Table Of Contents

SL No. Chapter Page No

RESPIRATORY PHYSIOLOGY

1 Lung Mechanics 1 2

2 Lung Mechanics 2 5

3 Lung Compliance 7

4 Surface Tension 14

5 Lung Volumes and Capacities 17

6 Pulmonary Circulation 22

7 Pulmonary Vascular Resistance 26

8 Carbon Dioxide Transport 34

9 Regulation Of Respiration 40

10 Role Of Chemoreceptors 42

11 Oxygen Transport 46

12 Hypoxia 52

13 Respiration in exercise 57

15 Respiration at High altitude 61

16 Pulmonary Function Test 70

17 Expiratory Flow curves 75

RESPIRATORY PATHOLOGY

18 Cystic Fibrosis 79

19 PNEUMOTHORAX 82

1
 2

Study of factors and

forces involved
•

in

INSPIRATION AND EXPIRATION

Major muscle for inspiration in

quite breathing
•

DIAPHRAGM INCREASES Vertical diameter .

During inspiration External intercostal

•

muscles

Laterally
5,5474387174 FEET
' "'
movement
-

Anteriorly
EyAn¥h: Patin Fo'T

:hEn¥§qTg
-

ACCESSORY MUSCLES OF INSPIRATION

Sternoclido mastoid
]→
•

LIFT THE RIBS

•
Scalene muscles
•
Pectoralis major

During quite breathing expiration passive

•

is a
process
ELASTIC RECOIL OF STRETCHED MUSCLES is
enough .

ACCESSORY MUSCLES OF EXPIRATION

•
Internal intercostals
•
Rectus Abdo mini

•
Elastance →
property of matter to resist
deformation .

Tissue Resistance provided by the

gliding of Pleura
• →

Resistance
•

Airway
 3
{} TRANS RESPIRATORY PRESSURE
{J 0 ^

goatsOf
() → Atmospheric
Pressure

inner:÷
, :O
:*

;÷←€f①
.

ag( if
§ggyYgh
Oj Intra alveolar ← •

\
Pressure
"
O ✓
Transp
.si:S #
.

O
✓
•-•

Trans thoracic # 0
Pressure

! pressure
'
ositive
extended
trans moral
across

pressure
a wall
causes inflation .

TRANS PULMONARY PRESSURE

•
PRESSURE INSIDE ALVEOLI -
PRESSURE OUTSIDE ALVEOLI

Trans Pressure
pulmonary
•
EQUAL TO

INTRA ALVEOLAR PRESSURE -

INTRA PLEURAL PRESSURE

Intra pleural negative with

gets
•

pressure more

Expansion
Layersofpleurastretchedi
of chest as

opposite direction

TRANS THORACIC PRESSURE

•
INTRA PLEURAL PRESSURE -

ATMOSPHERIC PRESSURE

TRANS RESPIRATORY PRESSURE

 4

INTRA ALVEOLAR PRESSURE

Meausered Mamo
using graph
•

INTRA PLEURAL PRESSURE

Measured BALLOON CATHETER → Balloon

using
•

(
Catheter
f- catheter

µ
•

with manometer is inserted

in
oesophagus
•
.

Bog!ko%gr%.cat?setern.aosisinblated at
•

,
Manometer
•

After disconnecting oesophagus from /

atmosphere , is measured
pressure
in DORSAL MEDIASTINUM

•
Which is determined by intra pleural pressure .

