7. Is vital capacity the maximal volume?
8. What is the functional residual capacity?
9. What is the inspiratory capacity?
10. Can residual volume be directly measured by spirometry?
Make the sentences of your own using the new words (10 sentences).
Make your own sentences using possessive case (10 sentences).
Find one word, which is a little bit different in meaning from others (Π½Π°ΠΉΠ΄ΠΈΡΠ΅ ΠΎΠ΄Π½ΠΎ ΡΠ»ΠΎΠ²ΠΎ, ΠΊΠΎΡΠΎΡΠΎΠ΅ Π½Π΅ΠΌΠ½ΠΎΠ³ΠΎ ΠΎΡΠ»ΠΈΡΠ°Π΅ΡΡΡ ΠΎΡ Π΄ΡΡΠ³ΠΈΡ ΠΏΠΎ ΡΠΌΡΡΠ»Ρ):
1. a) volume; b) head; c) lung;
2. a) air; b) breathing; c) hot;
3. a) stomach; b) bronchi; c) lungs;
4. a) nose; b) trachea; c) finger;
5. a) eye; b) alveoli; c) bronchi.
ΠΠΠΠ¦ΠΠ― β 25. Ventilation
Total ventilation (VT, minute ventilation) is the total gas flow into the lungs per minute. It is equal to the tidal volume (VT) x the respiratory rate (n). Total ventilation is the sum of dead space ventilation and alveolar ventilation.
Anatomic dead space is equivalent to the volume of the conducting airways (150 mL in normal individuals), i. e., the trachea and bronchi up to and including the terminal bronchioles. Gas exchange does not occur here. Physiologic dead space is the volume of the respiratory tract that does not participate in gas exchange. It includes the anatomic dead space and partially functional or nonfunctional alveoli (e. g., because of a pulmonan embolus preventing blood supply to a region of alveoli). In normal individuals, anatomic and physiologic dead space are approximately equal. Physiologic dead space can greatly exceed anatomic dead space in individuals with lung disease.
Dead space ventilation is the gas flow into dead space per minute. Alveolar ventilation is the gas flow entering functional alveoli per minute.
Alveolar ventilation: It is the single most important parameter of lung function. It cannot be measured directly. It must be adequate for removal of the CO2 produced by tissue metabolism whereas the partial pressure of inspired O2 is 150 mmHg, the partial pressure of O2 in the alveoli is typically 100 mmHg because of the displacement of O2 with CO2. PAo2 cannot be measured directly.
New words
total β ΠΎΠ±ΡΠ΅Π΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ
ventilation β Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΡ
flow β ΠΏΠΎΡΠΎΠΊ
per minute β Π² ΠΌΠΈΠ½ΡΡΡ
equal β ΡΠ°Π²Π½ΡΠΉ
the conducting β ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅
airways β Π²ΠΎΠ·Π΄ΡΡΠ½ΡΠ΅ ΠΏΡΡΠΈ
exchange β ΠΎΠ±ΠΌΠ΅Π½
tract β ΡΡΠ°ΠΊΡΠ°Ρ
to be measured β Π±ΡΡΡ ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½Π½ΡΠΌ
directly β Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎ
displacement β ΡΠΌΠ΅ΡΠ΅Π½ΠΈΠ΅
ΠΠ΅ΡΠ΅ΡΡΠ°Π·ΠΈΡΡΠΉΡΠ΅ ΡΠ»Π΅Π΄ΡΡΡΠΈΠ΅ ΡΠ»ΠΎΠ²ΠΎΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ ΠΈ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΈΡ, ΡΠΏΠΎΡΡΠ΅Π±Π»ΡΡ ΠΏΡΠΈΡΡΠΆΠ°ΡΠ΅Π»ΡΠ½ΡΠΉ ΠΏΠ°Π΄Π΅ΠΆ.
