Ventilation (1)

Mechanisms of Breathing
Rehab Badi 2017
Ventilation

 The Process by which air moves in and out of the lungs

 Ventilation include two processes:

1. Inspiration
2. Expiration
Ventilation
 For gas molecules to move from one place to another
there must be a pressure gradient
 When the glottis is open Inspiration or expiration
depends on the difference between the :
 Atmospheric (ambient pressure)
 intrapulmonary (alveolar)
pressure
Ventilation
During quite respiration :
 Intra-pumonary pressure drop one mmHg below
atmospheric
 Intrapulmonary pressure = -1 mmHg 760 mm Hg
 Air moves in = Inspiration

 Intrapulmonary pressure rises

one mmHg above atmospheric 759
761 mm Hg
 Intrapulmonary pressure = +1 mmHg
Air moves out = Expiration
2
1.5
1
0.5
0.5
1
1.5
2
Volume changes During a single breath
Inspiration Expiration
2
1.5
+ 1
0.5
0.5
- 1
1.5
2
Pressure and Volume changes /single breath
Inspiration Expiration
2
1.5
+ 1
0.5
0.5
- 1
1.5
2
Pressure changes During a single breath
Inspiration Expiration
2
1.5
+ 1
0.5
0.5
- 1
1.5
2
 Ventilation
 Pressures in the respiratory system are compared to
atmospheric pressure (pressure at the mouth)

 If = atmospheric = zero
 If < atmospheric = negative value
 If >atmospheric = positive value
Ventilation
 For example:
1. If Alveolar pressure = +1 mmHg
2. That means the alveolar pressure is more than the
atmospheric by one mmHg
3. Atmospheric pressure = 760 mmHg
4. Alveolar pressure = 760 + 1 =761 mmHg

 What is the true value in mmHg of the intrapleural

pressure if it was equal to -2 mmHg ????
Ventilation
 During quite respiration the (1 mmHg ) pressure
difference result in the movement of 500 ml of air into
or out of the lung
= Tidal volume
 inspiration or expiration of larger volumes requires a
larger change in intrapulmonary pressure
Alveolar pressure and Ventilation

 If alveolar pressure was equal to atmospheric (zero):

there is no airflow

 If alveolar pressure was below atmospheric ( minus):

air moves from the outside into the alveoli
(inspiration)

 If alveolar pressure rises above atmospheric pressure

(+ve): air moves from the alveoli to the outside
(Expiration)
Q1: How is the variation in the
intrapulmonary pressure
Achieved ?
The relation between Pressure and Volume
of a gas
 In constant temperature:
 Increasing the volume, decrease the pressure
 Decreasing the volume, increases the pressure
1. Lung volume increases
2. Intrapulmonary pressure decreases
3. Inspiration

1. Lung volume decreases

2. Intrapulmonary pressure rises
3. Expiration
Q2: How is the Volume of the
lung Changed
 Different types of Pressures involved in
ventilation:
1. The pressure of the gas inside
the lung is the alveolar
pressure = Intrapulmonary
pressure

2. The pressure inside the

pleural cavity (around the
lungs ) is the
itra pleural pressure
 Different types of Pressures involved in
ventilation:
3. Transpulmonary pressure is the
difference between the alveolar
pressure and the intrapleural
pressure

 Distending pressure that keep the lung

inflated

 = Alveolar pressure – intrapleural

pressure

 Has to overcome the recoil forces of

the lung
 1. Atmospheric pressure : is the pressure of the air outside the
body = pressure at the mouth

2. alveolar pressure = Intrapulmonary

pressure

3. itrapleural pressure

4. Transpulmonary pressure
Mechanism of Ventilation
Q1: How is the intrapulmonary (alveolar) pressure changed
during breathing to achieve air movement (ventilation) ?
A: Changing the lung volume

Q2: How is the lung volume changed ?

A: By changing the trans-pulmonary pressure

Q3:How can we change the trans pulmonary pressure?

