RESPIRATORY PHYSIOLOGY
Lecture Outline/Notes
For Medical Sciences, Health Sciences and Basic Medical Science
Undergraduate students
Hypoxia and Other Problems
Alterations in Pattern of Breathing
• Normal breathing pattern is called eupnea
• Altered patterns of respiration are:
– 1. Tachypnea: Increase in the rate of respiration
– 2. Bradypnea: Decrease in the rate of respiration
– 3. Polypnea: Rapid, shallow breathing resembling panting in
dogs. In this type of breathing, only the rate of respiration
increases but the force does not increase significantly.
– 4. Apnea: Temporary arrest of breathing
– 5. