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Muscles of respiration Elastic properties of lung and chest wall Compliance Elastic recoil Airway resistance Dynamic compression of airways Work of breathing

Muscles of respiration
Inspiration : requires generation of a negative pressure within alveolus Active process Quiet breathing at rest 1 Diaphragm 1. Di h 2. External intercostal muscles

Exercise or airway obstruction or weakness of diaphragm etc.

use accessory muscles of inspiration for generation of negative p.

rib 1 & 2 :sternocleidomastoid sternum

:scalene

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Expiration
1. Normal expiration Passive process :Elastic recoil of lung & thoracic 2. Forced expiration eg. exercise, cough Contraction of p y muscle expiratory - Internal intercostal muscle - Abdominal muscles (external abdominal oblique, internal abdominal oblique, transversus abdominis, rectus abdominis)

Elastic property of lung and thoracic Equilibrium position of chest wall and lung

FRC
(TV)

RV

TLC

(TV)

RV

TLC

TLC = total lung capacity, TV = tidal volume, FRC = functional residual capacity, RV = residual volume

Resting position of chest wall (lung volume 75% of TLC)

Resting position of respiratory system (FRC)

Resting position of lung (lung volume <RV)

Trasmural pressure = Pinside - Poutside + Transmural pressure Transmural pressure Transmural pressure 0

Transpulmonary pressure = Pairway/Ptrachea Ppl (Clinic) Palv = Pairway/Ptrachea at the beginning or end of each normal breath

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Events involved in a normal tidal breath

Exp

Exp

Expiration
1. Brain ceases inspiratory command 2. Inspiratory muscle relax *3. Thoracic volume decreases, causing Ppl to become less negative and decreasing the alveolar transmural pressure gradient *4. Decreased alveolar transmural p. gradient allows the increased alveolar elastic recoil to return the alveoli to their preinspiratory volumes *5. Decreased alveolar volume increases alveolar p. above atmospheric p., thus establishing a pressure gradient for airflow 6. Airflows out of the alveoli until alveolar p. equilibrates with atmospheric p.
*3-5 occur simultaneously

Inspiration
1. Brain initiates inspiratory effort 2. Nerves carry the inspiratory command to the inspiratory m. 3. Inspiratory muscles contract *4. Thoracic volume increases becomes more negative *5. Intrapleural p. become more negative *6. Alveolar transmural pressure gradient increases *7. Alveoli expand. This increases alveolar elastic recoil *8. Alveolar p. falls below atmospheric p. as the alveolar volume increases 9. Air flows into the alveoli until alveolar p. equilibrates with atmospheric p. *4-8 occur simultaneously

Ppl elastic recoil

Ppl pulmonary resistance

Lung compliance
Compliance : C=V/P
lungs are expandedfrom complete collapse to total lung capacity (in vitro)

Static lung compliance: measure of change in volume & pressure of lung when no flow

Compliance is greatest at lower lung volume and is smallest at higher lung volumes Hysteresis surface tension
Dynamic lung compliance: measure of change in volume & pressure of lung during breathing

Transmural pressure

PIN

Compliance/Distensibility Elastic recoil

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Lung compliance : Pulmonary fibrosis : Atelectasis : Alveolar edema : Pneumothorax, pleural effusion (Ppl ) Lung compliance : Emphysema : Chest wall compliance : Kyphoscoliosis : Obese people
Compliance of respiratory system 1/total compliance = 1/lung compliance + 1/chest wall compliance Normal value near FRC 0.1 L/cmH2O = 1/0.2 + 1/0.2 L/cmH2O

Elastic recoil
Elastic recoil 1. Elastic property (elastin & collagen) 2. (surface tension) Surface tension
: cohesive force between molecules of liquid at any gas-liquid interface or air-fluid interface : causes a liquid to shrink to form smallest s a est poss possible b e surface su ace area a ea : constant and not dependent on area of air-fluid interface : surface tension acts to pull surface inwards : positive pressure within bubble to expand it to prevent it from collapse

Role of surface tension forces in elastic recoil of lung

No surface tension No hysteresis Elastic recoil is due only to elastic property of lung tissue itself

Relationship between pressure inside and wall tension of alveolus

Laplaces law Pressure (dyn/cm2) = 2 x tension (dyn/cm) radius (cm)

Elastic recoil is due to elastic property of lung tissue & surface tension

P1 > P2

Smaller alveoli tend to collapse into larger one Collapsed alveoli require very great distending pressures to reopen
Pressure-volume curves for excised cat lungs inflated with air or saline

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Pulmonary surfactant
Consisting of about 85-90% lipids and 10-15% proteins Main lipid component is dipalmitoyl phosphatidylcholine (DPPC)

2. (alveolar stability)
B A

Smaller alveoli have lower surface tension

1. elastic recoil of the lung, lung compliance

inspiratory work of breathing

, collapse atelectasis

3. : surface tension tends to suck fluid from pulmonary capillaries and facilitates accumulation of fluid in alveolar space : surfactant minimize transdution of fluid from pulmonary capillaries

Alveolar stability
Factors 1. Pulmonary surfactant p 2. Structural interdependence
Middle alveolus begin to collapse, it would increase the stresses on the walls of the adjacent alveoli, which would tend to hold it open

surfactant

compliance ,

atelectasis t l t i , transudate fluid pulmonary edema

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Air flow Pulmonary resistance

1. Pulmonary tissue resistance (20%) : frictional resistance of lung and chest wall tissues as they move against each other during lung expands : pulmonary fibrosis 2. Airway resistance; Raw (80%) : resistance of airways to airflow : airway obstruction
Driving pressure airflow

V = P/R

Chief site of airway resistance

Re (Reynolds number) Re = 2rvd/ r = radius v = velocity of gas d = density of gas = viscosity of gas Re < 1,000 (laminar flow) 1,000 < Re < 1,500/2,000 (transitional flow) Re > 1,500/2,000 (turbulent flow)
= Pr4/8l V 10% Raw small airway ( < 2 mm.) silent zone Medium-sized bronchi
Tube in parallel, 1/Rtot = 1/R1+1/R2+1/R3 25-40% of Raw upper airway Tube in series, Rtot = R1+R2+R3

R = 8l/r4

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Dynamic compression of airways

Dynamic compression of airways if no cartilage

Palv = Ppl + Pel Pel = elastic recoil p. (Pel at lower lung volumes

EPP small airway & radial traction airway collapse

airway closure lung volume (elastic recoil )

Equal pressure point (EPP) airway collapse closing volume

closing volume

(work of breathing)
= V x P
V = Volume change is volume of air moved into and out of lung P = Pressure change is transpulmonary pressure necessary to overcome elastic work of breathing & resistive work of breathing Elastic recoil : elastic work pulmonary fibrosis, loss of pulmonary surfactant Tissue & airway resistance : pulmonary fibrosis Pulmonary resistance : airway obstruction