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Copyright  ©  The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 20 Respiratory Syst...
Respiration <ul><li>Movement of air into and out of the lungs (Ventilation or Breathing) </li></ul><ul><li>Exchange of O 2...
Functions of the Respiratory System <ul><li>Gas exchange </li></ul><ul><li>Regulation of blood pH </li></ul><ul><li>Voice ...
Anatomy of the Respiratory System <ul><li>The respiratory system consist of the upper and lower respiratory tract </li></u...
Fig. 20.1
 
Nose <ul><li>Consist of the external nose and the nasal cavity </li></ul><ul><ul><li>External nose </li></ul></ul><ul><ul>...
Nose <ul><ul><li>Provides an airway for respiration </li></ul></ul><ul><ul><li>Moistens and warms the entering air </li></...
The Pharynx <ul><li>Connects the nasal cavity and mouth to the larynx and esophagus inferiorly </li></ul><ul><li>Common pa...
Fig. 20.2
Larynx (Voice Box) <ul><li>Anterior part of the throat, from the base of the tongue to the trachea </li></ul><ul><li>The t...
Fig. 20.3
Vocal Cords <ul><li>Two pairs of ligaments </li></ul><ul><li>False vocal cords (vestibular folds) </li></ul><ul><ul><li>Su...
Fig. 20.4
Sound Production <ul><li>Sound:  Vibration of the vocal folds as air moves past them </li></ul><ul><li>Loudness:  depends ...
Trachea <ul><li>Descends from the larynx through the neck to the fifth thoracic vertebra  </li></ul><ul><li>Composed of de...
Main Bronchi <ul><li>The right and left bronchi are formed by the division of the trachea </li></ul><ul><li>Right primary ...
Lungs <ul><li>Principal organs of respiration </li></ul><ul><li>Base rest on diaphragm and the apex extends superiorly to ...
The Tracheobronchial Tree <ul><li>Once inside the lungs each main bronchus </li></ul><ul><ul><li>Subdivides into lobar (se...
The Tracheobronchial Tree <ul><li>Terminal bronchioles divide into respiratory bronchioles, which have a few attached alve...
Fig. 20.5
Fig. 20.6
Fig. 20.7
The Tracheobronchial Tree <ul><li>As air passageways become smaller, structural changes occur  </li></ul><ul><ul><li>Carti...
Alveoli <ul><li>Alveolar walls: </li></ul><ul><ul><li>Are a single layer of type I pneumocytes </li></ul></ul><ul><ul><ul>...
Respiratory Membrane <ul><li>Where gas exchange between air and blood occurs </li></ul><ul><li>It is very thin to facilita...
Fig. 20.8
Pleura <ul><li>Thin, double-layered serous membranes </li></ul><ul><li>Parietal pleura </li></ul><ul><ul><li>Covers the th...
Fig. 20.9
 
Blood Supply to Lungs <ul><li>Lungs are perfused by two circulations: pulmonary and bronchial </li></ul><ul><li>Pulmonary ...
<ul><li>Inspiration:  movement of air into the lungs </li></ul><ul><ul><li>Muscles involved are the diaphragm and those th...
Fig. 20.10
Pressure Changes and Airflow <ul><li>Physical Principles Influencing Pulmonary Ventilation </li></ul><ul><ul><li>Air flows...
 
Alveoli Airflow Fig. 20.11
Alveoli Airflow Fig. 20.11
Fig. 20.11
 
Lung Recoil <ul><li>Tendency for an expanded lung to decrease in size due to </li></ul><ul><ul><li>Elastic fibers in the c...
Surfactant <ul><li>Surf ace  act ing  a ge nt </li></ul><ul><li>Mixture of lipoprotein molecules </li></ul><ul><li>Acts in...
Pleural Pressure <ul><li>Pressure in the pleural cavity </li></ul><ul><ul><li>When pleural pressure is less than alveolar ...
Measurement of Lung Function <ul><li>Measurements can be used to  </li></ul><ul><ul><li>Diagnose disease </li></ul></ul><u...
