Notes from Mechanics of Breathing Part I

The trachea is going to branch off into the right and left primary bronchus serving the actual lung
specifically at the smallest structural unit called the alveoli
● Actual visceral pleura (layer 1)
- little thin epithelial tissue with a little bit of areolar connective tissue clinging onto to the
lung
● Pleural cavity (layer 2)
- little hollow cavity (space) that has a little bit of fluid
- “potential space” - the visceral pleura is almost completely tethered to the parietal pleura
by the pleural cavity that has pleural fluid - allows little to none friction and prevent
inflammation
● Parietal pleura (layer 3)
● Pleurisy
- where there is too much fluid accumulation or actually there's very little fuel
accumulation and these layers start rubbing up against one another and start causing a
lot of agitation
- a condition that can come about whenever there is a lot of friction developing between
the parietal pleura and the visceral pleura due to maybe a decreased situation, not
enough pleural fluid being produced
Pressures
● Intrapulmonary/alveolar pressure (pressure A)
- whenever the trachea is coming here it's getting away to the bronchi and then it goes
secondary tertiary and then eventually goes to terminal bronchioles respiratory and it
branches out to these actual small structures you see these little sacs here you smell a
little like grape like structures those are called the alveoli so technically when I say
intrapulmonary pressure I really mean intra alveolar pressure right which is the pressure
in the alveoli
- Ppul - approximately 760 millimeters of mercury = 0 mmHg (because it can be
interchangeable with atmospheric pressure)
● Intrapleural pressure (pressure B)
- occupied in the pleural cavity
- Pip = approximately always negative (negative pressure) - less than intrapulmonary
pressure - 756 millimeters of mercury
- Pip = 756 mmHG - 760 mmHG (subtracting intrapleural from atmospheric) = -4 mmHg
● Atmospheric pressure/Barometric pressure
- Patm = 760 millimeters of mercury
right so this is a negative pressure
this is a zero pressure here I want to
explain why this is negative because
this bugs people out okay let me take
intrapleural pressure down here there's
three reasons why intrapleural pressure
is actually negative so let me explain
this real quick so intra pleural
pressure or as we denote it here we
denote it as as V P IPL refer to this a
lot right so it's a negative pressure
there's three reasons why this is a
negative pressure okay first reason is
the elasticity of the lungs okay so the
first reason is the natural elasticity
of the lungs second reason is what's
called surface tension will have another
video specifically on surface tension
and surfactant but this one is going to
be surface tension and then the last
thing is going to be the elasticity of
the chest wall so the last thing is
going to be the elasticity of the chest
wall
okay let me explain what I mean by this
and there's also one last thing that
I'll mention and it's not with respect
to this it's due to the differences in
the intrapleural pressure throughout the
Interpol cavity and this is due to
gravity I'll mention this last one okay
but again this is not really one of the
things that's contributing to it it's
contributing to a difference in the
pressures okay so it can contribute the
differences in the pressure I'll explain
what I mean by that because you can see
that the pressure intrapleural pressure
could be different here here in here
I'll explain that first off elasticity
of the lungs in the surface tension
we're going to group those together for
a second and let me explain why now what
first off what is the definition of the
last things how would you define
elasticity elasticity is whenever you
try to stretch something right it
doesn't want to be stretched it wants to
resist the actual desire to be stretched
it wants to recoil it always wants to
assume the smallest size possible
that's what elasticity is think about
this for a second where is this
elasticity coming into play well
technically
whenever the lungs want to recoil what
are they actually doing imagine again I
told you that imagine the parietal
pleura in the visceral pleura is
actually close together actually
touching when I try for my lungs to
actually deflate if I try to deflate
them what is it going to do to the
visceral part it's going to pull it away
as it pulls it away because it's time
trying to deflate it trying to get
smaller as the lungs is trying to get
smaller it's pulling away from pulling
this visceral pleura away from the
parietal pleura now let's do surface
tension what a surface tension doing
surface tension is this concept that
because of the water molecules this
interaction between the air in the
alveoli and the water molecules it
causes this tension at the air water
interface and the whole thing is is that
