1. The respiratory system

2. Respiration: 4 components: 4 components: Ventilation Ventilation Diffusion Diffusion O2 and CO2 transport O2 and CO2 transport Utilization of O2 and generation of CO2 Utilization of O2 and generation of CO2

3. Ventilation: Respiratory center in brainstem Respiratory center in brainstem Motoric neurons Motoric neurons Peripheral nerve: Phrenic nerves Peripheral nerve: Phrenic nerves Diaphragm Diaphragm Chest wall Chest wall Airways Airways Alveoli Alveoli

4. Lung volumes: 4 Tidal volume: the volume of air moving into and out of the lungs during a normal, relaxed ventilatory effort. (500 ml) Tidal volume: the volume of air moving into and out of the lungs during a normal, relaxed ventilatory effort. (500 ml) Inspiratory reserve volume: the volume of air that can be inspired during a maximal inspiratory effort in excess of the tidal volume. (2L) Inspiratory reserve volume: the volume of air that can be inspired during a maximal inspiratory effort in excess of the tidal volume. (2L)

5. Expiratory reserve volume: volume of air expelled after a maximal expiratory effort in excess of the tidal volume.(1L) Expiratory reserve volume: volume of air expelled after a maximal expiratory effort in excess of the tidal volume.(1L) Residual volume: volume of air remaining in the lungs after a maximal expiratory effort. Can`t be expelled.(1L) Residual volume: volume of air remaining in the lungs after a maximal expiratory effort. Can`t be expelled.(1L)

6. Lung capacities: Total lung capacity: TV + IRV + ERV + RV. Total lung capacity: TV + IRV + ERV + RV. Inspiratory capacity: TV + IRV Inspiratory capacity: TV + IRV Vital capacity: IRV + TV + ERV Vital capacity: IRV + TV + ERV Functional residual capacity: ERV + RV Functional residual capacity: ERV + RV

7. FRC: Amount of air remaining in the lungs after a normal, relaxed expiratory effort. Amount of air remaining in the lungs after a normal, relaxed expiratory effort. At FRC the respiratory system is in equilibrium. The tendency of the lungs to collapse are balanced by the tendency of the thoracic wall to expand. At FRC the respiratory system is in equilibrium. The tendency of the lungs to collapse are balanced by the tendency of the thoracic wall to expand.

8. Physiological disturbances affecting ventilation: Brainstem: Respiratory center. Bleeding, tumor, raised intracranial pressure with herniation. Brainstem: Respiratory center. Bleeding, tumor, raised intracranial pressure with herniation. Motoric neurons in spinal cord: Poliomyelitis, motor neuron disease, trauma etc. Motoric neurons in spinal cord: Poliomyelitis, motor neuron disease, trauma etc. Peripheral nerve: Phrenic nerves. Peripheral nerve: Phrenic nerves.

9. Diaphragm: Myopathy Diaphragm: Myopathy Chest wall: Rib fractures, pleural effusion, pneumothorax, hemothorax, mesothelioma. Chest wall: Rib fractures, pleural effusion, pneumothorax, hemothorax, mesothelioma. Airways: Asthma, COPD, upper airway obstruction. Airways: Asthma, COPD, upper airway obstruction. Alveoli: Filled by blood, fluid, pus, tumor, protein etc.. Alveoli: Filled by blood, fluid, pus, tumor, protein etc..

10. Physiological lung function tests: Ventilatory function: Assess flow via flow-volume loop- FEV1. Assess adequacy of ventilation with PaCO2. Ventilatory function: Assess flow via flow-volume loop- FEV1. Assess adequacy of ventilation with PaCO2. Diffusion: Assess with CO-diffusion test: DLCO. Diffusion: Assess with CO-diffusion test: DLCO. Pulmonary perfusion: Ventilation-perfusion scan. Inhaled radioactive xenon matched with technetium. Pulmonary perfusion: Ventilation-perfusion scan. Inhaled radioactive xenon matched with technetium. Structure of lung: CT Structure of lung: CT Ciliary function tests Ciliary function tests Arterial blood gas analysis Arterial blood gas analysis