LSM 3212

Respiratory System (I):

Breathing

Dr. Deng Yuru Dept. of Physiology

Respiratory System
Lecture 1: Breathing Lecture 2: Gas Exchange, Gas Transport & Control of Breathing Lecture 3: Respiratory Responses to Exercise, V/Q ratio & Hypoxia Tutorial 3: Diving Physiology

Reading: Human Physiology From Cells to Systems, by Lauralee

Sherwood 7th Edition.

Lecture Outline
What is respiration? Mechanics of breathing Factors affecting breathing How to assess lung functions? What is dead space? its implication in alveolar ventilation & snorkeling

What is Respiration?

O2 consumption

Functions of Respiratory System?

gas exchange pH balance smell protection warm & humidify the air voice production enhance the venous return

Non-respiratory functions

Where the Air Goes?

Upper Respiratory System:
Nasal cavity Pharynx Larynx

Lower Respiratory System:

Trachea (1) Bronchus (2) Bronchioles

Where the Air Goes?

(continued)

Alveoli: where gas exchange occurs

Cellular Structure of Alveolus

Type II alveolar cells (arrows): produce lung surfactant

Respiratory membrane

What happens when air arrives alveoli?

Gas Exchange via diffusion:
* [O2] is higher in alveolus * [CO2] is higher in pulmonary capillary * Respiratory Membrane (0.5 m):
- capillary endothelium - interstitial fluid - alveolar epithelium

* blood flow is directed to well-ventilated alveoli (V/Q matching)

Lungs, Pleura, Diaphragm & 3 Pressures Parietal pleura: covers the

inner thoracic wall Visceral pleura: covers the lungs Pleural cavity: filled with fluid Diaphragm: separates thorax from abdomen
3 Pressures: - Atmospheric - Intrapulmonary (intra-alveolar) - Intrapleural

760 mm Hg

Lungs are stuck to the thoracic wall, how?

 Across lung wall:

Trans-mural Pressure Gradient

intra-alveolar pressure (760) vs. Intrapleural pressure (756)- lung is stretched

Across thoracic wall:

atmospheric pressure (760) vs. Intrapleural pressure (756)- chest wall is compressed

Intrapleural pressure is sub-atmospheric (<760), why?

If there is a hole in chest or lung wall, what would happen?

Pneumothorax is caused by accumulation of air in the pleural cavity

Mechanics of Breathing
P 1/V (Boyles Law)

How do we breathe?
No Flow

Generating air flow

Flow In

Flow Out

Volume changes (lung) Pressure gradient (Patm- Palv) Air flow

How do we breathe?

(continued)

2 phases in breathing (ventilation): Inspiration (inhalation): air IN Expiration (exhalation): air OUT How to generate air flow? How to create pressure gradient? Pressure is altered by changing lung volume (P1/V) How to change lung volume?

Respiratory Muscles

Thoracic Volume

move ribs upward & outward move ribs downward

flattened

push diaphragm up

Three Factors that Affect Energy Required to Breathe

1. Airway Resistance 2. Alveolar Surface Tension 3. Lung Compliance

1. Airway Resistance
Flowair= P/R
P: pressure difference; R: resistance; r: radius of airway

R 1/r4

Bronchial smooth muscle: - systemically affected by autonomic nervous system:

Parasympathetic broncho-constriction resistance Sympathetic broncho-dilation resistance

- locally influenced by immune system:

Histamine released airways constriction resistance

2. Alveolar Surface Tension

Alveolar surface: coated with a watery film At air-water interface, water molecules have stronger attraction to each other than to air This unequal attraction produces a force called surface tension LaPlace Law: describe the relations among P, T, r

Alveolar Stability
smaller radius (r), greater pressure (P) is generated pressure gradient is created between large & small alveolus what happen next?

When surfactant is present in alveoli

Lung Surfactant:
a mixture of phospholipids & proteins produced by Type II alveolar cells prevent lungs to collapse, how?
- alveolar surface tension - lung compliance

3. Lung Compliance
Ease with which the lungs can expand (distensibility) Determined in terms of lung (volume & pressure)

Volume/Pressure
vs.
2 mmHg 2 mmHg

Low compliance: stiff lung

More P needed to increase V Increase work of breathing

What is Newborn Respiratory Distress Syndrome?

