Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out...
-
Upload
everett-follen -
Category
Documents
-
view
217 -
download
2
Transcript of Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out...
![Page 1: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/1.jpg)
Part II - Respiratory Part II - Respiratory PhysiologyPhysiology
![Page 2: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/2.jpg)
4 distinct events4 distinct events Pulmonary ventilationPulmonary ventilation: air is moved in and out : air is moved in and out
of the lungsof the lungs External respirationExternal respiration: gas exchange between : gas exchange between
blood and alveoliblood and alveoli Respiratory gas transportRespiratory gas transport: CV system : CV system
transports oxygen and carbon dioxide between transports oxygen and carbon dioxide between lungs & tissues (discussed in Blood chapter)lungs & tissues (discussed in Blood chapter)
Internal respirationInternal respiration: gas exchange between : gas exchange between blood & tissue cellsblood & tissue cells Definition: Cellular respirationDefinition: Cellular respiration: actual use of : actual use of
oxygen & production of carbon dioxide in the cellsoxygen & production of carbon dioxide in the cells (this is why we have to breathe!!)(this is why we have to breathe!!)
![Page 3: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/3.jpg)
Pulmonary VentilationPulmonary Ventilation
![Page 4: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/4.jpg)
External Respiration External Respiration
![Page 5: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/5.jpg)
Resp. Gas TransportResp. Gas Transport
![Page 6: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/6.jpg)
Internal RespirationInternal Respiration
![Page 7: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/7.jpg)
Cellular RespirationCellular Respiration
![Page 8: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/8.jpg)
Mechanics of BreathingMechanics of Breathing
![Page 9: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/9.jpg)
Pulmonary Ventilation: Event #1 Pulmonary Ventilation: Event #1
Pulmonary ventilation: - Moving air into Pulmonary ventilation: - Moving air into and out of the lungsand out of the lungs Depends on pressure changesDepends on pressure changes BreathingBreathing
Inspiration = moving air into the lungsInspiration = moving air into the lungs Expiration = moving air out of lungsExpiration = moving air out of lungs
![Page 10: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/10.jpg)
Pressure RelationshipsPressure Relationships
Intrapulmonary pressureIntrapulmonary pressure Pressure within the alveoli (lungs)Pressure within the alveoli (lungs) Changes with phases of breathingChanges with phases of breathing Always equalizes itself with atmospheric Always equalizes itself with atmospheric
pressurepressure Intrapleural pressureIntrapleural pressure
Pressure within intrapleural space (between Pressure within intrapleural space (between the pleural membranes )the pleural membranes )
Always 4 mmHg less than intrapulmonary Always 4 mmHg less than intrapulmonary pressurepressure
![Page 11: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/11.jpg)
![Page 12: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/12.jpg)
AtalectasisAtalectasis
Any conditions that causes intrapulmonary Any conditions that causes intrapulmonary pressure to equal intrapleural pressure will pressure to equal intrapleural pressure will cause the lungs to collapsecause the lungs to collapse
This means they lose the ability This means they lose the ability to move air since there is NO to move air since there is NO more pressure differencemore pressure difference
![Page 13: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/13.jpg)
AtelectasisAtelectasis
term for lung collapseterm for lung collapse
![Page 14: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/14.jpg)
PneumothoraxPneumothoraxAir in the intrapleural Air in the intrapleural
space due to trauma – space due to trauma – causes lung collapsecauses lung collapse
![Page 15: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/15.jpg)
Pulmonary ventilationPulmonary ventilation
Question: Why does breathing happen?Question: Why does breathing happen? ONLY acceptable answer: The RULE: ONLY acceptable answer: The RULE:
Volume changes lead to pressure changes Volume changes lead to pressure changes which lead to the flow of gases to equalize which lead to the flow of gases to equalize the pressurethe pressure
![Page 16: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/16.jpg)
Diaphragm StructureDiaphragm Structure
Boyle’s Law = Pressure & Volume have an INVERSE relationship.
