CHAPTER10

10
STUDENTS’LEARNING OUTCOMES
After studying this chapter, the students will be able to:
Define the respiratory surface and list its properties
Describe the main structural features and functions of the components of human respiratory
system.
Explain the ventilation mechanism in humans.
Describe the transport of oxygen and carbon dioxide through blood.
Outline the role of respiratory pigments.
State the causes, symptoms and treatment of upper Respiratory Tract Infections (sinusitis, otitis
media) and lower Respiratory Tract Infections (pneumonia, pulmonary tuberculosis).
Describe the disorders of lungs (emphysema and COPD).

You have studied in your previous class

Recalling
how organisms get energy out of food Our cells obtain oxygen from the blood.
molecules. For this purpose, organisms carry The blood obtains this oxygen from air
out catabolic processes in their cells, present in our lungs. Oxygen diffuses
collectively called cellular respiration (glycolysis, across the wet membranes of the lungs,
which are filled with air in the process
Krebs cycle, and electron transport chain).
of breathing.
These processes use oxygen and produce
carbon dioxide. The term external respiration is used for the uptake of oxygen from
the environment and the disposal of carbon dioxide into the environment at the
body system level. It involves breathing and the exchange of oxygen and carbon
dioxide in the capillaries. The organs which carry out these processes constitute the
respiratory system. The theme of this chapter is to explain the respiratory system of
humans and important respiratory disorders.

10.1- RESPIRATORY SYSTEM OF M AN

It consists of the organs that carry out external respiration (uptake of oxygen
and disposal of carbon dioxide) at the body system level. The main organs of
respiratory systems are the lungs which provide suitable respiratory surface for this
gaseous exchange.

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Properties of the Respiratory Surface

Respiratory surface means the area where actual gas exchange occurs between
the environment and the blood. This gaseous exchange occurs through diffusion. In
humans and other vertebrates which breathe in air, oxygen from the air diffuses into
the blood and carbon dioxide diffuse from the blood to air. The following properties
enable respiratory surfaces for effective diffusion of gases across them.
1. It is moist and permeable – so that gases may pass through it.
2. It is thin – so that gases have to travel
minimum distance.
3. It has a blood supply – so that gases
can diffuse in and out of blood.
4. It has structural support– so that it
remains open and does not collapse.
5. It is located internally – so that its
moist surface does not lose water to
the atmosphere.
6. Air ventilates over it i.e., moves Figure 10.1: Some properties of
towards and away from it. respiratory surface
7. Air reaches to it after passing a branched tubular way – so that air becomes
saturated with water vapour before reaching it.
Components of Human Respiratory System
The organs of the respiratory system form a continuous system of passages,
called the respiratory tract, through which air flows into and out of the body. The
respiratory tract has two major divisions: the upper respiratory tract and the lower
respiratory tract.
Upper Respiratory Track
It consists of nasal cavity, pharynx and larynx. These organs are involved in
the movement of air into and out of the body. They also clean, humidify, and warm
the incoming air. No gas exchange occurs in these organs.
1- Nasal cavity
The external openings of nose, called nostrils, lead to a nasal cavity. It is a
large, air-filled space behind the nose and partitioned by a nasal septum (a part of
the nasal bone). As inhaled air flows through the nasal cavity, it is warmed and
humidified by blood vessels present very close to its surface. Hairs in the nose and
mucous produced by mucous membranes trap larger foreign particles in the air
before they go deeper into the respiratory tract. In addition to its respiratory
functions, the nasal cavity also contains chemoreceptors needed for sense of smell,
and contribution to the sense of taste.
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2- Pharynx
It is a tube-like structure that
connects the nasal cavity and oral cavity to
larynx and oesophagus. Both air and food
pass through it. So, it is part of both the
respiratory and the digestive systems. Air
passes from the nasal cavity through the
pharynx to the larynx (as well as in the
opposite direction). Food passes from the
mouth through the pharynx to the
esophagus.
3- Larynx
The larynx connects the pharynx
and trachea. It is composed of muscles and
cartilages. It is also called the voice box,
because it contains two bands of smooth
muscles called vocal cords. The vocal
cords vibrate when air flows over them and
so produce sound. Figure 10.2: Respiratory track
Epiglottis is a cartilaginous flap that extends in front and above the opening
of larynx called glottis. When air enters the larynx, the epiglottis keeps standing
upwards to give way to air. When we Muscles in the larynx move the vocal cords
swallow something, the backward motion apart to allow breathing. Other muscles in the
of the tongue raises the larynx. Due to it, larynx move the vocal cords together to allow
the production of vocal sounds. The latter
the epiglottis is forced downwards to muscles also control the pitch of sounds and
close the glottis. It prevents swallowed help control their volume.
material from entering the larynx.

