Choithram Institute of Health
Guided By- Submitted By-
Dr. Kiran P. S. Aparna Bhagwat
B.P.T. 3rd year
PHYSIOLOGY OF BREATHING
PARAMETERS OF ASSESSMENT
ABNORMAL BREATHING PATTERNS
PHYSIOLOGY OF BREATHING:
• Breathing is a process by which Oxygen is
taken in and Carbon dioxide is given out of
• It is the process of gas exchange that occurs
in alveoli by passive diffusion of gases
between the alveoli and blood.
• The normal rate of breathing is 12-20/min.
(in adults) and 30-50/min. (in infants).
• The normal relaxed breathing is called as
• There are two phases of breathing-
• New born- 30-50 breath/min
• 3 years - 20-30 breath/min
• 10 years – 16-22 breath/min
• Adults - 12-20 breath/min
2. Body size and stature
4. Body position
PARAMETERS OF ASSESING:
Suspension of breathing.
No movement of muscles of resp.
and volume of lungs remains same.
No airflow into or out from the
Gaseous exchange & cellular resp.
is not affected.
Apnea can be achieved _
1. Voluntarily (breath holding)
3. From neurological trauma
Prolonged apnea leads to severe
lack of oxygen in circulation, b’coz
under normal conditions body cannot
store much oxygen.
A person cannot sustain voluntary
apnea for more than 1-2 min. (This
is much more decreased in smokers)
This is to maintain constant values
of CO2 conc. & pH of blood.
Here CO2 is not removed out of
lungs, it accumulates in blood,
leading to stimulation of resp.
centers in brain c stops apnea.
Apnea test in determining brain
The 3 diagnostic criteria of brain
death are as follows-
2. Absence of pulse
o Increased rate of breathing ,
i.e. >20 breaths/min.
o Characterized by rapid, shallow
It is seen in following conditions-
3. Compensatory resp.alkalosis
4. Respiratory insufficiency
5. Lesions to resp. centers in brain
6. Salicylate poisoning
7. Elevated diaphragm
Transient tachypnea of newborns
Decreased rate of breathing ,
i.e. <12 breaths/min.
Characterized by slow, shallow
The rate at c bradypnea is
diagnosed depends on the age –
• 0-1 years - <30 breaths/min.
• 1-3 years - <25 breaths/min.
• 3-12 years - <20 breaths/min.
• 12 & above - <12 breaths/min.
It is see secondary to following
• Diabetic coma
• Respiratory depression
• Increased intra-cranial pressure
Characterized by rapid, deep
Caused by increased levels of CO2.
Other causes include –
• Anxiety or pain
• Excessive use of aspirin
• Obstructive disorders- COPD,
asthma, & pulmonary embolism.
• Infections – pneumonia
• Congestive heart failure
• Diabetic ketoacidosis
Hyperventilation leads to following
• Light headedness
• Shortness of breath
• Muscle spasm in hands & feet.
All these symptoms are the result
of increased CO2 in blood caused by
KUSSMAUL BREATHING :
Rapid, gasping & very deep type of
Commonly called as “air hunger”.
It is been named for -
“Adolph Kussmaul”, a German doctor
who first noted it among patients
with advanced diabetes mellitus.
It is associated with severe
metabolic acidosis, particularly
Mechanism of kussmaul breathing.
Kussmaul’s sign – increase in JVP
Also called as “periodic breathing”.
This condition was named after
“John Cheyne & William Stokes”,
the physicians who first described
it in 19th century.
Characterized by alternate periods
of tachypnea and apnea.
Occurs as a compensation for
changing serum pO2 & pCO2, and
classically seen in damage to pons
where resp. centers are located.
Conditions in c it is seen are-
• Traumatic brain injury
• Brain tumors
• Heart failure
• Toxic metabolic encephalopathy
BIOT’S BREATHING :
Also called as “cluster breathing" or
It is named for a French Physician
“Camille Biot” who characterized it
It is periodic in nature & is
characterized by unpredictable
irregularities in breathing that
alternates with periods of apnea.
It is a group of quick, shallow
inspirations followed by regular or
irregular periods of apnea.
• Lesion to brainstem (sp. Medulla)
• Cervical spine injury – leading to
In ataxic breathing, there is
complete irregularity of breathing,
with irregular pauses & increasing
periods of apnea.
As the breathing pattern
deteriorates, it merges with the
AGONAL BREATHING :
shallow & very slow inspirations
(about 3-4 breaths/min.) followed
by irregular pauses of apnea.
Characterized by gasping, labored
breathing, accompanied by strange
• Cerebral ischemia
• Severe hypoxia/anoxia
• Cardiac arrest
SIGHING RESPIRATION :
• Is is the breathing punctuated by
• Alerts you for possibility of
• Common cause of dyspnea &
OBSTRUCTED BREATHING :
Also called as “air trapping”.
It is seen in obstructive diseases
Here, expiration is prolonged
because of increased airway
As the respiratory rate increases
patient lacks sufficient time for
Hence the chest over-expands
i.e. air trapping occurs and the
breathing becomes more shallow.