Lec.

2
Dr. Hayder

Objectives:

1. The major respiratory events

2. Pulmonary ventilation
3. Mechanics of breathing
4. pressure changes in respiratory cycle
RESPIRATION:

The function of the respiratory system is to provide oxygen (O2) to the tissues
and to remove carbon dioxide (CO2) generated during metabolism.

Internal respiration: is the exchange of these gases (O2 & CO2) between
tissue cells and their fluid environment.

External respiration: is the exchange of these gases (O2 & CO2) between the
body and the external environment.

The process of respiration can be divided into four major functional

events:
1. Pulmonary ventilation which mean the inflow and outflow of air between the
atmosphere (external environment) and the lung alveoli.
2. Diffusion of O2 and CO2 between the alveoli and the blood.
3.Transport of O2 and CO2 in the blood and body fluids to and form the cells.
4.Regulation of respiration.
1- Pulmonary ventilation include:
-Mechanics of pulmonary ventilation.
-Pulmonary volumes and capacities.
-Minute respiratory volume.
-Alveolar ventilation.
-Functions of the respiratory passages.

Mechanics of pulmonary ventilation include:

1- Muscles of respiration.
2- Pressures.
3- Compliance of the lungs.
4- Surfactant, surface tension and collapse of the lungs.
5- Work of breathing.
Muscles of Respiration:
Respiratory cycle includes inspiration and expiration.
1- Muscles of inspiration:
Inspiration is active during which the respiratory muscles contract. Inspiratory
muscles involved:
A- Diaphragm: It is important muscle for inspiration, when it contracts; it pulls
the lower surfaces of the lungs downward. As it become flattened, it pushdown
the abdominal contents thus, it lengthen the chest cavity i.e. increasing the
volume of thoracic cavity.
B- External intercostals: When they contract, ribs and sternum move upward
& outward thus, they increase the anterioposterior diameter of the chest.
C- Accessory muscles include:
1-Sternocleidomastoid muscles which lift upward on the sternum.
2-Anterior serrati, which lift many of the upper ribs.
3-Scaleni muscles which lift the first two ribs.
These accessory muscles are not used for inspiration during normal quiet
breathing rather than they are used during exercise or in diseased conditions
like in Bronchial asthma.
2-Muscles of expiration:
Expiration is normally passive, brought about by:
1-Relaxation of inspiratory muscles (external intercostals). Thus the ribs and
sternum move downwards and inwards so the width of the chest diminishes.
When diaphragm relaxes, it ascends thus, diminishes the length of the chest.
2-Elastic recoil of the lung, it returns to its resting position after inspiration.
However expiratory muscles are used during heavy breathing, exercise & in
diseases as in bronchial asthma. They include:
A- Abdominal recti: Which have powerful affect of pulling downward on the
lower ribs. At the same time compress the abdominal contents upward
toward the diaphragm to push the air out.
B- Internal intercostals: Which pull the ribs downward & inward.
Pressures:
*Atmospheric pressure: Is the pressure of the air surrounding the body or at
the nose and mouth, it is 760mmHg at sea level {consider as zero (0mmHg)}.
All pressure in the respiratory system is given relative to atmospheric pressure.

*Alveolar pressure: Is the pressure inside the lung alveoli. It is (0mmHg)

which mean it is the same as atmospheric pressure between breaths (i.e. at the
end of normal expiration). During ventilation, for the air to enter inside the lungs
(inspiration) it must fall to a value (-1cmH2O) below atmospheric pressure and
must rise to (+1cmH2O) for the air to move out of the lung (expiration). Alveolar
pressure changes are caused by changes in the dimensions of the lung in such
way that increases in lung volume will decrease the pressure and vise versa.

*Intrapleural pressure: Is the hydrostatic pressure of the intrapleural fluid. It is

normally a slight suction which means a slightly negative pressure. Normally it
is -5 cmH2O at the beginning of inspiration. It is needed to hold the lungs open
to its resting level. Increased negatively from -5 to -7.5 cmH2O during
inspiration.

*Transpulmonary pressure: Is the pressure difference between alveolar &

intrapleural pressure. It is opposed by the elastic recoil of the lung that tend to
collapse the lungs, i.e. elastic recoil of the lungs is exactly balanced by the
transpulmonary pressure tending to expand the lung. The change in
transpulmonary pressure causes the changes in lung volume.
Pressure changes during respiratory cycle:
Air will move or flow from region of high pressure to one of low pressure.
Therefore air enters the lungs during inspiration because pressure within
the lungs (alveolar pressure) is less than that of atmospheric pressure.
Conversely during expiration, the alveolar pressure exceeds atmospheric
pressure and air expelled.

1.During normal inspiration at rest: As the thorax enlarges by contraction of

the inspiratory muscles (diaphragm & external intercostals), the
intrapleural pressure becomes more subatmospheric. This decrease in
intrapleural pressure increases the transpulmonary pressure therefore, the
force acting to expand the lungs (transpulmonary) , is now greater than the
elastic recoil of the lungs and so the lungs expand until the elastic recoil
equals the increased transpulmonary pressure (equilibrium) by the more
inflated lungs. Expansion of the lungs causes the alveolar pressure to drop
less than atmospheric, this pressure difference (Palv < Patm) causes a
bulk flow of air from the atmosphere into the alveoli, until the alveolar
pressure again equals atmospheric pressure at the end of inspiration.
2.During expiration: When the inspiratory muscles relax, the chest wall starts to
recoil to its original dimensions. This makes the intrapleural pressure less
negative (increase) and so decreases the transpulmonary pressure which
becomes smaller than the elastic recoil of the lungs and the lungs also passively
recoil to their original dimensions. As the lungs become smaller, alveolar
pressure increases more than atmospheric pressure so air flows from the alveoli
out into atmosphere.
The opposite recoils of the lungs and chest wall create a negative pressure
equal to –5cmH2O, {0-(-5) = 5cmH2O} as transpulmonary pressure which
will expands the lungs beyond their resting equilibrium.
Diaphragm and inspiratory Diaphragm and inspiratory
intercostals contract muscles stop contracting

Thorax expand Chest wall move inward

Pip becomes more Pip back toward

subatmospheric preinspiration value

Transpulmonary pressure Transpulmonary pressure back

toward preinspiration value

Lungs expand Lungs recoil toward

preinspiration size

Palv becomes Palv becomes greater

subatmospheric than Patm
Pip = intrapleural
pressure
Air flow into alveoli Air flow out of lungs
Palv = alveolar
pressure

Figure: Event & pressure Figure: Event & pressure Patm =atmospheric
changes during inspiration changes during expiration pressure