air pressure at mouth (Pmouth) Flow = Pmouth – Palv Raw resistance to flow of air in airways (Raw) air pressure in alveoli (Palv)

760 mmHg 756 mmHg Atmospheric pressure Intra-alveolar pressure Intrapleural pressure

0 mmHg - 4 mmHg Atmospheric pressure Intra-alveolar pressure Intrapleural pressure BEFORE INSPIRATION

Air flows in Atmospheric pressure 0 mmHg Intra-alveolar pressure Intrapleural pressure - 6 mmHg DURING INSPIRATION -1 mmHg Air flows in

Air flows out Atmospheric pressure 0 mmHg Intra-alveolar pressure Intrapleural pressure DURING EXPIRATION Air flows out

Air flows out rapidly Patm = 0 mmHg MAXIMAL FORCED EXPIRATION +16 +26 +31 +16 MAXIMAL FORCED EXPIRATION Air flows out rapidly 9

Patm Pmouth Plung = Ptp = Palv - Ppl outward recoil of chest wall Palv inward recoil of lung Plung = Ptp = Palv - Ppl Pmouth

Equal Pressure Point Patm = 0 mmHg Cartilaginous airways +26 +31 +12 +15 Cartilaginous airways +28 +14 MAXIMAL FORCED EXPIRATION OBSTRUCTIVE LUNG DISEASE Equal Pressure Point 9

NORMAL QUIET BREATHING Ppump = 5 mmHg - 4 +6 +5.5 Large airways NORMAL QUIET BREATHING

 stroke volume  airways resistance restrictive lung diseases = harder to expand stiff lungs obstructive lung diseases = reduced flow through narrow airways

bronchioles constricted and inflammatory response ASTHMA

deoxygenated blood flows from right ventricle to lungs via pulmonary arteries (12 mmHg) oxygenated blood flows from lungs to left atrium via pulmonary veins (8 mmHg)

initial pulmonary vasculature recruitment distension initial pulmonary vasculature

Blood that doesn’t gain oxygen Air that doesn’t lose oxygen arterial O2 = 95 mmHg expired O2 = 118 mmHg inspired O2 = 148 mmHg venous O2 = 40 mmHg Dead space ventilation Venous admixture (shunt) O2 = 102 mmHg Alveolar capillary membrane End-pulmonary blood “WASTED BLOOD” Blood that doesn’t gain oxygen “WASTED AIR” Air that doesn’t lose oxygen Air side Blood side

Trachea Airspace Alveolar wall O2 Interstitial space Capillary Blood CO2 Trachea Alveolar wall Capillary Interstitial space Airspace Blood

CO2 VENOUS ARTERIAL BLOOD O2 O2 = 150 mmHg, CO2= 0 mmHg CO2 = 40 mmHg Tissues Pulmonary arteries veins VENOUS BLOOD ARTERIAL CO2 O2 O2 = 150 mmHg, CO2= 0 mmHg O2 = 100 mmHg CO2 = 40 mmHg O2 = 40 mmHg CO2 = 46 mmHg O2 = 10 - 40 CO2 = 40 - 46

alveolus buildup of alveolar water = alveolar lymph drainage hydrostatic pressure colloid osmotic buildup of interstitial water = interstitial pulmonary edema alveolus capillary wall lymph drainage buildup of alveolar water = alveolar

afferent arteriole efferent arteriole GLOMERULUS normal flow normal flow normal pressure normal filtration TUBULE

afferent arteriole efferent arteriole GLOMERULUS normal flow decreased pressure decreased filtration decreased flow TUBULE

afferent arteriole efferent arteriole GLOMERULUS normal flow decreased flow increased filtration increased pressure TUBULE

EXOCYTOSIS H2O Distal Tubular Lumen ENDOCYTOSIS Basal high medullary cAMP PKA Ca PKC PG H2O ? EXOCYTOSIS ENDOCYTOSIS Distal Tubular Lumen Basal ADH = vesicles containing water channels high medullary osmotic gradient