Respiratory 1
Respiratory 1
Respiratory 1
The main functions of respiration are to provide oxygen to the tissues and remove carbon
dioxide.
The four major components of respiration are:
- (1) pulmonary ventilation, which means the inflow and outflow of air between the
atmosphere and the lung alveoli;
- (2) diffusion of oxygen (O2) and carbon dioxide (CO2) between the alveoli and the blood;
- (3) transport of oxygen and carbon dioxide in the blood and body fluids to and from the
body’s tissue cells; and
- (4) regulation of ventilation and other facets of respiration.
- During inspiration, contraction of the diaphragm pulls the lower surfaces of the lungs
downward.
- Then, during expiration, the diaphragm simply relaxes, and the elastic recoil of the lungs,
chest wall, and abdominal structures compresses the lungs and expels the air.
- all the muscles that elevate the chest cage are classified as muscles of inspiration, and
the muscles that depress the chest cage are classified as muscles of expiration.
The most important muscles that raise the rib cage are the external intercostals, but others that
help are the
- (1) sternocleidomastoid muscles, which lift upward on the sternum;
- (2) anterior serrati, which lift many of the ribs; and
- (3) scaleni, which lift the first two ribs.
The muscles that pull the rib cage downward during expiration are mainly
- (1) the abdominal recti, which have the powerful effect of pulling downward on the
lower ribs at the same time that they and other abdominal muscles also compress the
abdominal contents upward against the diaphragm, and (2) the internal intercostals.
Pleural Pressure and Its Changes during Respiration.
Pleural pressure
- the pressure of the fluid in the thin space between the lung pleura and chest wall pleura
(the pleural cavity)
- this pressure is normally a slight suction, which means a slightly negative pressure
- beginning of inspiration is about −5 centimeters of water
- normal inspiration, expansion of the chest cage pulls outward on the lungs with greater
force and creates more negative pressure, to an average of about −7.5 centimeters of
water.
- Normal pleural pressure is negative or less
than atmospheric pressure.
- Negative pleural pressure is created by the
elastic forces of the lungs and chest wall
pulling in opposite direction on the
intrapleural space.
- When the system is at equilibrium, the lungs,
with their elastic properties, are naturally
inclined to collapse, and the chest wall, with
its elastic properties, is inclined to spring out.
- These two equal and opposite forces pulling
on the intrapleural space create a vacuum, or
negative pressure, in the space.
Alveolar Pressure
- air pressure inside the lung alveoli
Transpulmonary Pressure
- difference between alveolar and pleural
pressures
- it is a measure of the elastic forces in the
lungs that tend to collapse the lungs at each
instant of respiration, called the recoil
pressure.
If the air passages leading from the alveoli of the lungs are blocked, the surface tension in the
alveoli tends to collapse the alveoli
This phenomenon is
especially significant in small
premature babies, many of whom have alveoli with radii less than one quarter that of an adult
person.
This situation causes the condition called respiratory distress syndrome of the newborn
Compliance of the Thorax and the Lungs Together
- To measure compliance, air is forced into the lungs a little at a time while recording lung
pressures and volumes.
- Therefore, the compliance of the combined lungthorax system is almost exactly one half
that of the lungs alone— 110 milliliters of volume per centimeter of water pressure for
the combined system, compared with 200 ml/cm for the lungs alone.
Work of breathing
o The work of inspiration can be divided into three frac tions: (1) that required to
expand the lungs against the lung and chest elastic forces, called compliance
work or elastic work; (2) that required to overcome the viscosity of the lung and
chest wall structures, called tissue resistance work; and (3) that required to
overcome airway resistance to move ment of air into the lungs, called airway
resistance work.
o Especially if the person has any degree of increased airway resistance or
decreased pulmo nary compliance. Therefore, one of the major limitations on
the intensity of exercise that can be performed is the person’s ability to provide
enough muscle energy for the respiratory process alone.
- Pulmonary volumes
o when added together, equal the maximum volume to which the lungs can be
expanded.
o Tidal volumes
o Inspiratory reserve volume
o Expiratory volume
o Residual volume
- Pulmonary Capacities
o The inspiratory capacity equals the tidal volume plus the inspiratory reserve
volume.
o The functional residual capacity equals the expiratory reserve volume plus the
residual volume.
o The vital capacity equals the inspiratory reserve volume plus the tidal volume
plus the expiratory reserve volume.
o The total lung capacity is the maximum volume
to which the lungs can be expanded with the
greatest possible effort (about 5800 milliliters);
it is equal to the vital capacity plus the residual
volume.
- For ease in describing the events of pulmonary
ventilation, the air in the lungs has been subdivided in
this diagram into four volumes and four capacities.
- All pulmonary volumes and capacities are about 20 to
25 per cent less in women than in men, and they are
greater in large and athletic people than in small and
asthenic people.
ALVEOLAR VENTILATION
- areas include the alveoli, alveolar sacs, alveolar ducts, and respiratory bronchioles. The
rate at which new air reaches these areas is called alveolar ventilation.
- Alveolar ventilation is the exchange of gas between the alveoli and the external
environment.
- ◦ Alveolar ventilation is usually defined as the volume of fresh air entering the alveoli
per minute.
- ◦ With a normal tidal volume of 500 ml, a normal dead space of 150 ml, and a
respiratory rate of 12 breaths/min, alveolar ventilation equals 12 × (500 − 150), or 4200
ml/min.
Anatomical Dead Space
o Some of the air a person breathes never reaches the gas exchange areas but simply fills
respiratory passages where gas exchange does not occur, such as the nose, pharynx,
and trachea.
o This air is called dead space air because it is not useful for gas exchange.
o The normal dead space air in a young adult man is about 150 milliliteres and this
increases slightly with age.
o The anatomic dead space can be determined by using Fowler’s method.
o This method uses a nitrogen meter to analyze the expired nitrogen
concentration after a single inspiration of 100% oxygen.
- Mucus Lining the Respiratory Passageways, and Action of Cilia to Clear the
Passageways
o All the respiratory passages, from the nose to the terminal bronchioles, are kept
moist by a layer of mucus that coats the entire surface.
o The mucus is secreted partly by individual mucous goblet cells.
o Functions:
◦ keeps the surfaces moist
◦ traps small particles out of the inspired air
o The mucus and its entrapped particles are swallowed or coughed to the exterior
o Zone 3
Continuous blood flow because the alveolar capillary pressure remains
greater than alveolar air pressure during the entire cardiac cycle
- Normally lungs only have zone 2 and 3; zone 2 in apices and zone 3 in all lower areas.
- when a person is in the upright position, the pulmonary arterial pressure at the lung
apex is about 15 mm Hg less than the pressure at the level of the heart. Therefore, the
apical systolic pressure is only 10 mm Hg (25 mm Hg at heart level minus 15 mm Hg
hydrostatic pressure differ-
- Zone 1 only occurs in abnormal conditions (no blood flow at any time in cardiac cycle).
o Either the pulmonary systolic arterial pressure is too low or the alveolar pressure
is too high to allow flow.
- Major increase in blood flow through all parts of the lungs occurs during exercise since
the pulmonary vascular pressure rise enough during exercise to convert the lung apices
from zone 2 pattern into zone 3.
Pulmonary edema
- Left-sided heart failure or mitral valve disease
- Damage to the pulmonary blood capillary membrane.
- Causes the pulmonary interstitial fluid pressure to rise from the nega- tive range into the
positive range will cause rapid filling of the pulmonary interstitial spaces and alveoli with
large amounts of free fluid.