The document provides an overview of human respiratory physiology. It discusses the mechanics of breathing including pressure relationships and factors that influence lung movement. It describes the processes of inspiration and expiration, how gas exchange occurs in the lungs and blood, and the transport of oxygen and carbon dioxide in the body. Key concepts covered include lung volumes and capacities, chemical regulation of breathing, and effects of exercise and altitude on respiration. Disease states like COPD and lung cancer are also summarized.
The document describes the normal respiratory cycle and gas exchange in the lungs. During inhalation, air enters the mouth and flows through the upper airways, lower airways, and into the alveoli. Oxygen diffuses into the blood in the alveoli while carbon dioxide diffuses out. Various volumes are involved including tidal volume, vital capacity, and residual volume. The relationship between these volumes and pressures allows for gas exchange through diffusion while also keeping the alveoli open.
This document provides an overview of respiration and respiratory mechanics. It defines internal and external respiration, describes the four steps of external respiration, and explains the mechanics of ventilation - the first step involving gas exchange between the atmosphere and the lungs. Inspiration is an active process relying on muscle contraction, while normal expiration is usually passive. Factors such as lung volumes, airway resistance, compliance, and work of breathing are also discussed.
This document discusses the mechanics of respiration including the muscles involved and pressure changes during breathing. It describes how inspiration is an active process involving contraction of the diaphragm and external intercostal muscles which increases the thoracic cavity volume and decreases intrapleural pressure. Expiration is a passive process involving relaxation of these muscles. Pressures measured include intrapulmonary/intra-alveolar pressure which decreases slightly on inspiration and increases on expiration, and intrapleural/intrathoracic pressure which decreases further on deep inspiration. Applied aspects discussed include airway resistance and effects of diseases like asthma and emphysema.
This document provides an overview of respiratory physiology, including:
1) The structures and functions of the conducting and respiratory zones of the lungs. Gas exchange occurs between air and blood in the alveoli.
2) The mechanics of breathing, including the roles of the diaphragm, intercostal muscles, and pleural membranes in inspiration and expiration.
3) Measurements of pulmonary function including lung volumes and capacities. Pulmonary disorders can be restrictive or obstructive.
The document provides information on the respiratory system. It discusses:
1. The respiratory system functions to exchange oxygen and carbon dioxide between the atmosphere and tissues through breathing and gas diffusion. It is divided into an upper and lower system.
2. The lower respiratory system includes the lungs, which are made up of conducting and respiratory zones. Gas exchange occurs in the alveoli via diffusion driven by partial pressures.
3. Respiration includes pulmonary ventilation, external respiration in the lungs, and internal respiration in tissues. Various tests like spirometry and diffusion testing evaluate lung function and gas exchange ability.
The document provides information on ventilation and the anatomy of the respiratory system. It defines ventilation as the mass movement of gas in and out of the lungs. It then describes the anatomy of the airways from the nostrils down to the alveoli. This includes details on structures like the nasal cavity, pharynx, larynx, trachea, bronchi, and terminal bronchioles. It also discusses factors that affect ventilation like pulmonary pressures, the mechanics of breathing, and control of breathing.
This document discusses respiratory function and its importance to anesthesia. It covers topics like cellular respiration, aerobic vs anaerobic respiration, muscles of respiration, mechanisms of ventilation, lung volumes, compliance, and factors that affect respiration. The speaker is Dr. Tipu and the event is being coordinated by Dr. Shivali Pandey.
The document discusses the process of respiration in four parts:
1. Pulmonary ventilation involves breathing air in and out of the lungs through inhalation and exhalation.
2. External respiration is the exchange of oxygen and carbon dioxide between the alveoli in the lungs and blood in the pulmonary capillaries.
3. Internal respiration is the exchange of gases between blood in the systemic capillaries and tissue cells throughout the body.
4. Respiration is regulated through various pulmonary volumes including tidal volume, vital capacity, functional residual capacity, and total lung capacity.
The document describes the normal respiratory cycle and gas exchange in the lungs. During inhalation, air enters the mouth and flows through the upper airways, lower airways, and into the alveoli. Oxygen diffuses into the blood in the alveoli while carbon dioxide diffuses out. Various volumes are involved including tidal volume, vital capacity, and residual volume. The relationship between these volumes and pressures allows for gas exchange through diffusion while also keeping the alveoli open.
This document provides an overview of respiration and respiratory mechanics. It defines internal and external respiration, describes the four steps of external respiration, and explains the mechanics of ventilation - the first step involving gas exchange between the atmosphere and the lungs. Inspiration is an active process relying on muscle contraction, while normal expiration is usually passive. Factors such as lung volumes, airway resistance, compliance, and work of breathing are also discussed.
This document discusses the mechanics of respiration including the muscles involved and pressure changes during breathing. It describes how inspiration is an active process involving contraction of the diaphragm and external intercostal muscles which increases the thoracic cavity volume and decreases intrapleural pressure. Expiration is a passive process involving relaxation of these muscles. Pressures measured include intrapulmonary/intra-alveolar pressure which decreases slightly on inspiration and increases on expiration, and intrapleural/intrathoracic pressure which decreases further on deep inspiration. Applied aspects discussed include airway resistance and effects of diseases like asthma and emphysema.
This document provides an overview of respiratory physiology, including:
1) The structures and functions of the conducting and respiratory zones of the lungs. Gas exchange occurs between air and blood in the alveoli.
2) The mechanics of breathing, including the roles of the diaphragm, intercostal muscles, and pleural membranes in inspiration and expiration.
3) Measurements of pulmonary function including lung volumes and capacities. Pulmonary disorders can be restrictive or obstructive.
The document provides information on the respiratory system. It discusses:
1. The respiratory system functions to exchange oxygen and carbon dioxide between the atmosphere and tissues through breathing and gas diffusion. It is divided into an upper and lower system.
2. The lower respiratory system includes the lungs, which are made up of conducting and respiratory zones. Gas exchange occurs in the alveoli via diffusion driven by partial pressures.
3. Respiration includes pulmonary ventilation, external respiration in the lungs, and internal respiration in tissues. Various tests like spirometry and diffusion testing evaluate lung function and gas exchange ability.
The document provides information on ventilation and the anatomy of the respiratory system. It defines ventilation as the mass movement of gas in and out of the lungs. It then describes the anatomy of the airways from the nostrils down to the alveoli. This includes details on structures like the nasal cavity, pharynx, larynx, trachea, bronchi, and terminal bronchioles. It also discusses factors that affect ventilation like pulmonary pressures, the mechanics of breathing, and control of breathing.
This document discusses respiratory function and its importance to anesthesia. It covers topics like cellular respiration, aerobic vs anaerobic respiration, muscles of respiration, mechanisms of ventilation, lung volumes, compliance, and factors that affect respiration. The speaker is Dr. Tipu and the event is being coordinated by Dr. Shivali Pandey.
The document discusses the process of respiration in four parts:
1. Pulmonary ventilation involves breathing air in and out of the lungs through inhalation and exhalation.
2. External respiration is the exchange of oxygen and carbon dioxide between the alveoli in the lungs and blood in the pulmonary capillaries.
3. Internal respiration is the exchange of gases between blood in the systemic capillaries and tissue cells throughout the body.
4. Respiration is regulated through various pulmonary volumes including tidal volume, vital capacity, functional residual capacity, and total lung capacity.
There are two types of respiration: internal and external. Internal respiration refers to cellular metabolism within cells, while external respiration involves the exchange of oxygen and carbon dioxide between the lungs and blood. The respiratory system, including the nasal passages, pharynx, larynx, trachea, bronchi, and alveoli, facilitates this gas exchange. Specifically, oxygen diffuses into and carbon dioxide diffuses out of the alveoli, which are tiny air sacs surrounded by pulmonary capillaries. Breathing is driven by changes in pressure that cause air to flow into and out of the lungs.
Respiratory physiology by Dr RamKrishnaram krishna
The document discusses respiratory physiology, including:
1) The anatomy of the respiratory system including the upper and lower respiratory tract.
2) Pulmonary ventilation driven by pressure differences caused by contraction of respiratory muscles.
3) Gas exchange that occurs via diffusion between alveoli and capillaries in the lungs. Oxygen binds to hemoglobin while carbon dioxide is transported as bicarbonate.
4) Controls of respiration centered in the medulla that regulate rate and depth of breathing in response to changes in oxygen and carbon dioxide levels.
The document discusses various topics related to respiratory physiology including:
1. Lung volumes such as tidal volume, inspiratory reserve volume, expiratory reserve volume, and residual volume. It defines total lung capacity and vital capacity.
