Respiratory Mechanisms Flashcards
Tidal Volume
Volume of air inspired or expired with each normal breath
Inspiratory Reserve Volume (IRV)
Volume that can be inspired over and above tidal volume
Used during exercise
Expiratory Reserve Volume
Volume that can be expired after the expiration of tidal volume
Residual Volume
Volume that remains after maximal expiration
Cannot be measured by spirometry
Inspiratory Capacity
The sum of tidal volume and inspiratory reserve volume
Functional Residual Capacity (FRC)
Sum of ERV and residual volume
Volume remaining in the lungs after tidal volume expiration
Includes residual volume so cannot be measured with spirometry
Vital Capacity or Forced Vital Capacity (FVC)
- Sum of tidal volume, ERV, and IRV
- Volume of air that can be forcefully expired after a maximal inspiration
Total Lung Capacity
- Sum of all 4 lung volumes
- Volume of air in the lung after maximal inspiration
- Includes residual volume so cannot be measured with spirometry
Define the mechanisms that determine the clinically important boundaries of lung volume (TLC, FRC, & RV).
- TLC: volume where static balance b/t maximal inspiratory force that can be generated by respiratory muscles and the expiratory force generated by the inward directed elastic recoils of the lung and chest wall
- FRC: volume at which the elastic recoil of the lung and chest wall are equal but opposite
- RV: volume where static balance achieved b/t max expiratory force that can be generated by respiratory muscles and the force generated by outward-directed elastic recoils of the lung and chest wall
Forced Expired Volume (FEV1)
- Volume of air that can be expired in the 1st second of forced maximal expiration
- FEV1 is normal 80% of FVC: FEV1/FVC=0.8
- In obstructive lung disease, such as asthma, FEV1is reduced more than FVC, so that overall ratio decreases
- In restrictive lung disease, such as fibrosis, FEV1 and FVC are reduced such that the ratio is either normal or increased
Surface Tension of the Alveoli
-Results from attractive forces between liquid molecules lining the alveoli
-Creates a collapsing pressure (LaPlace Law)
-Directly proportional to the surface tension
-Inversely proportional to alveolar radius
P=2T/r
-Large alveoli: low collapsing pressure and easy to keep open
-Small alveoli: high collapsing pressure & hard to keep open
-In the absence of surfactant, small alveoli have a tendency to collapse (atalectasis)
Surfactant
- Lines the alveoli and is synthesized by type 2 alveolar cells
- Reduces surface tension by disrupting intermolecular forces between water molecules
- Prevents small alveoli from collapsing
- increases compliance
- Consists of dipalmitoyl phosphatidylcholine
- Fetal surfactant production by week 35
- Sign of mature lungs: lectin:sphingomyelin ratio >2:1
- Neonatal respiratory distress syndrome can occur due to lack of surfactant
- atelectasis, difficulty re inflating, and hypoxemia
Causes and characteristics of obstructive lung disease (Emphysema) including the abnormalities in lung volumes
- tissue is distensible
- increased compliance
- But it is difficult to expel air from the alveoli
- Increased chest wall elastic recoil
- Decrease in lung elastic recoil due to degradation
- Barrel chested
- Increased TLC
Causes and characteristics of restrictive lung disease (Fibrosis), including the abnormalities in lung volumes are
- tissue is stiff
- increased elastic recoil
- Lung collapses and it is difficult to force air into the alveoli
- Decreased TLC
Define compliance (lung and chest wall)
C=V/P where compliance=volume/pressure
-Is the change in volume for a given change in pressure
-Pressure refers to transpulmonary pressure: the pressure difference across pulmonary structures
-Describes distensibility of the lung and chest wall
-Inversely related to elastance (amount of elastic tissue)
-Inversely related to stiffness
-Is the slope in the pressure volume loop
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