University based lecturers Chill medicos Chill medicos CHILL MEDICOS BY- HIMANSHU DASORIYA >: GEILE NTT,MECHANISM OF RESPIRATION © Mechanism of -Respigation favelve the breathing Hechanism and Exchanges Of © asses . *Respleatory | breathing Hechenism and Excbangal of Gasset.» ‘Components Ares 1. Respietory movements 2 -Respimntory pressure 3. Lungs Compliance. Ay wosk of Sreattag 1. Respiratosy_tovements ¢— © Respiration occurs tm 20 «phages? Inspiration Expiration During rosmal quiet breathing eR) HE bs, NER TL, clecent of liaphragen A change of thovadte, “Qe by ‘movernent of some Structured - 1. fende fh 4 by hernias stexat ned by LS at pate of ib e Movement of fovacte lid.g—> fa Antesto pasterfor diameter Ls eealene, used (contraction) 2, upper costal series Lard upper 6 parr of Rib e Hovernent t=) 1a -Ainterio Pastertior Transverse diametes, Teo Type i“ } reovement oo pump Handle — > Nuccled External Entercestel ovement ‘ ( Be parte. Cae > Elevation. of Ribs movement “s forard movement 2F Ls center pestion of =? Leal Ribs fea Anteriopesterior Comore [oreo rave TL ciaoaed te enere Hbtzonhl diameer of Thovode > fea Feantverse cbfomeler. ft%. Lover costal sesfes. s Ly tower — Ft Jo pale of rib: o rmovement ¢— fes transverse. diameter i handle movement « Bucket ; Gs kihs sotret siotaging dulrauels G upwards 4. plaphragen » neemally before Yptealion > cbme chert: digehragm { | vo Ty > During Saspisation Ly diapheg contol 8 Vos. portion Zia eq. i Ly teaverticel diameter O Mevements of Lungs s During. frspietion 3 fea —ve Pressure. tn thoratie cope Te Lungs volume [Ale come 7 Gast of tang. o ourkog expivation = Jes ve, pressure Urge come fo pre, -faspiralioa (volume Geir come out * SOIOPStAD. Ganteng of lungs Yoke We factors Causf éellapsing factors prevent . © Clostic prokes vies ® ata pleutel Pressure @ Susdace tension @ surncfankRESPIRATORY PRESSURE 0 Foe types of pressure ave exerted tn the ‘thoracte cap | cavity @_ Lungs duriag Respfratten 1. Tntrapleural pressyse, / intrathowacle Pressuse 2. Anta -alvelar pressuse | Intra pulmonary “pressure 4L. INTRAPLEORAL PREssuge [-ve pressure] Ls Pressure. Exesting fo pleural cave Ta TR Suction of the visceral and parfial Sayer of Pod bs please Pleural cout + Noma] values s— #® Ep ip aliooys Negative 1. “End of -inspteation « [Mommaly + Smet. (70-6 = 754mm ivedl ; Peercaltee wih Clase gto Hs Toren Hy. Forced trspivation 2 ~ Bommig- 2. End oF Expreation : oe a ee [1s8mmyg] forced expiration with clase, glottis « Lvedsenvalsalya maneuver) eso mm ry.@ Couse for NegaHlve oF intrapleunal pressure, Pht Pleural cauity always Uend a iin lager oF Fuld pocined by teh tap ae luld pump "Brom the Cf eet Plesgral cout we pressure: jp developed *Conditions when pressure, become -bve. pheurnothorax Hydvotherax Heme therax [Pyethorax, @ Nesurment of intrapleural pressure © divect method 2— Patreduct, needs -fato pleyral cavity eer . Hescsivy -manometer ® Sncktreek mether| $~ fabrddueog, esophageal ballon, Ceomest Mercury, Manom eben. @ significance of Jatrapleural pressure 4. dt prevents the collapsing terdonny. of Langa 2. Responsible for Venous Relurn CResptratory pump for venous Return]Q, ENTRA- ALVEOLAR Pressuge Ly here iveoln’ presciire exfitng- Tn he, cll of tte lungs y @Novmol Vales .2- e Normally fatra—alveslar pressuie, = Abmaspheriopressuse, (tee met) © Inspiration —s Gecomes eve Ye, © Expfealjon —> Gecomes +VE Normally 2 —Lmertas [q5g-om H 4. Inspiration ~—| 8 a as iT forced Fnsptsotion with dose. glettis —Bo:mmig. 2. enphrljon Toe = tromeg. [ getemng] forced expfration with clese, gles 18 me g @ measurement 3— by usteg Plethysmograph 6 SFpniffearce of Intva~ alvesler pressure. 1. flow of Ais tn ov out of alveol. 2. Helps Scan of gress behween Allveoli and Blood1 6 Franspulrrooary pressure | LL pressure ditferente, bio Tatra olveder pressure! and Tatra pleyso) pressure. reakfe\Preane Seale lero zoFicturg. Responsible or colonstog. Coa tyCOMPLIANCE : Hg at 4 Abily OF the: lungs and herex Av expand oF it tp ‘Sapanei buy OF Luss and hora. change fa volume per unit change, fn pressure Compliance = ae @ NoentAl VALE Ls compliance, expressed by Hee Yeaya, 1. In Relation 42 Patra- alveday pressure 2. In RelaHion te Intrapleural pressyre d-dh Relation 40 fntra-alveclar pressyre. Compliance = “Chae /vohime Jey fin bur es Io antra + alveslas Pressure. Complpasn)-| Lange+ thorax 130 ML] dom Hypo pressure. hangs + 2200} 10m Heo Pressure 2. compliance fo Relation te fotvapletimad pressure Compliance = Teavolame. of Lungs ee Of bares res fntoa pleural Pressure ~cimpuanin® SF hugs thorax % [60 mi.