Vous êtes sur la page 1sur 70

Chapter five

respiration
Duan-dongxiao
Metabolism
Need oxygen and nutriment
Discharge the carbon dioxide and
the end product of metabolism
Composition of the respiratory system

1. Air passageway 2. lung


Structural and Functional Features
Respiration Concept

The gas exchange process between


organization and environment is called
respiration.

O2 obtain oxygen
CO2 remove carbon dioxide
Respiratory function
Respiratory processes
Blood
atmosphere lung tissue
circulation

O2 O2 O2
CO2 CO2 CO2

Pulmonary Gas exchange Gas exchange


Ventilation In lung In tissue

1 .external 2. gas 3. internal


respiration transport respiration
Overview

1. Pulmonary Ventilation
2. Gas exchange In lung
3. Gas transport
4. Gas exchange In tissue
Section one
Pulmonary Ventilation
Pulmonary ventilation
is the gas exchange
process between lungs
and environment .
environment
inspiration exspiration
organs to complete pulmonary ventilation

1 . Respiratory passageway:communicates
alveoli and environment, warms the air,gets
the air wet, filters the air,cleans the air and
completes the defense reflex.
2 . Alveolus: place for exchange
3 . Thorax: power of pulmonary ventilation
Mechanics of Pulmonary Ventilation

Two factors:
One is the power to push gas flowing.
The other is resistance to prevent gas flowing.
The former must overcome the latter , and then
pulmonary ventilation can be completed.
power of pulmonary ventilation
1. respiratory movement
2. intrapulmonary pressure
3. intrapleural pressure
1. respiratory movement
Thoracic expansion and contraction
caused by respiratory muscles are
called respiratory movement.
(inspiration, expiration)
Muscles of inspiration :
diaphragm and external
intercostal muscles
Muscles of expiration :
internal intercostal muscles
and abdominal muscles
Muscles of assistant inspiration :
scalenus muscles ,
sternocleidomastoid muscles.
( 1 ) Process
1 ) Eupnea a. Inspiration:
inspiration muscles contract
thoraxes expand
lungs expand
lung volumes increase
intrapulmonary pressure
decreases temporarily
gas enters lungs
b. Expiration:
diaphragm relax and internal
intercostal muscles contract

thorax recoils

lung recoils

intrapulmonary pressure increases

gas is removed.
2 ) labored inspiration
3 ) labored expiration
( 2 ) patterns
Form of the movement
a. Abdominal breathing
Thoracic breathing

Form of the movement


b. eupnea
labored breathing
2. intrapulmonary pressure

Intrapulmonary pressure is the


pressure in pulmonary alveoli.
Intrapulmonary pressure is equal
to atmospheric pressure Under special
circumstance
intrapulmonary pressure
intrapulmonary pressure
At the first of inspiration, lung volume increases and
intrapulmonary pressure decreases below atmospheric
pressure. Air enters alveoli under the pressure difference.
Intrapulmonary pressure increases as the increasing of
gas in lung.
At the last of inspiration, intrapulmonary pressure is
equal to atmospheric pressure and the air flow stops.
At the first of expiration, lung volume decreases
and intrapulmonary pressure increases until it
exceeds atmospheric pressure. Air outflows lungs
and intrapulmonary pressure decreases by and by.
Intrapulmonary pressure is equal to
atmospheric pressure at the last of expiration.

1mmHg=0.133Kpa
1cmH2O=0.098Kpa
changes in lung volumes,alveolar pressure,and
transpulmonary pressure during normal breathing

PTP = PA – PIP pressure gradient across the lung wall,


keeps lungs from collapsing.
Artificial respiration:
once respiration stops,
intrapulmonary pressure
can be changed factitiously . positive
Pressure difference between
intrapulmonary pressure
and atmospheric pressure
can be created to maintain
pulmonary ventilation .

negative
3. Intrapleural pressure

pleuralvisceral
cavity
pleura

parietal
intrapleural
pleura
pressure

Intrapleural pressure is the pressure within the pleural


cavity. Pleural cavity is made up of two layers of pleura. One
is visceral layer stick to the surface of lung and the other is
parietal layer stick to thorax .
pressure within the pleural cavity. It is always lower than both
atmopsheric pressure and intrapulmonary pressure.
Inspiration

