NAME: Tooba RehmanROLL NO. 100CLASS: First Prof. Year PROGRAM: Pharm DCOURSE CODE: 309COURSE NAME: PhysiologyCOURSE TEACHER: DR. SARWAT

PULMONARY VENTILATION

INTRODUCTIONPulmonary ventilation is a major function event of respiration. It is the movement of air in and out of alveoli.The passage of air contains following parts; Nasal Cavity:- Air is drawn into the nasal cavity from nose through a pair of nostrils where two nasal sacs are present.

Pharynx:-The nasal cavity opens into a passage through glottis called pharynx.

Trachea:-It is a long wind pipe about 12 cm long. The walls of trachea are supported by incomplete rings of cartilage which keep the trachea open and resist it from collapsing.

Bronchi And Bronchioles:-The trachea branches into two bronchi which have almost same structureas the trachea but smaller diameter. Each bronchi splits into numerous branches called bronchioles.In all areas of the trachea and bronchi not occupied by cartilage plates, the walls are composedmainly of smooth muscles. Also , the walls of the bronchioles are almost entirely smooth muscles,with the exception of nose terminal bronchioles called the respiratory bronchioles which is mainlypulmonary epithelium and unlying fibrous tissue plus a few smooth muscles fibers.

Alveoli:- At the end of bronchioles tiny air sacs are present called alveoli. Each lung contains about300 Millions alveoli. The air we breathe in eventually reaches the alveoli. Each alveolus is surrounded by a network of thin blood vessels. O2 passes through the wall of the alveoli into the blood vessels. The blood then carries te O2 to the body cells. Meanwhile, the CO2 present in the blood passes out of the blood vessels and into the alveoli.

Lungs:- Lungs are most advance type of respiratory organs. They are situated in thorax. They are seperated from each other by a pleural membrane present inside the pleural cavity. Pulmonary ventilation or breathing is the exchange of air between the atmosphere and the lungs. As air moves into and out of the lungs,it travels from regions of high air pressure to the regions of low air pressure.

GOALS

• To identify the muscles used during ventilation.

• To understand how volume changes in the thoracic cavity cause pressure changes that lead to

breathing.

• To identify factors which influence airway resistance and lung compliance.

 

DEFINITION

Pulmonary ventilation is the process by which gasses flow between the atmosphere and lung alveoli. Air moves into the lungs when air pressure inside the lungs is less than the air pressure in the atmosphere and out of the lungs when the pressure inside the lungs is greater than the atmosphere pressure.

 

EXPLANATION

 

INHALATION

Breathing in is called inhalation or inspiration. Just before each inhalation air pressure inside the alveoli is equal to the atmospheric pressures, 760 rnmHg, and the intrapleural pressure is 756 mmHg. With inspiration, the cavity of the thorax is enlarged as external intercostals muscles and the diaphragm contract causing a decrease in the intrapleural pressure to about 754 mmHg. The parietal pleura lining the cavity is pulled outward in all direction and the visceral pleura and lungs are pulled along with it. As the lung volume increases in this way the pressure inside the lungs i.e. 760 mmHg drops to 758 mmHg. Thus a pressure difference is established between the atmosphere and alveoli and air flows into the lungs from the atmosphere.Inhalation or inspiration is an active process.

 

EXHALATION

Breathing out or exhalation or expiration starts when the inspiratory muscles and diaphragm relaxes, the dome of the diaphragm moves up, the ribs are depressed leading to decrease in the lung volume and increase in the lung pressure (763 rnm Hg). Air flows out form the area of higher pressure to the area of lower pressure in the atmosphere. The elastic recoil of the chest wall and the lungs is due to the recoil of elastic fibers and the inward pull of surface tension due to the alveolar fluid. A thin layer of alveolar fluid coats the surface of the alveoli and exerts a force known as surface tension. Exhalation or expiration is a passive process.

Mechanics of Pulmonary Ventilation

Muscles That Cause Lung Expansion and Contraction

The lungs can be expanded and contracted in two ways

 (1)By downward and upward movement of the diaphragm to lengthen or shorten the chest cavity:- During inspiration, contraction of the diaphragm pulls the lower surfaces of the lungs downward. Then, during expiration,the diaphragm simply relaxes, and the elastic recoil of the lungs, chest wall, and abdominal structures compresses the lungs and expels the air. During heavy breathing, however, the elastic forces are not powerful enough to cause the necessary rapid expiration, so that extra force is achieved mainly by contraction of the abdominal muscles, which pushes the abdominal contents upward against the bottom of the diaphragm, thereby compressing the lungs.