the alveoli wants to collapse it wants
to assume the small size possible so
another words same thing what's the
overall purpose the lungs are trying to
pull this visceral pleura away from the
parietal pleura
okay well that's trying to collapse the
lungs and increase this this volume here
okay that's one thing that's happening
the next thing that's happening is the
elasticity of the chest wall okay what's
the chest wall trying to do well you
know normally our chest wall is decently
elastic there's a lot of you know the
costal cartilage
we have a lot different types of
connective tissue that is allowing for
the chest wall to expand so the chest
wall if we were to kind of show this
here let's say that I'm going to
represent the chest wall and this collar
here and I'm going to represent the
elasticity of the lungs and this and the
surface tension the green color what
direction is it trying to pull lungs is
trying to pull it this way that's what
it's trying to do is trying to pull the
lungs in this way to collapse them
whereas the chest wall when you're
breathing what is it trying to do it's
trying to push the chest wall out to
expand the chest wall and if it's trying
to expand the chest wall what is that
doing it's pulling this parietal pleura
away from the visceral pleura if you're
pulling this actual parietal pleura away
from the visceral pleura what is that
doing to this volume in here it's
increasing the volume so the dynamic
interplay between these three concepts
here the elasticity lungs the surface
tension and the elasticity of the chest
wall what is the overall result of all
of these the overall results of all of
these three things is that they're
increasing or they're attempting to
they're not necessarily doing but
they're attempting to they're increasing
thoracic cavity volume which is that
intrapleural space right there that
pleural cavity space right the others of
a law Boyle he came up with a law and
what that law is it states that okay
pressure if you have a certain pressure
here let's say I call it p1 v1 is a
volume p2 is a second pressure and then
a v2 which is the second volume right he
says based upon this relationship okay
based upon this relationship whenever
because it's it's in this format
whenever I increase the pressure of this
reaction whatever reaction it might be
it's going to decrease the volume that's
the relationship with Boyle's law so
Boyle's law states that whenever there
is a increase in the pressure there will
be a direct decrease in the volume same
thing let's say that we actually do
something opposites let's say that I
increase the volume
whenever I increase the volume what is I
going to do the pressure it's going to
drop the pressure
oh that's interesting because isn't the
whole purpose to make this pressure
negative or decrease the pressure below
the intrapulmonary have it always being
a little bit lower or negative pressure
yes and that's the whole purpose that's
why the intrapleural pressure is
negative again one of those three
reasons the elasticity loans where they
want to do cause the lungs to snap and D
and actually collapse that back to their
small size possible surface tension
wants to collapse the alveoli which
tries to collapse the lungs pushing this
way creating a bigger volume of
potential volume space chest wall the
last tasting the chest wall constantly
whenever we're inspiring it wants to try
to bring the actual chest wall out
that's what you want to whenever you
bring area and what do you want to do
you want to try to expand that chest
wall so the chest wall is natural
elastic and it wants to express expand
out this way what is that trying to do
it's trying to pull on the parietal
pleura away from the visceral pleura but
normally in our chest wall when it's not
contracting what would it actually do it
can wreak low also so because of that
sometimes what it can do you know just
say that it's only ever going this way
it prefers to be expanded but it can
have an actual recoil capability here
too okay so it does have a little bit of
recoil capability here too but
nonetheless the dynamic interplay
between the elasticity
surface tension and the elasticity of
the chest will play a role in
maintaining this negative intrapleural
pressure maybe there's actually one more
thing you know there's lymphatic vessels
in this area let's say that I represent
this lymphatic vessels with this Brown
structure here let's say here I put a
little tube in here here's this little
tube and there's brown tube right here
and I'll put another one right here
this brown tube right here are lymphatic
vessels let's say that these are the
lymphatic vessels okay so this is my
lymphatic vessels you know what's really
important about this pleural cavity is
that we want to make sure that there's
not too much fluid accumulating on in
this area we don't want there to be too
much fluid and one of the ways that we
control that okay so here let's see
