Biology 336 - Human Physiology

Lecture 32 Friday, December 3rd, 2012

Factors affecting pulmonary ventilation Reading: Widmaier, 12th Ed. Chapter 13 Pages 443 - 448

Learning objectives
At the end of this lecture, you will be able to:
1) Describe the contributions of lung elasticity and surfactants upon lung compliance. 2) List and describe the factors that affect airway resistance. 3) Differentiate between an obstructive and a restrictive pulmonary disorder based on changes in lung capacity. 4) Contrast minute ventilation with alveolar ventilation.

Two factors affect pulmonary ventilation:

1) Lung compliance lungs are elastic and recoil
after being stretched. Compliance is a measure of the ease with which they can be stretched.

2) Airway resistance refers to the resistance of the

entire system of airways in the respiratory tract.

1) Lung compliance is defined as the change in lung volume (V) that results from a given change with transpulmonary pressure (Palv Pip) Ease in which lungs can be stretched V (Palv Pip)

Lung compliance =

Having larger lung compliance is advantageous because:

- A smaller change in transpulmonary pressure needed to bring in a given volume of air. - Thus less work or muscle contraction is required.

Factors affecting lung compliance

a) Elasticity the lungs are elastic because of the presence of
elastic connective tissue fibers. Forces exerted by these elastic fibers generally oppose lung expansion since as the lungs stretch, the fibers tend to recoil. More elastic less compliant Emphysema results in the destruction of elastin fibers normally found in lung tissue. As a result, the lungs exhibit high compliance and stretch easily during inspiration; however they do not recoil to their resting position during expiration.

Factors affecting lung compliance

b) Surface tension of a liquid is a measure of the work required
to increase its surface area by a certain amount. The greater the surface tension, the more work needed to spread the fluid out.

Surface tension of lungs is created by the air-liquid interface

formed by the thin layer of fluid lining the internal surface of the alveoli. As lung tissue expands, work is required not only to stretch the elastic tissue but also to increase the surface area of the fluid layer. Greater tension less compliant

Pulmonary surfactant (surface active agents) decreases the surface tension in alveoli.
Surfactant is a detergent secreted from type II alveolar cells that decreases surface tension by interfering with hydrogen bonding between water molecules. Surfactant increases lung compliance making inspiration easier. If surface tension were equal between two alveoli sharing a duct, the pressure would be higher in b, and air in b would move to the region of lower pressure in a causing b to collapse.

Surfactant stabilizes alveoli of different sizes by differentially altering surface tension allowing the alveoli to have the same pressure.

Babies who are born prematurely can develop newborn respiratory distress syndrome (NRDS).
Normally, surfactant synthesis begins about the 25th week of fetal development and reaches adequate levels by the 34th week, about 6 weeks before normal delivery. In addition to having stiff (lowcompliance) lungs, too little surfactant allows the alveoli to collapse and then they have to re-inflate every time. This is a huge energy drain. Treatment includes administration of steroid hormones to help stimulate surfactant production, aerosol administration of artificial surfactant, and artificial ventilation.

2) Airway resistance is the second major factor influencing the work of breathing.
The effect of airway resistance on breathing:
When resistance increases, a larger pressure gradient is required to produce a given rate of air flow.

Consider the following:

1. What three parameters contribute to resistance to flow? 2. Based on what you know about resistance in the circulatory system... ...or from personal experience ...make a list of all of the factors you can think of that increase airway resistance.

3. In a normal person, what contributes more to the work of breathing: airway resistance or lung and chest wall elastance?

Three parameters contribute to resistance (R): the systems length (L), the viscosity of the substance flowing through the system (), and the radius (r) of the tubes in the system. 1. 8L Resistance (R) = r4 2.

3. In healthy lungs, resistance to

air flow into and out of the lungs is low, because the radii of the tubes in the conducting zone are large and, in the respiratory zone, the total crosssectional area of the smaller tubes increases due to extensive branching. Consequently, lung and chest wall elastance provides more of the work of breathing.

The bronchioles have a total cross sectional area about 2000 times that of the trachea and do not normally contribute significantly to airway resistance.
The bronchioles, however, are collapsible tubes and a decrease in their diameter (bronchoconstriction) can contribute significantly to their resistance. Bronchioles, like arterioles, are subject to reflex control by the autonomic nervous system and by hormones. Most minute to minute changes occur in response to paracrines. For example, the paracrine signal Histamine acts as a powerful bronchoconstrictor. Histamine is released by mast cells in response to tissue damage or contact by allergens.

3. Respiratory volumes and capacities

Spirometry is a technique for measuring the volumes of inspired and expired air using a device called a spirometer. An individual breathes into and out of a tube connected to a transducer that converts the volume of air to an electrical signal proportional to the volume. Using spirometry, three of the four nonoverlapping lung volumes that together make up the total lung capacity can be directly measured, including: tidal volume, inspiratory, and expiratory reserve volumes.

The 4 nonoverlapping lung volumes.

