M.A.

Lung/PHYO2202//Respiration/15-16

MECHANICS OF BREATHING

When the respiratory system is totally relaxed, i.e. at the end-expiratory position, the lungs tend to
recoil inwards and the chest-wall tends to recoil outwards.

Recoil pressure of the lungs

The larger the lung volume, the greater the lung recoil pressure. At the level of total lung capacity,
lung recoil pressure is maximal.

1. Origin of lung recoil pressure

i. elasticity of the lung tissues (1/3).
ii. surface tension of the fluid lining the alveoli (2/3).

2. Surfactant - a protein-carbohydrate-phospholipid complex produced by cells (Type II and/or

Clara cells) lining the alveoli.
i. physiological advantages: it lowers the surface tension force, decreases work of breathing
and prevents the transudation of fluid into the alveoli.
ii. consequences of loss of surfactant: stiff lungs, areas of collapse and alveoli filled with
transudate (Infant Respiratory Distress Syndrome or Hyaline Membrane Disease).

Recoil pressure of the chest-wall

The chest-wall has a volume of about 60% vital capacity (VC) in its relaxed position. When
chest-wall is compressed to residual volume (RV), it tends to recoil outwards to its resting position.
When chest-wall is expanded to total lung capacity (TLC), it tends to recoil inwards to its resting
position.

Mechanical relationship between the lung and chestwall

When muscles of respiration are relaxed and the glottis kept open, the chest will take a
position, i.e. end-expiratory position (EEP), which is about 35% VC. The volume of air remaining
in the lungs is the functional residual capacity (FRC). No energy is required to maintain this
position. In order to exhale beyond EEP, one has to expand energy to overcome the outward recoil
of the chest-wall. In order to inhale beyond the EEP, one has to expand energy to overcome the
inward recoil of the lungs, but is helped by the outward recoil of the chest-wall. In order to inhale
beyond 60% VC, extra energy is required because the chest-wall is now recoiling inwards.

Learning objectives:

You should now be able to:

1. state the determinants of the elastic recoil of the lungs and which is most important.
2. state the function of surfactant and the consequence of its deficiency.
3. understand the mechanical relationship between the lung and chestwall.
4. explain why EEP is considered as the natural position of the respiratory system.

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 M.A. Lung/PHYO2202/Respiration/15-16

COMPLIANCE

Complinace is defined as the volume change per unit change in distending pressure (L/cm H2O). It
is the reciprocal of elasticity or elastance. For example, stiff lungs have a low compliance but a high
elasticity.

Principles of measurement of compliance

1. Total compliance = change in volume

change in alveolar-ambient pressure gradient

2. Pulmonary compliance = change in volume

change in alveolar-pleural pressure gradient

3. Chest-wall compliance = change in volume

change in pleural-ambient pressure gradient

All measurements being made at the time of zero flow at the end of inspiration or expiration.
Total compliance is about 0.1 L/cm H2O, with pulmonary compliance and chest-wall compliance
each equals to 0.2 L/cm H2O.

Factors affecting pulmonary compliance

1. size of lung.
2. posture.
3. age.
4. pathological conditions.

Learning objectives:

You should now be able to:

1. define total compliance, pulmonary compliance and chestwall compliance.
2. understand the principle underlying compliance measurement.
3. state the factors affecting pulmonary compliance.

2
 M.A. Lung/PHYO2202/Respiration/15-16

AIRWAY RESISTANCE

Airway resistance is the pressure difference between the alveoli and mouth divided by flow rate
(cm H20/L.sec).

Distribution of airway resistance

1. upper airways (pharynx, nose, mouth) - 50%.

2. medium sized airways (trachea, bronchi) - 40%.
3. small airways (bronchioles) - 10%.

Factors affecting airway resistance

1. lung volume and radial traction.

2. bronchomotor tone.
3. bronchial secretion, edema, vascular congestion.

Learning objectives:

You should now be able to:

1. define airway resistance.
2. state the distribution of resistance along the respiratory tract.
3. list the factors affecting airway resistance.

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 Respiratory Physiology

Theme:

On Mechanical Properties of
Respiratory System

1
Events during the respiratory cycle

volume
airflow
2
 Statics
Study of the stationary properties
of breathing apparatus -
properties independent of
movement during breathing

Volume
Factors affecting volume?

3
 More elastic = More difficult to distend
Less elastic = Easier to distend

Property of an elastic structure

1. Deformation of the structure must be

caused by an external force

2. When the external force is removed,

the structure recoils to its resting
position

3. The distending pressure is equal to

the recoil pressure
4
 1. Natural position
is at collapse
Residual volume = the volume of air remaining in the
lungs after a maximal exhalation 2. size, recoil
pressure
3. Inward recoil
direction

Vital Capacity: the volume of air breathed out after What determines the
the deepest inhalation elastic behaviour of
the lungs?
higher elasticity = higher recoil pressure

5
Total Lung Capacity = vol. in the lung at maximum inspiration
Air or Saline Inflation of Isolated Cat Lungs

Pressure required to
inflate air-filled lung >
pressure required to
inflate saline filled lung

What is happening at
air-liquid interface?

