Group 10

Remember to breathe. It is after all, the secret of life.

Gregory Maguire, A Lion Among Men

Introduction

The Primary Role of the Respiratory System

To distribute oxygen to, and remove carbon dioxide from all the cells of the body To achieve this, it works together with the circulatory system

Respiration
The movement of air into and out of the lungs

The transport of oxygen and carbon dioxide between the longs and body cells

Ventilation

Minute Ventilation
Amount of air that flows into and our of the lungs in one minute Frequency of breathing multiplied by the tidal volume

Partial Pressures
The proportion of pressure that the a gas exerts in a mixture In the atmosphere, at sea level, the total pressure is 760 mmHg Oxygen makes up 21% of the total atmosphere, and therefore has a partial pressure of 160 mmHg

Partial Pressures
Oxygen and carbon dioxide diffuse down their partial pressure gradients, from high partial pressure to low partial pressures

ACTIVITY 1
Measuring Respiratory Volumes and Calculating Capacities

Respiratory Volumes
Tidal Volume Inspiratory Reserve Volume Expiratory Reserve Volume Residual Volume

Tidal Volume
Amount of air inspired and then expired with each breath under resting conditions 500 ml

Inspiratory Reserve Volume

Amount of air that can be forcefully expired after a normal tidal volume inspiration Male: 3,100 ml Female:1,900 ml

Expiratory Reserve Volume

Amount of air that can be forcefully expired after a normal tidal volume expiration Male: 1,200 ml Female: 700 ml

Residual Volume
Amount of air remaining in the lungs after forceful and complete expiration Male: 1,200 ml Female: 1,100 ml

Respiratory Capacities
Total Lung Capacity Vital Capacity Forced Vital Capacity Forced Expiratory Volume

Total Lung Capacity

Maximum amount of air contained in lungs after a maximum inspiratory effort TLC = TV + IRV + ERV + RV Male: 6,000 ml Female: 4, 200 ml

Vital Capacity
Maximum amount of air that can be inspired and then expired with maximal effort VC = TV + IRV + ERV Male: 4, 800 ml Female: 3, 100 ml

Forced Vital Capacity

Amount of air that can be expelled when the subject takes the deepest possible inspiration and forcefully expires as completely and as rapidly as possible

Forced Expiratory Volume

Measures the percentage of the Vital Capacity that is expired during 1 second of the FVC test Normally 75-85% of the Vital Capacity

Baseline Results
Radius Flow
(L/min)

TV

ERV

IRV

RV

VC

FEV1

TLC

Breath Rate 15

5.00

7,485

499

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Baseline Results
Radius 5.00 Flow (L/min ) 7,500 TV ERV IRV RV VC FEV1 TLC Breath Rate 15 500 1,200 3,091 1,200 4,791 3,541 5,991

Decrease the Radius by Increments of .50 mm

Radius of 4.50 mm
Radius 4.50 Flow (L/min ) 4,920 TV ERV IRV RV VC FEV1 TLC Breath Rate 15 328 787 2,028 1,613 3,143 2,303 4,756


Radius of 4.00 mm Radius of 3.50 mm

Radius

Flow

Radius of 3.00 mm
TV ERV IRV RV VC FEV1

TLC

(L/min)

Breath Rate

3.00

975

65

156

401

2,244

621

436

2865

15

Summary of Results

Discussion
As the radius decreases, the flow rate decreases As the radius decreases, air resistance increases All measured parameters also decreased as the radius decreases except for Residual Volume

ACTIVITY 2
Comparative Spirometry

Spirometry
It is the most common of the pulmonary function tests (PFTs), measuring lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled.

Emphysema
There is a significant loss of elastic recoil in the lung tissue This occurs as the disease destroys the walls of the alveoli

Emphysema
Airways resistance is increased The lungs become overly compliant and expand easily Easy inspiration, difficult expiration

Acute Asthma Attack

bronchiole muscle spasms, and thus, airways become constricted They also become clogged with thick mucous secretions

Acute Asthma Attack

The airways collapse and pinch closed before a forced expiration is completed Volumes and peak flow rates are significantly reduced Elastic recoil is NOT diminished

Acute Asthma Attack

Many people seek to relieve symptoms with an inhaler Usually includes a smooth muscle relaxant (B2 agonist or an acetylcholine antagonist) Relieves bronchospasms and Induces bronchodilation

Exercise
Moderate Exercise Increased metabolic demand met in part by changes in respiration Rate of breathing and tidal volume increase Increase in tidal volume is greater than the increase in breathing Heavy Exercise Further changes in respiration are required to meet the metabolic demands of the body Rate of breathing and tidal volume increase to maximum tolerable limits

Results

Patient Type Normal

Normal Patient
TV ERV IRV RV FVC TLC FEV1 4,000 500 1,500 3,000 1,000 5,000 6,000

