Pulmonary Physiology

• Non-respiratory functions of the lung (self study)

• Ventilation
• Mechanics of respiration
• Diffusion of gases
• Pulmonary circulation
• Ventilation/perfusion relationship
• Causes of hypoxemia
• Transport of gases
• Control of ventilation
• Respiratory system under stress
• Pulmonary acid-base
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Ventilation

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 Objectives
• Draw a normal spirogram, labeling the
four lung volumes and four capacities.
List the volumes that comprise each of
the four capacities. Identify which
volume and capacities cannot be
measured by spirometry.
• Define the mechanisms that determine
the clinically important boundaries of
lung volume (i.e., TLC, FRC, and RV).

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 Ventilation
• Volume of fresh air entering the alveoli per minute

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 Spirometer Types

• Volume-displacement spirometers

• Flow-sensing spirometers

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 Volumes and capacities

• Are affected by:

– Gender
– Total body surface area
– Body position
– Force of respiratory muscles

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 Objectives

• Contrast the causes and

characteristics of restrictive and
obstructive lung disease, including
the abnormalities in lung volumes
that are associated with each.

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 Classification of lung diseases
• Restrictive disease • Obstructive disease
• Diminished airflow IN & • Hyperinflation
OUT increased inspiratory
(restriction of expansion efforts + increased RV)
from outside) • Can’t get air out
Hypoinflation decrease elastic recoil
• This leads to a Smaller of lungs
chest. • Airways close prematurely
at high lung volumes
• Barrel chest deformity
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 Restrictive disease

• Group of disorders that result in an increase in the connective

tissue of the lung. Fibrosis, alveolar wall thickening.
• Decreases compliance, increasing difficulty to expand the lung.
Increased elastic recoil. Lower: FRC, TLC, VC, IRV, ERV
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 Obstructive disease

• Conditions that causes shortness of breath and obstruction of

airflow as emphysema (destruction of connective and elastic
tissue of the lung), chronic bronchitis, asthma.
• Lung compliance is increased, elastic recoil is decreased.
• Increased: RV, FRC, TLC. Decreased: VC and ERV.
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 Obstructive disease: emphysema

Normal lung

Emphysema
Enlargement of air spaces
Reduced recoil (destruction
of alveolar walls)
• Smoking
• α1 antitripsin deficiency
• Bullae

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Universidad Autónoma de Guadalajara A.C.© 2017
 Objectives
• Define and contrast the following
terms: anatomic dead space,
physiologic dead space, wasted
ventilation, total ventilation per minute
and alveolar minute ventilation.
• Contrast the proportional relationship
between alveolar ventilation and the
arterial blood gases PCO2 and PO2.

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 IRV TV ERV RV DEAD SPACE

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 Anatomical Dead Space

Volume (L)
Tidal
volume

Anatomical
Dead
space

End-expiration

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 Anatomical Dead Space

Tidal
volume

Anatomical Anatomical
Dead dead space
space

Alveolar
Tidal ventilation
volume
Inspired
dead
space
End-expiration

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 Anatomical Dead Space
Fowler’s method

• Single inspiration of 100% O2 to TLC

• During the expiration the
Nitrogen concentrations is
measured and plot versus time

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Anatomical Dead Space
Fowler’s method

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 Anatomical Dead Space
Fowler’s method

Dead
space

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 Physiological dead space
Venous mix blood
PO2 = 40
PIO2 = 150 PCO2 = 46
PO2 = 100
PCO2 = 40

PO2 = 150
PCO2 = 0
Venous mix blood
PO2 = 40
PCO2 = 46
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 Physiological dead space
Bohr’s method

VD PaCO2 – PECO2
VT PaCO2

CO2 in mixed expired gas comes from alveoli

that are well ventilated and perfused.
Unperfused alveoli do not contribute with CO2.

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 Physiological dead space
VD PaCO2 – PECO2
VT PaCO2

PaCO2 = 40 mmHg
PECO2 = 30 mmHg
40 – 30 500
VD
VT = 500 ml 40

VD = 125 ml

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 Alveolar ventilation

.
• Minute volume VE = VT x n
.
• Alveolar ventilation VA = VA x n
.
• Dead space ventilation VD = VD x n

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 Alveolar ventilation
and Carbon Dioxide

• BEST parameter to evaluate adequate

breathing: PaCO2 = 40 mmHg

VCO2
PACO2 =
VA

PACO2 = PaCO2
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 Objectives

• Define the following terms:

hypoventilation, hyperventilation,
hypercapnea, eupnea, hypopnea,
and hyperpnea.

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Universidad Autónoma de Guadalajara A.C.© 2017
 PaCO2 > 40 hypoventilation
PaCO2 < 40 hyperventilation

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Universidad Autónoma de Guadalajara A.C.© 2017
 Definitions
• Eupnea: normal quiet breathing
• Hypercapnea: high PCO2
• Hypopnea: shallower or slower
than normal
• Hyperpnea: deeper and more rapid
than normal
• Dyspnea: shortness of breath,
distress in breathing
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 Pop quiz
Name______________list #_______

• In emphysema:
–How is Lung compliance
–Mention one volume or capacity
that is larger than normal

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