ Palate reflection
○ When swallowing food
○ Epiglottis : Structures that send food to the esophagus and air to the airways
○ 1st. The larynx moves up to close the epiglottis at the gate that corresponds to the entrance to the prayer
○ 2nd. Food goes down the esophagus and reaches over
○ Rest time : Prayer can open and breathe
○ Sends foreign substances trapped in the mucus of goblet cell to esophagus
④ vocal cords
○ The larynx and the lining of the airways (the role of the vocal cords) are fortified with cartilage to ensure airways at all times
○ High tone when strong contraction of vocal cord muscles, low tone when weak contraction
⑤ Bronchus : 2, the inner wall epithelial cells of the main bronchus pass the foreign body to the esophagus using cilia and mucus
⑵ Anatomy of the lungs
① The lungs are made of light spongy tissue, mostly filled with air-filled spaces
② Each lung is surrounded by a pleural sac that prevents gas exchange with the chest cavity
⑶ Alveoli
① 400 million, monolayer epithelium, diameter 0.1 to 0.3 mm
② Alveoli-capillary spacing : 0.1 to 1.5 μm for very smooth diffusion
③ Special structure of alveoli causes lung elasticity
○ The alveoli are muscleless (disrupting gas exchange) but the connective tissue contains large amounts of elastin, which allows it to contract and relax
○ Elastin fibers : Has elastic force opposite to tension
○ Moisture tension : Microscopic layers of moisture on alveoli attract each other to create strong contractile pressure
④ Types of Alveolar Cells
○ First alveolar cell : Mostly epithelial cells
○ Second alveolar cell : Secretion of surfactant on the surface of villi → Alveolar distortion due to surface tension of water
○ Smaller alveolar second alveolar cells secrete more surfactant to lower higher surface tension
○ Neonatal Respiratory Disorder Syndrome (NRDS) : Lack of surfactant secretion due to premature death of infants, second stage alveolar cells
○ Macrophage : Foreign object removal
⑤ Number of alveoli 8 × 106 → Respiratory epithelium area 50 ~ 100 m2 (See. Body surface area ~ 2 m2)
⑷ Functional structure of the lungs
① Lung blood : 0.5 L (10-12% of total blood)
② Volume of the lungs : 3 L
③ Mammals and fish have a larger respiratory surface area at higher weights
④ Oxygen respiration in mammals is proportional to alveolar surface area
⑤ Obesity : Lack of respiratory area → limited oxygen supply → decreased activity
3. Lung ventilation (mammals)
⑴ Breathing pressure : Consumes 3-5% of total energy
① The lungs are passively ventilated with diaphragm and intercostal contractions connected to the pleura
○ The lungs themselves have no muscles and cannot actively contract
○ Thoracic cavity : The lungs are floating in the chest cavity and the chest cavity is a closed space
○ Pleura : Comprised of proximal and pleural pleura, pleural effusion in interstitial space (3-4 mL)
○ Pneumothorax : Perforation of the pleura due to infection or cuts
○ Gang : Thin space surrounding the lungs
○ Contractions of the diaphragm and intercostal muscles are transmitted to the lungs through the pleural effusion so that the lungs are passive contractions
○ Lung flexibility : More surfactant, less scar tissue increases lung flexibility
② Inspiration (Inhalation) : Rib rise (external intercostal contraction), diaphragm descend (diaphragm contraction) → thoracic expansion → pressure drop → air inflow
③ Exhalation : Rib lowering (intercostal contraction), diaphragm rise (diaphragm relaxation) → thoracic contraction → pressure rise → air release
○ Less consumption of ATP during the exhalation process due to gravity and lung elasticity
④ Alveolar pressure, intrathoracic pressure change during breathing
○ Point 1. The pleural intraluminal pressure should be less than the alveolar pressure because the human body regulates the pleural cavity pressure to control the alveolar pressure
○ Point 2. The lungs show a wave graph because the air flows in when the pressure is lowered to offset the change.