A: By Changing the volume of the intra pleural cavity
 By Changing the volume of the thoracic cavity
 During respiration the volume of the lung is increased
by making the intrapleural pressure more negative
(decreasing the intrapleural pressure)

 For example during quite breathing:

From -2.5
To -6
Decreasing the intra-pleural pressure is achieved by
increasing the size of the intrathoracic cavity

Contraction of the inspiratory muscles

Mechanism of Ventilation
 During breathing changes in intraalveolar pressure are
achieved by:
changes in the volume of the thoracic cavity and the
lungs
 Inspiratory muscles
Contraction of theses muscles increases
the volume of the intra- thoracic cavity

1-The diaphragm
2- External intercostal muscles
3- Accessory inspiratory muscles
 Scalene muscles
 Sternocleidomastoid muscles
 Alae nasi
 Muscles of expiration
 Contraction of theses muscles decreases the volume of the intra-
thoracic cavity
 Muscles of expiration:
1) Anterior abdominal
wall muscles:
2) Internal intercostal muscles
 Remember:

 Expiration is active only during exercise

and voluntary hyperventilation
 Steps involved in Inspiration
 During inspiration:

1. The size of the Thoracic cavity is increased by the

contraction of Inspiratory muscles
2. The intrapleural pressure becomes more negative (ex: -5
to -8 mmHg)
3. Increase the (distending pressure)
4. The lungs are pulled outward and increased in size
5. The pressure inside the lung decreases (zero to -1 mmHg)
6. Air moves in(inspiration)
Quite Expiration
Relaxation of the of inspiratory muscles leaves the lung
recoli unchallenged

The lung recolis inward

Size of the lung decreases
Itra-alveolar pressure increases
 Quite expiration
During quite expiration:
1. Inspiratory muscles relaxes
2. The intrathoracic cavity decrease
3. Intra pleural pressure becomes less negative
4. the lung recoil inward
5. The lung volume decreases
6. The alveolar pressure increases (from zero to +1 mmHg)
7. Air moves out (expiration)
8. The chest wall is pulled inward
 Quite expiration
During quite expiration:
 The outward recoil of the chest wall balances the inward
recoil of the lungs =End of expiration
 Both the lungs and the chest wall are at the resting volume
(equilibrium position)
 The volume of air in the end of normal expiration ( when the
lung recoil balances the chest recoil) is called
= The Functional residual capacity
Pressure and Volume changes /single breath
Inspiration Expiration
2
1.5
+ 1
0.5
0.5
- 1
1.5
2
 The Intrapleural pressure
 Intrapleural pressure is always negative
 It acts like a suction to keep the lungs inflated
 Negative intra-pleural pressure provide the positive
distending pressure acting on the lungs

Distending pressure =
Alveolar pressure – intrapleural pressure
A – ( - inP)
A + inP
Distending pressure (trans-pulmonary p. )is always
positive to overcome the lung recoil
Causes of the negative intrapleural pressure
Causes of the negative intrapleural pressure

1st: Inward recoil of the lung:

•The abundant elastic tissue in the lung tends to recoil and pull
the lung inward

As the lungs moves away from the thoracic

wall, the cavity becomes slightly larger and
the pressure decreases
Causes of the negative intrapleural pressure

2nd : Surface tension :

•The Surface tension of the alveolar fluid

tends to pull each of the alveoli inward
and therefore pull the entire lung inward

•Surfactant which is produced by type II

alveolar cells reduces this force
Causes of the negative intrapleural pressure
3rd : The out ward movement of the chest wall:
The arrangement of the rips in the chest wall tends to pull
the chest outward, away from the lungs

This outward movement of the chest

wall, further enlarge the pleural cavity and
creates the negative pressure
Why is the intra-pleural pressure negative ?

4- strong Lymphatic drainage

• The pleural fluid resists the actual

separation of the lungs and the chest
wall
 Effect of Pneumothorax

• Pneumothorax is : Air inside the pleural cavity

• Air can inter through a penetrating wound in the

chest wall
 Effect of Pneumothorax
 Air will move into the pleural space so that the intrapleural
pressure will be equal to atmospheric pressure
Effect of Pneumothorax

• Te lung will collapse

inward

• The chest wall will

springs outward in the
affected side
Thank you