Main determinant of airway (bronchi

& bronchioles) R is radius of

airways
(R α 1/ r4)
• ↑ parasympathetic nerve activity
• smoke
• Histamine
• Cold air →
• Smooth muscles contraction →
• Bronchoconstriction →
• ↓ airway radius

• Adrenaline (through β2 receptors)

• ß2-agonists →

• Relaxation of smooth muscles of

airways
 Pip Transmural P

Airway resistance ↓ during inspiration:

• Transmural pressure (P in airway (Paw) minus Pip) ↑ during
inspiration because Pip more -ve → airways larger & airway R ↓
(because transmural P exerts a distending force on the small
airways)
• During inspiration, the alveoli expand → help to pull small
airways open. This is termed lateral traction/radial traction
25
 LUNG VOLUMES AND CAPACITIES
• All lungs volumes and capacities – measured directly using a spirometer
except for RV, FRC, TLC

• As the person breathes in & out of

thro’ a tube connecting the mouth to
the spirometer, the bell containing air
moves up & down
• The bell is attached by a pulley to a
pen that writes on paper attached to a
rotating drum
• A downward pen deflection
represents expiration & an upward pen
deflection represents inspiration
• The recording is known as spirogram CLASSICAL
SPIROMETER
 SPIROGRAM Volume (L)
Maximal
inspiration

4 lung volumes & 4

lung capacities

• Tidal volume (TV) ~

0.5 L
 Volume of air
inhaled or exhaled
with each breath
• Values given are for
adult males, 70 kg
Maximal expiration
• Normal values of lung
volume & capacities
depend on age, sex,
posture, height
Time (seconds)
 Volume (L)
Maximal
• Inspiratory reserve inspiration
volume (IRV) ~ 2.5
L
 The maximum
volume of air that
can be inhaled after
a normal tidal
volume inhalation

Maximal expiration

Time (seconds)
 Volume (L)
Maximal
inspiration
Expiratory reserve
volume (ERV) ~ 1.5
L
- The maximum
volume of air that
can be exhaled after
a normal tidal
volume exhalation

Maximal expiration

Time (seconds)
 Volume (L)
Maximal
inspiration
• Inspiratory capacity
(IC) ~ 3.6 L
 Maximal volume of
air that can be
inhaled after a normal
expiration

• IC = IRV + TV

Maximal expiration

Time (seconds)
 Volume (L)
Maximal
• Vital capacity (VC) inspiration

 ~ 4.5 L
 The maximum
volume of air that
can be exhaled after
a maximal
inspiration

• VC = IRV + TV +
ERV

Maximal expiration

Time (seconds)
 Volume (L)
Maximal
inspiration
Maximal inspiration

Maximal expiration

Time (seconds)
 Volume (L)
Maximal
• Forced vital capacity inspiration
(FVC) - after maximal
inspiration, the person
exhales as completely
& as fast as he can

Maximal expiration

Time (seconds)
 • FEV1 Forced
Maximal inspiration expiratory volume in
1st second
 Volume of FVC
exhaled/expelled in the
first second of
expiration

Maximal expiration
 Volume (L)
Maximal
inspiration
SPIROGRAM

FRC, RV & TLC

cannot be measured
directly with
spirometer

Maximal expiration

Time (seconds)
 SPIROGRAM Volume (L)
Maximal
inspiration
• Functional residual
capacity (FRC) ~ 3 L
 Volume of air
remaining in the lungs
after a normal exhalation
• FRC = ERV + RV
• Residual volume (RV) ~
1.2 L
 Volume of air
remaining in the lungs
after maximal expiration
• Total lung capacity (TLC)
~6L Maximal expiration
 Total volume of air in
the lungs after maximal
inspiration
• TLC = VC + RV
Time (seconds)
• Lung volumes measured by spirometer usually indicate the volume
at ambient temperature and pressure, saturated with water vapor
(ATPS)
• Lung volumes at ATPS can be converted to volumes they would
occupy in the lungs of subjects at body temperature and pressure,
saturated with water vapor (BTPS)
• Conversion from ATPS to BTPS

• O2 uptake , CO2
output usually
expressed at STPD
• STPD: Standard
Temperature (0oC)
and Pressure (760
mm Hg) and Dry
 Lungs volumes and capacities (part of lung function tests)