○ Volumetric-pressure curve of the lung (link : / 1464) : When inflating requires more pressure than when contracting
⑤ Disadvantages : Partial Pressure Slope Reduction, Backflow Gas Exchange ×
○ Due to the large amount of oxygen in the atmosphere, the disadvantages do not significantly affect species survival
⑵ Spirometry curve
① Parameter
○ Inspiratory residual volume
○ Expiratory residual volume
○ Residual volume
○ Spirometry = 1 tidal volume + absorbent reserve + phagocytic reserve
○ Total lung volume = 1 breath volume + absorbent reserve amount + eosinophilic reserve amount + residue amount
○ Intake volume = tidal volume + absorbent reserve
○ Functional residue amount = phagocytic reserve amount + residue amount
② Gas exchange at rest
○ Tidal volume : 500 mL
○ Ventilation rate : Respiratory Rate Per Minute. Typically 8-12 times per minute
○ Total waste ventilation : Ventilation rate × tidal volume = 8 × 500 mL / min to 12 × 500 mL / min = 3 to 6 L / min
○ Inspiration : Nitrogen 78%, Oxygen 21%, Carbon Dioxide 0.3%
○ Exhalation : Nitrogen 78%, Oxygen 17%, Carbon Dioxide 4%
○ 250 mL O2 / min influx into the blood → 360 to 600 L / day O2
○ 200 mL CO2 / min discharge into the lungs
○ Alveolar ventilation increased more than 20 times during exercise, alveoli blood flow increased 5-6 times
③ Dead space
○ Amount that does not contribute to gas exchange at one breath
○ Cause : Trachea from trachea to bronchioles lack respiratory epithelium and fail to participate in gas exchange
○ Degree : The anatomical dead space is about 140 mL, but the physiological dead space is about 150 mL, given that the bronchial dilated upon inspiration.
○ Alveolar ventilation volume (the amount of air reaching the alveoli) = ventilation rate (breath rate per minute) × (1 breath volume-dead space)
④ Ventilation volume and partial pressure of gas in the alveoli
○ Acidosis, Alkalosis General (See. 6)
○ Ventilation volume ↑ → CO2 release ↑ → respiratory alkalosis
○ Ventilation volume ↓ → CO2 in plasma ↑ → respiratory acidosis
⑶ Transpulmonary Pressure-Volume Graph
① Compliance
○ The degree to which the volume changes with pressure change
○ More surfactant increases the extension
② Inspiration : Confrontation between force to inflate alveoli and surface tension
○ Graphs that don’t seem to increase in volume
○ When treating surfactant : Reduced surface tension → Easy alveolar expansion → Moving graph in the direction of increasing volume
③ Exhalation : Strength of alveoli and surface tension strengthen each other
○ A graph that seems to increase in volume
○ When treating surfactant : Decrease in surface tension → negative alveolar contraction → move graph in the direction of increasing volume
4. Gas transport of blood
⑴ Breathing pigment : Special proteins that carry oxygen
① Hemocyanin : Breathing pigments of arthropods and molluscs, blue (including Cu)
② Hemoglobin : Breathing pigments of most vertebrates and invertebrates, red (including Fe)
③ Myoglobin : More oxygen affinity than hemoglobin, red (including Fe)
○ Diving mammals, heart and muscles are high in myoglobin
○ Myoglobin cannot enter the blood
⑵ Oxygen transport
① Function of hemoglobin : Oxygen transport
○ One red blood cell contains 250 million Hb → carries 1 billion molecules of oxygen (99%)
○ 198 mL / L of 200 mL / L of total blood oxygen
○ Less than 1% oxygen dissolved in plasma or red blood cell substrate
○ Respiratory pigment has higher saturation with higher oxygen partial pressure
○ Hemoglobin binds to oxygen in the lungs (100% saturation) and dissociates only about 30 to 40% at the tissue ends
② Structure : Allosteric enzyme, α2 β2 (quaternary structure, HbA), each unit consisting of heme and globin
○ Myoglobin only consists of tertiary structure
○ Heme : It has an organic ring structure called porphyrin, with Fe2+ in the center
○ Fetus : HbF (Hb Fetus) is present
○ Embryo ~ 8 weeks : ζ2 ε2
○ About 6 weeks pregnant, HbF begins to be produced in the liver
○ Around 8 months of pregnancy, HbA begins to form in the bone marrow
○ In newborns, 70% are HbF and 30% are HbA
○ Rapid HbA (Hb Adult) replacement between 3 and 6 months after birth (HbF destruction)
○ Oxygen affinity : α2 γ2 > α2 β2
○ Oxygen released from maternal hemoglobin binds to fetal hemoglobin
○ Cause : BPG binding site sequence difference, γ chain of HbF and β chain of HbA differ about 38% in amino acid sequence
○ BPG affinity : γ chain β chain (See. 4-⑶-④)
○ HbA2 : About 2% of hemoglobin in adults (98% is HbA), α2δ2
○ See : Hemocyanin is a respiratory pigment with copper, not iron, found in arthropods and molluscs a lot.