1. The handbags of these women.
2. The flat of my sister is large.
3. The children of my brother are at home.
4. The room of the boys is large.
5. The name of this girl is Helen.
6. The work of these students is interesting.
7. The dog of the brother.
8. The notebook of the teacher.
9. The friend of my friend.
10. The work of the scientist.
ΠΠ΅ΡΠ΅Π²Π΅Π΄ΠΈΡΠ΅ Π½Π° Π°Π½Π³Π»ΠΈΠΉΡΠΊΠΈΠΉ ΡΠ·ΡΠΊ, ΡΠΏΠΎΡΡΠ΅Π±Π»ΡΡ ΠΏΡΠΈΡΡΠΆΠ°ΡΠ΅Π»ΡΠ½ΡΠΉ ΠΏΠ°Π΄Π΅ΠΆ.
1. ΠΠ½ ΠΏΠΎΠΊΠ°Π·Π°Π» ΠΌΠ½Π΅ ΠΏΠΈΡΡΠΌΠΎ ΡΠ²ΠΎΠ΅ΠΉ ΡΠ΅ΡΡΡΡ.
2. ΠΠ½Π° Π²Π·ΡΠ»Π° ΠΊΠΎΠ½ΡΠΊΠΈ ΡΠ²ΠΎΠ΅Π³ΠΎ Π±ΡΠ°ΡΠ°.
3. ΠΠ°ΠΉΡΠ΅ ΠΌΠ½Π΅ ΡΠ΅ΡΡΠ°Π΄ΠΈ Π²Π°ΡΠΈΡ ΡΡΠ΅Π½ΠΈΠΊΠΎΠ².
4. ΠΡΠΈΠ½Π΅ΡΠΈΡΠ΅ Π²Π΅ΡΠΈ Π²Π°ΡΠΈΡ Π΄Π΅ΡΠ΅ΠΉ.
5. ΠΡΠ΅ΡΠ° Π΄Π΅ΡΠΈ Π½Π°ΡΠ»ΠΈ ΠΏΡΠΈΡΡΠ΅ Π³Π½Π΅Π·Π΄ΠΎ.
6. ΠΡΠΎ ΡΠ΅ΠΌΡΡ ΠΌΠΎΠ΅Π³ΠΎ Π΄ΡΡΠ³Π°.
7. Π§ΡΡ ΡΡΠΎ ΡΡΠΌΠΊΠ°? ΠΡΠΎ ΡΡΠΌΠΊΠ° Π’ΠΎΠΌΠ°.
8. Π§ΡΠΈ ΡΡΠΎ ΡΠ»ΠΎΠ²Π°ΡΠΈ? β ΠΡΠΎ ΡΠ»ΠΎΠ²Π°ΡΠΈ ΡΡΡΠ΄Π΅Π½ΡΠΎΠ².
9. ΠΡ Π²ΠΈΠ΄Π΅Π»ΠΈ ΠΊΠ½ΠΈΠ³Ρ Π½Π°ΡΠ΅Π³ΠΎ ΡΡΠΈΡΠ΅Π»Ρ?
10. ΠΠ½Π΅ Π½ΡΠ°Π²ΠΈΡΡΡ ΠΏΠΎΡΠ΅ΡΠΊ ΡΡΠΎΠ³ΠΎ ΠΌΠ°Π»ΡΡΠΈΠΊ.
Answer the questions.
1. How minutes does it take for total ventilation?
2. Is total ventilation equal to the tidal volume?
3. Describe the process of total ventilation?
4. Is anatomic dead space equipment to the volume of the conducting airways?
5. Does gas exchange occur in trachea and bronchi?
6. What is physiological dead space?
7. What does physiological dead space include?
8. Describe the alveolar ventilation?
9. What is the most important parameter of lung function?
10. What does tissue metabolism produce?
Make the sentences of your own using the new words (10 sentences).
Make your own sentences using possessive case (10 sentences).