|16n H20 p hangs & Room.) 16m Hoo PressureKe Apecific. compliance, i Ef hw Specific compliance = - 2m Lance 0. . oF Hangs Fanctioral Kestdual capacity FE Vypes of compliance -— 4. static Compliqnce s— Ly -compliance ree a Static J =~ Cenaition No} breathy © Pressure Requized to overcome athe elastic Resislana «of Cespivatory system for a given tidal volume under zero flow (Static), Condition @. ‘Dynamfe compliance ¢— dynaefe ginte T chusteg Breath Le -comptiance easing at 4 El Applied Physiology: © Jer compliance, © Jes compliance Sng 3 fibrotic. phuisy condition * 818 99 2 Frbvests 3 palategics > pleurod effis fon 3 -pheumotherax: ee 2 EnplyseraWORK OF THIN: © During quiet breathing 1 Respteatoray Muscles perform the pork. only duriog Inspiration both daring expieation. shelve. process P OVK of breathing. .fy york done. by suscles dust breathing. 40 ovdreome, the Resistance in thorax TI oR, dene by Respiratory Husces. sae EL -vtilization of ener. © vuring wore of “brenttfog- the enenyy used for covercome three, type of Resiclana, 1. Ate. Restctance Li Reststamce offered do the. Pusaje of alr Hough respiratory tract. © Bronchiolar Constraditon —> Te Reststanc, aan A Ly woke gore b muse, _ fF overcome, these. gesistancs, ° Alt way Resistants:’ tok 2. Elastic Resistance. of wre F -Aherax G Energy Tp Requived| “fo Expand Bangs cand Tharmx against the. elastic force Ly tor, clone 4. overcome this clase force Resistance enblsd Compliant OPK,3, Non~ Elastic viscous Resishanea u Energy equives| Jo over come the video: of lungs Hssue and Aissue of thoratte cope. bork done Pevencome this viscndie Reshstance if called issue gaststance. wsovt,.SuRfacTant © -Surfockant jp a -Burjace acting. Material tat tf Responcible fos lowestay durhace, tension ef | | Fluid : e durdactant > Ua of Alveot fn Logs cabled & putmonarce surfactant qe Surface kersion “of Alventi membres ae Source of “Zeeretfon of -pulmonary Burtactanh © Cype 1 alveolar epthrelial cell: [seh aver Alvear] Ly have microviui Lev alveoli] ® clora ceuus Ly present 8 the bronchioles Lexocvine, celle] ae Chenistry of Surfactant + durkactant ave. | #fpoprotefa. complex: form ec by -Upids betaine rotetn, fonds sphesphalipids 2 form arth of surfacanh Hajor for of -PPL fp dipaete phose ' Nidyhchal ‘ng [DPPC] * other Upids 3 [a phosphatidylatiscesol (Pa) * Proteins? [ specitic Surfactant protda Usp] ] ap type, PSEA Be Mndvophille Lepea P01 SRG fe =sp-c]fons: mostly Calcium ort present. 4F fosmation of Ausfactent.2— lar epith. coll: « Lamellar bedies 3~ present fa pt Atal Clara col. sph sipids Form susteclant «f sa nucle Lamellar bodies, Realise v foun ON HE alveoli Surfec! Latice — a— phospholipid , [tabular t__ prot ean aE protein’ rea Cemvert «Surfactant —» Form fflm. + form HE factors Nessessaty for the, formation and spreading of sucftetant © fomration s— 2 pet * Hydrophobic preteink LSp-B § sp-¢] © specnting sg [Film foraioe]*” + Higdrophobic: proteins [sp-2 © ¢P-) © spreading 4-9 PG + CH ions FE Glucccorticotds plays mp Role fo formation of Gressa functfons of Suefaotnk 1. Reduce Surface {exsfon 2 La prevent lange for ‘callapsing.- Lo rechaniem of surfactant fteg. 3 a Alveott te Hydvaphitie php Wwophalote Ineo aie 2. Stabilizalfon of Abveoli BS. Toflatfors of lungs Ales bisth, nants t — surpactant BeexeHoo begins After 3 month © Unk] bieth — lungs are solid. nto expanded. [dase agin hth SHionlate. Respiratory centes™ b Hiypoxt4 Cha iereo ¥ Respirator 4 cooverment Attempls 4. Role fa defense, 5— Le Sm bans extoopy Tieton eases Lo eamerton. © Hydvophilic. Sp-A 4p > destroy bactesiq, & virwd wey opsonizationaE Applied physfology . D Respiratory elgsctstvess synobrore. [ens] Ly Absent of durgectant Fihaae: anieece] {awe Lungs collapse, Infants, faatsd [reps]ad Fah LNG vaanaess ARE Volumes © oF AIR Tiese volumes Represents Tie volume ofS ATR present axl, LUNte UNDER A specie TaTic Condifion (posiTiont oF Tuorax) - 4 Types —> 2) Tat volome 8) AnspineTorY Rese@ve VoLUMe 3) expinaory Reserve volume 4) ResibuAL vowume @ Tioay Vong amps viwurte oF rin gree i and oot oF ules A ile Neen Qeiel RespieAiod > Siquities nlormat desta oF skenTuinle NogMAL VALIE —* S00 -mt (o-5L) a TuspinnfonY RESERVE VoluME => ‘ TaN ADDHTionaL VoloMe oF Ala THAT Can 8e INspined Forcefoy AFTER et of roeAl — Respinalion NoemaL valve —> asco ml Gab ww GpinaTon! Reseele volume. > © AN ADDITIONAL volume oF AIR TdT can ge expined oof Foreefuly , AFTeR Noettal. esi HoRMAL VALVE —> sooo mL (1) 4 RESIDUAL VoluME ==> « Yourte 0% AIR emPininr WW Lames Even ATER Forced Gepinllion stilplomice — d)nels Te Aceile Tie sloop il lo SeeATniee AND Dontnler expigATion . A NAiNThis THe Color of soils Norma Valve —> 1go0 me (1.2L)sae BING Capacities 1 — Lng capneiTies ARE Comsiniifion! oF ek aK Moke, Long Volottes 4 Typo 1) QnispieaTony capacties a) vital capasily A 8) FuncTiowmL Restount capnciT? 