Download Glossary on respiration and gas exchange1

JOURNAL
OF
APPLIED
Vol. 34, No. 4, April
PHYSIOLOGY
1973.
Glossary
Plhhd
in U.S.A.
on respiration
and gas exchange1
Prepared by Subcommittee for Respiration
Professor H. Bartels, Chairman
Medizinische Hochscule, Hanover,
Physiologisches Institut,
West Germany
ProfessorP. Dejours Labora toire de Physiologic Respiratoire,
Centre National de la Recherche ScientiJique, 67 Stasbourg 3, France
ProfessorR. H. Kellogg
Department of Physiology,
School of Medicine, San Francisco, California
University of California,
University,
Approved by
International
Union
of Physiological
Sciences
Committee
on Nomenclature,
ProfessorHans Schaefer, Chairman, Heidelberg, 1971; and the
International
Commission
of the IUPS for Kespiration
Professor S. M. Tenney, Chairman,
1972
INTRODUCTORY
Physiology,
REMARKS
The
International
Union
of Physiological
Sciences,
following
an idea of the late Professor Fenn, established
a
Committee
on physiological
nomenclature,
later on called
“Glossary
Committee,”
the respiration
subgroup
of which
has prepared the following
Glossary on terms of the physiol-
In respiratory
physiology,
as in any other
vital
field,
it
follows naturally that new terms will arise continuouslysome to express wholly new ideas, and others to replace
outmoded
terms. It is the latter that are most troublesome
in preparing
a glossary. For a while they can appear appro-
ogy of respiration. The aims of the Glossary are to stand-
priately as synonyms, but sooner or later they become
ardize the use of important
and frequently
used scientific
terms and to improve,
as one of the results of such standardizations,
the documentation
of physiological
literature.
HANS
SCHAEFER,
Chairman
IUPS Glossary Committee
(197 I>
misleading
and must be dropped.
The reader must be on
guard for expressions which may be in a transition
stage
and for which it is impossible to get unanimous
agreement,
even with a panel of experts. The same caution applies to
symbols, some of which are employed with entirely different
meanings in other fields, and some of which, even in respiratory physiology,
could be ambiguous
if taken out of context.
S. M. TENNEY, Chairman
International
Commission
of IUPS for
Respiration
Physiology
( 1972)
sentences that follow describe the scope of the definition.
‘DEFINITIONS
Each
English.
word of the Glossary
appears in capitals
French
(I?) and German
(G) equivalents
and is defined
in
are given.
The
words that are cross-referenced
are capitalized,
tion and scope, antonyms
(Ant.),
synonyms
(Abbr.),
and symbols (Symb.)
are given.
Glossary
Following
the defini(Syn.),
abbreviations
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Professor J. Mead
Department of Physiology, Harvard
School of Public Health, Boston, Massachusetts
550
GLOSSARY
ACIDEMIA:
Acidernie
(F); Azidamie
(G). Any state of systemic
arterial
plasma
in which
the pH is significantly
less than the
normal
value,
7.41 =t 0.02 in adult man at rest. Newborns,
infants,
and pregnant
women
show
deviations
from
the
‘ ‘normal”
figure,
as do many
birds
and mammals.
Ant.
ALKALEMIA.
-4CIDOSIS:
Acidose
(F); Azidose
(G). The result of any process
which
by itself adds excess CO2
(respiratory
acidosis)
or
nonvolatile
acids
(metabolic
acidosis)
to arterial
blood.
Acidemia
does not necessarily
result
since
compensating
mechanisms
(increase
of HC03
in respiratory
acidosis,
increase
of ventilation
and consequently
decrease
of arterial
CO2 in metabolic
acidosis)
may intervene
to restore
plasma
pH to normal.
Ant. ALKALOSIS.
,41 K SPACES
(G).
All
contrasted
: Espace alveolaire
(F) ; Alveolarraum
alveolar
ducts,
alveolar
sacs, and
with AIRWAYS.
(-volumen)
alveoli.
To
ATELECTASIS:
of air spaces
Acclimatation
Morphological
at high altitude.
B l’altitude
and physio-
ALVEOLAR-ARTERIAL
GAS
PRESSURE
DIFFERENCE
:
Difference
de pression
alveolo-arterielle
(F) ; Alveolararterielle
Gasdruckdifferenz
(G).
The difference
in partial
pressure
of a gas (e.g., 02 or N2) in the alveolar
gas spaces
and that in the systemic
arterial
blood,
measured
in torr.
Note
that a negative
difference
indicates
that the partial
pressure
is higher
in arterial
blood than it is in the alveolar
gas spaces. Symb. For oxygen,
as an example,
PACT - Paoz;
also sometimes
symbolized
AaDo2.
ALVEOLAR
PRESSURE
: Pression alveolaire
(F) ; Alveolardruck
(G). Total
gas pressure
in alveoli
commonly
expressed
relative to atmospheric
pressure
in cm H20.
Symb.
P~lv.
ANATOMICAL
DEAD
SPACE:
Espace mort
anatomique
(F);
Anatomischer
Totraum
(G).
Volume
of the conducting
airways
down
to the level where,
during
air breathing,
gas
exchange
with blood can occur,
a region
probably
situated
at the entrance
of the alveolar
ducts. Symb.
VD~,,~.
APNEA:
ApnCe
(F) ; Apnoe
-
(G).
Cessation
of breathing.
APNEUSIS:
Apneusis
(F); Apneusis
(G). A ventilatory
pattern
in which
the contraction
of inspiratory
muscle is intense and
sustained.
Apneusis
is observed
in a vagotomized
cat whose
rostra1
pons has been
transected;
an “apneustic
center”
located in the pons is thought
to be responsible.
GAS
EXCHANGE
Atblectasie
(F);
with elimination
Atelektase
(G). State
of the gas phase.
of collapse
CONDITIONS
: Conditions
(G).
Ambient
temperature
water
vapor.
These
are the
spirometer.
Abbr.
ATPS.
BASE
EXCESS:
Exces
de base (F) ; Baseniiberschuss
(G).
A
measure
of metabolic
alkalosis
or metabolic
acidosis
(negative
values
of base excess) expressed
as the mEq of strong
acid
or strong alkali required
to titrate
a sample of 1 liter of blood
to a pH of 7.40. The titration
is made with the blood sample
kept at 37’ C, oxygenated,
and equilibrated
at PCO~ of 40
torr. Abbr.
BE.
BLOOD
ATPS
(F) ; ATPS Bedingungen
and pressure,
saturated
with
conditions
existing
in a water
BUFFERING
CAPACITY:
(F) ; Blutpufferkapazitat
(G).
that can be made
to combine
blood.
The
normal
capacity
practice
it is estimated
as the
and the anionic
charges
on
proteins.
To a much lesser extent
are included.
BOHR
Valeur
tampon
du sang
The
maximum
mEq
of H+
with the solutes
in 1 liter of
is 45-53
mEq/liter,
and in
sum of the bicarbonate
ions
the hemoglobin
and plasma
phosphate
and other buffers
EFFECT:
Effet Bohr
(F); Bohr-Effekt
(G). Dependence
of oxygen
saturation
of hemoglobin
on H+ concentration.
Originally
Bohr
et al. (1904)
described
only the effect
of
PCOZ changes on oxygen
saturation.
The more usual practice
now is to relate
the effect to changes
in H+ concentration
(or pH).
An increase
in H+ concentration
decreases
the
oxygen
saturation
of hemoglobin.
A decrease
of the pH value
from
7.4 to 7.3 at 40 mm Hg oxygen
pressure
decreases
the
oxygen
saturation
by 6%, or approximately
1.2 ml 02/100
ml blood
(oxygen
capacity
20 ml O&O0
ml blood)
in man.
The effect is pronounced
in the capillaries
of working
muscles
(including
heart
muscle)
and in the maternal
and fetal exchange
vessels of the placenta.
The Bohr effect is generally
expressed
as Alog PoJApH
at a given oxygen
saturation.
For
human
blood
at lO--90%
oxygen
saturation
the quotient
at 37” C is 0.48 for a ApH of 0.1 unit.
BREATH
HOLDING:
ApnCe
volontaire
(F) ; Atemanhalten
(willkiirlich)
(G) . Ap nea, usually,
but not necessarily,
with
a closed glottis.
