Respiration
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Transcript of Respiration
RESPIRATION
The exchange of gases between aliving organism and its environment
FUNCTIONS OF THERESPIRATORY SYSTEM
Intake of O2 Remove CO2
Maintains homeostasis: pH, CO2 acid-base balance of blood
Endocrine functions
Respiratory system
Surface exposed to the environment is large 70 sq.m
Movement of air:10000 liters a dayHalf liter each breathIncreases during work/exercise60 liters per minute
FUELO2 CO2
H2O
METABOLISMMETABOLISM =SUM OF CHEMICAL ANDPHYSICAL PROCESSESWHICH MAINTAIN LIFE
VENTILATIONVENTILATION
O2CO2
UTILIZATIONUTILIZATION
TRANSPORTATIONTRANSPORTATION
DIFFUSIONDIFFUSION
PHASES OFPHASES OFRESPIRATIONRESPIRATION
Respiratory system
Neuro-regulatory mechanisms“The Pump” Musculo-skeletal :
rib cage, respiratory muscles, pleura
Conducting Airways : nose, pharynx, larynx, trachea, bronchi
Gas exchange surface: alveoli
Defense mechanismsHeart-lung interactions
RESPIRATORY MUSCLES
TRACHEA
BRONCHI
BRONCHIOLES
ALVEOLAR DUCTS
ALVEOLI(AIR SACS)
NASAL PASSAGE
TRACHEAITIS
BRONCHITIS
BRONCHIOLIOLITIS
ALVEOLAR DUCTS
ALVEOLITIS(AIR SACS)
RHINITIS
TRACHEAMAIN BRONCHI
PULMONARYVEINSPULM
ARTERIES
ALVEOLUS
BLOODCAPILLARY
O2
CO2
Capillary
Alveolus
RBC
BLOOD
Respiratory system
Neuro-regulatory mechanisms“The Pump” Musculo-skeletal :
rib cage, respiratory muscles, pleura
Conducting Airways : nose, pharynx, larynx, trachea, bronchi
Gas exchange surface: alveoli
Defense mechanismsHeart-lung interactions
Defense mechanisms
Clearance by Physical-physiological
– Rapid bulk removal
Cellular detoxification orImmunologic processing
Physical-physiologicalAgainst penetration and retention
– Gases: Humidification, Dilution, Neutralization,
Absorption– Particulates: Filtration– Laryngeal closure– Bronchospasm– Slow breathing, breathholding
Removal– Coughing, sneezing, gagging– Mucociliary transport– Alveolar clearance
A physiologic defense response may result in disease
Clearance by Cellular detoxification orImmunologic processing Highly controlled inflammatory
pathways = physiologic responseAmplified-uncontrolled expression of
those pathways = disease
Exposure
Impact onSignaling molecules-pathways Target cells responses
Altered homeostasis
InflammationStructural remodeling eg collagen + or –
e.g. Fibrosis or Emphysema
Gene polymorphisms determine responses
In blood, bronchial secretions, tissue:
Cells Macrophages Neutrophiles Eosinophiles Lymphocites Mast cells Basophiles Giant cells
Humoral Signaling moleculesEicosanoids:
– cytokines,– tachykinins,– reactive species – surfactant
proteinsAntiproteasesDefensins
SmokingSmoking
Leukocytes Leukocytes
Proteases Proteases
Destruction Destruction emphysemaemphysema
AntiproteasesAlpha 1 antitrypsin
O3O3
NOx
SO2
Activated Macrophage24 hrs to Clear 50%
3 mm/min
2 hours
Via lymphatics
3-4 months to
Clear 50%
Respiratory Diseases Symptoms Signs
Dyspnea on exertion
at rest Cough Expectoration Hemoptysis Wheezing Chest tightness Chest pain Fatigue, Wgt loss
Breathing rate, labored
Wheezes, ronchi
CracklesDullnessBreathsounds
Diagnostic studies
History and physical exam Imaging studies
Chest X-rayComputerized Axial Tomography CT & High Resolution CT
Pulmonary Function Tests : spirometry, lung volumes, diffusing capacityArterial Blood Gases PaO2, PaCO2, pH, HCO3
Exercise stress testing: SaO2 +++ Polysomnography
Invasive procedures
Fiberoptic BronchoscopyTransbronchial biopsyPercutaneous needle biopsyOpen lung biopsyVideo Assisted ThoracoscopyThoracocentesisPulmonary angiography
Bronch, pfts
Pulmonary Function Tests Spirometry
VOLUME
TIME1 SEC
FEV1=forced expiratory volume in first second
FVC = Vital capacity
Spirometry
Computerized Axial Tomography
BRONCHOSCOPY