- Identify the basic principles of gas exchange
- Name and describe lung volumes and capacities
Basic Principles of Gas Exchange
Gas exchange during respiration occurs primarily through diffusion. Diffusion is a process in which transport is driven by a concentration gradient. Gas molecules move from a region of high concentration to a region of low concentration. Blood that is low in oxygen concentration and high in carbon dioxide concentration undergoes gas exchange with air in the lungs. The air in the lungs has a higher concentration of oxygen than that of oxygen-depleted blood and a lower concentration of carbon dioxide. This concentration gradient allows for gas exchange during respiration.
Lung Volumes and Capacities
Different animals have different lung capacities based on their activities. Cheetahs have evolved a much higher lung capacity than humans; it helps provide oxygen to all the muscles in the body and allows them to run very fast. Elephants also have a high lung capacity. In this case, it is not because they run fast but because they have a large body and must be able to take up oxygen in accordance with their body size.
Human lung size is determined by genetics, gender, and height. At maximal capacity, an average lung can hold almost six liters of air, but lungs do not usually operate at maximal capacity. Air in the lungs is measured in terms of lung volumes and lung capacities (see Figure 1 and Table 1). Volume measures the amount of air for one function (such as inhalation or exhalation). Capacity is any two or more volumes (for example, how much can be inhaled from the end of a maximal exhalation).
|Table 1. Lung Volumes and Capacities (Avg Adult Male)|
|Tidal volume (TV)||Amount of air inhaled during a normal breath||0.5||–|
|Expiratory reserve volume (ERV)||Amount of air that can be exhaled after a normal exhalation||1.2||–|
|Inspiratory reserve volume (IRV)||Amount of air that can be further inhaled after a normal inhalation||3.1||–|
|Residual volume (RV)||Air left in the lungs after a forced exhalation||1.2||–|
|Vital capacity (VC)||Maximum amount of air that can be moved in or out of the lungs in a single respiratory cycle||4.8||ERV+TV+IRV|
|Inspiratory capacity (IC)||Volume of air that can be inhaled in addition to a normal exhalation||3.6||TV+IRV|
|Functional residual capacity (FRC)||Volume of air remaining after a normal exhalation||2.4||ERV+RV|
|Total lung capacity (TLC)||Total volume of air in the lungs after a maximal inspiration||6.0||RV+ERV+TV+IRV|
|Forced expiratory volume (FEV1)||How much air can be forced out of the lungs over a specific time period, usually one second||~4.1 to 5.5||–|
The volume in the lung can be divided into four units: tidal volume, expiratory reserve volume, inspiratory reserve volume, and residual volume. Tidal volume (TV) measures the amount of air that is inspired and expired during a normal breath. On average, this volume is around one-half liter, which is a little less than the capacity of a 20-ounce drink bottle. The expiratory reserve volume (ERV) is the additional amount of air that can be exhaled after a normal exhalation. It is the reserve amount that can be exhaled beyond what is normal. Conversely, the inspiratory reserve volume (IRV) is the additional amount of air that can be inhaled after a normal inhalation. The residual volume (RV) is the amount of air that is left after expiratory reserve volume is exhaled. The lungs are never completely empty: There is always some air left in the lungs after a maximal exhalation. If this residual volume did not exist and the lungs emptied completely, the lung tissues would stick together and the energy necessary to re-inflate the lung could be too great to overcome. Therefore, there is always some air remaining in the lungs. Residual volume is also important for preventing large fluctuations in respiratory gases (O2 and CO2). The residual volume is the only lung volume that cannot be measured directly because it is impossible to completely empty the lung of air. This volume can only be calculated rather than measured.
Capacities are measurements of two or more volumes. The vital capacity (VC) measures the maximum amount of air that can be inhaled or exhaled during a respiratory cycle. It is the sum of the expiratory reserve volume, tidal volume, and inspiratory reserve volume. The inspiratory capacity (IC) is the amount of air that can be inhaled after the end of a normal expiration. It is, therefore, the sum of the tidal volume and inspiratory reserve volume. The functional residual capacity (FRC) includes the expiratory reserve volume and the residual volume. The FRC measures the amount of additional air that can be exhaled after a normal exhalation. Lastly, the total lung capacity (TLC) is a measurement of the total amount of air that the lung can hold. It is the sum of the residual volume, expiratory reserve volume, tidal volume, and inspiratory reserve volume.
