CONCEPT OF GAS EXCHANGE

(REVISED)
LEMUEL C. MACASA, RN

RESPIRATOR
Organs of the Respiratory system
Upper Resp.Tract
• Nose
• Pharynx
• Larynx

Lower Resp. Tract

FUNCTIONS:
•
•
•
Trachea
Bronchi
Lungs –
• maintain physiolo
to body cells as fu
alveoli

Review of fxns:
Major function:
- Gas exchange, which includes the transfer of oxygen and CO2 between the
atmosphere and the blood
Divided into 2 tracts (structurally):
-
- • remove CARBON
Upper respiratory tract
Lower respiratory tract

product of metabo
UPPER RESPIRATORY
• Known as the upper airway
• Warms and filters the inspired air
• Nose, paranasal sinuses, conchae, pharynx, tonsils, larynx, trachea
nose
• Separated into 2 nasal cavities by a vertical divider or nasal septum
• Vestibule – contains coarse hair
• Each cavity is divided into 3 passageways or conchae (shelves)
• Nasal cavity is lined by nasal mucosa (pseudostratified ciliated epithelium with
many GC)
• Main fxn: serves as a passageway for air to pass to and from the lungs

• It filters impurities and humidifies and warms air as it is inhaled

• Responsible for olfaction (smell) – olfactory receptors are in nasal mucosa
(function diminishes with age)
Paranasal sinuses
• Are air-filled, cilia-lined cavities within the nose.
• Function: to trap particles of foreign matter that might interfere with the work of
RS
PHARYNX
- Serves as a passageway to the digestive and respiratory tracts
- Maintains the air pressure in the middle ear and contains mucosal lining
- Mucosal lining humidifies and warms inhaled air

• Larynx
- Known as “voice box” connects the upper and lower airways
- It contains vocal cords that produce sounds
- It initiates cough reflex
 Trachea
- Contains C-shaped cartilagenous rings composed of smooth muscle
- Connects larynx to bronchi

PARTS OF LRT
• BRONCHI
- Divided into two primary bronchus
- They are large air passages that lead to right and left lungs
- R bronchus – more vertical and slightly larger than left
alveoli
• Clustered microscopic sacs enveloped by capillaries
• Gas exchange occurs over millions of alveoli in the lungs
• Contains a coating – SURFACTANT (which reduces surface tension and keeps
them from collapsing)

The A

Processes in Gas Exchange

VENTILATION, DIFFUSION AND PERFUSION
a. VENTILATION
- Flow of gas in and out of the lungs

Inspiration – air flows from the environment into the trachea, bronchioles and
alveoli
Expiration – alveolar gas travels the same route in reverse

The basic structural

& functional unit of
• Diaphragm and inte
contract
 MECHAN
BREAT

AIRWAY RESISTANCE
- Determined by the size of the airway through which air is flowing
Increased resistance = greater-than-normal respiratory effort is required

COMPLIANCE
A measure of the elasticity, expandability, and distensibility of the lungs and thoracic
structures

LUNG VOLUME AND CAPACITIES

Lung volumes

LUNG PRESSURE
• Tidal volume [TV] – volume of air inhaled and exhaled with each breath
• 500 ml
• Residual volume (RV)– after exhalation, about 1200 ml of air remains in the
lungs
• Inspiratory reserve volume (IRV)
– Amount of air that can be taken in forcibly over the tidal volume
– 3000 ml
• Expiratory reserve volume (ERV)
–
– INHALATION =Negative (
Amount of air that can be forcibly exhaled
Approximately 1200 ml

Lung expa
EXPIRATION =Positive (+
LUNG CAPACITIES
• Vital capacity
Max. vol. of air exhaled from the point of maximum inspiration
– Vital capacity = TV + IRV + ERV (4,600 ml)
• Inspiratory capacity (TV + IRV = 3,500 ml)
Max. vol. of air inhaled after normal expiration
• Functional residual capacity
( ERV + RV)
Vol. of air remaining in the lungs after normal expiration
• Total Lung capacity ( 5, 800 ml)
Volume of air in the lungs after maximum inspiration
• B. DIFFUSION
• process by which
and carbon dioxide
exchanged at
the air–blood interfa

• C. PERFUSION
• Amount of blood i
Pulmonary capillarie
NEUROCHEMICAL C

• Respiratory cente
Pneumotaxic center
effort by limiting t
inspired
Apneustic center – p
inflation of the lun

Chemoreceptors re
pH
CONTROL MECHANIS
OF RESPIRATION
• NEURAL
1. Pons :
Pneumotaxic center –
limiting the volume o
CON T R OL M EC H A N IS
Apneustic center – pre
M S
OFRElungs
SPIRATION
• CH
2. EMICAL
Medulla: Controls r
1. Central: brain, CSF (pH
3. Spinal Cord : facilit
Sensitive to
respiratoryH center
+conc
4.
2.P Hering
eripheral:-Breuer Re
carotid &
lung tissue prom
to O oting
2 chan
c
medulla =
=  rate of
 A. INFECTIO
1. VIRAL INFEC
 INFLUENZA
A. INFECTIO
affects the upper and lo
 Usually occurs
SEVERE ACUTEin epidem
RES
(SA
Distinguishing feature :
A lower rapid
respiratory illness (1
onset of profost de

An influenza like disease

 A. INFECTIO
2. Bact er ial
 PNEUMONIA
PATHOPHYSIOLOGY:
 an inflammation of the
BA
include interstitial spaces, a
enter the lower airways
TYPES:
a. Community acquired – CAP
IF: /Nosocomial
b. Hospital acquired ORGANISMS
LARGE INOC
c. Pneumocystis Carinii Pneumon
IMPAIRED H
 2. Bact er ial
 PULMONARY T
 bacterial infectious disea
MYCOBACTERIUM TUBER
Inhaled DROPLET
NUCLEI
Risk factors:
MALNUTRITION
Bacilli surrounded and
OLDengulfed
AGE by MACROPHAGES
POOR VENTILATION
Development of SINGLE -GRAY
WHITE granulomatous lesions
IMMUNOCOMPRO

MODE of TRANSMISSION: D
 MEDICAL MANAGEME
MDT – to prevent bacteria

IRAMPICIN OR

Respir
SONIAZIDat or Pe
that
+ Vit. B6
alters VENTIL

YRAZINAMIDEChrH
BRONCHITIS
Caused by disorders th
•


characterized
THAMBUTOL by progr
An inflammation of the bronchioles that impairs airflow
Acute – occurs when bronchus becomes inflamed
Chronic – occurs when inflammation occurs several times a year

and out of the lungs,

- Diagnosed by the presence of productive cough that persists 3 mos – 2
consecutive years

ETIOLOGY
• Exposure to pulmonary irritants:
 Cigarette smoke
 Air pollutants
• Infections
 Respiratory tract infections
 Pneumococcal infections
 influenza

CHRONIC BRONCHITI
Cigarette smo

Inflammation of major and s

HYPERTROPHY and
HYPERSECRETION of Goblet cells

Increased sputum production,

bronchial congestion, decreased
mucociliary clearance
 BLOOD GA

HYPOXEMIA

REFLEX V

EMPHYSEMA Pulmonar

Pulmonar
Loss of elasticity/ elastic r
RIGHT-SIDE
ALVEOLI, with destruct
capillary beds ====== HY
and an increase in the PT
ci gar et t e
smok i ng

DESTRUCTIO
DYSPNEA
BRONCHITIS
Overdist
FEATURES BRON
DestructionAge
of alveolar walls & 40
capillary beds (ACM)
Body Towa
Altered Blood GasExchange
Cough consi