If swallowed material does

start to enter the larynx, it
irritates the larynx and
stimulates a strong cough
reflex. This generally expels
the material out of the
larynx, and into the throat.

Figure 10.3: Larynx and Trachea

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Lower Respiratory Track

The trachea and other passages
of the lower respiratory tract conduct air
between the upper respiratory tract and
the lungs. These passages make a tree-
like shape, with repeated branching.
There are an astonishing 2,414
kilometres of airways conducting air
through the human respiratory tract! It is
only in the lungs, however, that gas
exchange occurs between the air and
blood.
1- Trachea
The trachea, or windpipe,
connects the larynx to the lungs for the Figure 10.4: Tree-like branching of the
lower respiratory tract
passage of air. It is the widest
passageway in the respiratory tract. It is about 1 inch wide and 4–6 inches long. Its
walls are made of smooth muscles and C-shaped rings of cartilage. The trachea is
lined with mucus and cilia. The cilia propel foreign particles trapped in the mucus
toward the pharynx. The C-shaped cartilage provides strength and support to the
trachea to keep the passage open. The trachea branches at the bottom to form two
bronchi.
2- Bronchi, Bronchioles, and Alveoli
There are two primary bronchi (singular, bronchus). The right and left bronchi
enter the lungs and branch into smaller, secondary bronchi. There are two
secondary bronchi in left lung while three in right lung. In secondary bronchi, the C-
shaped cartilages are replaced with cartilage plates. The secondary bronchi branch
into still smaller tertiary bronchi, which branch further into very small bronchioles.
The bronchioles do not have cartilage plates. They divide many times and make
terminal bronchioles. The terminal bronchioles end in alveolar ducts, which
terminate in clusters of tiny air sacs, called alveoli (singular, alveolus), in the lungs.
3- Lungs
The lungs are the largest organs of the respiratory tract. The outside of each
lung is covered by two membranes. First membrane, visceral pleura, lines the lungs
while the second membrane, parietal pleura, lines the inner wall of thoracic cavity.
The small space between these two membranes, called pleural cavity, is filled with
fluid. This fluid allows the lungs to expand and contract freely during breathing. Each
lung is divided into lobes. The right lung is larger and contains three lobes. The left

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 Chap 10 HUMAN RESPIRATORY SYSTEM

lung is smaller and contains two lobes. The smaller left lung allows room for the
heart, which is just left of the centre of the chest.

Figure 10.5: Right and left lungs

As mentioned previously, the terminal Some epithelial cells of alveoli
bronchi end in alveolar ducts. Each alveolar duct secrete a liquid called surfactant,
which lines the inside of alveoli. It
opens in a cluster of alveoli. These clusters make the
prevents the alveoli from
bulk of the lung and are surrounded by blood collapsing and sticking together
capillaries. Each cluster contains 20-30 alveoli. An when air moves out of them. In
alveolus is made of moist epithelial tissue (only 0.1 healthy lungs, surfactant is
micrometre thick). So, they provide the respiratory constantly secreted and
reabsorbed.
surface where gas exchange takes place between
the air and blood.

Recalling
You have studied that pulmonary
arteries carry deoxygenated blood to
the lungs. This blood absorbs oxygen
in the lungs and pulmonary veins carry
the oxygenated blood back to the
heart to be pumped throughout the
body. The lungs also receive
oxygenated blood from the heart that
provides oxygen to the cells of the
lungs for cellular respiration.

