.

Just considering the lung as a static tissue (not in respiratory cycles)

fi
Normal value: 200 mL/cm H2O

Note: Lung compliance: For every 1 cm H2O of pressure change, lung distends with 200 mL. During quiet inspiration,

fi
.

the pressure changes from – 5 cm H2O to – 7.5 cm H2O; the total pressure change of 2.5 cm H2O. Thus, the volume
distension during quiet inspiration would be = 200 X 2.5 = 500 mL. This is called the tidal volume of breathing

fi
Speci c compliance: compliance per unit lung volume; or compliance/FRC. (FRC – functional residual capacity

Dynamic compliance
Although distensibility of the lung, as a static tissue, has a certain xed measure, the distensibility keeps changing with
the stages of respiration. This is “dynamic” compliance

At the beginning of inspiration, when lungs are not lled with much air, i.e., at lower lung volumes, the compliance is
high
At the end of inspiration, when alveoli are lled with air, i.e., at higher lung volumes, the compliance is low
Explanation: At lower lung volumes (start of inspiration), alveoli are smaller; the surfactant molecules are concentrated

over a smaller surface area. Hence, surfactant is more ef cient or effective in decreasing the surface tension within
alveoli

fi
.

Compliance is inversely related to surface tension. Thus, at lower lung volumes, lower surface tension means greater
compliance

The opposite is true for higher lung volumes. Surfactant molecules are dispersed at a larger surface area; hence,

surfactant is less effective in reducing surface tension. Thus, at higher lung volumes (When alveoli are large), a
relatively greater surface tension means a lower compliance

Compliance is greater at the base of the lungs, compared to apex. Due to weight of lungs, alveoli at the base are
compressed. They are not lled with much air; hence their compliance would be high
Limiting volume of the lung : At a transpulmonary pressure of 30 cm H2O , the compliance of the lungs approaches
zero. This is called “limiting volume” of lungs. This is at the last part of a very deep inspiration. [alveolar pressure about
– 1 cm H2O and intrapleural pressure about – 30 cm H2O.
Compliance of the lungs + thorax = 110 mL/cm H2O
Compliance diagram demonstrates pressure-volume relationship in lungs. It follows different paths for inspiration and
fl
expiration; hence called “hysteresis” loop
]

[Figure: The compliance diagram. The inspiratory curve from botto m endto th e to p end; pressure changing from – 5
cm H2O to – 7.5 cm H2O. The curve is steep at the start of inspiration and f lat to ward the end. The greater slope
indicates a greater increase in volume for even a small change in intrapleural or transpulmonary pressure, a high
compliance. Toward the end of inspiration, the curve attens. It indicates that the change in pressuredoes not cause a
proportionate change in volume and the compliance would be low. Also note that: The pressure-volume curve follows
different paths for inspiration and expiration.

[Figure: It shows the normal compliance (A) and changes with restrictive disease (B) and airway obstruction (C). Work
done = DP X DV. Hence, in the pressure-volume diagram, work done is the area covered under the curve. Note: In
restrictive disease, the loop shows there is a lesser increase in volume for the relatively more increase in pressure,
indicating reduced compliance. In COPD, the loop shows greater area covered under the expiratory curve, indicating
more work done during expiration. Ref: Physiology. Berne & Levy, 6th edi.]