1. What are the respiratory structures that let us breath? 3/2 Goals: -Describe the airway divisions that lead air to the alveoli where most gas exchange actually occurs. -Describe the structure and anatomy of the lower airway anatomy as it applies to health and disease -Describe gas transfer requirements as they apply to health and disease Compare and contrast the atmospheric pressures found in the lung and pleural space between the lung and the thoracic wall. -Describe pressure changes required for inspiration and expiration -Describe the implications of Boyle’s Gas Law? -Describe the role of surfactants with respect to alveolar surface tension in a premature newborn and an adult -Describe why alveoli tend to either fully expand or fully collapse with respect to surface tension and surfactants. -What are the typical lung volumes? VC, IRV, TV, ERV, RV

2. Anatomy and Physiology 212: Thinking and Learning go together for Test/Quiz scores A lot of the time you spend “studying” should be spend simply “thinking” try this every night after lecture. On “Average” each Week (not night before), don’t do it week before a test: 3 hours study time for each hour of lecture 3 X3 =9hours/wk 2 hours open lab for each hour in lab 2 X 2 = 4hours/wk in open lab Next Lecture Test: Wed Mar 4th Next Lab Exam: Thur Mar26th so please “think” ahead

3. Air Flow is distributed into tinier and tinier passages that lead to the dead-end Alveoli where gas exchange with blood finally occurs! Entry: Oral Cavity/Nasal Cavity Pharynx Larynx/Glottis Trachea Primary Bronchi Secondary Bronchi Tertiary Bronchi End cartilaginous rings Bronchiole Terminal Bronchiole –Above this its called Dead Space: no significant gas exchange ----------------------------------- Respiratory Bronchiole (Alveolar Ducts) Alveoli –Most Gas Exchange is Here! IF YOU HAVE HEALTHY LUNGS!- –Describe carbon dioxide and oxygen transfer to/from blood/air

4. Alveoli/Alveolar Sacs: Primary site of gas exchange Distance from alveolar surface to capillary is a function of cells in between and the depth of fluids lining the alveolus Distance from Alveolus to hemoglobin in a erythrocyte in a Capillary: –mucus/membrane distance 0.5 micrometers Smoker vs Non-smoker difference –More tar  greater mucus to clean surface  greater distance for gas to diffuse before reaching hemoglobin  harder to oxygenate blood! –A paradoxical difference in HEMATOCRIT is often observed! Remember: there are 5 plasma membranes that oxygen must pass through before reaching hemoglobin (can you count them?) Gas Diffusion REQUIRES a thin film of water on alveolar surface! Remember that very little oxygen or carbon dioxide can directly dissolve in water! –Oxygen is carried by the 4 subunits of hemoglobin to improve solubility! –Carbon Dioxide is converted to bicarbonate to improve its solubility!

5. The distance from the inside of the alveolus to the inside of an RBC in a capillary is a little as 0.5 micometers. To get oxygen to hemoglobin it passes through 5 plasma membranes. Wandering Macrophage (ma) on Alveolar Surface destroy bacteria and cleans the surface. RBCs inside capillaries Simple Squamous Epithelial Tissue of Alveolus or the Capillary (endothelium)

6. The alveolar sacs come in clusters where surfactants and mucus are important for air cleaning, optimal gas exchange and lowering internal surface tension. Alveolar macrophages are specialized monocytes (macrophages) actually leave the blood and patrol the alveolar surface against bacteria and unwanted items.

7. The lung sits in a fluid filled pleural cavity that is under a slight vacuum relative to the pressure outside the lung or in the airways. This keeps the visceral membrane (lung) tight against the parietal membrane (rib cage). Visceral and Parietal Pleural membranes: serosa Pleural Cavity: Pleural Fluid Functions: Friction- Pressure gradient/maintains suction- Pulmonary Cavity: air space inside airways (bronchi- alveoli) Pneumothorax/Atelectasis Pressure During Inspiration and Expiration Intrapulmonary vs. Intrapleural Pressures

8. Inspiration and Expiration require pressure gradients! These gradients can be very slight because air offers little resistance to flow!

