This powerpoint presentation will make you explore about the Perfusion and Ventilation in different zones of lungs with its co-relation with pulmonary tuberculosis.
Gas exchange between the alveoli and the pulmonary capillary blood occurs by diffusion, as will be discussed in the next chapter. Diffusion of oxygen and carbon dioxide occurs passively, according to their concentration differences across the alveolar-capillary barrier. These concentration differences must be maintained by ventilation of the alveoli and perfusion of the pulmonary capillaries.
Alveolar ventilation brings oxygen into the lung and removes carbon dioxide from it. Similarly, the mixed venous blood brings carbon dioxide into the lung and takes up alveolar oxygen. The alveolar Image not available. and Image not available. are thus determined by the relationship between alveolar ventilation and pulmonary capillary perfusion. Alterations in the ratio of ventilation to perfusion, called the Image not available., will result in changes in the alveolar Image not available. and Image not available., as well as in gas delivery to or removal from the lung.
Alveolar ventilation is normally about 4 to 6 L/min and pulmonary blood flow (which is equal to cardiac output) has a similar range, and so the Image not available. for the whole lung is in the range of 0.8 to 1.2. Image not available. However, ventilation and perfusion must be matched on the alveolar-capillary level, and the Image not available. for the whole lung is really of interest only as an approximation of the situation in all the alveolar-capillary units of the lung. For instance, suppose that all 5 L/min of the cardiac output went to the left lung and all 5 L/min of alveolar ventilation went to the right lung. The whole lung Image not available. would be 1.0, but there would be no gas exchange because there could be no gas diffusion between the ventilated alveoli and the perfused pulmonary capillaries.
Oxygen is delivered to the alveolus by alveolar ventilation, is removed from the alveolus as it diffuses into the pulmonary capillary blood, and is carried away by blood flow. Similarly, carbon dioxide is delivered to the alveolus in the mixed venous blood and diffuses into the alveolus in the pulmonary capillary. The carbon dioxide is removed from the alveolus by alveolar ventilation. As will be discussed in Chapter 6, at resting cardiac outputs the diffusion of both oxygen and carbon dioxide is normally limited by pulmonary perfusion. Thus, the alveolar partial pressures of both oxygen and carbon dioxide are determined by the Image not available. If the Image not available. in an alveolar-capillary unit increases, the delivery of oxygen relative to its removal will increase, as will the removal ...
Ventilation perfusion ratio (The guyton and hall physiology)Maryam Fida
Ventilation perfusion ratio is :
“The ratio of alveolar ventilation and the amount of blood that perfuse the alveoli”.
FORMULA
It is expressed as VA/Q.
VA is alveolar ventilation
Q is the blood flow (perfusion)
Normal value of ventilation perfusion ratio is about
0.8
VA is 4.2 L /min
Q is 5.5 L/min (Same as Cardiac output)
So VA/Q = 4.2/5.5 = 0.8
If VA becomes zero ratio becomes zero
If Q becomes zero ratio becomes infinite.
If ratio becomes zero or infinite then there is no gaseous exchange. So this ratio indicates the efficiency of gaseous exchange in lungs.
In standing or sitting position this ratio is not uniform in all parts of the lungs.
In standing position, in upper parts of lungs there is almost no blood flow so normally in upper parts of lungs the ratio is higher may be near 3.
In lower part of lungs, there is more blood flow so the ratio is decreased may be 0.6.
In certain diseases the VA/Q ratio is higher which means perfusion is inadequate i.e. in some parts of lungs the alveoli are non functional or partially functional. This is seen in cases of pulmonary thrombosis or embolism.
When there is higher VA/Q ratio, PO2 and PCO2 in the alveolar air resembles the values in the inspired air.
When exchange is not occurring because of lack of perfusion, inspired air goes to alveoli, as there is no exchange occurring so the same values of PCO2 and PO2 as in inspired air.
Gas exchange between the alveoli and the pulmonary capillary blood occurs by diffusion, as will be discussed in the next chapter. Diffusion of oxygen and carbon dioxide occurs passively, according to their concentration differences across the alveolar-capillary barrier. These concentration differences must be maintained by ventilation of the alveoli and perfusion of the pulmonary capillaries.