Inspiratory reserve volume (IRV): the maximum volume of air that can be inspired from the end of a normal inspiration (ave. IRV = 3000ml) Tidal volume (VT): the volume of air that moves into and out of the lungs during a single, unforced breath (ave. VT = 500ml) Residual volume (RV): the volume of air remaining remaining in the lungs following a maximal expiration (ave. RV = 1200ml). Expiratory reserve volume (ERV): the maximum volume of air that can be expired from the end of a normal expiration
(ave. ERV = 1000ml)

Lung capacities are sums of two or more of the lung volumes.

Use of spirometry to measure lung volumes and calculate lung capacities can differentiate between obstructive and restrictive pulmonary disorders.

Use of spirometry to measure lung volumes and calculate lung capacities can differentiate between obstructive and restrictive pulmonary disorders.
Restrictive pulmonary diseases involve an interference with lung expansion. Obstructive pulmonary diseases involve increases in airway resistance. In these cases, residual volume increases because an increase in resistance makes both expiration and inspiriation difficult. For egchronic obstructive pulmonary disease (COPD) refers to a combination of two lung diseases, chronic bronchitis and emphysema. The lungs become overinflated and ultimately the functional residual capacity and total lung capacity increase.

Restrictive disorders often involve structural damage to the lungs, plura, or chest wall that decrease the total lung capacity and vital capacity.

4. Minute ventilation is greater than alveolar ventilation because of dead space

Minute ventilation (ml/min) Tidal x volume (ml/breath) 500 ml/breath Respiratory rate (breath/ min) x 12 breath/min

6000 ml/min =

Note only a fraction of this air is available for exchange with the blood. The air that remains in the upper airways does not get to the alveoli. The upper airways are thus referred to as dead space. The upper conducting airways have a volume of ~150ml, therefore the volume of fresh air reaching the alveoli (or the alveolar ventilation) is:

4200 ml/min =

350 ml/breath

12 breath/min

Dead space filled with fresh air

150 mL

Ventilation
1 1

End of inspiration

2700 mL

RESPIRATORY CYCLE IN ADULT

KEY

PO2 = 150 mm Hg (fresh air) PO2 ~ 100 mm Hg (stale air) ~

Figure 17-14, step 1

Dead space filled with fresh air

150 mL

Ventilation
2700 mL 1

The first exhaled air comes out of the dead space. 1 End of inspiration Only 350 mL leaves the alveoli. 2 Exhale 500 mL (tidal volume)

RESPIRATORY CYCLE IN ADULT

150 mL

2200 mL

KEY

PO2 = 150 mm Hg (fresh air) PO2 ~ 100 mm Hg (stale air) ~

Figure 17-14, steps 12

Dead space filled with fresh air

150 mL

Ventilation
2700 mL 1

The first exhaled air comes out of the dead space. 1 End of inspiration Only 350 mL leaves the alveoli. 2 Exhale 500 mL (tidal volume)
3 At the end of expiration, the dead space is filled with stale air from alveoli.

RESPIRATORY CYCLE IN ADULT

Dead space filled with stale air
150 mL

150 mL

2200 mL

KEY

PO2 = 150 mm Hg (fresh air) PO2 ~ 100 mm Hg (stale air) ~ 3

2200 mL

Figure 17-14, steps 13

Dead space filled with fresh air

150 mL

Ventilation
2700 mL 1

Atmospheric air Dead space is filled with fresh air. Only 350 mL of fresh air reaches alveoli The first 150 mL of air into the alveoli is stale air from the dead space.
150 350 150 2200 mL 4

The first exhaled air comes out of the dead space. 1 End of inspiration Only 350 mL leaves the alveoli. 2 Exhale 500 mL (tidal volume)
3 At the end of expiration, the dead space is filled with stale air from alveoli.

RESPIRATORY CYCLE IN ADULT

Dead space filled with stale air
150 mL

150 mL

2200 mL

Inhale 500 mL of fresh air.

KEY

PO2 = 150 mm Hg (fresh air) PO2 ~ 100 mm Hg (stale air) ~ 3

2200 mL

Figure 17-14, steps 14

Dead space filled with fresh air

150 mL

Ventilation
2700 mL 1

Atmospheric air Dead space is filled with fresh air. Only 350 mL of fresh air reaches alveoli The first 150 mL of air into the alveoli is stale air from the dead space.
150 350 150 2200 mL 4

The first exhaled air comes out of the dead space. 1 End of inspiration Only 350 mL leaves the alveoli. 2 Exhale 500 mL (tidal volume)
3 At the end of expiration, the dead space is filled with stale air from alveoli.

RESPIRATORY CYCLE IN ADULT

Dead space filled with stale air
150 mL

150 mL

2200 mL

Inhale 500 mL of fresh air.

KEY

PO2 = 150 mm Hg (fresh air) PO2 ~ 100 mm Hg (stale air) ~ 3

2200 mL

Figure 17-14

Consider the following:

During a time of increased oxygen demand such as during exercise, alveolar ventilation must also increase. Which of the two strategies below would be the most efficient method to increase alveolar ventilation? 1) Increase tidal volume 2) Increase respiration rate