2. Ventilation, including minute ventilation, alveolar ventilation, anatomic and physiologic dead space.
3. Diffusion of gases in the lungs and blood including Fick's law of diffusion and measurement of diffusing capacity.
4. Ventilation-perfusion relationships in the lungs and how this impacts oxygen and carbon dioxide exchange.
5. The five main causes of hypoxemia: hypoventilation, diffusion abnormalities, shunts, ventilation-perfusion
1. Respiration includes ventilation, gas exchange, and oxygen utilization. Ventilation is the mechanical process of breathing that moves air in and out of the lungs. Gas exchange occurs through diffusion of oxygen and carbon dioxide between the alveoli and blood.
2. The lungs contain over 300 million alveoli which provide a large surface area for gas exchange. Each alveolus is lined by fluid and surfactant that helps reduce surface tension to facilitate breathing.
3. During inspiration, contraction of the diaphragm and intercostal muscles increases the thoracic cavity volume, lowering pressure and drawing air into the lungs. Expiration is passive as the lungs and chest wall recoil, increasing pressure to push
This document defines and describes the different types of dead space in the lungs, including anatomical, physiological, alveolar, and apparatus dead space. It explains that physiological dead space is greater than anatomical dead space due to the inclusion of alveolar dead space. The document also outlines methods to measure anatomical and physiological dead space, such as Fowler's method and Bohr's equation. Factors that can influence the amounts of anatomical and alveolar dead space are also discussed.
- Respiration includes ventilation (breathing), gas exchange between air and blood in the lungs, and oxygen utilization through cellular respiration.
- During inhalation, oxygen diffuses from air into the blood in the lungs and carbon dioxide diffuses from the blood into the air. Exhalation is driven by the elastic recoil of the lungs.
- The lungs contain over 300 million alveoli which have a large surface area for gas exchange and are only one cell thick, facilitating diffusion. Surfactant produced in the alveoli reduces surface tension to keep alveoli open during exhalation.
The document summarizes the mechanics of ventilation in the respiratory system. It discusses how inspiration and expiration occur through changes in pressure and volume in the thoracic cavity, lungs, and alveoli. Inspiration is driven by contraction of the diaphragm and external intercostal muscles, which increases thoracic cavity volume and causes air to flow into the lungs down the pressure gradient. Expiration occurs passively as the inspiratory muscles relax and the lungs and chest wall recoil, decreasing thoracic volume and causing air to flow out. The document also covers factors influencing ventilation like airway resistance, alveolar surface tension, and lung compliance.
The respiratory system facilitates gas exchange through inspiration and expiration. Inspiration is driven by contraction of the diaphragm and external intercostal muscles, while expiration occurs when these muscles relax. Factors like airway resistance, surfactant, and intrapleural pressure can impact ventilation. Different breathing patterns also affect carbon dioxide levels in the blood.
1) Breathing involves inspiration where gases flow into the lungs and expiration where gases exit. Changes in lung volume cause changes in pressure, driving gas flow.
2) Several factors influence breathing pressures, including atmospheric pressure, the elastic recoil of the lungs, and alveolar surface tension maintained by pulmonary surfactant.
3) The main muscles of breathing are the diaphragm and external intercostal muscles. Inspiration is an active process where muscles contract to increase lung volume, while expiration is usually passive as muscles relax.
Respiration involves three main functions: ventilation, gas exchange, and oxygen utilization. Ventilation is the mechanical process of breathing which moves air in and out of the lungs. Gas exchange occurs through diffusion between the alveoli and capillaries, allowing oxygen to diffuse from the air into the blood and carbon dioxide to diffuse out. Oxygen is then utilized in cellular respiration throughout the body. The document discusses the anatomy and physiology of respiration including the conducting and respiratory zones of the lungs, gas pressures, lung volumes, and disorders that can affect respiration.
This document provides an overview of pulmonary diffusion and related concepts. It begins with objectives around gas diffusion, alveolar ventilation, and the ventilation-perfusion ratio. The introduction discusses external respiration, pulmonary ventilation, diffusion, and gas transport. Key topics covered include the physics of gas diffusion and partial pressure, alveolar ventilation, dead space, and the diffusion of gases through the respiratory membrane. Clinical significance of various concepts is also discussed.
This document provides an overview of the applied physiology of the respiratory system. It discusses topics such as respiration, the respiratory passages, pulmonary circulation, mechanics of respiration, pulmonary volumes and capacities, ventilation, dead space, regulation of respiration, and respiratory disorders. Measurement techniques for lung function are also covered, including spirometry and plethysmography. Restrictive and obstructive respiratory disorders are defined. Various respiratory conditions and disturbances are listed and described briefly.
Respiration is the process of gas exchange between an organism and the environment. It consists of external respiration, which is breathing and the exchange of gases between the lungs and environment. And internal respiration, which is the exchange of oxygen and carbon dioxide between the blood and tissues via cellular respiration. The document defines the key terms and processes involved in respiration, explores factors affecting breathing rate, and how to measure lung volumes and vital capacity.
The document summarizes pulmonary ventilation and lung volumes and capacities. It discusses:
1) The basic functions of the respiratory system including breathing (pulmonary ventilation) which draws gases into and out of the lungs via inhalation and exhalation.
2) The mechanics of breathing including the roles of the diaphragm and intercostal muscles in inspiration and expiration as well as intrapulmonary, intrapleural, and transpulmonary pressures.
3) Lung volumes including tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, and total lung capacity.
This document discusses the respiratory cycle and mechanics of breathing. It defines respiration as the process of inhaling oxygen and exhaling carbon dioxide. The principal muscle of inhalation is the diaphragm, while exhalation is passive. It describes the pressures involved in respiration, including alveolar pressure, pleural pressure, and atmospheric pressure. Obstructive and restrictive lung diseases can alter these normal pressure values and disrupt the inhalation to exhalation ratio.
The document summarizes key aspects of breathing and respiration in the human body. It explains that (1) cells require oxygen to function, so we must breathe to supply oxygen through the respiratory system. It then (2) outlines the cycle of breathing where air enters the nose and trachea, oxygen diffuses into the blood in the lungs, and carbon dioxide diffuses out. Finally, it (3) describes the major functions and structures of the respiratory system including the lungs, alveoli, and transportation of gases in the bloodstream.
Pulmonary ventilation involves the movement of air into and out of the alveoli through the nasal cavity, pharynx, trachea, bronchi, and bronchioles. Muscle activity changes the volume of the thoracic cavity, altering intrapulmonary and intrapleural pressures to draw air into the lungs during inhalation and expel it during exhalation. Airflow is affected by airway resistance, which can change based on bronchiole diameter, and lung compliance, maintained by elastic tissues and surfactants. Alveolar ventilation determines the renewal of air in the gas exchange areas to influence oxygen and carbon dioxide concentrations.
Pulmonary ventilation functions to maintain favorable concentrations of oxygen and carbon dioxide in the alveoli during rest and exercise. Inspiration occurs when intrapulmonary pressure is reduced below atmospheric pressure through contraction of inspiratory muscles, while expiration is usually a passive process at rest but involves expiratory muscles during exercise. Pulmonary ventilation, measured as minute ventilation, ensures complete gas exchange before blood leaves the lungs for transport throughout the body.
This document provides an overview of respiratory physiology, including:
1. It describes the functional anatomy of the respiratory system from the nose to the alveoli.
2. It defines and explains various lung volumes and capacities that are measured by spirometry, such as tidal volume, functional residual capacity, and closing capacity.
3. It covers topics related to gas exchange including the roles of surfactant and preoxygenation in increasing oxygen stores in the lungs.
4. It discusses the concepts of ventilation, dead space, and the measurement of physiological dead space using the Bohr equation.
This document discusses how biodiversity loss can impact ecosystem functioning and processes. It begins by noting that human impacts have dramatically reduced biodiversity at all levels from genes to entire ecosystems. Many ecosystem processes are sensitive to biodiversity declines. Experimental studies show that reductions in biodiversity can decrease plant productivity and increase variability in processes like nutrient levels and plant growth. Maintaining biodiversity is important for preserving ecosystem services that support human welfare, and should be a priority in environmental policies.
This semester's BTO130 course has two 2-period classes per week in computer-equipped rooms, with Section A on Tuesdays and Thursdays and Section B on Tuesdays and Fridays. There are 13 teaching weeks followed by a study week and then exam week. Before the study week, the course focuses on skills assessment and hands-on learning as well as introductory topics. After the study week, there is in-depth coverage of networking, architecture, and storage/I/O. Students are evaluated based on tests, quizzes, assignments, and a final exam.