This covers
voluntary
apnea,
which
when
maximally
prolonged
is terminated
by an involuntary
breaking point,
and diving
breath
holding,
which
in some seals
or whales may last more than 1 hr.
BREATHING
PATTERN:
Regime
ventilatoire
(F) ; Atemform,
-art (G). A general
term
designating
the characteristics
the ventilatory
activity,
e.g., tidal
volume,
frequency
breathing,
and shape of the volume-time
curve.
BREUER-HERING
REFLEXES
: Reflexes
de
(F) ; Hering-B
reuer
Reflexe
(G).
Ventilatory
nating
in the lungs. The reflex arcs are formed
Breuer-Hering
reflexes
origiby the pulmo-
of
of
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,4LTITUDE
ACCLIMATIZATION:
imatisation
(G).
(F) ; Hijhenakkl
logical
adjustments
to a sojourn
of any
alkablood.
AND
ATPS
AIRWAYS
: Voies aeriennes
(F) ; Atemwege
(G). All passageways
of the respiratory
tract from
mouth
or nares down
to and
including
respiratory
bronchioles.
To be contrasted
with
AIR SPACES.
Symb.
aw.
ALKALOSIS:
Alcalose
(F) ; Alkalose
(G).
The
result
by itself, diminishes
acids (respiratory
process which,
losis) or increases bases (metabolic
alkalosis)
in arterial
Ant. ACIDOSIS.
RESPIRATION
ASPHYXIA:
Asphyxie
(F);
Asphyxie
(G).
A condition
of restricted
gas exchange
characterized
by an increase
of CO2
partial
pressure
above
and a decrease
of 02 pressure
below
normal
values.
Hypoventilation
gives rise to an asphyxia
throughout
the body;
regional
asphyxia
results when
blood
flow rate in an organ is low relative
to metabolic
rate of the
organ.
be
ALKALEMIA:
Alcalemie
(F);
Alkalamie
(G).
Any
state of
systemic
arterial
plasma
in which
the pH is significantly
greater
than the normal
value,
7.41 & 0.02 in adult
man
at rest. Newborns,
infants,
and pregnant
women
show deviations from the ‘cnormal”
figure,
as do many birds and mammals. Ant. ACIDEMIA.
ON
GLOSSARY
ON
RESPIRATION
AND
GAS
551
EXCHANGE
nary mechanoreceptors,
the vagal afferent
fibers, the respiratory centers,
the medullospinal
pathway,
the motoneurons,
and the respiratory
muscles.
The afferent
link informs
the
respiratory
centers of the volume
state or of the rate of change
of volume
of the lungs. Three
types of Breuer-Hering
reflexes
have been described:
I) an inflation
reflex
in which
lung
inflation
tends to inhibit
inspiration
and stimulate
expiration;
2) a deflation
reflex in which
lung deflation
tends to inhibit
expiration
and stimulate
inspiration;
and 3) a “paradoxical
reflex,”
described
but largely
disregarded
by Breuer
and
Hering,
in which
sudden
inflation
may stimulate
inspiratory
muscles.
BRONCHOSPIROMETRY:
Bronchospirometrie
(F) ; Bronchospirometrie
(G). Technique
for the study
of the ventilation
and gas exchanges
of one lung,
by introduction
of a tube
into the main bronchus
of the right or the left lung. A doublelumen
catheter
(e.g.,
Carlens’s
catheter)
permits
separate
and simultaneous
sampling
of the gas of bo th lungs.
CONDITIONS
: Conditions
BTPS (F) ; BTPS Bedingungen
(G). Body
temperature,
barometric
pressure,
and saturated
with water
vapor.
These
are the conditions
existing
in the
gas phase of the lungs. For man the normal
temperature
is
taken as 37’ C, the pressure
as the barometric
pressure,
and
the partial
pressure
of water vapor,
47 torr. Abbr.
BTPS.
CARBAMINOHEMOGLOBIN:
CarbaminohCmoglobine
Carbaminohamoglobin
(G).
Hemoglobin
in which
amino
groups
(Hb-NH
2) are combined
with carbon
to form a carbamino
compound
(Hb-NH-COOplus
(F) ;
ionized
dioxide
H+).
CARBON
DIOXIDE-BLOOD
(OR
-PLASMA)
EQUILIBRIUM
CURVE:
Courbe
d’equilibre
entre gaz carbonique
et sang (ou plasma)
(F); Kohlendioxid-Blut
(oder -Plasma)
Gleichgewichtskurve
(G).
Relation
between
total
carbon
dioxide
concentration
in blood (or separated
or true plasma)
and carbon
dioxide
pressure.
In vitro
curves are established
by equilibration
of blood
or plasma
(separated
plasma)
samples
with gas mixtures
containing
varying
fractions
of
carbon
dioxide.
The relation
for oxygenated
hemoglobin
is
obtained
by equilibrating
with
an oxygen
pressure
of at
least 200 torr.
In vivo
curves
are established
by inhaling
various
carbon
dioxide
fractions
in inspired
air for an appropriate
equilibration
time and measuring
the actual
carbon
dioxide
concentration
and pressure
in blood or true plasma
samples.
Because
extravascular
compartments
are
also
equilibrated
in vivo, at carbon
dioxide
pressures
higher
than
40 torr, the HCOsconcentration
is lower than is measured
in vitro.
Abbr.
CBEC,
CPEC.
CARBON
DIOXIDE
CONCENTRATION:
Concentration
du
dioxide
de carbone
(F) ; Kohlendioxid-Konzentration
(G).
The amount
of carbon
dioxide
that can be extracted
by
evacuation
from an acidified
sample of a liquid,
including,
in
the case of blood, the physically
dissolved
COz, the bicarbonate, and the CO2 bound
to hemoglobin.
Ordinarily,
it is
expressed
as ml CO2 (STPD) /lOO ml sample
or mmole
COJ
liter.
CO2 concentration
should
not be expressed
as mEq
COz/liter,
since mEq is appropriate
for HCOsbut not for
CO2. Symb.
CCO~.
CARBON
DIOXIDE
dissociation
du
DISSOCIATION
dioxide
de carbone
CURVE:
Courbe
(F) ; Kohlendioxid-Dis-
de
(G). See CARBON
DIOXIDE-BLOOD
EQUILIBRIUM
CURVE.
(OR
CARBON
DIOXIDE
STORES:
R&erves
de dioxide
de carbone
(F); Kohlendioxidspeicher
(G). Volumes
of CO2 stored in all
parts
of the body
as CO2,
carbonic
acid,
carbonate,
bicarbonate,
and carbaminohemoglobin.
In an adult
human
the CO2 stores amount
to several
liters.
In a respiratory
steady state the amount
of CO2 produced
by the cells is equal
to the amount
rejected
by the lungs. Hence,
the volume
of
CO2 stores remains
constant.
CARBONIC
ANHYDRASE
: Anhydrase
carbonique
(F) ; Karboanhydrase
(G). An enzyme
containing
zinc which speeds the
reaction
CO2 + Hz0
\ H&03.
Present
in many tissues and
red blood cells. In red blood
cells a 2,090-fold
acceleration
of the hydrolysis
of CO2 has been measured.
In aqueous
solutions the acceleration
is approximately
13,000-fold.
CARBOXYHEMOGLOBIN
boxyhamoglobin
associated
with
for CO is about
: Carboxyhtmoglobine
(F) ; Car(G).
Hemoglobin
in which
the iron
is
carbon
monoxide.
The affinity
of hemoglobin
300 times greater
than for 02. Symb. HbCO.
CHEST
WALL
: Paroi
thoracique
(F) ; Brust-(Thorax-)
Wand
(G).
All structures
outside
the lungs
which
take part
in
breathing
movements,
i.e., rib cage, diaphragm,
abdominal
contents,
and abdominal
wall. Symb.
w.
CHEYNE-STOKES
BREATHING
: Respiration
de CheyneStokes
(F) ; Cheyne-Stokes’sche
Atmung
(G).
Abnormal
pattern
of breathing
consisting
of progressively
increasing,
then progressively
decreasing
tidal movements
followed
by a
period
of apnea at relaxation
volume
before
the pattern
repeats.
CHLORIDE
SHIFT:
Effet Hamburger
(F) ; Chlorid
Shift (G).
