Regional Difference in Ventilation

By prof/Hala Salah

Regional difference in ventilation

Ventilation is the amount of gas moved in and out of a region irrespective to the initial volume of that region.

Regional difference in ventilation

In the upright position, the lungs under the effect of gravity are suspended in the thoracic cavity like a suspended slinky spring.
Slinky spring

Regional difference in ventilation

When this spring is freely suspended, it will be stretched mainly at the upper part .

Regional difference in ventilation

When it is pulled down, its length increases mainly in the lower part.

Regional difference in ventilation

In the standing position, the gravity pulls the lung down. This makes the IPP at the apex of the lung more negative than at the base. IPP at the apex -10cmH2O. At the base of the lung, IPP about -2.5 cmH2O . At the mid thoracic position.

Regional difference in ventilation

Apex of the lung
IPP more negative -10 cmH2O large expanding pressure Big resting volume and apical alveoli are more expanded

Base of the lung

IPP less negative -2.5 cm H2O Small expanding pressure Small resting volume and alveoli are less expanded

Small change in volume during inspiration

Large change in volume during inspiration

less ventilated under resting condition

more ventilation under resting condition

Regional difference in ventilation

In recumbent position ventilation of lower most part (posterior) exceeds that of the upper most part (anterior of the lung).
In the lateral position (subject on his side) the dependent lung is best ventilated.

Regional difference in ventilation

During exercise ventilation increases at the apex of the lungs and the regional difference between apex and base decreases.

Expired air 47mmHg

47mmHg

28mmHg
150 100

120mmHg
565mmHg

760mmHg

Causes of differences between atmospheric air and alveolar air

Alveolar air is only partially replaced by atmospheric air with each breath. O2 continuously diffuses from the alveolar air into the pulmonary blood.

Causes of differences between atmospheric air and alveolar air

CO2 continuously diffuses from the pulmonary blood into the alveoli. Dry atmospheric air that enters the respiratory passage is humidified even before it reaches the alveoli.

Diffusion

Diffusion
Is the exchange between alveolar and blood gases (O2 and CO2) through the alveolo-capillary membrane.

Respiratory Membrane

Diffusion
Diffusion through tissues is described by Fick's law which states that:
Surface area X solubility X Pressure gradient

D
Thickness x Sq Root M.wt

Factors affecting the rate of diffusion through respiratory membrane

1. Thickness of membrane:
The overall thickness =0.5 micron. Thickness increases in: 1. Pulmonary fibrosis 2. Pulmonary oedema

2. Surface area of the membrane

The surface area of the respiratory membrane is very large about 50-100 m2 in the normal adult. The surface area is decreased in:
1. Removal of one lung. 2. Emphysema .

3. Pressure gradient

46mmHg

100 mmHg

100mmHg

4. The diffusion coefficient

Depends on :
Solubility of gas in the membrane . Square root of its molecular weight.

A. The Solubility of the gas

It is calculated as the volume of the gas that dissolves in 1ml of the liquid. The greater the solubility of the gas in the fluid, the more the amount that is dissolved. CO2 Solubility is very high than for O2 i.e. the solubility of CO2 is 24 times greater than O2.

B.Square root of the molecular weight

Molecular weight of O2 32. Molecular weight of CO2 44.

The net result is that:

Diffusion coefficient for CO2 through the tissue sheet is about 20 times faster than O2.

Diffusion capacity of the Respiratory membrane

It is defined as:

The volume of a gas that diffuses through the membrane each minute with a pressure difference of 1 mmHg.

Diffusion capacity
Diffusion capacity for O2 At rest : 25 ml/min/mmHg. During exercise :65 ml/min/mmHg It decreases in lung diseases as in fibrosis. Diffusion capacity for CO2 At rest: 400 ml/min/mmHg. During exercise: 1200 ml/min/mmHg

Equilibration

Equilibration
It is the equalization of pressures of gases across respiratory membrane. Blood O2 tension and the alveolar O2 tension equalize in about 0.25 second (Equilibration time). In normal lungs blood travels along pulmonary capillaries in about 0.75 second (Transit time).

Po2=100mmHgp co2=40mmHg

alveolus

Po2=40 mmHg Pco2=46 mmHg

Po2=100 mmHg Pco2=40mmHg

capillary
100

40

46
40
0.25

0.75

Equilibration
There is about 0.5 sec with no increase in O2 content, this time provides safety margin . It ensures an adequate O2 uptake during periods of stress e.g. during exercise as the circulation is fast .

Transit time during exercise

For CO2
Diffusion of CO2 is more rapidly than O2 but the whole equilibration for CO2 is the same as that for O2 (0.25 sec) because:1. The reactions releasing CO2 from blood is relatively slow. 2. The pressure gradient driving CO2 from blood to alveolus is only 6 mm Hg ,while that driving O2 in the opposite direction is 60 mm Hg.