 As the thoracic
wall moves
outward during
inspiration, the
volume of the
pleural cavity
increases slightly,
decreasing
intrapleural
pressure (more
Expiration

As the thoracic wall


recoils during
expiration, the volume
of the pleural cavity
decreases, returning the
pressure to – 5 cmH2o
(less negative)
Intrapleural pressure is usually negative
pressure.
1. At the end of expiration of eupnea,
the pressure is about - 5 ~ - 3 cmH2o
2. At the end of inspiration of eupnea,
the pressure is about - 10 ~ - 5 cmH2o
3. Intrapleural pressure
There is only little liquid in the pleural cavity but
not gas.
The effect of this layer of liquid is :
(1) Lubrication effect between
two layers of pleura.
(2) The power between liquid
molecules pastes two layers
of pleura to make them tightly.

Significance :
Keep the lungs inflated
Facilitate venous return
(respiratory pump)
If pleura breaks,
pleural cavity will be
open to atmosphere
and air will enter
pleural cavity . This
is called
pneumothorax. At
this time , two layers
of pleura separate
and lungs contract
for the elastic recoil.

dyspnea
Power of Pulmonary Ventilation
(Summary)
Expansion and contraction of respiration muscles

expansion and contraction of thoracic cage

(lungs change with the moving of thoracic cage)


lung volumes change

pressure differences between lung volume


and atmospheric pressure

gas enters or is removed out of lungs.


Resistance of Pulmonary Ventilation
1. One is non- elastic resistance 30 %
1) airway resistance
2) inertia resistance: the resistance
produce when Air flowing, change
speed, change direction
3) viscous resistance of organization:
friction due to movement of lungs or chest
Airway Resistance——diameter

vagus nerve—smooth muscle contract


Sympathetic nerve — smooth muscle relax
airway resistance
diameter small airway resistance big
diameter big airway resistance small

As the resistance increases, the airflow decreases.


As the resistance decreases, the airflow increases.
In healthy lungs, the airways typically offer little
resistance, so air flows easily into and out of the lungs.
2. The other is elastic resistance 70 %
the main resistance of eupnea
elastic resistance of lung
elastic resistance of thorax
1. Elastic Resistance and Compliance

The deformation power caused by opposing pressure


is called elastic resistance.

COMPLIANCE is the ability of the lung to stretch; its


distensibility. It represents the change in volume that
occurs for a given change in pressure.

Relationship between compliance and elastic resistance


C= 1/R
( 1 ) Elastic Resistance of Lungs and
Compliance

(△ V )
change of lung volume
( CL ) =
L/cmH2O
lungs compliance ( △P)
change of transpulmonary pressure

transpulmonary pressure is the difference between


intrapulmonary pressure and pleural pressure.
CL is normally 0.2 l /cm H2O
Lung static compliance diagram

If curve slope is large , it


means the compliance is
large and the elastic
resistance is small.
If curve slope is small, it
means the compliance is
small and the elastic
resistance is large.
Source of lungs elastic resistance
a. The elastic recoil power of lungs
b. The recoil power caused by surface
tension between the liquid layer of
inner alveoli and gas in alveoli.
Pulmonary

Surfactant
1. Comformation of Pulmonary Surfactant

Dipamitoyl
phosphatidyl choline,
(DPPC) is a complex of
lipid-protein secreted by
type II cells of alveoli,
lining in inside of
alveoli.
Their primary function is the secretion of a chemical known as
surfactant , Crawling on and about both the type I and type II cells
P=2T/r P is the collapsing pressure
T is the surface tension
r is the radius of the alveolus.
2. physiological effect of pulmonary surfactant

