Mechanism of Breathing

HERBERT IZO NINSIIMA

Mechanical Factors in Breathing
Patmos
• Air flows from region of
Patmos = Palv
high pressure to region
Palv No air flow
of low pressure
Patmos – Flow = (P1 – P2)/R
– 1/R = k
Patmos > Palv
Palv – Flow = k(P1 – P2)
Inspiration

Patmos

Patmos < Palv

Palv
Expiration

Mar 24, 2024 Respiratory Movements 2

Mechanical Factors in Breathing
Patmos
• Two ways of producing
Patmos = Palv
the necessary pressure
Palv No air flow differences
Patmos
• Alveolar pressure can
be lowered below
Patmos > Palv atmospheric pressure
Palv
Inspiration
– Natural negative
Patmos
pressure breathing

Patmos < Palv

Palv
Expiration

Mar 24, 2024 Respiratory Movements 3

Mechanical Factors in Breathing
Patmos
• Atmospheric pressure
Patmos = Palv
can be increased above
Palv No air flow
alveolar pressure
Patmos – Positive pressure
breathing
Patmos > Palv
Palv
Inspiration

Patmos

Patmos < Palv

Palv
Expiration

Mar 24, 2024 Respiratory Movements 4

 Natural Breathing
• Accomplished by
– Active contraction of
inspiratory muscles
• Thoracic volume
increases
• Intrathoracic pressure
decreases
Increase in thoracic volume – Pulls on the lungs
decrease intrathoracic • Enlarges the alveoli
pressure

Mar 24, 2024 Respiratory Movements 5

 Natural Breathing
• Expands alveolar gas
– Decreases its pressure
below atmospheric
pressure
– Air at atmospheric
pressure
• Flows into lungs

Increase in thoracic volume

decrease intrathoracic
pressure

Mar 24, 2024 Respiratory Movements 6

 Respiratory Muscles
• Inspiratory muscles
– Diaphragm,external intercostals
– Others
• Scaleni, sternocleidomastoid, pectoralis minor
• Expiratory muscles
– Internal intercostals
– Abdominal recti

Mar 24, 2024 Respiratory Movements 7

 Respiratory Muscles
• Have no inherent rhythm
– Do not contract if they do not receive motor
impulses
• Motor impulses originate from
– Higher centers, respiratory centers, spinal
cord

Mar 24, 2024 Respiratory Movements 8

 Muscles of Inspiration
• Diaphragm
– Most important muscle of
inspiration
– In quite breathing
• May be the only active
Diaphragm inspiratory muscle
– Its motor nerve leaves the
spinal cord C3,4,5
Abdominal
content

Mar 24, 2024 Respiratory Movements 9

 Muscles of Inspiration
• When the diaphragm
move down
– Abdominal contents are
forced downward
– Increase the vertical
Diaphragm dimension of the thorax

Abdominal
content

Mar 24, 2024 Respiratory Movements 10

 Muscles of Inspiration
• In quite breathing
– Diaphragm moves
down by about 10mm
(1 cm)
• In forceful inspiration
Diaphragm
– It can move down by
10 cm
Abdominal
content

Mar 24, 2024 Respiratory Movements 11

 Muscles of Inspiration
• The area of the
diaphragm
– About 250 cm2
• During normal tidal
breathing
Diaphragm
– It increases the thoracic
volume by
• 250 x 1 = 250 cm3
Abdominal
content

Mar 24, 2024 Respiratory Movements 12

 Muscles of Inspiration
• During forceful
inspiration
– It increases the thoracic
volume by
• 250 x 10 = 2500 cm3
Diaphragm

Abdominal
content

Mar 24, 2024 Respiratory Movements 13

 Muscles of Inspiration
External • External intercostals
intercostals
Lift sternum
– Connect adjacent ribs
upwards and • Slope downwards & forwards
forwards
– When they contract
AP diameter
• Ribs are lifted upwards
• Causing an increase in AP
Diaphragm diameter
• “Pump handle”

Abdominal
content

Mar 24, 2024 Respiratory Movements 14

 Muscles of Inspiration
– When the external
intercostals contract
• Ribs are lifted upwards
• In addition they are also moved
outwards
• “Bucket handle” effect
• This increases the transverse
diameter

(From Hassen Taha Sherrif )

Textbook of Physiology CD
Mar 24, 2024 Respiratory Movements 15
Mar 24, 2024 Respiratory Movements 16
 Overall Effects
• Inspiratory muscles
– Increase the thoracic volume
– Increase lung volumes
– Decrease in intrapulmonary
pressure
• Cause influx of air
– From region of high pressure
– To region of low pressure
From Textbook of Work Physiology by
Astrand, Rodahl, Dahl & Stromme

