The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory...
Transcript of The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory...
![Page 1: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/1.jpg)
The respiratory system
Practical 1
Objectives
Respiration, ventilation
Intrapleural and intrapulmonary pressure
Mechanism of inspiration and expiration
Composition of the atmosphere and the expired air
Practical tasks
1. Hering´s model of the respiratory system
2. Paralellogram
3. Measurement of the vital capacity
4. Analysis of respiratory gases in exhaled air
5. Measurement of the expiratory peak flow with a peak
flow meter Vitalograph
© Katarína Babinská MD, PhD, MSc, 2017
![Page 2: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/2.jpg)
Respiration – vital function
![Page 3: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/3.jpg)
Respiration - exchange of the respiratory gasses
- the principal function of the respiratory system
supplying of O2 from atmospheric air for metabolism
removing excess CO2 (metabolic end-product) from the body
external respiration: exchange of gases between atmosphere and alveoli
internal respiration: exchange of gases between blood and cells of the body
cellular respiration – utilization of O2/ production of CO2 in the cell metabolism
atmosphere cells
![Page 4: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/4.jpg)
- a rhythmic, automatic process (breathing cycle)
• inspiration
• air moves from the atmosphere into the lungs
• tidal volume VT – 500 ml (quiet breathing)
• expiration
• the same volume moves from the lungs into
the atmosphere
• external signs of breathing – movements of the
chest and abdomen
Inspiration and expiration
- the air flow into and out of the lungs is driven by the pressure differences
between the lungs and the atmosphere
Ventilation (Breathing)
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 5: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/5.jpg)
Atmospheric pressureatmosphere
the atmosphere (mass of air) exerts pressure
- at seal level approx: 100 kPa (1 atm, 760 mm Hg)
the atmospheric pressure is lower in higher altitudes
- lower density of the air
- thinner layer of the atmosphere
in physiology, pressures in the body
are related the atmosperic pressure
e.g. if pressure in the lungs= 0,1 kPa,
it means, it is by +0,1 kPa higher than
atmospheric pressure
https://i.ytimg.com/vi/O37XuRkS5UE/hqdefault.jpg
![Page 6: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/6.jpg)
• lungs – lined with a thin membrane
pleura visceralis
• the internal side of the chest is lined with
pleura parietalis
• between both membranes is a thin space
- (intra)pleural space
• the space is filled with small volume of liquid
that surrounds the lungs
© Katarína Babinská, MD, PhD. MSc., 2010
Pleura, (intra)pleural space
![Page 7: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/7.jpg)
Intrapleural pressure - the pressure(of the liquid) in intrapleural space
lungs - exert an elastic recoil directed inwards
thorax - exerts an elastic recoil directed outwards
due to elastic recoil of the lungs and the
chest the pressure in intrapleural space
is lower than the pressure in
atmosphere (= it is subatmospheric)
by – 0,5 to –1,0 kPa in quiet breathing
The negative pressure
prevents the lung to collapse
is effective in inspiration and expiration
intrapleural space –
negative pressure
© Katarína Babinská, MD, PhD. MSc., 2010
visceral
pleura
parietal
pleura
![Page 8: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/8.jpg)
Intrapulmonary (alveolar) pressure
- pressure inside the lungs (i.e. in the lung alveoli)
- when the glottis is open and no air flows into/out of the respiratory
passageways, the pressures in all parts of the respiratory tree are equal to
the atmospheric pressure
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 9: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/9.jpg)
Physical laws in respiration
if two containers filled with air that differ in pressure
are connected, the air moves from the container
with higher pressure into the container with lower
pressure
pressure and volume of air within a closed
system is constant
i.e. if the volume increases, the pressure
decreases and vice versaV
p
V
p
P1 p2
P1 > p2
Boyle's law
Dalton's law
![Page 10: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/10.jpg)
Forceful breathing
- e.g. in stress, physical activity
Quiet breathing
- in rest
![Page 11: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/11.jpg)
1. Contraction of the inspiratory
muscles
= an active process
A. diaphragm – the main inspiratory muscle
- quiet breathing – by contraction it descends by 1-1,5 cm
- in forceful breathing – by a stronger contraction it descends by 6 -10 cm,
B. external intercostal muscles
- pull ribs up and out
- cause further increase in chest volume
C. accessory inspiratory muscles – active in forceful breathing
(m. sternocleidomastoideus, mm. scaleni, mm serrati ant.)