FEV1 (%) 80%

Emphysema Patient
Patient Type Emphys ema TV ERV
750

IRV

RV

FVC

TLC

FEV1
1,625

500

2,000

2,750

3,250

6,000

FEV1 (%) 50%

Patient Type Acute Asthma Attack

Asthma Patient
TV ERV
750

IRV

RV

FVC

TLC

FEV1
1,500

300

2,700

2,250

3,750

6,000

FEV1 (%) 40%

Asthma Patient with Inhaler

Patient Type Asthma Attack Plus Inhaler TV ERV IRV RV FVC TLC FEV1
3,840 500 1,500 2,800 1,200 4,800 6,000

FEV1 (%) 80%

Patient Type Modera te Exercise

Moderate Exercise
TV ERV IRV RV FVC
ND

TLC

FEV1
ND

1,875

1,125

2,000

1,000

6,000

FEV1 (%) ND

Patient Type Heavy Exercise

Heavy Exercise
TV ERV
750

IRV
600

RV

FVC
ND

TLC

FEV1
ND

3,650

1,000

6,000

FEV1 (%) ND

Summary

Graphical Summary

Discussion

Tidal Volume
Compared to the normal patient, the TV of the patient with acute asthma attack is lower The patient suffering from emphysema and acute asthma attack plus inhaler has the same TV to that of the normal patient Those who have done exercise, both moderate and heavy, have greater TV

Expiratory Reserve Volume

ALL patients have shown a lesser ERV compared to the normal patient The lowest ERV were exemplified by the patients who did heavy exercise, who had Acute Asthma Attack, and had Emphysema

Inspiratory Reserve Volume

ALL of the patients have shown a lesser IRV compared to the normal patient The lowest IRV is seen on the patient who underwent heavy excercise

Residual Volume
Those who did exercise had the same RV with the normal patient Patients with emphysema had the greatest increase in RV, followed by the patient with acute asthma attack, then the patient with the inhaler.

Forced Vital Capacity and Forced Expiratory Volume

Least in the patient with Emphysema, followed by the patient with Acute asthma attack, then by the Asthmatic patient with an inhaler


The different breathing classification among patients have varied values for their respiratory volumes and capacities. This is primarily due changes in the passageway of air (bronchoconstriction, mucous production, increased alveolar compliance).

ACTIVITY 3
Effect of Surfactant and Intrapleural Presure on Respiration

Surface Tension
A tension produced by unequal attraction in a gasliquid boundary This force resists any force that tends to increase the surface area of the gas-liquid boundary and acts to decrease the size of hollow spaces such as those in alveoli and microscopic air spaces

Surfactant
A detergent-like mixture of lipids and proteins that reduces the attraction between water molecules Through this, surface tension is decreased

Intrapleural Pressure
The pressure in the pleural cavity Between breaths, it is less than the pressure in the alveoli

Negative Pressure
Two forces cause this negative pressure condition: First, the tendency of the lung to recoil because of the elastic properties and the surface tension of the alveolar fluid Second, the tendency of the compressed chest wall to recoil and expand outward These two forces pull the lungs away from the thoracic wall, creating a partial vacuum in the pleural cavity

Pneumothorax
presence of air in the pleural space This can lead to lung collapse, a condition called atelectasis

Results

Radius
5

No Surfactant
Breath Rate 15
Surfactant

Pressure Left -4

Pressure Right -4

Flow Left
49.69

Flow Right 49.69

Total Flow 99.38

Radius
5

Breath Rate 15

Surfactan t 2

Pressure Left -4

Pressure Right -4

Flow Left
69.56

Flow Right 69.56

Total Flow 139.13

Radius
5

Breath Rate 15

Surfactan t 4

Pressure Left -4

Pressure Right -4

Flow Left
89.44

Flow Right 89.44

Total Flow 178.88

Radius
5

Breath Rate 15

Surfactan t 0

Baseline
Pressure Left -4 Pressure Right -4

Flow Left
49.69

Flow Right 49.69

Total Flow 99.38

Radius
5

Breath Rate 15

Valve Open
Surfactant

Pressure Left 0.00

Pressure Right -4

Flow Left
0.00

Flow Right 49.69

Total Flow 49.69

Radius
5

Breath Rate 15

Valve Closed
Surfactan t 0 Pressure Left 0.00 Pressure Right -4 Flow Left
0.00

Flow Right 49.69

Total Flow 49.69

Radius
5

Breath Rate 15

Lungs Reset
Surfactan t 0 Pressure Left -4 Pressure Right -4 Flow Left
49.69

Flow Right 49.69

Total Flow 99.38

Discussion

Effect of Surfactants
As surfactant was applied to the lungs, the pressure on the left and right lung was maintained Addition of surfactant increased the flow rate on each long

In Pneumothorax
In this activity, the left lung is the affected lung When the valve was opened, the left intrapleural pressure equalized with the atmospheric pressure Expansion did not take place, and the flow of air at the left lung is 0 Even when the left valve is closed, the left lung did not reinflate

Thank you!