Increase
of red cell HCOaconcentration
during
COT uptake
by the blood in peripheral
capillaries
results in a concentration gradient
for HCOawhich
favors
diffusion
of HCOZfrom the red cells into the plasma.
In exchange
Cl- diffuses
from plasma
into the red cells to maintain
electroneutrality.
This is known
as the chloride
shift. Because
the amount
of
intracellular
solute is increased
by entrance
of CO:! to form
the HCOsin the cell and is not further
changed
by the
HCOs--Clexchange,
water
also diffuses into the cell, which
consequently
swells very
slightly.
All these processes
reverse
when
CO2 is lost in the pulmonary
capillaries.
Syn. HAMBURGER
EFFECT.
CHRISTIANSEN-DOUGLAS-HALDANE
EFFECT:
Effet
Christiansen-Douglas-Haldane
(F) ; Christiansen-DouglasHaldane-Effekt
(G).
Dependence
of the carbon
dioxide
binding
capability
of the blood on the oxygen
saturation
of
hemoglobin.
An increase
of the oxygen
saturation
decreases
the carbon
dioxide
binding
capability.
In human
blood at 40
torr carbon
dioxide
pressure
and at 37’ C, fully deoxygenated
blood binds approximately
6 ml CO&
00 ml blood more than
fully oxygenated
blood
(oxygen
capacity
20 ml OJlOO
ml
blood).
The effect is explained
by the decrease
of the proton
affinity
of hemoglobin
due to the oxygen
uptake.
During
gas
exchange
in the lung of a resting subject the oxygen
saturation
increases
from
75 to 980/, and consequently
by the CDH
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BTPS
soziationskurve
-PLASMA)
552
GLOSSARY
effect
efl’ect.
1.4 ml COJlOO
Syn. HALDANE
COLLATERAL
VENTILATION
Kollaterale
Ventilation
indirect
pathways,
e.g.,
anastomosing
respiratory
ml blood
EFFECT.
are
liberated.
: Ventilation
(G) . Ventilation
through
pores in
bronchioles.
Abbr.
CDH
collaterale
(F) ;
of air spaces via
alveolar
septa, or
CONDUCTANCE:
reciprocal
Conductance
of RESISTANCE.
(F) ; Leitfahigkeit
Symb.
G.
(G).
The
COUNTERCURRENT
GAS
EXCHANGE
: Echange
gazeux
par contrecourant
(F) ; Gegenstromgasaustausch
(G).
Gas
exchange
between
two media flowing
in opposite
directions.
This type of exchange
exists in many
aquatic
animals.
Examples:
I) between
the blood flowing
in the lamellae
of the
and the water flowing
along the lamellae
from
3uill filaments
the buccal
cavity
to the opercular
cavity;
and 2) in the rete
mirabile
of the gas gland of some fish. This anatomical
disposition facilitates
the transfer
of gas.
CYANOSIS:
Cyanose
(F) ; Cyanose
(G). Cyanosis
is a condition
characterized
by a blue-purple
color of the skin and mucosae.
It is due to an abnormally
high amount
of deoxygenated
hemoglobin
in the capillaries
of the skin and mucosae.
According
to Lundsgaard
and Van Slyke
(Medicine
2 : 1-76,
1923) cyanosis
appears
when
capillary
blood contains
more
than 5 g deoxygenated
hemoglobin/100
ml blood.
DECOMPRESSION
SICKNESS
: Ma1 de d&ompression
(F);
Dekompressionskrankheit
(G).
A group
of illnesses
characterized
by formation
of gas bubbles
in blood
or tissues,
caused by release of physically
dissolved
gases when environmental
pressure
is decreased
at sufficient
rate and magnitude.
Limb
pain occurring
shortly
after emergence
from a hyperbaric environment
is the most common
symptom.
Illness may
also result from abrupt
exposure
to very low pressures,
as at
high altitude,
and symptoms
other than limb pain may occur.
The ideal treatment
is immediate
recompression;
with some
methods,
high inspired
oxygen
fractions
are employed.
Decompression
sickness
should
be distinguished
from
other
illnesses associated
with reduction
of environmental
pressure,
of which the most important
are those due to overdistention
air embolism.
Decompression
of lung tissue, e.g., traumatic
sickness
is avoided
by slow decompression.
Nine
days are
required
to decompress
from 50 Ata pressure.
The following
terms
are frequently
employed
as synonymous
with
decompression
sickness but they are not recommended
for use:
bends, caisson disease, ma1 des caissons,
Caisson
Krankheit,
compressed
air illness.
RESPIRATION
AND
GAS
EXCHANGE
DIFFUSING
CAPACITY
OF THE
LUNG:
Capacite
de diffusion pulmonaire
(F);
Diffusionskapazitat
der Lunge
(G).
Amount
of gas (02, CO,
COZ)
commonly
expressed
as ml
gas (STPD)
diffusing
between
alveolar
gas and pulmonary
capillary
blood per torr mean gas pressure
difference
per min,
i.e., ml Oa/(min
torr).
Syn. Transfer
factor,
diffusion
factor.
Symb.
DL, DL~~, DLCO~, DLCO.
DYNAMIC
COMPLIANCE
: Compliance
dynamique
(F) ;
Dynamische
Compliance
(G). The ratio of the tidal volume
to
the change in intrapleural
pressure
between
the points of zero
flow at the extremes
of tidal volume
in liters/cm
Hz0 or ml/
cm H20.
Since at the points of zero airflow
at the extremes
of tidal
volume,
volume
acceleration
is usually
other
than
zero,
and since, particularly
in abnormal
states, flow may
still be taking
place within
lungs between
regions
which
are
exchanging
volume,
dynamic
compliance
may
differ
from
static compliance,
the latter
pertaining
to conditions
of zero
volume
acceleration
and zero gas flow throughout
the lungs.
In normal
lungs
at ordinary
volumes
and respiratory
frestatic
and dynamic
compliance
are the same.
quencies,
Symb.
Cdyn.
DYSPNEA:
feeling
Dyspnee
of difficult
ELASTANCE:
COMPLIANCE;
Symb.
E.
(F); Dyspnoe
or labored
Elastance
(G). An unpleasant
breathing.
(F) ; Elastance
(G).
expressed
in cm HzO/liter
subjective
The reciprocal
or cm HzO/ml.
of
EQUIVALENT
LUNG
VOLUME
: Volume
pulmonaire
Cquivalent (F); Aq uivalentes
Lungenvolumen
(G). A virtual
volume
of dilution,
i.e., a hypothetical
volume
of pulmonary
gas
which
accounts
for change
of alveolar
partial
pressures
of
CO2 (or 0,) when CO2 (or 0,) is added or subtracted
from
the gas phase. ELV
is formed
of the actual
gas volume
plus
a hypothetical
volume
related
to the fixation
of CO2 (or 0,)
in lung
tissue and in pulmonary
blood.
ELV
for CO:! is
some 15 y0 greater
than the actual
lung volume.
ELV
for
oxygen
differs
little
from
the actual
lung
volume.
The
existence
of ELV
lessens the Pcoz
(and
Paz) fluctuations
which
normally
occur
during
the respiratory
cycle.
Abbr.
ELV.
EUPNEA:
Eupn6e
(F) ;
breathing
at rest.
Eupnoe
(G).
Normal,
comfortable
FORCED
EXPIRATORY
VOLUME.
Debit
expiratoire
maximal (F);
Maximale
Ausatmungskapazitat
(G).
Denotes
the
volume
of gas which is exhaled
in a given time interval
during
the execution
of a forced
vital capacity.
Conventionally,
the
times
used are 0.5, 0.75,
or 1 set, symbolized,
FE&s,
These
values
are often
expressed
as a
FEVo75, .
FEVlO* .
percent
of the forced
vital
capacity;
e.g., (FEVJVC)
X
100.
FLOW-VOLUME
CURVE
: Courbe
debit-volume
(F) ; Stromstarke-Volumen
Kurve
(G).
Graph
of instantaneous
forced
expiratory
flow recorded
at the mouth,
against
corresponding
lung volume.
When
recorded
over the full vital capacity,
the
curve
includes
maximum
expiratory
flow rates at all lung
volumes
in the VC range and is called a maximum
expiratory
flow-volume
curve,
abbreviated
MEFV
curve.