COMPLIANCE
•
The ease with which one can inflate or stretch a material .

change in volume of lung unit trans pleural

•

per change in
pressure

ELASTANCE
•

The property of a material to resist

deformation due to
more ELASTIC RECOIL

change in
pressure of lung per unit
change in volume

-2N mum
stretch

✓
| ↳ recoil
recoil

GmP4ANCEdE¥€
more

Thin rubber less elastic recoil

Fibrotic elastance less

lungs more and compliance
 5

RESTING VOLUME
•

Is the volume when trans mural pressure across the walls

that structure is
of zero .

complianceobchestwau-a n.m.ae?.-p.e. e- -pgI

Compliance of lung
Transptfmonaypressure 12%7
=
=

Compliance of Respiratory System = = #

Pa Patm
Trans
Respiratory Pressure -

COMPLIANCE OF LUNG

In of isolated
Lungs

r.ro/./ideistend7s..Poress:rea.snr.m
TLC case

due to the absence

of

RV -

T was

Resting Volume
0 Of Lung .

COMPLIANCE OF CHEST WALL

TLC
Ribs oppose excessive
DISTENSION and DEFLATION

÷ in:*:*:
i :

I
O
 6

COMPLIANCE OF COMBINED SYSTEM

A

f f
TLC --

"
in:÷:::÷::*::::÷ .

"
Chest wall HAVE A TENDENCY TO Destend outwards
Rv -
Resting state
Volume
Both held
→ are
together by sticky
a pleura .

Functional Residual capacity

→
Resting state volume
of
combined respiratory system .

TLC --

- RV
of chest wall

in .
ioiieiiiriiiiiiiiitem
LUNGS
#
O

Intra pleural
cavity is
negative
befgaugssembguemicnhesatpos7.IE
"
directions
I 0
I
Total Lung capacity
I
Flattening
✓ ✓
is observed
of
°

- - - -
curve

because has
stiffened
system
-
.
 7
-

O
Why is intra pleural NEGATIVE
•

pressure
-

Lungs and chest wall at

resting length when

DISTENDING PRESSURE = DEFLATING PRESSURE

¥
y
O
- una

INTRA PLEURAL H ✓
PRESSURE IS

NEGATIVE ,

TRANS MURAL PRESSURE = O

no
tendency to recoil or stretch
#
-
.

↳ ctiusntgsndifrgetcpressyere > deflating pressure

To teonidgnnaqtpobsifona.sk fibers to recoil

¥g
¥÷÷÷:÷÷÷÷:÷÷÷÷÷÷÷÷÷.÷÷÷÷÷
accompanied by change in
lung volume .
.

VP PP
Lungs stretched more than
Resting Volume
.

Thoracic
CHEST RECOIL
cavity compressed less than

Resting
WALL
volume

pp
fff
Two
layers of pleura stick to each other

I In a combined
respiratory system
→

← →
• Lungs HAVE A TENDENCY TO Recoil Inwards

✓
chest wall HAVE A TENDENCY TO Destend outwards
Both held
are
together by sticky pleura .
 8
Due to the
sticky nature
of the two

bae's:%e " dekeeiorsabeacwnengah.in: sign:3 .

sina.en.se
. wa . .

RECOIL

STICKY PLEURA

incinerating
•

During quite breathing , after NORMAL EXPIRATION ,

the volume

of Lungs is 2. BL ie FRC .
which is
way greater than the
isolated
Lung volume ie 500mL .

inhwisapiecreaeatespresasnreingreasegdamefnjscthecouiresc

When chest expands expand

wall
Lungs as
they adhere to
•

chest cavity .

T LUNG VOLUME = T ELASTIC RECOIL

Intra pleural negative with

gets
•

pressure more

INSPIRATION
Layersofpleurastretchedi
as

opposite direction

Lungs get smaller and lose their

tendency to RECOIL
•

L LUNG VOLUME = L LUNG ELASTIC RECOIL

EXPIRATION lessnegativePT.PT

Trauma
•

Abnormal communication b/w alveoli and Pleural cavity due

to
overlying NECROTIC TISSUE
 9

00 Due to ve IPP air

gets sucked b/w the pleura
• -

¥war.

