Respiration is the process of gas exchange between individual and environment

4 components
● ventilation
● Alveolar-capillary gas exchange, o2 and co2 between alveoli and pulmonary
capillaries
● Transport of oxygen and carbon dioxide between the tissues and the lungs
● Movement of oxygen and carbon dioxide between the systemic capillaries and the
tissues.

Pulmonary Ventilation
● inhalation- into the lungs; chest expands and diaphragm contracts (flat)
● exhalation- out of lungs; chest and diaphragm relaxes
> lung compliance- expansibility or stretchability of lung tissues
> lung recoil, the continual tendency of the lungs to collapse away from the chest wall.

Alveoli- gas exchange takes place

capillaries- thin layer

Alveolar Gas exchange

● Diffusion is the movement of gases or other particles from an area of greater pressure
or concentration to an area of lower pressure or concentration.
● When the pressure of oxygen is greater in the alveoli than in the blood, oxygen diffuses
into the blood. Then diffuses into cells

Transport of Oxygen and Carbon Dioxide

● Oxygen needs to be transported from the lungs to the tissues, and carbon dioxide must
be transported from the tissues back to the lungs then expiration
Several factors affect the rate of oxygen transport from the lungs to the tissues:
1. Cardiac output
2. Number of erythrocytes and blood hematocrit
3. Exercise.
● hematocrit is the percentage of the blood that is erythrocytes (RBC).
● Excessive increases in the blood hematocrit raise the blood viscosity, reducing the
cardiac output and therefore reducing oxygen transport.

⬆️hematocrit ⬆️blood viscosity ⬇️cardiac output ⬇️oxygen transport

Also, ⬇️hematocrit ⬇️rbc ⬇️hemoglobin ⬇️oxygen = anemia

CO2 transported to cells to lungs in 3 ways: bicarbonate, carbaminohemoglobin, carbonic acid

O2 transport Co2 transport

● From lungs to tissues ● From tissues/cells back to lungs

Systemic diffusion

⬇️
● between capillaries and tissues and cells
● cells consume O2, partial pressure of O2 in tissues = causing O2 at arterial end of
capillary to diffuse into cells
● CO2 from metabolic processes accumulates in tissues and diffuses into capillaries
where partial pressure of CO2 is lower

Respiratory Regulation
Neural (adjusts rate of alveolar ventilations to meet needs of body) and chemical controls
(Can increase activity of inspiratory center and rate and depth of respirations)

Emphysema- elevated co2 levels, barrel chest

Factors affecting respi function

● age
● environment
● lifestyle
● medications
● stress

epinephrine- released during stress

alterations during respi function

● Patency
● Ventilation
● Alveolar gas exchange
● Systemic diffusion

Breath sounds
● Stridor
● Stertor
● Wheeze
● Bubbling

Breathing patterns – rate, volume, rhythm, ease or effort of respiration

Eupnea- normal
Tachypnea- rapid respirations, fast
Bradypnea- slow rr
Apnea- absence of breathing
Dyspnea- DOB
Orthopnea- unable to breathe unless sitting/standing
Kussmaul’s breathing- body compensates, response to stress/anxiety

⬇️
⬇️
Hypoxemia- oxygen in blood
Hypoxia- oxygen in body, rapid pulse, dyspnea, flaring nostrils

• Adequate oxygenation essential for cerebral functioning

Circulation
Transport of oxygen, fluids and electrolytes via blood to and from tissues
CV – made up of heart and blood vessels

Heart
Located in mediastinum, between lungs, underlying sternum
Enclosed by pericardium
Epicardium- heart’s outermost layer
Pericardium- protects heart

Blood flow

coronary circulation
Supplies blood to heart muscle (outside of heart)

Cardiac cycle: Myocardium goes through:

Contraction (systole)
Relaxation (diastole)
Atrial kick- end of diastolic phase
S1 first sound; systole; closure of atrioventricular valves (tricuspid, mitral)
S2 second sound; diastole; closure of semilunar valves (aortic, pulmonic)
Lub, dub

Cardiac conduction system

Electrical activity and contractions

SA node > AV node> bundle of His/branches> purkinje fibers

Sinoatrial node- pacemaker of heart, in superior vena cava

Atrioventricular (AV) node, slightly delaying transmission of impulse to ventricles; delay allows
atria to contract slightly before ventricular contraction occurs
Then Bundle of His, R and L bundle branches, and Purkinje fibers- These fibers terminate
in ventricular muscle, stimulating contraction.

Cardiac Cycle – the repeated contraction and relaxation of the heart by SA node

⬆️
Preload- ventricles are stretched; end of relaxation (diastole)

⬆️
Afterload- heart must pump and eject blood; higher pressure to lower pressure. afterload=

⬆️ ⬆️
heart work harder= myocardial o2 demand

⬇️
Vasoconstriction bp and afterload workload of heart
Vasodilation bp and workload of heart

Blood vessels- blood to tissues then return to heart with each contraction
Tunica intima- inner most layer, facilitates blood flow
Tunica media- constrict or dilate vessels
Tunica adventitia- outermost layer =, supports and protects

Arterial blood flow

Blood from heart to tissues
Blood always move from higher pressure to lower

hgb - major component of rbc

Alterations in cv function
Decreased cardiac output
Impaired tissue perfusion
Blood alteration

Decreased cardiac output

Myocardial infarction/heart attack- rt blood clot
Heart failure- unable to keep up body needs
Congenital heart defects- abnormal blood flow