Lung Compliance <ul><li>Measurement of the ease with which the lungs and thorax expand </li></ul><ul><li>Volume increases ...
Pulmonary Function Tests <ul><li>Spirometry is the process of measuring volumes of air that move into and out of the respi...
Pulmonary Volumes <ul><li>Tidal volume (TV) </li></ul><ul><ul><li>volume of air inspired or expired with each breath (appr...
Pulmonary Capacities <ul><li>Sum of two or more pulmonary volumes </li></ul><ul><li>Inspiratory capacity (IC = IRV + TV) <...
Fig. 20.12
Pulmonary Function Tests <ul><li>Forced expiratory vital capacity </li></ul><ul><ul><li>individual inspires maximally and ...
Minute Ventilation <ul><li>Minute Ventilation </li></ul><ul><ul><li>equals tidal volume (~500mls) times respiratory rate (...
Alveolar Ventilation <ul><li>Alveolar ventilation (V A ) </li></ul><ul><ul><li>volume of air available for gas exchange </...
 
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Tissues <ul><li>In the tissues, CO 2  diffuses into the plasma and into RBC. Some of the CO 2  remains...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
Gas Exchange in the Lungs <ul><li>In the lungs, CO 2  diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li...
 
 
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Transcript of "Respiratory system 2003"

  1. 1. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 20 Respiratory System Alveolar Duct
  2. 2. Respiration <ul><li>Movement of air into and out of the lungs (Ventilation or Breathing) </li></ul><ul><li>Exchange of O 2 and CO 2 between the lungs and the blood </li></ul><ul><li>Transport of these gases </li></ul><ul><li>Exchange of O 2 and CO 2 between the blood and the tissues </li></ul>
  3. 3. Functions of the Respiratory System <ul><li>Gas exchange </li></ul><ul><li>Regulation of blood pH </li></ul><ul><li>Voice production </li></ul><ul><li>Olfaction </li></ul><ul><li>Protection </li></ul>
  4. 4. Anatomy of the Respiratory System <ul><li>The respiratory system consist of the upper and lower respiratory tract </li></ul><ul><ul><li>Upper respiratory tract: external nose, nasal cavity, pharynx, and associated structures </li></ul></ul><ul><ul><li>Lower respiratory tract: larynx, trachea, the bronchi, and lungs </li></ul></ul>
  5. 5. Fig. 20.1
  6. 7. Nose <ul><li>Consist of the external nose and the nasal cavity </li></ul><ul><ul><li>External nose </li></ul></ul><ul><ul><ul><li>only visible structure </li></ul></ul></ul><ul><ul><li>Nasal cavity </li></ul></ul><ul><ul><ul><li>Nares or Nostrils – external openings </li></ul></ul></ul><ul><ul><ul><li>Choanae – openings to pharynx </li></ul></ul></ul><ul><ul><ul><li>Vestibule – anterior portion of nasal cavity </li></ul></ul></ul><ul><ul><ul><li>Hard palate – separates the nasal cavity from the oral cavity </li></ul></ul></ul><ul><ul><ul><li>Nasal septum – divides nose into right and left parts </li></ul></ul></ul><ul><ul><ul><li>Conchae – boney ridges in the nasal cavity </li></ul></ul></ul><ul><ul><ul><li>Meatus – Passageway beneath each conchae </li></ul></ul></ul>
  7. 8. Nose <ul><ul><li>Provides an airway for respiration </li></ul></ul><ul><ul><li>Moistens and warms the entering air </li></ul></ul><ul><ul><li>Filters inspired air and cleans it of foreign matter </li></ul></ul><ul><ul><li>Serves as a resonating chamber for speech </li></ul></ul><ul><ul><li>Houses the olfactory receptors </li></ul></ul>