 (2) By elevation and depression of the ribs to increase and decrease the anteroposterior diameter of the chest cavity:- The second method for expanding the lungs is to raise the rib cage. This expands the lungs because, in the natural resting position, the ribs slant downward, thus allowing the sternum to fall backward toward the vertebral column. But when the rib cage is elevated, the ribs project almost directly forward, so that the sternum also moves forward, away from the spine, making the anteroposterior thickness

of the chest about 20 per cent greater during maximum inspiration than during expiration.Therefore,all the muscles that elevate the chest cage are classified as muscles of inspiration, and those muscles that depress the chest cage are classified as muscles of expiration.

External intercostals:-

The most important muscles that raise the rib cage.

Sternocleidomastoid muscles:-

They lift upward on the sternum.

Anterior serrate:-

Which lift many of the ribs.

Scalen:-

Which lift the first two ribs.

Abdominal recti:-

Which have the powerful effect of pulling downward on the lower ribs at the same time

that they and other abdominal muscles also compress the abdominal contents upward

against the diaphragm.

Internal intercostals:-

The muscles that pull the rib cage downward during expiration.

Pressures That Cause the Movement of Air In and Out of the Lungs

 Pleural PressurePleural pressure is the pressure of the fluid in the thin space between the lung

pleura and the chest wall pleura.This is normally a slight suction, which means

a slightly negative pressure. The normal pleural pressure at the beginning of

inspiration is about –5 centimeters of water, which is the amount of suction

required to hold the lungs open to their resting level. Then, during normal

inspiration, expansion of the chest cage pulls outward on the lungs with

greater force and creates more negative pressure, to anaverage of about

–7.5 centimeters of water.

 Alveolar PressureAlveolar pressure is the pressure of the air inside the lung alveoli. When the

glottis is open and no air is flowing into or out of the lungs, the pressures in all

parts of the respiratory tree, all the way to the alveoli, are equal to atmospheric

pressure, which is considered to be zero reference pressure in the airways,

that is, 0 centimeters water pressure. To cause inward flow of air into the alveoli

during inspiration, the pressure in the alveoli must fall to a value slightly below

atmospheric pressure (below 0). The second curve labeled “alveolar pressure”

in Figure demonstrates that during normal inspiration, alveolar pressure decreases

to about –1 centimeter of water. This slight negative pressure is enough to pull 0.5

liter of air into the lungs in the 2 seconds required for normal quiet inspiration.

During expiration, opposite pressures occur: The alveolar pressure rises to

about +1 centimeter of water, and this forces the 0.5 liter of inspired air out of the

lungs during the 2 to 3 seconds of expiration.

Transpulmonary PressureThe difference between the alveolar pressure and the pleural pressure. This is called

the transpulmonary pressure. It is the pressure difference between that in the alveoli

and that on the outer surfaces of the lungs, and it is a measure of the elastic forces

in the lungs that tend to collapse the lungs at each instant of respiration, called the

recoil pressure

Compliance of the LungsThe extent to which the lungs will expand for each unit increase in transpulmonary

pressure (if enough time is allowed to reach equilibrium) is called the lung compliance.

The total compliance of both lungs together in the normal adult human being averages

about 200 milliliters of air per centimeter of water transpulmonary pressure. That is,

every time the transpulmonary pressure increases 1 centimeter of water, the lung

volume, after 10 to 20 seconds, will expand 200 milliliters.

 

Compliance of the Thorax and the Lungs TogetherThe compliance of the entire pulmonary system (the lungs and thoracic cage together)

is measured while expanding the lungs of a totally relaxed or paralyzed person.To do this,

air is forced into the lungs a little at a time while recording lung pressures and volumes.To

inflate this total pulmonary system, almost twice as much pressure is needed as to inflate

the same lungs after removal from the chest cage.Therefore, the compliance of the

combined lung-thorax system is almost exactly one half that of the lungs alone—110

milliliters of volume per centimeter of water pressure for the combined system, compared

with 200 ml/cm for the lungs alone. Furthermore, when the lungs are expanded to high volumes

or compressed to low volumes, the limitations of the chest become extreme.

 

Effect of the Thoracic Cage on Lung ExpansibilityThus far, we have discussed the expansibility of the lungs alone, without considering

the thoracic cage.The thoracic cage has its own elastic and viscous characteristics,

similar to those of the lungs; even if the lungs were not present in the thorax, muscular

effort would still be required to expand the thoracic cage.

