Lab 8 Respiratory Physiology Laboratory 8 Respiratory Physiology The primary function of the respiratory system is to exchange oxygen and carbon dioxide between air and blood. This function sustains metabolism (via increasing blood oxygen and releasing blood carbon dioxide) and regulates blood pH. To completely understand how the respiratory system works you must understand: 1) how air moves in and out of the lungs = Lung Ventilation. 2) how blood moves to and from the alveoli = Pulmonary Circulation. 3) how oxygen and carbon dioxide are transported across the capillary-alveoli interface = Pulmonary Gas Exchange. 4) the neural control of breathing. Lung Ventilation The lung moves air in and out via BULK FLOW, which is governed by the following simple equation: Air Flow = Pressure Gradient ÷ Pulmonary Resistance. Where: Pressure Gradient = Atmospheric Pressure – Alveolar Pressure The Pressure Gradient is equal to the difference in pressure between atmospheric air (outside the lungs) and alveolar air (inside the lungs). The PRESSURE GRADIENT is the primary mechanism by which the lungs generate airflow and this is achieved by altering the pressure of the alveolar air! Alveolar air pressure can be altered very simply by changing the volume of the pleural (lung) cavity. And changing the volume of the pleural cavity is simply achieved by moving the diaphragm muscle and the accessory breathing muscles (intercostals, abdominal muscles, scalenes) on the ribcage! The following diagram shows how alveolar air pressure is altered by changing pleural volume via movements of the diaphragm and ribcage: When you INHALE, the diaphragm contracts by moving DOWN, which INCREASES the pleural cavity volume. Increasing this volume DECREASES the ALVEOLAR PRESSURE to less than atmospheric pressure. This creates a LARGE POSITIVE PRESSURE GRADIENT, which causes air to move into the lungs via bulk flow. 1 Lab 8 Respiratory Physiology When you EXHALE the exact opposite happens. The diaphragm relaxes moving UP, which DECREASES the pleural cavity volume. Decreasing pleural volume INCREASES ALVEOLAR PRESSURE to greater than atmospheric pressure. This creates a LARGE NEGATIVE PRESSURE GRADIENT which forces air OUT of the lungs. In both cases, air moves DOWN ITS PRESSURE GRADIENT from HIGH TO LOW PRESSURE. While changes in pressure gradients are the primary mechanism responsible for normal lung ventilation, INCREASE in Pulmonary Resistance is the primary mechanism responsible for reduced airflow associated with a variety of disease states. (Think back to the equation; an increase in Resistance will make the denominator bigger thus decreasing airflow in or out of the lungs). The Pulmonary Resistance is inversely proportional to the size of the anatomic structures through which air flows (nose, mouth, trachea, bronchi, bronchioles, and alveoli). Thus DECREASING the diameter of these structures INCREASES pulmonary resistance and thus DECREASES airflow. COPD (chronic obstructive pulmonary disease) and asthma are two diseases that increase pulmonary resistance. In COPD, the airways experience an increase in resistance due to either: 1) chronic long term narrowing (e.g. via excess mucus in bronchitis) or 2) destruction of the bronchioles and alveoli (emphysema). In asthma and allergies, spastic smooth muscle contraction of the muscle surrounding the airway leads to a very fast and dramatic increase in resistance. In both diseases, airway resistance is INCREASED by a decrease in airway diameter. The amount of air moving into or out of the lungs during any one breathing cycle is called the tidal volume (TV). The tidal volume is smaller than the maximum amount of air that can be moved through the lungs, the vital capacity (VC). The difference between the tidal volume and the vital capacity are the reserve volumes (IRV and ERV) that can be "tapped" to change the tidal volume and increase the depth of breathing. The amount of air moving into and out of the lungs can also be altered by changing the breathing rate. The depth and the rate of breathing are controlled by the respiratory control center, which is located in the medulla of the brain. The respiratory control center insures that the exchange of oxygen and carbon dioxide at the lungs takes place at a rate that matches the body's requirements. This is a dynamic process, since the body's requirements change over time. 2 Lab 8 Respiratory Physiology Directly measuring blood flow, gas exchange, and neural control is EXTREMELY INVASIVE and thus impossible for this laboratory. OBJECTIVES This week you will: 1) use PhysioEx simulations to examine normal lung physiology and the effects of obstructive