  8. 9. The Pharynx <ul><li>Connects the nasal cavity and mouth to the larynx and esophagus inferiorly </li></ul><ul><li>Common passageway for air, food, and drink </li></ul><ul><li>Commonly called the throat </li></ul><ul><li>There are 3 regions: </li></ul><ul><ul><li>Nasopharynx: air only </li></ul></ul><ul><ul><ul><li>posterior to the choanae and superior to the soft palate </li></ul></ul></ul><ul><ul><ul><ul><li>soft palate separates the nasopharynx from the oropharynx </li></ul></ul></ul></ul><ul><ul><li>Oropharynx: air and food </li></ul></ul><ul><ul><ul><li>soft palate to the epiglottis </li></ul></ul></ul><ul><ul><li>Laryngopharynx: primarily food and drink </li></ul></ul><ul><ul><ul><li>epiglottis to the esophagus </li></ul></ul></ul>
  9. 10. Fig. 20.2
  10. 11. Larynx (Voice Box) <ul><li>Anterior part of the throat, from the base of the tongue to the trachea </li></ul><ul><li>The three functions of the larynx are: </li></ul><ul><ul><li>To provide an airway </li></ul></ul><ul><ul><li>To act as a switching mechanism to route air and food into the proper channels </li></ul></ul><ul><ul><ul><li>Epiglottis: elastic cartilage that covers the laryngeal inlet during swallowing </li></ul></ul></ul><ul><ul><ul><li>Closure of the vestibular and vocal folds </li></ul></ul></ul><ul><ul><li>To function in voice production </li></ul></ul>
  11. 12. Fig. 20.3
  12. 13. Vocal Cords <ul><li>Two pairs of ligaments </li></ul><ul><li>False vocal cords (vestibular folds) </li></ul><ul><ul><li>Superior mucosal folds </li></ul></ul><ul><ul><li>Have no part in sound production </li></ul></ul><ul><li>True vocal cords (vocal folds) </li></ul><ul><ul><li>Inferior mucosal folds composed of elastic fibers </li></ul></ul><ul><ul><li>The medial opening between them is the glottis </li></ul></ul><ul><ul><li>They vibrate to produce sound as air rushes up from the lungs </li></ul></ul><ul><ul><li>Laryngitis: Inflammation of the vocal folds </li></ul></ul>
  13. 14. Fig. 20.4
  14. 15. Sound Production <ul><li>Sound: Vibration of the vocal folds as air moves past them </li></ul><ul><li>Loudness: depends on the amplitude of the vibration, which is determined by the force at which the air rushes across the vocal cords </li></ul><ul><li>Pitch: determined by the length and tension of the vocal cords, which changes the frequency of the vibrations </li></ul><ul><li>Sound is “shaped” into language by action of the tongue, lips, teeth, and other structures </li></ul><ul><li>The pharynx resonates, amplifies, and enhances sound quality </li></ul>
  15. 16. Trachea <ul><li>Descends from the larynx through the neck to the fifth thoracic vertebra </li></ul><ul><li>Composed of dense regular connective tissue and smooth muscle reinforced with 15-20 C-shaped rings of hyaline cartilage, which protect the trachea and keep the airway open </li></ul><ul><li>The mucous membrane lining the trachea is made up of goblet cells and pseudostratified ciliated columnar epithelium </li></ul><ul><ul><li>Goblet cells produce mucus </li></ul></ul><ul><li>It ends by dividing into the two primary bronchi </li></ul>
  16. 17. Main Bronchi <ul><li>The right and left bronchi are formed by the division of the trachea </li></ul><ul><li>Right primary bronchus is wider, shorter and more vertical than the left </li></ul><ul><ul><li>Common site for an inhaled object to become lodged </li></ul></ul><ul><li>By the time that incoming air reaches the bronchi, it is warmed, cleansed and saturated with water vapor </li></ul>
  17. 18. Lungs <ul><li>Principal organs of respiration </li></ul><ul><li>Base rest on diaphragm and the apex extends superiorly to ~2.5 cm above the clavicle </li></ul><ul><li>Right lung has 3 lobes, while the left has only 2 lobes </li></ul>
  18. 19. The Tracheobronchial Tree <ul><li>Once inside the lungs each main bronchus </li></ul><ul><ul><li>Subdivides into lobar (secondary) bronchi </li></ul></ul><ul><ul><li>Then segmental (tertiary) bronchi </li></ul></ul><ul><ul><li>Finally giving rise to the bronchioles, which subdivide many times to give rise to the terminal bronchioles </li></ul></ul><ul><li>~16 generations of branching from the trachea to the terminal bronchioles </li></ul>
