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Dr. Abdelaziz M. Hussein Objectives • • • • • • • Definition of respiration Division of respiration Physiological anatomy of respiratory system Mechanics of pulmonary ventilation Gas exchange at lungs O2 and CO2 carriage by blood Hypoxia Definition • Transport of oxygen from atmosphere to tissue • Oxidation of food stuff and removal of CO2 EXTERNAL RESPIRATION Resp. function of Blood INTERNAL RESPIRATION Divisions of Respiration External respiration • Pulmonary ventilation • Gas exchange between alveolar air and venous blood Respiratory functions of blood • Carriage of blood gases Internal respiration • Utilization of O2 by tissues Physiological anatomy of respiratory system • Respiratory system consists of → (I) Air conducting part (II) Respiratory part Nasal cavity Nostril Oral cavity Pharynx Larynx Trachea Carina of trachea Right main (primary) bronchus Right lung Left main (primary) bronchus Left lung Diaphragm Figure 22.1 I)Air conducting part Definition: nose, nasopharynx, larynx, trachea, two main bronchi, smaller branchioles resp branchioles -characters → thick wall, so not allow gas exchange. FUNCTIONS: 1)conduction of air to respiratory zone. 2)Air conditioning →to make temperature of air entering lung 37°C due to Blood capillaries of resp. passage 3) Air moistening by mucosa of the lung (dry air will damage delicate lung tissue) 4) Filtration & cleaning from foreign particles & bacteria 5) Protective reflexes → (i) cough reflex (ii) sneezing reflex 6) Non respiratory functions → (i)smell by olfactory receptors in nose (ii) voice production by larynx (II) Respiratory part -composed of alveoli -thin wall so allow gas exchange Pulmonary Ventilation: Def :- air in flow & out flow from respiratory System in the form of Respiratory cycles. Respiratory cycles -Composed of : • inspiration =1.3 second • expiration =1.7 second • expiratory pause=0.7 second 1.3 1.7 0.7 (c) Expiratory pause → period of rest after expiration (0.7 econds). → absent in rapid inspiration as in muscle exercise Respiratory rate = 60 sec 3.7 sec =16/min Mechanics of respiration: Inspiration Expiration 1) active process 2) due to contraction of diaphragm which ↑ vertical diameter of chest 5-7 cm & contraction of external intercostal muscles which ↑ anteroposterior & transverse diameter of chest. 1) passive process 2) due to relaxation of diaphragm & external inter costal muscles. Mechanics of respiration: Inspiration Expiration 3) chest cavity ↑ in all its dimensions 4) lung volume ↑ 5) pressure in alveoli ↓ to –2 mmHg 3) chest cavity ↓ in all its dimensions 4) lung volume 5) pressure in alveoli ↑ to + 2 mmHg 6) air rushes into the lung 6) air rush out of the lung Inspiration Expiration Ventilation (breathing) 3 6 2 0 2 Factors affecting pul. Ventilation: 1. Airway resistance to lung. 2. Pressure relationship in thoracic cavity. 3. Lung and chest compliance. 4. Surfactant. Pressure in thoracic cavity (i) intrapulmonary pressure: -Definition→ pressure inside lung alveoli & it’s connected with the atmosphere. -values during inspiration= -2 mmHg (air rush into lung) during expiration = +2 mmHg (air rush out lung) (ii) interpleural pressure: -Definition → pressure inside pleural cavity which space ()visceral & pleura(always –ve pr) is the parietal 3 6 2 0 2 Values→ –ve pressure→-3 mmHg at end of normal expiration -6 mmHg at end of normal inspiration -30 mmHg in forced inspiration +40 mmHg in forced expiration Surfactant * def → lipoprotein substance secreted by type II alveolar •mechanism of action → •↓ surface tension < > fluid molecules lining alveolar bec. surfactants are scattered ()fl. molecules lining alv. thus ↓ force of attraction ()them •Function → • (1) prevent lung collapse (2) ↓ muscle effort to expand lung (3) Has antibacterial action •Factors ↓ surfactant → (1) Resp. distress syndrome (↓ in infants) (2) Cigarette smoking 34 Exchange of gases Def → exchange of gases > < air in the alveoli and capillaries around alveoli through respiratory Membrane Respiration, Abdelaziz Hussein 36 Respiration, Abdelaziz Hussein 37 A) Properties of respiratory membrane (thickness and surface area) B) Properties of respiratory gas (pressure gradient, MW, Lipid solubility, and diffusion capacity ) C) Ventilation perfusion ratio Respiration , Abdelaziz Hussein 38 40 • Each 100 ml arterial blood contains 19.5 ml O2 • O2 is transported in blood in 2 forms O2 Transport 1) O2 in physical solution O2 dissolved physically in plasma It is about 0.3 ml O2 / 100 ml blood It reflects and determines the O2 tension (PO2) in the blood 2) O2 in Chemical combination O2 that combined with Hb in RBCs. It is more than 98% of the O2. 41 42 • Each 100 ml arterial blood contains 48 -52 ml CO2 CO2 Transport 1) CO2 in physical solution 5% dissolved physically in plasma and RBCs 2) CO2 in Chemical combination Carbamino compound s Bicarbonates 6% with Hb and plasma proteins 89% bicarbonates 43 44 46 Def: • O2 deficiency at tissue level. Types: • It can be divided into: 1) Disturbance in external respiration → Hypoxic hypoxia 2) Disturbance in respiratory function of the blood → a. Anaemic hypoxia b. Stagnant hypoxia 3) Disturbance in internal respiration → Histotoxic hypoxia. 47 Hypoxic hypoxia Anemic hypoxia Stagnant hypoxia Histotoxic hypoxia 48 49 O2 Venous blood CO2 Oxygenated blood Causes: 1. Reduced atmospheric O2 e.g. high altitude 2. Ventilation defect e.g. Obstructive Lung Diseases O2 CO2 3. Gas exchange defect e.g. pulmonary fibrosis Venous blood Partially oxygenated blood 52 Causes: Adequate O2 Adequate gas exchange 1) General: a. Shock. b. Congestive failure. heart 2) Local: -Obstruction of blood vessels either from inside by thrombus and emboli or from outside. RBCs Slow blood flow Body tissue 53 54 Causes: Adequate O2 Adequate gas exchange 1)All types of anaemia 2)CO poisoning RBCs Low Hb content or functions Body tissue 55 56 Causes: Adequate O2 1) Cyanide poisoning: It blocks cytochrome oxidase system. 2) Alcoholic poisoning: Alcohol blocks dehydrogenase enzyme. Adequate gas exchange RBCs Alcohol Body tissue toxicity 57