Find one word, which is a little bit different in meaning from others (Π½Π°ΠΉΠ΄ΠΈΡΠ΅ ΠΎΠ΄Π½ΠΎ ΡΠ»ΠΎΠ²ΠΎ, ΠΊΠΎΡΠΎΡΠΎΠ΅ Π½Π΅ΠΌΠ½ΠΎΠ³ΠΎ ΠΎΡΠ»ΠΈΡΠ°Π΅ΡΡΡ ΠΎΡ Π΄ΡΡΠ³ΠΈΡ ΠΏΠΎ ΡΠΌΡΡΠ»Ρ):
1) a) nose; b) mouth; c) nail;
2) a) lungs; b) bronchi; c) stomach;
3) a) brain; b) rib; c) thorax;
4) a) tissue; b) bone; c) pelvis;
5) a) arm; b) shoulder; c) finger.
ΠΠΠΠ¦ΠΠ― β 26. Air flow
Air moves from areas of higher pressure to areas of lower pres sure just as fluids do. A pressure gradient needs to be established to move air.
Alveolar pressure becomes less than atmospheric pressure when the muscles of inspiration enlarge the chest cavity, thus lowering the in-trathoracic pressure. Intrapleural pressure decreases, caus ing expansion of the alveoli and reduction of intra-alveolar pressure. The pressure gradient between the atmosphere and the alveoli drives air into the airways. The opposite occurs with expiration.
Air travels in the conducting airways via bulk flow (mL/min). Bulk flow may be turbulent or laminar, depending on its velocity. Velocity represents the speed of movement of a single particle in the bulk flow. At high velocities, the flow may be turbulent. At lower velocities transitional flow is likely to occur. At still lower velocities, flow may be laminar (streamlined). Reynold's number predicts the air flow. The higher the number, the more likely the air will be turbulent. The velocity of particle movement slows as air moves deeper into the lungs because of the enormous increase in cross-sectional area due to branching. Diffusion is the primary mechanism by which gas moves between terminal bronchioles and alveoli (the respiratory zone).
Airway resistance: The pressure difference necessary to produce gas flow is directly related to the resistance caused by friction at the airway walls. Medium-sized airways (βΊ 2 mm diameter) are the major site of airway resistance. Small airways have a high individual resis tance. However, their total resistance is much less because resistances in parallel add as reciprocals.
Factors affecting airway resistance: Bronchoconstriction (increased resistance) can be caused by parasympathetic stimulation, histamine (immediate hyper-sensitivity reaction), slow-reacting substance of anaphylaxis (SRS-A = leukotrienes C4, D4, E4; mediator of asthma), and irritants. Bronchodilation (decreased resistance) can be caused by sympathetic stimulation (via beta-2 receptors). Lung volume also affects airway resistance. High lung vol umes lower airway resistance because the surrounding lung parenchyma pulls airways open by radial traction. Low lung volumes lead to increased airway resistance because there is less traction on the airways. At very low lung vol umes, bronchioles may collapse. The viscosity or density of inspired gases can affect airway resistance. The density of gas increases with deep sea div ing, leading to increased resistance and work of breathing. Low-density gases like helium can lower airway resistance During a forced expiration, the airways are compressed by increased intrathoracic pressure. Regardless of how forceful the expiratory effort is, the flow rate plateaus and cannot be exceeded. Therefore, the air flow is effort-independent; the collapse of the airways is called dynamic compression. Whereas this phenomenon is seen only upon forced expira tion in normal subjects, this limited flow can be seen dur ing normal expiration in patients with lung diseases where there is increased resistance (e. g., asthma) or increased compliance (e. g., emphysema).