here's our pleural fluid right here's
our pleural fluid to prevent excessive
amounts of plural flow from accumulating
you know we have we have these little
lymphatic vessels from the bronco
mediastinal trunk area right that can
drain this actual
plural cavity and prevent the excessive
amounts of fluid from building up
because you know what happens if we
build up a lot of fluid it's going to
start trying to push on the lungs right
so we don't want that so again
pleural fluid is constantly being
actually drained out by learn Phatak
vessels to maintain a nice volume in
here so it doesn't disturb the
intrapleural pressure also okay so we
got that down so again what do we
covered so far recovered visceral pleura
is this little epithelial tissue layer
clinging to lung pleural cavity which is
this potential space right consisting of
a pleural fluid and we talked about the
third thing which is the parietal pleura
which is this layer clinging to the
chest wall then we said there's three
pressures in the lung or basically
across this whole lung structure here
right intrapulmonary pressure which is
also called the intra alveolar pressure
right and again we showed it by this
alveoli there it's approximately 760
millimeters of mercury then we said that
there's a pressure here which is the
intrapleural pressure which is 756
millimeters of mercury and then we said
there's an atmospheric pressure outside
of the body right around us that is the
atmospheric pressure which is
approximately 760 but I said we could
express it another way if I take the
intra pulmonary pressure and subtract it
from the atmospheric what is that that
is zero if I take the intrapleural
pressure and subtract from the
atmospheric pressure what is that that's
negative four okay and we explain why is
it a negative pressure because the
elasticity of the lungs in the surface
tension they want the lungs to collapse
they want to assume the small size
possible which is going to increase this
actual volume of this space potentially
then we also said that the elastic is a
chest wall two things can happen
whenever we're inspiring the chest wall
would want to expand outwards but
whenever we're resting it wants to kind
of actually just maintain that size but
it can have a force that's kind of
trying to direct inwards a little bit
right but no matter what the dynamic
interplay between the elasticity the
lungs the surface tension and the
elasticity of the chest wall helps to
keep this volume increasing and by
Boyle's law we said that whenever the
volume is increasing the pressure in
this actual cavity is decreasing okay so
because of this because the thoracic
cavity volume decreases I'm sorry
because the thoracic cavity volume
increased I'm sorry this would actually
decrease the actual thoracic cavity
volume but specifically the intra not
thoracic cavity volume but thoracic
cavity pressure so we've actually
decrease T
plural pressure okay because the Boyle's
law so again whenever you increase the
volume and thrash the cavity it's going
to decrease the thoracic cavity volume
pressure but specifically that pressure
that we call the thoracic cavity
pressure is really the intrapleural
pressure and that will decrease to about
negative four and then again we said
that the pleural fluid is actually
constantly being pumped out of the
pleural cavity by blowing fatik vessels
like the bronco mediastinal trunk to
maintain a normal volume so it doesn't
interfere with the actual intrapleural
pressure one more thing and then were
going to go over these actual changes of
how breathing is affected here gravity I
mentioned gravity
now when gravity is actually acting
downwards what happens let's say that I
actually pretend for a second that I
take the bottom of this long-hair I take
the bottom of this long and I try to
yank it down by gravity as I yank the
bottom of this lung down by gravity it's
going to pull on the apex - so I want to
pull the apex farther away what part of
my pulling farther away I'm pulling the
visceral pleura farther away from the
parietal pleura okay so as I'm yanking
down at the base of this long I'm
pulling down here I'm bringing this
visceral pleura closer to this product
apart but when I'm pulling I'm also
pulling on this apex here because
remember these are kind of closely
attached right they're almost really
like just rubbing up against one another
so I pull down here it starts pulling
this actual visceral pleura way from
that private aura so now if you think
about it for a second what's happening
to this volume here when I stretch and
pull that base down what's happening to
I bully the volume here is decreasing
what does that say for the pressure the
pressure will be a little bit larger in
this area what about up here
well I'm pulling this down if I'm
pulling the visceral pleura away from
the parietal pleura up here what does
that mean that what that means that the
