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Respiratory Physiology

Dr. senthil kumar


Respiration
• It is the process by which the body takes in oxygen and
utilizes and removes CO2 from the tissues into the expired
air
• It comprises of
 Ventilation by the lungs
inspiration and expiration
 Gas exchange across alveolar membrane
Diffusion in the alveoli= EXTERNAL RESPIRATION
 Transport of gases by blood (haemoglobin)
 Uptake of O2 and release of CO2 by tissues Diffusion
at the cellular level= INTERNAL RESPIRATION
Structures involved in ventilation
 Airway
 conducting zone
Respiratory zone
 Lungs
 Rib cage
 Muscles
 Chemical
 Nerves & respiratory center
AIRWAY
• Conducting zone:
• Includes all the
structures that air
passes through before
reaching the respiratory
zone.
• Mouth, nose, pharynx,
glottis, larynx, trachea,
bronchi.
Conducting Zone
• Conducting zone
• Warms and humidifies until inspired air
becomes:
– 37 degrees
– Saturated with water vapor
• Filters and cleans:
– Mucus secreted to trap particles
– Mucus/particles moved by cilia to be expectorated.
Respiratory Zone
• Respiratory zone

• Region of gas exchange


between air and blood
- Respiratory bronchioles
- Alveolar ducts, Alveolar
Sacs and
- Alveoli
LUNGS
Respiratory Muscles
Muscles of Inspiration
• Diaphragm
• External Intercostals
Accessory Muscles
• Sternocleidomastoid
• Anterior serrati
• Scaleni
• Etc,.
Respiratory Muscles
Muscle of Expiration
Recoiling force of lung
And chest wall
Active Expiration
• Abdominal Recti
• Internal Intercostals
• Other Abdominal Muscles
VENTILATION
• Ventilation is the air movement into and out
of the lung during each successive breath
• Movement of air into the lung is called
inspiration. It is an active process.
• Movement of the air out of the lung is called
expiration. it is a passive process
Mechanism of Inspiration
Contraction of Diaphragm Contraction of Chest elevating
muscles
Increase in vertical dimension of Thorax Increase in anteroposterior (mostly)
and transverse dimensions of thorax
Pulling of the lungs outward and downward

Expansion of lungs

Decrease in intrapulmonary pressure

Establishment of pressure gradient from atmosphere to alveoli

Start of inspiration

Intrapulmonary pressure becomes equal to atmospheric


Mechanism of Expiration
Relaxation of inspiratory muscles

Decrease in size of thorax

Compression of lungs

Decrease in size of lungs

Increase in intrapulmonary pressure

Establishment of pressure gradient from alveoli to atmosphere

Start of Expiration

Intrapulmonary pressure becomes equal to atmospheric Pressure

End of expiration
Pressure Changes During Breath
Pressure Changes During Breath
• Pleural pressure change
-5 cm H2O to -7.5 cm H2O
• Alveolar pressure change
0 cm H2O to -1 cm H2O
• Transpulmonary pressure change
Difference between the pleural and
alveolar pressure -5 cm H2O to -6.5 cm H2O
Transpulmonary Pressure

• Is a measure of the elastic force of the lung


• Elastic force also called recoil pressure

Lung Compliance
• The lung volume change per unit
transpulmonary pressure change
• Normal- average about 200 ml / cm H2O
compliance
• Determined by
 Elastic force of lung tissue
= elastic fibers and collagen fibers in lung
parenchyma
 Elastic force caused by surface tension of
the fluid that lines the inside wall of the alveoli
 The surface tension reduced by surfactant
Pulmonary Surfactant
• Is a complex mixture of several phospholipids,
proteins, and ions.
• It contains dipalmitoylphosphotidylcholine.
• Reducing the surface tension and prevent
alveolar collapse
• It is produced by the type II alveolar epithelial
cells
Alveolar ventilation
 Is the rate at which new air reaches the
Respiratory zone ( respiratory bronchioles,
alveolar duct, alveolar sacs, alveoli )
 around 350 ml
 Anatomical dead space volume
the volume of air present in anatomical dead
space = Conducting Zone
 around 150 ml
Rate of Alveolar Ventilation
 Alveolar ventilation per minute
is the total volume of new air entering the
respiratory zone each minute
 It is calculated by
Va = freq x (Vt – Vd)
= 12 x (500 – 150)
= 4200 ml/ minute
Minute Ventilation
 Is a Minute respiratory volume
= tidal volume x respiratory rate
= 500 x 12 /minute
= 6000 ml / minute
Rate of Alveolar Ventilation
subject Tidal Respiratory Anatomical Minute Alveolar
volume (ml ) rate dead space Ventilation Ventilation
(breath/ ventilation (ml ) (ml)
minute) (ml)

1 150 X40 150x40 6000 0


=6000

2 500 X12 150x12 6000 4200


=1800

3 1000 X6 150x6 6000 5100


=900

It is clear that the alveolar ventilation is one of the major factors


determining the concentrations of oxygen and carbon dioxide in the alveoli
Relationship B/W alveolar ventilation
and Partial pressures of O2 and CO2
 O2 concentration in the alveoli is controlled
by
1. The rate of O2 absorption into blood
2. The rate of entry of O2 into the lung by the
ventilation
 Normal Po2 in the alveoli 104 mm Hg
 Normal O2 absorption is 250 – 300 ml
/minute
 Pulmonary artery Po2 is 40 mm Hg
Relationship B/W alveolar ventilation
and Partial pressures of O2 and CO2
Relationship B/W alveolar ventilation
and Partial pressures of O2 and CO2
 The alveolar Pco2 increases directly in
proportion to the rate of CO2 excretion
 The alveolar Pco2 decreases in inverse
proportion to alveolar ventilation
 Normal Pco2 in the alveoli is 40 mm Hg
 Normal Pco2 in the pulmonary artery is
46 mm Hg
 rate of excretion around 250 ml / minute
Relationship B/W alveolar ventilation and
Partial pressures of O2 and CO2
Lung Volumes
 Tidal volume 500 ml
 Inspiratory reserve volume (IRV) 3000 ml
 Expiratory reserve volume (ERV) 1100 ml
 Residual volume (RV) 1200 ml
Lung volumes
Lung volumes
Lung volumes
• Tidal volume (TV):
the volume of air move in/out with each quiet breath (500 ml)

