Physiology 7th Lecture - Respiratory Physiology Ventilation

  • June 2020
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Respiratory Physiology Ventilation Major functions of respiratory system •

To supply the body with oxygen and dispose of CO2



Respiration – four distinct processes must happen: •

Pulmonary ventilation – moving air into and out of the lungs



External respiration – gas exchange between the lungs and blood



Transport – transport of oxygen and carbon dioxide between the lungs and tissues



Internal respiration – gas exchange between systemic blood vessels and tissues

Breathing •

Breathing, or pulmonary ventilation, consists of two phases: •

Inspiration – air flows into the lungs



Expiration

Eupnea •

Normal spontaneous breathing of which we are normally unaware



Ventilation is matched to metabolic demands

Hyperpnea •

Increased ventilation which matches increased metabolic demands such as exercise



Initially, increased ventilation is mainly increased tidal volume



Increased frequently is proportionately more important at higher intensities

Hyperventilation •

Inappropriately high ventilation for the metabolic demands



Hallmark. Alveolar and arterial are PCO2 decreased



Alveolar PO2 is increased

Tachypnea Increased frequency of breathing Ventilation may or may not be changed depending on what happens to tidal volume

Dyspnea Subjective sensation of difficulty to breath. Shortness of breath.

Apnea Temporary absence of cessation of breathing (usually at FRC) Implication that breathing will resume spontaneously Normally, apnea occurs after hyperventilation

Pressure relationships in the thoracic cavity •

Respiratory pressure is always described relative to atmospheric pressure



Atmospheric pressure ( P atm ) •

Pressure exerted by the air surrounding the body



Negative respiratory pressure is less than



Positive respiratory pressure is greater than

P atm P atm

Pressure relationships in the thoracic cavity •

Intrapulmonary pressure ( P pul )



pressure within the alveoli



Intrapleural pressure ( P ip )

Pressure relationships •

Intrapulmonary pressure and intrapleural pressure fluctuate with the phases of breathing



Intrapulmonary pressure always eventually equalizes itself with atmospheric pressure



Intrapleural pressure is always less than intrapulmonary pressure and atmospheric pressure



Tho forces act to pull the lungs away from the thoracic wall, promoting lung collapse





Elasticity of lungs causes them to assume smallest possible size



Surface tension of alveolar fluid draws alveoli to their smallest possible size

Opposing force – elasticity of the chest

Lung collapse •

Caused by equalization of the intrapleular pressure with the intrapulmonary pressure



Transpulmonary pressure keeps the airways open •

Transpulmonary pressure - the pressure difference across the lung. Alveolar pressure minus pleural pressure ( P alv - P pl )

Pulmonary ventilation A mechanical process that depends on volume changes in the thoracic cavity

Boyle's law Boyle's law – the relationship between the pressure and volume of gases P 1⋅V 1= P 2⋅V 2

How do we breath? •

Inspiration is normally active



Expiration is normally passive

Inspiration •

The diaphragm and external intercostal muscles (inspiratory muscles) contract and the rib cage

Expiration •

Inspiratatory muscles relax and the rib cage descends due to gravity



Thoracic cavity volume decreases



Elastic lings recoil passively and intrapulmonary volume decreases



Inrapulmonary pressure rises above atmospheric pressure (+1 mm Hg)



Gases flow out of the lungs down the pressure gradient

Airway resistance •

Friction is the major nonelastic source of resistance to airflow



The relationship between flow (F), pressure (P), and resistance (R) is: F = ΔP / R



The amount of the gases that flows in and out of the alveoli is directly proportional to ΔP, the pressure gradient between the atmosphere and alveoli



Gas flow is inversely proportional to resistance with the greatest being in the medium-sized ......



As airway resistance rises, breathing movements becomes more strenous

Alveolar surface tension •

Surface tension – the atrraction of liquid molecules to one another at a liquid-gas interface



The liquid coating the alveolar surface is always acting to reduce the alveolil to smallest size



Surfactant, a detergent-like complex, reduces surface tension and helps keep the alveoli from collapsing

Lung compliance •

The ease with which lungs can be expanded



Specifically, the measure of the change in lung volume that occurs with a given change in transpulmonary pressure



Determined by two main factors

Factors that diminish lung compliance •

Scar tissue or fibrosis



Blockage of the smaller passages



Reduced production of surfactant



Decreased flexibility



Examples include:



Deformities of thorax



Ossification of the costal cartilage



Paralysis of ontercostal muscles

Three ways to inflate the lungs •

Increase alveolar pressure – possitive pressure respirators



Decrease body surface pressure - “iron lungs”



Activate inspiratory muscles – normal way to breath

Cyclical variation of pressure •

Tidal volume: 500ml (350 alveoli)



FRC: ~3000ml --> (TV/FRC) ~10%



Cyclical variation in PaO2 and PaCO2 is small

Minute ventilation •

Flow (vol/time) moved into or out of the lungs



measured by collecting expired volume for a fixed time



Normal value is 7.5 L/min (BTPS)



V(.)e = Vt x f

Alveolar ventilation V.e = Vt x f

Anatomic dead space •



Volume of lung that is not involved in gas exchange •

Include: mouth, trachea ...



Ventilation of these areas results in no gas exchange

Estimating anatomical dead space in ml = ideal body weight measured in pounds

Alveolar dead sapce •

Treat lung as of only two types exist: •

With ideal gas exchange



With no gas exchange at all



Partition poorly ventilated units



Alveolar dead space as is

Physiological dead space Defenition – anatimical dead space + alveolar dead space

Partitioning minute ventilation •

Alveolar ventilation: the volume per min entering gas exchange surfaces



-V.a = Vt – Vds x f



Dead space ventilation: the volume per minute that is wasted



- V.ds = Vds x f

Ventilator adjucments & respiratory efficiency •



Increase tidal volume •

alveolar ventilation increases



dead space ventilation unchanged

increase respiratory frequency •

alveolar ventilation increases



dead space ventilation increases

Factors determining alveolar PaCO2 •

insoired air: no CO2



increaseing CO2 production

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