.

(.)
( )



:

Guyton and Hall 2006

()

.

:
a.
(

)
()
. -


Guyton and Hall 2006

:
A. :
mm. intercostales externi (
)
mm. sternocleideomastoidei (
)
mm. serrati anteriores (
)
mm. scaleni (
)
. :
mm. intercostales interni (
)
mm. recti abdominis (


)
Guyton and Hall 2006

 (
):
-5 cmH2O
-7.5 cmH2O
(
):
-1 cmH2O
+1 cmH2O

(
)


( )

Guyton and Hall 2006

 ()

.

200
ml/cmH2O

:

.
()


.

110
ml/cmH2O
Guyton and Hall 2006



2/3

( !!!)

.

(
) :

()
(
) .
:
(dipalmitoilfosfatidil holin
)

(apoprotein)

Guyton and Hall 2006


( je
)

(2-3% BMR).
:
(
)

( )


Guyton and Hall 2006




.


.

Guyton and Hall 2006

(Tidal) (VT)


500 ml

(IRV)

oo 3000
ml

(ERV)


oo 1100 ml

(RV)


oo 1200
ml
Guyton and Hall 2006

Guyton and Hall 2006

(IC)
( oo 3500 ml)
:
IC = VT + IRV

(FRC)
( oo 2300 ml)
:
FRC = ERV + RV

(VC)
( oo 4600 ml)
:
VC = VT + IRV + ERV

(TLC)
( oo 5800 ml)
:
TLC = VT + IRV + ERV + RV TLC = VC + RV



1. (FRC)
.

2. (TLC)
:
TLC = FRC + IC

 (VD) (Christian Bohr je

1891. )


:




-



( )
.

oko 150 ml.
(MAV)

.

:
MAV = (VT - VD) x

Guyton and Hall 2006

( )

Guyton and Hall 2006


()

- oo 5 L/min (


1-2%
)
,
,
:
(
)
( 7
ml/mmHg)
:
: 25 mmHg
: 0-1 mmHg

Guyton and Hall 2006

 :
: 25mmHg
: 8mmHg
: 15mmHg
: 17mmHg
:
7mmHg

: 1-5 mmHg
( 2 mmHg)

Guyton and Hall 2006

 450 ml (
9% ).
70
ml (

).


50%
( ).


O2

(


)
(
) .

Guyton and Hall 2006


(
):

1
15 mmHg

2
( ,
)

3
8 mmHg

(
)

2 i 3.
(
)
(
700-800%,
200-300%).

Guyton and Hall 2006


(
4-7 ) :

( 3 )

( 2 )
a

( ).


(
).

25-30 mmHg



.
Guyton and Hall 2006

 (1)


(
):

(

)
7 mmHg

(
)

-8 mmHg

(
) 28
mmHg

-
(

)
(

) 14
mmHg
Guyton and Hall 2006

 (1)

- 1 mmHg.
:

Guyton and Hall 2006

(

)

(
-

)
( )
:

21
mmHg.


40-45
mmHg ( ).

Guyton and Hall 2006




.

(

)
:
medijastinum

( )
.
Guyton and Hall 2006


.

.
-
.

Guyton and Hall 2006




.


.

760 mmHg, :

N2 600 mmHg (79% 760 mmHg)

O2 160 mmHg (21% 760 mmHg)

 :
a.
. (
- )

():

(

1
760mmHg 101,3 kPa)


- .
- (D) :
P
A
S
d
MW

 * :
S MW
:
= S / MW

* P (
), A ( ) i d (
)

(
1):

Guyton and Hall 2006

Guyton and Hall 2006

2300 ml (FRC)

350 ml

1/7
( )

1/2
17
( )

,

pH.

Guyton and Hall 2006


(P2) :

( je P2
149 mmHg)


.

P2.

P2.
P2 104
mmHg.

Guyton and Hall 2006



(Pc2) :

(
Pco2 45 mmHg) .

Pco2.



Pco2.
Pco2 40
mmHg.

Guyton and Hall 2006

 ( 300
aa ):

( 0.2 mm)

Guyton and Hall 2006

Guyton and Hall 2006

 ():
1.
( )
2.
3.
4.

5.
6.

0.6m.

je 50-100 m2.
5m.

Guyton and Hall 2006


(

)
ml/min/mmHg.

21 ml/min/mmHg.
11 mmHg, -
230 ml/min.

400-500 ml/min/mmHg (???).
1 mmHg, .