( 1 ) Accommodate surface tension and stable


alveolar pressure.
( 2 ) Lower alveolar surface tension and reduce
inspiration resistance.
( 3 ) Reduce the producing of alveolar liquid
and prevent pulmonary edema. The effect
of suction is reduced too.
二 Pulmonary Volume and
Pulmonary Capacities
(一) Pulmonary Volume
Tidal Volume(TV) 500mL
IRV( inspiratory reserve volume) 3000mL
ERV( expiratory reserve volume) 1100mL
RV( residual volume) 1200mL
(二) pulmonary capacities
IC Inspiratory Capacity
TV + IRV 3500 mL
FRC Functional residual capacity
RV+ERV 2300 mL
Physiology significance :dampen the change
of O2 and CO2 in the process of respiration.
VC vital capacity = TV+ IRV +ERV
4600mL
TVC timed vital capacity
expired 83% of all vital capacity at the first second
expired 96% of all vital capacity at the second second
expired 99% of all vital capacity at the third second
The total lung capacity : 5800mL
=VC+RV
figure of lung volume and vital capacity
三 . lung ventilation volume

(一) Minute ventilation volume is the


total amount of new air moved into the
respiratory passage each minute.
Minute ventilation volume=
Tidal Volume×respiratory frequency
500 12
(二) Dead space and
Alveolar Ventilation
500
1. dead space
Not all of the inspired
air reached the alveoli.
 As fresh air is inhaled it is
mixed with air in
anatomical dead space.
– Conducting zone and
alveoli where [02] is lower
than normal and [C02] is
higher than normal.
2. alveolar ventilation
is the total volume of new air entering
the alveoli and adjacent gas exchange areas
each minute.
 Alveolar ventilation = (TV- DS) x F
– F = frequency (breaths/min.).
– TV = tidal volume.
– DS = dead space.

= (tidal volume- dead space)× respiratory frequency


= ( 500mL - 150mL ) ×12 p/min
= 350 ×12
= 4200 ml/min
If tidal volume decreases
half, respiratory frequency
increases double.Minute
ventilation volume keeps
constant, but alveolar
ventilation will decrease
greatly. Considering as
ventilation efficiency of
slow and deep respiration
is higher than fast and light
respiration.
elastic resistance of thorax

Total amount <67% >67%


of lung 67%
( 2 ) elastic resistance of thorax

When thorax is at the natural location and the


lung volume is equal to about 67 % of total
lung capacity.thorax does not deformate and
does not display elasrtic resistance.
When lung volume is smaller than 67 % of
total lung capacity,thorax is constracted by
the traction .The elasrtic resistance
outward is the drive of inspiration and
resistance of expiration.
When lung volume is bigger than 67 % of
total lung capacity,thorax is enlarged by the
traction.The elasrtic resistance inward is the
resistance of inspiration and drive of
expiration.
How Come the Negative Pressure?

 Two forces act to pull the lungs (visceral pleura)


away from the thorax wall (parietal pleura):
– Recoil due to elasticity of the lungs
 The abundant elastic tissue in the lungs tends to recoil

and pull the lung inward. As the lung moves away from
the thoracic wall, the cavity becomes slightly larger. The
negative pressure this creates acts like a suction to keep
the lungs inflated.
– Surface tension of aveolar fluid tends to pull each of the
alveoli inward and therefore pulls the entire lung inward
How?
 These force are opposed by the
third factor:
– The elasticity of the thoracic wall.
 The elastic thoracic wall tends to pull away
from the lung, further enlarging the pleural
cavity and creating this negative pressure.
The surface tension of pleural fluid resists
the actual separation of the lung and thoracic
wall.
How?
 As the lung and the thoracic wall 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 drops the intrapleural
pressure below atmospheric pressure.
 Thus the elastic recoil of the lungs and chest wall
creates the subatmospheric intrapleural pressure
that keeps them from moving apart more than a
tiny amount.
Assays of intrapleural pressure

1. direct assay oesophagus

2. indirect assay
Factors Affecting Airway
Resistance
 Several factors change airway resistance by
affecting the diameter of the airways. They do
this by contracting or relaxing the smooth muscle
in the airway walls, especially the bronchioles.
– Parasympathetic neurons release the Ach which
constricts bronchioles.
– Histamine, released during allergic reactions,
constricts bronchioles.
– Adrenalin, released by the adrenal medulla during
exercise or stress, dilates bronchioles, thereby
decreasing airway resistance.
Effects of Surface Tension in a
Sphere
Surface tension pulls inward, creates pressure, depends on radius

In the absence of surfactant and at low lung volumes


Interconnected small alveoli would collapse into larger
alveoli
Because high pressure moves to lower pressure