Functional

Anatomy
henge :

covered
• Two
lungs ,
by a membrane called Pleura .

left lung 2 lobes b- ' a'

Parfitt:}
lobes tabs
Right lung 3 visceral
( inner)

Airway :

Nasal Cavities
Nose
Pharynx Larynx Tryachea
•
→ → → →

Terminal c- Bronchioles Bronchus

Respiratory
Bronchioles
←

Bronchioles

Alto Lan duets → Alveolar sac → Alveoli

tract
Upper Respiratory
: -

°
From Nostrils upto Larry me .

• Three
functions : ca ) filter
large particulates
( bi
Adjust temp the .

es
Humidifies Air as it enters the
body .

tower Respiratory tracts :

. Below
lagna ( Trachea to Alveoli )
tract divides
Respiratory 23 times
. .

. The first 16
generations Conducting zone
•
I 7th to lqtb Transition zone
zotb to 23rd
Exchange zone
•

23rd
•

Exchange gases
g take place from Htbcan to .

•
Trachea is designated generation Lez as
.
 Alveoli :

• site
for gaseous exchange .

•
The cells are
flattened and
form a
single layer .

. Two
types y
cells cis
type and iiis
Type I
-

Mainlining
I
-
Pttnoduce Surfactant
Gas exchange Sy
by surface
-

- .

95%
y surface all cells
-

Goy
g
-

407
g all cells Thicker
- -
-

Histology g Respiratory Tract : c -

cartilage
Absent
19
• Three
layers Terminal
fibrous
C shaped Cartilage till

layer
s
Outer
-

-
(a) Bronchioles
Middle Smooth muscle
( bi muscular
layer
→

T for broncho constriction

( Cl Inner Epithelial layer broncho dilation
4- memb &
By mucus .

columnar ciliated
having
cells .

Bronchioles
-
The
epithelium
cuboidal ( with
g Respiratory
in no cilia ) .

Nerve
Supply :

By ANS

stimulation Broncho dilation and is

Sympathetic
causes
•

mediated
by Bz receptors .

bronchial secretion and

o
.

Parasympathetic increases
broncho constriction .
causes
 Functions g
Respiratory system :

Non function
Respiratory function
Respiratory

÷ ÷ ÷ :÷ ÷ : f:÷ ÷ ÷
-
.

action
Nasal
cavity : Cal
Defensive
.

(a) filtration g dust particles : -

Mucosa
g keys produces
dust IgA ( protects against
larger particle 5-
10pm
settle in mucous membrane Infection )
(b) Humidification
-
Alveolar
macrophages are

phagocytic
(c , olfaction - cilia
present in lungs

(b) Expulsion g coz from body .

in
:÷÷÷÷÷÷:±÷::
maintaining
structural

-
framework .

Cdl Conversion g Angiotensin I

Respiratory Membrane :
to
Angiotensin I
by ACE
Thickness
Respiratory memb occurs in
Pulmonary capillary
°

y
lie around to
Endothelium
5
pm
.

+
pem
.
.

(e) A PUD ( A mine Precursor

blood
Thin
layer separating
•

in uptake Decarboxylase ) cells

pulmonary capillaries
&
store
air in alveoli
biologically active

substances
like VIP subs P
.

,
,

Diameter g
Pulmonary capillary hormones like Cck P2 & -

÷÷÷÷÷:* :÷:i÷:n
.

:: * am

Acid base balance

(g)
-

for 3/4 function ( coz )

•
RBC remains T a ch , Excretory
second Production
in
pulmonary capillary cis Voice
network .
 Alveolar
epithelia
'

consists g surfactant T
Respiratory memb

%÷÷¥⇐
:
"
• .

'" . ,
teh:
la ,
layer , surfactant lining ,

do , Alveolar epithelium coz #

(c) Basement memb g Alveolar epithelium

(d) Interstitial
space Basement Interstitial f

Capillary
(es basement memb -

memb.rs space
if capillary
' Endothelium .
Alveolar epithelium

Total Fo m2
surface
=
•
area

Blood
• Amount g in
lung capillaries = 150 me

Mem b
Diffusion across the
Respiratory :

Thickness g the membrane thickness double

(a)
Inversely if ,
→

Rate g diffusion →
* soy .

(b)
Surface Area Directly proportional
( es Diffusion Coefficient Rate g diffusion in
directly
proportional to the
diffusion coefficient
1-
g gas
.

a
solubility
a t
' TM

( di Pressure
gradient Directly proportional -

The
-

diffusion gradient across the

resp
. memb in
and
mmHg for
60 6 Co2
mmHg for
Oz .