New words
to move β ΠΏΠ΅ΡΠ΅ΠΌΠ΅ΡΠ°ΡΡΡΡ
from β ΠΎΡ area β ΠΎΠ±Π»Π°ΡΡΡ
higher β Π²ΡΡΠ΅
pressure β Π΄Π°Π²Π»Π΅Π½ΠΈΠ΅
lower β Π½ΠΈΠΆΠ΅
just β ΡΠΎΠ»ΡΠΊΠΎ
fluids β ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ
gradient β Π³ΡΠ°Π΄ΠΈΠ΅Π½Ρ
to be established β Π±ΡΡΡ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠΌ
intrapleural β Π²Π½ΡΡΡΠΈΠΏΠ»Π΅Π²ΡΠ°Π»ΡΠ½ΡΠΉ
to decrease β ΡΠΌΠ΅Π½ΡΡΠ°ΡΡΡΡ
caus ing β ΠΏΠΎΡΠΎΠΆΠ΄Π΅Π½ΠΈΠ΅
expansion β ΡΠ°ΡΡΠΈΡΠ΅Π½ΠΈΠ΅
reduction β ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΠ΅
intra-alveolar β Π²Π½ΡΡΡΠΈΠ°Π»ΡΠ²Π΅ΠΎΠ»ΡΡΠ½ΡΠΉ
atmosphere β Π°ΡΠΌΠΎΡΡΠ΅ΡΠ°
opposite β Π½Π°ΠΏΡΠΎΡΠΈΠ²
expiration β ΠΈΡΡΠ΅ΡΠ΅Π½ΠΈΠ΅
collapse β ΠΊΠΎΠ»Π»Π°ΠΏΡ
viscosity β Π²ΡΠ·ΠΊΠΎΡΡΡ
density β ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΡ
ΠΠ΅ΡΡΠΎΠΈΠΌΠ΅Π½ΠΈΡ some, any, no, every ΠΈ ΠΈΡ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄Π½ΡΠ΅
Some ΠΎΠ±ΠΎΠ·Π½Π°ΡΠ°Π΅Ρ Π½Π΅ΠΊΠΎΡΠΎΡΠΎΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ.
Π£ΠΏΠΎΡΡΠ΅Π±Π»ΡΠ΅ΡΡΡ Π² ΡΠ»Π΅Π΄ΡΡΡΠΈΡ ΡΠ»ΡΡΠ°ΡΡ .
1. Π£ΡΠ²Π΅ΡΠ΄ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠΎΡΠΌΠ°: Β«We have some dictionariesΒ».
2. ΠΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½Π°Ρ ΡΠΎΡΠΌΠ°: Β«We have no dictionariesΒ».
3. ΠΠΎΠΏΡΠΎΡΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠΎΡΠΌΠ°: Β«Have you any dictionaries?Β»
ΠΡΡΠ°Π²ΡΡΠ΅ some, any, no.
1. There are⦠pictures in the book.
2. Are there⦠new students in your group?
3. There are⦠old houses in our street.
4. Are thereβ¦ English text books on the desks? β Yes, there areβ¦
5. Are thereβ¦ maps on the walls? β No, there aren'tβ¦
6. Are thereβ¦ pens on the desk? β Yes, thereβ¦
7. Are thereβ¦ sweets in your bag? β Yes, there areβ¦
8. Have you gotβ¦ English books at home? β Yes, I haveβ¦
9. There are⦠beautiful pictures in the magazine.
10. I have. nice gloves.
11. There are.ink in my pen.
12. Is there⦠paper on your table?
13. I have got⦠exercise-books. Give me please.
14. It is. winter. There are. leaves on the trees.
15. There are. schools in this street.
16. Are the. pictures in your book?
17. There are. flowers here in winter.
18. I can see⦠children in the yard. They are playing.
19. Are there⦠new buildings your street?
20. There are. people in the park because it is cold.
Answer the questions.
1. Where does air move from?
2. What does pressure gradient need?
3. Does alveolar pressure become less than atmospheric pressure?
4. Between what does the pressure gradient drive the air into the airway?
5. Via what does the air travel?
6. What may bulk flow be?
7. What does the bulk flow depend on?
8. What does velocity represent?
9. What may the flow be at high velocities?
10. What is the pressure difference needed for?
Make the sentences of your own using the new words (10 sentences).
Make your own sentences using SOME, ANY, NO, EVERY (10 sentences).