Bg§g¥÷Hwm
o mouna
e.
.cl?Ynesstnega9Yvecanfressoii4uinsgsdisdnipaitendg gem.to

ti
,
O wall
push chest outwards

:
O

O
t a
'
-

O
Collapse of previously inflated lungs
'

: •

÷
"

:÷::÷÷÷÷:÷÷÷; :*::
"

nasaiineeven
a

detaches
0 pleura transmitting the
change .

To
•
Air is sucked out
BILATERAL PNEUMOTHORAX
Defect
•
•
is sealed .

is not compatible with Life .

INCREASE IN LUNG COMPLIANCE

Any condition that decreases the ELASTIC MATERIAL

•

of Lung

EMPHYSEMA

Macrophages

⑧d
.
-

i
need:*: were:O '
'

Fontenot.ge.
carbon particles inhaled
Otb
.

during smoking .
 10

ELAsen-siyG@JdgagIaga.ca
Elastase
•

N p .

Disintegration of alveolar septa

division
biforate:{
CARBON
Air doesn't out
easily trapper
•

air
go

Ignite.IE?:i:isYng.sotoinai:::egsema
.

During inspiration increase

•

in

volume stretches the elastic

adherent
parenchyma and
airways .

DESTRUCTION →
of alveolar Septa .

.
Due to release
of enzymes .

•
Loss of RADIAL TRACTION PULL

Barrel → TTLC
shaped
Observations
chest ←
TRV

Tidal volume d ← ↳ TFRC

 11

ELAseas€D¥
Elastase
•

N p .

Disintegration of alveolar septa

Yay:÷÷÷¥÷a¥g:{
division

CARBON
Air doesn't out
easily trapper
•

air
go

}÷÷ng"÷.FI?I:i:isYnaosotoinai:::egsema
"
i
.

During inspiration increase

•

in

volume stretches the elastic

adherent
parenchyma and
airways .

DESTRUCTION →
of alveolar Septa .

.
Due to release
of enzymes .

•
Loss of RADIAL TRACTION PULL

Barrel → TTLC
shaped
Observations
chest ←
TRV

Tidal volume d ← ↳ TFRC

EMPHYSEMA TOUS LUNG N

?
r.ro#-fAAffy.2ev0
a

Etf
EF i TLC - - - - - - - - - - -

FRC
I

TRANS MURAL PRESSURE RV

VITAL
•
For the same
pressure AIR CAPACITY
Volume emphymatous
of Long
is More . #
 DECREASE IN LUNG COMPLIANCE 12

Any condition that increases the ELASTIC MATERIAL

of lungs .

E]
•
RESTRICTIVE LUNG DISEASES (J

⇐
Ei:c:S:X:c .
uneaten side Eiht .

TLC
^

Egging
only

÷÷÷!÷÷÷÷÷im
-

⑤ a

÷
r.ro#-AAA-f-AAA-
.
O '
I

§ : ,
Lunas
/ l
l
l

- →
5cm H2O

TRANS MURAL PRESSURE

•
STATIC LUNG COMPLIANCE

Pressure -
Volume relationship is studied when air
the
is not
flowing through airways .

•
DYNAMIC LUNG COMPLIANCE
Pressure -
Volume relationship is studied
during
inspiration and expiration when air is
flowing in
airways .
 13
^

/
TLC -
•
→ END INSPIRATORY VOLUME

¥:*:::O:
RV -
.
I

Atagivenpres.su#IFor
For inspiration Lung volume is LESS
•

expiration Lung volume is MORE

ie →
Lungs
less
are more compliant during expiration and
compliant during inspiration .

Lung compliance is DYNAMICALLY CHANGING

during
inspiration and expiration .

During inspiration
Initially lungs are
difficult to expand ,
due to smaller
size of alveoli
More is required to overcome the intermolecular
energy
force of attraction This makes
Lungs less compliant

During expiration .

because
of larger alveoli and
relativly less intermolecular
force of attraction lungs are more compliant .

↳
TLC •

Lung compliance greatly

.

t
-

increases due to loss

of
surface tension

.
→ game .
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