Class: 05/09/17

Physiology Lecture 1
Objectives
1. Describe the respiratory and metabolic functions and the defense mechanisms of the lung.
(lecture)
2. Define the following: eupnoea, apnoea, dyspnoea, hypopnoea, hyperpnoea, tachypnopea,
hypoventilation, hyperventilation, hypoxia, hypoxaemia, hyperoxia, oxygen debt, hypocapnia,
hypercapnia, asphyxia. (lecture)
3. Explain the difference between breathing, ventilation and respiration.

The Respiratory System: Respiratory Functions

Movement of air into and out of the lungs
Warming and humidifying inspired air (maintenance of lung temperature)
Defense against foreign inhaled matter (filtration, precipitation, trapping of mucus, reflexes and
macrophages)
Provision of a route for water loss
Performance of external work, including mechanical, osmotic and electrical work
Assistance in maintaining normal arterial blood gas by altering the amount of H + generated in CO2
exhalation

The Respiratory System: Metabolic Functions

Storage of Blood available for circulatory compensation
Filtering of the circulation (thrombi, microaggregates, etc)
Removal, modification, inactivation/activation of various substances which pass through the
pulmonary circulation:
o Inactivation of PGE1 and PGF2
o Inactivation of noradrenaline, bradykinin and serotonin
o Activation of angiotensin I to angiotensin II (ACE)
o Synthesis of lipids e.g. pulmonary sufactant
Enhancement of venous return by action of the respiratory pump. (pressure in chest veins is 5
mm Hg lower than in veins in the abdomen and extremities. Breathing facilitates increased
return.)
o Immunological: IgA secretion into bronchial mucus
o Enabling of speech, singing and other vocalisations
o Participation in olfaction

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Summary: Functions of the respiratory system

Respiratory Metabolic

Moves air in and out of lungs
Warms and humidifies air
Defends the lungs against foreign
bodies
Provides a route for H2O loss
Performance of external work
Maintains ABG levels through
exhalation of CO2
Acts as reservoir of blood during circulatory
compensation
Filters circulation
Removes, modifies, activates and
inactivates substances
Enhances venous return through breathing

The Respiratory System: Defense Mechanisms

Physical
Hormonal
Cellular

Some foreign bodies to which the respiratory system is exposed

Dust
Pollen
Fungal spores
Bacteria
Viruses
Airborne pollutants

Defense Mechanisms: Physical

Prevents entry of organisms / foreign bodies
o Filtration by vibrissae ad sticky mucus
o Swallowing by elevation of larynx to prevent aspiration
o Stimulation of irritant C fibres causes reflex contraction of bronchial smooth muscle
(constricts airways and mucus secretion
Removal of foreign bodies
o Cough reflex
o Mucociliary clearance
o Alveolar macrophages
o 1 antitrypsin

Defense Mechanisms: Hormonal

Antimicrobial peptides (defensins, lysozymes, lactoferrin)
Pulmonary surfactant (surfactant protein A enhances alveolar phagocytosis)
Immunoglobulins (mainly IgA - found in mucus)
Complement (found in high concentrations in inflammation)
Anti-proteases (1 antitrypsin - inhibits destruction of elastase)

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Defense Mechanisms: Cellular

Alveolar macrophages (phagocytic and mobile)
o Involved in the inflammatory response by secretion of proteins that recruit other cells
Complement
Cytokines, chemokines
Growth factors
Neutrophils (primary cells involved in inflammatory response) move from intravascular space to
lumen of alveoli (intracellular site of bacterial destruction by oxidative and non-oxidative
processes)
o Oxidative - through reactive oxygen species
o Non-oxidative - through proteases

Respiration
Definition: The physical and chemical processes by which cells obtain and use oxygen needed for
metabolism, and the physical and chemical processes by which the carbon dioxide produced by
the cells is removed from the body.
The term respiration includes three separate functions:
o Ventilation:
Breathing
o Gas Exchange:
Occurring between air and blood in the lungs
Occurring between blood and tissues
o O2 utilization:
Cellular respiration

To differentiate between external and internal respiration

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DEFINITIONS:

External Respiration
Sequence of events involved in exchange of O2 and CO2 between the external environment and cells of
the body. This involves four steps:
1. Ventilation
2. Diffusion
3. Transport to tissues
4. Exchange at tissue level

Internal Respiration
The intracellular metabolic processes occurring within the mitochondria, which utilize oxygen and
produce CO2 during the derivation of energy.

