PHYSIOLOGY

Costanzo Respiratory Physiology LUNG VOLUMES AND CAPACITIES

LUNG VOLUMES AND CAPACITIES

Tidal volume VT normal breathing 500mL Inspiratory Reserve Volume IRV additional volume with maximal inspiration 3000mL. Expiratory Reserve Volume ERV additional volume with maximal expiration 1200mL. Residual Volume RV volume remaining after maximal expiration 1200mL

LUNG VOLUMES AND CAPACITIES

Inspiratory Capacity (IC) IRV + V = 3000 + 500 = 3500mL Functional Residual Capacity (FRC)* volume remaining after a normal tidal volume is expired. ERV + RV = 1200 + 1200 = 2400mL Vital Capacity (VC) volume that can be expired after maximal inspiration IC + ERV= 3500 + 1200 = 4700mL Total Lung Capacity (TLC) = VC + RV = 4700 + 1200 = 5900mL
RV cannot be measured by spirometry therefore FRC and TLC. 2 METHODS TO MEASURE FRC: helium dilution and body plethysmograph

DEAD SPACE
volume of the airways and lungs that does not participate in gas exchange (i) Anatomic Dead Space volume of conducting airways

Volume of conducting airways 150mL

Volume in alveoli for gas exchange = VT 150 = 500 150 = 350mL Inspired tidal volume = 350mL (makes it to the alveoli ) To sample alveolar air sample end-expiratory air since the 1st air expired is dead space air.

DEAD SPACE
(ii) Physiologic Dead Space total volume of the lungs that does not participate in gas exchange. Includes : Anatomic Dead Space + Functional Dead Space in alveoli Functional Dead Space in alveoli ventilated alveoli that do not participate in gas exchange. Ventilation/perfusion defect ventilated alveoli are not perfused by pulmonary capillary blood.

Volume of Physiologic Dead Space

based on: the measurement of partial pressure of CO2 of mixed expired air. and 3 assumptions >>> 1. All of CO2 in expired air comes from exchange of CO2 in FUNCTIONING (ventilate and perfused alveoli) 2. There is NO CO2 in inspired air. 3. Physiologic Dead Space neither exchanges nor contributes any CO2.

 If Physiologic Dead Space = 0 Then partial pressure of CO2 in mixed expired volume will be = to the partial pressure of CO2 in the alveoli. PECO2 = PACO2 If Physiologic Dead Space is PRESENT Then the partial pressure of CO2 in mixed expired volume will be diluted by dead space air and will be LESS THAN the partial pressure of CO2 in the alveoli by a dilution factor. PECO2 < PACO2

 Dilution Factor volume of physiologic dead space that can be measured by comparing partial pressure of CO2 in mixed expired volume and partial pressure of CO2 in alveolus.
POTENTIAL PROBLEM: in measuring physiologic dead space is that alveolar air cannot be sampled DIRECTLY. Using the assumption that alveolar air equilibrates with pulmonary capillary blood (which become systemic arterial blood) The Partial pressure of CO2 of systemic arterial blood (PaCO2)= Partial pressure of CO2 of alveolar air (PACO2) PaCO2 = PACO2

The volume of physiologic dead space is calculated by the following equation:

Physiologic Dead Space (VD)= Tidal Volume (VT)x

VD (mL) = VT (mL)

Partial pressures in mm Hg

VD =Physiologic dead space (mL) VT =Tidal volume (mL) PaCO2 =PCO2 of arterial blood (mm Hg) PECO2 =PCO2 of mixed expired air (mm Hg)

In the first example, assume that physiologic dead space is zero; in the second example, assume that physiologic dead space is equal to the entire tidal volume. In the first example, in which dead space is zero, the PCO2 of expired air (PECO2) will be the same as the PCO2of arterial blood (PaCO2), since there is no "wasted" ventilation: The fraction in the equation is equal to zero, and thus the calculated value of VD is zero. In the second example, in which dead space is equal to the entire tidal volume, there is no gas exchange: Therefore, PECO2 will be zero, the fraction will be 1.0, and VD will be equal to VT.

VENTILATION RATES
- Is the volume of air moved into and out of the lungs per unit time. - expressed as Minute ventilation the total rate of air movement into and out of the lungs Alveolar Ventilation which corrects for the physiologic dead space.

Minute ventilation
Minute ventilation = VT X BREATHS/ MIN

Alveolar Ventilation

ALVEOLAR VENTILATION EQUATION

- fundamental relationship of respiratory physiology. - it describes the inverse relationship between alveolar ventilation and alveolar partial pressure of CO2.

VA =Alveolar ventilation (mL/min) VCO2 =Rate of CO2 production (mL/min) PACO2 =Alveolar PCO2 (mm Hg) K =Constant (863 mm Hg)

ALVEOLAR GAS EQUATION

FORCED RESPIRATORY VOLUMES