volume up here will be a little bit
greater than it was down here so what
does that mean for the pressure the
pressure will be a little bit lower up
there now we're not going to
specifically talk about that but I want
you guys to realize that there
intrapleural pressure is not uniform
throughout the entire pleural cavity it
is different it's approximately like 758
here 756 here in 753 up here we're only
going to refer to
at 7:56 but I do want you to realize
that it isn't uniform throughout the
entire pleural cavity okay now we got to
do another thing that I need to mention
here that is really really important
we're not going to spend a lot of time
but I want you understand that there is
other pressures a pressure across a wall
so for example remember we said that
this was intrapulmonary pressure let's
denote it again with a B this is a right
here but we're going to just denote this
a here for a second again entry I'll be
able to pressure and travel pressure I'm
just to noting in here so it's close to
this this is the B pressure which was
the intrapleural pressure and here was
the seed pressure let's say I make a
line here I have a pressure that's being
exerted across these two walls okay
so there's a pressure that's being
exerted across these two walls then
there's also another pressure let's do
this one in pink there's a pressure
being exerted across the chest wall
there's a pressure being observed across
the chest wall what are these two
pressures and why are they important
this pressure here across this wall
which is the difference between the
intrapulmonary and the intrapleural
pressure this pressure here that is
across this wall let's write it
according with the color this pressure
is called B let's write it down here
trans pulmonary pressure
that's interesting or you have to note
this TP to make it easier so TP there's
no transpulmonary pressure okay
alright so that's good for right now
we're going to talk about that in just a
second then there's a pressure exerted
across this chest wall and it's the
difference between the intrapleural
pressure in the atmospheric pressure
okay what is that pressure called this
pressure here is called the trans
thoracic pressure it's called the trans
thoracic pressure okay and we'll just
call this one TTP
alright whatever it doesn't matter but
as long as you understand that the TP is
the transpulmonary pressure and the TTP
is the transfer Rasik pressure okay
there is one more unmentionable we're
not going to really spend a lot of time
on because it's not super super
significant here but I will mention it
quickly it's the pressure all the way
from a all the way to C and this
pressure here is actually called the
trans respiratory pressure I'll write it
up here trans respiratory pressure okay
so I just want to explain something real
quick here all right so now with the
trans respiratory pressure and with this
transthoracic pressure and trans
pulmonary pressure what is the
significance of this okay well let's
write out a little formula here so let
me actually bring this one down a little
bit so we have more room I'm going to
bring this one down here so this is
again trans thoracic pressure and again
we denote as that is TTP all right so
TTP here okay now transpulmonary
pressure what do we say we said it was
the difference from the intra pulmonary
a minus B that's the difference so what
do we actually say we're not going to
say a minus B we're going to say it's B
P pull which is the intra pulmonary
pressure minus the B will be was the
intrapleural pressure so we're going to
put intra plural pressure
this is equal to the trans pulmonary
pressure
okay well what is that let's get a
number out of this bad boy
let's say that this is at rest okay with
intrapulmonary pressure we said was
about I'm sorry
760 millimeters of mercury but again we
could use zero also wouldn't matter if
you use your we'll do zero just for the
heck of it zero for that one and then
negative 4 for the intrapleural okay
let's write that down
so the intrapulmonary again I could have
put 760 and I could have put 4/7 756 it
doesn't matter but what we're going to
do is enter pulmonary pressure here is
going to be specifically zero let me do
some mercury and then what is it over
here for this negative so it's minus
intrapleural pressure which is negative
four so then if I do 0 minus minus 4
it's just I'm adding right I'm adding in
this case and I should actually use the
unit's right I shouldn't be lazy let me
put the unit's in here so I'm consistent
I'm sorry negative 4 millimeters of
mercury the difference in this will give
me 4 millimeters of mercury so you see
how if I took 760 minus 756 it would
still give me 4 millimeters of mercury
well let's even define it a little bit
more it's positive it's not negative
it's positive what does that mean for to
be positive if the transpulmonary
pressure is positive that's good thing
