Schematic representation of strain-stress distribution and its impact on alveolar size distribution between the supine and prone position. Schematic representation of strain-stress distribution and its impact on alveolar size distribution between the supine and prone position. The Slinky effect of a triangular-shaped spring suspended from its apex (supine position) causes higher strain and larger variation in the distribution of alveolar sizes due to the effects of gravity and a steeper stress production during mechanical inspiration in the upper lung regions. In contrast, suspending the spring by its base across a wider surface area (prone position) produces a more even strain and more homogeneous distribution of alveolar size that lessens inhomogeneity in stress development throughout the lungs during mechanical inspiration. Richard H Kallet Respir Care 2015;60:1660-1687 (c) 2012 by Daedalus Enterprises, Inc.