Figure 10.6: Clusters of alveoli

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The alveoli are the functional units of the lungs where gas exchange takes
place. The two lungs may contain as many as 700 million alveoli. They provide a
huge total surface area for gas exchange. When we breathe in, the alveoli fill with air,
making the lungs expand. Oxygen in the air inside the alveoli is absorbed by the
blood via diffusion in the network of tiny capillaries that surround them. The blood
in these capillaries also releases carbon dioxide (also by diffusion) into the air inside
the alveoli. When we breathe out, air leaves the alveoli and rushes into the outside
atmosphere, carrying carbon dioxide with it.
Mechanism of Breathing or Ventilation
The movement of the air in and
Atmospheric pressure is lower at high
out of the body is called breathing or altitudes. It means a greater increase in thorax
ventilation. Our lungs do not draw in air is required to make the pressure in lungs
or push it out. Rather, it is done by lower than the atmospheric pressure. That is
why it is harder to breathe at high altitudes.
creating negative and positive pressures
The body adapts mechanisms to improve
in the lungs. This role is played by two oxygen uptake under these conditions, which
sets of muscles i.e., (i) diaphragm (dome- is why athletes often undertake high altitude
like large skeletal muscle that separates training prior to competitions.
thoracic cavity and abdomen) and (ii) the intercostal muscles (present between
each pair of ribs).
Inspiration: Taking in of air is called inspiration or inhalation. For this purpose, the
diaphragm contracts. It causes the diaphragm to lower and take a more flattened
shape. At the same time, the intercostal muscles contract.
It raises the ribs and expands the rib cage. These contractions increasing the space in
the thorax. As a result, lungs expand
because of the adherence of the
visceral and parietal pleural
membranes. The expansion of lungs
lowers the air pressure inside them.
The pressure in lungs becomes lower Birds have lungs as well as air sacs in their body.
than the atmospheric pressure and Air flows in one direction. It flows from outside to
the air enters the lungs. posterior air sacs. For here, the air goes to the
lungs, then to anterior air sacs, and then outside.
Expiration: Moving the air out of
The flow of air is in the opposite direction from
lungs is called expiration or blood flow. So, gas exchange takes place much
exhalation. Expansion of the thorax more efficiently. This type of breathing enables
and lungs during inspiration places birds to obtain the required oxygen, even at high
altitudes where oxygen concentration is low.
these structures under elastic tension.
This elastic tension is relieved by the
relaxation of the intercostal muscles and diaphragm. When diaphragm relaxes, it
assumes its dome-like shape. Similarly, when intercostal muscles relax, the ribs lower
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and rib cage moves inward. These movements decrease the space in thorax and
allow the lungs to recoil. So, the pressure inside lungs becomes more than the
atmospheric pressure and the air moves out of the lungs.