A partial
expiratory
flow-volume
curve
is one which
describes
maxi-
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CO,MPLIANCE
: Compliance
(F) ; Compliance
(G). A measure
of distensibility.
Pulmonary
compliance
is given by the slope
of a static volume-pressure
curve
at a point,
or the linear
approximation
of a nearly
straight
portion
of such a curve,
expressed
in liters/cm
H20
or ml/cm
HZO.
Since the static
volume-pressure
characteristics
of lungs
are
nonlinear
(static compliance
decreases
as lung volume
increases)
and
vary
according
to the previous
volume
history
(static
compliance
at a given
volume
increases
immediately
after full
inflation
and decreases
following
deflation),
careful
specification of the conditions
of measurement
are necessary.
Absolute
values
also depend
on organ
size. See also DYNAMIC
COMPLIANCE.
Symb.
C.
ON
GLOSSARY
ON RESPIRATION
AND GAS EXCHANGE
mum expiratory flow rate over a portion
only. Abbr. PEFV.
FUNCTIONAL
Funktioneller
SPACE.
GAS EXCHANGE
Symb. R.
553
of the vital capacity
DEAD SPACE: Espace mort fonctionnel (F) ;
Totraum (G). See PHYSIOLOGICAL
DEAD
RATIO
: See RESPIRATORY
QUOTIENT.
GASP: Gasp ou secousse inspiratoire (F) ; Schnappatmung
ventilatory
movement consisting of an abrupt,
transient inspiratory effort.
(G). A
sudden,
HYPERCAPNIA:
Hypercapnie (F) ; Hyperkapnie (G). Any state
in which the systemic arterial carbon dioxide pressure is
significantly above 40 torr. May occur when alveolar ventilation is inadequate for a given metabolic rate (HYPOVENTILATION)
or during CO2 inhalation.
HYPERCARBIA:
PERCAPNIA.
Hypercarbie
(F) ; Hyperkarbie
(G). See HY-
HYPEROXIA:
H yperoxie (F) ; Hyperoxie (G). A condition in
which the inspired oxygen pressure is greater than that of
air at sea level but not more than 1 Ata.
HYPERVENTILATION:
Hyperventilation
(F) ; Hyperventilation (G). An alveolar ventilation which is excessive relative
to the simultaneous metabolic rate. As a result the alveolar
Pco2 is significantly reduced below the normal 40 torr. See
HYPOCAPNIA.
HYPOCAPNIA:
H ypocapnie (F) ; Hypokapnie
(G). Any state
in which the systemic arterial carbon dioxide pressure is
significantly below 40 torr, as in hyperventilation.
HALDANE
DANE
HYPOCARBIA:
POCAPNIA.
HAMBURGER
EFFECT:
EFFECT.
See CHRISTIANSEN-DOUGLAS-HAL-
EFFECT:
See CHLORIDE
SHIFT.
HEMOGLOBIN
: HCmoglobine
(F) ; Hamoglobin
(G). A
hemoproteid
naturally occurring in most vertebrate blood,
consisting of four polypeptide chains (the globulin) to each
of which there is attached a heme group. The heme is made
of four pyrrole rings and a divalent iron (Fe2+-protoporphyrin) which combines reversibly with molecular
oxygen.
Symb. Hb.
HENDERSON-HASSELBALCH
EQUATION
: Equation
de
Henderson-Hasselbalch
(F) ; Henderson-Hasselbalch
Gleichung (G). This equation relates the different forms of
carbon dioxide in plasma:
pH = pd + log
[total CO21 - S X
s x PC02
PC02
= p&
+ log WC%-1
s x PC02
pKfl is the negative logarithm of the apparent first ionization
constant of H&O3 corrected for the ratio of CO2 to H&03.
S is the factor relating the partial pressure of carbon dioxide
and the sum of the millimolar
concentrations of dissolved
carbon dioxide and carbonic acid in plasma (0.0301).
Calculation of one of the three variables, pH, [HCOa-+], and
Pco2, from the other two is valid only for a single phase such
as the plasma or serum sample as separated from whole blood.
There is no simple procedure for applying the HendersonHasselbalch equation to whole blood.
HYPERBARIC
OXYGENATION:
Oxygenation hyperbare (F) ;
Hyperbare Oxygenation
(G). The condition produced by
breathing a gas in which the partial pressure of oxygen is
greater than that of 100% oxygen at sea level. This requires
use of a pressure chamber. As a therapeutic technique, it is
commonly used for the treatment of CO intoxication
or
gangrene associated with anaerobic bacteria.
Hypocarbie
(F) ; Hypokarbie
(G). See HY-
HYPOPNEA
: HypopnCe (F) ; Hypopnoe (G). Decreased breathing in comparison with breathing at rest (less exact than
and not to be confused with hypoventilation).
HYPOVENTILATION:
Hypoventilation
(F) ; Hypoventilation
(G). An alveolar ventilation which is small relative to the
simultaneous
metabolic
rate so that alveolar Pco:! rises
significantly above the normal 40 torr.
HYPOXEMIA:
HypoxCmie (F); Hypoxamie
(G). A state in
which the oxygen pressure and/or concentration
in arterial
and/or venous blood is lower than its normal value at sea
level. Normal oxygen pressures at sea level are 85-100 torr
in arterial blood and 37-44 torr in mixed venous blood. In
adult humans the normal oxygen concentration is 17-23 ml
O&O0 ml arterial blood; in mixed venous blood at rest it is
13-18 ml OJlOO ml blood.
HYPOXIA:
Hypoxie (F); Hypoxie (G). Any state in which the
oxygen in the lung, blood, and/or tissues is abnormally low
compared with that of normal resting man breathing air at sea
level. If the POZ is low in the environment, whether because
of decreased barometric
pressure or decreased fractional
concentration
of 02, the condition is termed environmental
hypoxia. Hypoxia when referring to the blood is terrned
hypoxemia. Tissues are said to be hypoxic when their Po2 is
low, even if there is no arterial hypoxemia, as in “stagnant
hypoxia” which occurs when the local circulation
is low
compared to the local metabolism.
INTRAPLEURAL
Intrapleuraler
PRESSURE : Pression
Druck (G). See PLEURAL
INTRAPULMONARY
(F) ; Intrapulmonaler
SURE.
INTRATHORACIC
Intrathorakaler
intrapleurale
PRESSURE.
(F) ;
PRESSURE : Pression intrapulmonaire
Druck (G). See ALVEOLAR
PRES-
PRESSURE : Pression intrathoracique
(F) ;
Druck (G). See PLEURAL
PRESSURE.
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GAS POCKET:
Poche de gaz (F) ; Gastasche (G). A term designating originally a gas cavity artifically created by an injection of gas into the subcutaneous tissue. Pneumoperitoneum, pneumothorax,
a closed middle ear, subcutaneous
emphysema, as examples, are analogous to artificial subcutaneous gas pockets. The gas composition in the pocket has
been taken as an index of the partial pressures of gas in the
surrounding tissue.
554
GLOSSARY
ISOVOLUME
volume
relations
inflation
PRESSURE-FLOW
pression-debit
(F).
Lines
in the airways,
measured
(isovolume).
Symb.
IVPF
CURVES:
describing
at equal
curves.
Courbes
isopressure-flow
degrees
of lung
MAXIMUM
BREATHING
CAPACITY:
Capacite
ventilatoire
maximale
(F) ; Maximale
Atemkapazitat
oder Atemgrenzwert (G). Maximal
volume
of air which
can be breathed
per
minute
by a subject
breathing
as quickly
and as deeply
as
possible.
This tiring
lung function
test is usually
limited
to
12-20 set, but given in liters (BTPS)/~~~.
Abbr.
MBC.
Syn.
Maximum
voluntary
ventilation
(Abbr.
MVV).
MIXED
VENOUS
BLOOD:
Sang veineux
melEt (F) ; Gemischtvenijses Blut (G). Blood composed
of a mixture
of the venous
blood from all systemic
tissues in proportion
to their venous
returns.
In the absence
of abnormalities
of the heart
and
great
vessels, mixed
venous
blood
is present
in the main
pulmonary
artery.
Blood samples drawn
from right atrium
or
even right ventricle
may be inadequately
mixed.
Symb.
v.
MOUNTAIN
SICKNESS:
Ma1 des montagnes
(F) ; Hohenkrankheit (G). Pathological
state induced
by high altitude.