that means that the lungs are actually
going to be able to be inflated if it's
negative that's a bad thing that means
it's going to try to deflate okay let's
now let's do the transfer Rasik pressure
the transthoracic pressure we said was
the difference across the chest wall so
it's intrapleural pressure minus the
atmospheric pressure okay let's do that
one so we said T T P which is a
transthoracic pressure is equal to the
anti b intrapleural pressure so I'm
going to put P IP minus B atmospheric
pressure which is the pressure C so P of
the atmosphere what does that give me
okay intrapleural pressure we said was
negative 4 so we're going to write here
it was negative 4 millimeters of mercury
and then the atmospheric pressure is
zero zero millimeters of mercury
okay so then if that's the case then
transthoracic pressure is actually just
equal to the intrapleural pressure then
because this is zero so what does this
actually equal then this equals negative
four minus zero which is negative four
millimeters of mercury and so what does
that mean that negative formula musa
mercury means that is trying to deflate
that's why the chest-wall because of
this if you look at the actual
transthoracic pressure naturally this is
actually going to one to try to come
this way right it's not going to want to
be inflated it will actually cause a
deflating pressure so the transthoracic
pressure is a deflating pressure okay so
we've done transpulmonary transthoracic
there is the last one we can mention it
really quickly and it's just again intra
alveolar pressure right here minus the
atmospheric pressure so if we wrote that
one down just for the heck of it it
would be the intra pulmonary pressure
right so trans respiratory pressure
we'll call this one t RP so trans
respiratory pressure is equal to thee
p-pull minus D P of the atmospheric
pressure okay well what is that equal to
that's equal to zero minus zero so will
this be it'll be zero millimeters of
mercury and again we're doing all of
this at rest this will be zero
millimeters of mercury is all arrest
we're going to compare this to what it
would look like afterwards whenever
we're going to do the inspired
inspiration process all right so again
with all these pressures let's quickly
go through them trans respiratory
pressure is the intra pulmonary pressure
minus the atmospheric pressure so
therefore it is zero millimeters of
mercury so therefore there's no real gas
flow that's moving in any direction here
and there is no pressure differences
across this okay transpulmonary pressure
this is a really important one this one
in transthoracic are the more important
pressures transthoracic pressure
I'm sorry transpulmonary pressure is the
intrapulmonary minus to enter plural and
we said again you'll take this zero
millimeters of mercury which was 760
again we could write like that
my name is the intrapleural which could
either be 756 or is here right negative
four doesn't matter you're still going
to get the same number which is going to
be positive four millimeters of mercury
again what does that mean
that means that this is trying to expand
ours that you want what you won here is
you want this actual long to be able to
inflate right you want it to be able to
inflate so positive pressure means that
you're trying to inflate the structure
now if we look at transthoracic pressure
what's happening here this one's a
little interesting right because you're
taking the intrapleural pressure
subtracting from the atmospheric
pressure but what do you really what are
you actually left with you're really
only left with intrapleural pressure so
if that's the case then you're
transthoracic pressure is equal to your
actual intrapleural pressure negative
four millimeters of mercury so what does
that mean then it goes back to that
thing that we said is due to this
natural outward elasticity or recoil of
the chest wall right because that's
trying to pull this what parietal pleura
away from the visceral pleura which is
increasing this volume what else did we
say we said it was also due to the
natural elasticity and the surface
tension of the lungs which is trying to
pull the actual visceral pleura away
from the product Laurel what is that
doing to the volume it's increasing me
volume and what would that do to the
pressure in this area it'll decrease the
pressure and that's why this should make
sense okay now that we've done that
we've gone over a whole bunch of
pressures and a whole bunch of different
formulas and numbers I'm sorry about
that
what we're going to do is we're going to
go over how is these pressures changing
whenever we're going through the
inspiratory process so if you guys stick
with us go to part two we're going to
specifically see how the nervous system
is affecting the actual this whole
respiratory structure here and how
that's actually producing pressure
differences all right engineers I'll see
you in part two