Mar 24, 2024 Respiratory Movements 17

 Expiration
• During quite breathing
– Expiration is Passive
• After inspiratory muscles relax
• Elastic recoil of lungs and chest wall
– Cause movement of air from lungs to atmosphere

Mar 24, 2024 Respiratory Movements 18

 Expiration
• During exercise
– Expiration is by active process
• Contraction of expiratory muscles
• Internal intercostal muscles
– Assist active expiration by
• Pulling ribs downwards and inwards

Mar 24, 2024 Respiratory Movements 19

 Mechanics of Breathing

From: Exercise Physiology

by McArdle, Katch & Katch

Mar 24, 2024 Respiratory Movements 20

 Pressure Changes in the Lungs
and Thorax
• Lungs are separated
from the rib cage by
– Parietal & visceral
pleura
• Between these there
is
– Pleural fluid
– Lubricant film 20 m
thick

Mar 24, 2024 Respiratory Movements 21

 Pressure Changes in the Lungs
and Thorax
• The thoracic cage
– Has a tendency to
expand
• The lungs
– Have a tendency to
collapse
• Held together by the
action of pleural fluid

Mar 24, 2024 Respiratory Movements 22

 Pressure Changes in the Lungs
and Thorax
• Intrathoracic (intra pleural)
pressure
– Normally = -5 mm Hg
• At the end of expiration
during quiet breathing
• During inspiration it is = -8
to –10 mm Hg
– It is a measure of elastic
recoil of the stretched
lungs and the compressed
thoracic cage

Mar 24, 2024 Respiratory Movements 23

 Pressure Changes in the Lungs
and Thorax
• Alveolar pressure
P atmos
– Pressure of the air inside
the lung alveoli
– When glottis is open & no
air flowing into or out of the
lung
P alv • This pressure is equal to
atmospheric pressure

Alveolus

P alv = P atmos

Mar 24, 2024 Respiratory Movements 24

 Pressure Changes in the Lungs
and Thorax
• To cause inward flow of air
P atmos
into alveoli during
inspiration
– Pressure falls to values
below atmospheric (-1 cm of
water)
P alv • This is enough to cause 0.5
liters of air move into lungs

Alveolus

P alv < P atmos

Mar 24, 2024 Respiratory Movements 25

 Pressure Changes in the Lungs
and Thorax
• During expiration
P atmos
– Alveolar pressure
increases (+1 cm of
water)
• Enough to cause
movement of 0.5 liters of
air out of the lung
P alv

Alveolus

P alv > P atmos

Mar 24, 2024 Respiratory Movements 26

 Pressure Changes in the Lungs
and Thorax
Inspiration Expiration • Trans-pulmonary pressure
Alveolar
pressure – Pressure difference between
+2 alveolar pressure and pleural
pressure
0 – It is a measure of elastic forces
Trans-
pulmonary in the lungs that tend to
-2 pressure collapse the lungs
-4 • Recoil pressure

-6
Pleural
pressure
-8

Mar 24, 2024 Respiratory Movements 27

 Elastic Resistance
• Lung tissue is elastic
Vol of lung
– Natural un-stretched
volume
1 lt
• Elastic element neither
stretched nor
compressed
2.5 lt • Is 1 liter

5 lt Thoracic
cavity &
lung

Thorax

Mar 24, 2024 Respiratory Movements 29

 Elastic Resistance
• Human lung at the end
Vol of lung
of expiration
– Volume = 2.5 liters
1 lt
• Thus the elastic tissue
is always under tension
2.5 lt – Tends to oppose
expansion of the lungs
5 lt Thoracic
cavity &
lung

Thorax

Mar 24, 2024 Respiratory Movements 30

 Elastic Resistance
• The natural un-stretched
Vol of lung
thorax volume is 5 liters
1 lt • At end of expiration
– Volume of thorax is 2.5
liters
2.5 lt
• The elastic tissues of
thorax are compressed
5 lt Thoracic
cavity &
lung

Thorax

Mar 24, 2024 Respiratory Movements 31

 Elastic Resistance
• Thus
Vol of lung
– Lungs tend to contract
1 lt
– Thorax tends to
expand
• The lungs and thorax
2.5 lt – Held together by the
integrity of the pleural
Thoracic
cavity
5 lt
cavity &
lung

Thorax

Mar 24, 2024 Respiratory Movements 32

 Elastic Resistance
Vol of lung
• If a gas is introduced
in the pleural space
1 lt – Chest volume tends to
expand
– Lung volume tend to
2.5 lt
decrease (collapse of
the lungs)
5 lt Thoracic
cavity &
lung

Thorax

Mar 24, 2024 Respiratory Movements 33

 Compliance
• Compliance
Increased – Measure of the ability of the
compliance
lung or chest cavity to be
expanded
ΔP
• The degree to which
– The lung volume can be
Volume in ml

