mechanism of ventilation, gas exchange
TRANSCRIPT
• Surface tension • Thorax+pleura• Interdependency of
the alveoli
Az orvosi élettan tankönyve - Attila, Fonyó
Thorax
• Surface tension • Thorax+pleura• Interdependency of
the alveoli• Surfactant
Az orvosi élettan tankönyve - Attila, Fonyó
Thorax
Pleura space
Parietal pleura
Visceral pleura
Lungs
• Surface tension • Thorax+pleura• Interdependency of
the alveoli• Surfactant
Az orvosi élettan tankönyve - Attila, Fonyó
Thorax
Pleura space
Parietal pleura
Visceral pleura
Lungs
Athmospheric pressure
Intrapulmonary pressure
Intrapleural pressure
Transpulmonary pressure
Az orvosi élettan tankönyve - Attila, Fonyó
Thorax
Pleura space
Parietal pleura
Visceral pleura
Lungs
Athmospheric pressure
Intrapulmonary pressure
Intrapleural pressure
Transpulmonary pressure
Az orvosi élettan tankönyve - Attila, FonyóGuyton and Hall Textbook of Medical Physiology
Thorax
Pleura space
Parietal pleura
Thorax
Pleura space
Parietal pleura
Az orvosi élettan tankönyve - Attila, Fonyó
Lung volume (liter)
Thorax Lungs Thorax + lungs
Transpulmonary pressure(H2O cm)
Compliance
Az orvosi élettan tankönyve - Attila, Fonyó
Saline
AirLu
ngv
olu
me
(%
TLC
)
Transpulmonary pressure(H2O cm)
𝑅 =𝑣𝜌𝑑
𝜇
Resistance
• Elastic recoil: resistance from lung tissue • Viscose resitance: resistance from the air
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of PhysiologyAz orvosi élettan tankönyve - Attila, Fonyó
Respiratory volume(liter)
IntrapleuralPressure(H2Ocm)
Speed of flow(liter/s)
Intrapulmonary pressure(H2Ocm)
Start of insp. End of insp. End of exp.
~3500 ml
~500 ml
~1200 ml
~1200 ml
~2400 ml
~4800 ml
~6000 ml
Guyton and Hall Textbook of Medical Physiology
Dead space
• anatomical • alveolar
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of PhysiologyGuyton and Hall Textbook of Medical Physiology
https://en.wikipedia.org/wiki/High-frequency_ventilationhttps://www.youtube.com/watch?v=guodauleCC0
High frequency ventilation – Taylor dispersion
V= 𝑘 𝑥 𝐴 𝑥 ഥ𝐷Δ𝑃
0,75s
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of Physiology
98 Hgmm
40 Hgmm
40 Hgmm
46 Hgmm
V/Q mismatch
Perfusion (Q) Ventilation (V)
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of Physiology
https://rk.md/2018/hypoxic-pulmonary-vasoconstriction-hpv/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310129/
• Dorsal respiratory center
• Ventral respiratory center(Pre-Bötzinger complex)
• Bötzinger complex
• Pneumotaxic center
• Apneustic center
• Pons: parabrachial nucleus, Kölliger –Fuse nucleus
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of Physiology
• Dorsal resp. center ->resting inspiration, rythm generator
• Ventral respiratory center (Pre-Bötzinger complex) -> forced in & expiration
• Bötzinger complex -> inhibitory, startin postinhibitory phase
• Pons: parabrachial nucleus, Kölliger –Fuse nucleus
• Pneumotaxic center
• Apneustic center
inhibition
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of Physiology
• Slow adapting receptors
• Inhibiting inspiratory reflex
• Hering Breuer reflex
• Fast adapting receptros
• In the wall of the airways
• Histamin, PG, dust
• Coughing, hyperpnoe, mucus secretion
• Juctacapillary receptors
• Chemical stimuli in blood
• Apnoe, bronchoconstriction, mucus secration
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of Physiology
• Central chemoreceptors
• Ventral part of medulla
• CO2 diffuses through BBB
• H+ + HCO3- in CSF
• Emelkedett H+ ingerli a receptorokoat-> ventilation stimulus
• Peripherial receptors
• Glomus caroticum, glomus aorticum
• Sensitive: hypoxia, hypercapnia, acidosis
Silbernagl, Stefan, and Agamemnon Despopoulos. Color Atlas of Physiology