Unacclimatized
subjects,
during
their
first
few days
at high
headache,
breathlessness,
altitude,
commonly
experience
sensorial
or intellectual
disturbances,
sleeplessness,
nausea,
and eventually
vomiting.
This symptom
complex
is known
as acute mountain
sickness, or ‘CSoroche.”
It is rare for these
symptoms
to last more than a few days at high altitude,
and
they are frequently
relieved
by inhalation
of an Op-enriched
mixture.
Permanent
residents
at high altitude
may develop
chronic
mountain
sickness
(Monge’s
disease)
in which
alveolar
ventilation
is diminished,
and signs and symptoms
referable
to the cardiovascular
and central
nervous
systems
appear.
The relative
hypoventilation
aggravates
the hypoxia,
and right
heart
failure
supervenes.
Extreme
polycythemia
develops
and hematocrit
ratios,
sometimes
as high as 75%,
are seen. The syndrome
can be relieved
by a return
to sea
level.
MULLER’S
MANEUVER:
scher Versuch
(G).
Intrapulmonary
and
nary gas is expanded.
Manoeuvre
Inspiratory
intrathoracic
de Miiller
(F); Miiller’effort
with
closed
airway.
pressures
fall and pulmo-
RESPIRATION
by replacing
NP to a certain
certain
pressure
of substituted
GEN
POISONING.
N 2 can
AND
GAS
EXCHANGE
extent
with
02, but above
a
02 there is a danger
of OXYbe replaced
by helium.
NITROGEN
WASHOUT
CURVE:
Elimination
de l’azote
(F) ;
Stickstoffauswaschkurve
(G). The curve obtained
by plotting
the fractional
concentration
of N2 in expired
alveolar
gas vs.
time, for a subject
switched
from
breathing
ambient
air to
an inspired
mixture
of pure 02. A progressive
decrease
of Np
concentration
ensues which may be analyzed
into two or more
exponential
components.
Normally,
after 4 min of pure
O2
breathing
the fractional
N:! concentration
in expired
alveolar
gas is down to less than 2oj,.
NORMOVENTILATION
: Normoventilation
(F) ; Normoventilation
(G). Normoventilation
is characterized
by an alveolar
ventilation
that produces
an alveolar
carbon
dioxide
pressure
of about 40 torr at any metabolic
rate. Syn. EUPNEA.
NORMOXIA:
Normoxie
(F) ; Normoxie
(G).
A state in which
the ambient
oxygen
pressure
is approximately
150 rt 10 torr
(i.e., the partial
pressure
of oxygen
in air at sea level).
OLIGOPNEA:
OligopnCe
(F);
Oligopnoe
(G).
See HYPOPNEA.
OXYGEN
AFFINITY
OF HEMOGLOBIN:
Affinite
de l’hemoglobine
pour
1’oxygCne
(F);
Sauerstoffaffinitat
des HZmoglobins
(G).
The
oxygen
affinity
expresses
the degree
of
oxygen
saturation
of blood
or hemoglobin
solutions
at a
defined
oxygen
pressure.
The pH and temperature
must be
specified
and,
for most homeotherms,
are 7.4 and
body
temperature.
The oxygen
affinity
can be characterized
by the
OXYGEN
HEMOGLOBIN
EQUILIBRIUM
CURVE.
A
widely
used term
characterizing
the oxygen
affinity
is the
oxygen
pressure
at half saturation
of blood
or hemoglobin,
respectively.
See OXYGEN
HALF-SATURATION
PRESSURE
OF HEMOGLOBIN
(PsO).
OXYGEN
CAPACITY:
Capacite
d’oxygsne
(F) ; Sauerstoffkapazitat
(G). The maximum
amount
of oxygen
that can be
made to combine
chemically
with the hemoglobin
in a unit
volume
of blood. Ordinarily,
it is expressed
in ml 02 (STPD)/
100 ml blood or mmole
OJliter
blood. Note that the oxygen
capacity
does not include
physically
dissolved
oxygen.
For
mammalian
blood
at least 150 torr of oxygen
pressure
are
necessary
for 100%
oxygen
saturation
of the hemoglobin.
For male human
blood the mean hemoglobin
content
is 15.3
corresponds
to an oxygen
capacity
of
g/100
ml blood, which
2 1 ml 02/l 00 ml blood.
It follows
that 1 g hemoglobin
binds
almost
1.389 ml 02, the value theoretically
predictable.
MYOGLOBIN
: Myoglobine
(F) ; Myoglobin
(G) . A hemoproteid
naturally
occurring
in muscle
cells, consisting
of one polypeptide
chain to which a heme group
is attached.
The heme
is made
of four pyrrole
rings and a divalent
iron
(Fe2fprotoporphyrin)
which
combines
reversibly
with molecular
oxygen.
Symb.
Mb.
OXYGEN-CARBON
DIOXIDE
CONCENTRATION
DIAGRAM:
Diagramme
des concentrations
Oz-CO2
(F) ; 02CO2 Konzentrationsdiagramm
(G).
Plot of CO2 concentration vs. 02 concentration,
used almost
exclusively
for blood.
02 and CO2 concentrations
in the arterial
blood and in the
venous
blood may be simultaneously
represented
for various
organs.
The slope of the line joining
an arterial
and a venous
point of an organ in the steady state indicates
the respiratory
quotient
of that organ.
NITROGEN
narkose
pressure
at 7 Ata
OXYGEN-CARBON
DIOXIDE
PRESSURE
DIAGRAM:
Diagramme
des pressions
partielles
02-CO?
(F);
OS-CO2
Druck-Diagramm
(G).
Plot of the CO2 partial
pressure
vs.
the 02 partial
pressure
in biological
media
such as inspired
NARCOSIS:
Narcose
a l’azote
(F);
Stickstoff(G). Depression
of brain function
due to high partial
of nitrogen.
In a deep dive, for example,
air breathing
may lead to a Nz narcosis. N2 narcosis
may be avoided
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METHEMOGLOBIN
: Methemoglobine
(F) ; Methamoglobin
(G).
Hemoglobin
in which
iron is in the ferric
state. Because the iron is oxidized,
methemoglobin
is incapable
of
oxygen
transport.
Methemoglobins
are formed
by various
drugs
and
occur
under
pathological
conditions.
Many
methods
for hemoglobin
measurements
utilize
methemoglobin (chlorhemiglobin,
cyanhemiglobin).
Syn. Hemiglobin;
ferrihemoglobin.
ON
GLOSSARY
ON RESPIRATION
AND GAS EXCHANGE
gas or water, expired gas or water, alveolar gas, or arterial
and venous blood. All representative points of the 02 and
CO2 pressures throughout
the body can be represented
simultaneously
on this diagram. Furthermore,
since for a
given fluid, 02 and CO2 concentrations are completely defined by the 02 and CO2 pressures, it is possible to draw on
the Op-CO2 pressure diagram a family of 02 and CO2
isoconcentration
lines, demonstrating
simultaneously
and
quantitatively
the Bohr and Haldane effects. Finally, gas
exchange ratio lines in gas and in blood may be plotted on
the diagram. Also called Fenn-Rahn-Otis
diagram, Fenn
diagram, or 02-CO2 diagram.
OXYGEN
CONCENTRATION
: Concentration
d’oxyg2ne (F) ;
Sauerstoffkonzentration
(G). The concentration of oxygen in
a blood sample, including
both oxygen combined
with
hemoglobin
and physically dissolved oxygen, ordinarily
expressed as ml 02 (STPD) /lOO ml blood, or mmole OJliter.
Not recommended
synonym: oxygen content. Symb. For
arterial blood, Cao2.
plotted on the ordinate may be given in ml 02/100 ml blood
or in mmole On/liter blood or as a percent of the OXYGEN
CAPACITY,
i.e., the percent saturation. Note that sometimes the total amount of oxygen in the blood, both combined with hemoglobin and free in solution, is plotted. Abbr.
OHEC.
OXYGEN
POISONING:
Empoisonnement
par l’oxygene (F) ;
Sauerstoffvergiftung
(G). Deleterious effects due to high
partial pressures of oxygen. See OXYGEN
TOXICITY.
