Common disorders of

Respiratory system

Dr. Pallav Sengupta

Assistant Professor, Physiology

www.gmu.ac.ae COLLEGE OF MEDICINE

 Learning Objectives

➢ List different pulmonary volumes and capacities

➢ List common disorders of respiratory system
➢ Describe common disorders of respiratory system
 Pulmonary Function Tests
• Assessed by spirometry.
• Subject breathes into a closed system in which air is trapped within a bell floating in H2O.

Insert fig. 16.16

 LUNG VOLUMES
➢Tidal Volume:
❖ It is the amount of air breathed in or out in a quiet respiration
❖ Its value is 500 ml
➢Inspiratory reserve volume
❖ It is the amount of air that can be maximally inspired from the end of normal inspiration
❖ Its value is 3 – 3.2 L
➢Expiratory Reserve Volume
❖ It is the amount of air that can be maximally expired from the end of normal expiration.
❖ Its value is 1.1- 1.2 L
➢Residual Volume
❖ It is the amount of air that remains in the lungs after a maximal expiration
❖ Its value is 1-1.2 L.

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➢Pulmonary capacity is the sum of two or more lung volumes.

➢There are 5 pulmonary capacities

❖Inspiratory capacity IC = TV + IRV
❖Functional residual capacity FRC = ERV + RV
❖Vital Capacity VC = IRV + TV + ERV
Inspiratory capacity
❖ It is the amount of air that can be maximally inspired from the end of normal expiration.

Functional Residual Capacity

❖ It is the amount of air that remains in the lungs after a normal expiration.
❖ Its value is 2. 5 L
❖ FRC includes expiratory reserve volume and residual volume.

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➢It is the amount of air that can be maximally expired after a forceful inspiration.
➢Its value is 3.1 – 4.8 L and depends on age, sex, height, body weight and surface area.

Vital capacity is increased in

❖ Athletes (Physiological)
❖ Standing posture(Physiological)

Vital capacity is decreased in

❖ Old age & Females, Supine position lying down position (Physiological)
❖ Factors that limits thoracic cage movement-restrictive lung disease

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➢ The fraction of Vital Capacity expired in unit time is known as forced expiratory
volume (FEV).

❖ FEV1 – Fraction of vital capacity expired during the first second of forced expiration.
❖ FEV1 % - It is the percentage of FVC expired in one second

How to calculate FEV1 %

➢ FEV1 / FVC x 100 = FEV1 %
➢ Normal value = 80 % of FVC

Clinical Application
▪ Useful in distinguishing obstructive and restrictive lung disorders
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➢ In obstructive pulmonary disease like Asthma, Chronic bronchitis and Emphysema
FEV1 is reduced.
➢ In restrictive pulmonary disease like Interstitial lung fibrosis, Pulmonary edema the
FVC is reduced but FEV1 % is normal for the reduced FVC

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Terms Used to Describe Lung Volumes and Capacities
 Dead Space Air
The amount of air in the respiratory passageways that does not take part in exchange of gases is known
as dead space air
1. Anatomical dead space
2. Physiological dead space

Anatomical dead space

It is Volume of air present in conducting zone (from nose to terminal bronchiole) where gaseous exchange does not take part.
• It is 150 ml

Physiological dead space

• Anatomical dead space + alveolar dead space
• Alveoil—partially functional or non functional-of poor blood supply
• Alveoli are over ventilated – negligible blood flow

• Normal condition
Anatomical dead space & Physiological dead space are equal
 Surfactant
Alveoli wall has two type of cells

• Type I main sites of gaseous exchange –

simple squamous epithelial cells form a
continuous lining of alveolar wall

• Type II (granular pneumocyte) secrete

surfactant
• Phospholipid produced by alveolar type II cells.
• Lowers surface tension
• Reduces attractive forces of hydrogen bonding by becoming
interspersed between H20 molecules.
• As alveoli radius decreases, surfactant’s ability to lower
surface tension increases.
Common disorders of Respiratory system

• Atelectasis
• Pneumonia
• Emphysema
• Asthma
• COPD
• Pnemothorax
• Tuberculosis
 Atelectasis
Atelectasis means collapse of the alveoli.
➢ Major causes
1. Total obstruction of the airway
2. Lack of surfactant in the fluids lining the alveoli.

