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Breathing mind map
This is a mind map about breathing, including an overview, pulmonary ventilation, gas exchange, gas transport, etc. Friends in need hurry up and collect it!
Edited at 2024-03-05 17:08:10
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- Outline
breathe
Overview
The process of gas exchange between the body and the external environment
process
external breathing
Pulmonary ventilation: lungs-external environment
Pulmonary ventilation: alveoli-pulmonary capillary blood
Gases are transported in the blood
lung-tissue
internal breathing
blood-tissue cells
pulmonary ventilation
principle
Motivation (breathing movement)
Respiratory muscle contraction (primary force) → Thoracic cage size → Changes in intra-alveolar pressure → △P = P intra-alveolar pressure – P atmosphere (direct power)
respiratory movements
Rhythmic expansion or contraction of the thorax caused by contraction and relaxation of respiratory muscles
Inspiratory muscles: diaphragm, external intercostal muscles Accessory inspiratory muscles: scalenes, sternocleidomastoid Expiratory muscles: internal intercostal muscles, abdominal muscles
Calm breathing: diaphragm, external intercostal muscles 12～18 times/min
Inspiration (active): contraction of inspiratory muscles
The center of the diaphragm bulge moves downward, and the upper and lower diameter of the chest increases
External intercostal muscles: lift the ribs and sternum, and evert the lower edge of the ribs
Exhalation (passive): inspiratory muscles relax
Breathe hard/deeply
Inhalation: The inspiratory muscles strengthen the contraction, and the auxiliary respiratory muscles also participate (inhalation and exhalation are both active)
Exhalation: Relaxation of inspiratory muscles, contraction of expiratory muscles
Chest breathing (external intercostal muscles) and abdominal breathing (diaphragm), usually mixed breathing
intrapulmonary pressure
Inhalation: Lung volume increases, intrapulmonary pressure decreases <atmospheric pressure, and gas enters the lungs
Exhalation: Lung volume decreases, intrapulmonary pressure increases > atmospheric pressure, and gas flows out of the lungs
End of inspiration, end of expiration: intrapulmonary pressure = atmospheric pressure
pleural cavity
Potential space between parietal and visceral pleura
intrapleural negative pressure
Under normal circumstances, there is no air in the pleural cavity. Since the thorax grows faster than the lungs after the baby is born, the lungs are usually in a state of passive expansion, which generates a certain retraction force and causes the pleural cavity to become negative pressure.
Negative intrathoracic pressure = intrapulmonary pressure – lung elastic recoil Inspiration/end of expiration: negative intrathoracic pressure = atmospheric pressure – lung elastic recoil force
Reasons: a: Expansion of the thorax; b: Inward retraction of the lungs; c: Tightness of the pleural cavity
physiological significance
Make the lungs change with changes in thoracic volume
Maintaining the expansion of the alveoli is conducive to respiratory movement
Reduce central venous pressure to facilitate the return of blood and lymph fluid
pneumothorax
Pleural rupture → the pleural cavity is connected to the atmosphere → air enters the pleural cavity to form
resistance
Elastic resistance 70%
The force R of an elastic body against deformation caused by external forces
Compliance C: The ease with which elastic tissue deforms under the action of external forces
Easy to deform: high compliance, low elastic resistance
C=1/R
include
lung elastic resistance
constitute
1/3 lung elastic recoil force, 2/3 surface tension
P (reflects retraction force) = 2T (reflects surface tension)/r (alveolar radius)
pulmonary surfactant
Produced by alveolar type II epithelial cells, the ingredients are dipalmitoyl lecithin (reduces surface tension) and surfactant binding protein
Reduce alveolar surface tension, reduce alveolar retraction, and maintain alveolar size stability
Neonatal respiratory distress syndrome NRDS: lack of surfactant, excessive alveolar retraction leading to atelectasis
Thoracic elastic resistance: inspiratory resistance/expiratory power
Inelastic resistance 30%
Airway resistance 80% to 90%
inertial resistance
tissue viscous resistance
Pulmonary ventilation function evaluation index
lung volume and lung volume
lung volume
deep inspiratory volume
tidal volume TV
average breathing, the amount of air inhaled or exhaled with each breath
400～600ml (average 500ml)
Inspiratory supplementary volume/inspiratory reserve volume IRV
Calm down to the end of your inhalation, then try your best to inhale the amount of air you can inhale. Reserve volume for reaction inspiration
1500～2000ml
functional residual capacity
expiratory reserve volume/expiratory reserve volume ERV
The amount of air that can be exhaled after calming down at the end of the inhalation and then exhaling as hard as you can. Exhaled reserve volume
900～1200ml
Residual volume RV
The amount of air that is not retained in the lungs and cannot be exhaled at the end of maximum expiration
1000～1500ml
Lung capacity
Deep inspiration volume IC
Tidal volume supplementary inspiratory volume
One of the indicators of maximum ventilation potential
Functional residual capacity FRC
residual volume, supplementary expiratory volume
2500ml
physiological significance
The amplitude of changes in alveolar oxygen partial pressure and carbon dioxide partial pressure during buffered breathing (dilution effect)
vital capacityVC
The maximum amount of air that can be exhaled from the lungs
Tidal volume Supplementary inspiratory volume Supplementary expiratory volume
3500ml for men, 2500ml for women
It is a commonly used indicator for lung function measurement.
