RESPIRATION is the process of
exchanging gases (O2) and (CO2)
between the atmosphere and the cells
Atmosphere - Lungs Blood Cells
External Respiration
Internal Respiration
ALVEOLAR DIFFUSION /
ALVEOLAR VENTILATION / GAS
EXCHANGE
DALTONS Law of Partial Pressure
Gas moves from an area of
higher concentration to lower
concentration to equalize
between two sides of a semi
permeable membrane
 RESPIRATORY SYSTEM

THE
INHALATION
PROCESS
 SURFACTANT

A lipoprotein
that lowers the
surface tension
in the alveoli
Insufficient
surfactant
ATELECTASIS
collapsed airless
alveoli
 PHYSIOLOGY OF RESPIRATION
Ventilation
inspiration and expiration
Gas flows from an area of higher pressure (atmospheric
pressure) to lower pressure (intrathoracic pressure)
Compliance
distensibility or expansion of the lungs

Diffusion
movement of oxygen an carbon dioxide across the
alveolar- capillary membrane
 PHYSIOLOGY OF RESPIRATION

Oxygen-Hemoglobin Dissociation Curve

describe the relationship between partial
pressure of oxygen and oxygen saturation
partial pressure is high in the lungs so oxygen
binds readily to hemoglobin
Hemoglobin can only fill oxygen in a high
partial pressure
 PHYSIOLOGY OF RESPIRATION

Arterial Blood Gases

An arterial blood gas (ABG) test measures the
acidity (pH) and the levels of oxygen and
carbon dioxide in the blood from an artery.
This test is used to check how well your lungs
are able to move oxygen into the blood and
remove carbon dioxide from the blood.
ATMOSPHERIC GASES AND PRESSURES
Partial Pressure Volumes (%)
(mmHg)
Atmospheric O2 159.3 20.96
(PaO2)
Atmospheric CO2 0.3 0.04
(PaCO2)
Atmospheric N 600.4 79.00
(PaN)
Total Atmospheric 760mmHg 100%
Pressure
 GAS PRESSURE IN THE ALVEOLI, PULMONARY
ARTERIES & PULMONARY VEINS

Venous Blood Gas Pressure (PA) PvN 569 mmHg

PvO2 40-50 mmHg
PvCO2 45-55 mmHg
Normal Alveolar Pressure PAN 569mmHg
PACO2 40 mmHg
PAO2 104 mmHg
Arterial Blood Gas ABG (PV) PaN 569 mmHg
PaO2 80-100 mmHg
PaCO2 35-45 mmHg
Inspiration &
expiration
Inspiration &
expiration
 About Lung volumes...
The maximum volume of the lungs is about 5dm3 (5
litres) although we never completely empty the
lungs; even if we breathe out as much as possible
(expiratory capacity) there will still be about 1.5
dm3 left in the lung (residual volume).

The amount of air breathed in and out at each

breath is called the tidal volume. At rest this will be
around 0.5 dm3, rising to about 2.5 dm3 when we
are breathing very deeply.

The maximum volume that can be exchanged by

breathing in as much as possible and then forcing
out as much as possible is our vital capacity.
6. Mixed Venous Blood
Mixed venous oxygen saturation (SvO2) is the
percentage of oxygen bound to hemoglobin in
blood returning to the right side of the heart.
the amount of oxygen "left over" after the
tissues remove what they need.
can help to determine whether the cardiac
output and oxygen delivery is high enough to
meet a patient's needs.
 NORMAL ARTERIAL BLOOD GAS VALUE
Acidity index pH 7.35-7.45

Partial Pressure of Pa02 80-100mmHg

Dissolved Oxygen

Percentage of Sa02 95% and above

Hemoglobin saturated
with Oxygen

Partial pressure of PaC02 35-45 mmHg

dissolved carbon
dioxide

Bicarbonate HC03- 22-28Meq/L

 BLOOD SUPPLY

The Lungs have 2 types of circulation

Pulmonary circulation where oxygen and
carbon dioxide occurs.
Bronchial circulation starts with the
bronchial arteries which arise from the aorta and
provides oxygen to the bronchi and pulmonary
tissues. Deoxygenated blood returns from the
bronchial circulation thru the LEFT ATRIUM
 CONTROL FO RESPIRATION
The control of respiration is tied to the principle
of Homeostasis controlled by 3 homeostatic
mechanism. Central
1. Receptors chemoreceptors
2. Control System Peripheral
3. Effectors chemoreceptors
RESPIRATORY DEFENSE MECHANISMS
It protects the lungs from inhaled particles,
microorganisms and toxic gases.
1. Filtration
2. Mucociliary Clearance System
3. Cough reflex
4. Reflex Bronchoconstriction
5. Alveolar macrophages
 ASSESSMENT OF THE RESPIRATORY
SYSTEM
Past Health History
Medications
Surgery or other
treatments
Functional
Health Patterns
IPPA
 CUES TO RESPIRATORY PROBLEM
Shortness of Known as Dyspnea
Breath
Wheezing sound high-pitched whistling sound
Pleuritic Chest sharp and 'stabbing' in a part
Pain of the chest. The pain is usually
made worse when you breathe
in or cough.
Cough Productive/non productive
Sputum Material coughed up
Production
 PHYSICAL ASSESSMENT

Major Symptoms
1. Vital Signs Sputum Production
(Breathing Chest Pain
Patterns) Wheezes
2. Signs & Clubbing of fingers
Symptoms Hemoptysis
3. Chest Cyanosis
Configuration
Common Chest Deformities
 (density of the lungs)

Dullness or Flatness
Hyper resonance
Louder & lower than
Resonance

Normal, air filled

 ABNORMAL BREATH SOUNDS
Rales (crackles)
Wheezes (Sibilant Rhonchi)
Sonorous Rhonchi
Normal Breath Sounds
Absent or diminished breath
Bronchial Breath
sounds
Sounds
Pleural friction rub
Bronchovesicular
Bronchipony
Breath Sounds
Egophony
Vesicular Breath
Whispered pectoriloquy
Sounds
 DIAGNOSTIC STUDIES OF THE
RESPIRATORY SYSTEM
Blood Studies (Hb, Hct, ABG)
Oximetry
Radiologic Studies
Chest Xray
CT Scan, MRI
Ventilation Perfusion Scan
Pulmonary Angiography
Position Emission Tomography
 DIAGNOSTIC STUDIES OF THE
RESPIRATORY SYSTEM
Endoscopic Examinations
Bronchoscopy
Mediatinoscopy

Lung Biopsy
Thoracentesis
Pulmonary Function Test