Before the inspiration Inspiration
Mechanism of inspiration
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 12: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/12.jpg)
2. increase in chest volume
- by 0,5 L in quiet breathing,
(forceful breathing by 2-3 L)
3. decrease of intrapleural pressure
- becomes more negative
- parietal pleura follows the chest
movement, thus volume of pleural cavity , intrapleural pressure
4. decrease in intrapulmonary pressure
- before inspiration: pressure in lungs = pressure in atmosphere
- the increased negativity of intrapleural space
„pulls the lungs outwards“ therefore, lung expand
- during lung expansion – alveolar pressure becomes than atmospheric
5. the air moves
- from the place with higher pressure (atmosphere)
- to the place with lower pressure (lung)
- until the pressures get equal (end of inspiration)
Before inspiration inspiration
© Katarína Babinská, MD, PhD. MSc., 2018
![Page 13: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/13.jpg)
Mechanism of expiration
a quiet expiration is passive
(i.e. it does not require
muscle contraction)
1. inspiratory muscles are relaxed
- the diaphragm moves upwards, ribs move downwards
(because of their elastic recoil)
2. chest size decreases
3. intrapleural pressure increases (less negative)
4. intrapulmonary pressure exceeds atmospheric pressure
5. air moves
- from the place with higher pressure (lung)
- to place with lower pressure (atmosphere)
- expiration is terminated when the pressures in lungs/atmosphere are equal
expiration
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 14: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/14.jpg)
Expiration
• in forceful breathing – active
(requires muscle contraction)
• involves:
Expiratory muscles- contraction
1. internal intercostal muscles
- move ribs downwards
- further decrease in thoracic volume
2. accessory expiratory muscles – abdominal muscles
expiration
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 15: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/15.jpg)
intrapleural space –
negative pressure
after exspiration / prior to next inspiration
- two recoil forces are in equilibrium( )
= relaxation position of the chest
- position whan the respiratory muscles
(inspiratory and expiratory) are relaxed
- optimum starting position for breathing –
least work of respiratory muscles
![Page 16: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/16.jpg)
Inspiration
- starting from relaxation position is active
- activity=contraction of inspiratory muscles
Expiration
- above relaxation position is passive (quiet expiration)
- relaxation of inspiratory muscles
Expiration
- starting from relaxation position is active (forced expiration)
- activity=contraction of expiratory muscles
Inspiration
- up to relaxation position is passive (forced breathing)
- relaxation of expiratory muscles
relaxation
position –
respiratory
muscles are
relaxed
![Page 17: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/17.jpg)
Non-relaxation positions
1. inspiratory position
- during inspiration, when inspiratory
muscles are contracted
2. expiratory position
- during forceful expiration when
expiratory muscles are contracted
- inspiratory and expiratory position are
a result of respiratory muscle activity
(contraction)
![Page 18: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/18.jpg)
Pressures in the respiratory system
Intrapleural pressure – quiet breathing
• beginning of inspiration: - 0,5 kPa
• beginning of expiration: - 1,0 kPa
Intrapleural pressure - forceful breathing
• end of inspiration – more negative values
• end of expiration – may be a positive
beginning beginning
of inspiration of expiration
0
-1
![Page 19: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/19.jpg)
Pressures in the respiratory system beginning beginning
of inspiration of expiration
0
-1
0
0,5
0
Intrapulmonary (alveolar) pressure
• inspiration – negative values
a) at the beginning of inspiration – chest expands, decrease of the intrapulmonary pressure
b) later during inspiration - air moves into the lungs – pressureprogressively increases (from negative values to zero value)
• expiration – positive values
c ) at the beginning of expiration – chest volume reduces, increase in the intrapulmonary pressure
d) later during expiration - air moves out of lungs – progressivedecrease pressure (from positive values to zero value)
Volume of air in the lungs
- increase during inspiration, decrease during expiration
inspiration exspiration
ab
c
d
![Page 20: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/20.jpg)
Inspiration
- starting from relaxation position is active
- activity=contraction of inspiratory muscles
Expiration
- above relaxation position is passive (quiet expiration)
- relaxation of inspiratory muscles
Expiration
- starting from relaxation position is active (forced expiration)
- activity=contraction of expiratory muscles
Inspiration
- up to relaxation position is passive (forced breathing)
- relaxation of expiratory muscles
relaxation
position
Relaxation position of the chest
- respiratory muscles (inspiratory and expiratory) are relaxed
-volume in the lungs = functional residual capacity (FRC=ERV+RV)
![Page 21: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/21.jpg)
Task 1. The Hering´s model of respiratory system
Hering´s model
a glass bell represents the chest, the bottom is made of rubber
and it imitates the diaphragm
shows the function of diaphragm in breathing
Principle
pull down or push up the bottom of
Hering´s model, observe and
explain changes in pleural space,
lung and vena cava
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 22: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/22.jpg)
Procedure
Diaphragm – pulling down („inspiration“)
volume of the thoracic cavity is increasing
pressure in the pleural space is decreasing
pressure in alveoli (lung) is decreasing from atmospheric level
air moves from the atmosphere into the lungs
v. cava expands
Diaphragm – pushing up („expiration“)
volume of the thoracic cavity is decreasing
pressure in the pleural space is increasing
pressure in alveoli is increasing – exceeds the atmospheric
pressure
air is moving from the lungs into the atmosphere
blood flow in v. cava is decreased
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 23: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/23.jpg)
Valsalva manoeuvre
a forcible expiration against closed airways (nose, mouth)
a major increase in pleural pressure (that may get even positive)
it helps to normalize the middle ear pressure
it is used in some clinical examinations
Műller´s manoeuvre
after a forced expiration an attempt of deep inspiration with closed
airways (nose, mouth)
a major decrease in pleural pressure
the manoeuvre is used in some clinical examinations of respiratory tract
Result and conclusion: describe the observation
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 24: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/24.jpg)
Pneumothorax
„a hole“ in the pleura
due to injury of chest wall, lung disease, etc.