Figure 10.7: Mechanism of breathing

Control of Breathing
Each breath is initiated by neurons in a respiratory centre located in the
medulla oblongata i.e., a part of the brain stem. These neurons send impulses to the
diaphragm and intercostal muscles, stimulating them to contract., causing
inspiration. When these neurons stop producing impulses, the diaphragm and
intercostal muscles relax and expiration occurs.
10.2- TRANSPORT OF GASES
The process known as gas transport is an essential component of respiration.
Oxygen is transported from lungs to all tissues and, at the same time, carbon dioxide
is transported from tissue to the lungs. The following is a brief description of the
mechanisms by which gases are transported in human body.
Transport of Oxygen
The partial pressure of oxygen in alveoli Oxyhaemoglobin is bright red while
allows to diffuse through alveoli into pulmonary deoxyhaemoglobin is dark red. But
capillaries. Inside the blood, small amount of deoxyhaemoglobin imparts a bluish
tinge to tissues. Because of these
oxygen dissolves in the blood plasma. Blood
colour changes, vessels that carry
plasma can dissolve a maximum of only about 3 oxygenated blood are always shown
mL O2 per litre. Yet whole blood car ries almost with a red colour, and vessels that
200 mL O2 per litre! The reason is that most of carry oxygen-depleted blood are
the oxygen is not dissolved in blood plasms but indicated with a blue colour.
is bound to molecules of haemoglobin inside the RBCs.
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The partial pressure of oxygen in alveoli (at sea level) is approximately 105
mm Hg, which is less than the partial pressure of oxygen in the atmosphere. So,
about 97% of the haemoglobin within RBCs combines with oxygen and becomes
oxyhaemoglobin. This molecule has a bright red, tomato juice colour. As the blood
travels through the blood capillaries, some of the oxyhaemoglobin releases oxygen
and becomes a dark red coloured deoxyhaemoglobin. Consequently, when blood
leaves the tissue in the veins, it has a low partial pressure of oxygen (40 mm Hg).
Here, 75% of haemoglobin is saturated in the form of oxyhaemoglobin. It means
that 22% (97% minus 75%) of the oxyhaemoglobin has released its oxygen to the
tissues, leaving 78% oxyhaemoglobin in the blood as a reserve. This large reserve of
oxygen enables the blood to fulfil the body’s oxygen needs during exercise as well
as at rest.
Factors affecting Oxygen Transport
During exercise, the muscles use more The oxygen reserve also ensures that
oxygen from the capillary blood. It decreases the the blood contains enough oxygen to
maintain life for four to five minutes if
venous blood partial pressure of oxygen to 20
breathing is interrupted or if the heart
mm Hg. In this case, the percent saturation of stops pumping.
haemoglobin drops from 75% to 35%. Because
arterial blood still contains 97%
oxyhaemoglobin, the amount of oxygen unloaded is now 62% (97% minus 35%),
instead of the 22% at rest.
The CO 2 produced by tissues lowers the pH of blood. This lowered pH
reduces haemoglobin’s affinity for oxygen and thus causes it to release oxygen more
readily. The effect of pH on haemoglobin’s affinity for oxygen is known as the Bohr
effect. Increasing temperature has a similar effect on haemoglobin’s affinity for
oxygen. During exercise, skeletal muscles produce more heat, haemoglobin unloads
a higher percentage of the oxygen.
Transport of Carbon dioxide
Blood capillaries deliver oxygen to the tissues and remove carbon dioxide
from tissues. The partial pressure of CO 2 is higher in tissues than in blood. It causes
the carbon dioxide to enter from tissues into blood. While, the process reverses in
lungs where the partial pressure of CO 2 is lower in alveoli than in blood. Blood
transports carbon dioxide from tissues to lugs in three ways.
1- As bicarbonate ions
Approximately 72% of carbon dioxide is The formation of carbonic acid is
carried in the blood as bicarbonate ions. CO 2 important in maintaining the acid-
base balance of the blood, because
enters the RBCs and combines with water to
bicarbonate serves as the major buffer
form carbonic acid (H2CO3) in the presence of of the blood plasma.
enzyme carbonic anhydrase. Carbonic acid
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(H2CO3) disassociates to form hydrogen ions (H+) and bicarbonate ions (HCO3-). The
hydrogen ion readily associates with oxyhaemoglobin and oxygen of
oxyhaemoglobin is released to the tissue. While the bicarbonate ions (HCO 3-) moves
out from RBCs into plasma. The movement of bicarbonate ions (HCO 3-) is facilitated
by a transporter that exchanges one chloride ion (Cl-) for a bicarbonate ion (this is
called the “chloride shift” or “Hamburger phenomenon”).
2- As Carboxyhaemoglobin
About 20% of CO2 is carried as CO2 binds to the protein portion of
carboxyhaemoglobin. When partial pressure of haemoglobin while O2 binds to the
haem irons. So, both do not compete
CO2 is higher in blood than tissues, CO 2
for attachment to haemoglobin.
combines with the globin chains of haemoglobin
and forms carboxyhaemoglobin.
3- As dissolved CO2 in Plasma
When CO 2 enters blood, a little amount dissolves in the water of blood
plasma. About 8% of CO 2 is carried this way.
The blood carries CO 2 in these three forms to the lungs. The lower PCO 2 of
the air inside the alveoli causes the conversion of H2CO3 into H2O and CO2. The CO 2
diffuses out of blood into the alveoli, so that it can leave the body in the next
exhalation.