ΔV
changed
decreased – By imposed intrapulmonary
compliance pressure

Pressure cm H2O

Mar 24, 2024 Respiratory Movements 34

 Compliance
• Compliance
Increased – Change in volume
compliance (liters)/change in pressure
(cm H2O)
• Compliance of
ΔP – Adult male = 0.09 to 0.26 L/
cm H2O
Volume in ml

ΔV
– Newborn = 0.005 l/cm H2O
decreased
compliance – At 10 yrs = 0.06 L/ cm H2O
– Old age = ↓ compliance

Pressure cm H2O

Mar 24, 2024 Respiratory Movements 35

 The Airways Resistance
• Resistance offered to air
as it flows through the
respiratory airways
• Flow = (P1-P2)/R
– Vol of air that flow in/out
of alveolar
• Directly proportional to
pressure gradient
• Indirectly proportional to
resistance

From: Nunn’s Applied

Respiratory physiology; 5th Ed

Mar 24, 2024 Respiratory Movements 36

 The Airways Resistance
• Airway resistance
– Frictional resistant
offered by the walls of
tracheobronchial tree
– This is note evenly
distributed

From: Nunn’s Applied

Respiratory physiology; 5th Ed

Mar 24, 2024 Respiratory Movements 37

 The Airways Resistance
• During quiet breathing
with mouth closed
– Nose offers 50% of total
resistance
• During mouth breathing
– Pharynx offers 25% of
overall resistance
• This figure can increase
up to 50% during exercise

From: Nunn’s Applied

Respiratory physiology; 5th Ed

Mar 24, 2024 Respiratory Movements 38

 Airway Resistance
• Within the chest
Airway resistance VS airway generations
– Trachea, lobar &
0.08 segmental bronchi
offer 80% of the
Airway resist (cm H2O/L/S)

0.06 remaining resistance

– Small airways with
0.04 Segmental
bronchi Terminal diameter less than
bronchi
0.02
2mm contribute 20%

5 10 15 20
Airway generations

Mar 24, 2024 Respiratory Movements 39

 Airway Resistance
• Cross section of
Airway resistance VS airway generations
individual peripheral
0.08
airways are small
– Their large numbers
Airway resist (cm H2O/L/S)

0.06 • Generate large overall cross

section area
0.04
• Lowers the resistance
Segmental
bronchi Terminal
bronchi
0.02

5 10 15 20
Airway generations

Mar 24, 2024 Respiratory Movements 40

 Determinants of Airway
Resistance
Airway resistance VS lung volumes
• Lung volumes
• Greater tethering effect
4 of lung parenchyma on
airways
Airway resist (cm H2O/L/S)

3
– Produce an increase in
2
cross section area of
each airway
1 – Results in reduced
resistance

2 4 6 8
Lung volumes (L)

Mar 24, 2024 Respiratory Movements 41

 Determinants of Airway
Resistance
• Others
– Resistance is proportional to
• Length of airway
• Physical properties of the gas
– Density, viscosity
– Resistance is inversely proportional to
• 4th power of radius of the airway

Mar 24, 2024 Respiratory Movements 42

 Determinants of Airway
Resistance
– Under normal condition
• Airways diameter “large”
• Interaction between gas molecules negligible
• Length of conducting tube relatively constant
– Resistance is largely controlled by radius
– Bronchial tree contain smooth muscle
• Under the influence of autonomic nerves
– Parasympathetic
– Sympathetic

Mar 24, 2024 Respiratory Movements 43

 Determinants of Airway
Resistance
• Parasympathetic activity causes
– Constriction of smooth muscles
• Reduction in cross section of airways
• Increased resistance
– Increased secretion of mucous glands
• Sympathetic activity
– Bronchodilatation
– Inhibition of mucous glad secretion
– Reduction in resistance

Mar 24, 2024 Respiratory Movements 44

 Airway Resistance
• Certain disease condition
– Increase airway resistance
• Asthma
– Contraction of bronchial smooth muscles
– Narrowing of airways
– Increased airway resistance

Mar 24, 2024 Respiratory Movements 45

 Airway Resistance
• Chronic bronchitis
– Oedema of bronchial mucosa
• Excessive secretion by bronchial mucosa
• Increase airway resistance
• Intramural masses
– Bronchogenic carcinoma
– Occlude airways

Mar 24, 2024 Respiratory Movements 46

 The Work of Breathing
• Breathing involves
– Application of force over distance
• Work is performed by respiratory muscles
– Stretching elastic tissues of chest wall & lungs
• Elastic work, compliance work
– Moving inelastic tissue (viscous resistance)
• Tissue resistance work

Mar 24, 2024 Respiratory Movements 47

 Work of Breathing
• Work involved in moving air through the
respiratory passages
– To overcome airway resistance
• Normally negligible
• But can be marked
– With increase in ventilation (turbulence)
– In asthma

Mar 24, 2024 Respiratory Movements 48