 

Resistance Within Airways

• As air flows into the lungs, the gas molecules encounter resistance when they strike the walls of theairway. Therefore the diameter of the airway affects resistance.• When the bronchiole constricts, the diameter decreases, and the resistance increases. This is because more gas molecules encounter the airway wall. Airflow is inversely related to resistance.• Airflow equals the pressure difference between atmosphere and intrapulmonary pressure, divided by the resistance.• As the resistance increases, the airflow decreases.• As the resistance decreases, the airflow increases.• In healthy lungs, the airways typically offer little resistance, so air flows easily into and out of the lungs. 

 Factors Affecting Airway Resistance

• Several factors change airway resistance by affecting the diameter of the airways. They do this bycontracting or relaxing the smooth muscle in the airway walls, especially the bronchioles.• Parasympathetic neurons release the neurotransmitter acetylcholine, which constricts bronchioles.As you can see in the equation, increased airway resistance decreases airflow.• Histamine, released during allergic reactions, constricts bronchioles. This increases airwayresistance and decreases airflow, making it harder to breathe.• Epinephrine, released by the adrenal medulla during exercise or stress, dilates bronchioles, therebydecreasing airway resistance. This greatly increases airflow, ensuring adequate gas exchange.

SURFACTANTS AND SURFACE TENSION 

Surface tension:- is the tendency of molecules in a fluid to be pulled toward the center of the fluid. It is measured as an energy per unit area (J/m2) or as the force across a line (N/m)

 

Surfactants:- They are substances that reduce surface tension

 

· They prevent water droplets from blocking airways.

· High surface tension would tend to decrease the surface area of the lungs, thus making it harder to absorb air.

The surface tension of pure water is about 70 mN/m. With lung surfactant, it can drop lower than 2 mN/m. (Possmayer et al., 2001, Measurement online)

Components of lung surfactant:-· 35-40% dipalmitoyl phosphatidylcholine (DPPC), a phospholipid

· 30-45% other phospholipids

· 5-10% protein (SP-A, B, C, and D)

· cholesterols (neutral lipids) and trace amounts of other substances

 

Minute Respiratory Volume Equals Respiratory Rate Times Tidal Volume The minute respiratory volume is the total amount of new air moved into the respiratory passages each minute;

this is equal to the tidal volume times the respiratory rate per minute. The normal tidal volume is about 500 milliliters, and the normal respiratory rate is about 12 breaths per minute. Therefore, the minute respiratory volume averages about 6 L/min. A person can live for a short period with a minute respiratory volume as low as 1.5 L/min and a respiratory rate of only 2 to 4 breaths per minute. The respiratory rate occasionally rises to 40 to 50 per minute, and the tidal volume can become as great as the vital capacity, about 4600 milliliters in a young adult man. This can give a minute respiratory volume greater than 200 L/min, or more than 30 times normal. Most people cannot sustain more than one half to two thirds these values for longer than 1 minute.

Alveolar Ventilation The ultimate importance of pulmonary ventilation is to continually renew the air in the gas

exchange areas of the lungs, where air is in proximity to the pulmonary blood. These areas include the alveoli, alveolar sacs, alveolar ducts, and respiratory bronchioles.The rate at which new air reaches these areas is called alveolar ventilation.

 

Rate of Alveolar Ventilation Alveolar ventilation per minute is the total volume of new air entering the alveoli and adjacent gas

exchange areas each minute. It is equal to the respiratory rate times the amount of new air that enters these areas with each breath.

 

VA = Freq • (VT – VD)

 

where VA is the volume of alveolar ventilation per minute, Freq is the frequency of respiration per minute, VT is the tidal volume, and VD is the physiologic dead space volume. Thus, with a normal tidal volume of 500 milliliters, a normal dead space of 150 milliliters, and a respiratory rate of 12 breaths per minute, alveolar ventilation equals 12 ¥ (500 – 150), or 4200 ml/min.

Alveolar ventilation is one of the major factors determining the concentrations of oxygen and carbon dioxide in the alveoli.Therefore, almost all discussions of gaseous exchange in the following chapters on the respiratory system emphasize alveolar ventilation.

CONCLUSION 1. Muscle activity causes changes in the volume of the thoracic cavity during breathing.2. Changing the thoracic cavity volume causes intrapulmonary and intrapleural pressure

changes, which allow air to move from high pressure to low pressure regions.3. Airway resistance is normally low, but nervous stimulation and chemical factors can

change the diameter of bronchioles, thereby altering resistance and airflow.4. Lung compliance is normally high due to the lung's abundant elastic tissue and

surfactant's ability to lower the surface tension of the alveolar fluid.

REFERENCES

Guyton and Hall textbook of medical physiologyMedical physiology LANGE William F. Ganongwww.wiona.eduwww.youngpharmacist.com