and restrictive diseases, and 2) use the iWorx spirometer to actually measure air movement into and out of the lungs at rest, during forced expiration, after Exercise, and under simulated Restrictive and Obstructive Lung Diseases. Program 1: physioEX Exercise 7: Respiratory System Mechanics Reading the introduction in the lab manual for each of the activities will help you to better follow and understand this week’s lab. Complete Activities 1-9 (pp.87-97). Answer the questions listed at the end of each activity. Program 2: LabScribe2 Respiration Experiments The SAME SUBJECT (one person per group) should make ALL RECORDINGS using the Spirometer! This lab involves MANY, MANY, MANY calculations and variables. Record your data carefully and make your calculations carefully so that you can sort out the variable and understand what they mean and why they are important! Activity 1: Breathing While Resting Aim: To measure breathing parameters in a healthy, resting subject. 1.1. Procedure: 1. 2. 3. 4. Sit quietly and become accustomed to breathing through the spirometer flowhead. Breathe normally before any recordings are made. Hold the flowhead so that its outlets are pointed up. Remove the flowhead from his or her mouth and hold it at the mouth level in a position that prevents a breath from moving through the flowhead. 5. The LabScribe software will zero the Volume channel during the first five seconds of recording. No air should be moving through the flow head during this time. 6. Click on the Record button. After waiting five seconds for the Volume channel to zero, have the subject place the flowhead in his or her mouth and begin breathing. 7. Record five normal breaths followed by a inhaling as deeply as possible, followed by exhaling as quickly and completely as possible. Every sixty seconds into the recording, the baseline of the Volume channel automatically resets itself to zero, but you should be able to complete the five normal breaths and deep inhalation/complete exhalation within that time. See figure below for example of what your data should look 3 Lab 8 Respiratory Physiology like. Do not forget to AUTOSCALE your data!! The bottom (blue) display is the data you will analyze. 8. Click Stop to halt recording. 1.2. Data Analysis-Normal Breathing at Rest 1. Scroll through the recording and find the section of data recorded when the subject was breathing while resting. 2. Use the Display Time icons to adjust the Display Time of the Main window to show at least four complete breathing cycles on the Main window. 3. Click on the Analysis window icon in the toolbar. 4. Look at the Function Table that is above the uppermost channel displayed in the Analysis window. The mathematical functions, V2-V1, Max_dv/dt, Min_dv/dt, and T2-T1 should appear in this table. Tidal Volume (TV): the volume of air inhaled or exhaled during a normal breathing cycle. To measure the tidal volume of the subject during breathing at rest, place one cursor in the trough prior to inhalation, and the second cursor on the peak of the cycle (see Figure 1). The value for the V2-V1 function on the Volume channel is the Tidal Volume. Figure 1. 4 Lab 8 Respiratory Physiology Breath Period (BP): the duration of each breathing cycle. To measure the breath period of the subject during breathing at rest, place one cursor on a peak of a breath cycle, and the second cursor on the peak of an adjacent cycle (see Figure 2). The value for T2-T1 on the Volume channel is the Breath Period. Figure 2 Calculate the normal breathing rate of the subject at rest using the following equation: Breath Rate (breaths/minute) = {60 seconds/minute } / { mean breath period (sec/breath)} 5. Multiply the mean tidal volume by the breathing rate to calculate the volume of air passing in and out of the resting subject's lungs each minute (Minute Volume). 6. Record the all values below:. REST Tidal Volume: Breath Period: Breath Rate: Minute Volume: 1.3. Data Analysis-Forced Expiration at Rest 1. Use the slider or the arrows on the scroll bar, at the bottom of the Analysis window, to position data recorded when the subject exhaled with maximum force in the window. 