4) Tort won Capacity @ InspinaTony Capacity —» e MaxiMum VoluMG oF AIR THAT fs ‘Sispinep AFTER noxeat expigilion (eno “Expiralor posiliont) » "Te =v +Tev soot 3,300 3.600 mL a \ila_capacily (ve) —> = maximum Volume of ate Taal CAN GE expeed oo Foreefuui afer A acer (maxima) aneptealion! « ves IRV+ TV +ERV = 3300+ 500+ 1000 = 4,800 mt slgitFiowee—> its DaleRMindion is vseFun fH ciflfonL Diagnosis « a FunllionaL ResinvaL CApacily —» + YoluMe of Ae REMAINING jd LuNGs AFTER NORMAL expiration: (ACTER NoRMAL TioaL expinalion) . FRO = enV +RV ‘ fone +800 > 2,200 mt a Tota Lune capacity —» © VOLUME .of AIR. pReseNT N-lNGs' AER A DEEP(waKimaL) dnispiralion . Tic= TRv +1v teRv +RV = 3,300 + 500 +1000 +1g00 = 6,000 mL ‘ spinor vy one Inv (aacom) z w & (seomt) a z a fev Ly vote caper z (ooo a) (RO) = Rv‘TinsporT_oF _oxtcen! © Wgen fs “Tennisporten From atveot! TS Tue ‘Wssve aY sloot) an & Forma t+ ) siarte. prfstenl ) comeination wily Hb soLsTion TABLE 125.1: Gases in arterial and venous blood Arteriall||Venous Peete erected Partial pressure (mm Hg) Content (mL%) Partial pressure (mm Hg) Content (mL%) sine _SotdTion —> Orlged afesolves IN wafer , oF peasy? patsicat. Form AND 18 Tranepofen al HOS /rom, OF patna ke pecnuse oF pk solueicity oF oxften! pasa - : kAmponTan? Donte conbifiens Ike MusedlAR exeRGSE Jo mel te cress emma of oxford 87 ne Tissoes ani witen conten? of on Comainlion _vlill,_neMogiosinl —> pottcal comiies Ott Hb Blood AND Taonsporten as Ontnerowes © Max, Amo? (ae) oF Og Tinsported OrtgenaltoN oF Hb = «OXYGEN Gomes WITH Hb only Ad A prifsical coustvalion onda Not oxinalion ‘Cas asccesnacticien cace onfged COMBINES Oi Tre Tao tN HeMe pal oF tb ‘ Enc} MOLECOLE OF Mb Confnils 4. Toms of Sort Tron! hows tn entovs Foam (Fe*?) EAC} Seon ATOM ComBNE wily DNe MOLECULE oF Oy Aten contin tRoN Renanins id FeRRoos FoRM ltt Tyas WHY qnuLeD onTGeNATion MoT oxipfilion! dk onoert caning Capacity” —> eamoowt of ox Gen! TranepoTeo 8 sq of Hb cs x ovfeen! CARRYING capadly oF sroop, —> fe Amount oF oxVaen ‘TRANSPORTED ef GLo0d NogMAL Hb — 157% offen CARRITHG: CApACTY oF Hb — 4434 mb /s Isyh ak Hb caReies onftf a0.tmi7/, °F o¥fted (eo mt of 03, W490 4 Ha) + iy fw carries ont 14 mi -[ oteal pecnuse Hb ts Ae jul sfloraten itt oxen only Pow ash, eo gATURlioN is Tye slate oR CondiTtoN wren Hb ts UNABALE To Hoy 8 CARRY any more oxen DepenDs on parliaL presse oF gyco es 5 Cred FIGURE 124.6: Paral pressure and content af exygen and carbon dioxide in bod, alveot and issuesOXYGEN - HEMOGLOBIN. DicsociaTion CuRVE - * Come TT demonaites THe Reuifonerip 'bj.9 prea pesssone of often AND *7/. SeTuRAToN oF Hb | Dim oxfterls A ExpIAiIS esiogoninl's AFFiNTY FoR oiler! 6 WHEN Tie paRlin pressure oF oien 4 Moke 1 wesaguosid ceefls. cnVtpenl yen. Tie paRlinL. pressoRe oF ger! is Less» Hb Retense offen. WoRMAL oUlGes! -HEmoqiogi DissodATion CURIE =P a cake Fe 6? siege ot - shard “ onnped + Logger PART Anofemlee tesodilion oF OnGen! FRoM viertorio nil + OppeR pakT tuoielles optake oF oMftreN. of, emosnogin, depen cpt prfliat.pressike oF onfaer! - Shitfoett Percentage saturation of hemoglobin (%) 20 ' 4 | 60 | 80 | 100 120 : Partial pressure of oxygan (mm Ho) FIGURE 125.1: Oxygen-hemoglabin desociaton curve # Bo — «pian pressoRe of eee AT tlio] Hemoaiogin —sétvaaTtont wily ofeed 1s 507. eprint paessine oF ty 8 (e-em) Hb silveiieD To aBil 50/ 2) Paomm ip oF oy ——> silunilion 40% D faery fy ——> flint yeR Factors AgpEcling coRVE <=> eoapve aitTen To Rea (on LeAT at vantous, paclows —= 4) snigl To Left > Acceplance (assoctilon) oF & at Hb ®) suifT To RiaiT —> pissodalion oF oy FROM Hb xdeniT To Ret > CoND'Tfons > @) Jae Int panliaL. pRessoRe of 1) tae iN pakltaL presauRe of Cog (eon cevedt) tee SH MyaRoGe Ton contcedteaTion! Anta Lae tt PA (uss) @) fe worl Tempensivee ©) excess of 2,3 Diptos} 2.3 tgnospuocdlccrale (80) roswreensle (Dptr) Id aac 8 peovel trl Gaanen) - MeleR-or piled” 4 omeies it} poems oF Wb MmescotaR ExeRcist ce i RBC vical hwode 2, tees $ conve sil te Ril @ ang Te lel + onDilionts —> 0) FETAL seed Fae, gy THON THE (ub me Hig a FT anoit xb) + 8) Lee in Ht GncenfiaTont ann fee i pt k BaHR ered — crtedT aX Wao} presence oF CaRBen! viorine Lees Te arf (nveatntil) iM oF nb Fo ovfired pode a1 cuniTian BoHR iN N04. eG Hrssve