OXYGEN
SATURATION:
Saturation d’oxyghne (F) ; Sauerstoff-Sattigung
(G). The amount of oxygen combined with
hemoglobin, expressed as a percentage of the oxygen capacity
of that hemoglobin. Symb. So2; in arterial blood, Sao,.
OXYGEN
STORES : R&erves
d’oxyg&ne
(F) ; Sauerstoffspeicher (G). Amount of 02 which is stored in the various
compartments of the body: lung, arterial and venous blood,
and tissues. Great amounts of oxygen are fixed in blood (as
oxyhemoglobin)
and muscles (as oxymyoglobin),
800 and
150 ml, respectively, for a 70-kg man. The alveolar gas contains a few hundred ml of oxygen. Some 50 ml are dissolved
in the tissues.
l
Qo2*
OXYGEN
COST OF BREATHING:
Gout energetique de la
respiration (F) ; Sauerstoffverbrauch
der Atemarbeit (G). The
rate of consumption of oxygen required by the respiratory
muscles to ventilate the lungs.
OXYGEN
DEBT: Dette d’oxygene (F) ; Sauerstoffschuld
(G).
During recovery from a period of exercise or of apnea, there
is a volume of oxygen which is taken up by the lungs, which
is in excess of the volume of oxygen necessary to meet the
resting metabolism of the preexercise period. This is called
the oxygen debt. It represents repayment of oxygen and
energy stores which were depleted at a time when oxygen
supply from the environment
was inadequate
to sustain
aerobic metabolism, and the stores had to be called upon.
OXYGEN
DISSOCIATION
CURVE
OF HEMOGLOBIN:
Courbe de dissociation de l’hemoglobine
(F) ; Sauerstoffbindungskurve
oder Sauerstoffdissoziationskurve
des Hamoglobins (G). See OXYGEN
HEMOGLOBIN
EQUILIBRIUM
CURVE.
OXYGEN
TOXICITY:
T oxicit6 de l’oxyg2ne
vergiftung (G). The poisonous quality of
pressures, which tends to interfere with
functions, causing loss of consciousness and
example.
(F); Sauerstoffoxygen at high
various bodily
convulsions, for
OXYGEN
UPTAKE : Pr&vement
d’oxygene (F) ; Sauerstoffaufnahme (G). Amount of oxygen taken up by the body from
the environment, by the blood from the alveolar gas, or by
an organ or tissue from the blood. When this amount of
oxygen is expressed per unit of time one deals with an
“oxygen uptake rate.” “Oxygen consumption”
refers more
specifically to the oxygen uptake rate by all tissues of the
body and is equal to the oxygen uptake rate of the organism
only when the 02 stores are constant. Symb. Vo2.
PANTING:
Haletement (F) ; Hecheln (G). A pattern of ventilation characterized by high frequency and small tidal volume.
Rapid and shallow breathing. Some animals, such as the dog
and the cow, pant when exposed to heat; hence the terms
thermal panting and tachypnea. During panting the flow
rate of gas moved back and forth in the dead space of the
upper airways is high. This process allows for evaporation
of water, and hence of heat loss, with little or no increase of
alveolar ventilation.
PARTITION
COEFFICIENT
: Coefficient de partition
(F) ;
Trennungskoeffizient
(G). The ratio at equilibrium
between
the concentration of a given gas in two or more solvents.
OXYGEN
HALF-SATURATION
PRESSURE
OF HEMOGLOBIN : Pression d’oxyg&e
de demi-saturation
(F) ;
Sauerstoffhalbsattigungsdruck
des Hamoglobins (G). Oxygen
pressure necessary to saturate hemoglobin 50y0 with oxygen
(at pH 7.4 or 40 torr CO2 pressure and body temperature).
Widely used for quantification
of oxygen affinity (see OXYGEN AFFINITY).
Symb. P50.
PERIODIC
BREATHING
: Respiration periodique (F) ; Periodische Atmung (G). Abnormal pattern of breathing in which
groups of ventilatory
cycles are separated by pauses, for
example, in CHEYNE-STOKES
BREATHING.
OXYGEN
HEMOGLOBIN
EQUILIBRIUM
CURVE. Courbe
d’equilibre entre l’hemoglobine
et l’oxyg&ne (F) ; SauerstoffHamoglobin
Gleichgewichtskurve
(G). Relation
of the
amount of oxygen chemically bound to hemoglobin
as a
function of the oxygen pressure in torr (pH or Pco:! and
temperature
should be stated). The amount of oxygen
PHYSIOLOGICAL
DEAD SPACE : Espace mort physiologique
(F) ; Physiologischer Totraum (G). Calculated volume which
accounts for the difference between the pressures of CO2 in
expired and alveolar gas (or arterial blood). Physiological
dead space reflects the combination
of anatomical dead
space and alveolar dead space, the volume of the latter
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OXYGEN
CONSUMPTION:
Consommation
d’oxygene (F) ;
Sauerstoffverbrauch
(G). Rate of oxygen uptake of organisms,
tissues, or cells. Common units: ml 02 (STPD) /(kg min) or
ml 02 (STPD) /(kg l hr). For whole organisms the oxygen consumption is commonly expressed per unit surface area or
some power of the body weight. For tissue samples or isolated
cells Qo2 = ~1 02/hr per mg dry weight. Symb. Vo2 or
555
556
GLOSSARY
increasing
ventilation
with the
/perfusion
importance
of the
ratio in the lung.
nonuniformity
Abbr.
VD.
of the
PL ,ASMA,
SEPARATED
: Plasma, &pare
(F) ; Plasma,
abgetrennt
(G).
Plasma
separated
from
blood
cells. ‘Separated”
is
specified
to emphasize
that, since the plasma
is no longer
associated
with blood
cells, the results of equilibration
with
various
gas pressures
will differ
from those of plasma
which
has been
separated
from
the blood
after
equilibration
(which
is termed
TRUE
PLASMA).
Sometimes
SEPARATED
PL-4SMA
is used for studies
of acid-base
balance,
with varying
CO2 pressures
and measuree.g., equilibration
ment
of CO2
concentration.
Its composition
under
new
equilibration
conditions
cannot
include
any influence
of red
cell exchanges
since they have been excluded.
ON
RESPIRATION
AND
GAS
EXCHANGE
PNEUMOGRAPH
: Pneumographe
(F) ; Pneumograph
(G). Apparatus
which
records
the movements
of ventilation,
for
instance
by an inflated
coil around
the thorax.
The record
itself is called
a pneumogram.
A pneumograph
measures
exactly
the duration
of the ventilatory
cycle but generally
does not reliably
record
the amplitude
of the ventilatory
movement.
See SPIROGRAPH.
PNEUMOTACHOGRAPH
: Pneumotachographe
(F) ; Pneumotachograph
(G). A d evice for measuring
instantaneous
gas
flow rates in breathing
by recording
the pressure
drop across
a fixed flow resistance
of known
pressure-flow
characteristics,
commonly
connected
to the airway
by means of a mouthpiece, face mask, or cannula.
The flow resistance
usually
consists either of parallel
capillary
tubes (Fleisch
type) or of finemeshed
screen (Silverman-Lilly
type).
PI JASMA,
TRUE:
Plasma,
vrai (F) ; Plasma, wahres
(G). Plasma
separated
anaerobically
from
whole
blood.
Its analysis
reveals the composition
it had while still in contact
with the
cells. Commonly
used for studies of acid-base
balance.
PRESSURE
: Pression pleurale
(F) ; Pleuraldruck
(G).
PI ,EURAL
Literally,
the pressure
between
the visceral
and parietal
pleura relative
to atmospheric
pressure,
in cm H20. Particular
definition
is necessary.
In respiratory
measurements
pleural
pressure
is used to estimate
transpulmonary
pressure,
i.e.,
the pressure
difference
between
the airway
opening
and the
pleural
surface
of the lung.
Average
local
lung
surface
pressures
are measured
directly
from
small
induced
pneumothoraces,
or indirectly
from esophageal
balloon
catheters.
Pressures
in the pleural
liquid
as it exists normally
in the
pleural
space depend
on the equilibrium
between
capillary
blood
and pleural
liquid
colloid
osmotic
and hydrostatic
pressures.
Pleural
liquid
pressures
may
be negative
with
respect
to average
local surface
pressures.
