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Anatomy
henge :
covered
• Two
lungs ,
by a membrane called Pleura .
Airway :
Nasal Cavities
Nose
Pharynx Larynx Tryachea
•
→ → → →
Bronchioles
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 .
. 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
- -
-
cartilage
Absent
19
• Three
layers Terminal
fibrous
C shaped Cartilage till
layer
s
Outer
-
-
(a) Bronchioles
Middle Smooth muscle
( bi muscular
layer
→
columnar ciliated
having
cells .
Bronchioles
-
The
epithelium
cuboidal ( with
g Respiratory
in no cilia ) .
Nerve
Supply :
By ANS
mediated
by Bz receptors .
Parasympathetic increases
broncho constriction .
causes
Functions g
Respiratory system :
Non function
Respiratory function
Respiratory
÷ ÷ ÷ :÷ ÷ : f:÷ ÷ ÷
-
.
action
Nasal
cavity : Cal
Defensive
.
phagocytic
(c , olfaction - cilia
present in lungs
-
framework .
Respiratory Membrane :
to
Angiotensin I
by ACE
Thickness
Respiratory memb occurs in
Pulmonary capillary
°
y
lie around to
Endothelium
5
pm
.
+
pem
.
.
substances
like VIP subs P
.
,
,
Diameter g
Pulmonary capillary hormones like Cck P2 & -
÷÷÷÷÷:* :÷:i÷:n
.
:: * am
consists g surfactant T
Respiratory memb
%÷÷¥⇐
:
"
• .
'" . ,
teh:
la ,
layer , surfactant lining ,
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 :
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
-
Ventilation
Pulmonary
• The
process g flow g air
into the
lungs during inspiration
and out g the
lungs during expiration .
Respiratory Minute Volume :
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
Alveolar Ventilation :
Volume air
entering the alveoli in t min
•
g
.
= 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 :
not involved in
is
exchange g gases
.
nose , , , ,
-
Too thick for gas exchange
-
Normal value 150 ml
-
Measured by Single breath
Nitrogen Analyzer Method .
Normally fADs=PDT/
• PDS in
monimpignificant than ADS . It ni increased
Arteriovenous shunts
in case
y and
Pulmonary
Embolism .
Volumes
Lung -
g air ceo ,
capacity
amount
:
largest
og
air that be expired
inspiration
can
with each
inspiratory
maximal
after a
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)
-
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
volume g Air
inspired
.
g air in the
lung .
•
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 :
Some features :
and
Pulmonary circulation in a
low -
pressure ,
low -
resistance ,
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 :
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 :
T
d-
is in ke
To
maiming among Pulmonary Arteries
me
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 .
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
.im/:o: : : a: : : : t: :
I
If →
If
.
IT
and Blood flow A and Blood
flow
VI IT than normal ¥ I than normal
through capillaries .
/
in blood
portion g
venous
; this
not
being oxygenated
-
¥
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 :
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
Expiratory Muddles :
→ ca , Reclus Abdominis
(a) Muscles g Anterior Abdominal Hall Is cb ) Int .
e Ext Oblique
Is
.
Ant abdominal
-
wall causes increased
intra - abdominal
pressure resulting in elevation g diaphragm .
-
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 :
serratus Anterior
Fixing the thoracic that
c'
( so
cage
ribs
efficiently
can move .
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 :
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
btw both (
cavity
Pleural 10 ml 9
Space
n
Pleural
fluid )
Intra pleural Pressure :
•
Pressure within the
pleural cavity .
Normally ve
-
•
Hg L 5 to 8 cm H2o )
-
•
- -
-
and its
•
At beginning g inspiration it is -2.5mm
ng it
peak it is 6 mm
comes
back to -2.5
my
mm
.
.ae?gs.sundunizIntraalIar
fig :
Intraple:L
Pressure [ Intra Pressure ] :
pulmonary
• Pressure within the
lungs .
•
At the end g Inspiration Expiration it is O or
,
17
F
t ÷:
Alveolar Pressure
Fig : Intra - .
-
Transport neon any Pressure :
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
}
°
lungs
Blood He mo thorax a
Difficult in
•
In Pneumothorax ( Pnsenseg Air Breathing .
inside the
pleural cavity ) ,
the normal
collapse
7 Lungs .
Compliance =
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
-
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
,
Surfactant
:
Surface -
agent that it
in
spread over the
surface .
alveoli
• Secreted
by TypeT
II cells in .
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 .
di Prevent the
(
formation Pulmonary Edema g
Applied :
toki Hyaline Membrane
Disease
Infant Respiratory Distress
syndrome :
baby is premature
µ
Small diameter alveoli and Reduced surfactant
increases the
tendency for alveoli to
collapse
.
Treatment : la , continuous + n
pressure breathing
lbs Administration g Bovine
Surfactant;
② Med Notes ( med notes . in )
got