Cove To GNTINvoUs mélagoitc Adliviles ) Pag ts Wary fag 18 Lowdue To Tuls pressure Gendient Cog enters Bio) ety RELEASED Feo nleed - Tissues - L . = ; presence oF tog ses Abeinily oF Hb fog %q Enumlce ReLense of a To tissues. Le Bi | 4 conve sniffed To Rice a Au paloes 5 won eT cveve Te RicoiT envinite Bowe erredTRansporR! oF CARBON dioxivé & Teantsporlen aY THe guood from ceits To Alvel 1 an 4 ways 4) AS afesolved FoR (4%) 3) As Carsoniic acto (settigtave) 3) AS aicaggonsle (c3"/) 4) as caraaraina. Comeond? (307) As Discuvep FoR > Zs ‘i a vio 7 Lo tug, Dittuses SATO teed AND pissouves fl Farid oF porMing =A SIMPLE solution . led . Le only amt jngrinc® PAM OF Cy ‘TRansporTes a CaRBonlic Acid —> hi Fo LeSisselven (og IN plasma Gomnties Ott We wisleg To feet cARBonic Acid - a As*cangonale—? 1 eam pina , oan ENTERS RAC \ GN REG , Cog LoMaine ity H,0—FoRM caRBauic, Add. Raplo Dve To presence oF cagsontc. AnlafoRace OnLy iste ROCs XT Les © casonic Aco onslaae int puasean pissocdates fo siageoale Any wfarogen! ions DE To Hie contcentRAlion HE oteFases. TaRooget eth MEMBRANE ¢uifo pracaa) CHLORIDE iéT_.o8_HaM Paenomenion, fon FoR 4 sSicaRBonlAilé tee Acaoss —> sxuinlte oF A CHO Rec MemBpane . — siseoere sf Hanlog Taxes nameorGer in ge fiers) —> ocoR WHEN Cay Gifers ‘Tie sLoad FRom Tissues . Naci NaHCO, FIGURE 125.2: Transpen of carbon dioxide in blood inthe form of bicarbonate and chleide shit ! + Auli Giamnlgen 4 (anno 3 peed) A Ihe ntipoeT ponte aN Rec MeMBRane respisane for Gxuan@e OF GheARBoniTe Tons — any cHuoslae fa + patag (cutie blearkonaSi)—> Teawsporlen in Glesd + nition Dfssocislen Feo Carsodic Aci> — offered ny Hb Inlsive Cu. x SE CHLORIDE SHiF] ==> % process BY WHicy eHLoRiDE Tons ACE HoveD sack, info pLasHA From aoc swifT. vecvRs IN Jones.— > nets SN etiminslfionl oF (oy FROM load « —> winert Bow — REACHES —Atveori , NaHteos nat wok ‘lt Rec) de Moe ovT oF REC into plasma Nac 4 te gut (Qusine rec) “Psm) ir ape yo t tog Cexpetced od). | As _CaRsAwtino _compown DS —™ eo TRanspoRteD tx Btooy IN comeindTga! wWiTd Hb + pLasH® peoleins| + Cog tH Hb >: Hbtog (careaminio Hb /congnemo oats) © te come Wit} plasma proieins — caggamino proteins * carsamtvo Hb + caegamtino pRateivs T— carer CARBAMING Compouel © AmouNT oF toy TaansponTed iN Comsinalion! .OiTH puasmia pealeins 1s ver{ Less canipatea “To AMoONT — TeansperTep. th comein dol with ab secause » QUANTHTY of proteins tN paste Te ont] MALE oF Romy La * Hanoanle Ene ECT. x eereT ay iio comainalion! of © onYaen OITH Hib Drs places (og FROM ab i x pescriged BY Youn) Scotl HALDANE iA 1860., 2 EXCESS OF Gy cone! ——> caose aif of Gey disodétion Cuave sate R- Rio80 Deoxygenated blood 60 Oxygenated blood 40. 20 Carbon dioxide 0 2 40 60 8 Partial pressure of carbon dioxide (mm Hg) FIGURE 125.3: Carbon dioxide dissociation curve w CAUSES oF HALDANE EFFECT =» L, awe Te comatvalion wil 0, , Hb BEwMes SleonatY Addie . 2 HiatY Acioic. Wb loo Tennencl Te coming wliTH tog cay Bispace FROM i009 « L) wecnse of acioily, Hho Rerensed in Excess . 9, faam carga. acd (ps sind wld Woy iow) wt 4? 4 5 RELEASED FROM @ Revense- oF Gy FRM Blond Inte Alveoti oF LwNGs @ sie og by the dubeed .gay REQUATION J oF RESPIRATION 4. “+ Reaphefion fs A REFLEX process. oe 1 con 86 -coneouien votonTariY fog 4 anni. pegion oF 40 secu. de & ReqalieY reayavfents —» 2) sleainas / evra, mecvanfan 3) cuenta, Meotanion NERVous MECHANISM —> Tat Requriles “Tie RespiRion Wemes 1) Reapieatiny CENTERS 8) APrenenT nlenves 3) erremenT NeRvES 4, RespiRAToRY CENTERS —> co RespieaTeRy cenlTeRs ARE Group oF Neoonls , THAT. patti AND fence of: Respiniion fe conTers Ane sisTerauty situ i RéTicuLAR, . oamilior tonTeo. Tie RATE» nN oF 2) VENTRAL RespiRATOR ge Pantin CENTERS p—> 4) ApNenslic center, C5 PacumTaxtc ceNTER, |MEDUARY CENTERS => 4. DoRaAL_ REspiRATD OF NEURONS amy SITUATION =ev-Tsl Tie nucleus oF Tendlos solitaRios (vppee paRl ob Tie mepuuta, eBtANGeTA) - a colledlivery CALED “InsptRilry cenlTeR e ALL NevRonls ARe INapinaTorY nleuRoNs 4 Generale Twepieiloey’ Ramp 8 vive oF Taeik, AuToenYTamic prepeelt, FuntCTion==> Respunidinie Por «Basic RNYTHM oF Respicilion! .Chemoreceptors Vagus nerve FIGURE 126.1: Nervous regulation of respiration. Solid green line = Stimulation, Dotted red tine = Inhibition. ALVENTRAL RespinaToRY Gawp of NEURONS —=y SiTOATION ==>. TH noeicus wi Mid Nvcteve. RéTRoassavous Srvatep A meouiin ostangala « ANTERIOR, “AND Lileeai To Nucieus of Teaélos sotTAn eCoutedlively cnuten excitatory calteR . eHins eiT SusptesTory any exigaTony Nevgonis . Font Tl CONTRAL AREA fd CAUDAL AND REAL