Ventilation
Pulmonary
• The
process g flow g air
into the
lungs during inspiration
and out g the
lungs during expiration .
 Respiratory Minute Volume :

Volume Air breathed in & out minute

g
lungs every
•

og
under condition
nesting .

R MY Tv x RR ( Resp rate ) -

500 ×
121 min
→ 6 L
/ min
o RMV can be as low as
t.gl/min or as
high as 2004 min

for short duration a .

Alveolar Ventilation :

Volume air
entering the alveoli in t min
•

g
.

Alveolar ventilation =L Tidal volume Dead RR

space )
-

= 350 X 12

4.2 L
/ min
=

.
It decreases
rapid shallow breathing
in & increases in
slow deep
breathing .

Headspace :

• Part where no
exchange g
gases
takes place .

Types :

( at Anatomical dead (A Ds ) : Party Resp passage which

space
.

not involved in
is
exchange g gases
.

This includes air in

larynx trachea
pharynx
-

nose , , , ,

and bronchi upto terminal bronchioles .

-
Too thick for gas exchange
-
Normal value 150 ml

-
Measured by Single breath
Nitrogen Analyzer Method .

Is , physiological dead space (

Pbs ) : It includes anatomical
dead
space does
and
parttake
7
lungs where the
exchange
not place .
 PDS ADS + Alveolar Dead
space
=
→

Alveolar dead the volume of air wi

present in
space
•

which does not

alveoli in
participate gaseous exchange .

Normally fADs=PDT/
• PDS in
monimpignificant than ADS . It ni increased

Arteriovenous shunts
in case
y and
Pulmonary
Embolism .

Volumes
Lung -

Tidal Volume Amount g forced Vital

" :
-

air ceo ,
capacity
amount
:

that moves into the

lung level the .

largest
og
air that be expired
inspiration
can
with each
inspiratory
maximal
after a

during quiet breathing .

effort .

( Tv + Irv + ERV +
. . - I

• It in about Soo -
750 me .
.
It in measured clinically as an
indene g
Pff? :L;] .

(2)
Inspiratory Reserve to lame : The air
inspired with
-

a maximal

in about
inspiratory effort in excess 9 Tv

. I RY 2 l
12000 me .

expelled by
Reserve to lame Volume active
Expiratory
: an
(3)
-

expiratory effort after passive expiration .

in about 11000
Expiratory Capacity
•
ERV t l me
Volume
is , :

air
Residual Volume expire after
The
left lungs after
can
141 -
air in the a g
a

person
inspiration
expiratory
maximal normal
effort
a .

( TV ERV )
It about
+
is
.

•
1300 me .

It in about 1500mL
(5) Total
capacity
dung make : -
Kl hen all are

about
taken
together .

which is Functional
they Tlc 5 L (9)

Residual Capacity :

(as vital

expelled
capacity : Maximum air

from fully inflated

171
Inspiratory capacity
Volume
:

volume g Air
inspired
.

g air in the
lung .

( Tut Irv + ERU )

following quiet remaining
after expiration
a

•
9 t in about 3500mL
expiration .

(
Tvt IRD lungs
og Normal breath .

•
It in about 2.5 L / E RV )
( Rr t
2500 me

.
g t in about 2 -
5 L
 Pulmonary Circulation :

Flow blood between the ventricle and

•
g
right left Atrium .

Some features :

and
Pulmonary circulation in a
low -

pressure ,
low -
resistance ,

high capacitance system

- .

cbl vessels walled and be

The
pulmonary
distended
thin
.
are can
easily
(c) The
pulmonary capillaries are
larger than systemic capillaries .

(d) They also have rich anastomoses .

Thickness and the ventricle

cel g Pulmonary artery ventricle right in

Yzrdg that g Aorta &

left .

Functions Circulation
g Pulmonary :

•
Gas
exchange
• Metabolic
functions [ secretion g ACE
by capillary endothelium
•
filtration and dissolution g
clots -
small dots and emboli
side heart
formed on the
vessels
right y are
filtered in

pulmonary
.

Reservoir blood
Blood : Holds 450 me
g
thereby functioning
•

as a reservoir .

Pressure in
Pulmonary system :

Right Ventricular Pressure T

' 25
mmHg during systole
ng during
↳ o mm diastole

r
' 25
mmHg
( systole )
Pressure in
Pulmonary Artery ↳
°

8 ( diastole )
ng
mm

Mean
Pulmonary Arterial Pressure 15 mm
Hg
•
Pressure in
Pulmonary Vein 5 mm
ng
•
So Pressure Gradient 15 -
5
flommtegl
#
 this Pressure rises above will Edema
•

If 25
mmHg
→ cause .