9. PRESSURE IN AND AROUND THE LUNG CAN BE DESCRIBED USING BOYLE’S GAS LAW. “Pressure is inversely proportional to volume if temp same”SO: +P>>-V and +V>>-P 1 Atmosphere is equal to: 760 mmHg Pressure inside an alveoli: Intrapulmonary P Pressure inside pleura: Intrapleural P Intrapulmonary/Intrapleural pressure difference: Transpulmonary Pressure- determines if lung inflates (- mmHg) or deflates (+mmHg). Circulatory rules also apply to air in lung: Q=ΔP/R What are some pathological sources of increased airway resistance?

10. HOW/ WHY DOES AIR MOVE IN/OUT OF THE LUNGS? Insipiration: diaphragm contracts and pulls down and/or External intercostal muscles contract+Volume and -Pressure (↑Vol ↓Press) ….air sucked into lung Expiration: relax diaphragm (contract internal intercostals)  If pressure inside lung is more than outside then pressure gradient favors air moving out! Generally: expiration is a passive process (ELASTIN) 75% breathing work is from diaphragm Forced Expiration: METABOLICALLY EXPENSIVE Contact abdominals and internal intercostals Required with increased airway resistance: asthma You only do this if you have too….heavy exercise or if you have respiratory disease If you have emphysema forced expiration is required for even tidal breathing……very expensive indeed.

11. HOW IS TENSION CREATED/REDUCED IN THE LUNG? Elastin in lung tissue and surfactant in alveoli conserves energy! Surface Tension (hydrogen bonds) of fluid lining alveoli critical Law of Laplace: Force= 2 Tension/radius As the radius is increased the force to inflate is reduced Energy is required to pull volume open Surfactant: is a phospholipid/protein mix that reduces surface tension in alveoli Critical for infants and adults alike! –Repulsion: negative repels negative –Lipid-PO4--  --PO4-Lipid –Attraction: water attached to PO4 pulls them together if they are far apart Often premature infants lack sufficient surfactant: results in Sudden Infant Death Syndrome. Surfactant also improves gas diffusion to/from blood

12. Water molecules create surface tension in the alveoli: 1) it causes small alveoli to collapse, and 2) it causes air to be diverted to the larger of any two alveoli because larger alveoli are easier to keep inflated. Surfactants are phospholipids that help prevent complete alveolar collapse due to the compaction of strong opposing negative charges on the phosphates! They also provide elasticity to help the lung work passively, this adds to the effect of elastin proteins found in the lung tissue itself!

13. A Spirometer is used to measure Breathing Patterns and Lung Volumes: Reduce these values about 20% in females. Approximate Volumes: memorize these numbers: Total Lung Capacity : TC=5-6 Liters Vital Capacity: VC=5 L…its what you can manipulate Tidal Volume : TV=500 ml Typical size of a typical resting breath Inspiratory Reserve Volume : IRV=3L Air added to a tidal volume with Max Inspiration Expiratory Reserve Volume : ERV=1.5L Amount you can exhale after a typical Tidal Exhalation Residual Volume : RV=1L Air that’s left in Trachea, Bronchi, etc after a max. expiration

15. Old School Spirometer In our Respiratory Physiology lab we will use an electronic spirometer that converts air velocity and flow into respiratory volumes using a set of computer algorithms.

16. Could you answer these questions? 1 Where does most gas exchange occur in the lung? 2 How far apart is the inside of an alveolus from the inside of a red blood cell? 3 What are the methods used to clean the alveolus and larger bronchi? Are they the same? 4 How do pleural and pulmonary cavities differ? 5 What are the typical pressures in the atmosphere, airway and pleural space during inspiration? 5 What is Boyle’s Law? 6 Do surfactants contain lipids, phosphates or both? 7 What do surfactants do?