AREAS of GAtUp- oF kop Funclion: aap x svndTive’ outing gute seeititng X héive poping —~ EORCED GReATTING-. * Nevgons STimouile aot GnspinAToeY museres any expinalory muscies,TABLE 1261: Medullary centers a Pr erat Difusely situated in nucleus of tractus solitarius In nucleus ambiguous and nucleus retroambiguous ao Insieory and expiratory neurons Inacve ding qt breathing Active dung forced beating @ PonTINE CENTERS —> 4. Apneuilic CeiTeg —> SiTuaTion > sx Tie ReTicaaR Formilion of tower pols. Funlclion mp fses Defit oF spinon ef Aling- DinecTty on DoRsAL. GRwp NEURONS, 2. PueutiTaxic CENTER => SiTueTion| —ape2n Tie soesonTEnat pol of RélfcalaR formalin fry UPPER ports . «Forme 8 NevtoNé oF mesa pagnBRacitaL AND SuapnrasraceiaL Nuelef . iso coiven VENTRAL paraarncifal (koultkeR - Fase Nueteus) » Funclion =p «. 1 Te GNTROL THe“ MEDULIARY RespizaTorY -cavlTeRs , preted ay ‘We porsil. Gaop Neurone. © Ads Tarovgy Apredilic center . efucomiTaric center tuuteTs Tie aprlevalic celTke o Taal Tie dorsal Group NevRols are. funtefTed . ‘Bee oF Tats , Inspheilion “Tops € expterlion in « celTeR feo Relea eile of enact Tig DURATION of SylapiRaliOnConnections _ oF fesperel CENTERS —> EFFERENT PaTuuie anlerve Peers ht sie cenTers Leave Te seninslem ‘Sesconn Ww ANTeR‘oR, paw oF LATERAL coluwins oF $C. Nowe fines Terminale on milog, evens a Te adTerioe Hoey cells. oF cite & Thorncie seqments of spiar wed. D parent ed Flaers Ccs-Cs) » —sopply The aiaparadet s)aNeRComTAL lege: Asers (4 ~ Ty) — soppy, efleRnaL ‘qnTeReosTaL Mosc. Newve Fegs * VAGUS NERVE ALs0 CoNTRINE ¢ome EFFERENT Freces from Tae Respiedlon) carers APFERENT Pathway ==> 4 Dyegtprera, GHemtogeceplors £ asaroReceplona via sRanaies oF GossopNARNGemL AND VAGUS ENDS / eaves 3) sTReTo} RecefTons oF Longe vin vagus. serves. Ls ef teceiving, AFFERENT Dnpolses Rom These RecepTons eapiaaTory: celTens menotiTe The MovemlTs oF Tome cage € bones , TikovGr erterenT NERVE Freeeea CHEMICAL MECHANIGM sGjertion miearmifam ts opeaiTer “Taeovgn otemorecepTons ‘Ane SeNSoRY Nerve enoTNgs Give Response To cHanGes fo cuemttenl. conlsTt TuerlTe of SLoad KCHANGES TH CHEMICAL ConeTiTvenTs oF groay —> 2) njpoxia (seo Pee) : )nypereaplen Ctsen peor) teen wUoRoGEN Yank GolcentTRATiOn . Trees _0F _CnEMORECESTORS mp & Gaoups —> 1) CONTRA cnemenecerfors » periperaL cHemoreceplors 9 cenTa_cuonecTRs —> cvnaeceffons preset “hl Tie apahl x SiloaTionl —» 401 Deeper, pal of —mepoli4 oeangala Clase To oneal Resptailoey’ Group of steveens. Also knlorlN AS CHtEMtOsENGiTIVE AREA a CHemarecclars ARE “N eLose NTT wlITH siooo £ at + meaiAnliany oF Action —> * CONTRAL cueMtaReteplnes conwedTed ith Respledloey cevTens , DoReal RespiRaloeY Greup Tien x Ags stonlly ol Brvécliveyy Fieougy Synapses, ReSPINSHBLE eRe te. - 80% oF Agen welTTLilion Tiwé tHericnt. — RecruLsTory — mecantign ,eMail AimwuanT as tsen ANDROGEN ons canlcenTRATiGA Tk Ht concen tRATion toes iN Tie 1009 He con a6T atimouile The cedTRAL. — cateonecefTons Bey WE FRM Blond CON-NOT Ross Tie BER & 4, diTvaTion —> CHemonecepTons presen SN carlin & Avelic Regtond a MeoNisM oF — aelion’ —> a ifpoita te meat ATEN GTinotanT J BecAvSe of THE PRESENCE oF oy aensilive: ct aunnnets Guomtus cus oF pelprenel otenanecepToes -Hfpoxin causes close A yy SENSTTVE iE CHANNEL 4 prevenTa Kt erFtux J Leaps To DepolaRigaTion OF Glomus ceive Getenslion oF AcTiunl péTeNTials Tl Neve endiner- “Fiypise pase Tivootsl AoiTic. & Neste eaves « GxaTe SoRsAL Gaps oF Neveonls Senn ETAT “apuises Te eeapiesToey musuce L reste td Seen YesTiLATion! 4 proves enoog ovfien! £ RERIRes THe Lacks wt ty» CHEMICAL REGULATION OF RESPIRATION Decissed vention Decreased paral pressure of O; Increased HY Increased partial pressure of CO, inbioes inbleed inblood 4 gest ‘Simson of perperal ,__Miefect_] homareoper weet meet Dison f COs io CSF Fomaton ot | ‘rant impuleos via Stimulation of Staton of conve! eing nae ond oral group neurons hamerecrirs Sorte nene 7 a! ferent impulses to respiratory musces Incronsed ventiaon FIGURE 126.4: Chemical equation of espation. CSF = Cerebrospinal ui-FaéTors Arftling RespinaTory cenTaes, —o- - ® Resptedfoey cenTens RequiiTe THe genpinilory movemenTs ef aecciviny Aimpuises , Fee various, Soveces wit The, oa, 4. Tepolge FROM Vumperty ce nati ‘ong Thebes “an pt a kale Sutarer Toulon oF ee recefne oF aie postee siTudle on Tie vial oF SRonutt £ sexortotfates. expenision oF Lund» STimolaTes 5 # Dokl Reapinaiod Caalspination) 4. * gRelon “ReéepToRs . * Coie eenadin ores * qyypuses Fae, Tats REACHES, Deeenl. Geovp even! Le a NT 4 vie ata, AvreREMT Paes L SuuteiT