③ Ligands that bind to Hb’s heme (competitive inhibition of oxygen)
○ oxy Hb : Hb + O2 → HbO2(red)
○ saturated oxy HB : Hb + 4O2 → Hb(O2)4
○ reduced Hb : Hb + H+ → HHb (reddish brown)
○ met Hb : OH- (Fe3+) occurs occasionally, but resolves itself in vivo
○ carboxy Hb : CO (affinity ) causes carbon monoxide poisoning
○ cyano Hb : Causes of death of CN- (affinity ) and cyanide (KCN)
○ (Note) Carbon dioxide and 2,3-BPG bind to globin and do not act as an inhibitor, but lower red blood cell oxygen transport ability.
④ Cooperative : In the fourth structure, when the substrate is bound to one monomer, the affinity of the substrate of the surrounding monomer increases.
○ Myoglobin forms the shape (MM type) expected by the Michaelis-Menten equation because of the constant affinity of the substrate.
○ Myoglobin is not an allosteric protein such as hemoglobin
○ Myoglobin has higher oxygen affinity than hemoglobin, so oxygen storage at low oxygen partial pressure; The presence of multiple myocytes
○ Seals, which are submersible mammals, store about twice as much oxygen per kilogram of body weight as myoglobin ↑.
○ Hemoglobin shows the sigmoid type (S-shape) because the affinity of the substrate is gradually increased
○ Hemoglobin is an allosteric protein to which two or more ligands can bind
○ Even if only one oxygen molecule is bound to hemoglobin, the subunit becomes a structure with high affinity with oxygen
○ Conversely, only one oxygen molecule escapes from saturated hemoglobin, resulting in a low oxygen affinity.
○ Stability : Oxygen carrying capacity is greatly reduced even when the partial pressure of oxygen in alveoli and arterial blood reaches 100 mmHg to 60 mmHg ×
⑶ Bore effect : Oxygen Affinity Change of Hemoglobin by Four Factors (pH, pCO2, Temperature, 2,3-BPG)
① H+ effect
○ [H+] ↑ → pH ↓ → Changes in ionic bonds in Hb (eg histidine of β chain) → Hb conformation change → oxygen affinity ↓
○ Oxygen and dissociated hemoglobin combine with hydrogen ions to prevent acidification of blood
○ Ion Bond Change 1 : -COOH ↔ -COO- + H+ (Place : Globin)
○ Ion Bond Change 2 : -NH2 + H+ ↔ -NH3+ (Location : Globin)
○ Oxygen affinity change during exercise 1 : PH ↓ → oxygen affinity ↓ due to lactic acid and fatty acid production
② CO2 effect
○ CO2 ↑ → CO2 binding or acid increase at N-terminus → Hb conformational change → oxygen affinity ↓
○ CO2 bonding at the N-terminus
○ Acid increase : If pCO2 is high, pH is reduced to H + derived from carbonic acid.