Forced vital capacity (FVC)
Refers to the maximum amount of air that can be exhaled as quickly as possible after one maximum inhalation.
Forced inspiratory volume FEV
It refers to the amount of gas exhaled within a certain period of time after trying to exhale as quickly as possible after one maximum inhalation.
FEV1/FVC has the greatest application value and is the most commonly used indicator for clinically identifying obstructive pulmonary disease and restrictive pulmonary disease.
Asthma, COPD: decreased ratio Pulmonary fibrosis: normal ratio
total lung capacity
The maximum amount of air the lungs can hold
vital capacity remaining air volume
Men: 5000ml
Women: 3500ml
Pulmonary ventilation and alveolar ventilation
pulmonary ventilation
The total amount of air inhaled or exhaled per minute
Tidal volume x respiratory rate
Respiratory rate 12 to 18 times/min
Lung ventilation: 6~9L/min
maximum voluntary ventilation
The maximum amount of air that can be inhaled or exhaled per minute while trying to breathe deeply and quickly
Reflects the ventilation volume that can be achieved by fully utilizing all ventilation capabilities per unit time.
One of the physiological indicators that estimates the maximum amount of exercise the body can perform
alveolar ventilation
The amount of fresh air inhaled into the alveoli per minute
(tidal volume - dead space volume) * respiratory rate
Deep and slow breathing is more efficient than shallow and fast breathing, but requires more work
physiological dead space
Does not participate in gas exchange between alveoli and blood
Anatomical dead space: 150ml
alveolar dead space
Normal people are close to 0
gas exchange
lung ventilation tissue ventilation
gas exchange
principle
partial pressure difference
Molecular weight and solubility of gases
temperature
Diffusion area (direct ratio: emphysema, atelectasis), distance (inverse ratio: pulmonary fibrosis, pulmonary edema)
Influencing factors
Gas partial pressure difference, diffusion rate
respiratory membrane
Thickness (inverse ratio) 6 layers
liquid layer of pulmonary surfactant
Alveolar epithelial cell layer
epithelial basement membrane
The space between the epithelial basement membrane and the capillary basement membrane (stromal layer)
capillary basement membrane layer
capillary endothelial cell layer
Area (proportional)
ventilation/blood flow ratio
Alveolar ventilation per minute (VA, 4.2L/min)/pulmonary blood flow per minute (Q, 5L/min)
Normally quiet, ratio is about 0.84
A measure of pulmonary ventilation function, reflecting the degree of matching between alveolar ventilation and pulmonary capillary blood perfusion.
The ratios of each part are not the same
Lung apex 3.3, lung base 0.63
The ratio increases, indicating insufficient ventilation or relatively excessive blood flow, as if a functional arteriovenous short circuit occurs.
Regardless of whether the value increases or decreases, especially the lack of oxygen
>0.84: Hyperventilation/insufficient blood flow → pulmonary embolism (increased alveolar dead space)
<0.84: Hypoventilation/excess blood flow → functional arteriovenous short circuit, bronchial asthma
gas transportation
oxygen
Physically dissolved about 1.5% (indispensable)
Chemically bonded 98.5%
(Hb) Hemoglobin
1 globin 4 heme
There is ferrous iron in the center of the heme group
Combined with oxygen, oxyhemoglobin (HbO2): bright red
Hemoglobin without oxygen bound, deoxygenated hemoglobin (Hb): blue-violet
Depends on oxygen partial pressure
Characteristics of hemoglobin binding to oxygen
Binding is rapid, reversible, and does not require enzyme catalysis
The binding reaction is oxygenation rather than oxidation
Amount of oxygen bound to hemoglobin
hemoglobin oxygen capacity
Refers to the maximum amount of oxygen that hemoglobin can bind in 100ml of blood
hemoglobin oxygen content
Refers to the amount of oxygen actually bound to hemoglobin in 100ml of blood
hemoglobin oxygen saturation
Hemoglobin oxygen content/hemoglobin oxygen capacity
When the hemoglobin content in the blood reaches more than 5g/100ml, the skin and mucous membranes turn dark purple: cyanosis
Fe2 is oxidized to Fe3: methemoglobin (nitrite, aniline poisoning)
The oxygen dissociation curve is S-shaped
Influencing factors
allosteric effect
Deoxygenated hemoglobin
Tight T-shape
oxygenated hemoglobin
Loose R type
synergy
The four subunits of hemoglobin have synergistic effects with each other
Oxyhemoglobin dissociation curve: oxygen partial pressure (X) - blood oxygen saturation (Y)
S type
Shang Duanping
Blood oxygen partial pressure: 60~100mmhg
Hb combined with O2
It shows that: within this range, the partial pressure of oxygen has little effect on hemoglobin oxygen saturation or blood oxygen content.