Treg ery 8%, Muspieiton Tops oe wrertTy. pit FIGURE 126.2: Hering Brousr inflation rofiex. DGN = Dorsal A Fespiatory group oF neurone,@ + Hering - Beever Reflex does AKT operate. Doaing- Quic BREATHING + openiles oily Wiel ‘ipa volume tees teyinl> #090 a, r HERING ever, TNCATonN REFLEX € peFiilfon eerLgX —> sHeNG — aeevee, IyfdiTion geriey’ REMHTS Wie ENspinhion! aNd nits THe ovesTRewinG oF Lot, Tissves - |e Reverse oF Tile aefiey fe HERING - BREVER DEFLATION REFLEX - L Ties piace avenge expos Fi AMecToin oF WAGs poset , DEFLATION secure. Tepysts Feo Hiciter CENTERS me ae Htcuee;’ cenTens ATER, The gesplelion af stnpine tapos Dinedlty {0 DoRsAL GReip ort oF Neoronls . Dantes, cngnaTe eYeve fem Ze 8) cea ve cogpos crise Sines Resp on — 4) weTon] ToseRete " 1) potTenion oneiTAL toe te eReBRAL, CORTEX a enpase Fon on amen & aad anen at cceetel tly enuse PoRteD — sReATHING— Tiapotse_Feot ‘J’ Receplens of wiles ae aT peseflans ane ToxTacnpitlael Receflone pResenlT onl WALL of Alveori AND exose conTae] wily pulmonnel capluneles. = Tuese eeceflons ee sensor NERVE evnings aR XY 7 WE = Heme - FiseRs oF Trese Receplogs age Now - MYELNnTED € sete To c-TieimouiTion oF T-Reveffore — peodoce A REFLEX Response coumendTenlses 6 Apter . Faiuawed #{°— H/peRventLaTion Gi TesitonT ecceffons presenT TA BRONCHT £ BRoneRioLES | STimailed sY Teatran cHewicaL aged — Arantontin i suctu, Di orl DE PRODUCED. REFLEX —MipeeveslTHLATION + sAavienospAsn 4 preven eaTHy of nnenfol. Agen 5 Tegpilst_ FRM BagoRecesleRe > + Brioneceflons 0 phessoneceslons Give Response: To Hance oP. + BaRoReceplons nl cagilin sinus 4 ARey’.oF dolla Give Recpatte To tae in BP fa Ave Send WHtehTony f JwifelToet fepouses To vasomitor, cotter, TW Mennut eeuangala Causes Lae iq TpTnpelnT pllons iMfol Lean To Hfpxia )orfted Tension i aaTeniat sed 8) YGent caRRtin- Copady oF i 8) vetodly of giond FLovd 4) Tigo oF onfeen by cours. RON THe Badia of These 4 Fecloee , Wporta 2s of 4 Types *- Dpipovic w{por'e Merlo WYgoxia ®) Tnquantt “ul poxia 4) MisTeToxic. Hypoxia A.HYPoxic_HYpoxia —» Meats Leen oxfgenl” CodTeNT TH B00 , ALSO “CALLED --ATeRiAL HY poxin CAUSES - 4 Facloes Duowl_oeqen Tenleten Gn fasptren aig 9 Hign atTupe Y arediing- ate, 1 cuosen space ©) SReitinge Gas Willie GNTaiNing- ton! pailiaL phecevee OF orfigeN (Pog') sD RespinaTory “plavavens VassodhleD WiTH sen _pulttontagy vedi Toa 6 PacumsTuoeay 1b) depression oF RespinaTory center CIN Bean Tortore) 6) ossiaveiod oF ReopiRAToey passace as in AdTama 4) Nee Any Mecunnical. MiNDRANCE To Reapinsloey MovenentTs Ctx poltotyetiTis )3) Replay Maonoeea —_AgaodATed. . iT,» tHAneg gale ox}GenAli ont ®) Tmpnired ALVEOLAR DiFFosion AS inl empivsemn ¥) presence or Non-Fovélioning- ALvecH Ia Fiagosie’ UK oF sunendanT 4) pulotoineyenenia, pneumonia , puLmouaey werogannice e) coLLapse oF LUNGS 48 IN BeonentoLA oaslevcliont W) premaTnoeay HYoRETHOEAE , weonsTioang A) CARDIAC _DIBORDERS —> Ta conGesTve nengT paicuee , oWcen Avnivienily & Diffusion ARE NORMAL , t fot steed com put be pumped: fear, bean ppl anemic HYpoxia —> anoint canancTesen a annellY ot nen To camel enone AmonT of oxficend, ofteent AvailABiTY fs nloemat. Causts => + ANY GonpiTion THAT causes Anewia can cause ANemic HYpoxia 1) Sen sgn 0h Rats — 6) Bole Marron Diseases ‘B) HEMORRHAGE 8) sep Hb GoNTeNT IN GLo0D > . coNDiTioN WHich bse The Rec | lonT Jonge Tre leecloe, sHApe se oF RBC { Mae THe Hb tanTENT inl gioco 3) Formation oF ALTERED Hl —» pelsoving- WITH cHroriles » NiTeales , FeesicYanines causeovibélion pe Teen iNTo Feretc ford AND Hb knlownl Aa MeTHOMOGglosiN - t GNNOT Comaine wi o%cen Hb comatwea wit} CD. (cae6on MonoxiDe) , Hg (WoRoGen guide) oR HAiTaovs,, OXIDE - Wh Loses Capnettl To Teanspodl ottcen. 3. STagranT HYpertA _ a WYporfa caves af Leen NewociTY “oF road FLOW. # vTtemifae callep HYpokinelic HY poxia Causes —> emniiy due To Redodlion in wetocily yf given FLovl J) enGedive corning ralwee 4) Hemonginge A) surefeaL Shock, 4) Trigertbosis 9) empaiism 4. Widteloxic UYpoxin —> a WYpoxla propoceD — ¢Y awneiilly oF Tesves To oTige oflven CRUSES <> «due To CYanive oR aufine poisoning: + poisonous syesTonces eaTeal celiviAR, oxivilive evz\mes ann ieee Te A complete paratfsis oF ctTouinome exivase Aster=. = a EFFECTS. OF _H{poxid —p t a AciTe aNd severe: HYporin LERDS Tt “‘wldowsdtvstect erin > D)Saineatsle evsecTy ‘) deutien reeds © QTypes eppedls oF HY s.Tmmenidle_ Erred¢ —» }) eFFEATS onl _Bisod {- + CRITROpATETIN tees proselion oF RBC. tues enya cane capac, ot Steen, #) peepdTs wn coasting ame © oe Sisto oF carainc eens ‘cei + tse fH feb Powe. oF ColTgot uc envi oolpsT BP sUTeR , ALL ARE Reduced. 