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PHYSIOLOGY
Dr. Arif santoso, Sp.P, Ph.D, FAPSR
Lecture Outline
Gas Laws
Ventilation
Diffusion & Solubility
Gas Exchange
Lungs
Tissues
Atmosphere to blood
Blood to tissues
Regulation of pH
Dependent on rate of CO2 release
Protection
Vocalization
Synthesis
What is respiration?
Respiration = the series of exchanges that
synthesis
External Respiration
Internal Respiration
ventilation
& Membranes
well
Tree
conductive tube
The lower respiratory tract starts after the larynx and divides
again and againand again to eventually get to the smallest
regions which form the exchange membranes
Trachea
Primary bronchi
Secondary bronchi
Tertiary bronchi
conductive portion
Bronchioles
Terminal bronchioles
Respiratory bronchioles with
exchange portion
respiratory tract?
Warm
Humidify
Filter
Vocalize
of the upper
Raises
incoming air to
37 Celsius
Raises
incoming air to
100% humidity
Forms
mucociliary
escalator
Protection
Free alveolar macrophages (dust cells)
Surfactant produced by type II alveolar cells (septal
cells)
network results in
anatomy
Respiratory Physiology
Gas Laws
Respiratory Physiology
Gas Laws
Daltons Law
Law of Partial Pressures
each gas in a mixture of gases will exert a pressure
atmospheric gas
- PO2 = 760mmHg x 21% (.21) = 160 mm Hg
Respiratory Physiology
Gas Laws
Gradient sizes
Diffusing molecule sizes
Temperature
concern?
Respiratory Physiology
Gas Laws
Boyles Law
Describes the relationship between pressure and
volume
the pressure and volume of a gas in a system are
inversely related
P1V1 = P2V2
Respiratory Physiology
Gas Laws
pressure goes up
Respiratory Physiology
Gas Laws
Do we care?
Respiratory Physiology
Gas Laws
Ventilation
Terminology
Inspiration = the movement of air into the respiratory tracts
Cause of Inspiration?
Biological answer
Contraction of the inspiratory muscles causes an increase in the
thoracic cavity size, thus allowing air to enter the respiratory tract
Physics answer
As the volume in the thoracic cavity increases (due to inspiratory
muscle action) the pressure within the respiratory tract drops below
atmospheric pressure, creating a pressure gradient which causes
molecular movement to favor moving into the respiratory tract
Cause of Expiration?
Ventilation
Besides the
diaphragm (only
creates about
60-75% of the
volume change)
what are the
muscles of
inspiration &
expiration?
Ventilation
Ventilation
Ventilation
Ventilation
Inspiration
Occurs as alveolar pressure drops below atmospheric
pressure
For convenience atmospheric pressure = 0 mm Hg
A (-) value then indicates pressure below atmospheric P
A (+) value indicates pressure above atmospheric P
At the start of inspiration (time = 0),
atmospheric pressure = alveolar pressure
Ventilation
Expiration
Occurs as alveolar pressure elevates above
Ventilation
gradient
Ventilation
Things to consider
surfactant effect
airway diameter
Minute volume respiration (ventilation rate times
rates
Ventilation
Ventilation
Airway diameter
& other factors
that affect airway
resistance?
Ventilation
The relationship between minute volume (total pulmonary ventilation)
and alveolar ventilation & the subsequent mixing of air
Next Time
Gas exchange
Gas transport in blood
Regulation of pulmonary function
DIFFUSION OF
GASES
Objectives
perfusion limitation
Describe the diffusion of oxygen from the alveoli
into the blood
Describe the diffusion of CO2 from blood to alveoli
Define diffusing capacity and discuss its
measurement
Airway Branching
Trachea
Main Bronchi
Lobar Bronchus
Segmental Bronchus
3-4
Bronchioles
5-15
Terminal Bronchioles
16
Resp. Bronchioles
17-19
Alveolar Ducts
20-22
Alveolas Sacs
23
reaching a delta.
Source: Undetermined
molecules in alveolus.
Diffusion
individual gases.
Source: Undetermined
Alveolar Epithelium
Diffuses/Dissolves
Alveolar Interstitium
Diffuses/Dissolves
Capillary Endothelium
Diffuses/Dissolves
Plasma
Diffuses/Dissolves
Hemoglobin
Diffusivity
D Solubility/MW
Diffusion Across a
Membrane
Limitations of Gas
Transfer
Diffusion Coefficient.
Different gases behave differently.
Carbon
monoxide
N2O is Perfusion
Limited
N2O is very soluble in biological tissues and
diffuses rapidly.
PcN2O rises rapidly in the alveolar capillary
Quickly have PcN2O =PAN2O.
Because there is no pressure gradient, no
diffusion occurs after about 0.1 sec.
Fresh blood entering the capillary has not
yet equilibrated and can still take up N2O.
Increased blood flow will increase gas
transfer
Transfer of N2O is perfusion limited.
Carbon
Monoxide
Transfer of Oxygen
Transfer of Oxygen
Transfer of CO2
Is transfer of
CO2 diffusion
or perfusion
limited?
Transfer of CO2
Why is the transfer of CO2 so similar to that of
O2?
( AxD)
Vgas
x P1 P 2
T
Vgas = volume of gas diffusing through
the tissue barrier per time, in ml/min
A = surface area available for diffusion
D = diffusion coefficient of the gas (diffusivity)
T = thickness of the barrier
P1 P2 = partial pressure difference of the gas
(AxD)/T = diffusing capacity of the lung (DL)
Diffusing Capacity
Measuring Diffusing
Capacity
Choice of gas:
Readily available.
Easily measured.
Diffusion limited.
No arterial partial pressure.
DLO2 =
VO
2
(PA O2 PC O2 )
CO binds avidly to
hemoglobin.
Carbon
Monoxide
V CO
DLCO
PACO PcCO
PcCO 0
V CO
DLCO
PACO
Normal DLCO = 20-30 ml/min/mmHg
1
1
1
DL Dm xVc
AxD
DLCO
T