生理学双语课件呼吸详解.ppt

The surface tension accounts for about two thirds of the total elastic forces in the normal lungs. The surface tension elastic forces of the lungs also increase tremendously when the substance called surfactant is not present in the alveolar fluid. Surfactant is a surface active agent, which means that it greatly reduces the surface tension of the water. It is secreted by special surfactant-secreting epithelial cells that constitute about 10 per cent of the surface area of the alveoli. These cells are are called type II alveolar epithelial cells. Surfactant is a complex mixture of several phospho-lipids, proteins, and ions. Surfactant consists primarily of the phospholipid, (DPPC) which is responsible for reducing the surface tension. Abnormalities of Lung Elastic Recoil Lung elastic recoil is increased by reduced surfactant activity resulting from decreased synthesis or inactivation. The best-known clinical disorder associated with decreased surfactant synthesis is the respiratory distress syndrome of the newborn. Surfactant production may also be impaired following the interruption of pulmonary perfusion, as in pulmonary thromboembolism血栓栓塞. Hydrostatic pulmonary edema and adult respiratory distress syndrome are associated with surfactant inactivation due to alveolar flooding. The consequences of decreased surfactant activity include decreased lung compliance due to increased surface tension and alveolar collapse (atelectasis肺萎陷), decreased lung volumes (TLC, total lung capacity, RV residual volume, and FRC functional residual capacity), and increased elastic work of breathing. The decreased lung compliance of interstitial or infiltrative浸润性的lung diseases results from two mechanisms－ decreased distensibility and lung shrinkage Pathologically these diseases are characterized by alveolar filling with inflammatory exudate渗出物and/or replacement of alveoli by fibrosis, and this loss of alveolar units or lung shrinkage decreases compliance (see above). In