Lecture 2: Mechanics Of Respiration Flashcards
What are the 4 goals of the respiratory system?
- Distribute air and blood flow for gas exchange
- Provide oxygen to cells in body tissues
- Remove carbon dioxide from body
- Maintain constant homeostasis for metabolic needs
What are the four functional events of respiration?
- Mechanics of pulmonary ventilation
- Diffusion of O2 and CO2 between alveoli and blood
- Transport of O2 and CO2 to and from tissues
- Regulation of ventilation and respiration
What is EXTERNAL respiration?
- Mechanics of breathing
- Movement of gases into and out of body
- Gas transfer from lungs to tissues of body
- Maintain body cellular homeostasis
What is INTERNAL respiration?
- Intracellular oxygen metabolism
- Cellular transformation
- Krebs cycle—aerobic ATP generation
- Mitochondria and O2 utilization
What is the main purpose of ventilation?
To maintain an optimal composition of alveolar gas
Alveolar gas acts as a ___ ___ ___ between the ___ and ___.
- stabilizing buffer compartment
- between the environment and pulmonary capillary blood
How does alveolar gas act as a stabilizing buffer compartment? (3 things)
- Oxygen is constantly removed from alveolar gas by blood
- Carbon dioxide continuously added to alveoli from blood
- O2 replenished and CO2 removed by process of ventilation, by simple diffusion
What provides the stable alveolar environment?
The two ventilation phases—inspiration and expiration
Breathing is the act of ___
Creating inflow and outflow of air between the atmosphere and the lung alveoli
How much does the lung weigh?
- 1.5% of body weight
- 1 kg in 70 kg adult
Alveolar tissue is ___ of lung weight
60%
Alveoli have ___
Very large surface area—40x the external body surface area
___ diffusion pathway for gases
Short
What does the short diffusion pathway for gases permit?
Permits rapid and efficient gas exchange into blood—only 1.5 micrometers between the air and alveolar capillary RBC (very thin layer)
What is the blood volume in the lung?
500 mL (10% of total blood volume)
Respiratory muscles generate ___ to inflate and deflate the lungs
Force
What are two things that impede ventilation?
Tissue elastance and resistance
What are two other factors that alter lung volumes?
- Distribution of air movement within the lung, resistance within the airway
- Overcoming surface tension within alveoli
Air flow requires ___
A pressure gradient
Air flows from ___ to ___ pressures
High to low
During inspiration, alveolar pressure is ___
Sub-atmospheric, allowing air flow into the lungs
During expiration, alveolar pressure is ___
Higher than atmospheric pressure, allowing airflow out of the lungs
What generates changes in alveolar pressure?
Changes in pleural pressure
Inspiration is the ___ phase of the breathing cycle
ACTIVE phase
What nerves transmit motor stimulation to the diaphragm?
Phrenic nerve—C3, 4, 5
What nerves send signals to the external intercostal muscles?
Intercostal nerves T1-T11
Describe what happens during inhalation (4 main things)
- Thoracic cavity expands to lower pressure (to sub-atmospheric) in pleural space surrounding the lungs
- Pressure in alveolar ducts/alveoli decreases
- Fresh air flows through conducting airways into terminal air spaces until pressures are equalized
- Lungs expand passively as pleural pressure falls
The act of inhaling is ___
Negative-pressure ventilation
What is the most important muscle of inspiration?
Diaphragm
The diaphragm is responsible for ___ of inspiratory effort
75%
What is the diaphragm?
Thin, dome-shaped muscle attached to the lower ribs, xiphoid process, lumbar vertebra
What is the diaphragm innervated by?
Phrenic nerve—C3, 4, 5
During contraction of diaphragm—abdominal contents are forced ___
Downward and forward, causing an increase in vertical dimension of chest cavity
During contraction of diaphragm—rib margins are ___
Lifted and moved outward, causing increase in the transverse diameter of the thorax
How much does the diaphragm move down during normal inspiration?