![Page 17: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/17.jpg)
Pressure differences cause gas to flow from Pressure differences cause gas to flow from high to lowhigh to low
![Page 18: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/18.jpg)
When the diaphragm contracts, the When the diaphragm contracts, the muscle fibers shorten – so muscle muscle fibers shorten – so muscle
comes downcomes down
![Page 19: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/19.jpg)
InspirationInspiration
Main inspiratory musclesMain inspiratory muscles Diaphragm & external intercostalsDiaphragm & external intercostals
Thoracic dimensions change to increase Thoracic dimensions change to increase volume of thoracic cavity by 0.5 litersvolume of thoracic cavity by 0.5 liters
Intrapulmonary pressure drops 1-3 mmHg Intrapulmonary pressure drops 1-3 mmHg and air rushes info normal quiet inspirationand air rushes info normal quiet inspiration
A deep forced (active) inspiration requires A deep forced (active) inspiration requires activation of accessory muscles – see activation of accessory muscles – see diagram in notesdiagram in notes
![Page 20: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/20.jpg)
ExpirationExpiration
A passive process dependent on natural A passive process dependent on natural lung elasticitylung elasticity
lungs recoil when inspiration stops – so lungs recoil when inspiration stops – so alveoli compress –which leads to a volume alveoli compress –which leads to a volume
decreases -causing intrapulmonary pressure decreases -causing intrapulmonary pressure to rise - gas outflows to equalize the to rise - gas outflows to equalize the pressure with atmospheric pressurepressure with atmospheric pressure
Forced (active) expiration requires Forced (active) expiration requires contraction of abdominals, etc – see diagramcontraction of abdominals, etc – see diagram
![Page 21: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/21.jpg)
![Page 22: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/22.jpg)
What doctors listen forWhat doctors listen for
Bronchial sounds: produced by air rushing Bronchial sounds: produced by air rushing through trachea & bronchithrough trachea & bronchi
Vesicular sounds: produced by air filling Vesicular sounds: produced by air filling alveolialveoli
![Page 23: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/23.jpg)
Respiratory SoundsRespiratory Sounds
WheezingWheezing: whistling : whistling soundsound
Rales: Rales: rasping rasping soundsound
![Page 24: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/24.jpg)
Hear the soundsHear the sounds
Basic Lung Sounds – Bronchial Auscultating The Lungs - Reference Guide
![Page 25: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/25.jpg)
Physical factors influencingPhysical factors influencing
Pulmonary ventilation can be influenced Pulmonary ventilation can be influenced by 4 physical factorsby 4 physical factors Respiratory passage resistanceRespiratory passage resistance Lung complianceLung compliance Lung elasticityLung elasticity Alveolar surface tension forcesAlveolar surface tension forces
![Page 26: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/26.jpg)
Respiratory passage resistanceRespiratory passage resistance
Resistance due to Resistance due to increased friction as increased friction as air moves through air moves through passagespassages Smooth muscle Smooth muscle
bronchoconstriction bronchoconstriction Disorders such as Disorders such as
asthmaasthma – when – when bronchi constrict bronchi constrict
Local accumulations Local accumulations of mucus, infectious of mucus, infectious material, and tumors – material, and tumors – also block air passagealso block air passage
![Page 27: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/27.jpg)
Asthma Asthma
![Page 28: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/28.jpg)
Lung complianceLung compliance
The ease with which lungs can readily The ease with which lungs can readily expandexpand
Affected by the elasticity of the lungs and Affected by the elasticity of the lungs and the thoracic cage which can be diminished the thoracic cage which can be diminished by 2 main factors:by 2 main factors: FibrosisFibrosis of the lung tissue of the lung tissue Ossification and/or muscle paralysis impairs Ossification and/or muscle paralysis impairs
flexibility of the thoracic cageflexibility of the thoracic cage
![Page 29: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/29.jpg)
Lung fibrosisLung fibrosis
![Page 30: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/30.jpg)
Lung ElasticityLung Elasticity
Essential for normal expirationEssential for normal expiration
EmphysemaEmphysema: tissue becomes less : tissue becomes less elastic and more fibrouselastic and more fibrous loss of elasticity & increase in fibrous tissue loss of elasticity & increase in fibrous tissue
causes enormous effort to exhale – at end causes enormous effort to exhale – at end stages, alveolar walls break down and surface stages, alveolar walls break down and surface area is lost for gas exchangearea is lost for gas exchange
![Page 31: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/31.jpg)
![Page 32: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/32.jpg)
Alveolar Surface Tension forcesAlveolar Surface Tension forces
Surface tension is caused by the tendency Surface tension is caused by the tendency of polar molecules such as water to stick to of polar molecules such as water to stick to each other with hydrogen bondseach other with hydrogen bonds
this can cause the walls of the alveoli to this can cause the walls of the alveoli to stick together like plastic wrap every time stick together like plastic wrap every time you exhale.you exhale.