2. Use the Display Time icons to adjust the Display Time of the Analysis window to show the forced expiration curve and the two normal breaths that occurred before the force expiration curve on the same window. Record the following variables: Inspiratory Reserve Volume (IRV): Place one cursor on the peak of the normal breath prior to the maximum inhalation and the second cursor on the peak of the forced breath cycle (refer to Figure 3). The value for the V2-V1 function on the Volume channel is the inspiratory reserve volume. Forced Inspiratory Flow Rate: Keep the cursors in the same positions used for measuring IRV. The value for the Max dv/dt function on the Volume channel is the forced inspiratory flow rate. 5 Lab 8 Respiratory Physiology Forced Vital Capacity (FVC): Place one cursor on the peak of the forced breath cycle and the other cursor on the flat line after the subject expelled all the air from his or her lungs (refer to Figure 3). The value for the V2-V1 function on the Volume channel is the forced vital capacity. Forced Expiratory Flow Rate: Keep the cursors in the same positions used for measuring FVC. The value for the Min dv/dt function on the Volume channel is the forced expiratory flow rate. Expiratory Reserve Volume (ERV): Place one cursor in the trough before maximal inhalation and the second cursor on the flat line after subject expelled all the air from his or her lungs (refer to Figure 3). The value for the V2-V1 function on the Volume channel is the expiratory reserve volume. Forced Expiratory Volume at 1 Second (FEV1): Place one cursor on the peak of the maximum breath cycle and the other cursor on the data point that is one second after the peak (refer to Figure 3). Use the T2-T1 function to determine the data point that is one second after the peak. The value for the V2-V1 function on the Volume channel is the forced expiratory volume at one second. Calculate the subject's FEV1/FVC ratio by dividing the subject's FEV1 value by his or her FVC value. FORCED EXPIRATION, record data below: Tidal Volume Inspiratory Reserve Volume Forced Inspiratory Flow Rate Force Vital Capacity Force Expiratory Flow Rate Expiratory Reserve Volume Forced Expiratory Volume at 1 second FEV1 /FVC Activity 2: The effect of Obstructive and Restrictive Diseases on Lung Ventilation. Pulmonary function tests examine the ratio of FEV1 to FVC to determine disease states. In normal adults this ratio is approximately around 0.8. We will consider ratios between 0.770.83 as normal. In obstructive diseases, this ratio is reduced because both FVC and FEV1 are reduced, but FEV1 is more drastically reduced. Thus, people with obstructive diseases have a hard time pushing air out of the lungs quickly. In restrictive lung diseases, FVC is reduced but FEV1 remains unchanged, which results in ratios greater than 0.8. 6 Lab 8 Respiratory Physiology Obstructive diseases = FEV1 to FVC ratios < 0.77. Restrictive diseases = FEV1 to FVC ratios > 0.83. In this experiment, you will simulate obstructive and restrictive disease states using simple treatments! 2.1. Obstructive diseases: find a bacterial filtered that has been packed with cotton balls. Follow the procedure 1.1 described above and record the variables in the space provided below. 2.2. Restrictive diseases: exhale deeply and simultaneously tighten a belt around your upper chest just under your armpits (its should feel hard to breathe! Follow the procedure 1.1 described above and record the variables in the space provided below. Obstructive Restrictive Tidal Volume Forced Vital Capacity Force Expiratory Volume Forced Expiratory Volume (1 sec) Inspiratory Reserve Volume Forced Inspiratory FLOW Rate Forced Expiratory FLOW rate FEV1/FVC Do you think it is harder for a person with an Obstructive or a Restrictive disease to breath? WHY? 7 Lab 8 Respiratory Physiology Activity 3: The effect of Exercise on Lung Ventilation We all know that you breathe faster and deeper during and just after exercise. But exactly how does lung ventilation change from rest to exercise and then during recovery? This exercise explores how exercise affects minute ventilation (the volume of air pushed through the lung per minute) and tidal volume. 3.1. Procedure: 1. 2. 3. 4. Start recording and allow the flowhead to zero out for five seconds. Begin breathing normally through the flowhead. Mark the plot with RESTING. Continue breathing at rest for 15 seconds. Now start a vigorous exercise. I suggest chopping your feet very quickly in place (it’s a basketball drill). YOU MUST EXCERCISE AT A HIGH LEVEL OF EXERTION FOR THIS EXPERIMENT TO WORK! Mark the plot with EXCERSICE and record until the subject begins to feel fatigued. 5. Stop exercise. 6. Mark the plot with RECOVERY and record for 60 seconds. 3.2. Data Analysis 1. Go to the Analysis window and record the following variable for RESTING, EXCERSISE, and RECOVERY REST EXCER RECOVERY TIDAL VOLUME BREATH PERIOD BREATH RATE (per Min) MINUTE VENTILATION 2. In addition, scroll across you plot and note when changes in Tidal Volume and Breath Period occurred Is tidal volume and breath period adjusted relatively quickly or slowly after exercise? How about after recovery? 8