2) bieedlé_ on RespleaTion s'aespinafory ‘RTE tes ave To cuemoRecrple kehiet + "Lyne AMCONT oF cay waved 05T — Leadinte To ALKALOAth 1 LAER, QeapebTos Tens To 2HPLionl & penieate. « 4) opts onl DGeTive Aol, —> » assodiles WITH Less oF appeR Te & Novsen 2nd YomiTinG , Moly geuMe DY L Feeuinge oF TeiesT. 8) cetecT _oh_Kiote|—> sey seuteTon oF cafTenopibelin fam Tea. 77 pune vein exc0éTen .@) erFceT oh cog, almfToma are Siena To Those oF avcouontc ‘ANToxicaTion eTnpivinvaL 1s Depressen , apielic WliTH Loss oF seuk coNTROL J ; Peron Becomes Taixélive Tun Temperen , Rune peVsod STagls anoiling , sintaing /caving 2 deLveD EFFECTS oF M]poria waap, DEPENDING pon Lent 2 severily oF exposure To HW povin, pevcon acomnes -suilmare 4. everops AYaplons oF mounTAIN, sicxness As - NAUSEA vorniTi ag Depressi weneetest FaTique * Tr T FoR wipovin — oxYaen Thenagy 4 ovfeen THeeapy - Treating Tne ArredTen person wit omen, BY g malHos | 4) Alacint Tiie piltenT's Head td A°TeNT’ CouThining- by: )AlioliG Te patenT Te exeiiie ved efTuer, Fem A Mask, o@ nl iNleanncel Tose. Tu pari. Alpoxta — oXGEN Therapy ts 190% userot aalewiic HYpoxin - moveralery erreclive (40x) TncannT HYposis — Lest “Tae 50% isTeTaxic Ypoxia = NT -useFOL AT ALL3 DEFINATIONS— © ‘Dyspnea means difsieuty fn breathing. «Also called Ate Hunger « iolen breathing enters {he Cncioysness and produchbs [Produce dlstomfort 4p called alyspnes se DYSPNEA Pon? Ly “We level at which -theve Ventilation ith severe breathing i increasesl discomfort. + Real discomfort develops when ventilation Tek 4-5 pimes 4p coNnrgioNs WHEN PyspleA occurs. le piystoLogrcaL Dyspreq % Severe Nusculae Exescfse 2. -PATHALOGTCAL DYSPNEA ==> Condi phen ayspneq occas, RESPIRATORY DisospeRs — CARPIC DISORDERS METABOLTC. U) Pneumonia # heft ventifeular OTSORDERS 8 paleenary elem, failure, * diabetic @ purmonary effusion + decompensated Aebloste, @ Poliomyelitis ita) stenesis 7 Gremit & pneamothorax ayy" ® severe Asthma,= DYSPNEA INDEX Ls tndex between bat geserve, @ Haxienarn Breath "a capacita (nec) | + Breathion, Reserve t= “piffevence. behoeen | ac & Respirajosy mfaute Velame (env) Me RAY ——* ™Be 100 « DYSPNEA INDEX = © pyspaicn-deyelops,ehen the . bysprica INDEX ges belie 960%CYNOSIS ® DEFINATION S oynosts tg defteation as the diffused « blufsh colovetiog of akin @ rtycus membrane > cymats dye f presenee -of Lage Amount of Reclycedd Hemoglbig fa the bleod. D Ae Zeast S- 7g] Reduced Hb fn blood cause egmneis @ DISTRIBUTION oF CYNOSIS 0 cynasls ip distributed all over the body but “TE fy more asked fa costaln Regions ahere the kta ig Gunn ips 0 anes ake TL Cheans ear Lobes Nese firgoytips Above the base, of lai! @ TYPEs OF CYNosrs 1. CENTRAL CyNosrg : 2. PERIPHERAL CyNOsrs +Cent cyanosis Perpherleyaness Mecham ‘tel desaration Increased psipherl utzaton sites Sin mecousmembraneofealeavty __Onlyskinimelved Temperature Warm Colds ctbing Present resent Secondary ertncytss Preset Absent On warming jansissame yansisredces Ongentheaey Pulmonary cause can inpeove Cjanosisredces Brrcie jones worsens janis same orimproves ‘eal bloed gs 0,0" O,aetmal ‘Snes: of Poss Cartan 218 @ conostios wen cyNosis occurs © Any contttion hich Leads to Arterial Hyporfa andl stagnant Hvpexia : + Anemfe Hypoxia z— cynosis does net occas beens “foun Hb cone. Tn blood © Histotoxte Hypoxia 3- cynosi’s does Not coccus ‘ bet Co cahasue, damage @. condition hen alter Hb ip formed 1» LeiseS§ | Hethemoglobin [or -sulfhemea lbh HI 3 3 cause »cynosis: © -Cygnolic discoloration@ - poycythemig s—s gloed Flew Ves 4 Hor 2 Nes RBC count A L viscosity, of blead Tes BLUE prseeLDRATION AI, bees oP ssa siggfhness. of bleed Flow \ tes deorygenated bleed @ TREATMENT + some drags used for trastment of eynasts © DRUGS DWRETICS 2 Help fa deafa oul -excesstve. Fluids that have accumulated antigperes . 1 Pedy dae te bow 4 Greutation of blood, Great infections © eauyed Ye Edoasts Uke!” penuemonta, 4eNofe s— cyanlosig CanNo? -occug iN ANEMIA. LEZ . 5m cymasis at least geduted Hb tone. ‘Should be 5-79/d) buf Anemig Hb Con. itself heseACCLIMATI ZATION @ DEFINATION © Acclimatization Refers to the Adeptations er the Adjustment by the body in uiigh At altitude © high altitude body Adapted to ews O,,bension sboly pe Hypexio effecTs et B CHANGES DURING ACCLIMATIZATION © Various changes tane Plate dusting Aectorattantfon Help the beely cope with odvese effects of Hypoxia at Higher altitude. Le onmlges IN e100, . boring ‘Acelimatization ¢ @ Tes Rec count norma) volue 45%. @ fes pack cell volume Cpe) { change value | P08 vale (pev) 69% @ ub contant Vs Prom 16 Yh —> 9h Lo Ais fp duc Ao Tes. Erythrepoietin action’. : A Restised by. Due do Ase Tos Oe Tyee carstoy capacity are rove Fide. &2 supply fo Ltssue.