The middle section is steeper
Blood oxygen partial pressure: 40~60mmhg
HbO2 releases O2
Indicates: the oxygen supply of blood to tissues under resting conditions
The lower section is steepest
Blood oxygen partial pressure: 15~40mmhg
It shows that small changes in blood oxygen partial pressure can lead to significant changes in hemoglobin oxygen saturation.
Can reflect the reserve capacity of blood to supply oxygen
Influencing factors
Effect of blood pH and PCO2
hydrogen ion concentration
Effect of temperature
2,3-bisphosphoglycerate in red blood cells
Effects of carbon monoxide
P50
to express the affinity of hemoglobin for oxygen
It is the PO2 when the hemoglobin oxygen saturation reaches 50%, the normal value is about 26.5mmhg
Increases, and the oxygen dissociation curve shifts to the right, indicating that hemoglobin's affinity for oxygen decreases.
T type
Decrease, the oxygen dissociation curve shifts to the left, indicating an increase in hemoglobin's affinity for oxygen
Type R
Factors affecting the dissociation curve
Carbon dioxide partial pressure, pH value
Bohr effect: Lowering blood pH or increasing CO2 partial pressure will reduce Hb’s affinity for O2
Temperature: Increase, shift to the right, affinity decrease
2,3-Diphosphoglycerate (DPG): As the concentration increases, Hb’s affinity for oxygen decreases
Move right, affinity decreases
carbon dioxide
Physically dissolved 5%
Chemically bonded 95%
form
Bicarbonate 88%
reaction reversible
carbonic anhydrase required
Depends on the level of PCO2
Carbamate hemoglobin 7%
Rapid, reversible, no enzyme involvement required
Mainly regulated by oxygenation
carbon dioxide dissociation curve
The carbon dioxide content in the blood can increase as PCO2 increases
linear relationship
Holden effect: The combination of O2 and Hb will promote the release of CO2
Regulation of respiratory movements
Respiratory center - respiratory rhythm
respiratory center
spinal cord
Located in the anterior horn of the spinal cord in the 3rd to 5th cervical segments (which controls the diaphragm) and thoracic segments (which controls the intercostal muscles and abdominal muscles, etc.)
No respiratory rhythm
lower brainstem
Medulla oblongata
respiratory rhythm basic respiratory center
pons
upper part
respiratory adjustment center
Inhibitory effect on the long-inhalation center
lower part
Long breathing center (deep breathing)
*Respiratory rhythm remains unchanged after cerebral cortex resection
higher brain
Cerebral cortex, limbic system, hypothalamus
Respiratory movement is dually regulated by the voluntary nature of the cerebral cortex and the autonomy of the lower brainstem
reflexive conditioning
chemoreceptive reflex
chemoreceptors
Peripheral chemoreceptor PCR
Carotid body: regulates breathing
Aortic body: regulates circulation
Oxygen partial pressure decreases, CO2 partial pressure increases, H concentration increases: excitement, breathing deepens and accelerates
Hypoxia
Completely dependent on PCR
Directly inhibits the respiratory center
central chemoreceptor CCR
Medulla oblongata
The most effective stimulus: increased H concentration in cerebrospinal fluid → deep and fast breathing
CO2: Mainly via CCR (in H form) and secondarily via PCR H: Mainly through PCR, secondarily through CCR (H does not easily pass through the blood-brain barrier)
Pulmonary stretch reflex (Black-Berry reflex)
mechanoreceptive reflex
Inspiratory depression or inspiratory excitement caused by expansion or contraction of the lungs
negative feedback regulation
Receptors: within airway smooth muscle The vagus nerve is the afferent nerve for this reflex
lung expansion reflex
Physiological significance: to prevent inhalation from being too deep or too long, and to speed up inhalation and turn to exhalation
Cutting off both vagus nerves: inhalation is prolonged and deepened, breathing is deep and slow
lung collapse reflex
Facilitate the transition of exhalation to inhalation
Prevent excessive exhalation and atelectasis
During calm breathing, respiratory movement regulation is not involved.
defensive breathing reflex
cough reflex
Receptors located in the airway mucosa
sneeze reflex
Receptors are located in the nasal mucosa
Respiratory muscle proprioceptive reflex
Receptors: muscle spindles and tendon organs