( 3x):

/
Guyton and Hall 2006

 / (VA/Q) PO2 PCO2

VA/Q = 0 PO2 PCO2

VA/Q = PO2 PCO2

VA/Q = (
) PO2 104 mmHg PCO2 40 mmHg.

Guyton and Hall 2006


VA/Q ,
,

.
:
- .
-

.

( )

VA/Q ,


( ).
:
- ,
-

.

( )

Guyton and Hall 2001.



.

PO2 40 mmHg
PO2
104 mmHg



( )
:

:

(3x)

Guyton and Hall 2006

 PO2
:

PO2 40 mmHg

PO2
104 mmHg

PO2
95 mmHg (
)

PO2 95
mmHg

PO2
40 mmHg

(PO2 40 mmHg)

Guyton and Hall 2006

(PO2 95 mmHg)
(PO2 40 mmHg)

(PO2 40 mmHg) (PO2

23 mmHg)

Guyton and Hall 2006

 P2
:
PO2

PO2

P2 :

P2

P2

Guyton and Hall 2006

(PCO2 46 mmHg)
(PCO2 45 mmHg)

(PCO2 45 mmHg)
(PCO2 40 mmHg)

Guyton and Hall 2006

(PCO2 45 mmHg)

(PCO2 40
mmHg)

Guyton and Hall 2006


PCO2 :

PCO2

PCO2

PCO2 :

PCO2

PCO2

Guyton and Hall 2006

T :

97%
()

3%


:

PO2 Hgb
O2

PO2 Hgb
O2

:

PO2 95 mmHg
( )
Hgb 97%

PO2 40 mmHg (
) Hgb
75% (
)

PO2 40
mmHg
Hgb
( )
Guyton and Hall 2006

 200
ml O2 (150g Hgb
po 1.34 ml O2).

50 ml
( 97%
75%, PO2 95 mmHg
40 mmHg)
150 ml

(
25%).


50 ml/l .

1 l
150 ml
( 50 ml
,
75%)

Guyton and Hall 2006


(
Hgb O2):

(
Hgb O2):

CO2 (
)

DPG

(Christian Bohr (1855-1911),
1903-1904. , ,
Niels Bohr-a
Harald Bohr-a)

CO2 O2
H

CO2
O2

Guyton and Hall 2006

(
Hgb O2):

( Hgb
O2):
Guyton and Hall 2006





1-3 mmHg.

ADP.

Guyton and Hall 2006



.


.
250


(

)

Guyton and Hall 2006

70%
( ,
)
23%

7% (

)

40 ml
.

Guyton and Hall 2006

52 vol% ( )
48 vol% ( )
PCO2 40 mmHg ( )

Guyton and Hall 2006


(John Scott Haldane)
O2
CO2
( )
.
O2
CO2
:

,
,
CO2 CO2

a
H+



( ) CO2
.

: 50
vol%
CO2 PO2
(100 mmHg)
CO2
48 vol% (
CO2 100% - 2 4 vol%)

Guyton and Hall 2006


40 ml 50 ml
.

.
, :

1.00

0.7

,
0.825

Guyton and Hall 2006

 ( )


:

( n. tractus solitarii,
n.
vagusa n. glosofaringeusa
)

( )

ramp ()
,
2
3 (

)

Guyton and Hall 2006


(
n. ambiguus n.
retroambiguus)

(
,

)

(


)

(
n. parabrachialis)

Guyton and Hall 2006

 ??? (
)

(Hering-Breuer
inflation reflex),

n.
vagusa

1500 ml (
)
Guyton and Hall 2006

( CO2 i H )

(
)

(
, 0,2 mm
)

H ()

( H
)

CO2

,
,

H j
( )

CO2

(
)
Guyton and Hall 2006

 CO2 H

:

PCO2
35-60 mmHg (
)

pH
7.3-7.5 mmHg
(
)

(1/10 CO2)

PO2



PCO2
1-2
1/5
(
pH)
Guyton and Hall 2006

(
)

PO2
( 95 mmHg)

(
n. ilosofaringeusa)
( n. vagusa)

PCO2 pH


( PCO2 7x 5x

).

Guyton and Hall 2006

 PO2

( 95 mmHg)

O2



PCO2 (
).

PCO2

efekta PO2


.
PCO2, PO2 pH



.




.

Guyton and Hall 2006

20x

:




(
)

.
Guyton and Hall 2006







(

).





( ).






( )
.

Guyton and Hall 2006

"J-"
(


)
(
)
(
)

(

) ejn-Stoksovo
( )
Guyton and Hall 2006