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PULMONARY VENTILATION, GAS EXCHANGE & CONTROL OF RESPIRATION DEPARTMENT OF PHYSIOLOGY UNSOED SCHOOL OF MEDICINE
Referensi
Martini, F.H., Nath J.L.. 2009. Fundamentals of
Anatomy & Physiology 8th Ed. USA; Pearson Benjamin Cummings Tortora, G.J., Derrickson B.. 2006. Principles of Anatomy & Physiology 11th Ed. USA; John Wiley & Sons
LEARNING OBJECTIVE
Describe the event that cause inhalation & exhalation Explain Daltons Law & Henrys Law Describe the exchange of oxygen & carbondioxide in
internal & external respiration Describe blood gas transportation Explain how nervous system controls breathing Explain role of respiratory system on acid-base balance
PULMONARY VENTILATION
Respiration has 3 basic steps Pulmonary ventilation
Mechanical procces that moves air in & out of the lung Inspiration/inhalation Expiration/exhalation
Pulmonary respiration (external) Gas exchange between alveoli & lung capillary By diffusion Tissue respiration (internal) Gas exchange between systemic capillary & tissue By diffusion
Inspiration Air flows from atmosphere to alveoli Air pressure inside lung is less than the atmosphere Active procces
Expiration Air flows from alveoli to atmosphere Air pressure inside lung is higher than the atmosphere Passive procces Ventilation Alternating pressure difference Boyles Law
Pressure of gas is inversely proportional to its volume Pressure in alveoli is directly proportional to surface tension & inversely proportional to radius of alveoli
Laplaces Law
Abbility to expand 100 x more distensible than balloon Related to the low surface tension & high elasticity Decreased : Scar lung tissue Pulmonary oedem Increased surface tension Impede lung expansion (paralysis) Increased : Emphysematous lung Increased airway resistance disturb air flows Increased : Mucus production Bronchoconstriction
Airway resistance
Elasticity
Lung is very elastic & ressist of distension Abbility to return to initial size after distension High content of elastin protein
Intrapulmonary pressure changes from 0 to -3 mmHg Intrapleural changes from -4 to -6 mmHg Transpulmonary pressure = + 3 mmHg Intrapulmonary pressure changes from -3 to +3 mmHg Intrapleural changes from -6 to -3 mmHg Transpulmonary pressure = + 6 mmHg
Ekspiration
GAS EXCHANGE
Passive diffusion as transport mechanism Daltons Law Each gas in a mixture of gases exerts its own pressure called partial pressure Henrys Law Quantity of gas that will dissolve is proportional to its partial pressure & solubility in water
At normal PO2
arterial blood = 100 mm Hg PO2 level in the systemic veins is = 40 mm Hg; PC02 = 46 mm Hg Provides a good index of lung function
circulation = flow rate through the systemic circulation Pulmonary resistance is low Autoregulation
Pulmonary arterioles constrict when alveolar PO2 decreases Bronchioles dilate when alveolar PCO2 decrease Matches ventilation/perfusion ratio
Ventilation/perfusion
rate
Alveoli at apex are underperfused (overventilated) Alveoli at the base are underventilated (overperfused)
The rate of gas exchange depends on Partial pressure difference of the gases Surface area available for gas exchange Diffusion distance
Alveolar wall Epithelial basement membrane Capillary basement membran Capillary endothelium
transporter RBC has 280 million Hb Hb has 4 polypeptide chains & 4 hemes Heme has 1 atom iron that combine 1 molecule oxygen Methemoglobin
Erithrocyte 1,3 bifosfogliserat bifosfogliserat mutase 2,3 bifosfogliserat 2,3 bifosfogliserat fosfatase 3 fosfogliserat 2,3 bifosfogliserat (DPG) decrease affinity of Hb to O2 that can be used by cell/tissue
Bohr Effect
H20 + C02
H2C03
H+ + HC03-
At the tissues, C02 diffuses into the RBC; shifts the reaction to the right At the alveoli, C02 diffuses into the alveoli; reaction shifts to the left
RESPIRATION CONTROL
Respiratory center DRG
Control diaphragm & external intercostal Function in every respiratory cycle
VRG
Control accessory respiratory muscle Function only during forced breathing
Apneustic & Pneumotaxic Center Adjust the output of respiratory center Regulate depth & rate of respiration Apneustic
Stimulation to DRG Promotes inspiration by activating I neuron Respiration become slow & deep
Pneumotaxic
Inhibit apneustic activity Promote active or passive exhalation Respiration become fast & shallow
DRG & I VRG active E VRG inhibited Inspiratory muscle contract Expiratory muscle relax Inspiration occur
DRG inactive Inspiratory muscle relax Passive expiration occur DRG active Expiration occur E VRG active DRG & I VRG inhibited Inspiratory muscle relax Expiratory muscle contract
CHEMORECEPTOR REFLEX
Chemoreceptor
Carotid & aortic bodies Stimulated by decrease in pH or PO2 & indirectly by PCO2 Ventrolateral surface of medulla oblongata Stimulated by decrease in pH & PCO2
Hypercapnea Stimulation chemoreceptor Stimulation DRG Increased respiratory rate Increased elimination CO2 Decrease PCO2 Bact to normal
Hypocapnea Decreased PCO2 Inhibition arterial chemoreceptor Reduced stimulation of CNS chemoreceptor Reduced stimulation of DRG Decrease respiratory rate Decrease elimination PCO2 Increased arterial PCO2 (normal)
Inflasi Deflasi
Refleks lainnya
Stimulasi sistem limbik Suhu Nyeri Peregangan otot sfinkter ani Iritasi saluran nafas Tekanan darah
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