Lung volumes are measured by a technique called spirometry. An important measurement taken during spirometry is the forced expiratory volume (FEV), which measures how much air can be forced out of the lung over a specific period, usually one second (FEV1). In addition, the forced vital capacity (FVC), which is the total amount of air that can be forcibly exhaled, is measured. The ratio of these values (FEV1/FVC ratio) is used to diagnose lung diseases including asthma, emphysema, and fibrosis. If the FEV1/FVC ratio is high, the lungs are not compliant (meaning they are stiff and unable to bend properly), and the patient most likely has lung fibrosis. Patients exhale most of the lung volume very quickly. Conversely, when the FEV1/FVC ratio is low, there is resistance in the lung that is characteristic of asthma. In this instance, it is hard for the patient to get the air out of his or her lungs, and it takes a long time to reach the maximal exhalation volume. In either case, breathing is difficult and complications arise.
The inspiratory reserve volume measures the ________.
- amount of air remaining in the lung after a maximal exhalation
- amount of air that the lung holds
- amount of air the can be further exhaled after a normal breath
- amount of air that can be further inhaled after a normal breath
Of the following, which does not explain why the partial pressure of oxygen is lower in the lung than in the external air?
- Air in the lung is humidified; therefore, water vapor pressure alters the pressure.
- Carbon dioxide mixes with oxygen.
- Lungs exert a pressure on the air to reduce the oxygen pressure.
- Oxygen is moved into the blood and is headed to the tissues.
The total lung capacity is calculated using which of the following formulas?
- residual volume + expiratory reserve volume + tidal volume + inspiratory reserve volume
- residual volume + tidal volume + inspiratory reserve volume
- residual volume + expiratory reserve volume + inspiratory reserve volume
- expiratory reserve volume + tidal volume + inspiratory reserve volume
residual volume + expiratory reserve volume + tidal volume + inspiratory reserve volume
Careers in ScienCE
Respiratory therapists or respiratory practitioners evaluate and treat patients with lung and cardiovascular diseases. They work as part of a medical team to develop treatment plans for patients. Respiratory therapists may treat premature babies with underdeveloped lungs, patients with chronic conditions such as asthma, or older patients suffering from lung disease such as emphysema and chronic obstructive pulmonary disease (COPD). They may operate advanced equipment such as compressed gas delivery systems, ventilators, blood gas analyzers, and resuscitators. Specialized programs to become a respiratory therapist generally lead to a bachelor’s degree with a respiratory therapist specialty. Because of a growing aging population, career opportunities as a respiratory therapist are expected to remain strong.
Respiratory therapists use various tests to evaluate patients. For example, they test lung capacity by having patients breathe into an instrument that measures the volume and flow of oxygen when they inhale and exhale. Respiratory therapists also may take blood samples and use a blood gas analyzer to test oxygen and carbon dioxide levels.
Respiratory therapists also perform chest physiotherapy on patients to remove mucus from their lungs and make it easier for them to breathe. Removing mucus is necessary for patients suffering from lung diseases, such as cystic fibrosis, and it involves the therapist vibrating the patient’s rib cage, often by tapping the patient’s chest and encouraging him or her to cough. Respiratory therapists may connect patients who cannot breathe on their own to ventilators that deliver oxygen to the lungs. Therapists insert a tube in the patient’s windpipe (trachea) and connect the tube to ventilator equipment. They set up and monitor the equipment to ensure that the patient is receiving the correct amount of oxygen at the correct rate.
Respiratory therapists who work in home care teach patients and their families to use ventilators and other life-support systems in their homes. During these visits, they may inspect and clean equipment, check the home for environmental hazards, and ensure that patients know how to use their medications. Therapists also make emergency home visits when necessary.
In some hospitals, respiratory therapists are involved in related areas, such as diagnosing breathing problems for people with sleep apnea and counseling people on how to stop smoking.
In Summary: Breathing Capacity
The lungs can hold a large volume of air, but they are not usually filled to maximal capacity. Lung volume measurements include tidal volume, expiratory reserve volume, inspiratory reserve volume, and residual volume. The sum of these equals the total lung capacity.