○ Reduced oxygen affinity allows hemoglobin to dissociate oxygen better in tissue cells
③ Temperature effect
○ Temperature ↑ → Hb conformation change → Oxygen affinity ↓
○ Actively metabolizing or exercising cells release heat
○ Enzymes rapidly lose their activity as their intramolecular bonds weaken at temperatures after their activation temperature
④ 2,3-BPG (2,3-bisphosphoglycerate) effect
○ 2,3-BPG : Active production of glycolysis, isomer of 1,3-BPG, an intermediate product of glycolysis
○ Mammalian erythrocytes have high concentrations of 2,3-BPG
○ 2,3-BPG ↑ → Stabilizes deoxyhemoglobin by combining with β globin in the middle of hemoglobin → additional oxygen affinity ↓
○ Oxygen affinity change during exercise 2 : Tissue cell oxygen debt phenomenon → Some G3Ps convert to 2,3-BPG → Oxygen bond in β globin ↓
⑤ When moving to a high altitude mountain
○ 1st. Reduction of partial pressure of oxygen in the atmosphere
○ 2nd. Decreases the amount of oxygen binding of hemoglobin in the lungs
○ Increase respiratory rate to compensate for insufficient oxygen binding
○ Respiratory algorithm : Increasing respiratory rate releases excess CO2, increasing blood pH
○ 3rd. Decreased oxygen supply to tissue cells → Increased 2,3-BPG in red blood cells
○ Reduced oxygen affinity of hemoglobin releases more oxygen from oxygen hemoglobin
○ 4th. Reduced oxygen supply to the kidneys
○ 4th-1st. Increased erythropoietin secretion in the kidneys
○ 4th-2nd. Promote red blood cell production in bone marrow → increase red blood cell count
⑷ Carbon dioxide transport
① Plasma : 8%, simple diffusion (melting)
○ CO2 (g) → CO2 (aq)
② Combined with hemoglobin : HbCO2, about 22%
③ Bicarbonate ion : HCO3-, about 70%
○ 1st. CO2 (aq) simply diffuses from plasma to red blood cells
○ 2nd. Promoted by CO2 (aq) + H2O (l) → H2CO3 (aq), carbonic anhydrase (CA)
○ 3rd. H2CO3 → H+ + HCO3-
○ 4th. H+ combines with Hb to become HHb (See. ⑶-①)
○ 5th. HCO3- is one-to-one reverse cotransport with Cl- and discharged out of plasma
○ 6th. Osmotic pressure causes water to enter as Cl- increases in erythrocytes → volume increases
⑸ Pulmonary and body circulation : Circulation and respiratory system harmony
① Pulmonary Circulation (12% Blood Retention)
○ Right ventricle → Pulmonary artery → Pulmonary capillary → Pulmonary vein → Left atrium
○ Blood with O2↓, CO2↑ → Blood with O2↑, CO2↓
② Circulation (79% blood retention)
○ Left ventricle → aorta → artery → capillary → vein → vena cava → right atrium
○ Blood with O2↑, CO2↓ → Blood with O2↓, CO2</sub↑
○ Aortic partial pressure : 80 to 100 mmHg
○ Venous oxygen partial pressure : 40 mmHg
○ Supply nutrients and oxygen to tissue cells
5. Control of breathing
⑴ Control of number : Cortex → Cortex spinal cord → Motor neurons
⑵ Self-regulating central : Pontoon, training → voluntary, rhythmic activity
① Soft water : Basic breathing control
○ Soft water is more affected by carbon dioxide than oxygen
② Pons : Adjusts for smooth transition between inspiration and exhalation, breathing rate
③ Input and receiver
○ Chemical receptors in the central nervous system (especially cerebrospinal fluid) (pO2, pCO2, H+)
○ H+ cannot cross the brain-vascular barrier so chemical receptors determine H+ by the amount of CO2
○ Increase metabolism through exercise → CO2 ↑ → Increase respiration → Excessive CO2 emissions → Normalize pH
○ Input of chemical receptors (H+, pO2, pCO2) of aortic bodies (next to the aortic arch) and carotid bodies (next to the carotid artery)
○ O2 concentration does not have a significant effect on breathing, but increases respiration rate when O2 levels are low
○ Plasma epinephrine and potassium concentration receptors
○ Muscle and joint kidney receptor input
○ Renal Receptor Input to Lung
○ Stimulation (temperature, etc.) input through other receptors and under Thalamus
④ Breathing control process
○ Breathing exercise : Sympathetic stimulation, adrenaline secretion
○ Respiratory movement suppression : Parasympathetic stimulation, acetylcholine secretion