This is possible
because
the lung surface
is not solely
exposed
to pleural
liquid;
it is exposed
also to solid contact
with parietal
pleura,
which
exerts the equivalent
of positive
pressures
on the lung
surface
in compensation
for differences
between
liquid
and
average
surface pressures.
Symb.
Ppl.
PNEUMOTHORAX
The presence
space.
POLYPNEA:
: Pneumothorax
(F) ; Pneumothorax
(G).
of gas outside
the lungs and within
the pleural
Polyp&e
(F) ; Polypnoe
(G).
See TACHYPNEA.
PULMONARY
CAPACITIES:
CapacitCs
pulmonaires
(F) ;
Lungenkapazitaten
(G).
Denote
lung
volumes
which
are
formed
of two or more
subvolumes.
Functional
residual
capacity
is the sum of residual
volume
and expiratory
reserve volume.
Inspiratory
capacity
is the sum of tidal volume
and inspiratory
reserve
volume.
Total
lung capacity
is the
pulmonary
volume
at the end of maximal
inspiration;
it is
formed
by the sum of two capacities:
functional
residual
capacity
and inspiratory
capacity,
i.e., the sum of inspiratory
reserve
volume,
tidal volume,
expiratory
reserve volume,
and
residual
volume.
REBREATHING:
Rebreathing
(F); Riickatmung
(G). Ventilation of the lungs in a closed system,
i.e., without
renewal
of
inhaled
gas. Rebreathing
occurs only exceptionally
in normal
life. Experimentally
it may be used to attempt
to equilibrate
alveolar
gas and venous
blood
CO2 pressure
and thus to
determine
the latter.
RESISTANCE,
FLOW:
Resistance
a 1’6coulement
(F) ; Strijmungswiderstand
(G).
The
ratio
of the flow-resistive
components
of pressure
to simultaneous
flow, in cm HzO/liter
per sec. Flow-resistive
components
of pressure
are obtained
by
subtracting
any elastic
or inertial
components,
proportional
respectively
to volume
and volume
acceleration.
Most
flow
resistances
in the respiratory
system
are nonlinear,
varying
with
the magnitude
(see ROHRER’S
CONSTANTS)
and
direction
of flow, with lung volume
and lung volume
history,
and possibly
with volume
acceleration.
Accordingly,
careful
specification
of the conditions
of measurement
is necessary.
Note that flow resistance
is not limited
to gas flow; it also is
used to describe
tissue flow resistance.
Symb.
R.
RESPIRATOR:
device
Respirateur
used to produce
(F) ; Respirator
or assist pulmonary
(G). A mechanical
ventilation.
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: Plethysmographe
(F) ; Plethysmograph
PI JE THYSMOGRAPH
placed
around
a living
structure
for
(G). A rigid c h amber
the purpose
of measuring
changes
in the volume
of the
structure.
In respiratory
measurements,
the entire
body
is
ordinarily
enclosed
(“body
plethysmograph”)
and
the
plethysmograph
is used to measure
changes
in volume
of gas
in the system produced
1) by solution
and volatilization
(e.g.,
uptake
of foreign
gases into the blood),
2) by changes
in
pressure
or temperature
(e.g., gas compression
in the lungs,
expansion
of gas upon passing
into the warm,
moist lungs),
or 3) by breathing
through
a tube to the outside.
Three types
of plethysmograph
are used: a) pressure,
b) volume,
and c)
pressure-volume.
In ty:pe a, the body
chambers
have fixed
volumes
and volume
changes
are measured
in terms
of
pressure
change
secondary
to gas compression
(inside
the
chamber,
outside
the body).
In tvpe b, the body
chambers
serve essentially
as conduits
between
the body
surface
and
devices
(spirometers
or
integrating
flowmeters)
which
measure
gas displacements.
Type c combines
a and b by
appropriate
summing
of chamber
pressure
and volume
displacements.
GLOSSZKY
ON
RESPIR.4TORY
zentren
activity
cspiratory
CENTERS:
Centres
respiratoires
(G).
Bilateral
brainstem
structures
results
in periodic
alternation
of
activities.
RESPI
RESPIRATION
AND
EXCHANGE
(F) ; Atmungswhose
periodic
inspiratory
and
R4TORY
CYCLE
: Cycle
respiratoire
(F) ; Atemzyklus
(G).
A respiratory
cycle is constituted
by the inspiration
followed
by the expiration
of a given
volume
of gas, called
tidal volume.
The duration
of the respiratory
cycle is the
respiratory
or ventilatory
period,
whose reciprocal
is the ventilatory
frequency.
RESPIR~4TORY
QUOTIENT.
EXCHANGE
RESPIR4TORY
Pitemfrequenz
of time. Symb.
FREQUENCY:
(G). The number
f.
RESPI
GAS
RATIO
: See RESPIRATORY
Frequence
of breathing
respiratoire
(F) ;
cycles per unit
RE SPIli.4’~~ORY
QUOTIENT:
Quotient
respiratoire
(F);
Respiratorischer
Quotient
(G).
Quotient
of the volume
of
CO? produced
divided
by the volume
of 02 consumed
by an
organism,
an organ,
or a tissue during
a given
period
of
time. Respiratory
quotients
are measured
by comparing
the
composition
of an incoming
and an outgoing
medium,
e.g.,
inspired
and expired
gas, inspired
gas and alveolar
gas, or
arterial
and venous
blood.
Sometimes
the phase “respiratory
exchange
ratio”
is used to designate
the ratio of CO2 output
to the 02 uptake
by the lungs, ‘?espiratory
quotient”
being
restricted
to the actual metabolic
CO:! output
and 02 uptake
by the tissues. With
this definition
respiratory
quotient
and
respiratory
exchange
ratio are identical
in the steady
state,
a condition
which
implies
constancy
of the 02 and CO2
stores. ,4bbr.
RQ or R.
ROHRER’S
CONSTANTS:
Constantes
de Rohrer
(F); Rohrers
Konstanten
(G).
Constants
in an empirical
expression
for
airway
resistance,
namely
: R = K1 + K&
where
K1 is
the flow-independent
component
and Kz the flow-dependent
component
of the resistance,
R, and V is the instantaneous
rate of flow. Rohrer’s
original
expression
had a theoretical
The expression
nevertheless
fits obbasis, since disproved.
served
flow-resistive
pressure-flow
relationships
closely
if
applied
over a small range of flows and excluding
expiratory
plateaus.
Symb. K1 and Kz.
ROOT
EFFECT:
Eflet Root (F) ; Root-Effekt
(G). A property
of many
fish hemoglobins
which
is characterized
by displacement
of the oxygen
hemoglobin
equilibrium
curve
clown
and to the right
with
increasing
Hf
concentration.
This effect differs
from the BOHR
EFFECT
in that, even
at high oxygen
pressures
(sometimes
up to several
hundred
.4ta), no complete
oxygen
saturation
is accomplished.
SHUNT:
Shunt
(F);
K urzschluss
(G).
Vascular
connection
between
circulatory
pathways
so that venous blood is diverted
into vessels containing
arterialized
blood
(right-to-left
shunt,
venous
admixture)
or vice versa (left-to-right
shunt).
Rightto-left
shunt
within
the lung, heart,
or large vessels due to
malformations
are more important
in respiratory
physiology.
Flow from
left to right
through
a shunt
should
be marked
with a negative
sign.
SOLUBILITY
COEFFICIENT
FOR
GASES:
Coefficient
de
solubilite
des gaz (F);
Loslichkeitskoeffizient
fur Gase (G).
The ml gas physically
dissolved
(STPD)
in 1 ml of fluid at 1
atmosphere
test gas pressure,
at a given
temperature.
For
02 in water
at 37’ C; a = 0.0239
ml. For 02 in blood at
37O c; a = 0.0223
ml (15 g Hb).
Symb.
cy, e.g., cyo,,.I
SPIROGRAPH
device,
collects
volume
TORY
: Spirographe
(F) ; Spirograph
(G).
Mechanical
including
bellows
or other sealed, moving
part, which
and stores gases and provides
a graphical
record
of
changes.
See BREATHING
PATTERN,
RESPIRACYCLE.
SPIROMETER:
similar
Spirom&re
to a spirograph
(F) ; Spirometer
(G).
but without
recording
An apparatus
facility.
STANDARD
BICARBONATE
: Bicarbonate
standard
(F) ;
Standardbikarbonatwert
(G).
