Respiratory Physiology

Chapter 16

Objectives of Chapter 16
To understand the: Structure and function of the lungs

Mechanics of breathing

Assessment of pulmonary function

Principles of gas exchange

Respiration
Encompasses 3 related functions:
Ventilation: breathing Gas exchange: occurs between air and blood in the lungs and between the blood and body tissues Oxygen utilization: cellular respiration

Ventilation: External respiration ventilation moves air in and out of lungs for gas exchange with blood Internal respiration gas exchange between the blood and other tissues, and O2 use by tissues
Gas exchange is passive via diffusion

Structures of Respiratory System

Inhaled air passes from pharynx larynx trachea right and left bronchi bronchioles terminal bronchioles respiratory bronchioles alveoli

Pharynx and Larynx

Air enters the trachea from the pharynx
Air must enter or leave trachea and lungs thru the glottis between the vocal folds ventricular and vocal folds are part of the larynx (voice box)

Structure of Respiratory System

Respiratory zone region of gas exchange occurs only in respiratory bronchioles and the terminal alveoli sacs Conducting zone airways that conduct air to the respiratory zone

Lung Alveoli and Pulmonary Capillaries

Gas exchange occurs across the 300 million alveoli (6080 m2 total surface area) Alveolus one cell-layer thick Total air-blood barrier only 2 thin cells across
Between lung air and blood: 1 alveolar cell and 1 endothelial cell

EM of a Capillary within the Alveolar Wall

Alveoli
Polyhedral in shape clustered at ends of respiratory bronchioles, like units of honeycomb
Air in 1 cluster can pass to others through pores

2 types of alveolar cells

Type I: comprise 95 97% of total surface lung area
Primarily where gas exchange occurs Diffusion distance between blood and air as little as 0.3 m

Type II: secrete pulmonary surfactant and reabsorb Na+ and H2O
Prevents fluid buildup within the alveoli

SEM of Lung Tissue

A small bronchile passes between many alveoli Arrow indicating an alveolar pore
air can pass from one cluster to another

Tensile strength of alveolar wall provided by fused basement membranes (collagen) of the capillaries and alveolar walls

Conducting Zone
Warms and humidifies inspired air reaches respiratory zone at 37 C Mucus lining filters and cleans inspired air mucous moved by cilia to be expectorated

Thoracic Cavity
Created by the diaphragm contains heart, large blood vessels, trachea, esophagus, thymus, and lungs Abdominopelvic cavity below the diaphragm contains liver, pancreas, GI tract, spleen, and genitourinary tract

Physical Aspects of Ventilation

Ventilation results from pressure differences induced by changes in lung volumes
Air moves from higher to lower pressure Compliance, elasticity, and surface tension of lungs influence ease of ventilation

Intrapulmonary and Intrapleural Pressures

Visceral and parietal pleurae normally adhere to each other so that lungs remain in contact with chest walls
And expand and contract with thoracic cavity Intrapleural space contains a thin layer of lubricating fluid

Intrapulmonary and Intrapleural Pressures

During inspiration, intrapulmonary pressure is about -3 mm Hg pressure; during expiration is about +3 mm Hg Positive transmural pressure (intrapulmonary minus intrapleural pressure) keeps lungs inflated

Boyle s Law (P = 1/V)

Implies that changes in intrapulmonary pressure occur as a result of changes in lung volume
Pressure of a given quantity of gas is inversely proportional to its volume

Increase in lung volume during inspiration decreases intrapulmonary pressure to subatmospheric levels
air therefore goes in

Decrease in lung volume raises intrapulmonary pressure above that of the atmosphere
Expelling air from the lungs

Changes in lung volume occur as a consequence of changes in thoracic volume

Physical Properties of the Lungs

In order for inspiration to occur lungs must be able to expand when stretched Lung compliance how easily lung expands with pressure Lung compliance is defined as the change in lung volume per change in transmural pressure ((V/(P) Compliance is reduced by factors that cause resistance to distension

Elasticity
For expiration to occur, lungs must get smaller when tension is released Elasticity tendency to return to initial size after distension
Due to high content of elastin proteins

Elastic tension increases during inspiration and is reduced by recoil during expiration

Surface Tension (ST)

And elasticity forces that promote alveolar collapse and resist distension Lungs secrete and absorb fluid (antagonistic processes), normally leave a very thin film of fluid on alveolar surface
Fluid absorption occurs by osmosis driven by Na+ active transport Fluid secretion is driven by active transport of Cl- out of alveolar epithelial cells This film causes ST because H20 molecules are attracted to other H2O molecules ST acts to collapse alveoli; thus increasing pressure of air within alveoli

Surface Tension
Law of Laplace states that pressure in alveolus is directly proportional to ST; and inversely to radius of alveoli
Thus, pressure in smaller alveoli would be greater than in larger alveoli, if ST were same in both Greater pressure of smaller alveolus would cause it to its empty air into the larger one

Surfactant
Consists of phospholipids secreted by Type II alveolar cells Lowers ST by getting between H2O molecules at the water-air interface
Reducing their ability to attract each other via hydrogen bonding As a result the ST of thhe alveoli is negligible

Surfactant
Prevents ST from collapsing alveoli Surfactant secretion begins in late fetal life Premies are often born with insufficient surfactant = Respiratory Distress Syndrome or RDS
Have trouble inflating lungs

In adults, septic shock (fall in BP due to widespread vasodilation) as a result of a systemic infection
Inflammation increases capillry and alveolar permeability leading to accumulation of protein-rich fluid in the lungs may cause acute respiratory distress syndrome (ARDS) which decreases compliance and surfactant secretion

Mechanics of Breathing
Pulmonary ventilation consists of inspiration (inhalation) and expiration (exhalation) Accomplished by alternately increasing and decreasing volumes of thorax and lungs

Quiet Breathing
Inspiration occurs mainly because diaphragm contracts, increasing thoracic volume vertically Parasternal and external intercostal contraction contributes a little by raising ribs
increasing thoracic volume laterally

Expiration is due to passive recoil

Deep Breathing
Inspiration involves contraction of extra muscles to elevate ribs: scalenes, pectoralis minor, and sternocleidomastoid Expiration involves contraction of internal intercostals and abdominal muscles

Mechanics of Pulmonary Ventilation

During inspiration, intrapulmonary pressure is lower while During expiration it is greater than atmospheric pressure

Table 16.4 Ventilation Terminology

Pulmonary Function Tests

Spirometry method that measures volumes of air moved during inspiration and expiration
Subject breathes in a closed system Air is trapped within a light plastic bell floating in water Bell moves up with exhalation and down with inhalation Movements of the bell cause movement os a pen that traces a record of the breathing (spirogram)

Anatomical dead space is air in conducting zone where no gas exchange occurs

Pulmonary Function Tests

Tidal volume amount of air expired/breath in quiet breathing Vital capacity amount of air that can be forcefully exhaled after a maximum inhalation = sum of inspiratory reserve, tidal volume, and expiratory reserve