There are two types of respiration: internal and external. Internal respiration refers to cellular metabolism within cells, while external respiration involves the exchange of oxygen and carbon dioxide between the lungs and blood. The respiratory system, including the nasal passages, pharynx, larynx, trachea, bronchi, and alveoli, facilitates this gas exchange. Specifically, oxygen diffuses into and carbon dioxide diffuses out of the alveoli, which are tiny air sacs surrounded by pulmonary capillaries. Breathing is driven by changes in pressure that cause air to flow into and out of the lungs.
Respiratory physiology by Dr RamKrishnaram krishna
The document discusses respiratory physiology, including:
1) The anatomy of the respiratory system including the upper and lower respiratory tract.
2) Pulmonary ventilation driven by pressure differences caused by contraction of respiratory muscles.
3) Gas exchange that occurs via diffusion between alveoli and capillaries in the lungs. Oxygen binds to hemoglobin while carbon dioxide is transported as bicarbonate.
4) Controls of respiration centered in the medulla that regulate rate and depth of breathing in response to changes in oxygen and carbon dioxide levels.
The document discusses various topics related to respiratory physiology including:
1. Lung volumes such as tidal volume, inspiratory reserve volume, expiratory reserve volume, and residual volume. It defines total lung capacity and vital capacity.
2. Ventilation, including minute ventilation, alveolar ventilation, anatomic and physiologic dead space.
3. Diffusion of gases in the lungs and blood including Fick's law of diffusion and measurement of diffusing capacity.
4. Ventilation-perfusion relationships in the lungs and how this impacts oxygen and carbon dioxide exchange.
5. The five main causes of hypoxemia: hypoventilation, diffusion abnormalities, shunts, ventilation-perfusion
1. Respiration includes ventilation, gas exchange, and oxygen utilization. Ventilation is the mechanical process of breathing that moves air in and out of the lungs. Gas exchange occurs through diffusion of oxygen and carbon dioxide between the alveoli and blood.
2. The lungs contain over 300 million alveoli which provide a large surface area for gas exchange. Each alveolus is lined by fluid and surfactant that helps reduce surface tension to facilitate breathing.
3. During inspiration, contraction of the diaphragm and intercostal muscles increases the thoracic cavity volume, lowering pressure and drawing air into the lungs. Expiration is passive as the lungs and chest wall recoil, increasing pressure to push
This document defines and describes the different types of dead space in the lungs, including anatomical, physiological, alveolar, and apparatus dead space. It explains that physiological dead space is greater than anatomical dead space due to the inclusion of alveolar dead space. The document also outlines methods to measure anatomical and physiological dead space, such as Fowler's method and Bohr's equation. Factors that can influence the amounts of anatomical and alveolar dead space are also discussed.
- Respiration includes ventilation (breathing), gas exchange between air and blood in the lungs, and oxygen utilization through cellular respiration.
- During inhalation, oxygen diffuses from air into the blood in the lungs and carbon dioxide diffuses from the blood into the air. Exhalation is driven by the elastic recoil of the lungs.
- The lungs contain over 300 million alveoli which have a large surface area for gas exchange and are only one cell thick, facilitating diffusion. Surfactant produced in the alveoli reduces surface tension to keep alveoli open during exhalation.
The document summarizes the mechanics of ventilation in the respiratory system. It discusses how inspiration and expiration occur through changes in pressure and volume in the thoracic cavity, lungs, and alveoli. Inspiration is driven by contraction of the diaphragm and external intercostal muscles, which increases thoracic cavity volume and causes air to flow into the lungs down the pressure gradient. Expiration occurs passively as the inspiratory muscles relax and the lungs and chest wall recoil, decreasing thoracic volume and causing air to flow out. The document also covers factors influencing ventilation like airway resistance, alveolar surface tension, and lung compliance.
The respiratory system facilitates gas exchange through inspiration and expiration. Inspiration is driven by contraction of the diaphragm and external intercostal muscles, while expiration occurs when these muscles relax. Factors like airway resistance, surfactant, and intrapleural pressure can impact ventilation. Different breathing patterns also affect carbon dioxide levels in the blood.
1) Breathing involves inspiration where gases flow into the lungs and expiration where gases exit. Changes in lung volume cause changes in pressure, driving gas flow.
2) Several factors influence breathing pressures, including atmospheric pressure, the elastic recoil of the lungs, and alveolar surface tension maintained by pulmonary surfactant.
3) The main muscles of breathing are the diaphragm and external intercostal muscles. Inspiration is an active process where muscles contract to increase lung volume, while expiration is usually passive as muscles relax.
Respiration involves three main functions: ventilation, gas exchange, and oxygen utilization. Ventilation is the mechanical process of breathing which moves air in and out of the lungs. Gas exchange occurs through diffusion between the alveoli and capillaries, allowing oxygen to diffuse from the air into the blood and carbon dioxide to diffuse out. Oxygen is then utilized in cellular respiration throughout the body. The document discusses the anatomy and physiology of respiration including the conducting and respiratory zones of the lungs, gas pressures, lung volumes, and disorders that can affect respiration.
This document provides an overview of pulmonary diffusion and related concepts. It begins with objectives around gas diffusion, alveolar ventilation, and the ventilation-perfusion ratio. The introduction discusses external respiration, pulmonary ventilation, diffusion, and gas transport. Key topics covered include the physics of gas diffusion and partial pressure, alveolar ventilation, dead space, and the diffusion of gases through the respiratory membrane. Clinical significance of various concepts is also discussed.
This document provides an overview of the applied physiology of the respiratory system. It discusses topics such as respiration, the respiratory passages, pulmonary circulation, mechanics of respiration, pulmonary volumes and capacities, ventilation, dead space, regulation of respiration, and respiratory disorders. Measurement techniques for lung function are also covered, including spirometry and plethysmography. Restrictive and obstructive respiratory disorders are defined. Various respiratory conditions and disturbances are listed and described briefly.
Respiration is the process of gas exchange between an organism and the environment. It consists of external respiration, which is breathing and the exchange of gases between the lungs and environment. And internal respiration, which is the exchange of oxygen and carbon dioxide between the blood and tissues via cellular respiration. The document defines the key terms and processes involved in respiration, explores factors affecting breathing rate, and how to measure lung volumes and vital capacity.
The document summarizes pulmonary ventilation and lung volumes and capacities. It discusses:
1) The basic functions of the respiratory system including breathing (pulmonary ventilation) which draws gases into and out of the lungs via inhalation and exhalation.
2) The mechanics of breathing including the roles of the diaphragm and intercostal muscles in inspiration and expiration as well as intrapulmonary, intrapleural, and transpulmonary pressures.
3) Lung volumes including tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, and total lung capacity.
This document discusses the respiratory cycle and mechanics of breathing. It defines respiration as the process of inhaling oxygen and exhaling carbon dioxide. The principal muscle of inhalation is the diaphragm, while exhalation is passive. It describes the pressures involved in respiration, including alveolar pressure, pleural pressure, and atmospheric pressure. Obstructive and restrictive lung diseases can alter these normal pressure values and disrupt the inhalation to exhalation ratio.
The document summarizes key aspects of breathing and respiration in the human body. It explains that (1) cells require oxygen to function, so we must breathe to supply oxygen through the respiratory system. It then (2) outlines the cycle of breathing where air enters the nose and trachea, oxygen diffuses into the blood in the lungs, and carbon dioxide diffuses out. Finally, it (3) describes the major functions and structures of the respiratory system including the lungs, alveoli, and transportation of gases in the bloodstream.
Pulmonary ventilation involves the movement of air into and out of the alveoli through the nasal cavity, pharynx, trachea, bronchi, and bronchioles. Muscle activity changes the volume of the thoracic cavity, altering intrapulmonary and intrapleural pressures to draw air into the lungs during inhalation and expel it during exhalation. Airflow is affected by airway resistance, which can change based on bronchiole diameter, and lung compliance, maintained by elastic tissues and surfactants. Alveolar ventilation determines the renewal of air in the gas exchange areas to influence oxygen and carbon dioxide concentrations.
Pulmonary ventilation functions to maintain favorable concentrations of oxygen and carbon dioxide in the alveoli during rest and exercise. Inspiration occurs when intrapulmonary pressure is reduced below atmospheric pressure through contraction of inspiratory muscles, while expiration is usually a passive process at rest but involves expiratory muscles during exercise. Pulmonary ventilation, measured as minute ventilation, ensures complete gas exchange before blood leaves the lungs for transport throughout the body.
