s su re

Basic Pressures
Two forces act to pull the lungs away from the thoracic wall. Elasticity of lungs causes them to assume smallest possible size Surface tension of alveolar fluid draws alveoli to their smallest possible size The lungs would collapse if these were the only forces.
760

Atmospheric Pressu re = ssure (Pip) = 4m e r P l a r u e l p a r t 7 n I mHg le ss th 60 mm a n Hg Atmospheric Pres Int Intrapulm onary Pre sure = 7 rapulmo ssure 60 m sure (Pip) - P n Intrapleural Pre =s7 59 p ( m ary

Ppu H - 761 mm ul - 4 l) g Intrapulmonary H m m Hg ) Pressug re (P pul)

If the volume of the lung is decreased The pressure increases The pressure in the lung is higher than atmosphere Breathe out

Boyles Law

If the volume of the lung is increased The pressure decreases The pressure in the lung is lower than atmosphere Breathe in

761 Decreased volume = Increased pressure

Breathe Out

Increased volume = Decreased pressure

Breathe In

760

759

Breathe out

Transpulmonary Pressure= Ppul - Pip

-offsets elasticity and surface tension in lung

These lines are to help you visualize what respiratory steps are affected by various pathologies (a question on the exam). Please find various respiratory pathologies (CF, asthma, COPD, ARDS, diabetes, smoke inhalation, CO poisoning, etc) and determine which steps in respiration would be affected. Most pathologies will affect multiple steps directly and then all indirectly through CO2. On the test, each step in respiration should be represented by a pathology.

Pre

All In Inspiratory Reserve Volume (IRV) Inspiratory Capacity Vital Capacity (VC)

1. Ventilation

Respiratory Volumes
Normal In Normal Out

Flow/ Volume Graph

Expiration

10 8 6 4 2

Medium Airways FEF 50% FEF 75%

FEF 25%

Breathing Out

Upper Airway Obstruction

FVC

Oxygen

Carbon Dioxide

Tidal Volume (Vt) Restrictive Disorders reduce volumes. Obstructive Disorders slow inhalation/exhalation flow. Many disorders will be mixed Obstructive and Restrictive.
1. Partial pressure gradients and gas solubilities Henrys and Daltons Laws

Total Lung Capacity (TLC)

Flow (L/sec)

0 2

Volume (L)
2 FEV1
Breathing In

4
Obstru

ctive

Expiratory Reserve Volume (ERV) Functional Residual Capacity Residual Volume

Inspiration

4 6

Res

tric

tive

All Out 0L

8 10

FIF 75%

FIF 50%

FIF 25% Upper Airways

2. Matching of alveolar ventilation and pulmonary blood perfusion

Slower flow, more time to take in O2
O2

O2

3. Structural characteristics of the respiratory membrane Fluid will act as a barrier to O2 leaving the alveoli and entering the blood.
O2 O2 O2 O2

Mucous will act as a barrier to O2 leaving the alveoli and entering the blood.

Air

N2
N2

O2 O2

CO 2

O2

Were full of O2 so lets go

Blood

2. External Respiration

CO2
Haldane effect

O2 O2 O2

O2 O2 O2 O2

Blood gases in blood: CO 2 >> O 2 >> N 2

O2 O2 O2 O2 O2 O2 O2

Loss of surface areas (as in emphysema) will decrease the area available for oxygen to enter the blood and increases the distance some O2 molecules ahve to traverse to get to a capillary.

...Work Tissue is nourished and recovers from... Temp O2 is dropped off BPG acid CO2 Hb likes O2 less

100 80

Oxygen Loading

% Hb Saturation

O2 O2

60
Reserve

40 20 0

3. Oxygen/Carbon Dioxide Transport

O2

Hemoglobin is 100% saturated when leaving the lungs. It returns 80% loaded. Thus, Hb 70 mm Hg 2 of will drop off only one oxygen per trip except 2 produce in extenuating circumstances. Oxygen only loading strategies like canned oxygen are thus ineffectual and CPR will be helpful even without airway or breaths. 2 is below normal

20

40 Tissue

60

80

100 Lungs

70% 98. 5 %

Hb:O2

O2

O2 O2
1.5%

H2CO 3 CO2
23%

Hb

Hb:CO2

Hb CO2
7%

4. Internal Respiration
O2 CO2 O2 H2O

Glycolysis

Krebs Cycle

Electron Transport Chain

5. Cellular Respiration

32

Emphysema will directly affect ventilation and external respiration. It will indirectly affect all other steps due to the increase in CO2.

PEFR Large Airways

Normal