英国纽卡斯尔生理学课件0011课程.pptVIP

Respiratory System Lecture 11 Synopsis Ventilation, Boyle’s law Muscles and nerves in ventialtion Resistance and flow (again) Assessing lung volumes Dead space * Stroke volume Airway resistance Fibrotic lung dieases Asthma Muscular dystrophy Brochitis Gas Laws: Boyle’s Law: P1.V1=P2.V2 Gases move from areas of higher pressure to areas of lower pressure Volume and pressure are related Muscles used for ventilation Inspiration Diaphragm (phrenic nerve) external intercostal muscles (intercostal nerves) scalenes sternocleidomastoids During quiet inspiration the diaphragm is primarily used. The other groups are recruited with increasing force Expiration is usually passive! For forced expiration: internal intercostal muscles abdominal muscles External intercostal muscles move ribcage upwards (involvement of accessory muscles for forced inspiration) Increasing the size of the thoracic cavity Diaphragm contracts and moves downwards Pressure changes during quiet breathing Airway resistance Flow rate ~ ΔP/r4 radius of the airways according to Poiseuille’s law the flow rate is proportional to r4 flow pattern turbulent flow (upper airways) transitional flow (medium sized bronchi) laminar flow (small airways) the flow pattern is not homogenous throughout the airway! high frequency artificial ventilation 40% 40% 20% Small airways less than 2mm Large airways more than 2mm Larynx Resistance in different airways Physical obstruction Broncioles: o PS (Ach) Histamine o CO2 NA Conducting airways / dead space Anatomic dead space : volume of the conducting airways. Physiologic dead space: anatomic dead space plus alveolar dead space. In unhealthy or elder people not all the alveoli function properly, i.e. they are insufficiently perfused and not all the O2 and CO2 is exchanged: alveolar dead space The conducting airways are ventilated but do not contribute to gas exchange: dead space The consequences of dead space Patient Tidal