Pulmonary ventilation

The pressure in the lungs must be greater or less than atmospheric pressure so that air can
flow between the environment and the alveoli.
During inspiration the contraction of the diaphragm and inspiratory muscles leads to an
increase in the capacity of the thoracic cavity, so that the intrapulmonary pressure becomes
slightly lower compared to the atmospheric one, which causes the air to enter the airways
During expiration the respiratory muscles relax and return to their resting positions. As this
happens, the capacity of the thoracic cavity decreases so that the intrapulmonary pressure
increases with respect to the atmospheric and the air leaves the lungs.
The lungs are unable to expand and contract on their own, they have to move in association
with the thorax, the lungs are attached to the rib cage by the pleural fluid that is between the
two pleural leaves, the visceral and parietal.
Intrapleural pressure, from the intrapleural space, is lower than atmospheric and arises
during development, as the rib cage with its associated pleural layer grows faster than the
lung with its associated pleural layer.
The elastic force tends to bring the lungs to their resting position, away from the rib cage.
The pleural cavity is tightly closed, so that intrapleural pressure can never be balanced with
atmospheric pressure.
Respiratory work
In normal calm pressure, the contraction of the respiratory muscles only occurs during
inspiration, while expiration is a passive process because it is due to muscle relaxation, the
respiratory muscles only work to cause inspiration and not expiration. The two factors that
have the greatest influence on the amount of work are
- The expandability or compliance of the lungs
- Resistance of airways to air flow
Expandability or compliance is the ability of the lungs to be stretched or expanded. The fact
that a lung is easily stretched does not mean that it will return to its original shape and
dimensions when the stretching force disappears.
Carbon dioxide moves from the plasma into the alveoli. As more gas diffuses from one area
of the membrane to another, the partial pressure decreases on one side and increases on
the other, so that the 2 values are getting closer and therefore, the intensity of diffusion is
increasing less until a time comes when the pressures on both sides of the alveolus-capillary
membrane equalize and diffusion stops.
The amount of alveolar air replaced by new atmospheric air with each respiratory movement
is only 1/7 of the total, so several reparative movements are needed to renew most of the
alveolar air.
Respiratory membrane or alveolus-capillary membrane
The alveolar walls are very thin and on them there is an almost solid wall of capillaries
interconnected with each other. Due to the large extent of this capillary network, the flow of
blood through the alveolar wall is described as laminar and therefore the alveolar gases are
in close proximity to the blood of the capillaries.
The average diameter of the pulmonary capillaries is 8 microns which means that the red
blood cells must be deformed to pass through them and therefore, the membrane of the red
blood cell usually touches the capillary endothelium, so that O2 and CO2 almost do not need
to pass through the plasma when they diffuse between the red blood cell and the socket so
that their diffusion rate increases
Alveolar ventilation / perfusion ratio (VA / Q)
In order for the alveolar ventilation and diffusion of gases to be correct, it is necessary that
all the alveoli be ventilated equally and that the blood flow through the pulmonary capillaries
be the same for each alveolus. Pulmonary perfusion is pulmonary blood flow.
The normal value of current VA / Q is 0.8 which means that the alveolar ventilation (in
liters7min) is 80% of the value of the pulmonary blood flow.
Alveolar ventilation
The importance of ventilation lies in the continuous renewal of the air in the respiratory units,
which is where the air is in close proximity to the blood.
The respiratory volume per minute (VRM) is calculated by multiplying the volume of the
current by the respiratory rate.
FR * VC = VRM
12 BREATHES / MIN * 500 ML = 600 ML / MIN = 6 LITERS / MIN
Total pulmonary ventilation represents the physical movement of air in and out of the
respiratory tract.
Diffusion or exchange of capillary gas alveoli
Once the alveoli have been vented with fresh air, the next respiratory process is the diffusion
of oxygen (O2) from the alveoli to the blood and carbon dioxide (CO2) in the opposite
direction.
The amount of oxygen and carbon dioxide that dissolve in the plasma depends on the
pressure gradient and the gas solubility. Since the solubility of each gas is constant, the
main determinant of gas exchange is the gradient of the partial pressure of the gas on both
sides of the alveolocapillary membrane.
Gases flow from regions of high partial pressure to regions of low partial pressure. The PO2
in the alveoli is 100 mmHg while the PO2 in the venous blood that reaches the lungs is 40
mmHg.
Functional residual capacity (CRF) is the combination of expiratory reserve volume plus
residual volume (VRE + VR). In an adult male it is about 2300 ml.
Vital capacity (CV) is the combination of the inspiratory reserve volume plus the tidal volume
plus the expiratory reserve volume (VRI + VC + VRE) is the maximum amount of air that a
person can remove from the lungs after having filled them to the maximum.
The volume of air exhaled in the first second, under these conditions, is called forced
expiratory volume in one second (FEV1).
Total lung capacity (CPT) is the combination of vital capacity plus residual volume (CV +
VR) is an adult male is about 5800 ml.
Resistance of the airways to the air flow The factors that contribute to the resistance of the
airways to the air flow are:
- Length of the tracks
- The viscosity of the air flowing through the tracks
- The radius of the tracks
The length of the airways is consistent with the viscosity of the air is also consistent under
normal conditions, so that the most important factor in airflow resistance is the radius of the
airways.