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RESPIRATORY SYSTEM

PULMONARY VENTILATION, GAS EXCHANGE & CONTROL OF RESPIRATION DEPARTMENT OF PHYSIOLOGY UNSOED SCHOOL OF MEDICINE

Referensi
Martini, F.H., Nath J.L.. 2009. Fundamentals of

Anatomy & Physiology 8th Ed. USA; Pearson Benjamin Cummings Tortora, G.J., Derrickson B.. 2006. Principles of Anatomy & Physiology 11th Ed. USA; John Wiley & Sons

LEARNING OBJECTIVE
Describe the event that cause inhalation & exhalation Explain Daltons Law & Henrys Law Describe the exchange of oxygen & carbondioxide in

internal & external respiration Describe blood gas transportation Explain how nervous system controls breathing Explain role of respiratory system on acid-base balance

PULMONARY VENTILATION
Respiration has 3 basic steps Pulmonary ventilation

Mechanical procces that moves air in & out of the lung Inspiration/inhalation Expiration/exhalation

Pulmonary respiration (external) Gas exchange between alveoli & lung capillary By diffusion Tissue respiration (internal) Gas exchange between systemic capillary & tissue By diffusion

Inspiration Air flows from atmosphere to alveoli Air pressure inside lung is less than the atmosphere Active procces

Muscle contraction : m. intercostalis external & diafragma

Expiration Air flows from alveoli to atmosphere Air pressure inside lung is higher than the atmosphere Passive procces Ventilation Alternating pressure difference Boyles Law

Pressure of gas is inversely proportional to its volume Pressure in alveoli is directly proportional to surface tension & inversely proportional to radius of alveoli

Laplaces Law

Factors affecting pulmonary ventilation Compliance of the lungs


Abbility to expand 100 x more distensible than balloon Related to the low surface tension & high elasticity Decreased : Scar lung tissue Pulmonary oedem Increased surface tension Impede lung expansion (paralysis) Increased : Emphysematous lung Increased airway resistance disturb air flows Increased : Mucus production Bronchoconstriction

Airway resistance

Surface tension of alveolar fluid


Force exerted by fluid in alveoli to resist distension H20 molecules at the surface are attracted to other H20 molecules by attractive forces Force is directed inward, raising pressure in alveoli Alveoli has alveolar type II cells which produce phospholipid (surfactant) that decrease surface tension

Elasticity
Lung is very elastic & ressist of distension Abbility to return to initial size after distension High content of elastin protein

Component Intrapulmonary pressure Intrapleural pressure Transpulmonary pressure

Pressure changes Inspiration


Intrapulmonary pressure changes from 0 to -3 mmHg Intrapleural changes from -4 to -6 mmHg Transpulmonary pressure = + 3 mmHg Intrapulmonary pressure changes from -3 to +3 mmHg Intrapleural changes from -6 to -3 mmHg Transpulmonary pressure = + 6 mmHg

Ekspiration

GAS EXCHANGE
Passive diffusion as transport mechanism Daltons Law Each gas in a mixture of gases exerts its own pressure called partial pressure Henrys Law Quantity of gas that will dissolve is proportional to its partial pressure & solubility in water

Partial pressure PATM (760 mm Hg) = PN2

+ P02 + PC02 + PH20 + P other gases

At normal PO2

arterial blood = 100 mm Hg PO2 level in the systemic veins is = 40 mm Hg; PC02 = 46 mm Hg Provides a good index of lung function

Rate of blood flow through the pulmonary

circulation = flow rate through the systemic circulation Pulmonary resistance is low Autoregulation

Pulmonary arterioles constrict when alveolar PO2 decreases Bronchioles dilate when alveolar PCO2 decrease Matches ventilation/perfusion ratio

Ventilation/perfusion

rate

Alveoli at apex are underperfused (overventilated) Alveoli at the base are underventilated (overperfused)

The rate of gas exchange depends on Partial pressure difference of the gases Surface area available for gas exchange Diffusion distance
Alveolar wall Epithelial basement membrane Capillary basement membran Capillary endothelium

Molecular weight and solubility of gases


O2 has lower molecular weight than C02 (diffusion rate 1,2 x faster) C02 has greater solubility than O2 (diffusion rate 24 x faster) C02 diffusion occurs 20 more rapidly than O2

TRANSPORT OF OXYGEN & CARBONDIOXIDE


Hemoglobin as main

transporter RBC has 280 million Hb Hb has 4 polypeptide chains & 4 hemes Heme has 1 atom iron that combine 1 molecule oxygen Methemoglobin

Lacks of electrons & cant bind oxygen

Carboxyhemoglobin Bind with CO Stronger affinity to CO than Oxygen (210x)

Loading depends on PO of environment. Affinity between hemoglobin and 02


2

Factors affecting affinity pH DPG Temperature PCO2

Erithrocyte 1,3 bifosfogliserat bifosfogliserat mutase 2,3 bifosfogliserat 2,3 bifosfogliserat fosfatase 3 fosfogliserat 2,3 bifosfogliserat (DPG) decrease affinity of Hb to O2 that can be used by cell/tissue

Bohr Effect

C02 transportation Dissolved C02 Carbaminohemoglobin HCO3-

H20 + C02

H2C03

H+ + HC03-

At the tissues, C02 diffuses into the RBC; shifts the reaction to the right At the alveoli, C02 diffuses into the alveoli; reaction shifts to the left

RESPIRATION CONTROL
Respiratory center DRG
Control diaphragm & external intercostal Function in every respiratory cycle

VRG
Control accessory respiratory muscle Function only during forced breathing

Interaction of inspiratory & expiratory neuron

Apneustic & Pneumotaxic Center Adjust the output of respiratory center Regulate depth & rate of respiration Apneustic
Stimulation to DRG Promotes inspiration by activating I neuron Respiration become slow & deep

Pneumotaxic
Inhibit apneustic activity Promote active or passive exhalation Respiration become fast & shallow

DRG active Inspiratory muscle contract Inspiration occur

DRG & I VRG active E VRG inhibited Inspiratory muscle contract Expiratory muscle relax Inspiration occur

DRG inactive Inspiratory muscle relax Passive expiration occur DRG active Expiration occur E VRG active DRG & I VRG inhibited Inspiratory muscle relax Expiratory muscle contract

CHEMORECEPTOR REFLEX
Chemoreceptor

Carotid & aortic bodies Stimulated by decrease in pH or PO2 & indirectly by PCO2 Ventrolateral surface of medulla oblongata Stimulated by decrease in pH & PCO2

Hypercapnea Stimulation chemoreceptor Stimulation DRG Increased respiratory rate Increased elimination CO2 Decrease PCO2 Bact to normal

Hypocapnea Decreased PCO2 Inhibition arterial chemoreceptor Reduced stimulation of CNS chemoreceptor Reduced stimulation of DRG Decrease respiratory rate Decrease elimination PCO2 Increased arterial PCO2 (normal)

Regulasi pusat pernafasan

Regulasi korteks serebri Stimulasi proprioseptor Refleks Hering-Breuer

Inflasi Deflasi

Refleks lainnya
Stimulasi sistem limbik Suhu Nyeri Peregangan otot sfinkter ani Iritasi saluran nafas Tekanan darah

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