Find one word, which is a little bit different in meaning from others (Π½Π°ΠΉΠ΄ΠΈΡΠ΅ ΠΎΠ΄Π½ΠΎ ΡΠ»ΠΎΠ²ΠΎ, ΠΊΠΎΡΠΎΡΠΎΠ΅ Π½Π΅ΠΌΠ½ΠΎΠ³ΠΎ ΠΎΡΠ»ΠΈΡΠ°Π΅ΡΡΡ ΠΎΡ Π΄ΡΡΠ³ΠΈΡ ΠΏΠΎ ΡΠΌΡΡΠ»Ρ):
1) a) organism; b) salt; c) body;
2) a) health; b) rest; c) cold;
3) a) brick; b) blood; c) liquid;
4) a) hair; b) head; c) foot;
5) a) lamp; b) organ; c) tissue.
ΠΠΠΠ¦ΠΠ― β 27. Mechanics of breathing
Muscles of respiration: inspiration is always an active process. The following muscles are involved: The diaphragm is the most important muscle of inspiration. It is convex at rest, and flattens during contraction, thus elongating the thoracic cavity. Contraction of the external in-tercostals lifts the rib cage upward and outward, expanding the thoracic cavity. These muscles are more important for deep inhalations. Accessory muscles of inspiration, including the scalene (elevate the first two ribs) and sternocleidomastoid (elevate the sternum) muscles, are not active during quiet breath ing, but become more important in exercise. Expiration is normally a passive process. The lung and chest wall are elastic and naturally return to their resting positions after being actively expanded during inspiration. Expiratory muscles are used during exercise, forced expiration and cer tain disease states. Abdominal muscles (rectus abdominis, internal and exter nal obliques, and transversus abdominis) increase intra-abdominal pressure, which pushes the diaphragm up, forc ing air out of the lungs. The internal intercostal muscles pull the ribs downward and inward, decreasing the thoracic volume. Elastic properties of the lungs: the lungs collapse if force is not applied to expand them. Elastin in the alveolar walls aids the passive deflation of the lungs. Collagen within the pulmonary in-terstitium resists further expansion at high lung volumes. Compliance is defined as the change in volume per unit change in pressure (AV/AP). In vivo, compliance is measured by esophageal balloon pres sure vs. lung volume at many points during inspiration and expiration. Each measurement is made after the pressure and volume have equilibrated and so this is called static compli ance. The compliance is the slope of the pressure-volume curve. Several observations can be made from the pressure-volumecurve.
Note that the pressure-volume relationship is different with deflation than with inflation of air (hysteresis). The compliance of the lungs is greater (the lungs are more distensible) in the middle volume and pressure ranges.
At high volumes and expanding pressures, the compliance is lower (the lungs are stiffer). Even when the lung has no expanding pressure, some air remains in the lungs. When saline is used to fill the lung, compliance is much greater (small pressure changes bring about large changes in volume). With saline inflation, there is little difference in the pressure-volume relationship with inflation or defla tion. This indicates that the differences seen between infla tion and deflation of air must be due to surface forces in the air-liquid interface of the alveoli.
Causes of decreased compliance: pulmonary fibrosis, pulmonary venous congestion and edema, deficiency of surfactant. Causes of increased compliance: emphysema, age.
New words
muscles β ΠΌΡΡΠΊΡΠ»Ρ, ΠΌΡΡΡΡ
respiration β Π΄ΡΡ Π°Π½ΠΈΠ΅
inspiration β Π²Π΄ΠΎΡ
always β Π²ΡΠ΅Π³Π΄Π°
process β ΠΏΡΠΎΡΠ΅ΡΡ
following β ΡΠ»Π΅Π΄ΡΡΡΠΈΠΉ
to be involved β Π±ΡΡΡ Π²ΠΎΠ²Π»Π΅ΡΠ΅Π½Π½ΡΠΌ
diaphragm β Π΄ΠΈΠ°ΡΡΠ°Π³ΠΌΠ°
the most β Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅
important β Π²Π°ΠΆΠ½ΡΠΉ