I Made Muliarta

Anatomy Pulmonary
Review Ventilation

Respiratory System

Gas Respiration
Exchange Control

Gas Transport
 RESPIRATORY SYSTEM

Ventilation Diffusion Perfusion

Boyles law
Muscles involvement Daltons Law
Pressure Changes Henrys law Not all regions ventilated equally
(intrapulmonary and intrapleura)
Pulmonary and bronchial response
V/Q matching

Lung compliance
Factors influence
Surface tension
Surfactant gas exchange

Airway resistance

Lung Function Measurement

Some volumes can be measured
Lung capacities
Patern of the lung function
INTRODUCTION

Our cells need oxygen & produce carbondioxide

The respiratory system brings the needed O2
into and eliminate CO2
The blood transport these gases
Pulmonary Ventilation
Air entering adjusted to body temp., filtered,
almost completely humidified
(Silverthorn, 2001)
INTRODUCTION

The lung provide gas exchange surface separating blood

from the surrounding alveolar gaseous environment
Oxygen transfer simultaneously
Adults lung: 1 kg, 4-6 L, if spread out: 50-100 m2
(badminton court)
More than 300 million alveoli
INTRODUCTION
Alveoli:
Elastic thin walled
Membranous sacs
0,3 mm in diameter
Millions of short, thin walled
capillaries and alveoli lie side by side
Gases diffuse across the extremely
(Silverthorn, 2001)
thin barrier (0,3m)

(Cumings, 2003)
VENTILATION

Ventilation????
The function of ventilation: to maintain blood gases at their
optimum level
The Ventilation occurs due to pressure differences
respiratory muscles
lung elasticity, resistance
Two lungs shaped
balloons
Each lung sorrounded:
serous membrane
(visceralis and parietalis
pleurae)
Ventilatory system:
Conducting zone (conduct, humidification,
warming, filtration, vocalization, Ig
secretion)
Respiratory zone (gas exchange)
Inspired air held within conducting zone
referred to as dead air (dead space)
Anatomical Dead space (VD) is usually about
150 ml
Wasted ventilation:
Anatomical dead space
Alveolar dead space
Minute Ventilation/Minute Volume/Pulmonary
Ventilation

Gas moved in-out of the lungs 1 minute

Calculate: respiration rate per minute, volume each
breath (VT)
Alveolar Ventilation
Not all air inspired reaches the alveoli
Therefore, two values:
VE
VA
Alveolar Volume = VT VD
VA = (VT - VD)f

Ventilatory system:
Conducting zone (conduct, humidification, warming,
filtration, vocalization, Ig secretion)
Respiratory zone (gas exchange)
 VT = 500 ml
VD = 150 ml
f = 12 x/mnt
VA = 350 x 12
= 4200 ml/mnt

Mechanics of Breathing

Including:
The pressure differences that generate air flow
The respiratory muscles that effect these pressure
differences
Tissue properties that influence how easily the lungs
expand
 Mechanics of Breathing
Breathing: air moves into and out of the lung
It travels from regions of high air pressure to low air pressure
Relationship between Boyles law and ventilation
Lung volume is changed by muscles contraction and
relaxation
During quiet breathing: inspiration is an active process,
expiration is a passive process
Forced expiration and inspiration involve additional muscles
 Diaphragm and ext. int. m. contr.

Increasing the volume of thoracic cavity

Intrapleural pressure becomes more negative

Lung expand

Intrapulmonary pressure becomes negative

Air flows into the lung

 Diaphragm and ext. int. m. relax

Decreases Thoracic cavity volume

Intrapleural pressure becomes less negative

Lung recoils

Intraplulmonary pressure rises above atm. pressure

Air flows out of the lung

 SPIROMETRY
To assess lung function
SPIROMETRY
 Lung Volumes and Capacities
Some of these volumes can be measured using spirometry
Typical trace spirometer
 Patterns of Lung Function

Pattern Grade %FEV1/FVC %FVC

Normal 70 % 80 %

Mild 61-69% 80 %
Obstructive Moderate 45-60% 80 %
Severe 45% 80 %
Mild 70 % 66-79%
Restrictive Moderate 70 % 51-65%
Severe 70 % 50%

Combination < 70% < 80%

Elastic properties of the lung
Caused by:
Elastic fibres and collagen
Surface tension forces
Compliance: capacity to stretch
 Lung Compliance

Compliance is greatest at lower lung volumes and is

smallest at higher
difference in ventilation
Surface Tension and Surfactant

Lung elasticity depend on:

Elastic fibre
Surface tension
Surfactant:
Prevention of alveolar collapse
Increasing lung compliance
Prevention of transudation
Airway Resistance

Factors affecting airway resistance:

Lung volume
Bronchial smooth muscle tone
Altered airway calibre
Change in density and viscosity of inspired air