Breathing
The rhythmic process by which the ventilatory system draws a tidal volume (V T) of ambient gas of liquid
into the lungs (inspiration) and expels it (expiration)

Ventilation
The rhythmic movement of gas into and out of the lungs usually expressed as a rate.

To differentiate between pulmonary ventilation and alveolar ventilation.

Pulmonary ventilation = VT f
Alveolar ventilation (VA) = (VT -VD) f
(VD: volume of dead space)

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Patterns of Ventilation

Pattern Description

Eupnoea Normal, quiet breathing

Dyspnoea Difficulty in breathing

Apnoea Absence of breathing

Tachypnoea Rapid breathing

Bradypnoea Slow breathing

Hyperpnoea Deep breathing

Hypopnoea Shallow breathing

Special Definitions

Hyperventilation
Breathing in excess of the body's metabolic needs.

Hypoventilation
Breathing below metabolic needs.

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Airway Dimensions

Generation Name Diameter Total Cross-sec. Cum. Number

(cm) area Volume
(cm2) (%)

0 Trachea 1.8 2.5 1.7 1

10 Small Bronchi 0.13 13.0 4.0 103

14 Bronchioles 0.08 45.0 7.0 104

18 Respiratory 0.05 540.0 31.0 3 105

Bronchioles

24 Alveoli 0.01 8 105 100.0 3 108

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Respiration: Structure and Function

Generation Name Cilia Smooth Mucus Cartilage

Muscle Secretion

0 Trachea

10 Small Bronchi

14 Bronchioles

18 Respiratory
Bronchioles

24 Alveoli

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Main muscles of Respiration

Inspiration
Main muscle is the diaphragm.
On contraction abdominal contents move downward and forward thus increasing the vertical
dimension of the thorax.
Ribs move up and out thus increasing the transverse diameter of the thorax.
Other muscles of inspiration include external intercostal muscles and the accessory muscles.

Expiration
Muscles are passive in quiet breathing.
During active or forced expiration the most important muscles are the abdominal muscles.
Internal intercostal muscles also assist

Respiration: Structure and Function

Structure Function

Diaphragm Primary muscle of inspiration

External intercostals Complementary role to action of diaphragm

Neck muscles Accessory muscles.

Activated during forceful inspiration

Abdominal Muscles Active during forced expiration only

Internal intercostals Active during forced expiration only

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Respiratory Physiology: Mechanics

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Pressures during breathing

Alveolar (intrapulmonary) pressure (PA)

Pressure within alveoli
Equalises with atmospheric pressure between breaths
PA=Patm

Intrapleural pressure (Ppl)

Pressure in the intrapleural liquid
Always about 4 mm HG less than alveolar pressure

Transpulmonary (Ptp) (transpleural pressure)

Pressure across the lung wall
Sub-atmospheric
Hold the lungs open

Lung Pressures

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Pressure changes during quiet breathing

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Pressures in the Lungs

During inspiration: PA < PB

During expiration: PA > PB

At the end of inspiration and expiration: P A = PB

o Alveoli are in direct contact with the atmosphere and air continues to flow down its
pressure gradient until the two pressures equilibrate.

Intrapleural pressure
o During the entire respiratory cycle, inspiration P pl is less than PA.
o The resultant effect is that a transpulmonary pressure is created

Transpulmonary Pressure
o Ptp = PA - Ppl
o This acts to expand the lungs and keep them open

Intrapleural Pressure: Mechanism

Two forces act to pull the lungs (viscera pleura) away from the thoracic wall (parietal pleura):
o Elastic recoil of lungs
o Surface tension of alveolar fluid

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These forces are opposed by a third factor:

o Surface tension created by pleural fluid in the pleural cavity

As the lungs (tending to move inward from their stretched position) and the thoracic wall (tending to
move outward from its compressed position) move very slightly away from each other, there occurs an
infinitesimal enlargement of the fluid-filled intrapleural space between them.

Since fluid cannot expand the way air can, this tiny enlargement of the intrapleural space causes a drop
in the intrapleural pressure to below atmospheric pressure.

Thus the elastic recoil of the lungs and chest wall creates the sub-atmospheric intrapleural pressure that
keeps them from moving apart more than a tiny amount.

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