  19. 20. The Tracheobronchial Tree <ul><li>Terminal bronchioles divide into respiratory bronchioles, which have a few attached alveoli </li></ul><ul><ul><li>Alveoli – small air filled chambers where gas exchange between the air and blood takes place </li></ul></ul><ul><li>Respiratory bronchioles lead to alveolar ducts, then to terminal clusters of alveolar sacs composed of alveoli </li></ul><ul><li>Approximately 300 million alveoli </li></ul><ul><ul><li>Account for most of the lungs’ volume </li></ul></ul><ul><ul><li>Provide tremendous surface area for gas exchange </li></ul></ul><ul><li>~7 generations of branching occur from the terminal bronchioles to the alveolar ducts </li></ul>
  20. 21. Fig. 20.5
  21. 22. Fig. 20.6
  22. 23. Fig. 20.7
  23. 24. The Tracheobronchial Tree <ul><li>As air passageways become smaller, structural changes occur </li></ul><ul><ul><li>Cartilage support structures decrease </li></ul></ul><ul><ul><li>Amount of smooth muscle increases </li></ul></ul><ul><ul><li>Epithelium types change </li></ul></ul><ul><li>Terminal bronchioles are mostly smooth muscle with no cartilage, which allows the bronchioles to alter their diameter when a change in air flow is needed (i.e. during exercise) </li></ul>
  24. 25. Alveoli <ul><li>Alveolar walls: </li></ul><ul><ul><li>Are a single layer of type I pneumocytes </li></ul></ul><ul><ul><ul><li>Squamous epithelial cells </li></ul></ul></ul><ul><ul><ul><li>Compose 90% of the alveolar surface </li></ul></ul></ul><ul><ul><ul><li>Permit gas exchange by simple diffusion </li></ul></ul></ul><ul><ul><li>Type II pneumocytes </li></ul></ul><ul><ul><ul><li>Round or cube-shaped secretory cells that produce surfactant </li></ul></ul></ul><ul><ul><ul><li>Surfactant reduces surface tension, which makes it easier for the alveoli to expand </li></ul></ul></ul>
  25. 26. Respiratory Membrane <ul><li>Where gas exchange between air and blood occurs </li></ul><ul><li>It is very thin to facilitate the diffusion of gases </li></ul><ul><li>Consists of: </li></ul><ul><ul><li>Thin layer of fluid lining the alveolus </li></ul></ul><ul><ul><li>Alveolar epithelium </li></ul></ul><ul><ul><li>Basement membrane of the alveolar epithelium </li></ul></ul><ul><ul><li>A thin interstitial space </li></ul></ul><ul><ul><li>Basement membrane of the capillary endothelium </li></ul></ul><ul><ul><li>The capillary endothelium </li></ul></ul>
  26. 27. Fig. 20.8
  27. 28. Pleura <ul><li>Thin, double-layered serous membranes </li></ul><ul><li>Parietal pleura </li></ul><ul><ul><li>Covers the thoracic wall, diaphragm, and mediastinum </li></ul></ul><ul><li>Visceral pleura </li></ul><ul><ul><li>Covers the external lung surface </li></ul></ul><ul><li>Pleural cavity </li></ul><ul><ul><li>Negative pressure space between the parietal and visceral pleura </li></ul></ul><ul><li>Pleural Fluid </li></ul><ul><ul><li>Fills the pleural cavity </li></ul></ul><ul><ul><li>Made by the pleural membranes </li></ul></ul><ul><ul><li>Serves as a lubricant </li></ul></ul><ul><ul><li>Holds the pleural membranes together </li></ul></ul>
  28. 29. Fig. 20.9
  29. 31. Blood Supply to Lungs <ul><li>Lungs are perfused by two circulations: pulmonary and bronchial </li></ul><ul><li>Pulmonary circulation </li></ul><ul><ul><li>Pulmonary arteries: supply deoxygenated systemic blood to be oxygenated </li></ul></ul><ul><ul><ul><li>Ultimately feed into the pulmonary capillary network surrounding the alveoli </li></ul></ul></ul><ul><ul><li>Pulmonary veins: carry oxygenated blood from lungs back to the heart </li></ul></ul><ul><li>Bronchial circulation </li></ul><ul><ul><li>Bronchial arteries: provide systemic oxygenated blood to the lung tissue </li></ul></ul><ul><ul><ul><li>Supply all lung tissue except the alveoli </li></ul></ul></ul><ul><ul><li>Bronchial veins: carry the deoxygenated blood back to the heart </li></ul></ul>
