Download - Pulmonary Ventilation
Pulmonary Ventilation
Pulmonary Structure and Function
Pulmonary Ventilation –
Process by which ambient air is moved into and exchanges with air in the lungs
…Different from oxygen consumption
Figure 12.1
Pulmonary Structure and Function
Gas exchange (O2 and CO2) occurs in the alveoli
O2 transfers from alveolus to capillary blood
CO2 transfers from capillary blood to alveolus
Fig 12.1
Each minute at rest 250 ml of O2 and 200 ml of CO2 diffuse in opposite directions
Pulmonary Structure and Function
Fig 12.1
Lungs contain 600 million alveoli
Extremely thin-walled sacs (0.3 mm thick)
Lie side by side with thin walled capillariesAlveoli receive largest blood supply of any organ in the body
Pulmonary Structure and Function
Lungs – Extremely large surface area for gas exchange
Lungs provide the gas exchange surface separating blood from alveolar gases
Figure 12.2
Adult lung weighs 1 kg and hold 4-6 L of air
Pulmonary Structure and Function
Pulmonary ventilation functions primarily to maintain a constant and favorable concentration of O2 and CO2 in the alveoli during rest and exercise
Adequate pulmonary ventilation ensures complete gas exchange before blood leaves lungs for transport to tissues
Pulmonary Structure and FunctionBreathing mechanics
Inspiration – diaphragm descends, ribs are raised, volume increases, intrapulmonic pressure decreases, air rushes in (chest cavity size increases)Contributing muscles: external intercostals, sternocleidomastoids, scalenes, spinal extensors
Fig 12.3
Pulmonary Structure and Function
Breathing mechanics
Expiration – Passive process
diaphragm relaxes, ribs lower, volume decreases, intrapulmonic pressure increases, air rushes out (chest cavity size decreases)Contributing muscles: rectus abdominus, internal intercostals, posterior inferior serratus
Fig 12.3
Pulmonary Structure and Function
Ventilatory System:
Conducting Zone – Trachea to Bronchioles
No alveoli
Air transport, warming, humidification, particle filtration
Anatomic "Dead" Space*Respiratory Zone – Bronchioles to Alveoli
Surface area for gas exchange
Fig 12.4
Pulmonary Structure and Function
Measuring Lung Volume:
Lung volumes measurements (static or dynamic) can help identify potential obstructive or restrictive lung diseases
Lung volumes vary with age, gender, body size, body composition and stature
Fig 12.6
Water-sealed, volume displacement recording spirometer
Pulmonary Structure and Function
Static Lung Volume Measurements: Provides record of ventilatory volume and breathing rate
Tidal Volume (TV) – volume inspired or expired per breath (600 ml)
Inspiratory Reserve Volume (IRV) – maximal inspiration at end of tidal inspiration (3000 ml)
Expiratory Reserve Volume (ERV) – maximal expiration at end of tidal expiration (1200 ml)
Force Vital Capacity (FVC) – maximal volume expired after maximal inspiration (TV+IRV+ERV; 4800 ml)
Fig 12.6
Pulmonary Structure and Function
Static Lung Volume Measurements:
Residual Lung Volume (RLV) – air volume remaining in lungs after maximal expiration (1200 ml)
-allows uninterrupted gas exchange between blood and alveoli
Functional Residual Capacity (FRC) – Volume in lungs after tidal expiration (ERV + RLV; 2400 ml)
Total Lung Capacity (TLC) – volume in lungs after maximal inspiration (FVC + RLV; 6000 ml)
Fig 12.6
Pulmonary Structure and FunctionDynamic Lung Volumes:
Adequate pulmonary ventilation depends on ability to sustain high airflow levels (not air movement in single breath)
Dynamic Ventilation depends on:
1) FVC (“stroke volume” of the lungs)
2) Breathing rate
High airflow levels (velocity) depends on lung compliance (ability to stretch or expand):
“loose” (high compliance) – emphysema, asthma
“stiff” (low compliance) – fibrosis
Pulmonary Structure and FunctionDynamic Lung Volumes
Forced Expiratory Volume (FEV) to FVC ratio:
FVC measured over 1 s (FEV1.0) – measures pulmonary airflow capacity, or overall resistance to air movement upstream in the lungs (normal value = 80-85% of FVC)
Fig 12.8
No Elastic Recoil (loose)
Too Much Elastic Recoil (stiff)
Pulmonary Structure and Function3. Minute Ventilation (VE):
•Volume of air moved in and out of respiratory tract per minute
•VE=Breathing Rate (BR) x TV
At rest VE = 12 breaths/min x 0.5 L/breathVE = 6 Lmin
Exercise VE = 30 x 2.5 VE=50 x 3.5VE = 75 Lmin VE=150 LminModerat
eVigorous
Pulmonary Structure and Function
Dynamic Lung Volumes:
• Measurements of dynamic lung function can indicate the severity of obstructive or restrictive lung diseases
• FEV/FVC - Normal or increased for restrictive lung disease (80% or greater)
• FEV/FVC - <70% indicates obstructive lung disease
Pulmonary Structure and Function
Aging and lifestyle affect lung volumes and pulmonary function Aging: Decreased lung compliance
FEV1.0 and FVC decrease after age 20
Diffusion capacity decreases
Partial Pressure of O2 decreasesDiaphragm muscles weakens by ~25%
Pulmonary Structure and Function
Dynamic Lung Volumes:Provide no information about aerobic fitness:
No difference in healthy vs olympic athletes
Not predictive of track or marathon performance, distance running
Pulmonary Structure and Function
Dynamic Lung Volumes:
• Important part of standard medical/health examination for “at risk” exercisers (smokers, asthmatics)
Pulmonary Structure and Function
By increasing rate and depth of breathing - increases alveolar ventilation
•TV increases at start of moderate exercise
•As intensity increases, TV plateaus at 60% of FVC
•Breathing rate provides alveolar ventilation at higher exercise intensities
How do we ensure sufficient air reaches the alveoli during exercise?
Fig 12.10
Pulmonary Structure and Function
Definitions:
Hyperventilation – increase in pulmonary ventilation that exceeds the O2 needs of metabolism (“overbreathing”)
Unloads CO2 excessively (which constricts arteries with less O2 to brain)
Can lead to unconsciousness.
Pulmonary Structure and Function
Definitions:
Dyspnea – shortness of breath or subjective distress in breathing (sense of inability to breathe)
Occurs in physical exertion (novel exercisers), at altitude, or with obstructive or restrictive pulmonary disorders
Result of elevated CO2 and H+ in blood from fatigue of poorly trained respiratory muscles (shallow, ineffective breathing)
Pulmonary Structure and Function
Definitions:
Valsalva Maneuver – Increases intrathoracic pressure that occurs when exhalation is forced against a closed glottis
Results:
Collapse of veins in thoracic region
Impaired venous return
Acute DROP in arterial blood pressure
Decreased blood supply to brain
"spots before the eyes" "fainting"
Pulmonary Structure and Function
Definitions:
Valsalva Maneuver
Fig 12.11
Acute drop in blood pressure
Blood pressure overshoot
Pulmonary Structure and Function
Valsalva Maneuver
Fig 12.11
*Valsalva Maneuver does NOT cause the acute rise in blood pressure with resistance training