Figure 10.8: Transport of Carbon dioxide by blood

Carbon Monoxide Poisoning
Incomplete combustion of fuels such as wood, gasoline, propane, or natural gas produces CO gas.
If gas heaters are left burning overnight in closed environments, CO accumulates in the room. It
enters the body through inhalation and binds to haemoglobin with a much higher affinity than
oxygen. This binding reduces the amount of haemoglobin available to transport oxygen to the
body's tissues, leading to tissue hypoxia (oxygen deprivation). It leads to CO poisoning. Symptoms
of CO poisoning may include headache, dizziness, weakness, nausea, confusion, shortness of
breath, chest pain, and loss of consciousness. In severe cases, it can cause permanent brain
damage, and even death.
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10.3- RESPIRATORY PIGMENTS

Respiratory pigments are special proteins in blood or tissues and are
involved in transporting oxygen throughout body. They also serve other purposes
e.g., O2 storage, CO2 transport, and transport of substances other than respiratory
gases. The two well-known respiratory pigments are haemoglobin and myoglobin.
Haemoglobin
Haemoglobin is a protein present in RBCs. A
haemoglobin molecule is composed of four globin The four polypeptide chains of
haemoglobin are bound to each
(globular) polypeptide chains (two α chains and two other by salt bridges, hydrogen
β) and four haem groups. There are 141 and 146 bonds, and hydrophobic effect.
amino acids in the α and β chains, respectively. Each
polypeptide chain is folded in such a way that it contains a pocket where the heme
group binds. So, each chain is associated with a haem group. A haem group consists
of an iron ion held in a porphyrin ring. The iron ion is attached with four nitrogen
atoms of the polypeptide chain. Under higher partial pressure of oxygen, iron ion
attaches a molecule of O2. In this way, one haemoglobin molecule can carry up to
four O2molecules.
Myoglobin
Myoglobin is the oxygen-binding protein in skeletal and cardiac muscle cells
of vertebrates. It gives a distinct red or dark gray colour to muscles. It is a monomer,
composing of a single polynucleotide chain (made of 153 amino acids) and contains
a single haem group. Therefore, it is capable of binding with a single O2 molecule.
The binding affinity of myoglobin is high as compared to that of haemoglobin. As a
result, myoglobin serves as the oxygen-storing protein in muscles. It releases oxygen
when the partial pressure of oxygen is below 20 mm Hg. In this way, myoglobin
provides oxygen to the muscles when they need.

Figure 10.9: Structure of haemoglobin and myoglobin

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Table10.1: Differences between Haemoglobin and Myoglobin

Haemoglobin Myoglobin
1 Consists of four polypeptide chains. Consists of one polypeptide chain.
2 Possesses four haem groups. Possesses one haem group.
3 Found in blood (RBCs). Found in skeletal and cardiac muscles.
4 Can attach four O2 molecules. Can attach one O2 molecule.
5 Transports oxygen. Stores oxygen.
6 Has less affinity with oxygen. Has more affinity with oxygen.
7 Loses oxygen at PO2 60 mm Hg. Loses oxygen at PO2 20 mm Hg.