Pressure in around
•
Left Atrial 5
mmHg .

Blood Volume og
lungs :

Lungs contain 450 me

g blood .

T
d-
is in ke
To
maiming among Pulmonary Arteries
me

Pulmonary capillaries and veins .

Applied :

Sustained elevation
Pulmonary Hypertension : -

g Pulmonary
arterial There in increase in
pressure pulmonary
.
an

resistance
vascular
leading to
right heart
failure .

Oz therapy .
Vasodilators ,
and Ca
"
channel blockers
are used as a treatment .

Occurs due
Pulmonary interstitial
Edema : - to an increase in
pulmonary
fluid pressure -
It causes accumulation
interstitial
g fluid in
pulmonary space
& alveoli

Causes :

car
Left side
heart failure
(bi Pneumonia
'
Oz
toxicity
c
(

( di Altitude
high .

Ventilation Perfusion - Ratio

•
Ratio g Alveolar ventilation to the volume og
blood
the alveoli
perfusing
• Alveolar ventilation -
-
tha
¥7 Q

Normal at A pen 3
If
~

More
=

° Value =
0.8
at Base = Oo 6
 a Tuberculosis y
in base
lung
because
in

tubercle
more common

bacilli
in the a
pen
better in
than

grow
better
regions
where Oz
availability in .

Physiological Dead
.

space Physiological
-
shunt

Alveolar ventilation IT Alveolar vent

.im/:o: : : a: : : : t: :
I
If →
If
.

IT
and Blood flow A and Blood
flow
VI IT than normal ¥ I than normal

ants:c ::c;÷i ::: :c

leading to an increase in all the blood
flowing
Results
physiological dead
space
.

through capillaries .

/
in blood
portion g
venous

; this
not
being oxygenated
-

IgA → IT in Ventricular septal called

Physiological shunt .

defect and Fallot 's

tetralogy
Pneumonia and
tf in
•

¥
Embolism
Pulmonary
.

Me changing Breathing
active while Expiration Passive
•

Inspiration in in
process
.

•
Involvement og ca )
changes
in size g Thoracic
cavity
Intra and Intra
( bi
changes
in
pleural palm -

on
any pressures
-
.

Mm
Respiration :

• Muscle g Respiration are

necessary for
the
process g Inspiration
and Expiration .
 Inspiratory Muscles :

cat
Diaphragm 75%
change in volume in
quiet breathing .

↳
supplied by Phrenic nerve .

-
moves L -
1.5 an in normal
breathing and upto
to cm in
deep breathing .

Contraction g Diaphragm
ftp.p#
-

causes :

ca , g in Intra - abdominal
9ns pina him Expiration pressure
(b) lateral and Anterior
thoracic
Cbl External Intercostals : expansion g
-

cavity .

-
Directed downward and medially .

-
Contraction causes : ca ) Increase in Transverse diameter y
Rib

Cbs Tl Antero posterior diameter and cafe

volume Rib
y
eye
.

Expiratory Muddles :

→ ca , Reclus Abdominis
(a) Muscles g Anterior Abdominal Hall Is cb ) Int .
e Ext Oblique
Is
.

f- cc ) Trans versus
contraction muscles 7 abdominis
og .

Ant abdominal
-
wall causes increased
intra - abdominal
pressure resulting in elevation g diaphragm .

lbs Internal Intercostals : Between the Ribs .

-
fed . in Volume as
they pull
the nibs downward ,
reducing
both Antero posterior & transverse diameters n
f-horan .

Imp .

during Coughing .
 Accessory muscles 9 Respiration :

Normally do not take part in

respiration but
mainly
work during force full
and
Asthma .
-
Inspiration as
during exercise

(a) Scalene Cause elevation thoracic

g
cage
b Sterno dei do
( , mastoid ( som ) causes elevation g t
cage
-

serratus Anterior
Fixing the thoracic that
c'
( so
cage
ribs
efficiently
can move .

( di Alae Nasi Lateral

portion y nose # Atanas Nostril
←
"
'
"

wings g

Inspiration Expiration
contracting diaphragm feat .
Relaxation 9 Diaphragm /
intercostal muscles intercostal muscles
If I
Decreased inter pleural Pressure t
Elastic recoil
cage
-

g
I
thoracic
1
Expansion g cafe positive in
pressure
H Alveoli
Negative Pressure in Alveoli
µ
A
✓
Air flows out
keys
.

into
Air flow

Types 3
Breathing :

( al Ab domino thoracic Gm males [ stronger abdominal muscles )

in males

(b) Thora co abdominal In females & children

be heard stethoscope
Breathing scorn d , → can via over

chest wall
② Bronchial
.

