Mechanics of Pulmonary Ventilation

Respiration primary function - O2 supply & Co2 expulsion Thoracic Cavity Bony cage bounded by sternum front vertebrae behind 12 pairs of ribs laterally Intercostal Muscle Diaphragm Below

Lung spongy tissue Irregularly cone shaped Connected with trachea by bronchi Trachea connected to atmosphere.

Upper Respiratory Tract

Includes Nasal passages. Pharynx (throat) Larynx (voice box) Vocal folds

Lower Respiratory Treat

Trachea Two bronchi Bronchioles Lungs

Division of Trachea
23 Times 16 division only conducting syst. Till terminal bronchioles 7 division exchange of gases Includes Resp bronchioles Alveolar ducts + alveoli

Pulmonary Ventilation inflow and outflow of air in between atmosphere and lung alveoli Done through change in size & volume of thoracic cavity & lungs follow those changes During inspiration thoracic cavity expand sub atmospheric pressure in lung alveoli, Intrapleural pressure more negative During expiration thoracic cavity shortens Alveolar pressure increases

1 atm = 760 mmHg = 0 cm of water

Muscle of Quiet Inspiration

Main muscles involved 1. Diaphragm (lengthening & shortening of chest cavity) 2. External Intercostals (elevation and depression of rib cage)

Diaphragm
Nerve supply phrenic nerve , C 3,4,5 Contraction pulls the lower surface of lung downward Descend by 1.5 cm in quiet breathing, +7-10cm in forceful inspiration In expiration diaphragm simply relaxes 60-75% of inspiration Section of spinal cord below or above C 3,4,5 Leads to complete cessation of breathing

External Intercostal Muscles

25 40% inspiration Two type of movements 1. Pump handle Sternum moves forward, ribs moving up and away from spine, Antero posterior diameter increases 2. Bucket handle ribs moving outward, transverse diameter increase

Accessory Inspiratory Muscle

During forceful inspiration, exercise & asthma Sternocleidomastoid, serratus anterior & sclani

Muscles of Expiration

Quiet expiration a passive process Inspiratory muscles relax Thoracic cavity in size, Alveolar pressure Pleural pressure less negative During forceful expiration- internal intercostals and abdominal muscles

Alveolar Surface Tension

At the interface of air and water, water molecules have great attraction to each other, so tend to contract the surface Water lining the interior of alveoli tend to expel the air out So alveoli tend to collapse The net effect is to cause the elastic contractile force of entire lungs, surface tension elastic forces

Surfactant

Surface active agent, reduces the surface tension so preventing the full collapse of alveoli Secreted by type II alveolar cells Lipoprotein mixture in thin fluid layer on the interior of alveoli Composed of surfactant apoproteins, phospholipids, dipalmityol-phasphatidylcholine, calcium ions Dipalmitoyl component reduces the surface tension Surface tension inversely proportional to concentration of surfactant

During inspiration water molecules move apart & expiration close to each other without surfactant, alveolar surface tension is 50 dynes/cm2 With surfactant, alveolar surface tension is 5- 30 dynes/cm2

Law of LaPlace

In water bubble surface tension directed inward to the center The positive pressure in alveoli to push the air out is expressed by law of Laplace

Two factors, Surface tension Radius of viscous P = 2 T/R T = Surface tension, R = Radius of viscous

Role of surfactant

Dec. ST Dec. collapse pressure Dec. work of breathing Inc. compliance Prevents development of pulmonary edema

Deficiency Respiratory distress syndrome (RDS) of newborn Surfactant secretion at 6th-7th of intrauterine life into amniotic fluid Surfactant secretion stimulated by glucocorticoid, thyroxin, epinephrine and by contact of air with alveoli Deficiency in premature babies, babies of thyroid deficient, diabetic & smoker mothers Smoker Deficient in surfactant Premature babies also have smaller alveoli so their collapse tendency is more.