the intrapleural cavity communicates with
the atmosphere
air enters the intrapleural space
an increase of the intrapleural pressure
lack of underpressure, that prevents the
collapse of lungs – the lung collapses
decreased effectiveness of breathing – the
lung fails to expand
![Page 25: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/25.jpg)
Task 2. Parallelogram – a model of intercostal muscles
Principle
imitate the contraction of mm. intercostales interni and externi
and observe movements of the ribs
sternum
ribs
backbone
miemii
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 26: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/26.jpg)
Procedure
Modelling the inspiratory movement
inspiration - contraction of m. intercostales externi
contract the rubber that is directed obliquely downward and medially
immitate both quiet and forceful inpiration
Modelling the expiratory movement
immitate both A/ quiet and B/ forceful expiration
A/ relaxation of the inspiratory muscles
B/ contraction of the m. intercostales interni (they are directed obliquely
downward and laterally)
Result and conclusion: describe the observation
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 27: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/27.jpg)
Task 3. Measurement of the vital capacity
© Katarína Babinská, MD, PhD. MSc., 2010
VC
vital capacity (VC)
- The volume of maximum forceful expiration that follows previous maximum inspiration
![Page 28: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/28.jpg)
Procedure
close the nose with a clamp
insert a disinfected mouthpiece into the rubber tube
make maximum inspiration
make maximum expiration – exhale into the
spirometer
a spirometer – a metal jar with a smaller jar inside
the internal jar is pushed up by the expired air
read the volume of the expired air on the scale
repeat the measurement of VC 3 times
calculate the average of your measurements
1000
2000
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 29: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/29.jpg)
Procedure
make the BTPS correction
VC BTPS= VC x BTPS factor (find in tables)
BTPS correction = recalculation for standard body conditions
temperature – 37 °C
barometric pressure – 101.3 kPa
water vapour saturation – 6.3 kPa
Calculate the normal value of vital capacity: VCphys
Men: VCphys = 5,76 x H – 0,026 x A - 4.34
Women: VCphys = 4,43 x H – 0,026 x A - 2.89
H = height in m A = age in years
is your VC BTPS in the range of 90 – 110 % of the VC phys?
% VC = VC(BTPS) x 100/VCphys
© Katarína Babinská, MD, PhD. MSc., 2010
![Page 30: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/30.jpg)
Respiratory passageways
A/ Conducting zone
upper respiratory tract (passageways)
nasal cavity, nasopharynx, larynx
lower respiratory tract
trachea, bronchi, bronchioles (most)
B/ Respiratory zone (gas exchange)
lower respiratory tract
respiratory bronchioles
alveolar ducts
alveolar saccules
alveoli
![Page 31: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/31.jpg)
2. alveolar dead space
- involves alveoli where no gas exchange takes place
- in a healthy human:
- all alveoli serve for gas exchange
- alveolar dead space 0
- in people with a lung disease - alveoli are malfunctioning
- alveolar dead space > 0 (e.g. in pneumonia, fibrosis)
- parts of respiratory passageways where no significant
gas exchange occurs between lungs and blood
1. anatomical dead space – approx 150 ml
= conductive part of airways
- function: the inspired air is heated, cleaned, moisturized
Physiological dead space = anatomical dead space + alveolar dead space
Dead space (VD)
- alveolar dead space
- pneumonia, x- ray exam
- lungs are blocked with
fluid and bacteria
![Page 32: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/32.jpg)
- the atmosphere exerts atmospheric pressure- pressure of individual gasses is proportional to their content (%)
partial pressure of a gas
= atmospheric pressure x percent of the gas
e.g. if the atmospheric pressure is 100 kPa
O2 content in atmosphere 21% partial pressure of O2 = 100 x 0,21=21 (kPa)
CO2 content in atmosph. 0,04 % partial pressure of CO2=100 x 0,0004=0,04 (kPa)
- gasses dissolved in fluids also exert partial pressures
Partial pressures of O2, CO2
- diffusion O2 and CO2 from lungs into blood is based on differences in pO2, pCO2
Composition of atmosphere (inspired air):
N2 78 %
O2 21 %
CO2 0,04 %
H2O vapour 0,5% (non constant component)
N2 O2
atmosphere
CO2