This document provides an overview of respiratory physiology, including:
1. It describes the functional anatomy of the respiratory system from the nose to the alveoli.
2. It defines and explains various lung volumes and capacities that are measured by spirometry, such as tidal volume, functional residual capacity, and closing capacity.
3. It covers topics related to gas exchange including the roles of surfactant and preoxygenation in increasing oxygen stores in the lungs.
4. It discusses the concepts of ventilation, dead space, and the measurement of physiological dead space using the Bohr equation.
This document discusses how biodiversity loss can impact ecosystem functioning and processes. It begins by noting that human impacts have dramatically reduced biodiversity at all levels from genes to entire ecosystems. Many ecosystem processes are sensitive to biodiversity declines. Experimental studies show that reductions in biodiversity can decrease plant productivity and increase variability in processes like nutrient levels and plant growth. Maintaining biodiversity is important for preserving ecosystem services that support human welfare, and should be a priority in environmental policies.
This semester's BTO130 course has two 2-period classes per week in computer-equipped rooms, with Section A on Tuesdays and Thursdays and Section B on Tuesdays and Fridays. There are 13 teaching weeks followed by a study week and then exam week. Before the study week, the course focuses on skills assessment and hands-on learning as well as introductory topics. After the study week, there is in-depth coverage of networking, architecture, and storage/I/O. Students are evaluated based on tests, quizzes, assignments, and a final exam.
1. Cell membranes protect cell organelles and allow things to enter through diffusion or osmosis. Enzymes speed up chemical reactions and their activity depends on temperature, pH, and ionic conditions. Prokaryotic cells lack nuclei while eukaryotic cells have nuclei and viruses infect cells.
2. RNA is used in protein synthesis. Transcription transmits DNA information to RNA and translation uses mRNA to make proteins. The endoplasmic reticulum and Golgi apparatus move and package proteins.
3. Photosynthesis uses chloroplasts to convert sunlight into chemical energy in sugars. Mitochondria produce ATP through glucose breakdown. Macromolecules like polysaccharides are made from smaller precursors.
Today's science session covered ecology and taxonomy. Ecology lessons included defining ecosystems as consisting of biotic (living) and abiotic (non-living) components. Taxonomy lessons reviewed the hierarchical order of classification from kingdom to species, and discussed the five main kingdoms including the animal kingdom and its representative phyla such as porifera, echinodermata, cnidaria, and others. The session concluded with a review of the chordate class and its vertebrate subgroups.
For most scientists and scientific organizations, external communications is an afterthought. In this age of “instant” news and nonstop social media feeds, how can scientists break through the noise and broaden the appeal of their research to garner media attention and grow public understanding? Hsiao-Ching Chou, the Director of Communications at Institute for Systems Biology, shares some insight about how she was able to transform the communications program at ISB from zero to a bustling network of news – and on a nonprofit budget.
The urinary system maintains homeostasis by filtering the blood and producing urine. It is composed of the kidneys, ureters, urinary bladder, and urethra. The kidneys filter waste from the blood to produce urine, which travels through the ureters to the bladder. The bladder stores urine until urination, when it is expelled through the urethra. Together these organs excrete waste from the body while regulating water balance and electrolyte levels in tissues and blood.
The document discusses the goals and major functional events of respiration, including pulmonary ventilation, diffusion of gases, transport of gases, and regulation of ventilation. It describes the respiratory system and muscles involved in inspiration and expiration. It also covers topics like compliance, surfactant, work of breathing, lung volumes, capacities, factors affecting lung function, and the functions of the respiratory passages.
The document discusses the goals and major functional events of respiration, including pulmonary ventilation, diffusion of gases, transport of gases, and regulation of ventilation. It describes the respiratory system and muscles involved in inspiration and expiration. It also covers topics like compliance, surfactant, work of breathing, lung volumes, capacities, factors affecting lung function, and the functions of the respiratory passages.
The document discusses the goals and major functional events of respiration, including pulmonary ventilation, diffusion of gases, transport of gases, and regulation of ventilation. It describes the respiratory system and muscles involved in inspiration and expiration. It also covers topics like compliance, surfactant, work of breathing, lung volumes, capacities, factors affecting lung function, and the functions of the respiratory passages.
The document summarizes key aspects of respiratory system anatomy and physiology. It describes the main functions of the respiratory system as taking in oxygen and giving out carbon dioxide, while also regulating acid-base balance, heat, phonation, and vocalization. Anatomically, the respiratory system is divided into intrathoracic and extrathoracic parts, with the intrathoracic part involving structures like the trachea, bronchi, bronchioles, alveoli and lungs where gas exchange occurs. Physiologically, the system is divided into conductive and respiratory zones. Other topics covered include pulmonary volumes and capacities, ventilation, forces controlling lung volumes like pleural pressure and surface tension, diffusion of gases, and work of breathing
This document provides information about ventilation and mechanical ventilation. It defines ventilation as the process of moving air in and out of the lungs for gas exchange. Mechanical ventilation is the use of a device to provide artificial breathing when a patient cannot maintain adequate oxygen and carbon dioxide levels on their own. The document discusses the mechanics of normal breathing and ventilation, as well as the components, controls, phases and physiological principles of mechanical ventilation. It provides indications for mechanical ventilation and factors that affect ventilation such as lung compliance, airway resistance, and work of breathing.
1. The document discusses the physiology of pulmonary ventilation and the respiratory system.
2. It describes the mechanics of breathing including the roles of the diaphragm and ribs in expanding and contracting the lungs.
3. It also discusses the volumes and capacities of the lungs including tidal volume, inspiratory reserve volume, residual volume, and total lung capacity.
The document is a lecture on respiratory physiology that covers several topics:
1. It describes the anatomy and functions of the respiratory system, including gas exchange, lung volumes, and respiratory muscles.
2. Respiration is explained as the process of inspiration and expiration, which is driven by changes in pressures within the lungs and chest cavity.
3. Other concepts covered include diffusion of gases, transport of oxygen and carbon dioxide in the blood, and regulation of breathing.
1. Respiration involves gas exchange, host defense, and metabolism. It includes pulmonary ventilation, diffusion of gases between alveoli and blood, and transport of gases through the body.
2. The respiratory system has an upper airway and lower airway. The lower airway is made up of the trachea, bronchi, and alveoli. The conducting zone includes the trachea and bronchi while the respiratory zone contains respiratory bronchioles, alveolar ducts, and alveoli.
3. During inspiration, the diaphragm contracts and ribs are elevated. During expiration, the diaphragm and ribs relax. Lung expansion and contraction occurs through changes in the chest cavity
1. Respiration involves gas exchange, host defense, and metabolism. It includes pulmonary ventilation, diffusion of gases between alveoli and blood, and transport of gases through the body.
2. The respiratory system has an upper airway and lower airway. The lower airway is made up of the trachea, bronchi, and alveoli. The alveoli are the sites of gas exchange.
3. During inspiration, the diaphragm and external intercostal muscles contract to expand the lungs and lower intrapleural pressure. During expiration, elastic recoil of the lungs and chest wall passively return the lungs to the resting volume.
Respiratory system pulmonary ventilation.sofian awamleh.pptx مختصرHamzeh AlBattikhi
The document summarizes the structure and function of the respiratory system. It describes the major parts including the nose, pharynx, larynx, trachea, bronchi, lungs and alveoli. It explains how breathing works through the contraction of the diaphragm and movement of the ribs. Gas exchange occurs in the alveoli through diffusion. Various pressures and volumes related to breathing are also defined. Pulmonary ventilation involves the inflow and outflow of air and is regulated by the nervous system and local factors.
The respiratory system is made up of organs involved in breathing, including the nose, pharynx, larynx, trachea, bronchi, and lungs. Breathing occurs through inspiration and expiration, driven by contraction and relaxation of respiratory muscles. Various lung volumes exist including tidal volume, inspiratory reserve volume, and total lung capacity. External respiration involves gas exchange between the alveoli and blood based on partial pressures. Oxygen is transported bound to hemoglobin while carbon dioxide is transported as bicarbonate ion. Breathing is regulated by respiratory centers in the brainstem and chemoreceptors responding to carbon dioxide and oxygen levels.
