Date post: | 14-Oct-2014 |
Category: |
Documents |
Upload: | drmanthony-david |
View: | 2,575 times |
Download: | 2 times |
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
11
LUNG COMPLIANCE & LUNG COMPLIANCE & SURFACTANTSURFACTANT
ByByDr. M. Anthony David, MD.Dr. M. Anthony David, MD.
Professor of PhysiologyProfessor of Physiology
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
22
LUNG COMPLIANCELUNG COMPLIANCE The ‘The ‘stretchabilitystretchability’ of the lung is ’ of the lung is
called it’s Compliance.called it’s Compliance. Compliance is defined as the Compliance is defined as the
volume change per unit volume change per unit pressure change during inflation pressure change during inflation or deflation.or deflation.
Volume change : VVolume change : V22 – V – V11
Pressure Change: PPressure Change: P22 – P – P11
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
33
Compliance = Compliance = VV22 – V – V11
PP22 – P – P11
= = ∆ V∆ V
∆ ∆ PP
LUNG COMPLIANCELUNG COMPLIANCE
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
44
Lung ComplianceLung Compliance
0
10
20
30
40
50
60
70
0 2 4 6 8 10 12 14 16P1 P2
V2
V1
PRESSURE
VOLUME
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
55
LUNG COMPLIANCELUNG COMPLIANCE Compliance:Compliance:
•StaticStatic•Dynamic: considers time dimension Dynamic: considers time dimension
also.also.•Specific = Specific = Static ComplianceStatic Compliance
FRCFRC
Used for comparing lungs of Used for comparing lungs of different sizes.different sizes.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
66
RESISTANCERESISTANCE The oppostion to the flow of The oppostion to the flow of
air in the respiratory air in the respiratory passages is called as passages is called as Resistance.Resistance.
TYPES OF RESISTANCE:TYPES OF RESISTANCE:• AIRWAYAIRWAY• VISCOUSVISCOUS• ELASTICELASTIC
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
77
AIRWAY RESISTANCEAIRWAY RESISTANCE The resistance air encounters The resistance air encounters
while passing through the airways.while passing through the airways. Resistance depends on the tone of
the Respiratory smooth muscle. This accounts for 20% of the
Respiratory work done.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
88
VISCOUS RESISTANCE The resistance offered by the The resistance offered by the
opening up of the lung tissues.opening up of the lung tissues. Accounts for 20% of the work Accounts for 20% of the work
done.done. Is caused by the opening up of Is caused by the opening up of
the tissues and the lungs to air.the tissues and the lungs to air.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
99
ELASTIC RESISTANCEELASTIC RESISTANCE Is offered by the elastic recoil of
the lungs during inspiration. Decreases in diseases like
Emphysema. Increases in Fibrosis. Contributes to 60% of the work
done.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1010
REVIEWREVIEW Lung Compliance is defined as the Lung Compliance is defined as the
volume change per unit pressure volume change per unit pressure change during inflation or deflation.change during inflation or deflation.
Lung Compliance Lung Compliance = = ∆ V∆ V
∆ ∆ PP The opposition to flow air The opposition to flow air
encounters is called as encounters is called as resistance.resistance.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1111
REVIEWREVIEW Types of resistance :Types of resistance :
•AirwayAirway•ViscousViscous•ElasticElastic
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1212
WORK OF BREATHINGWORK OF BREATHING Is the work done for breathingIs the work done for breathing Basically needed to overcome Basically needed to overcome
Resistance:Resistance:•Elastic resistance: 60%Elastic resistance: 60%•Airway resistance: 20%Airway resistance: 20%•Viscous resistance: 20%Viscous resistance: 20%
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1313
AIR DISTRIBUTION IN THE AIR DISTRIBUTION IN THE LUNGSLUNGS
The dependent parts ventilate The dependent parts ventilate well.well.
The dependent part or theThe dependent part or the base base of of the lungs has:the lungs has:•Less recoilLess recoil•Better ventilation. Better ventilation.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1414
APEX
BASE
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1515
FLOW VOLUME CURVE
0
50
Lung Volume
Flow
Rat
e
TLC RV
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1616
PRESSURE – VOLUME CURVESPRESSURE – VOLUME CURVES
Obtained by plotting different lung Obtained by plotting different lung volumes against respective trans volumes against respective trans pulmonary pressures.pulmonary pressures.
Depict the relationship between Depict the relationship between Pressure & Volume of the lung.Pressure & Volume of the lung.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1717
PRESSURE – VOLUME CURVESPRESSURE – VOLUME CURVES
Inflation curve: Flat- steep- flatInflation curve: Flat- steep- flat•Easiest inflation at moderate Easiest inflation at moderate
pressures.pressures. Hysteresis: Gap between the Hysteresis: Gap between the
inflation and deflation curves.inflation and deflation curves.•Cause: Surface tension of the Cause: Surface tension of the
Alveolar fluid.Alveolar fluid.•Not seen with saline.Not seen with saline.
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1818
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
1919
PULMONARY SURFACTANTPULMONARY SURFACTANT
A chemical secreted by by the type II A chemical secreted by by the type II Alveolar cells.Alveolar cells.
Composition:Composition:• Dipalmitoyl Lecithin.Dipalmitoyl Lecithin.• Phosphatidyl Glycine.Phosphatidyl Glycine.• Other Phospholipids.Other Phospholipids.• Neutral lipids.Neutral lipids.• Proteins & CarbohydratesProteins & Carbohydrates
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
2020
SURFACTANT MOLECULESURFACTANT MOLECULE
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
2121
FUNCTIONS:•Reduces the surface tension of
the thin film of alveolar fluid. This makes it easier to inflate the lungs.
• Increases the Lung Compliance.
•Prevents the Tissue fluid formation.
PULMONARY SURFACTANTPULMONARY SURFACTANT
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
2222
Surfactant: FunctionSurfactant: Function
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
2323
Surfactant: Applied AspectsSurfactant: Applied Aspects
INFANT RESPIRATORY DISTRESS SYNDROME( IRDS):•Also called Hyaline Membrane
Disease.•Can be fatal.•Seen in premature babies:
As the surfactant production has not begun in them
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
2424
Adult Respiratory Distress Syndrome(ARDS):• Primarily due to cigarette smoking.
Surfactant: Applied AspectsSurfactant: Applied Aspects
NOMAD: RESPIPHYSIOL: Lung Compliance NOMAD: RESPIPHYSIOL: Lung Compliance II
2525