• Total minute volume: tidal x breaths/min


– 500 x 12 = 6 L/min
– Exercise: even 200 L/min!
• Anatomical dead space:
– Conducting zone
– Dilutes tidal volume, by a constant amount.
– Deeper breaths -> more fresh air to alveoli.
Lung volumes
• Inspiratory reserve volume (IRV): the maximum
volume of air forcefully inspired beyond the normal
tidal inspiration.

• Expiratory reserve volume (ERV): the maximum


volume of air forcefully expired beyond the normal
tidal expiration.

• Residual volume: the volume of air remains in the lung


beyond the forcefull expiration.
– Not measured with spirometer
Lung capacity
 Inspiratory capacity
IRV+TV=IC
 Functional residual capacity
RV+ERV=FRC
 Vital capacity
IC+ERV=VC or IRV+TV+ERV=VC
 Total lung capacity
VC+RV=TLC or FRC+IC=TLC
Lung Capacity
• Vital capacity (VC): the most you can actually
ever expire, with forced inspiration and
expiration.

VC= IRV + TV + ERV

• Total lung capacity: VC plus residual volume


Pulmonary Circulation

• Pulmonary Circulation.
– Arises from Right Ventricle.
– Receives 100% of blood flow.

• Bronchial Circulation.
– Arises from the aorta.
– Part of systemic circulation.
– Receives about 2% of left ventricular output
Pulmonary Circulation
Pulmonary Circulation
• In series with the systemic circulation.

• Receives 100% of cardiac output (3.5L/min/m2).

• RBC travels through lung in 4-5 seconds.

• 280 billion capillaries, supplying 300 million alveoli.


– Surface area for gas exchange = 50 – 100 m2
Pulmonary Vascular Resistance During
Exercise
• During exercise cardiac output increases (e.g. 5-fold), but with little
change in mean pulmonary artery pressure
– How is this possible?
input pressure-output pressure
– Vascular resistance = ---------------------------------
Blood flow
• Pressure= Flow x Resistance
• If pressure does not change, then PVR must decrease with
increased blood flow
• Passive effect (seen in isolated lung prep)
– Recruitment: Opening of previously collapsed capillaries
– Distensibility: Increase in diameter of open capillaries.
Recruitment and Distention in Response
to Increased Pulmonary Artery Pressure
Influences of Pulmonary Vascular Resistance
Influences of Pulmonary Vascular Resistance
Control of ventilation and perfusion
• air flow
• Po2
• Vasoconstriction of blood vessels
• Decreased blood flow
• Diversion of blood flow away from local area
of disease to healthy areas of the lung
Control of ventilation and perfusion

• Blood flow
• Alveoli Pco2
• Broncho constriction
• Decreased Air flow
• Diversion of Air flow away from local area of
disease to healthy areas of the lung
Diffusion of gases
Diffusion of gases through
alveolar membrane

Fick’s law
Alveolar membrane
Fick’s law

• A= cross tissue area


• (P1-P2)=Difference in partial pressure b/w the two
sides
• T= thickness of the membrane
• D = constant
- proportional to solubility
- inversely proportional to MW
O2 Transport in the Blood
• O2 transported by blood in two form
1. Hb bound
2. Dissolved in plasma
• O2 is bound to hemoglobin (Hb) for transport in
the blood
• The amount of O2 dissolved in plasma is
proportional to the Po2
• In normal arterial blood with Po2 of 100 mm Hg
contains 0.3ml O2/ 100 ml
Bohr effect
 A shift of the O2-Hb dissociation curve to the
right in response to increases in blood CO2
and H+ ions is called bohr effect
CO2 Transport in Blood
• Dissolved in plasma (10%)
• Bound to Hb (20%)
• Bicarbonate (70%)
– CO2 + H2O  H2CO3  H+ + HCO3-
– Also important for buffering H+
3 Forms of CO2 Transport in Blood
CO2 Exchange in Lung
Cough
• Cough is a protective reflex of Forceful expiration
against a initial closed glottis after a deep
inspiration
• It helps to clear airways foreign body
• Components of cough reflex
1. Cough receptors
2. Afferent nerves
3. Cough center
4. Efferent nerves
5. Effector muscles
Cough reflex

• The cough reflex has both sensory (afferent) mainly


via the vagus nerve and motor (efferent)
components.
• The cough receptors or rapidly adapting irritant
receptors are located mainly on the posterior wall of
the trachea, pharynx, and at the carina of trachea is
more sensitive to touch
• Terminal bronchioles and even the alveoli are
sensitive to chemical stimuli such as sulfur dioxide
gas or chlorine gas.
Mechansim of cough reflex
Mechansim of cough reflex
1. Deep inspiration,
closed glottis
2. Increased intrapleural
pressure then glottis
opens suddenly with
outflow of air at high
velocity
Events in the cough reflex
afferent pathway
• Irritant receptors stimulation

• Internal laryngeal nerve( branch of superior


laryngeal nerve, vagus nerve)

• the cough center in the brain


Efferent pathway
• From the cerebral cortex and medulla via the
vagus and superior laryngeal nerves to the
glottis
• Through intercostal nerve to intercostal
muscles

• Through phrenic nerve to diaphragm


Thank you to all

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