( cumniges_anl_CVS L, confovasculay system] a Se 0 over all actully of evs ff fos. tn High altitude O tes Heart Rate @ tes force, of contraction @ tes cardiac ouput @ tes vasculasity L_, vasodilation frdluced by Hyponia. due to © -cuanges_ sn RESPERQORY SYStEN, UD _puttonary VENtrLACION @ pulmonary ventilation Tes by ess Limmectiate, compensation] for Hypoxia in High alttude Opvtes due te stimulation of chemorecepto xs Gid -portoniagy HYPERTENSION. @ Mes cxrdiae output Jes pulmonary blood fled | heads Pulmonary, 1ypertenston Some time Pi} asseciated with Ve Right Venter HY pext-r0 phy, * (iD Durrussnlg cAprerey of gases ae fee. a Fusloy capseity oF gases fo alveott Ly erence, ths pulmorany bleed Blew | Tuyen® g cHANges _IN PEEVES vis @ Aes -calular -onietative naires favolved fo Netabolic Rexns fe cde only fal Aicelimalization persons @ “tes the no. of maitochendia.DECOMPRESSION SICKNESS @ DEFINATION © Decompression sforness ‘fs the disorder thot oie Fohen person Return Rapidly te Nlosmot duerourslings (atmospheric pressuce) from the arrest of High Atmaspheric pressure Like deep ser. ¢ Also Known as dysbasism., compressed ate sickness, carson oxsense: , ofver's palsy @ cause barometric. pressure at deep gea. Leads 40 compression of gasses and Reduces volume, of gs o Nitrogen gas Ly nest ase [80% ene. Ly Not witized or slot -exptred by body. LS fat soluble. se sehen persion descend fate deep gea Prom Atmpsphere. (sea level) Tes Atmespherte pressure Ay case compresston of, tly dass Moves / escape From expt blood Vessels © LES 40. organs [tommen Brefn Assue]nia ta ovgan disolved in the fat © [we complication occurs hs long’ as the persion Remata ia deep sea] AW, Because le gass Remains fn Solutio He yohen persion ascends footy and Return Atmospherte, pressure te cause, Decompression Sickness - occurs - {Soe Conpressed Nz gass start de compressed A) ft cause: formation of Bubbles of nl ans v These bubbles Restrfoted blood flow fn — Blood vessels , pucks. Cause €ATe -Embolism Sihally cause PS 4E UNDERGROOND Qe NINE! PORKERS USE CALSSONS [pressurtea] chombers] ako caise/ develop bs [ eaissous pisense] tH “DS 4lso -oceurs fn persone which ascending ap Rapidy From Sea Level fa a -Aigplane sthouk any “Precaution@ syrqeTons @ Severe pofa IN Pissue + pata Ta. Fotats + Aabubble Form fa rigelth sheath of - sensory SF ® sensation of —s numbness SP Mogtiogs or Prfoking gona Oe gun ce oe @ Muscle cramps Associated with severe pata © occlusfon of coronary A. followed by erenary scherdia. ® damage of Brain issue ond spinal core ® paralysis of rtuscle y shosiness of breath ® fotigue . unconciousness and death. Fanally.. @ _PREVENTON @® Ascend should be vey Slow with shost tay at Regular [atervals + "Gtep pice ascend allow ro bubble bate % blood Bithoat forming bubbles - @ Aeorment ® Recompression should be done in Rucompreasion chgenlo— and slowly Reduce, pressure upto Aimoeph ent e p. ® Hyperbaric cmygen therapy may be usepa)HEATSTROKE - SUNSTROKE, @ HEATSTROKE : © Heatsbvoexe 18 an abnormal type of typesthermia that occurs durtog exposuse, bo extreme Heat © Heatstroaxe characterized by fies body Gempratare above A1ve [ite] « + Heatstrowe fp very severe and ‘often become Fetal if nob treat Tmmeclfately + ‘Hypothalamus loses the power of gequlativa of body Femprature. @ _SUNSTROKE ° Hypothesmia Caused by Prolonged exposure te sunt ‘during gummer jn —s desert — Fropteal frvea H PERsenls suscePfiele To HEATSTROKE - suNsT 0 W infants UI) “old people. sotth Rend, < eirine. |- Disorder > pulmonary GD people. det o Physical -dabor under Ban Uv) -£portmens fovelve. tn continuous setts Activity ito! tea”@ FeATuRES Common features of -Heakstroke. ox -sonstrore, Aves — D Navseq anal vernattiog ® vizziness ® Headache. ® abclominal pain © oifetculty fa breathias LO i} © vertho. ® confusion . ® convalsions @ nustles -cromps ® paralysis and uncensiousness ate Heatstyoke and Hurnicltt © Development of Heatstroxe, depends ‘on Humility Q. emp. S44 'c. [1367] + Dey ABR = No. Heatstroce (Q. fem. 42%e [1068°F] + 10% a = Heatistrone 0 PREVENTION Gy Avoiding, ehyd sation Gi) faves Frequents break aluring. tore ov sport Activity. Giid ene. Ught clothes ith it @ TREATMENT GD Hosptiabzed as soon os possi ble (HD persion immersed ta cold roster GD Rub fee cube on Head | Neck yy con HD ice packs must keep under & armptte and $rein nue up to 35"c.