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The design and dimensions of the healthy pulmonary system are nearly perfect to meet the considerable demands on O 2 transport and CO 2 elimination imposed by physical exercise. In our chapter, we briefly describe the features of the nervous system pathways and the structure of the airways, lung surface area and respiratory muscles which ensure both the completeness of gas exchange at the level of alveolar gas, pulmonary capillaries and arterial blood and the high level of mechanical efficiency with which the respiratory muscle pump operates. We also discuss the absence of a physical training effect on pulmonary vs. systemic structures which determine O 2 delivery and the implications of a relatively underbuilt lung and chest wall to exercise-induced arterial hypoxemia, diaphragm fatigue and the distribution of systemic vascular conductance and blood flow.

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