10.4- RESPIRATORY DISORDERS

A range of disorders can affect the respiratory system and interfere with
respiration. These respiratory disorders can range from mild and self-limiting
conditions such as the common cold to more severe diseases such as sinusitis, otitis
media, pneumonia, pulmonary tuberculosis, emphysema and COPD.
Upper Respiratory Tract Infections
Upper Respiratory-tract Infections (URIs) affect the nose, throat, sinuses, and
larynx and can be easily transmitted from person to person through respiratory
droplets.
1. Sinusitis
It is the inflammation of the lining of the sinuses (four paired air-filled spaces
that surround the nasal cavity i.e., under
the eyes; above the eyes; between the
eyes and behind the eyes). It may be
acute (lasts for 7 to 10 days) or chronic
(lasts longer than 12 week). Most case of
sinusitis are due to viral infections; some
may be due to bacterial infections and
rare cases may also involve fungal
infections.
Figure 10.10: Sinuses
Symptoms of sinusitis include fever,
plugged nose, pus-like nasal discharge, loss of sense of smell, facial pain, a feeling
that phlegm is falling from the back of nose into throat, and headache that is
sometimes aggravated by bending over.

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Treatment: Most cases are caused by viruses and resolve without antibiotics. If it is
due to a bacterial infection, antibiotics or sulpha drugs are usually prescribed. Beside
it, the physician may also prescribe nebulization which can be useful in reducing
inflammation in the sinuses and nose and to accelerate recovery. For chronic or
recurring sinusitis, treatment may include nasal surgery in which the pathogens and
mucous are removed.
2. Otitis media
It is the inflammation of the middle
ear. Otitis may be acute (rapid onset) or
chronic (lasts more than six weeks). The
common cause of otitis media
accumulation of fluid in Eustachian tube,
which cannot be drained from the middle
ear. When this fluid is not drained, it allows
the growth of bacteria and viruses in the
middle ear that lead to otitis media.
Symptoms of otitis media include severe Figure 10.11: Otitis media
ear pain, pulling at one or both ears, fever, fluid draining from ear(s), loss of balance,
and hearing difficulties.
Treatments include oral and topical pain killers and antibiotics (if caused by
bacterial infection).
Lower Respiratory Tract Infections
Lower Respiratory-tract Infections include pneumonia, pulmonary tuberculosis, lung
abscess and bronchitis. Pneumonia killed more than 808
1. Pneumonia 000 children under the age of 5
Pneumonia is a form of acute in 2017, accounting for 15% of all
deaths of children under 5 years.
respiratory infection. It can cause
mild to life-threatening illness. In
pneumonia, the alveoli of one or
both lungs are inflamed and are filled
with pus and fluid. It makes breathing
painful and limits oxygen intake.
Pneumonia is most commonly caused
by viruses or bacteria. It is the single
largest infectious cause of death in
children worldwide.

Figure 10.12: Pneumonia

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A variety of organisms, primarily bacteria (particularly Streptococcus

pneumoniae) or viruses (e.g., human rhinovirus) and less commonly fungi, can cause
pneumonia.
Symptoms: Its symptoms include cough with phlegm, shortness of breath, chest
pain, fever, blueness of skin, loss of appetite, high heat rate, and fatigue.
Treatment: Specific antibiotics are used to treat bacterial pneumonia. Analgesics,
also used to reduce fever and pain. Vaccination prevents against certain bacterial
and viral pneumonias both in children and adults.
2. Pulmonary Tuberculosis
Tuberculosis (TB) is a chronic infection
caused by bacteria Mycobacterium
tuberculosis. It can affect many parts of the
body but it generally affects the lungs. The
tuberculosis of the lungs is called pulmonary
tuberculosis. It is highly contagious and
spreads through cough or sneezes. The
bacteria enter the lungs, multiply and cause
inflammation and damage to the lung tissue, Figure 10.13: A lung affected with TB
including the alveoli. The damage to the
alveoli can lead to the formation of small cavities or holes in the lung tissue, which
can make it difficult for the lungs to function properly. In advanced stages, the
alveoli are so damaged that the lungs may become unable to supply the body with
enough oxygen. This can lead to a condition called respiratory failure, which is a
medical emergency.
Symptoms: Major symptoms of pulmonary
tuberculosis are cough-with blood, intermittent
intermittent fever usually in the evening,
night sweats, weight loss, anorexia,
depression, weakness and dry cough, chest
pain due to Inflammation of the pleura of
the lungs.

Treatment: includes the use of multiple

antibioticsover a long period of time (for
9 months) regularly.