Large amounts of energy /effort will be Large amounts of energy /effort will be required to simply re-expand the lungs and required to simply re-expand the lungs and allow you to inhale (allow you to inhale (IRDSIRDS))
![Page 33: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/33.jpg)
Alveolar Surface Tension ForcesAlveolar Surface Tension Forces
Surfactant – interferes with cohesion of Surfactant – interferes with cohesion of water molecules so less energy needed to water molecules so less energy needed to expand lungs – this is one of the things expand lungs – this is one of the things that keeps our lungs partially expanded at that keeps our lungs partially expanded at all times. (the other thing is the pressure all times. (the other thing is the pressure difference previously discussed)difference previously discussed)
Secreted by Type II cells in lungsSecreted by Type II cells in lungs
![Page 34: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/34.jpg)
Alveoli & Surface TensionAlveoli & Surface Tension
![Page 35: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/35.jpg)
IRDSIRDS – Infant Respiratory Distress – Infant Respiratory Distress SyndromeSyndrome
AKA: Hyaline AKA: Hyaline Membrane DiseaseMembrane Disease
Caused by lack of Caused by lack of surfactant due to surfactant due to prematurity prematurity
28 weeks of gestation is 28 weeks of gestation is consideredconsidered
![Page 36: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/36.jpg)
Nonrespiratory Air ManeuversNonrespiratory Air Maneuvers
Reaction or reflex responseReaction or reflex response
• Cough Cough
• Sneeze –travels up to 40 miles per hourSneeze –travels up to 40 miles per hour
• Hiccup – phrenic nerve irritation causes Hiccup – phrenic nerve irritation causes diaphragm to spasmdiaphragm to spasm
• Yawn – saturates alveoli with fresh airYawn – saturates alveoli with fresh airNeed for increased oxygenNeed for increased oxygen
![Page 37: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/37.jpg)
Control of BreathingControl of Breathing
NeuralNeural
Medulla oblongata sets rate of breathingMedulla oblongata sets rate of breathing
Pons fine-tunes rate and transition Pons fine-tunes rate and transition
![Page 38: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/38.jpg)
Hering-Breuer ReflexesHering-Breuer Reflexes
Stimulation is sentStimulation is sent
Inflation reflex- prevents overexpansion Inflation reflex- prevents overexpansion via receptors around bronchiolesvia receptors around bronchioles
Deflation reflex – inhibits expiratory centers Deflation reflex – inhibits expiratory centers and stimulates inspiratory centers. and stimulates inspiratory centers.
Receptors in alveolar wallsReceptors in alveolar walls
Usually during forced activityUsually during forced activity
![Page 39: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/39.jpg)
Control of Breathing Chemical Control of Breathing Chemical FactorsFactors
Central chemoceptors monitor pH levels in Central chemoceptors monitor pH levels in cerebrospinal fluid.cerebrospinal fluid.
High levels of CO2 increase hydrogen level in High levels of CO2 increase hydrogen level in blood – therefore pH decreases.blood – therefore pH decreases.
Peripheral chemoreceptors located in aorta and Peripheral chemoreceptors located in aorta and carotid arteries monitor blood oxygen level.carotid arteries monitor blood oxygen level.
Mechanoreceptors located in muscles and Mechanoreceptors located in muscles and joints detect muscle contraction and force joints detect muscle contraction and force increased ventilation.increased ventilation.
![Page 40: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/40.jpg)
Lung VolumeLung Volume
Static Lung VolumeStatic Lung Volume
Instructed to perform following breathing Instructed to perform following breathing maneuversmaneuvers
Tidal volume – amount inhaled during Tidal volume – amount inhaled during normal breathingnormal breathing
Vital capacity – breath in maximum, followed Vital capacity – breath in maximum, followed by maximum expirationby maximum expiration
![Page 41: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/41.jpg)
Lung VolumeLung Volume
Residual volume – Residual volume – volume of air that volume of air that never leaves the never leaves the lungslungs
Important for continual Important for continual gas exchangegas exchange
![Page 42: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/42.jpg)
Lung VolumeLung Volume
Dynamic Lung VolumeDynamic Lung Volume
![Page 43: Part II - Respiratory Physiology. 4 distinct events Pulmonary ventilation: air is moved in and out of the lungs External respiration: gas exchange.](https://reader036.fdocuments.in/reader036/viewer/2022062421/56649cb85503460f9497f406/html5/thumbnails/43.jpg)
End of Quiz #2 MaterialEnd of Quiz #2 Material