2022年医学专题—第1章-呼吸系统生理.ppt

祝同学们新年学习(xux)进步！圆圆满满！,第一页，共四十九页。,Chapter 1Respiratory Physiology,Hong Cao,第二页，共四十九页。,Vocabulary,第三页，共四十九页。,vocabulary,respiratory：呼吸(hx)respiration：呼吸expiration：呼气inspiration：吸气respiratory center：呼吸中枢respiratory muscle：呼吸肌inspiratory neurone：吸气神经元diaphragm：膈肌,第四页，共四十九页。,upper airway：上呼吸道(shnghxdo)lung：肺pharynx：咽larynx：喉trachea：气管bronchi：支气管terminal bronchioles：终末支气管respiratory bronchioles：呼吸性支气管alveolar：肺泡,vocabulary,第五页，共四十九页。,intrapleural pressure：胸内压functional residual capacity（FRC）：机能余气量vital capacity（VC）：肺活量forced vital capacity（VC）：用力(yng l)肺活量residual volume（RV）：余气量total lung capacity（TLC）：肺总容量closing capacity（CC）：闭合容量the minute ventilation：每分通气量,vocabulary,第六页，共四十九页。,arterial carbon dioxide tension：动脉血二氧化碳分压arterial oxygen tension：动脉血氧分压cerebrospinal fluid：脑脊液peripheral chemoreceptor：外周化学(huxu)感受器central chemoreceptor：中枢化学感受器respiratory reflex：呼吸反射,vocabulary,第七页，共四十九页。,laryngospasm：喉痉孪airway obstruction：气道阻塞compliance：顺应性surfactant：表面活性物质surface tension：表面张力(biominzhngl)hypoxic pulmonary vasoconstriction：缺氧性肺血管收缩,vocabulary,第八页，共四十九页。,dead space：无效(wxio)腔anatomical dead space：解剖无效腔respiratory quotient：呼吸商oxyhaemoglobin dissociation curve：氧离曲线Haldane effect：Haldane效应Bohr effect：Bohr效应second gas effect：第二气体效应,vocabulary,第九页，共四十九页。,1.1.1 Lung Functions,第十页，共四十九页。,肺通气肺换气(hun q)气体运输组织换气氧化代谢,第十一页，共四十九页。,Lung Functions,Lungs are a site for gas exchange with the external environmentRegulation acid-base balanceLungs are a defence mechanismLungs are a blood reservoirServe a biosynthetic function,气体(qt)交换,外环境(hunjng),酸碱平衡(pnghng),贮血库,生物合成功能,第十二页，共四十九页。,1.1.2 Lung Structure,第十三页，共四十九页。,鼻腔(bqing),喉,气管(qgun),左主支气管,右主支气管,左肺,右肺,咽,食道(shdo),膈肌,第十四页，共四十九页。,气管支气管细支气管终末细支气管呼吸(hx)性细支气管肺泡管肺泡囊,传导单位(dnwi)呼吸单位(dnwi),第十五页，共四十九页。,肺泡(fipo)内气体,肺泡(fipo)内气体,基底膜,毛细血管(mo x xu un)内皮,组织间隙,毛细血管内血浆,第十六页，共四十九页。,1.2 Control of Respiration,第十七页，共四十九页。,中脑(zhngno),脑桥,脑干呼吸(hx)中枢,第十八页，共四十九页。,颈动脉体,主动脉体,颈动脉窦,主动脉,第十九页，共四十九页。,Respiration,Central Control,Peripheral Chemoreceptors,carotid and aortic bodies,The central chemoreceptors,Lie in the floor of the fourth ventricle and are either the neurones responsible for generation of the respiratory rhythm or are closely related to them.,They are best regarded as sensors of oxygen delivery as they respond to both a decrease in PaCO2 and in blood flow rate.,Peripheral Control,第四脑室(nosh),呼吸(hx)节律,颈动脉体主动脉体,第二十页，共四十九页。,1.3 Mechanics of Respiration,第二十一页，共四十九页。,1.3.1 Lung Volumes,肺容量(rngling),补吸气(x q)量,肺总容量(rngling),余气量,功能余气量,潮气量,补呼气量,第二十二页，共四十九页。,1.3.2 Compliance,Both the lungs and the chest wall require a distending force,usually expressed as volume change per unit of distending pressure:compliance The compliance is approximately linear over most of the range,but is less when the lung is small and nearly fully inflated.The lung exhibits hysteresis,i.e.the compliance differs during inflation and deflation.This is due to the effect of alveolar surfactant and is absent if the lung is inflated with a fluid.,顺应性,第二十三页，共四十九页。,Law of Laplace：P：回缩压力P=2T/r T：肺泡(fipo)表面张力 r:肺泡半径,If the alveoli are regarded as a series of interconnected bubbles then the normal surface tension effects would ensure that the smaller bubbles emptied into the larger.,1.3.3 Surfactant,第二十四页，共四十九页。,In fact,it doesnt!the presence of a surface active material,secreted by the type II alveolar cells,ensures that this does not occur.,第二十五页，共四十九页。,1.3.4 Resistance,The flow of air into and out of the lungs is opposed by the frictional resistance of the airways The type of flow is important,with laminar flow offering less resistance than transitional or turbulent flow.Laminar flow occurs at low flow rates and in the smaller bronchi.In the larger airways and at branches in the bronchial tree,turbulent flow may occur.Airway resistance is related to lung volume,decreasing as the lung expands.It is also related to bronchomotor tone and the thickness of the mucosal layer.,阻力(zl),摩擦阻力,层流(cn li),湍流(tunli),第二十六页，共四十九页。,1.4 Matching of Ventilation and Perfusion,第二十七页，共四十九页。,1.4.1 Distribution of Perfusion,The distribution of blood flow within the lungs is largely influenced by gravity.In the erect posture three distinct zones may be described as three zones.In the upper zone,there is almost no flow.In the middle zone and the lower zone,flow increases in the more dependent areas.,分配(fnpi),灌流(un li),重力(zhngl),第二十八页，共四十九页。,1.4.2 Distribution of Ventilation,Several factors ensure that the inspired gas is directed towards the dependent parts of the lungs.The major factor is the compliance of the different parts of the lung.The different parts of the lung are on different parts of the compliance curve.,通气(tng q),第二十九页，共四十九页。,1.4.3 Ventilation:perfusion ratio,Normal gas exchange repuires both that alveoli are adequately ventilated and that they are perfused with pulmonary blood at an appropriate rate.VA/Q=Alveolar ventilation rate Pulmonary blood flow,通气(tng q)/血流比值,肺泡(fipo),肺血流量,第三十页，共四十九页。,An area of the lung is perfused but inadequately ventilated,VA/Q will ob