  30. 32. <ul><li>Inspiration: movement of air into the lungs </li></ul><ul><ul><li>Muscles involved are the diaphragm and those that elevate the ribs and sternum </li></ul></ul><ul><ul><li>As the diaphragm and other muscles of inspiration contract and the rib cage rises and thoracic volume increases </li></ul></ul><ul><li>Expiration: movement of air out of the lungs </li></ul><ul><ul><li>Muscles actively involved are those that depress the ribs and sternum (usually only with forceful expiration) </li></ul></ul><ul><ul><li>Largely a passive process </li></ul></ul><ul><ul><li>M uscles of inspiration relax, the rib cage descends due to gravity and the thoracic cavity volume decreases </li></ul></ul><ul><li>Pressure changes in the thoracic cavity change air pressure in the lungs, which in turn causes ventilation </li></ul><ul><ul><li>largest change in thoracic volume is due to the diaphragm </li></ul></ul>Ventilation
  31. 33. Fig. 20.10
  32. 34. Pressure Changes and Airflow <ul><li>Physical Principles Influencing Pulmonary Ventilation </li></ul><ul><ul><li>Air flows from areas of higher to lower pressure </li></ul></ul><ul><ul><ul><li>If pressure is higher at one end of a tube (P 1 ) than at the other (P 2 ), air will flow down its pressure gradient </li></ul></ul></ul><ul><ul><li>Changes in volume result in changes in pressure </li></ul></ul><ul><ul><ul><li>As volume increases in a closed container the pressure decreases or as volume decreases pressure increases </li></ul></ul></ul><ul><ul><ul><li>This inverse relationship is known as Boyle’s law </li></ul></ul></ul><ul><ul><li>Changes in tube diameter result in changes in resistance </li></ul></ul><ul><ul><ul><li>Poiseuille’s law: resistance (R) to airflow is proportional to the diameter (d) of a tube raised to the fourth power (d 4 ) </li></ul></ul></ul>F = F=Airflow (mm/min) P 1 – P 2 R
  33. 36. Alveoli Airflow Fig. 20.11
  34. 37. Alveoli Airflow Fig. 20.11
  35. 38. Fig. 20.11
  36. 40. Lung Recoil <ul><li>Tendency for an expanded lung to decrease in size due to </li></ul><ul><ul><li>Elastic fibers in the connective tissue </li></ul></ul><ul><ul><li>Surface tension </li></ul></ul><ul><li>Two factors keep lungs from collapsing </li></ul><ul><ul><li>Surfactant </li></ul></ul><ul><ul><li>Pleural Pressures </li></ul></ul>
  37. 41. Surfactant <ul><li>Surf ace act ing a ge nt </li></ul><ul><li>Mixture of lipoprotein molecules </li></ul><ul><li>Acts in reducing surface tension in the alveoli </li></ul><ul><ul><li>Attraction of water molecules to each other </li></ul></ul><ul><li>Surfactant reduces the surface tension in alveoli by 10-fold </li></ul>
  38. 42. Pleural Pressure <ul><li>Pressure in the pleural cavity </li></ul><ul><ul><li>When pleural pressure is less than alveolar pressure alveoli expand </li></ul></ul><ul><li>Subatmospheric pleural pressure is caused by </li></ul><ul><ul><li>Removal of fluid from the pleural cavity </li></ul></ul><ul><ul><li>Lung recoil </li></ul></ul>
  39. 43. Measurement of Lung Function <ul><li>Measurements can be used to </li></ul><ul><ul><li>Diagnose disease </li></ul></ul><ul><ul><li>Track progress of disease </li></ul></ul><ul><ul><li>Track recovery from disease </li></ul></ul><ul><li>Measurements include </li></ul><ul><ul><li>Lung compliance </li></ul></ul><ul><ul><li>Pulmonary volumes and capacities </li></ul></ul><ul><ul><li>Minute ventilation </li></ul></ul><ul><ul><li>Alveolar ventilation </li></ul></ul>