• Blockage of many small bronchi with mucus or

• Obstruction of a major bronchus by either a large mucus plug or some solid
object such as a tumor.
• The air entrapped beyond the block is absorbed within minutes to hours by
the blood flowing in the pulmonary capillaries
• Leads to collapse of the alveoli.
• when an entire lung becomes atelectatic, a condition called massive collapse
of the lung
 Pneumonia

• Inflammatory condition of the lung in which some or all of the

alveoli are filled with fluid and blood cells
• It can be caused by viruses, fungi or bacteria
• A common type of pneumonia is bacterial pneumonia, caused
most frequently by pneumococci.
Major pulmonary abnormalities in pneumonia

1. Reduction in the total available surface area of the respiratory

membrane.
2. Decreased ventilation-perfusion ratio.
• Cause hypoxemia (low blood oxygen) and hypercapnia (high
blood carbon dioxide).
 Emphysema
Complex obstructive and destructive
process of the lungs caused by many years
of smoking.
1. Chronic infection.
2. The infection, excess mucus, and inflammatory
edema of the bronchiolar epithelium.
3. cause chronic obstruction of many of the smaller
airways.
4. Difficult to expire due to obstruction.
5. entrapment of air in the alveoli and
overstretching.
Emphysematous lung (top figure)
6. marked destruction of as much as 50 to 80 per the normal lung (bottom figure)
cent of the alveolar walls.
Lung alveolar changes in pneumonia and emphysema
 Asthma
• Also known as bronchospasm
• Inability to get air out and cause gas trapping
• Partially obstructs the bronchioles and causes extremely
difficult breathing
• Patients breathes same air again and again
• Lowers amount of oxygen and increases amount of carbon
dioxide
• It is generally allergic reaction, hypersensitivity reactions.
• The following substances released by allergic reaction
• histamine,
• slow-reacting substance of anaphylaxis (which is a mixture of leukotrienes),
• eosinophilic chemotactic factor
• bradykinin.
• The combined effects to produce
1. localized edema in the walls of the small bronchioles, as well as
secretion of thick mucus into the bronchiolar lumens
2. spasm of the bronchiolar smooth muscle.
The airway resistance increases greatly
 Chronic obstructive pulmonary disease
(COPD)
• Is a group of diseases
• Difficulty in getting air out of the lung
• Large amount of secretions and lung damage

• COPD refers to combination of emphysema and chronic

bronchitis
Pneumothorax: It is a condition in which air enters into the pleural
cavity resulting in positive intra pleural pressure. This causes
collapse of the lung. Any injury to the chest wall may cause
pneumothorax.

Pleural effusion or hydrothorax: Fluid accumulation in the pleural

space.

Hemothorax: Bleeding into the pleural cavity.

 Tuberculosis

• Is a bacterial infection
• Thrives in a area of the body where O2 content is high like Lung
• Can stay dormant for years
• Symptoms: dyspnea, tachypnea, cyanosis, tachycardia
• Major concern: Multidrug-resistant form of tuberculosis

• The tubercle bacilli cause a peculiar tissue reaction in the lungs

• Invasion of the infected tissue by macrophages and "walling off" of the lesion by fibrous
tissue to form the so-called tubercle.
• It cause
1. increased "work" on the part of the respiratory muscles to
cause pulmonary ventilation and reduced vital capacity and
breathing capacity.
2. reduced total respiratory membrane surface area causing
decreased pulmonary diffusing capacity.
3. abnormal ventilation-perfusion ratio in the lungs.
The major preventable cause of many respiratory diseases is
smoking
 Check your knowledge!!!!

➢The maximum amount air that can be expired after maximum

inspiration is called____________
➢ COPD is a combination of_____________
➢ The respiratory disease that is caused by allergic reaction is
_______________
➢ Condition may arise after chest injury is_______________
 Learning Resources
➢ Text Book: Colbert BJ, Ankney J, Lee KT. Anatomy and
Physiology for health professions. 2nd edition, Pearson
education; 2011. ISBN-13: 978-0-13-506077-3. Chapter
14, pp. 355-359.
➢ PowerPoint presentation in the moodle

www.gmu.ac.ae COLLEGE OF MEDICINE