Respiration.

Mechanics of pulmonary
ventilation. Pulmonary volumes and
cavities
 Respiration
• Respiration is the process by which the body
takes in oxygen (O₂) for metabolic processes
and removes carbon dioxide (CO₂), a
byproduct of metabolism. It involves:
• 1. External Respiration: Gas exchange
between the lungs and the blood.
• 2. Internal Respiration: Gas exchange
between the blood and body tissues.
• 3. Cellular Respiration: Utilization of oxygen
in cells to produce energy (ATP).
 respiration releases energy
respiration releases energy it is chemically the
reverse of photosynthesis, which uses energy
from the Sun to make organic molecules.
Photosynthesis and respiration are also
connected ecologically because the vast
majority of organisms use the oxygen
produced by photosynthesis for respiration.
Today, most organisms on land, freshwater and
the oceans, including plants, use cellular
respiration to extract the energy they need to
function, grow, and reproduce.
Mechanics of Pulmonary Ventilation
• Pulmonary ventilation refers to the process
of air movement in and out of the lungs,
driven by pressure changes in the thoracic
cavity.
• are atmospheric pressure (P ); the air
atm

pressure within the alveoli, called alveolar

pressure (P ); and the pressure within the
alv

pleural cavity, called intrapleural pressure

(P ).
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• Inspiration (Inhalation)
• Active process that requires muscle
contraction:
• Diaphragm: Contracts and moves
downward, increasing thoracic cavity
volume.
• External intercostal muscles: Contract,
raising the ribs and expanding the chest
laterally and anteroposteriorly.
• Pressure Changes:
• Increased thoracic cavity volume decreases
intrapulmonary pressure (below
atmospheric pressure), allowing air to ow
into the lungs.
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 Expiration (Exhalation)
• Passive process during quiet breathing:
• Diaphragm and external intercostal muscles
relax, leading to elastic recoil of the lungs
and thoracic cavity.
• Forced Expiration: Active process involving
contraction of abdominal and internal
intercostal muscles.
• Pressure Changes:
• Decreased thoracic volume increases
intrapulmonary pressure (above
atmospheric pressure), pushing air out of the
lungs.
 Key Pressures in Ventilation
• Intrapulmonary Pressure: Pressure inside the
alveoli, equalizes with atmospheric pressure
during rest.
• Intrapleural Pressure: Pressure in the pleural
cavity, always slightly negative to keep lungs
in ated.
• Transpulmonary Pressure: Difference
between intrapulmonary and intrapleural
pressure, preventing lung collapse.
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 Pulmonary Volumes
• Tidal Volume (TV):
• The amount of air inhaled or exhaled during
normal, quiet breathing (~500 mL).
• Inspiratory Reserve Volume (IRV):
• Additional air that can be inhaled with
maximum effort after normal inspiration
(~3000 mL).
• Expiratory Reserve Volume (ERV):
• Additional air that can be exhaled with
maximum effort after normal expiration
(~1100 mL).
• Residual Volume (RV):
• Air remaining in the lungs after maximum
expiration (~1200 mL).
 • Tidal Volume(TV) with obesity, ascites or after upper abdominal
surgery [4]
It is the amount of air that can be inhaled or
exhaled during one respiratory cycle . This
[3] • Residual Volume(RV)
depicts the functions of the respiratory centres,
respiratory muscles and the mechanics of the It is the volume of air remaining in the lungs after
lung and chest wall . [4]
maximal exhalation. Normal adult value is
averaged at 1200ml(20 25 ml/kg) .It is indirectly
The normal adult value is 10% of vital capacity measured from summation of FRC and ERV and
(VC), approximately 300-500ml (6 8 ml/kg); but cannot be measured by spirometry.
can increase up to 50% of VC on exercise
In obstructive lung diseases with features of
• Inspiratory Reserve Volume(IRV) incomplete emptying of the lungs and air
trapping, RV may be signi cantly high. The RV
It is the amount of air that can be forcibly inhaled can also be expressed as a percentage of total
after a normal tidal volume.IRV is usually kept in lung capacity and values in excess of 140%
reserve, but is used during deep breathing. The signi cantly increase the risks of barotrauma,
normal adult value is 1900-3300ml. pneumothorax, infection and reduced venous
• Expiratory Reserve Volume(ERV) return due to high intra thoracic pressures as
noticed in patients with high RV who require
It is the volume of air that can be exhaled forcibly surgery and mechanical ventilation thus needs
after exhalation of normal tidal volume. The high peri-operative in ation pressures.
normal adult value is 700-1200ml. ERV is reduced •
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• Total Lung Capacity (TLC): • The volume of air remaining in the lungs
after a normal expiration.
• The maximum volume of air the lungs can
hold. • FRC = ERV + RV (~2300 mL).
• TLC = TV + IRV + ERV + RV (~5800 mL).
• Vital Capacity (VC):
• The maximum amount of air that can be
exhaled after maximum inhalation.
• VC = TV + IRV + ERV (~4600 mL).
• Inspiratory Capacity (IC):
• The maximum amount of air that can be
inhaled after a normal expiration.
• IC = TV + IRV (~3500 mL).
• Functional Residual Capacity (FRC):
 Pulmonary Capacities
• Inspiratory capacity(IC) • Vital Capacity(VC)
It is the maximum volume of air that can be It is the total amount of air exhaled after maximal
inhaled following a resting state. It is calculated inhalation. The value is about 4800mL and it
from the sum of inspiratory reserve volume and varies according to age and body size. It is
tidal volume. IC = IRV+TV calculated by summing tidal volume, inspiratory
reserve volume, and expiratory reserve volume.
• Total Lung Capacity(TLC) VC = TV+IRV+ERV.
It is the maximum volume of air the lungs can VC indicates ability to breathe deeply and cough,
accommodate or sum of all volume re ecting inspiratory and expiratory muscle
compartments or volume of air in lungs after strength.VC should be 3 times greater than TV for
maximum inspiration. The normal value is about effective cough. VC is sometimes reduced in
6,000mL(4 6 L). TLC is calculated by summation obstructive disorders and always in restrictive
of the four primary lung volumes (TV, IRV, ERV, disorders
RV).
TLC may be increased in patients with obstructive
defects such as emphysema and decreased in
patients with restrictive abnormalities including
chest wall abnormalities and kyphoscoliosis
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• Function Residual Capacity(FRC)
It is the amount of air remaining in the lungs at
the end of a normal exhalation. It is calculated
by adding together residual and expiratory
reserve volumes. The normal value is about
1800 – 2200 mL. FRC = RV+ERV.
FRC does not rely on effort and highlights the
resting position when inner and outer elastic
recoils are balanced. FRC is reduced in
restrictive disorders. The ratio of FRC to TLC is
an index of hyperin ation . In COPD, FRC is
[9]

upto 80% of TLC

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