Resp Physio and PFTmade by me welcome tokaqib1234789
This document discusses respiratory physiology and pulmonary function tests. It covers the mechanics of respiration including the roles of the diaphragm and accessory muscles. It also discusses the controls of respiration in the medulla and pons, and the factors that control the rate and depth of breathing like oxygen, carbon dioxide and pH levels. Nerve supply, intra-thoracic pressures, lung mechanics, compliance, volumes and classifications of lung defects are summarized. Common pulmonary function tests are then described like spirometry, plethysmography, diffusion capacity testing and what measurements each provides.
The document discusses various aspects of respiration including external respiration in the lungs involving gas exchange, and internal respiration in the mitochondria involving oxygen utilization. It describes the conducting and respiratory zones of the lungs, pleura, pulmonary pressures, respiratory muscles, mechanisms of inspiration and expiration. It also summarizes lung compliance, surfactant, pulmonary ventilation tests, lung volumes, dead space, and pulmonary function tests.
The document summarizes key aspects of the respiratory system, including:
- External respiration involves gas exchange between the lungs and blood, transporting oxygen to tissues and carbon dioxide away. Internal respiration occurs via cellular respiration in mitochondria.
- The respiratory tract involves the nose, pharynx, larynx, trachea, bronchi and bronchioles leading to alveoli where gas exchange occurs by diffusion across pulmonary capillaries.
- Breathing is driven by changes in thoracic pressure and lung volumes via contraction of respiratory muscles and elastic recoil of the lungs and chest wall. Inspiration occurs as lungs fill a expanded chest cavity, expiration when it relaxes.
This document discusses mechanisms of respiration including external and internal respiration. External respiration involves the exchange of oxygen and carbon dioxide between the lungs and blood. Internal respiration is the exchange between tissues and blood at the cellular level. The document describes the mechanics of breathing including inspiration, which is an active process involving movement of the ribs and diaphragm, and expiration, which is a passive process as the lungs return to their resting position. It also discusses pressures involved in respiration including intrapulmonary pressure, intrapleural pressure, and how pressure and volume changes occur during ventilation.
The respiratory system has three main functions: gas exchange between the atmosphere and blood, filtering and warming of inspired air, and sound production. It has three basic steps: pulmonary ventilation (breathing), external (pulmonary) respiration involving gas exchange in the lungs, and internal (tissue) respiration involving gas exchange in tissues. Inspiration is an active process using inspiratory muscles like the diaphragm and external intercostals to expand the thoracic cavity and lower lung pressure, allowing air to flow in. Expiration is usually a passive process involving elastic recoil of the lungs and chest wall. Other factors like alveolar surface tension, lung compliance, and airway resistance also influence ventilation.
This document provides an overview of the physiology of the respiratory system. It begins with the anatomical structures of the respiratory tract, including the nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, alveolar ducts and alveoli. It then describes the mechanics of ventilation, including how the diaphragm and intercostal muscles cause inhalation and exhalation through changes in thoracic cavity volume. Finally, it discusses pulmonary volumes such as tidal volume, vital capacity, functional residual capacity, and their clinical measurements using spirometry.
This document discusses airway management and ventilation for EMS professionals. It covers topics such as airway anatomy, causes of respiratory distress, methods of assessing the airway and ventilation, and basic life support airway management techniques including oxygen delivery devices. The objectives are to ensure optimal ventilation by delivering oxygen to the blood and removing carbon dioxide from the body.
This document provides information and procedures for microscopic examination of urine samples at Oregon Health & Science University hospitals and clinics. It describes the principles behind what normal and abnormal urine samples can indicate about renal health. Guidelines are given for sample collection and storage, as well as potential interfering factors. Reference ranges for expected findings are listed, along with steps for microscopic procedure, results reporting, and correlating microscopic and dipstick test results. Accuracy and competency requirements are also outlined.
This document discusses reflexes and the reflex arc. It defines a reflex arc as the anatomical nervous pathway of a reflex, consisting of 5 components: receptor, sensory neuron, integration center, motor neuron, and effector. It describes stretch reflexes, including the dynamic stretch reflex activated by changes in muscle length and the static stretch reflex maintaining constant muscle tone. Various types of reflexes are classified, including superficial, deep, and visceral reflexes. Clinical uses of assessing reflexes are also discussed.
Reflexes are involuntary responses mediated by the reflex arc in the central nervous system. There are different anatomical and clinical classifications of reflexes depending on the segments and pathways involved, and the number of synapses that can be either monosynaptic or polysynaptic. Reflexes also have conditional or unconditional responses and affect somatic or visceral functions typically as flexor or extensor responses.
The document discusses action potentials and how neurons conduct impulses. It explains that action potentials are rapid changes in membrane potential that allow neurons and muscles to communicate. Action potentials are initiated when stimuli open sodium channels, allowing sodium to rush into the cell and depolarize the membrane. Potassium channels then open, repolarizing the membrane back to its resting potential. This process allows impulses to propagate down axons via changes in membrane potential driven by ion fluxes.
Anemia of chronic disease and chronic kidney disease can have several underlying mechanisms. Hepcidin regulates iron availability and contributes to decreased red blood cell production in chronic inflammatory states. Cytokines like interleukin and tumor necrosis factor can destroy red blood cell precursors. In chronic kidney disease, there is a primary deficiency of erythropoietin production by interstitial fibroblasts in the kidneys, leading to anemia related to residual renal function. Anemia is common in later stages of chronic kidney disease and prevalence increases with age. Evaluation of anemia includes symptoms, physical exam, blood tests of red blood cell indices, peripheral smear, reticulocyte count, and potentially bone marrow biopsy.
Acute renal failure is the sudden loss of kidney function resulting in the buildup of waste products and fluid dysregulation in the body. It occurs in three phases: oliguric, diuretic, and recovery. Causes include prerenal issues interfering with blood flow, intrarenal kidney tissue damage, and postrenal urinary tract blockage. Chronic renal failure is the gradual and progressive loss of kidney function over time that eventually results in permanent kidney damage and requires dialysis or transplant to survive. It is characterized by the slow destruction of nephrons and decreased glomerular filtration rate.
The countercurrent mechanism in the kidney produces a hyperosmotic renal medullary interstitium through three key processes: 1) the countercurrent multiplier effect of the thick ascending loop of Henle which repetitively reabsorbs sodium chloride, 2) active transport of ions from the collecting ducts into the medullary interstitium, and 3) facilitated diffusion of urea from the inner medullary collecting ducts into the medullary interstitium. This hyperosmotic interstitium is maintained by the countercurrent exchange function of the vasa recta blood vessels.
The three basic renal processes are:
1) Glomerular filtration filters blood in the kidneys into tubules forming primitive urine.
2) Tubular reabsorption reabsorbs necessary substances like water and sodium back into the blood from the tubules.
3) Tubular secretion secretes substances to be eliminated like protons and potassium from the blood into the tubules.
The document provides an overview of nerve physiology, including:
1) It describes the basic structure and function of neurons, how they transmit signals via graded potentials and action potentials, and how this allows for fast signaling in the nervous system.
2) It explains how action potentials are generated via voltage-gated sodium and potassium channels, and how they propagate along axons through continued stimulation of these channels.
3) It discusses how myelination aids in faster signal transmission and the roles of supporting cells like oligodendrocytes and Schwann cells in myelinating axons in the central and peripheral nervous systems.
1. The document discusses the mechanisms of glomerular filtration and factors that can affect it. Glomerular filtration rate (GFR) is the rate of fluid filtered from the blood into the kidney glomeruli.
2. Inulin clearance is used to measure GFR because inulin is filtered by the glomeruli but not reabsorbed or secreted by the kidneys, so its clearance directly reflects GFR.
3. Several structures are involved in glomerular filtration, including the glomerular capillaries, Bowman's capsule, and the cells of the juxtaglomerular apparatus that help regulate GFR and renin secretion.
The document discusses renal handling of substances and factors that affect glomerular filtration rate (GFR). It describes how substances are filtered through the glomerular capillaries and pass through the basement membrane into Bowman's capsule. GFR is determined by the glomerular filtration coefficient and net filtration pressure, which is influenced by hydrostatic and oncotic pressures across the glomerular membrane. Autoregulation mechanisms and tubuloglomerular feedback help regulate GFR in response to changes in arterial pressure or fluid delivery to the macula densa.
The nephron is the functional unit of the kidney that filters blood to form urine. Glomerular filtration occurs when blood plasma filters through the glomerulus into the nephron tubules. Reabsorption and tubular secretion then alter the filtrate's composition as it travels through the tubules. Reabsorption moves substances like water, ions, and glucose from the filtrate back into blood to concentrate the urine. Tubular secretion actively transports substances like hydrogen ions and potassium into the filtrate. Together these processes determine the final volume, concentration and composition of urine to regulate blood chemistry and remove waste.