  40. 44. Lung Compliance <ul><li>Measurement of the ease with which the lungs and thorax expand </li></ul><ul><li>Volume increases for each unit of pressure change in alveolar pressure </li></ul><ul><ul><li>Liters (volume of air)/Centimeter of H 2 O (pressure) </li></ul></ul><ul><ul><ul><li>In a normal person = 0.13 L/cm H 2 O </li></ul></ul></ul><ul><ul><li>Higher than normal compliance = less resistance to lung and thorax expansion </li></ul></ul><ul><ul><ul><li>Emphysema </li></ul></ul></ul><ul><ul><li>Lower than normal compliance = more resistance to lung and thorax expansion </li></ul></ul><ul><ul><ul><li>Pulmonary fibrosis, infant respiratory distress syndrome, pulmonary edema, asthma, bronchitis, and lung cancer </li></ul></ul></ul>
  41. 45. Pulmonary Function Tests <ul><li>Spirometry is the process of measuring volumes of air that move into and out of the respiratory system </li></ul><ul><li>Spirometer – a device used to measure these pulmonary volumes </li></ul><ul><li>The following factors can cause variations in Pulmonary Volumes and Capacities </li></ul><ul><ul><ul><li>Sex </li></ul></ul></ul><ul><ul><ul><li>Age </li></ul></ul></ul><ul><ul><ul><li>Body Size </li></ul></ul></ul><ul><ul><ul><li>Physical Condition </li></ul></ul></ul>
  42. 46. Pulmonary Volumes <ul><li>Tidal volume (TV) </li></ul><ul><ul><li>volume of air inspired or expired with each breath (approximately 500 ml at rest) </li></ul></ul><ul><li>Inspiratory reserve volume (IRV) </li></ul><ul><ul><li>amount of air that can be inspired forcefully after inspiration of the tidal volume (approximately 3000 ml at rest) </li></ul></ul><ul><li>Expiratory reserve volume (ERV) </li></ul><ul><ul><li>amount of air that can be forcefully expired after expiration of the tidal volume (approximately 1100 ml at rest) </li></ul></ul><ul><li>Residual volume (RV) </li></ul><ul><ul><li>volume of air still remaining in the respiratory passages and lungs after the most forceful expiration (approximately 1200 ml) </li></ul></ul>
  43. 47. Pulmonary Capacities <ul><li>Sum of two or more pulmonary volumes </li></ul><ul><li>Inspiratory capacity (IC = IRV + TV) </li></ul><ul><ul><li>Amount of air that a person can inspire maximally after a normal expiration (approximately 3500mL at rest ) </li></ul></ul><ul><li>Functional residual capacity (FRC = ERV + RV) </li></ul><ul><ul><li>Amount of air remaining in the lungs after a normal expiration (approximately 2300mL at rest ) </li></ul></ul><ul><li>Vital capacity (VC = IRV + TV + ERV) </li></ul><ul><ul><li>Maximum volume of air that a person can expel from the respiratory tract after a maximum inspiration (approximately 4600mL at rest ) </li></ul></ul><ul><li>Total lung capacity (TLC = IRV + ERV + TV + RV) </li></ul><ul><ul><li>Sum of all lung volumes (approximately 5800 ml at rest) </li></ul></ul>
  44. 48. Fig. 20.12
  45. 49. Pulmonary Function Tests <ul><li>Forced expiratory vital capacity </li></ul><ul><ul><li>individual inspires maximally and then exhales maximally as rapidly as possible </li></ul></ul><ul><ul><li>volume of air expired at the end of the test is the person’s forced expiratory vital capacity </li></ul></ul><ul><li>Forced expiratory volume in 1 second (FEV 1 ) </li></ul><ul><ul><li>amount of air expired during the first second of the test </li></ul></ul><ul><ul><li>decreased FEV 1 can be caused by airway obstruction, asthma, emphysema, tumors, pulmonary fibrosis, silicosis, kyphosis, and scoliosis </li></ul></ul>