P2 P1 air-liquid interface at air-filled lung >

surface tension

6
 Surface tension at air-liquid interface
1. pressure added overcome such surface tension
2. then tissue elasticity

water Intermolecular
molecule force between
water molecules

alveolar
Resolved direction of surface tension

7
Determinants of Lung Recoil Pressure?

1. Lung Tissue Elasticity (1/3 of Total Recoil Pressure)

2. Surface Tension at air-liquid interface (2/3 of Total Recoil Pressure)

8
Surfactant: protein-carbohydrate-phospholipid complex
(produced by Type II epithelial cells)

Surfactant molecules decreases

adjacent
Intermolecular force between water molecules
smaller surface tension 9
 conc. of surfactant molecules determines the surface tension

T1

normal film of fluid

Insufficient surfactant
lacking surfactant = more contact surface area = more difficult to breath

T2
T2 > T1 (greater tension to contract
air-liquid interface)

Thicker film of fluid

(more fluid is sucked into alveolus
from capillaries) 10
What is the consequence of inadequacy in
surfactant on breathing?
Difficulty in breathing
- stiff lung
- areas of lung collapse
- alveoli filled with fluid (transudate)

What is Infant Respiratory Distress Syndrome?

Difficulty in breathing in prematurely born baby due to inadequacy in surfactant

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 1. Natural position is
at 60 %VC
2. size, outward
recoil pressure
compressing the lung > size decreases > outward recoil pressure increases
3. size, inward
recoil pressure

What is the origin of

chestwall recoil pressure?
ONLY Tissue Elasticity

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Mechanical relationship between the lung and chestwall

TLC
(Max. insp.) RPL(in) > RPC(in)

60%VC RPL(in)

FRC
(End exp.) RPL(in) = RPC(out)

RV
(Max. exp)
RPL(in) < RPC(out) 13
Why the end-expiratory position is considered as
the natural position of the respiratory system?

Lung inward recoil pressure balances chest wall outward recoil pressure

Why energy is needed to increase or decrease

the size of the lung from the end-expiratory
position?

Increase in size to overcome the inward recoil of the lung

Decrease in size to overcome the outward recoil of the chestwall

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 Compliance (distensibility)

= change in volume
change in distending pressure

Compliance = 1
elasticity
high compliance = easier to distend
increased elasticity = decreased compliance

15
 Fundamental pressures
PB, barometric pressure
PA, alveolar pressure
PPL, pleural pressure

Derived pressures
PTP, transpulmonary pressure
PCW, transchestwall pressure
PTT, transthoracic pressure

Pulmonary Compliance = change in volume

PA - PPL
Chestwall Compliance = change in volume
PPL - PB
Totall Compliance = change in volume
PA - PB 16
Factors affecting lung compliance

1. Size of lungs
CL (children) < CL (adult)
Specific compliance = CL / FRC
(0.08/cm H2O)

2. Posture
Upright to supine position lung volume
( pulmonary blood volume;
diaphragm pushed forward)
CL

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3. Aging and pathological changes on Lung Compliance

Increased
compliance Compliance
emphysema
loss of tissue elasticity
aging

Compliance
fibrosis
increased tissue elasticity
edema

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Give 4 factors that can affect lung compliance.

Quality & Quantity of tissues

Surfactant lining
Edema
Vascular congestion

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 Learning Objectives
On Static Properties of Respiratory System -

You should now be able to:

1. state the determinants of the elastic recoil of the lungs and

which is most important.
2. state the function of surfactant and the consequence of its
deficiency as in Infant Respiratory Distress Syndrome.
3. understand the mechanical relationship between the lung
and chestwall.
4. explain why EEP is considered as the natural position of the
respiratory system.
5. define total compliance, pulmonary compliance and
chestwall compliance.
7. understand the principle underlying compliance
measurement.
8. state the factors affecting pulmonary compliance.
20
 Dynamics

Study of the properties of the

respiratory system that are related
to movement during breathing

Airflow

21
 Airway Resistance (Raw)

= Trans-airway pressure / airflow

= (PA - PB) / V (cm H2O.sec/L)
where PA, alveolar pressure
PB, barometric pressure
V, instantaneous airflow

22
 *

small airways disease > might not notice that, due to small contribution
Why the small airways contribute least to Raw?
Enormous cross-sectional area (dichotomous branching)
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 (by keeping the airway open)

alveolus

radial traction
on airway wall
outward
caused by lung
recoil pressure

low lung recoil pressure

low radial traction on airway wall high lung recoil pressure
high radial traction on airway wall 24
 normal emphysema pulmonary fibrosis
high airway resistance due to
loss of lung tissue elasticity
airway collapsed

high elastic recoil > larger

airways > lower resistance
Will there be a change in Raw in emphysema? Why?
increased Raw - due to loss of lung elasticity (alveoli damage)
= decreased radial traction

How about the change in Raw in pulmonary fibrosis?

What is the cause?
decreased Raw - due to higher elasticity of fibrous tissue
= increased radial traction
25
 Normal Asthma

What are the factors that can increase Raw in

asthmatic subject?
1. Broncho-motor tone: contraction of smooth muscle (increased thickness,
decreased size of lumen)
2. Bronchial secretion
3. Mucosal edema & congestion
26
 ANS

release of neurotransmitter causing constriction

(Beta-receptor causing dilation) drug
Alpha-receptor causing constriction
*

physical

27
 Learning Objectives

On Dynamic Properties of Respiratory System -

You should now be able to:

1. define airway resistance.

2. state the distribution of resistance along the
respiratory tract.
3. list the factors affecting airway resistance.

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References

1. Human Physiology
The Mechanisms of Body Function
ed. Vander, Sherman & Luciano
(McGraw Hill)

2. Pathophysiology
Concepts of Altered Health States
ed. C.M. Porth
(Lippincott)

3. Pulmonary Physiology - the essentials

ed. J.B. West
(Williams & Wilkins)
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