6. Acidosis and Alkalosis
⑴ Steady state
① PH : 7.41 to 7.45
② O2 : 40 mmHg (tissue) or more 100 mmHg (lung) or less
③ CO2 : 40 mmHg (lung) or more 46 mmHg (tissue) or less
④ HCO3- : 24 mmEqmol
⑵ Acidosis and Alkalosis
① Acidosis : pH 7.35 or less
② Alkalosis : pH 7.45 or more
⑶ Metabolic alkalosis : Metabolism Excessive HCO3-
① Excess HCO3- reacts with H+ resulting in high pH
② Compensation : Increased partial pressure of CO2 by lowering breathing rate to lower pH
③ Example : Vomiting (exhaust acid from the stomach)
⑷ Metabolic acidosis : If HCO3- is low due to metabolism
① Less HCO3sup>-</sup>, H+ remains in the blood, resulting in lower pH
② Compensation : Lowers CO2 partial pressure by increasing respiration rate to increase pH
③ Example : Diarrhea (Bicarbonate Release)
⑸ Respiratory alkalosis : When the partial pressure of CO2 is lowered in relation to breathing
① Lower CO2 partial pressure results in higher blood pH
② Compensation : Suppresses HCO3-reaction to lower pH
③ Example : Hyperventilation, limited lung disease (e.g., Pulmonary fibrosis)
⑹ Respiratory acidosis : High CO2 partial pressure associated with respiration
① Low CO2 pH due to no CO2 emissions
② Compensation : Activate HCO3<sup-</sup> reaction to increase pH
③ Example : Obstructive pulmonary disease (e.g., asthma)
7. Lung disease
⑴ Tobacco hazards : 100,000 chemicals, 20 species Class A carcinogens, tar, carbon monoxide, nicotine are the most hazardous substances
① Tar (tobacco, less than 10 mg) : Including 40 kinds of carcinogens, perturbing blood, destroying cells, causing chronic inflammation, disturbed immune system, cilia (ex. Elastin) damage
② carbon monoxide : Incomplete combustion products, most substances in cigarette smoke, the main causes of chronic hypoxia, premature aging, arteriosclerosis
③ Nicotine (one open 0.1 to 0.6 mg) : 7 seconds reach brain, addictive, narcotic, insecticide, herbicide, blood pressure rise
④ Benzopyrene, dimethylnitrosamine : Carcinogen
⑤ Cyanide : Death Gas Poison
⑥ Niphthylamine : Antiseptic
⑦ Naphthalene : Mothballs
⑧ DDT : Pesticide
⑵ Chronic obstructive pulmonary disease (COPD)
① Symptom : Ventilation disorders caused by narrowing the airways and increasing resistance to air flow
② Characteristic : Total lung capacity and residues are higher than normal (compensation), respiratory function usually lower than normal
③ Example 1. Chronic bronchitis : Bronchial mucus hypersecretion → chronic inflammation of the lower airways
④ Example 2. Bronchial asthma : Allergic reactions, viral infections, alveolar contractions, increased mucus secretion, increased airway resistance in the airways, chronic inflammation, particulates exacerbate asthma
⑤ Example 3. Emphysema : Causes of wound tissue formation due to bronchitis and asthma, small airway destruction and obstruction reduce alveoli and surface area, inability to regenerate
⑶ Restrictive Lung Disease
① Symptom : Ventilation disorders caused by decreased lung extension (compliance, compliance)
② Characteristic : Total lung capacity and residues are less than normal, performing a respiratory function equivalent to normal in a limited range
③ Example 1. Pulmonary fibrosis
③ Example 2. Pneumoconiosis, tuberculosis
④ Example 3. Occupational lung disease
○ Asbestos, coal dust, silicon, paper dust, pollen, etc., accumulate in macrophages that remove it
○ Increased scar tissue → Fibrous tissue sutures wounds instead of lung tissue → Fibrocystic cysts and lung flexibility decreases
⑷ Lung cancer
① It contains a burning carcinogen of tobacco smoke
② Particulates, such as tar, remain on the lung surface for a long time causing mutations and cancer
⑸ Pulmonary edema (pulmonary edema)
① Moisture in the pulmonary vein due to excess lymph retrieval capacity (pulmonary capillary tissue fluid) leaves the alveoli and pools into water → difficulty breathing
② Cause : Heart failure increases blood pressure in pulmonary veins, lowers external pressure
Input : 2015.7.19 11:19