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Chapter: Medical Physiology: Pulmonary Ventilation

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Effect of the Thoracic Cage on Lung Expansibility

Thus far, we have discussed the expansibility of the lungs alone, without considering the thoracic cage.

Effect of the Thoracic Cage on Lung Expansibility

Thus far, we have discussed the expansibility of the lungs alone, without considering the thoracic cage. The thoracic cage has its own elastic and viscous charac-teristics, similar to those of the lungs; even if the lungs were not present in the thorax, muscular effort would still be required to expand the thoracic cage.

Compliance of the Thorax and the Lungs Together

The compliance of the entire pulmonary system (the lungs and thoracic cage together) is measured while expanding the lungs of a totally relaxed or paralyzed person. To do this, air is forced into the lungs a little at a time while recording lung pressures and volumes. To inflate this total pulmonary system, almost twice as much pressure is needed as to inflate the same lungs after removal from the chest cage. Therefore, the com-pliance of the combined lung-thorax system is almost exactly one half that of the lungs alone—110 milliliters of volume per centimeter of water pressure for the combined system, compared with 200 ml/cm for the lungs alone. Furthermore, when the lungs are expanded to high volumes or compressed to low volumes, the limitations of the chest become extreme;when near these limits, the compliance of the com-bined lung-thorax system can be less than one fifth that of the lungs alone.

“Work” of Breathing

We have already pointed out that during normal quiet breathing, all respiratory muscle contraction occurs during inspiration; expiration is almost entirely a passive process caused by elastic recoil of the lungs and chest cage. Thus, under resting conditions, the respira-tory muscles normally perform “work” to cause inspi-ration but not to cause expiration.

The work of inspiration can be divided into three fractions: (1) that required to expand the lungs against the lung and chest elastic forces, called compliance work or elastic work; (2) that required to overcome the vis-cosity of the lung and chest wall structures, called tissueresistance work; and (3) that required to overcomeairway resistance to movement of air into the lungs, called airway resistance work.

Energy Required for Respiration. During normal quiet respi-ration, only 3 to 5 per cent of the total energy expended by the body is required for pulmonary ventilation. But during heavy exercise, the amount of energy required can increase as much as 50-fold, especially if the person has any degree of increased airway resistance or de-creased pulmonary compliance. Therefore, one of the major limitations on the intensity of exercise that can be performed is the person’s ability to provide enough muscle energy for the respiratory process alone.

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