Académique Documents
Professionnel Documents
Culture Documents
Chapter 12
Changes in the intra-alveolar pressure produces the flow of air into and out of the lungs.
If this pressure is less than atmospheric pressure, air enters the lungs. If the opposite occurs, air exits from the lungs. Boyles law states an inverse relationship between the pressure exerted by a quantity of gas and its volume. Temperature remains constant.
Inspiration begins with the contraction of the respiratory muscles: the diaphragm (innervated by the phrenic nerve) and the external intercostal muscles (innervated by intercostal nerves).
75 % of the enlargement of the thoracic cavity during quiet respiration is due to the contraction and flattening of the diaphragm. This expansion decreases the intrapleural pressure (down to 754). The lungs are drawn into this area of lower pressure. They expand. This increase in volume lowers the intra-alveolar pressure to a level below atmospheric pressure. By this difference, air enters the lungs. The action of accessory inspiratory muscles can further enlarge the thoracic cavity.
The onset of expiration begins with the relaxation of the inspiratory muscles.
Relaxation of the diaphragm and the muscles of the chest wall, plus the elastic recoil of the alveoli, decrease the size of the chest cavity. The intrapleural pressure increases and the lungs are compressed. The intra-alveolar pressure increases. When it increases to a level above atmospheric pressure, air is driven out - an expiration. Forced expiration can occur by the contraction of expiratory muscles. These skeletal muscles are ones in the abdominal wall and the internal intercostal muscles. Their contraction further increases the pressure gradient between the alveoli (greater pressure) and the atmosphere.
See Figure 13-12
Lung volumes and capacities can be measured by a spirometer. These volumes include:
tidal volume (TV) - The air entering or leaving the lungs in a single breath. inspiratory reserve volume - The extra air that can be maximally inspired over the typical resting TV. inspiratory capacity - The maximum volume of air that can be inspired at the end of a normal quiet expiration. expiratory reserve volume - The extra volume of air that can be actively expired by maximal contraction beyond the normal volume of air after a tidal volume. vital capacity - The maximum volume of air that can be expired following a maximal inspiration. Various respiratory dysfunctions can be detected by abnormal patterns measured with the spirometer. Abnormal results include obstructive lung disease and restrictive lung disease.
Partial pressure gradients change the partial pressures of oxygen(e.g., 100) and carbon dioxide (e.g., 40) in the blood returning to the heart from the lungs.
By diffusion, the partial pressures for oxygen and carbon dioxide in the pulmonary capillaries equilibrate with the partial pressures for these gases in the alveoli. The greater the partial pressure gradients between the alveoli and the blood, the greater the rate of transfer for the gases. The blood passing through the lungs gains oxygen and eliminates some of its carbon dioxide. This blood passes through the left side of the heart and enters the systemic circulation. It arrives at the tissues with the same gas content (e.g., 100 for oxygen and 40 for carbon dioxide) established at lung equilibration.
Other factors in addition to the partial pressure gradient affect the rate of gas transfer.
As surface area increases the rate increases. The alveoli collectively offer a tremendous surface area. Increased pulmonary blood pressure, from an increased cardiac output, increases the area. The walls of the alveoli and pulmonary capillaries are thin for rapid gas transfer. Pulmonary edema, pulmonary fibrosis, and pneumonia thicken the barriers for gas exchange. Gas exchange is also directly proportional to the diffusion coefficient for a gas. This coefficient is twenty times as great for carbon dioxide compared to oxygen, as carbon dioxide is more soluble.
Gas exchange across systemic capillaries also occurs down partial pressure gradients.
By equilibration in the alveoli, the oxygen in the systemic capillaries has a high partial pressure (e.g., 100) compared to tissue cells (e.g., 40). These cells are using oxygen. The partial pressure for carbon dioxide in the systemic capillaries is low (e.g., 40) compared to the tissue cells (e.g., 46), which are making this gas through their metabolism. By partial pressure gradients, oxygen diffuses from the systemic capillaries into the tissue cells (100 to 40, higher to lower). Carbon dioxide diffuses in the opposite direction. Having equilibrated with the tissue cells, the blood leaving the systemic capillaries is low in oxygen and high in carbon dioxide. This blood returns to the right side of the heart and on to the lungs. At the pulmonary capillaries, the blood acquires oxygen and releases some of its carbon dioxide.
The partial pressure of oxygen is the main factor determining the percent hemoglobin saturation.
The percent saturation is high where the partial pressure of oxygen is high (lungs). The percent saturation is low where the partial pressure of oxygen is low (tissue cells). At the tissue cells oxygen tends to dissociate from hemoglobin, the opposite of saturation. This relationship is shown in the oxygenhemoglobin dissociation curve. The plateau part of the curve is where the partial pressure of oxygen is high (lungs). The steep part of the curve exists at the systemic capillaries, where hemoglobin unloads oxygen to the tissue cells.
Hemoglobin promotes the net transfer of oxygen at both the alveolar and tissue levels.
There is a net diffusion of oxygen from the alveoli to the blood. This occurs continuously until hemoglobin is as saturated as possible (97.5% at 100 mm of Hg). At the tissue cells hemoglobin rapidly delivers oxygen into the blood plasma and on to the tissue cells. Various factors promote this unloading. An increase in carbon dioxide from the tissue cells into the systemic capillaries increased hemoglobin dissociation from oxygen (shifts the dissociation curve to the right). Increased acidity has the same effect. This shift of the curve to the right (more dissociation) is called the Bohr effect. Higher temperatures also produces this shift, as does the production of BPG. Hemoglobin has more affinity for carbon monoxide compared to oxygen.
Examples include hypoxic hypoxia, which is characterized by a low partial pressure in the arterial blood. In anemia hypoxia there is reduced oxygen-carrying capacity in the blood. Hyperoxia is an above-normal arterial partial pressure of oxygen.
Hypercapnia is an excess of carbon dioxide in the blood caused by hypoventilation. Hypocapnia is a below-normal arterial level of carbon dioxide in the blood, due to hyperventilation. Hyperpnea is an increased need for oxygen delivery and carbon dioxide elimination during exercise.
Respiration is controlled.
There are respiratory centers in the brain stem that establish a rhythmic breathing pattern. There are inspiratory and expiratory neurons in the medullary respiratory center. The inspiratory neurons send signals to the inspiratory muscles. When they do not fire signals, the expiratory center takes over and expiration occurs. The pneumotaxic center in the pons sends impulses that switch off the inspiratory neurons. The apneustic center in the pons prevents the inspiratory neurons from being switched off. By the Hering-Breuer reflex, stretch receptors in the lungs are activated when the lungs inflate with air from an inspiration. Signals travel from these receptors to the lungs by afferent neurons, inhibiting the inspiratory center. The expiratory center then dominates, allowing expiration to occur. With the completion of this, the inspiratory center dominates again, starting another