Alveolar ventilation brings oxygen into the lung and removes carbon dioxide from it. Similarly, the mixed venous blood brings carbon dioxide into the lung and takes up alveolar oxygen. The alveolar Image not available. and Image not available. are thus determined by the relationship between alveolar ventilation and pulmonary capillary perfusion. Alterations in the ratio of ventilation to perfusion, called the Image not available., will result in changes in the alveolar Image not available. and Image not available., as well as in gas delivery to or removal from the lung.
Alveolar ventilation is normally about 4 to 6 L/min and pulmonary blood flow (which is equal to cardiac output) has a similar range, and so the Image not available. for the whole lung is in the range of 0.8 to 1.2. Image not available. However, ventilation and perfusion must be matched on the alveolar-capillary level, and the Image not available. for the whole lung is really of interest only as an approximation of the situation in all the alveolar-capillary units of the lung. For instance, suppose that all 5 L/min of the cardiac output went to the left lung and all 5 L/min of alveolar ventilation went to the right lung. The whole lung Image not available. would be 1.0, but there would be no gas exchange because there could be no gas diffusion between the ventilated alveoli and the perfused pulmonary capillaries.
Oxygen is delivered to the alveolus by alveolar ventilation, is removed from the alveolus as it diffuses into the pulmonary capillary blood, and is carried away by blood flow. Similarly, carbon dioxide is delivered to the alveolus in the mixed venous blood and diffuses into the alveolus in the pulmonary capillary. The carbon dioxide is removed from the alveolus by alveolar ventilation. As will be discussed in Chapter 6, at resting cardiac outputs the diffusion of both oxygen and carbon dioxide is normally limited by pulmonary perfusion. Thus, the alveolar partial pressures of both oxygen and carbon dioxide are determined by the Image not available. If the Image not available. in an alveolar-capillary unit increases, the delivery of oxygen relative to its removal will increase, as will the removal ...
Ventilation perfusion ratio (The guyton and hall physiology)Maryam Fida
Ventilation perfusion ratio is :
“The ratio of alveolar ventilation and the amount of blood that perfuse the alveoli”.
FORMULA
It is expressed as VA/Q.
VA is alveolar ventilation
Q is the blood flow (perfusion)
Normal value of ventilation perfusion ratio is about
0.8
VA is 4.2 L /min
Q is 5.5 L/min (Same as Cardiac output)
So VA/Q = 4.2/5.5 = 0.8
If VA becomes zero ratio becomes zero
If Q becomes zero ratio becomes infinite.
If ratio becomes zero or infinite then there is no gaseous exchange. So this ratio indicates the efficiency of gaseous exchange in lungs.
In standing or sitting position this ratio is not uniform in all parts of the lungs.
In standing position, in upper parts of lungs there is almost no blood flow so normally in upper parts of lungs the ratio is higher may be near 3.
In lower part of lungs, there is more blood flow so the ratio is decreased may be 0.6.
In certain diseases the VA/Q ratio is higher which means perfusion is inadequate i.e. in some parts of lungs the alveoli are non functional or partially functional. This is seen in cases of pulmonary thrombosis or embolism.
When there is higher VA/Q ratio, PO2 and PCO2 in the alveolar air resembles the values in the inspired air.
When exchange is not occurring because of lack of perfusion, inspired air goes to alveoli, as there is no exchange occurring so the same values of PCO2 and PO2 as in inspired air.
Like heartbeat, breathing must occur in a continuous, cyclic pattern to sustain life processes.
Inspiratory muscles must rhythmically contract and relax to alternately fill the lungs with air and empty them.
The rhythmic pattern of breathing is established by cyclic neural activity to the respiratory muscles
Basic concepts in neonatal ventilation - Safe ventilation of neonatemohamed osama hussein
Lecture by by dr Muhammad Ezzat Abdel-Shafy MB.BCh, M.Sc Pediatrics Neonatology Sp. , Benha Children Hospital, provided during our Doctors neonatology workshop, 20th of January 2017
Like heartbeat, breathing must occur in a continuous, cyclic pattern to sustain life processes.
Inspiratory muscles must rhythmically contract and relax to alternately fill the lungs with air and empty them.
