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ANATOMI DAN FISIOLOGI

PERNAFASAN

Dr. Aidi Nasrul

AKBID SUMBAR
LUBUK ALUNG
2008
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Introduction to Pulmonary Physiology

• The pulmonary system, in tandem with

the cardiovascular system, works to
carry out three functions:
– Ventilation
– Perfusion
– Diffusion
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Anatomy
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Upper Airways

• Structures
– Nasopharynx
– Oropharynx
– Tongue
– Epiglottis
– Larynx
• Function
– Protection
– Humidification
– Filtration
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Lower Airways

• Structures
– Trachea
– Mainstem bronchi
– Bronchioles
– Terminal bronchioles
• Function
– Filtration
– Transmission of air
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Structural Considerations
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Structural Considerations

• Cilia: beat 100

times/second
• MAST cells secrete
sticky substance filled
with WBCs
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Alveolus

• 100 million alveoli in

each lung
• Single cell thick wall
• Immediately adjacent
to pulmonary
capillary
• Gas exchanges via
diffusion
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1. Ventilation

• Definition: movement of
air from the external
environment to the
alveoli
• Components:
• Brain
• Innervation
• Chest wall
• Upper airways
• Lower airways
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Inspiration

• Increased
intrathoracic space
• Negative pressure
• Bronchioles dilate
• Air enters
airways/alveoli
(unless a hole is
present in the chest
wall)
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Expiration

• Diaphragm &
intercostals relax
• Thoracic space gets
smaller
• Increased
intrathoracic pressure
• Air passively exits via
airways
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What Happens to the Airways?

• Smooth-muscle lined Inspiration

airways (bronchioles)
naturally change
diameter with
inspiration and
expiration
• (This will be Expiration
important when we
discuss obstructive
lung disease)
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2. Perfusion
• Definition of perfusion:
adequate blood flow
through the pulmonary
capillary bed
R Heart L Heart
• Components:
– Intact pulmonary capillary
bed
– Adequate cardiac function
– Adequate blood volume
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Pulmonary Capillary Bed

May be damaged by:

• Clots (pulmonary
emboli)
• Crushing injuries R Heart L Heart
(pulmonary
contusion)
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Cardiac Function

• The pulmonary capillary

bed is part of the
cardiopulmonary circuit
• Impairment of flow
through any chamber or
valve will impact
pressures and flow
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Blood Volume

• Adequate perfusion requires adequate

blood volumes AND composition

• Reduction of volume, or decreased/

inadequate RBCs will diminish perfusion
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3. Diffusion

– Definition of diffusion:
movement of gases
between the alveoli and
the pulmonary capillary
bed
– Components:
• Alveolus
• Basement membrane
(interstitial space)
• Capillary wall
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Diffusion?
• The passive exchange Before diffusion
of gases along a
concentration O2
CO2 CO2

gradient (high to low)

O2

• Exchange continues
until the
concentrations are After diffusion
equal
O2
O2
CO2
CO2
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Diffusion?
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Basement Membrane

• Includes the walls of the

alveolus and capillary
• Most importantly,
includes the interstitial
space between the walls
of the capillary and
alveoli
• Drainage via lymphatics
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Capillary Wall

• If capillary wall is
thickened, diffusion
will be impaired
• If capillary wall is
damaged, diffusion
will be impaired
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