Figure 10.14: A lung affected by COPD

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Disorders of the Lungs

Chronic obstructive pulmonary disease (COPD) is an important disorder of the lungs.
1. Chronic Obstructive Pulmonary Disease(COPD)
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory
disease of lungs. The common causes of COPD are tobacco smoking, long terms
exposure to harmful pollutants and chemical fumes etc., A small percentage genetic
predisposition (protein alpha-1 antitrypsin deficiency) can also develop COPD, even
without smoking or significant exposure to pollutants.
Symptoms: The symptoms of COPD are persistent cough with mucus (sputum),
shortness of breath, wheezing, chest, fatigue and frequent respiratory tract
infections.
Treatment : COPD is incurable but by minimizing exposure to smoke, pollutants, and
chemicals, this disease can slow its progression. Others therapies include
bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and oxygen
therapy. In some severe cases, surgery such as lung transplantation may be
considered.
Chronic bronchitisis a type of COPD. It involves inflammation and narrowing of the bronchial tubes in
the lungs. It leads to increased mucus production, which can further block the airways and make
breathing difficult. This disease lasts for three months to two years. It is caused by long-term exposure
to irritants such as cigarette smoke, air pollution, or industrial dusts Symptoms of chronic bronchitis
are almost same as of COPD such as wheezing, shortness of breath, chest tightness, and frequent
respiratory infections.. Chronic bronchitis can be managed by quitting smoking. Other treatments are
bronchodilators, pulmonary rehabilitation, and in some cases oxygen therapy.

Emphysema
Emphysema is a type of COPD. In emphysema, the inner walls of alveoli are
damaged, causing them to
eventually rupture. This creates one
larger air space instead of many
small ones and reduces the surface
area available for gas exchange.
The primary cause of emphysema is
smoking. It can also be caused by
long-term exposure to air pollution,
dust, or chemical fumes.
Emphysema disease can also be
caused by a genetic deficiency of a
protein called alpha-1 antitrypsin.

Figure 10.15: Emphysema

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Symptoms: The symptoms of emphysema include shortness of breath, coughing,

wheezing, fatigue, and chest tightness.
Treatment: Quitting smoking is the most important step in managing emphysema,
as continued smoking can speed up the progression of disease. Other treatments
include bronchodilators, inhaled steroids, oxygen therapy, and pulmonary
rehabilitation.

MULTIPLE CHOICE QUESTIONS

1. During inhalation, diaphragm;
(a) Contracts and moves upward (b) Contracts and moves downward
(c) Relaxes and moves upward (d) Relaxes and moves downward
2. Which part of the respiratory system acts as the respiratory surface?
(a) Larynx (b) Trachea (c) Bronchi (d) Alveoli
3. How many oxygen molecules can attach with a haemoglobin molecule?
(a) 1 (b) 2 (c) 3 (d) 4
4. What is TRUE about respiratory pigments?
(a) Transport oxygen from lungs to tissues
(b) Transport oxygen and carbon dioxide in equal amounts
(c) Transport less oxygen and more carbon dioxide
(d) Regulate the pH of blood
5. Which respiratory pigment is found in muscle tissue?
(a) Haemoglobin (b) Melanin (c) Myoglobin (d) Chlorophyll
6. What is the maximum amount of air that can be inhaled or exhaled during a
respiratory cycle?
(a) Tidal volume (b) Vital capacity
(c) Inspiratory reserve volume (d) Expiratory reserve volume
7. In what form is carbon dioxide primarily transported in the bloodstream?
(a) Dissolved in plasma (b) Bound to haemoglobin
(c) Converted to bicarbonate ions (d) None of the above
8. Which of the following treatments is commonly used to manage pulmonary TB?
(a) Antibiotics (b) Cough syrup (c) Surgery (d)
Chemotherapy
9. Which of the following is a common cause of pneumonia?
(a) Bacterial infection (b) Viral infection
(c) Fungal infection (d) All of these

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10. Emphysema is characterized by:

