Experiment 2: Respiration by Saboohi Khan Results

Vitalograph measurements:

Subject 1 (normal respiration) Static vital capacity (L) Forced vital capacity (L) FEV1(L) MVV(L)[FEV1x37.5] 2.21 4.01 1.40 52.5

Subject 2 (during exercise) 3.34 3.60 ----* **

Subject 3 (Grp1) 3.41 5.77 3.39 127.13

Subject 4 (Grp3) 2.67 4.32 1.69 63.38

*There are no readings here because the subject did not exhale within the first second of forced exhalation. ** Refer to *. Break point in breath holding: Subject 1 47 38 72 122 45 Subject 2 58 44 85 142 12

Mean duration of control test (sec) Duration at end expiration (sec) Duration at full inspiration(sec) Duration following hyperventilation(sec) Duration following re breathing (sec)

Peak expiratory flow (PEP) rate: Subject 1 (male) 425 625 Subject 2 (male) 500 645 Subject 3 (female) 300 505 Subject 4 (female) 320 515

Measured PEP rate (Lit/min) Predicted PEP rate (Lit/min)

Work sheet: Experiment 2 By Saboohi Khan

Respiration Q1) Define FEV1 and outline factors which affect the volume measured. FEV1 (forced expiratory volume1) is the amount of volume exhaled out measured at the end of the first second of forced expiration. Hence the 1 attached to the FEV at the end. About 80% of vital capacity.
Factors that can also affect the volume measured are the patients gender (males have a larger FEV1), age (FEV1 declines after mid to late twenties) and height (capacity of lung more in taller people). A reduced FEV1 volume of about 80%differnce form the predicted measured means there is an obstruction in the upper respiratory tract (bronchi).the rate of air flow in the smaller airways is reduced as the larger airways are obstructed or narrowed such as in the case of asthma. (Lab notes/ module hand book)

Q2) Why is a high level of accuracy considered important in the measurement of respiratory volumes and capacities? Measurement of Respiratory volumes and lung capacities will give the doctor a clear picture of how well is the patients lung compliance. The doctor can diagnose if it is an obstructive or restrictive disease of the lungs and from there work out a mode of treatment for the patient. (Module handbook) Q3) Respiratory obstruction is reversible in asthma but not in emphysema, why is this? Emphysema and asthma may initially have similar obstructive disease symptoms like labored breathing and wheezing. However emphysema is a non reversible disease, as the alveoli in the lungs have been permanently damaged and replaced by empty space or scar tissue. It is the permanent loss of elastin that helps in the stretch and recoil of the alveolar sacs that reduce the airflow by reducing the surface area for gas exchange and there for, less air is inhaled and exhaled. This damage is due to constant contact with toxic irritants such as smoking and heavy air pollution. Some people stand a greater chance of developing emphysema due to the potential in their genetic makeup. In asthma the obstruction is due to the inflammation of the airways of the upper respiratory tract leading to the lungs. However, the lung cavities/ alveoli are usually alright. This inflammation may be caused by several different factors some such as allergens (dust, pollen) and temperature (cold). This kind of obstruction is reversible as medicine such as Bronchodilators can be administered to reduce the swelling of the airways to allow for an ease the airflow activity. (Module handbook/ referred also to respiration case study)

Q4) What is the effect on respiration of rebreathing expired air? The process in which you inhale in previously exhaled air from a closed container/bag is called rebreathing expired air. Exhaled air is high in carbon dioxide and low in oxygen, this air then inhaled again and then exhaled. This process is repeated until the subject reaches his/her breakpoint. Subsequently the concentrations of CO and O steadily increase and decrease respectively, Hypoventilation. The persons break point threshold reduces considerably as compared to normal breathing. Also the persons heart rate decreases due to slower rate of respiration. Hyperventilation sets in to counter the diminished O2 and increased CO2 levels in blood. Prolonged rebreathing can result in arterial hypercapnia (increased PCO). Q5) Explain the effects of hyperventilation on subsequent respiration pattern. Hyperventilation, affects the normal breathing pattern by reducing the levels of PCO in blood. This lowers respiration in the person. hyperventilation causes to breathe faster and deeper. So the person ends up exhaling more carbon dioxide and there is not enough time for compensation; thus reducing the rest period in between breaths. Panic attacks, certain medications, infections, stresses both mental and physical can cause hyperventilation. Q6) Which sites in the body are stimulated by increased blood pCO? Blood pCO increases due to hypoventilation, as not enough oxygen is supplied to the lungs and CO concentration increases. This increase in the blood pH creates a slightly acidic environment thus, stimulating the peripheral chemo receptors, located in the carotid and aortic bodies. A response is fired via the carotid sinus to the respiratory center in the medulla from the carotid bodies. The vagus nerve sends the aortic impulse via the afferent fibers. The normal response to the stimuli is to breathe faster and deeper to remove excess CO from the blood, Hyperventilation. Until the blood pH, Co and O have returned to normal. (Referred to Sircar, Sabyasachi, 2008)

