TOPIC: TUBERCULOSIS

OBJECTIVE:
 To explain alveolar and pulmonary ventilation with special
mention of the ventilation perfusion ratio.
PULMONARY VENTILATION

 Pulmonary ventilation, is the volume of air moving in and

out of the respiratory tract in a given unit of time during
quiet breathing.

 Pulmonary ventilation = Tidal volume x Respiratory rate

= 500 x 12 = 6 L
 ALVEOLAR VENTILATION
 Alveolar ventilation is defined as the total volume of new air entering
the alveoli and adjacent gas exchange areas per minute.

 It is equal to the respiratory rate times the amount of new air that
enters these areas with each breath.

 Alveolar ventilation = (Tidal volume – Dead space)X Respiratory rate

= (500-150) X 12 = 4.2 L/min
VENTILATION PERFUSION RATIO
 Ventilation perfusion is the concept which help us understand
the respiratory exchange when there is imbalance between
alveolar ventilation and alveolar blood flow.

 It is denoted as VA /Q where VA is the alveolar ventilation and Q

is the perfusion.

 The normal value of VA /Q is 0.84

 VA /Q IS BELOW NORMAL
 When the VA /Q rate is below normal it denotes the the
inadequate ventilation.

 A certain fraction of the venous blood passing through the

pulmonary capillaries is not oxygenated. This fraction is called
shunted blood.

 Physiological shunt is usually seen in the bottom of the lungs.

Here VA /Q = 0.6
 VA /Q IS ABOVE NORMAL
 When the VA /Q is above normal there is greater ventilation
but low blood flow i.e. there is far more oxygen in the alveoli
than that can be transported away by blood.

 The ventilation of these alveoli are said to be wasted like that

of the anatomical dead spaces.

 Physiologic dead spaces are seen in the apex of the lungs

where there is a decrease in ventilation as well as perfusion but
the reduction in perfusion is much greater.
REFERENCE
 Textbook of Medical Physiology , Guyton and Hall,13th
edition