1 cm
How much does the diaphragm move down during forced inspiration?
10 cm
What happens to the diaphragm when paralyzed?
- Paradoxical movement
- Upward movement with inspiratory drop of intrathoracic pressure
- Occurs when the diaphragm muscle is denervated (paralyzed)
What is transdiaphragmatic pressure?
When the effect of abdominal pressure on the chest wall mechanics is transmitted across the diaphragm
In supine position, abdominal pressure equals ___
Atmospheric pressure (when respiratory muscles are relaxed)
What happens to the diaphragm when abdominal pressure is increased?
The diaphragm is pushed cephalad (towards the head) into the thoracic cavity, decreasing functional residual capacity (FRC)
FRC is reduced by…
Increased intra-abdominal pressure situations
Examples: pregnancy, obesity, bowel obstruction, laparoscopic surgery, ascites, abdominal mass, hepatomegaly, trendelenburg position, valsalva maneuver
What are 3 positions that can decrease abdominal pressure and allow easier lung ventilation?
- Upright
- Reverse trendelenburg
- Prone position
What do the external intercostal muscles connect to?
Adjacent ribs
EIM are responsible for ___ of inspiratory effort
25%—diaphragm is responsible for 75%
Where do the nerves that innervate the intercostal muscles (intercostal nerves) originate?
Motor neurons to the EIM originate in the respiratory centers of the brainstem and travel down the spinal cord
Where do the intercostal nerves originate?
T1-T11
-The nerves pass under each rib along with the intercostal veins and arteries
Contraction of the EIM pulls the ribs ___
Upward and forward—ribs move outward in “bucket-handle” fashion
What happens to the diameters of the thorax when the EIMs contract?
Thorax diameters increase in both lateral and anteroposterior directions
What nerves innervate the EIMs?
Intercostal nerves
What happens with paralysis of the EIMs?
Inspiration is not seriously altered because the diaphragm is so effective
-Sensation of inhalation is decreased (i.e.: may see this in pregnant women under spinal anesthesia)
What do the accessory muscles of inspiration do?
They assist with forced inspiration during periods of stress or exercise
Scalene muscle
- Attaches cervical spine to apical rib
- Elevates the first two ribs during forced inspiration
Sternocleidomastoid muscle
- Attaches base of the skull (mastoid process) to top of sternum and clavicle medically
- Raises the sternum during forced inspiration
What are two accessory muscles of inspiration?
- Scalene muscle
- Sternocleidomastoid muscle
Expiration is the ___ phase of the breathing cycle
PASSIVE phase
During expiration—chest muscles and diaphragm ___
Relax
During expiration—pleural and alveolar pressures…
Rise
During expiration, gas flows ___
Passively out of the lung
Expiration is active during ___ and ___
Hyperventilation and exercise
What does active expiration require?
Abdominal and internal intercostal muscle contraction
What are 3 different muscles of active expiration?
- Rectus abdominis
- Abdominal oblique muscles
- Internal intercostal muscles
Rectus abdominis/abdominal oblique muscles (function)
- Contraction raises intra-abdominal pressure to move diaphragm upward
- Intra-thoracic pressure raises and forces air out from lung
How do the internal intercostal muscles assist with active expiration?
- Pull the ribs downward and inward
- Decrease thoracic volume
- Stiffen intercostal spaces to prevent outward bulging during straining
The muscles of active expiration also contract forcefully during ___, ___, and ___
- coughing
- vomiting
- defecation
What is transpulmonary pressure?
-The pressure difference between the alveolar pressure and pleural pressure on the outside of the lungs
What happens to the alveoli when the pleural pressure attempts to pull outward?
Alveoli tend to collapse together
What is recoil pressure?
The elastic forces which tend to collapse the lung during respiration
What are two parts of the pleural membrane?
- Visceral pleura
- Parietal pleura