Q7) How may residual volume be measured? The residual volume (R.V) cannot be directly measured. As it is the amount of volume left in the lungs after a forceful exhalation. Some in direct methods such as nitrogen dilution, gas dilution tests and body plethysmography can be used.; Gas Dilution Method; since a spirometer captures exhaled volumes of air, it cannot measure R.V. hence blood gas dilution method is used. The patient is attached to a spirometer containing a known n concentration of an inert insoluble gas such has helium so it doesnt diffuse out of the lungs. The patient then breathes in this helium gas for several minutes until equilibrium in concentration is reached between the lungs and the spirometer. Thus, following the law of conservation of matter, the amount of total helium before inhalation and after inhalation is unchanged. The functional residual capacity (FRC) is calculated from the helium concentrations as follows:

FRC = (% helium initial - % helium final) / % helium final x system volume The dead space of the system (patient valve, filter and mouthpiece) is subtracted from this value.(Morgan) Body plethysmography; the patient sits in an enclosed space where they inhale/exhale a known volume such as their functional residual capacity. Then a flap shuts of their air supply from the tube and the patient has to make an effort to breathe. Since the passage of external air exchange is temporarily blocked the patients efforts of respiration look like panting, this causes their diaphragm to expand increasing the chest cavity/ volume and expand the air in their lungs. This decreases the volume of the enclosed space thus causing a light increase in overall pressure of the space. This method of measuring FRC actually measures all the conducting pathways including abdominal gas; the actual measurement made is VTG (Volume of Thoracic gas). (Morgan). Body plethysmography is particularly appropriate for patients who have air spaces within the lung that do not communicate with the bronchial tree.(JHU,1995). These patients would have a lower R.V if they used a gas dilution method as accurate communication between the alveoli and the bronchi is not there. Q8) How is carbon dioxide transported in the body?
Carbon dioxide is transported in the blood in three ways:

(i) (ii)

(iii)

Dissolved in blood plasma (~8%) and soluble in water. Bound to Hemoglobin as Carbaminohemoglobin (20%): Blood protein that bind to CO2 form carb + amino compounds. Carbaminohemoglobin is a CO2 bound to hemoglobin, this happens more frequently when O2 has just disassociated there for increasing O2 facilitation. It is the reverse in alveoli. As bicarbonate ion in plasma (72%): Bicarbonate ion is a weak acid. It acts as a buffer in the blood and helps in the chloride shift. The slight decrease in pH also helps dissociate O2 faster. (Module handbook)

Q9) Reduction in a patients ability to cough has serious consequences. What are they and why are they serious for the patient? Coughing is the bodys protective mechanism to expel any congestion in the lower respiratory tract/lungs. Congestion is caused by a buildup of mucous produced to remove any irritant/ foreign particle from the lungs such as infection or dust particle and prevent them from disrupting normal lung function. It is one big forceful contraction of the diaphragm and propulsion of air upwards under pressure. When a patient is unable to cough out an infective particle, it stagnates and multiplies and causes damage to the lungs. E.g: infections, pneumonia and bronchitis.(module handbook) Q10) A 55 year old male smoker has a vital capacity of 2.0, an FEV1 of 0.6L and a peak expiratory flow of 60 L/min. is this subject normal and if not what disorder of the respiratory tract may be present? Patient values 0.6L Normal values

FEV1

Vital capacity V.C Peak expiratory flow(PEP)

2.0L 60L/min

4.5L 650L/min

The subject is not normal he has low vital capacity and peak expiratory flow from the normal values. The low PEP and V.C indicate a chronic obstructive pulmonary disease (COPD) most likely Emphysema which is common in smokers. His airflow and lung compliance is diminished.

*Peak Expiratory flow (PEF) spreadsheet (see attached)

Explanatory Legend: A. Peak expiratory flow (PEF), measured in one forceful expulsion of air into the peak flow meter, liters per minute. B. Predicted results of peak expiratory flow calculated in regards to height and age from the nomogram. C. Difference= (B-A), the difference between the predicted and measured readings. D. Percentage of the difference found after subtracting predicted from measured. E. Height indicates the length of the chest cavity. Taller person has larger lungs and shorter person has smaller lungs. F. Age, younger person has more elastic ability of the alveoli and it diminishes with age. Thus an older person will not have the force and volume behind their PEF as a young person would. Brief conclusion: The difference between male and female values; males are taller and bulkier therefore have a bigger chest cavity and thus larger lungs and a greater ability to exhale large quantities of air. Females are slimmer and shorter in stature thats why they have smaller lungs and chest cavities, thus, their ability to expel air is less as compared to males. Predicted results differ from the measured results because Asians are generally shorter in stature as compared to Caucasians and the predicted results are for the Caucasians. However, if you look at subject 8 in females; her results are higher than the predicted results this is because of mechanical error or human error. Therefore her results are not accurate.

References Module hand book lecture notes and lab notes Respiration Case study

Sircar, Sabyasachi, 2008. Principles of medical Physiology, Thieme publication, Germany. ISBN 978-158890-572-7. (Pages 353-5) JHU, 1995. interactive respiratory physiology. Johns Hopkins University http://oac.med.jhmi.edu/res_phys/Encyclopedia/GasDilution/GasDilution.HTML Morgan. PFT lung volumes.http://www.morgansci.com/choose-your-pft-solution/what-is-a-pft-test/pftlung-volumes.php