Lung surfactant can only be produced by fetus at late stage of pregnancy. Pre-mature babies:
- not enough surfactant to reduce alveolar surface tension - poor lung compliance - alveoli tend to collapse at end of expiration - each breath- like blowing up a new balloon - newborn muscles are still weak. Treatment: surfactant replacement

The Work of Breathing

more energy: less energy:
- airway resistance - alveolar surface tension - high lung compliance - airway resistance - alveolar surface tension - low lung compliance

Note: only 3% total body energy expenditure is used for quiet breathing!

How to assess lung function?

spirogram

TV= Tidal Volume (~ 500ml) IRV= Inspiratory Reserve Volume ERV= Expiratory Reserve Volume RV = Residual Volume Capacity: two or more volumes IC= Inspiratory Capacity VC= Vital Capacity FRC= Functional Residual Capacity TLC= Total Lung Capacity

Restrictive vs. Obstructive

Pulmonary Disorder
Pulmonary fibrosis:
RV normal IRV VC TLC , , low lung compliance FEV1 normal
Pulmonary fibrosis

Emphysema:
RV, FRC VC TLC normal , high lung compliance FEV1 < 80%

Emphysema

Obstructive vs. Restrictive

(a) Obstructive disorder:
- diagnosis by measuring the expiration rate - FEV1/FVC <80%

(b) Restrictive disorder:

- FEV1 is normal (a)

(b)

FEV1 (forced expiratory volume in 1 sec): expressed as (FEV1/FVC)

What is Dead Space?

The air in the conducting zone ~150ml If tidal volume is 500ml, only 350ml is involved in actual alveolar gas exchange The consequence of this anatomical dead space: when we breathe normally, only 350ml of air reaches our alveolar area (respiratory zone)

dead space

Pulmonary vs. Alveolar

Ventilation
1. Pulmonary Ventilation
= tidal volume (ml/breath) x respiratory rate (breaths/min) = (500 ml)(12 breaths/min) = 6000 ml/min

2. Alveolar Ventilation
= (tidal volume - dead space volume) x respiratory rate = (500 ml - 150 ml)(12 breaths/min) = (350 ml)(12 breaths/min) = 4200 ml/min

Good Pulmonary Ventilation Good Alveolar Ventilation

Person A 500 ml/breath 12 breaths/min 150 ml 6000 ml/min 4200 ml/min Person B 250 ml/breath 24 breaths/min 150 ml 6000 ml/min 2400 ml/min

Tidal volume Respiratory rate Dead space Pulmonary ventilation Alveolar ventilation

Conclusion: Slow, deep breathing is better than fast, shallow breathing

Snorkeling
Why cant you buy a snorkel tube more than 30cm long?

How to go deep more than 30cm?

How do Elephants Snorkel?

Some Facts:
1. 2. 3. Elephant trunk is about 2m long Snorkeling at depth (2m) creates very large pressure differentials around the lungs Unique pleura structure of elephant

Reference:
West JB. 2002. Why doesn't the elephant have a pleural space? News Physiol Sci 17:47-50. West JB. 2001. Snorkel breathing in the elephant explains the unique anatomy of its pleura. Respi Physiol 126:1-8.

How does body clear its airway.

Coughing
- begin with a deep inspiration followed by forced expiration against a closed glottis - glottis is then suddenly opened, producing explosive outflow

Sneezing - same as coughing except in the upper airways

- the highest recorded sneezing speed is 160 km/hr! - what muscles are involved?

What and Why???

What causes hiccup?
what is the part to blame? a repetitive contraction (spasm) of the diaphragm (involuntary) 2-month-old fetus hiccup in the womb! an early stage in the development of the suckling?

Why do we yawn?
deep inspiration with mouth wide open, often accompanying with stretching (involuntary) Hypothesized causes of yawning:
To cool the brain (2007) Certain brain chemicals (serotonin and dopamine) make us more likely to yawn? (tiredness, stress, boredom) An excess of CO2 and lack of O2 in the blood? A way of displaying empathy: contagious!

When Lungs Fail

Diseases or conditions that:
1. influence the Mechanics of Breathing:
- Pneumothorax - Pulmonary fibrosis - Emphysema - Bronchitis - Asthma

2. minimize or prevent Gas Exchange:

- Pulmonary edema - Smoke inhalation - CO poisoning

When the system is challenged & balance is broken...

Breathing at High Altitude

Exercise

Breathing Underwater