The rhythmic pattern of breathing is established by cyclic neural activity to the respiratory muscles
Basic concepts in neonatal ventilation - Safe ventilation of neonatemohamed osama hussein
Lecture by by dr Muhammad Ezzat Abdel-Shafy MB.BCh, M.Sc Pediatrics Neonatology Sp. , Benha Children Hospital, provided during our Doctors neonatology workshop, 20th of January 2017
This presentation deals with the basic physics of human ventillation. I have made an effort to clarify most of the venti lingo , so as to make way for further discussions on ventilator use. Hope it turns out to be helpful for you. Thank you.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. To define and classify ventilation and perfusion
in lungs.
To describe zone of perfusion in lungs
To describe ventilation perfusion ratio in lungs
To correlate VENTILATION and PERFUSION
ratio with PULMONARY TUBERCULOSIS
OBJECTIVES
3.
VENTILATION
The rate at which air enters or leaves the lungs.
Types : i) Pulmonary Ventilation
ii) Alveolar Ventilation
1)Pulmonary Ventilation (minute ventilation or
respiratory minute volume): Is the volume of air
moving in and out of respiratory tract in a given unit of
time during quiet breathing.
INTRODUCTION
4.
Pulmonary Ventilation= Tidal volume X Respiratory Rate
= 500 ml x 12/minute
= 6000 ml/minute
2) Alveolar ventilation: It is the amount of air utilized for
gaseous exchange every minute.
Alveolar ventilation
= (Tidal volume – Dead space) X Respiratory Rate
= ( 500 – 150 ) ml x 12/minute
= 4200ml/minute
TYPES OF VENTILATION.....
5.
PERFUSION: The movement of blood into
the lungs through pulmonary capillaries.
VENTILATION/PERFUSION RATIO :
It is the ratio of alveolar ventilation and
the amount of blood that perfuse the alveoli.
Mathematically, V/Q = 0.84
VENTILATION AND PERFUSION
7.
Zone 1: No blood flow
Reason: More negative intrapleural pressure alveoli
size↑ & lower arterial pressure due to gravity →
decrease diameter of vessels
Zone 2: Intermittent blood flow
Reason: arterial pressure is greater than alveolar and
venous pressure. Whereas, venules pressure are
less than alveolar pressure venules are collapsed
Zone 3: Continuous blood flow
Reason: Due to gravity, there is high pressure →
vasodilation → more blood flow
ZONE OF PERFUSION
9. Zone 1: 1.92 L/minute
Reason: Increase size of alveoli
Zone 2: 4 L/minute
Reason: intermittent size of alveoli
Zone 3: 6.5 L/minute
Reason: Decrease size of alveoli
ZONE OF VENTILATION
10.
It is the ratio of alveolar ventilation and the
amount of blood that perfuse the alveoli.
Calculation:
V/Q= alveolar ventilation ÷ pulmonary blood flow
Alveolar ventilation= 4200ml/minute
Pulmonary blood flow=5000ml/minute
So, V/Q= 0.84
Ventilation/Perfusion (V/Q)
Ratio
12.
Zone 1: Ventilation(V) >>> Perfusion(Q)
V/Q= 3.4 (high)
Zone 2: Ventilation(V) = Perfusion(Q)
V/Q= 0.8 (average)
Zone 3: Perfusion(Q) >>> Ventilation(V)
V/Q=0.63(low)
V/Q IN DIFFERENT
ZONES OF LUNGS
13. Apical Zone of lungs : It is more infected by
Pulmonary Tuberculosis
Reasons: i) There is low perfusion.
ii) There is higher V/Q , higher PO2 and lower
PCO2
(M.tubercle is strict aerobes)
iii) Less of the oxygen is carried away by the
blood in apex of lungs. ( Highest O2 available)
V/Q and PULMONARY
TUBERCULOSIS
14. Zone 1: Ventilation(V) >>> Perfusion(Q)
V/Q= 3.4 (high)
Zone 2: Ventilation(V) = Perfusion(Q)
V/Q= 0.8 (average)
Zone 3: Perfusion(Q) >>> Ventilation(V)
V/Q=0.63(low)
Apex: It is more infected by Pulmonary Tuberculosis
because
SUMMARY
15.
Guyton and Hall ( 13th edition) Text Book of Medical
Physiology
K Sembulingam and Prema Sembulingam(6th
edition) Essentials of Medical Physiology
Ananthanarayan and Paniker’s( 9th edition)
Text Book of Microbiology
REFERENCES