Bicarbonate
concentration
in
plasma
(SEG PLASMA,
TRUE)
separated
anaerobically
from
whole blood that has been saturated
with oxygen
and equilibrated
at PCO~ = 40 torr at 37O C. A measure
of the metabolic
disturbance
of acid-base
balance
in a sample
of blood after
any
respiratory
disturbance
has been corrected.
Normal
value 2 l-26 mEq /liter.
STPD
CONDITIONS:
Conditions
STPD
(F);
STPD
Bedingungen
(G). Standard
temperature
and pressure,
dry. These
are the conditions
of a volume
of gas at 0’ C, at 760 torr,
without
water
vapor.
A STPD volume
of a given gas contains
a known
number
of moles of that gas. Abbr.
STUD.
SURFACTANT,
PULMONARY:
Surfactant
pulmonaire
(F) ;
Oberflachenaktive
Substanzen,
Lunge
(G).
Phospholipid
(mainly
dipalmitoyl
lecithin)-protein
complex
which
lines
alveoli
(and possibly
small airways)
and accounts
for the low
surface
tension
which
makes air space (and airway)
patency
possible
at low transpulmonary
pressures.
TACHYPNEA
breathing
defined
TIDAL
: Tachypnee
(F) ; Tachypnoe
(G).
Increased
in comparison
with breathing
at rest (less exactly
than and not to be confused
with hyperventilation).
VOLUME
: Volume
Volume
of gas which
ventilatory
cycle. Symb.
courant
(F) ; Atemzugvolumen
is inspirecl
and expired
during
VT.
(G).
one
TONOMETRY:
Tonometrie
(F);
Tonometrie
(G).
A method
for measuring
gas pressures
in fluids, by equilibrating
a small
gas bubble
at known
pressure
and temperature
with a relatively large volume
of fluid, followed
by analysis of the bubble.
More
recently
it has come to be used (illogically
and regrettably)
to mean any equilibration
of gas and liquid
phases
including
situations
in which
the volume
of gas is relatively
large and the volume
of liquid
relatively
small so that the gas
phase determines
the gas pressure
in the liquid
rather
than
vice versa.
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R4TORY
MUSCLES
: Muscles
respiratoires
(F) ; Atemmuskeln
(G).
Those
muscles
whose
actions
produce
the
volume
changes
of the respiratory
system
during
breathing.
They
include
inspiratory
muscles
(mainly
Diaphragm
and
External
Intercostals,
but also accessory
muscles:
Scaleni,
Sternomastoids,
Trapezius,
Pectoralis
Major,
Pectoralis
Minor,
Subclavius,
Latissimus
Dorsi,
Serratus
Anterior,
and
others,
including
all muscles
which
extend
the back),
and
espiratory
muscles
(mainly
Internal
Intercostals
and Abdominals,
and also all muscles which
flex the back).
557
558
TORR:
GLOSSARY
Torr
(F); Torr
(G). A unit of pressure
equal to 1,333.22
dynes/cm2
or 1.33322
millibars.
The torr
is equal
to the
pressure
required
to support
a column
of mercury
1 mm high
when
the mercury
is of standard
density
and subjected
to
standard
acceleration.
These standard
conditions
are met at
0’ C and 45’ latitude,
where
the acceleration
of gravity
is
a mercury
barometer
at other
980.6
cm/set 2. In reading
temperatures
and latitudes,
corrections,
which
commonly
exceed
2 torr,
must be introduced
for these terms
and for
the thermal
expansion
of the measuring
scale used. The torr
is synonymous
with pressure
unit, mm Hg. Symb.
torr.
TRANSPULMONARY
PRESSURE
: Pression
transpulmonaire
(F) ; Transpulmonaler
Druck
(G). Pressure difference
between
airway
opening
(mouth,
nares, or cannula
opening)
and the
visceral
pleural
surface,
in cm H20.
Transpulmonary
in
the sense used
includes
extrapulmonary
structures,
e.g.,
trachea
and extrathoracic
airways.
This
usage
has come
about
for want
of an anatomic
term which
includes
all of
the airways
and the lungs together.
Symb.
PL.
VENTILATION,
ALVEOLAR
: Ventilation
alveolaire
(F) ;
Alveolare
Ventilation
(G).
Physiological
process
by which
alveolar
gas is completely
removed
and replaced
with fresh
gas.
ventilation
is less than total ventilation
because
- Alveolar
when a tidal volume
of gas leaves the alveolar
spaces, the
AND
GAS
EXCHANGE
last part does not get expelled
from
the body
but occupies
the dead space, to be reinspired
with
the next inspiration.
Thus the volume
of alveolar
gas actually
expelled
completely
is equal
to the tidal volume
minus
the volume
of the dead
space.
This
truly
complete
expiration
volume
times
the
ventilatory
frequency
constitutes
the alveolar
ventilation.
Symb.
VA.
VENTILATION/PERFUSION
RATIO
: Rapport
ventilation
perfusion
(F) ; Ventilation-Durchblutungs
Verhtiltnis
(G).
Ratio
of the alveolar
ventilation
to the blood
perfusion
volume
flow through
the pulmonary
parenchyma.
This ratio
is a fundamental
determinant
of the 02 and CO2 pressure
of the alveolar
gas and of the end-capillary
blood. Throughout
the lungs
the local
ventilation/perfusion
ratios
vary
and
consequently
the local alveolar
gas and end-capillary
blood
compositions
also vary.
Symb.
VA/Q.
VENTILATORY
EQUIVALENT
: Equivalent
ventilatoire
(F) ;
Ventilationsaquivalent
(G).
Ratio
of the ventilatory
flow
rate expressed
in BTPS conditions
to the oxygen
uptake
rate
expressed
in STPD conditions.
This ratio indicates
how many
volumes
BTPS of air are breathed
to obtain
one volume
02
STPD. In normal
man a common
figure
is 28 liters
(BTPS)
breathed
for 1 liter (STPD) 02 taken up.
VITAL
CAPACITY:
CapacitC
vitale
(F) ; Vitalkapazitat
(G).
Volume
measured
on complete
expiration
after the deepest
inspiration,
but without
respect
to the effort
involved.
Abbr.
VC. Inspiratory
vital capacity
is the maximal
volume
measured on inspiration
after a full expiration.
Abbr.
IVC. Forced
vital capacity
is the volume
of gas expired
after full inspiration,
and with expiration
delivered
as rapidly
and completely
as
possible.
Abbr.
FVC.
WORK
OF BREATHING
: Travail
ventilatoire
(F) ; Atemarbeit
(G). The energy
required
for breathing
movements.
Usually
estimated
as s PdV from volume-pressure
diagrams
of the
passively
driven
respiratory
system
or from
volume-transpulmonary
pressure
diagrams
during
spontaneous
breathing
with additional
work
done on the chest wall approximated
from separate
measurements
made during
voluntary
relaxation, commonly
expressed
as a rate of work,
i.e., work
per
respiratory
cycle times respiratory
frequency.
Work
of inspiration (Symb.
Winsp ) and work of expiration
(Symb.
We,&
may
be separately
specified,
and rate of work is symbolized,
W.
VALSALVA’S
MANEUVER:
Manoeuvre
de Valsalva
(F) ;
Valsalva’scher
Versuch
(G).
Expiratory
effort
with
closed
During
this maneuver
intrathoracic
pressure
is
airway.
raised, and venous return
and cardiac
output
are diminished.
VENTILATION:
Ventilation
(F) ; Ventilation
(G). Physiological
process by which gas is renewed
in the lungs. The word ventilation
sometimes
designates
ventilatory
flow rate (or ventilatory minute
volume)
which is the product
of the tidal volume
by the ventilatory
frequency.
Ventilation
is often referred
to
as “total
ventilation”
to distinguish
it from “alveolar
ventilation”
(see VENTILATION,
ALVEOLAR).
RESPIRATION
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TRANSTHORACIC
PRESSURE
: Pression
transthoracique
(F) ; Transthorakaler
Druck
(G). Pressure
difference
between
parietal
pleural
surface
and body
surface.
Transthoracic
in
the chest wall”
(see CHEST
the sense used means “across
WALL).
It is a misnomer
which
has come into use because
of the lack of an adjectival
term for chest wall. Symb.
Pw.
ON