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Meaning of Respiration
There are two quiet different meaning of respiration
1. Utilization of oxygen in the metabolism of organic molecules by cells 2. The exchange of oxygen and carbon dioxide between an organism and the external environment Ventilation
7.
Bronchiole
Respiratory bronchiole
Alveolar duct
Alveolus
1. 2. 3. 4. 5. 6. 7.
Trachea Primary bronchus Secondary bronchus Tertiary bronchus Bronchiole Terminal bronchiole Respiratory bronchiole 8. Alveolar duct 9. Alveolus
1
4 2
1 2 6 7 8 9 10 11
2.
3 4 5
6 7 8 9 10 11
Red blood cell Capillary endothelium Capillary basement membrane Epithelial basement membrane Type I alveolar cell Surfactant layer
Sternocleidomastodeus
Scalenus
Abdominal muscles
Abdominal muscles
S.E = Sternum during Expiration S.I = Sternum during Inspiration D.E = Diaphragm during Expiration D.I = Diaphragm during Inspiration
Ventilation
Ventilation is defined as the exchange of air between the atmosphere and alveoli Like blood, air moves by bulk flow, from a region of high pressure to one of low pressure by the equation: F = P/R. For air flow into and out the lungs, the relevant pressure are the gas pressure in the alveoli (PALV) and the gas pressure in the atmosphere (PATM). The pressure difference P = |PATM PALV| All pressure in the respiratory system are given relative to atmospheric pressure, which is 760 mmHg at sea level
Ventilation (cont)
During ventilation air moves into and out of the lungs because the alveolar pressure is alternately made less than and greater than atmospheric pressure (remember the Boyles law) During inspiration and expiration the volume of the container the lungs is made to change, and these changes then cause, by Boyles law, the alveolar pressure changes that drive air flow into or out of the lungs There are no muscles attached to the lungs surface to pull the lungs open and push them shut the volume of the lungs depend on the transpulmonary pressure and how stretchable the lung are.
Boyles Law
The movement of air into and out of the lungs depends on pressure change
ALVEOLI
Chest Wall
PALV = 0 mm Hg
Intrapleural fluid
ELASTIC RECOIL PALV PIP = 4 mm Hg
PIP = - 4 mmHg
Transpulmonary pressure: the difference in pressure between the inside and the outside of the lungs (PALV PIP)
Inspiration
During inspiration, the contractions of the diaphragm and inspiratory intercostal muscles increase the volume of the thoracic cage
a. This make intrapleural pressure more subatmospheric, increase transpulmonary pressure, and causes the lungs to expand to a greater degree than between breath b. This expansion initially makes alveolar pressure subatmospheric, which create the pressure difference between atmosphere and alveoli to drive air flow into the lungs
THORAX EXPANDS
Expiration
During expiration, the inspiratory muscles ceases contracting, allowing the elastic recoil of the chest wall and lungs to return them to their original between-breath
a. This initially compresses the alveolar air, raising alveolar pressure above atmospheric pressure and driving air out of the lungs b. In forced expiration, the contraction of expiratory intercostal muscles and abdominal muscles actively decreases chest dimensions.
P F R
Flow (F) is proportional to the pressure difference (P) between two points and inversely proportional to the resistance (R) determined by their radius
Patm Palv F R
Air moves into and out of the lungs because the alveolar pressure is made alternately less than and greater than atmospheric pressure
Airways Resistance
Patm Palv F R
Neuroendocrine agents
Parasympathetic nerves (neurotransmitter = acetylcholine) constrict Circulating epinephrine dilates (action is on beta adrenergic)
Paracrine agents
Histamine constricts Several eicosanoids, notably the leukotrienes, constrict Several eicosanoids dilate
Compliance
The compliance is expressed as the volume increase of the lungs for each unit increase in intra-alveolar pressure (cm3/mm Hg) The greater the increase in volume for a given increase in pressure, the greater the compliance. Lung compliance is determined by the elastic connective tissues of the lungs, the surface tension of the fluid lining the alveoli, and the muscle tones. The surface tension of the fluid is decreased by surfactant that is produced by the type II cells of the alveoli
V L CL ( Palv Patm )
The greater the increase in volume for a given increase in pressure, the greater the compliance.
The alveolar surface tension tends to collapse the alveoli the greater the surface tension the lesser the compliance
Law of La Place
2T r P = inward-directed collapsing pressure T = Surface tension R = Radius of Bubble of Alveolus P=
PULMONARY VENTILATION
BREATHING PATTERNS
Eupnea
Apnea Dyspnea
Costal breathing = Shallow (chest) breathing Diaphragmatic breathing = Deep (abdominal) breathing
Breathing Pattern
Eupnoea is normal quiet breathing Apnea is a temporary cessation of breathing Dyspnea is a painful or labored breathing + tachypnea Costal breathing is shallow (chest) breathing Diaphragmatic breathing is deep (abdominal) breathing