① Vesicular
D Tetro turbulent
Due If low g air in flow g
air

larger airways & Alveoli in bronchi

 Respiratory Pressure changes :

• Visceral Pleura covers outer surface and Parietal pleura

thoracic
line the inner
surface g cavity
.

btw both (
cavity
Pleural 10 ml 9
Space
n

Pleural
fluid )
Intra pleural Pressure :

•
Pressure within the
pleural cavity .

Normally ve
-
•

During forced Expiration ,

it can be
positive .

Normally btw 2.5 & 6 mm

Hg L 5 to 8 cm H2o )
-

•
- -
-

and its
•
At beginning g inspiration it is -2.5mm
ng it
peak it is 6 mm

ng At the end g expiration

-
.

comes
back to -2.5
my
mm
.

.ae?gs.sundunizIntraalIar
fig :

Intraple:L
Pressure [ Intra Pressure ] :
pulmonary
• Pressure within the
lungs .

During inspiration mmHg )

,
it becomes -
re
( -
Irs

During expiration it becomes htt Hg )

,
+ ve mm

•
At the end g Inspiration Expiration it is O or
,

17
F

t ÷:
Alveolar Pressure
Fig : Intra - .

-
 Transport neon any Pressure :

and intra alveolar

•

Difference btw
pleural
Intra -

pressure
called Pressure
pulmonary
in Trans .

. gt is a measure
g
Elastic forces 9
fangs .

Applied :

Pleural
Effusion
:
Accumulation g fluid in
pleural cavity .

•
Commonest cause
→ Tuberculosis
Diminishes

}
°

Accumulating Pus Pyro thorax

expansion 7
•
Accumulation g
fluid Hydro than an

lungs
Blood He mo thorax a
Difficult in
•
In Pneumothorax ( Pnsenseg Air Breathing .

inside the
pleural cavity ) ,
the normal

intra lost It results in

pleural pressure in .

collapse
7 Lungs .

Compliance =

• It is the stretchability g lungs

Extent of for each unit
lung expansion
•

increase in trans
pulmonary pressure
.

• Normal compliance -
200 mL
/ cm H2O

A will
means I am Hzo expand
the
lung 200 me .

|Compliamee='¥# soo -

Fiji mpliancenhge
③

?
'
.

curve
•

compliance /
i.

°
( cm H2O )
 Types g Compliance :
(
2.52

Expressed termed
( at specific Compliance -
as a
function g FRC in
as
specific compliance .

fspecificcompliancee-comphe.am#
FRI
-

(b) Dynamic Compliance -

Expressed with Respect to time .

Factors
affecting Lung compliance :

determined
•

Mainly by Elastic
forces =L
tissue
,
due to elastic &
(a)Elastic forces g
hung collagen fibres
.

Tension within
(b) Elastic forces
the alveoli
caused
by surface
↳ z, 3rd g Total elastic forces
9 henge
Abnormal
Lung compliance
-

fibrosis
lungs Tuberculosis
Lung compliance
•
µ in y as in
and silicosis .

9
•

hung compliance in
Emphysema .

Surface tension
without reduction
,/P=2/ 97
law RA
°
Ale to Laplace in Tension the PA
,

and the alveoli collapse .

Surfactant
:

active reduces tension when

•

Surface -

agent that it
in
spread over the
surface .

alveoli
• Secreted
by TypeT
II cells in .

and contain inclusions

-

Granular lipidtubular .

-
secrete tubes of lipid myelin
 Composition : ca '
Dipalma toy I phosphatidylcholine
( bi Phosphatic yl glycine
(c) Other
phospholipids .

Functions :

(a)
lung Alveoli to collapse
Prevents .

cbs Increase
lung compliance and seduces the work g breathing .

( keep the alveoli dry by preventing Tissue formation

c, .

cdi Prevent the formation

Pulmonary Edema g

cei Increase Alveolar stability

fi Provides Immunity ( IgA &
Apo proteins )
•
Production g Surfactant 7th month g Intrauterine
life .

Thyroid hormone and Glucocorticoids Enhance

production g surfactant .

Applied :
toki Hyaline Membrane
Disease
Infant Respiratory Distress
syndrome :

Respiratory effort by baby at birth expands the

alveoli the .

If
low
production g surfactant in or
,

baby is premature
µ
Small diameter alveoli and Reduced surfactant
increases the
tendency for alveoli to
collapse
.

• Can be fatal without treatment .

Treatment : la , continuous + n
pressure breathing
② Med Notes (med notes .in)
lbs Administration g Bovine
Surfactant;
② Med Notes ( med notes
I Revision Notes med notes site
company
in )
-
. .

got
. '

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