  46. 50. Minute Ventilation <ul><li>Minute Ventilation </li></ul><ul><ul><li>equals tidal volume (~500mls) times respiratory rate (~12 breaths/min.) </li></ul></ul><ul><ul><li>Average ~ 6 L/min </li></ul></ul><ul><ul><li>Only measures movement of air into and out of the lungs, not amount of air available for gas exchange </li></ul></ul><ul><li>Dead space </li></ul><ul><ul><li>Areas of the respiratory system where gas exchange does not take place </li></ul></ul><ul><ul><li>Includes the nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, and terminal bronchioles (~150 mLs) </li></ul></ul><ul><ul><li>Nonfunctional alveoli can also contribute, but are rare in healthy individuals </li></ul></ul>
  47. 51. Alveolar Ventilation <ul><li>Alveolar ventilation (V A ) </li></ul><ul><ul><li>volume of air available for gas exchange </li></ul></ul><ul><li>Slow, deep breathing increases AVR and rapid, shallow breathing decreases AVR </li></ul>V A = ƒ X <ul><ul><li>(V T – V D ) </li></ul></ul>(mLs/min) (frequency, breaths/min) <ul><ul><li>(Tidal Volume – Dead Space) </li></ul></ul><ul><ul><li>(mLs/respiration) </li></ul></ul>
  48. 53. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  49. 54. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  50. 55. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  51. 56. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  52. 57. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  53. 58. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  54. 59. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA). </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ). </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them. </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  55. 60. Gas Exchange in the Tissues <ul><li>In the tissues, CO 2 diffuses into the plasma and into RBC. Some of the CO 2 remains in the plasma </li></ul><ul><li>In RBC, CO 2 reacts with H 2 O to form carbonic acid (H 2 CO 3 ) in a reaction catalyzed by the enzyme carbonic anhydrase (CA) </li></ul><ul><li>H 2 CO 3 dissociates to form bicarbonate ions (HCO 3 - ) and hydrogen ions (H + ) </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuses out of the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) into them </li></ul><ul><li>Oxygen (O 2 ) is released from hemoglobin (Hb). O 2 diffuses out of RBCs and plasma into the tissues </li></ul><ul><li>H + combine with Hb, which promotes the release of O 2 from Hb (Bohr effect) </li></ul><ul><li>CO 2 combines with Hb. Hb that has released O 2 readily combines with CO 2 (Haldane effect) </li></ul>
  56. 61. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  57. 62. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  58. 63. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  59. 64. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  60. 65. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  61. 66. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  62. 67. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
  63. 68. Gas Exchange in the Lungs <ul><li>In the lungs, CO 2 diffuses from the RBCs and plasma into the alveoli </li></ul><ul><li>Carbonic anhydrase (CA) catalyzes the formation of CO 2 and H 2 O from carbonic acid (H 2 CO 3 ) </li></ul><ul><li>Bicarbonate ions (HCO 3 - ) and H + combine to replace H 2 CO 3 </li></ul><ul><li>In the chloride shift, as HCO 3 - diffuse into the RBC, electrical neutrality is maintained by the diffusion of chloride ions (Cl - ) out of them </li></ul><ul><li>Oxygen diffuses into the plasma and into RBCs. Some of the O 2 remains in the plasma. O 2 binds to Hb </li></ul><ul><li>H + are released from Hb, which promotes the uptake of O 2 by Hb (Bohr effect) </li></ul><ul><li>CO 2 is released from Hb. Hb that is bound to O 2 readily releases CO 2 (Haldane effect) </li></ul>
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