呼吸系统生理1Respiration.ppt

Pulmonary capacities Forced expiratory volume (用力肺活量，timed vital volume时间肺活量) The maximal volume of air that can be exhaled as fast as possible from the lungs following a maximal inspiration Normal value: 1st sec. (FEV1) -- 83％ 2nd sec. (FEV2) -- 96％ 3rd sec. (FEV3) -- 99％ Pulmonary ventilation Pulmonary ventilation (每分通气量VE) The total amount of air inspired (or expired) during one minute VE = TV x breaths/min = 500 X12 = 6000 ml Pulmonary ventilation Alveolar ventilation (肺泡通气量VA) The amount of inspired air that is available for gas exchange each minute VA = (TV - dead space无效腔) x breaths/min = (500-150) X12 = 4200 ml Dead space Anatomical dead space Volume in respiratory passageways which can not be exchanged ~150ml Alveolar dead space Alveoli which have little or no blood supply and cease to function in gas exchange Normally ~0 Dead space Because of the anatomic dead space, “Fresh” inspired air is diluted by the left over air remaining in the lungs from the previous breathing cycle. Increased depth of breathing is far more effective in evaluating alveolar ventilation than is an equivalent increase in breathing rate. 一秒用力呼气容积(Forced expiratory volume in one second, FEV1) ：吸气至肺总量位后一秒之内快速呼出气量。 　　临床上常以FEV1/用力肺活量FVC的比值(FEV1%)做判定，正常值为83%；阻塞性或者混合型是轻度降低到明显降低； 限制性是数值正常或轻微升高。FEV1%测定是判定哮喘的一个常用指标，哮喘主要是出现呼气性的呼吸困难，所以FEV1%测定会降低或者明显降低。 　　Ⅰ级(轻度) ：FEV1/FVC70%，FEV1占预计值百分比≥80%；避免危险因素：接种流感疫苗；按需使用短效支气管舒张剂 　　Ⅱ级(中度)： FEV1/FVC70%，50%≤FEV1占预计值百分比80%，在上一级治疗的基础上，规律应用一种或多种长效支气管舒张剂，康复治疗 　　Ⅲ级(重度)： FEV1/FVC70%，30%≤FEV1占预计值百分比50%，在上一级治疗的基础上，反复急性发作，可吸入糖皮质激素 　　IV(极重度)： FEV1/FVC70%，FEV1占预计值百分比30%，或伴有慢性呼吸衰竭，在上一级治疗的基础上，如有呼吸衰竭，长期氧疗，可考虑外科治疗 FEV1，FVC，FEV1/FVC * * 13.06.jpg * 13.07.jpg * Match color of high compliance curve and text describing it. Physiological significance of intrapleural negative pressure Allow expansion of the lungs Facilitate the venous lymphatic return Pneumothorax （气胸） Air escapes from the lungs or leaks through the chest wall and enters the pleural cavity---