(a) Inflammation of airways (b) Narrowing of airways
(c) Destruction of the alveoli in lungs (d) Fluid build-up in lungs
SECTION 2: SHORT QUESTIONS
1. Define respiratory surface and list its properties.
2. How nasal cavity functions in filtering the inhaled air?
3. Trace the path of air through different parts of the respiratory system.
4. Describe the structure and function of alveoli.
5. What is the role of diaphragm during inhalation and exhalation?
6. What the three ways of the transport of carbon dioxide in blood?
7. What are the advantages of having millions of alveoli rather than a pair of simple
balloon-like lungs?
8. Differentiate between:
Internal and external respiration
Upper and lower respiratory tract
Bronchi and bronchioles
Haemoglobin and myoglobin
LONG QUESTIONS
1. Describe the mechanism of inhalation and exhalation.
2. Describe the transport of oxygen through blood.
3. Describe the transport of carbon dioxide through blood.
4. Describe the structure and function of haemoglobin.
5. Describe the causes, symptoms and treatment of sinusitis.
6. Describe the causes, symptoms and treatment of pneumonia and pulmonary
tuberculosis.
7. Describe causes, symptoms and treatment of emphysema.
INQUISITIVE QUESTIONS
1. How does the structure of the alveoli optimize the exchange of gases like oxygen
and carbon dioxide?
2. How do diseases like chronic obstructive pulmonary disease (COPD) affect
gaseous exchange efficiency?
3. Can you explain the process of external respiration versus internal respiration in
the context of gaseous exchange?
4. How does the transport of like oxygen in the bloodstream support cellular
respiration?
5. What are the environmental factors that can influence gaseous exchange in
humans?

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STUDENTS’LEARNING OUTCOMES
After studying this chapter, the students will be able to:
State the location of heart in the body and define the role of pericardium.
Describe the structure of the walls of heart and rationalize the thickness of the walls of each
chamber.
Trace the flow of blood through the heart as regulated by the valves.
State the phases of heartbeat.
Explain the role of SA node, AV node and Purkinje fibers in controlling the heartbeat.
List the principles and uses of Electrocardiogram.
Describe the detailed structure of arteries, veins and capillaries.
Describe the role of arterioles in vasoconstriction and vasodilation.
Describe the role of precapillary sphincters in regulating the flow of blood through capillaries.
Trace the path of the blood through the pulmonary and systemic circulation (coronary, hepatic -
portal and renal circulation).
Compare the rate of blood flow through arteries, arterioles, capillaries, venules and veins.
Define blood pressure.
State the role of baroreceptors and volume receptors in regulating the blood pressure.
Define the term thrombus and differentiate between thrombus and embolus.
Identify the factors causing atherosclerosis and arteriosclerosis.
Categorize Angina pectoris, heart attack, and heart failure as the stages of cardiovascular disease
development.
State the congenital heart problem related to the malfunctioning of cardiac valves.
Describe the principles of angiography.
Outline the main principles of coronary bypass, angioplasty and open-heart surgery.
Define hypertension and describe the factors that regulate blood pressure and can lead to
hypertension and hypotension.
List the changes in lifestyles that can protect man from factors that regulate blood pressure and can
lead to hypertension and hypotension.
List the changes in lifestyles that can protect man from hypertension and cardiac problems.
Describe the formation, composition and function of intercellular fluid.
Compare the composition of intercellular fluid with that of lymph.
State the structure and role of lymph capillaries, lymph vessels and lymph trunks.
Describe the functions of lymph nodes and state the role of spleen as containing lymphoid tissue.

Humans have two systems Recalling:

for the transport of different Blood is the medium in which dissolved nutrients, gases,
hormones, and wastes are transported throughout the
materials in different parts of body
body. It is composed of two main components (i) plasma
i.e., blood circulatory system and and (ii) cells or cell-like bodies (white blood cells, red
lymphatic system. The closed blood blood cells, platelets). In a healthy person, plasma
circulatory system of humans constitutes about 55% by volume of the blood, and cells
or cell-like bodies about 45% by volume of the blood.
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