1. Respiratory Physiology

2. heart

3. circuitry

4. heart circuitry tissues

5. lung heart circuitry tissues

6. lung heart circuitry tissues cell

8. STRUCTURE of respiratory system - Conducting zone - Respiratory zone

9. STRUCTURE of respiratory system - Conducting zone (nose, larynx, trachea, bronchi, bronchioles) The walls conducting airways contain smooth muscle -Sympathetic -Parasympathetic -  2 receptors relaxation, dilatation of the airway

10. STRUCTURE of respiratory system - Conducting zone Anatomic dead space -V of the conducting airways Physiologic dead space -V of the lungs that does not participapate in gas exchance

11. STRUCTURE of respiratory system - Conducting zone Physiologic dead space (VD) -V of the lungs that does not participapate in gas exchance Pa CO2 – PE CO2 VD = VT x ---------------- Pa CO2 VT – tidal volume Pa CO2 – P CO2 of arterial blood PE CO2 – P CO2 of mixed expired air

12. STRUCTURE of respiratory system Respiratory zone Alveoli Lung ~ 300 x 10 6 alveoli

13. diaphragm inspiration expiration

14. inspiration – mm. intercosales externi

15. expiration – mm. intercosteles interni

16. inspiration – mm. intercosales externi expiration – mm. intercosteles interni

17. inspiration – mm. intercosales externi expiration – mm. intercosteles interni

18. inspiration – mm. intercosales externi expiration – mm. intercosteles interni

19. inspiration – mm. intercosales externi expiration – mm. intercosteles interni

20. inspiration – mm. intercosales externi expiration – mm. intercosteles interni

21. inspiration – mm. intercosales externi expiration – mm. intercosteles interni

23. diaphragm inspiration expiration pleura parietalis

24. diaphragm inspiration expiration pleura visceralis

25. diaphragm inspiration expiration pleura parietalis pleura visceralis transmural pressure

26. diaphragm inspiration expiration pleura parietalis pleura visceralis transpulmonal pressure

27. diaphragm inspiration expiration pleura parietalis pleura visceralis intrapulmonal pressure

28. diaphragm inspiration expiration pleura parietalis pleura visceralis transmural pressure transpulmonal p. intrapulmonal pressure

30. diaphragm inspiration expiration pleura parietalis pleura visceralis transpulmonal p.

31. bránice - diaphragma inspirace expirace pleura parietalis pleura visceralis transmural p. PNEUMOTHORAX

32. diaphragm inspiration expiration pleura parietalis pleura visceralis transmural p. transpulmonal p. intrapulmonal pressure alveoli

37. ventilation V

38. Physiologic dead space Is the volume of air in the lungs that does not participate in gas exchance (i.e.e it is dead) Anatomic dead space – is the volume of conducting airways Functional dead space volume – which is made up of alveoli that do not participate in gas exchance (alveoli that are ventilated, but are not perfused by pulmonary capilary blood)

39. Physiologic dead space P aCO2 – P ECO2 V D =V T x ----------------------- P aCO2 V D – physiologic dead space (mL) V T – tidal volume (mL) P aCO2 – P CO2 of arterial blood (mmHg) P ECO2 - P CO2 of expered air (mmHg)

40. Physiologic dead space P aCO2 – P ECO2 V D =V T x ----------------------- P aCO2 40 - 30 V D = 500 x -------------- 40 =500 x 0.25 =125

41. Alveolar ventilation V A = (V T – V D ) x breasths/min V A - alveolar ventilation (mL/min) VT- tidal volume (mL) VD- physiologic dead space (mL/min)

42. Alveolar ventilation V A = (V T – V D ) x breasths/min V A = (500 – 125) x 16 = 375 x 16 = 6000 mL/min

43. lung heart circuitry tissues cell

45. diffusion

47. perfusion

51. ventilation diffusion perfusion

52. ventilation - static volums - dynamic volums

54. STATIC VOLUMS

55. 1 s FEV 1 VC V t DYNAMIC VOLUMS FEV1 -------- x 100 VC > 80 % Physiological value:

56. 1 s FEV 1 VC V t DYNAMIC VOLUMS OBSTRUCTION  FEV1 = VC Restriction  VC = FEV1

58. Infection inhaled allergens inhaled irritants food allergens inducing stimuli mental stress medicines Triggers

59. respiratory irritant factors physical activity preventing infection sick people, vaccination, intensive treatment sufficient fluid intake eat small portions breathing exercises

60. Differential diagnosis

61. steroid potentiation of beta-adrenergic receptor bronchospasmolytic effect cholinergic antagonism reduction in mucus production - anti-inflammatory effect - block the formation of antibodies - stabilization of lysosomes block - formation and release of histamine

62. 1 s FEV 1 VC V t DYNAMIC VOLUMS RESTRICTION = FEV1  VC

63. difusion alveolo-capillary membrane (surfactant)

64. difusion alveolo-capillar membrane (surfactant)

65. perfusion (heart)

67. Pulmonary edema - cardiogenic - noncardiogenic

68. Cyanosis (right ventricle)

69. Causes of cyanosis Central cyanosis Decreased arterial saturation Hemoglobin abnormalities Peripheral cyanosis Reduced cardiac output Cold exposure Redistribution of blood flow from extremities Arterial obstruction Venous obstruction

70. lung heart circuitry tissues cell

71. perfusion (anemia)

72. perfusion (emboli)

73. perfusion (emboli)

75. dg. pulmonal emboli

76. Dg. pulmonal emboli

77. % hemoglobin saturation 100 pO 2 Bohrs effects

78. % hemoglobin saturation 100 Bohrs effect – O 2 hemoglobin dissociation curve 0 25 5075 100 pO 2

79. % hemoglobin saturation 100 Shift to the right 0 25 5075 100 pO2

80. 100 čas Shift to the right  temperature  pH  [H+]  2,3 - DPG % hemoglobin saturation 0 25 5075 100 pO2

81. 100 Shift to the left  temperature  pH  [H+]  2,3 - DPG % hemoglobin saturation 0 25 5075 100 pO2

82. % hemoglobin saturation 100 Bohr effect 0 25 5075 100 pO2

83. pO 2 mmHgsaturation (%) 1025 2035 2550 3060 4075 5085 6090 8096 10098 Values of pO 2 and corresponding values of percent saturation of hemoglobin

88. lung heart circuitry tissues cell