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Learning Outcomes
Learning Outcomes
With reference to pressure and volume changes,
describe the mechanism of air movement in and out
of the lungs.
Define Tidal Volume (TV) and Respiratory Rate (RR)
& state the average amounts in a healthy adult.
Describe how tidal volume and respiratory rate can
be measured and how Pulmonary Ventilation Rate
(PVR) and Alveolar Ventilation Rate (AVR) can be
calculated.
Learning Outcomes
Explain why breathing is more efficient when the
depth of breathing (tidal volume) is increased as
opposed to the rate of breathing.
Explain briefly how oxygen and carbon dioxide
are transported in the blood.
State briefly what physiological parameters a
pulse oximeter measures.
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Structural organization
Fig. 23.1a
Nose
Nasal cavity
Upper
respiratory
tract
Pharynx
Larynx
Trachea
Bronchus
Bronchiole
Lower
respiratory
tract
Terminal bronchiole
Lungs
Structure of Haemoglobin
Haemoglobin is a globulin protein with four heme
groups within its structure.
2 polypeptide chains
2 polypeptide chains
Each heme group contains an atom of iron, to
which the O2 binds.
1 Hb binds with 4 O2 molecules oxyhaemoglobin.
Structure of Haemoglobin
Pulse oximetry
Pulse oximetry is a
simple, non-invasive
method of monitoring
the percentage (%) of
haemoglobin (Hb)
which is saturated
with oxygen.
Understanding Gases
Boyles law applies to containers with flexible
walls like our thoracic cage.
It says that volume and pressure are inversely
related.
If there is a decrease in
volume; there will be an
increase in pressure.
V 1/P
10
Mechanics of inspiration
Inspiratory muscles contract Intercostals/Diaphragm
Increased thoracic cavity volume
Lungs stretched - pleura
Increased intrapulmonary volume
(Boyles Law)
Decreased intrapulmonary pressure (-1 mmHg)
Air flows into lungs from atmosphere
to equalise pressure (0 mm Hg)
11
Pulmonary Ventilation
The number of
inspirations per
minute.
12-18 breaths per
minute (adults)
40-50bpm (newborns)
Measuring Ventilation
Only about 70% of the tidal volume reaches the respiratory zone
the other 30% remains in the conducting zone (called the anatomic
dead space).
If a single VT breath = 500 ml, only 350 ml will exchange gases
at the alveoli.
In this example, with a respiratory rate of 12, the Pulmonary
ventilation rate = 12 x 500 = 6000 ml.
The alveolar ventilation rate (volume of air/min that
actually reaches the alveoli) = 12 x 350 = 4200ml.
12
Dead Space
13
Dead space
volume
Tidal volume
Respiratory
rate
Pulmonary
ventilation
rate
Alveolar
ventilation
rate
% of TV =
dead space
volume
Normal
rate and
depth
150 ml
500ml
20/min
10L/min
7L/min
30%
Slow, deep
breathing
150 ml
1000ml
10/min
10L/min
8.5/min
15%
Rapid,
shallow
breathing
150 ml
250ml
40/min
10L/min
4L/min
60%
Neonates
9ml/Kg
40-60/60-80
5 years
18ml/Kg
25-30
8 years
35ml/Kg
20-25
Adult
250-500ml
12-18/20
Pregnancy
700ml
No change in
frequency, but increase
in depth
14
Lung Compliance
High lung compliance means the lungs and
chest wall expand easily.
Diminished by any factor that:
Reduces natural resilience of lungs.
Blocks the bronchi or smaller passageways.
Impairs flexibility of thoracic cage.
broken rib, or by diseases such
as pneumonia or emphysema.
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
6000
5000
4000
Inspiratory
capacity
Inspiratory
reserve
volume
Vital
capacity
Tidal
volume
Total
lung
capacity
3000
2000
Expiratory
reserve
volume
Functional
residual
capacity
1000
Residual
volume
15
Measuring Ventilation
Ventilation can be measured using spirometry.
Measuring Ventilation
Lung capacities are the sum of two or more
lung volumes.
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