Physiology of the Respiratory System | Jindal chest clinic

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Physiology of the Respiratory System
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Physiology of the Respiratory System

• Structure of the Respiratory System
• Mechanical Properties in Respiration
• Pulmonary Circulation, Ventilation/Perfusion
  Ratio
• Diffusion and Transport of Respiratory Gases
• Control of Respiration
• Nonrespiratory Functions of the Respiratory
  System

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Nonrespiratory Functions

• Air conditioning
• Immune functions
• Metabolic functions
• Other functions

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Air Conditioning

• Warming
• Humidifying
• Clearing

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Warming and Humidifying
By the lobar bronchi 37ºC and fully
moist Nasal cavity! 250 ml/day loss
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Clearing - Mucociliar Cleareance

• 5-10 µm gel, not
• continuous
• islands of mucus
• 5-6 µm periciliary
• fluid
• cilia
• goblet cells, glands,
• Clara-cells

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Cystic Fibrosis

• cystic fibrosis transmembrane conductance
  regulator (CFTR), impaired function of this
  cyclic AMP regulated Cl-ion channel
• Autosomal recessive, 13000 (caucasian)

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Cilia
250 cilia/cell 2-5 µm length Only the tip
reaches the gel 1000 strokes/min
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The Airway Cleaning Function of Cilia
Trachea, main bronchi 5-20 µm/min Bronchioli
0,5-1 µm/min
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Clearing as a Function of Particle Size
gt 10µm nasal cavity, nasal hair 2 -
10µm lower airways, trachea, bronchi,
turbulent flow! 0,2 - 2µm
bronchioli lt 0,2µm reaches the
alveoli ? macrophages
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Immune Functions

• Special immune system is
• necessary
• Mucosa Associated Lympoid Tissue (MALT)
• Bronchus Associated Lympoid Tissue (BALT)
• B-lymphocytes ? IgA
• NK cells, macrophages

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Asthma
IgE, mast cells
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Metabolic Functions

• Renin angiotensin system
• Angiotensin converting enzyme (ACE) is located
  mainly on the surface of
• endothelial cells in the lung A I. ?
  A II.
• Metabolism of biologically active substances
• serotonin, noradrenalin, prostaglandin
• Production of factors influencing blood
  coagulation
• source of plasminogen activator,
  thromboplastin production,
• heparin production

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Other Functions

• Filter function
• Elimination of volatile substances
• Smelling
• Vocalization
• Body posture stability
• Sighing, yawning

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Filter Function
Lung functions as a filter for substances from
the venous side of circulation -
Embolus - Tumour-metastasis
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Elimination of Volatile Substances
Certain volatile substances diffuse into the
alveoli from the blood and can be detected and
smelt in the expired air - acetone
? diabetes -
methyl-mercaptan ? liver disease -
ethyl-alcohol ? high blood level
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Smelling and Vocalization
Behavioral control!!
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Body Posture Stability, Sighing, Yawning
Stability Valsalva-maneuver Sighing
increasing superficial surfactant
concentration (?) Yawning
?
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Cardiorespiratory Adaptation during Exercise,
Primary Prevention
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Processes Involved in O2 Consumption
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Reserves in the Cardiorespiratory System
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Respiratory Changes during Exercise

• Ventilation/perfusion ratios become more equal
• Reserves are used more and more

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Respiratory Changes during Exercise
Anaerobic threshold
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Determination of Anaerobic Threshold
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Circulatory Changes during Exercise
Postexercise hypotension
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Blood Flow in Coronary Arteries
HR x SBP double product
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Redistribution
Sympathetic outflow Epinephrin, norepinephrin
a1  IP3/DAG vasoconstriction   ß2 cAMP
vasodilation
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Distribution of Cardiac Output (ml/min) in
Resting State and during Various Levels of
Exercise
Exercise Intensity
Organ
Resting Mild
Intermediate Maximal
Splanchnic
Kidney
Brain
Heart
Muscles
Skin
Other
Total
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Oxygen Consumption
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Changes in Cardiorespiratory Parameters during
Exercise
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Primary Prevention
Preventing the occurence of diseases.

• Hand washing, immunization
  H1N1
• Natures editorial
• A tsunami is coming. No one knows how
  big it will be. Prepare to go for higher
  ground.
• Health promotion

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Effects of Smoking

• Decreased alveolar surface
• Increased FRC, decreased IRV
• Decreased mucociliar clearance
• Increased airway resistance
• Decreased O2-transport due to CO-Hb
• Tumours due to carcinogens
• Decreased physical capabilities
• Increased atherosclerosis ? AMI
• Acute
  Myocardial Infarct

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The Smoking Epidemic
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Percentage of Female Smokers in the EU
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Percentage of Male Smokers in the EU
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Percentage of Smokers in the EU
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Acute Myocardial Infarct Related Deaths
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Theory and Advice
Fight-or-flight response W.
Cannon Originally Stress ? Muscle
work, exercise Current fight answers
angry, argumentative beaviour Current flight
answers social withdrawal, substance
abuse ?
smoking
Friedman, H. S., Silver, R. C. (2007).
Foundations of Health Psychology. New York
Oxford University Press.
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Thank You