The document summarizes key aspects of kidney function and structure. It defines excretion as the removal of waste from the body, like nitrogenous wastes from protein digestion. The kidney filters blood and reabsorbs necessary substances while excreting waste in urine. The kidney contains nephrons which filter blood in the glomerulus and reabsorb most water and nutrients back into blood along various portions of the nephron tubules. The loop of Henle and collecting duct help concentrate urine by establishing salt gradients. Urine composition differs from the original glomerular filtrate due to selective reabsorption of useful substances in the kidney.
More from Smt. N.H.L. Municipal Medical college (13)
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
1. Lecture: Physiology of Respiration
I. The Mechanics of Breathing
A. Relationships of Pressure
1. atmospheric air pressure 760 mm Hg (at sea level)
2. negative air pressure - LESS than 760 mm Hg
3. positive air pressure - MORE than 760 mm Hg
4. intrapleural pressure - pressure within the pleural "balloon" which surrounds the lung
5. intrapulmonary pressure - pressure within the alveoli (tiny sacs) of the lung itself
Factors holding lungs AGAINST the thorax wall:
1. Surface tension holding the "visceral" and "parietal" pleura together
2. Intrapulmonary pressure ALWAYS slightly greater than intrapleural pressure by 4 mm
Hg
3. Atmospheric pressure acting on the lungs
a. atelectasis (collapsed lung) - hole in pleural "balloon" causes equalization of
pressure and collapse of the lung
b. pneumothorax - abnormal air in the intrapleural space, can lead to collapsed lung
Factors facilitating lung movement AWAY from thorax wall:
1. Elasticity of lungs allows them to assume smallest shape for given pressure conditions
2. Fluid film on alveoli allows them to assume smallest shape for given pressure conditions
II. Volume/Pressure & Inspiration/Expiration
A. Boyle's Law on Volume/Pressure Relationships
1. Volume is INVERSELY proportional to Pressure
a. INCREASE in Volume -> DECREASE in Pressure
b. DECREASE in Volume -> INCREASE in Pressure
VOLUME change --> PRESSURE change gas flows to equalize the pressure
2. Simple Example of Boyle's Law
- plastic bag with plastic tube in the top
- as bag expands by pulling, gas moves IN
- as bag shrinks by squashing, gas moves OUT
2. B. Inspiration
1. diaphragm muscle contracts, increasing thoracic cavity size in the superior-inferior
dimension
2. external intercostal muscles contract, expanding lateral & anterior-posterior dimension
3. INCREASED volume (about 0.5 liter)
DECREASED pulmonary pressure (-1 mm Hg) air rushes into lungs to fill alveoli
4. deep/forced inspirations - as during exercise and pulmonary disease
* scalenes, sternocleidomastoid, pectorals are used for more volume expansion of thorax
C. Expiration
1. quiet expiration (exhalation) - simple elasticity of the lungs DECREASES volume
INCREASED pulmonary pressure -> movement of air out of the lungs
2. forced expiration - contraction of abdominal wall muscles (i.e. obliques & transversus
abdominus) further DECREASES volume beyond relaxed point ----> further INCREASE
in pulmonary pressure ---> more air moves out
III. Factors Influencing Pulmonary Ventilation
A. Respiratory Passageway Resistance
1. upper respiratory passageways - relatively large, very little resistance to airflow (unless
obstruction such as from food lodging or cancer)
2. lower respiratory passageways - from medium-sized bronchioles on down, can alter
diameter based on autonomic stimulation
a. parasympathetic - causes bronchioconstriction
b. sympathetic - inhibits bronchioconstriction
epinephrine - used to treat life-threatening bronchioconstriction such as during asthma and
anaphylactic shock (carried by people susceptible to sudden constriction)
B. Lung Compliance & Elasticity
1. lung compliance - the ease with which lungs can be expanded by muscle contraction of
thorax
a. fibrosis - decreases compliance
b. blocked bronchi - decreases compliance
c. surface tension - alveoli difficult to expand
d. thorax inflexibility - decreases compliance
3. 2. lung elasticity - the ease with which lungs can contract to their normal resting size
(exhalation) a. emphysema - decreases elasticity
3. alveolar surface tension - liquid on surface of alveoli causes them to collapse to smallest
size
a. surfactant - lipoproteins that reduces surface tension on alveoli, allowing them to
expand more easily
b. infant respiratory distress syndrome - premature babies that do not yet produce enough
surfactant; must be ventilated for respiration
IV. Volumes, Capacities, and Function Tests
A. Respiratory VOLUMES (20 yr old healthy male, 155 lbs.)
1. tidal volume (TV) - normal volume moving in/out (0.5 L)
2. inspiratory reserve volume (IRV) - volume inhaled AFTER normal tidal volume when
asked to take deepest possible breath (2.1-3.2 L)
3. expiratory reserve volume (ERV) - volume exhaled AFTER normal tidal volume when
asked to force out all air possible (1.- 2.0 L)
4. residual volume (RV) - air that remains in lungs even after totally forced exhalation (1.2
L)
B. Respiratory CAPACITIES
1. inspiratory capacity (IC) = TV + IRV (MAXIMUM volume of air that can be inhaled)
2. functional residual capacity (FRC) ERV + RV (all non-tidal volume expiration)
3. vital capacity (VC) = TV + IRV + ERV (TOTAL volume of air that can be moved)
4. total lung capacity (TLC) = TV + IRV + ERV + RV (the SUM of all volumes; about 6.0
L)
D. Dead Space
1. anatomical dead space - all areas where gas exchange does not occur (all but alveoli)
2. alveolar dead space - non-functional alveoli
3. total dead space - anatomical + alveolar
E. Pulmonary Function Tests
1. spirometer - measures volume changes during breathing
a. obstructive pulmonary disease - increased resistance to air flow (bronchitis or
asthma)
b. restrictive disorders - decrease in Total Lung Capacity (TB or polio)
2. minute respiratory volume (MRV) - total volume flowing in & out in 1 minute (resting
rate = 6 L per minute)
4. 3. forced vital capacity (FVC) - total volume exhaled after forceful exhalation of a deep
breath
4. forced expiratory volume (FEV) - FEV volume measured in 1 second intervals (FEV1...)
F. Alveolar Retention Rate (AVR)
AVR = breath rate X (TV - dead space)
(NORMAL) AVR = 12/minute X (500 ml – 150 ml)
(NORMAL) AVR = 4.2 L/min
V. Basic Properties of Gases
A. Dalton's Law of Partial Pressures
1. partial pressure - the "part" of the total air pressure caused by one component of a gas
Gas Percent Partial Pressure (P)
ALL AIR 100.0% 760 mm Hg
Nitrogen 78.6% 597 mm Hg (0.79 X 760)
Oxygen 20.9% l59 mm Hg (0.21 X 760)
Carbon Dioxide 0.04% 0.3 mm Hg (0.0004 X 760)
2. altitude - air pressure @ 10,000 ft = 563 mm Hg
3. scuba diving - air pressure @ 100 ft = 3000 mm Hg
B. Henry's Law of Gas Diffusion into Liquid
1. Henry's Law - a certain gas will diffuse INTO or OUT OF a liquid down its concentration
gradient in proportion to its partial pressure
2. solubility - the ease with which a certain gas will "dissolve" into a liquid (like blood
plasma)
HIGHest solubility in plasma Carbon Dioxide
Oxygen
LOWest solubility in plasma Nitrogen
C. Hyperbaric (Above normal pressure) Conditions
1. Creates HIGH gradient for gas entry into the body
2. therapeutic - oxygen forced into blood during: carbon monoxide poisoning, circulatory
shock, asphyxiation, gangrene, tetanus, etc.