• 2 types of lung / pulmonary diseases :

 Restrictive pulmonary/lung diseases
o Expansion of lungs restricted & compliance of lungs
↓ e.g.. :
 Fibrosis
 Pulmonary edema
 Obstructive pulmonary diseases - characterized by
airflow limitation (airway resistance is high) e.g.. :
o Chronic obstructive pulmonary diseases (COPD)
o Asthma
ASTHMA
• A chronic inflammatory disorder of the airways, usually
associated with airway hyper-responsiveness (airway smooth
muscles contract strongly when exposed to a variety of
triggers) and variable airflow obstruction, that is often
reversible spontaneously or under treatment

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

• Related to cigarette smoking
• Airflow limitation – not fully reversible, progressive
•Caused by emphysema (destruction of the alveolar walls →
permanent enlargement of the airspaces distal to the terminal
bronchioles & loss of pulmonary capillaries, collapse of small
airways) or chronic bronchitis (excessive mucus production &
chronic inflammation of airways) or a combination of the two
 Maximal inspiration

Maximal expiration

or normal

• (FEV1 (Forced expiratory volume in 1st second): Volume of forced vital

capacity (FVC) exhaled in the first second of expiration
• Normal ratio of FEV1/FVC ~ 0.8 or 80%
• In obstructive pulm. diseases, ratio is < 70%
Restrictive lung diseases
• All lung volumes & capacities are small
 *
*
*

Obstructive pulmonary diseases

• Obstruction to airflow in the airways
• Airway R ↑ e.g. :
 COPD (chronic bronchitis, emphysema)
 Asthma
 RV ↑
FRC ↑
TLC ↑
 .
Pulmonary or minute ventilation
(VE)

• Volume of air breathed in or out

per minute
• VE = tidal volume (TV) X resp. rate
(breathing freq.)
• Normal resp. rate ~ 10 -18 / min
• At rest, pulmonary ventilation ~ 6
-7 L/min (~ 0.5L X 12)
ANATOMICAL DEAD SPACE

• Not all the fresh air breathed

in during each inspiration
enters alveoli – some occupies
the conducting airways where
there is no gas exchange
(nose, pharynx, trachea,
bronchus, bronchioles)
• The volume of air in the
conducting airways ( nose,
pharynx, trachea, bronchi,
bronchioles where there is no
gas exchange is called the
anatomical dead space
• Usually estimated ~ 2.2 ml
per kg body weight
 ~154 ml in 70 kg man)
 Factors affecting VANA
.

• Size of subject – VANA ↑ with

↑ in body size
VANA ~ 1 ml/ lb body weight

2. Age –from early adulthood,

VANA ↑ ~ 1 ml/year

3. VANA ↑ slightly in inspiration –

airway diameter larger
Airway resistance ↓ during
inspiration

i. Transmural P ↑ because
Pip more –ve
Pip • Transmural P exerts a
distending force on the
small airways

ii. During inspiration, the

alveoli expand → help
to pull small airways
open. This is termed
lateral traction

25
 .
FACTORS AFFECTING VANA
4. Tracheostomi → ↓ VANA

5. Breathing thro’ snorkel, additional

tubes →↑ dead space
 .
ALVEOLAR VENTILATION (VA)
• Vol of fresh air entering alveoli per
minute

VA = (TV – VANA) X f
 .
ALVEOLAR VENTILATION (VA)
• Vol of fresh air entering alveoli per
minute

VA = (TV – VANA) X f

TV = tidal volume
VANA = anatomical dead space
f = resp. rate
 TV = 500ml, body weight = 70 kg, resp. rate = 10/min

.
VA = (TV – VANA) f Estimation of VANA:
= (500 - 154) X 10 VANA (ml) = body wt in lbs
.
VA = 3.46 L/min 1 kg = 2.2 lbs

• Normal alveolar ventilation ~ 4L/min (adult male)

• Normal pulmonary ventilation ~ 5-6L/min

 Pulmonary ventilation & alveolar
ventilation (VA)

TV VE VANA VA
Subject Freq.
(ml) .
(ml/min) . (ml) ..
(ml/min)

A 150 40 6000 150 0

B 500 12 6000 150 4200

C 1000 6 6000 150 5100