LUNG MECHANICS
DR. NAJEEB LECTURE NOTES
BY FATIMA HAIDER
KGMC
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Study of those forces and factors which are responsible for bringing the air in and out of lungs is called
lung mechanics.
INSPIRATORY MUSCLES
Major muscle of inspiration during quite breathing is Diaphragm.
During quiet breathing, diaphragm is enough for inspiration but in forced breathing, external intercostal
muscles also plays a role. Due to external intercostal muscles, sternum moves upward and outward and
chest cavity increase in size.
Accessory muscles of inspiration are involved in rapid, deep and fast inspiration. These accessory
muscles include sternocleidomastoid, scalene and sometimes pectoralis major muscle.
EXPIRATORY MUSCLES
During quiet breathing, expiration is passive. It is mainly mediated by elastic recoil of the lungs and
assisted by simultaneous relaxation of muscles of inspiration.
Accessory muscles of expiration involved in forceful breathing:
1. Internal intercostals – pull the ribs downward and eventually reduce the size of chest cavity
2. Rectus abdomini – contracts strongly hence push the contents of abdomen backward and
upward so diaphragm is more rapidly going up and reducing the size of chest cavity
ANTI EXPANSION FORCES
Anti-expansion forces include:
1. Elasticity of lungs
2. Tissue resistance
3. Airway resistance
LUNG ELASTICITY: Lungs have elastic fibers and collagen fibers and these fibers prevent the expansion
of the lungs. To counter of the force of this elasticity, intercostal muscles are used.
TISSUE RESISTANCE: When lungs are expanding, both layers of pleura glide against each other, thereby
producing resistance.
AIRWAY RESISTANCE: When lungs are expanding, air is moving in. when air moves in, layers of air resist
against each other and against the airways.
TERMS RELATED WITH RESPIRATORY MECHANICS
1. INTRA ALVEOLAR PRESSURE - Pressure within the alveoli
2. INTRA PLEURAL PRESSURE – pressure inside the pleural cavity. Interpleual pressure is normally
negative.
3. ATMOSPHERIC PRESSURE – pressure outside the body
4. TRANSMURAL PRESSURE – The pressure across the wall of a structure. Transmural pressure can
be positive, negative or zero.
Positive transmural pressure inflate the structure
Negative transmural pressure deflate the structure
Transmural pressure = Pressure inside the wall – Pressure outside the wall
5. TRANS PULMONARY PRESSURE – Transmural pressure which is across alveolar wall (between
alveoli and plura)
Trans Pulmonary Pressure = Intra alveolar Pressure – Intra pleural pressure
6. TRANS THORACIC PRESSURE – Transmural pressure which is across the chest wall
Trans Thoracic Pressure = Intra Pleural Pressure – Atmospheric pressure
7. TRANS RESPIRATORY PRESSURE
Trans Respiratory Pressure = Intra Alveolar Pressure - Atmospheric Pressure
PRESSURE MEASUREMENT
To Determine Intra alveolar Pressure, manometer is connected with airways
To determine intrapleural pressure, a catheter is pushed into esophagus. There is a monometer
at the end of the catheter. When the catheter goes in, a balloon is inflated and lower third of
the esophagus is disconnected with the oral cavity. After inflation of balloon, whatever is the
pressure in esophagus measured by manometer will be same as inetrpleural pressure.
COMPLIANCE AND ELASTANCE
Compliance is the measure of distensibility. Those structures which are easily distended are said to be
more compliant.
Elastance is reciprocal of compliance. If lung elastance is increased, then their compliance is decreased.
All those diseases which destroy elastic tissue in lungs, reduce the elastance and thereby increase the
compliance. A high lung compliance means that the lungs are too pliable and have a lower than normal
level of elastic recoil.
Pulmonary fibrosis stiffens the lungs through deposits of scar tissue, decreasing compliance and making
it more difficult for the lungs to inflate or deflate.
∆𝑉
Compliance = ∆𝑃
∆𝑃
Elastance = ∆𝑉
RESTING VOLUME
Resting Volume of a structure is the volume when transmural pressure across the wall of the structure is
zero.
COMPLIANCE FORMULAS
∆𝑉
Compliance of lungs = ∆𝑃
Here ∆𝑃 is change in Transpulmonary pressure so
∆𝑉
Compliance = 𝑖𝑛𝑡𝑒𝑟𝑎𝑙𝑣𝑒𝑜𝑙𝑎𝑟 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒−𝑖𝑛𝑡𝑒𝑟𝑝𝑙𝑒𝑢𝑟𝑎𝑙 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒
∆𝑉
Compliance of chest wall = ∆𝑃
Here ∆𝑃 is transthoracic pressure so
∆𝑉
Compliance = 𝐼𝑛𝑡𝑒𝑟𝑝𝑙𝑒𝑢𝑟𝑎𝑙 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒−𝐴𝑡𝑚𝑜𝑠𝑝ℎ𝑒𝑟𝑖𝑐 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒
Atmospheric pressure is considered zero so
∆𝑉
Compliance of chest wall =
𝐼𝑛𝑡𝑒𝑟𝑝𝑙𝑒𝑢𝑟𝑎𝑙 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒
∆𝑉
Compliance of Rspiratory system i.e. lungs and chest wall together = ∆𝑃
Here ∆𝑃 is transrespiratory pressure so
∆𝑉
Compliance =
𝐴𝑙𝑣𝑒𝑜𝑙𝑎𝑟 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒−𝑎𝑡𝑚𝑜𝑠𝑝ℎ𝑒𝑟𝑖𝑐 𝑝𝑟𝑒𝑠𝑠𝑢𝑟𝑒
SOME TERMS
Residual volume – volume left in lungs even after forceful expiration
Lung operating normally at:
Functional Residual capacity during expiration
Functional residual capacity is the combined resting volume of lungs and chest wall
Adds tidal volume during inspiration
Inspiratory Reserve Volume – air that can be forcibly inhaled after a normal tidal volume
GRAPHS CORRELATING INTERPLEURAL PRESSURE AND CHANGE IN
VOLUME