3. harmful - SCUBA divers may suffer the "bends" when they rise too quickly and Nitrogen
5. gas "comes out of solution" and forms bubbles in the blood
VI. Gas Exchange: Lungs, Blood, Tissues
A. External Respiration (Air & Lungs)
1. Partial Pressure Gradients & Solubilities
a. Oxygen: alveolar (104 mm) ---> blood (40 mm)
b. Carbon Dioxide: blood (45 mm) ----> alveolar (40 mm) (carbon dioxide much
more soluble than oxygen)
2. Alveolar Membrane Thickness (0.5-1.0 micron)
a. very easy for gas to diffuse across alveoli
b. edema - increases thickness, decreases diffusion
3. Total Alveolar Surface Area for Exchange
a. total surface area healthy lung = 145 sq. Meters
b. emphysema - decreases total alveolar surface area
4. Ventilation-Blood Flow Coupling
a. low Oxygen in alveolus -> vasoconstriction
b. high Oxygen in alveolus -> vasodilation
c. high Carb Diox in alveolus -> dilate bronchioles
d. low Carb Diox in alveolus -> constrict bronchioles
B. Internal Respiration (Blood & Tissues)
1. Oxygen: blood (104 mm) -> tissues (40 mm)
2. Carbon Dioxide: tissues (>45 mm) -> blood (40 mm)
VII. Oxygen Transport in Blood: Hemoglobin
A. Association & Dissociation of Oxygen + Hemoglobin
1. oxyhemoglobin (HbO2) - oxygen molecule bound
2. deoxyhemoglobin (HHb) - oxygen unbound
H-Hb + O2 <= === => HbO2 + H+
3. binding gets more efficient as each O2 binds
4. release gets easier as each O2 is released
6. 5. Several factors regulate AFFINITY of O2
a. Partial Pressure of O2
b. temperature
c. blood pH (acidity)
d. concentration of “diphosphoglycerate” (DPG)
B. Effects of Partial Pressure of O2
1. oxygen-hemoglobin dissociation curve
a. 104 mm (lungs) - 100% saturation (20 ml/100 ml)
b. 40 mm (tissues) - 75% saturation (15 ml/100 ml)
c. right shift - Decreased Affinity, more O2 unloaded
d. left shift- Increased Affinity, less O2 unloaded
C. Effects of Temperature
1. HIGHER Temperature --> Decreased Affinity (right)
2. LOWER Temperature --> Increased Affinity (left)
D. Effects of pH (Acidity)
1. HIGHER pH --> Increased Affinity (left)
2. LOWER pH --> Decreased Affinity (right) "Bohr Effect"
a. more Carbon Dioxide, lower pH (more H+
), more O2 release
E. Effects of Diphosphoglycerate (DPG)
1. DPG - produced by anaerobic processes in RBCs
2. HIGHER DPG > Decreased Affinity (right)
3. thyroxine, testosterone, epinephrine, NE - increase RBC metabolism and DPG
production, cause RIGHT shift
F. Oxygen Transport Problems
1. hypoxia - below normal delivery of Oxygen
a. anemic hypoxia - low RBC or hemoglobin
b. stagnant hypoxia - impaired/blocked blood flow
c. hypoxemic hypoxia - poor lung gas exchange
2. carbon monoxide poisoning - CO has greater Affinity than Oxygen or Carbon Dioxide
VIII. Transport of Carbon Dioxide
7. A. Dissolved in Blood Plasma (7-10%)
B. Bound to Hemoglobin (20-30%)
1. carbaminohemoglobin - Carb Diox binds to an amino acid on the polypeptide chains
2. Haldane Effect - the less oxygenated blood is, the more Carb Diox it can carry
a. tissues - as Ox is unloaded, affinity for Carb Diox increases
b. lungs - as Ox is loaded, affinity for Carb Diox decreases, allowing it to be
released
C. Bicarbonate Ion Form in Plasma (60-70%)
1. Carbon Dioxide combines with water to form Bicarbonate
CO2 + H2O <==> H2CO3 <==> H+
+ HCO3
-
2. carbonic anhydrase - enzyme in RBCs that catalyzes this reaction in both directions
a. tissues - catalyzes formation of Bicarbonate
b. lungs - catalyzes formation of Carb Diox
3. Bohr Effect - formation of Bicarbonate (through Carbonic Acid) leads to LOWER pH
(H+ increase), and more unloading of Ox to tissues
a. since hemoglobin "buffers" to H+
, the actual pH of blood does not change much
4. Chloride Shift - chloride ions move in opposite direction of the entering/leaving
Bicarbonate, to prevent osmotic problems with RBCs
D. Carbon Dioxide Effects on Blood pH
1. carbonic acid-bicarbonate buffer system
low pH --> HCO3
-
binds to H+
high pH --> H2CO3 releases H+
2. low shallow breaths --> HIGH Carb Diox --> LOW pH (higher H+
)
3. rapid deep breaths --> LOW Carb Diox --> HIGH pH (lower H+
)
IX. Neural Substrates of Breathing
A. Medulla Respiratory Centers
Inspiratory Center (Dorsal Resp Group - rhythmic breathing) ---->
phrenic nerve ---->
intercostal nerves ---->
8. diaphragm + external intercostals
Expiratory Center (Ventral Resp Group - forced expiration) ---->
phrenic nerve ---->
intercostal nerves ---->
internal intercostals + abdominals (expiration)
1. eupnea - normal resting breath rate (12/minute)
2. drug overdose - causes suppression of Inspiratory Center
B. Pons Respiratory Centers
1. pneumotaxic center - slightly inhibits medulla, causes shorter, shallower, quicker breaths
2. apneustic center - stimulates the medulla, causes longer, deeper, slower breaths
C. Control of Breathing Rate & Depth
1. breathing rate - stimulation/inhibition of medulla
2. breathing depth - activation of inspiration muscles
3. Hering-Breuer Reflex - stretch of visceral pleura that lungs have expanded (vagal nerve)
D. Hypothalamic Control - emotion + pain to the medulla
E. Cortex Controls (Voluntary Breathing) - can override medulla as during singing and talking
X. Chemical Controls of Respiration
A. Chemoreceptors (CO2, O2, H+
)
1. central chemoreceptors - located in the medulla
2. peripheral chemoreceptors - large vessels of neck
B. Carbon Dioxide Effects
1. a powerful chemical regulator of breathing by increasing H+
(lowering pH)
a. hypercapnia Carbon Dioxide increases ->
Carbonic Acid increases ->
pH of CSF decreases (higher H+
)>
DEPTH & RATE increase (hyperventilation)
b. hypocapnia - abnormally low Carbon Dioxide levels which can be produced by
excessive hyperventilation; breathing into paper bag increases blood Carbon Dioxide
levels
C. Oxygen Effects
1. aortic and carotid bodies - oxygen chemoreceptors
9. 2. slight Ox decrease - modulate Carb Diox receptors
3. large Ox decrease - stimulate increase ventilation
4. hypoxic drive - chronic elevation of Carb Diox (due to disease) causes Oxygen levels to
have greater effect on regulation of breathing
D. pH Effects (H+
ion)
1. acidosis - acid buildup (H+
) in blood, leads to increased RATE and DEPTH (lactic acid)
E. Overview of Chemical Effects
Chemical Breathing Effect
increased Carbon Dioxide (more H+
) increase
decreased Carbon Dioxide (less H+
) decrease
slight decrease in Oxygen effect CO2 system
large decrease in Oxygen increase ventilation
decreased pH (more H+) increase
increased pH (less H+) decrease
XI. Exercise and Altitude Effects
A. Exercise Effects
1. hyperpnea - increase in DEPTH, not rate
2. steady state - increase in RATE and DEPTH gradually altered to MATCH gas exchange
needs
a. conscious awareness of exercise
b. cortex stimulates muscles & respiratory center
c. proprioceptors in muscles, tendons, joints
B. Altitude Effects
1. acclimatization - physiological adaptation to lower Oxygen content at higher altitude
a. body “set-points” for Oxygen and Carb Diox will reset over a period of time
XII. COPD and Cancer
A. Chronic Obstructive Pulmonary Disease (COPD)
10. 1. Common features of COPD
a. almost all have smoking history
b. dyspnea - chronic "gasping" for air
c. frequent coughing and infections
d. often leads to respiratory failure
2. obstructive emphysema - usually results from smoking
a. enlargement & deterioration of alveoli
b. loss of elasticity of the lungs
c. "barrel chest" from bronchiole opening during inhalation & constriction during
exhalation
3. chronic bronchitis - mucus/inflammation of mucosa
B. Lung Cancer
1. squamous cell carcinoma (20-40%) - epithelium of the bronchi and bronchioles
2. adenocarcinoma (25-35%) - cells of bronchiole glands and cells of the alveoli
3. small cell carcinoma (10-20%) - special lymphocyte-like cells of the bronchi
4. 90% of all lung cancers are in people who smoke or have smoked
Oliguria may result from a number of causes, the conventional approach is:
1. Outrule post-renal obstruction.
2. Outrule renal hypoperfusion / hypotension (pre-renal).
3. Outrule acute renal injury.
Oliguria is based firmly in physiology, either the kidney is making urine or it is not. If the kidney is
making urine and none is flowing, then there is a blockage to flow. If the kidney is not making urine, is
this because it has no substrate to work off (low filtered load) or because the renal tubules
themselves are damaged. It is essential to understand the difference between acute renal success
(renal self preservation) and acute renal failure (renal injury).