![Page 33: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/33.jpg)
inspiration(atmospheric air)
O2 21%
CO2 0,04%
expiration
O2 16,3%
CO2 3,8%
alveoli*
O2 14% 13,3 kPa
CO2 5,6% 5,3 kPa
pO2 5,3 kPa
pCO2 6,1 kPa
pO2 12,6 kPa
pCO2 5,3 kPa
the inspired air is mixed with the air
from previous expiration
the expired air is mixed with the air
from previous inspiration
* in alveoli O2 is
instantly diffusing into
blood and CO2 from
blood, therefore their
% differ from % in
inspired and expired
air
rection of
blood flow
![Page 34: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/34.jpg)
Task: Analysis of the respiratory gases
![Page 35: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/35.jpg)
Gas analyzer SPIROLYT
measures and records
concentration of O2
concentration of CO2
If atmospheric air is analysed: composition is constant straight (zero)
lines are recorded on a sheet of paper (blue for CO2, red for O2 )
Task: Into a sampler (balloon) collect a sample of expired air from
the beginning of expiration
the end of expiration
and analyze the O2 and CO2 content
O2CO2
![Page 36: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/36.jpg)
Analysis of the expired air:
attach the sampler to the SPIROLYT analyzer
observe the blue and red lines
if the blue and red lines move upwards = a change in O2 a CO2 is detected
proceed with the measurement until a „new“ straight line is recorded again
distance between lines = difference in O2 a CO2 % between the sample and
atmosphere
read the results by using a ruler (blue for CO2, red O2 )
DO2DCO2
![Page 37: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/37.jpg)
Result: calculate the % O2 and CO2 in the sample
%O2 = decrease in O2 in the sample in contrast to atmospheric air
O2 in expired air = O2 in atmospheric air - DO2
% CO2 = increase in CO2 in the sample in contrast to atmospheric air
CO2 in expired air = CO2 in atmospheric air + DCO2
Conclusion: is the result normal? Explain
DO2DCO2
![Page 38: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/38.jpg)
Task: Measurement of the expiratory peak
flow with a peak flow meter
![Page 39: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/39.jpg)
important marker of respiratory function
the highest velocity of air flow during forceful exhalation
i.e. it measures the fastest rate of air (airflow) that a person can blow out of
lungs (airflow in litres per minute - L/min).
The peak expiratory flow rate
![Page 40: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/40.jpg)
Forced expiratory volume (FEV) measures how much air a person can exhale
during a forced breath. The amount of air exhaled may be measured during the
first (FEV1), second (FEV2), and/or third seconds (FEV3) of the forced breath.
- FEV1 normal value: 80 - 85% of FVC
- FEV 3: normal value 97-100 % of FVC
Forced expiratory volume
![Page 41: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/41.jpg)
Procedure
Put the marker to zero.
Take a deep breath.
Seal your lips around the
mouthpiece.
Blow as hard and as fast as you
can into the device.
Note the reading.
Repeat three times.
The 'best of the three' is the
reading to record on the chart.
![Page 42: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/42.jpg)
Normal peak flow
readings vary,
depending on
Age
Body size
Gender
The range of
normal peak flow
readings is
published on a
chart
![Page 43: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/43.jpg)
![Page 44: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/44.jpg)
Measurement of peak flow
- often used in asthma
- regular readings can be used to help
assess how well treatment is working.
- readings improve if narrowed airways
open up with treatment.
![Page 45: The respiratory system - uniba.sk › fileadmin › lf › sucasti › ... · The respiratory system Practical 1 Objectives Respiration, ventilation Intrapleural and intrapulmonary](https://reader030.fdocuments.net/reader030/viewer/2022040617/5f20d88d3043d825ab3596ba/html5/thumbnails/45.jpg)
Air flow in the respiratory passageways
air flow through the respiratory passageways depends on their diameter
Normal breathing
Inspiration - bronchi dilated and prolonged „easier air flow
Expiration - bronchi narrower and shorter „more difficult“
expiration normally longer 2:1
in disease (e.g. asthma, bronchitis, etc.)
the air flow may be limited by
Bronchocinstriction (contraction of the
smooth muscle in the wall of bronchi –
mainly smaller bronchi and bronchioles)
Inflammed and swollen mucosa
Presence of mucus