Volume depletion is a manifestation of abnormality of fluid distribution: the patient is either relatively (third space fluid loss such as capillary
leak, or vasodilatation) or absolutely (hemorrhage, dehydration) hypovolemic. The endpoint is the same: the patient initially
compensates (by the extrinsic system discussed below) to restore circulating volume. If the injury persists or is not corrected then
decompensation occurs: decompensation = shock and tissue hypoperfusion. Oliguria is a sensitive indicator of volume depletion.
What causes a low urinary output (oliguria)?
On an average night on call in ICU you will receive multiple calls because patients are oliguric.
Oliguria means “little urine” and is conventionally considered to be <400ml/day. In ICU “oliguria”
means insufficient urinary output for that particular patient. As a rule of thumb, 0.5 ml per kilo per hour
is a good limit. However, after major surgery or trauma, where large amounts of waste materials have
11. been generated by tissue damage, an output of 1ml/kg/hour may be more appropriate. In other
words, urinary output must be tailored to patient needs - an output of 200ml/hour may be required in
rhabdomyolysis.
Oliguria is an important clinical sign: it is one of the best measures, for a number of reasons, of end
organ perfusion and circulating volume.
Human beings are, essentially, big bags of water, the volume of which must be kept under tight
control to prevent us from either drying out or drowning. The kidney is a sophisticated organ, which
maintains circulating volume and excretes waste products in response to materials presented to it.
Overall control of body fluid is via a complex set of reflexes in the vascular system and the brain. This
is the extrinsic system of volume control. The kidney is partially independent of the circulation in that it
is able to control it’s own blood flow and protect itself in the face of hypoxemia. This is the intrinsic
system of control.
Oliguria may result from a number of causes, the conventional approach is:
1. Outrule post-renal obstruction.
2. Outrule renal hypoperfusion / hypotension (pre-renal).
3. Outrule acute renal injury.
Oliguria is based firmly in physiology, either the kidney is making urine or it is not. If the kidney is
making urine and none is flowing, then there is a blockage to flow. If the kidney is not making urine, is
this because it has no substrate to work off (low filtered load) or because the renal tubules
themselves are damaged. It is essential to understand the difference between acute renal success
(renal self preservation) and acute renal failure (renal injury).
What is meant by volume depletion?
Volume depletion is a manifestation of abnormality of fluid distribution: the patient is either relatively
(third space fluid loss such as capillary leak, or vasodilatation) or absolutely (hemorrhage,
dehydration) hypovolemic. The endpoint is the same: the patient initially compensates (by the
extrinsic system discussed below) to restore circulating volume. If the injury persists or is not
corrected then decompensation occurs: decompensation = shock and tissue hypoperfusion. Oliguria
is a sensitive indicator of volume depletion.
How does the extrinsic system work in a fluid depleted patient?
In a volume depleted patient, it is the purpose of the vascular system and kidneys to conserve salt
and water and maintain blood flow to vital organs (the brain and heart).
12. Extrinsic Control
Hypovolemia, for any reason, reduces venous return to the heart, preload and atrial stretch, reducing
the release of atrial natiuretic peptide: the brain produces more anti-diuretic hormone as a result –
conserving water. Blood pressure falls due to lower stroke volume (Starling curve). The baroreceptors
in the carotid sinus and aortic arch sense the fall in blood pressure, their output is reduced activating
the vasomotor center and inhibiting the cardioinhibitory center, leading to increased sympathetic (and
decreased parasympathetic) discharge -> increased heart rate, blood pressure, and cardiac output
and peripheral vasoconstriction. Simultaneously, in the kidney, the combination of hypotension and
sympathetic activation lead to reduced perfusion pressure in the afferent arteriole and a decrease in
the GFR. A decrease in tubular NaCl (due to slower transit and increased reabsorption) is sensed by
the macula densa in the distal convoluted tubule, and this causes the juxta-glomerular apparatus to
release renin. Renin activates angiotensin, which is converted peripherally to angiotensin II. This
agent is a potent vasoconstrictor, it also acts on the adrenal cortex to produce aldosterone, which
increases salt and water reabsorption in the kidney. Hypovolemia also decreases atrial stretch,
reducing the release of atrial natiuretic peptide: the brain produces more anti-diuretic hormone as a
result – conserving water.
Fluid overload is dealt with in an opposite manner. Baroreceptor output decreases, atrial
natiuretic peptide release increases (which has diuretic effects and antagonizes
ADH). Renal perfusion pressure increases, leading to higher GFR, and increased
NaCl delivery to the distal tubule, with a resultant decrease in renin release. The
overall effect is decreased sympathetic activity, increased vascular capacitance,
and increased salt and water excretion from the kidneys
. Think of the kidney as being a little brain, if the kidney is not being perfused (oliguria), then
13. neither is the brain?
Intrinsic Regulation
The kidney, like the brain, is able to control it’s own blood flow. This is essential because, in the
course of an active day, systemic blood pressure may go up and down depending on factors such as
sitting or standing, activity, anxiety etc. The kidney, in general, acts as a passive filter, so the amount
filtered would vary enormously. This is inefficient. The kidney is able to control it’s own blood flow and
filtration rate over a large range of blood pressures (e.g. a MAP of 80 to 180mmHg). The urinary flow
rate is determined principally by renal perfusion pressure.
The kidney neither autoregulates or perfuses at low blood pressures; this appears to be a protective
effect due to the fact that the medulla is relatively hypoxemic. Treatment for oliguria, under these
circumstances, is to increase the renal perfusion pressure.
Oliguria, therefore, signals low renal perfusion, and the kidney protecting itself from ischemia.
Acute Renal Failure Acute
Renal Success
What is “prerenal syndrome”?
The renal tubules remain intact and avidly conserve salt and wa
in the face of sensed renal hypoperfusion. When normal re
hemodynamics are restored, urine flow returns to normal. Beca
this is undoubtedly a good response (a means of organ protectio
prerenal syndrome is often called “acute renal success”.
Acute Renal Success
14. What is meant by the term: “acute tubular necrosis”?
A variety of injuries will cause the renal tubules become necr
and lose their ability to conserve salt and water. When normal re
hemodynamics are restored, urine flow remains low. The persist
reduction of GFR to less than 10% of baseline is ascribed
tubular obstruction by necrotic cells at pars recta, where
proximal tubule narrows into the descending loop of He
Proximal intraluminal pressure increases and lessens
glomerular-tubular gradient; GFR declines. Injury to the tubu
basement membrane results in back leak of tubular fluid into
interstitial tissue
Causes of Renal Failure
What is the connection between pre-renal syndrome and
acute tubular necrosis (ATN)?
The difference between acute renal success and acute ren
15. failure.
It is apparent that the physiologic, reversible prerenal syndro
may deteriorate into frank ATN if the ischemic insult persists lo
enough. A prerenal state also sensitizes the kidney to nephroto
insults. Nephrotoxic agents such as nonsteroidal anti-inflammat
drugs (NSAIDs), aminoglycoside antibiotics, intraven
radiocontrast dye, and cyclosporin A are much more likely
induce ATN in a dehydrated patient.
How am I supposed to differentiate the two if the patient is
putting out very little urine?
As we have said, a normally functioning kidney is able to conser
salt and water. A sensitive indicator of tubular function is sodium
handling because the ability of an injured tubule to reabsorb
sodium is impaired, whereas an intact tubule can maintain this
reabsorbtive capacity in the face of a hemodynamic stress. With
prerenal insult, the urine sodium should be less than 20, and the
calculated fractional excretion of sodium should be less than 1%
the patient has tubular damage for any reason (i.e. ATN) the
urinary sodium will be greater than expected (>80 mEq). Likewis
urinary osmolality is high in pre-renal syndrome and low in ATN
(see table below). The use of diuretics, however, can complicate
the interpretation of these results.
Table 1: Evaluation Of Oliguria
Pre-Renal ATN
U:P Osmolality >1.4:1 1:1
U:P Creatinine >50:1 <20:1
Urine Na (mEq/L) <20 >80
FENa (%) <1 >3
RFI % <1% >1%
CCR (mL/min) 15-20 <10
BUN/Cr >20 <10
ATN = acute tubular necrosis; CCR = creatinine clearance; FEN
= fractional excretion of sodium; Na = sodium; U:P = urine:plasm
RFI = Renal Failue Index, calculated as Urinary Sodium / (Urina
Creatinine / Serum Creatinine)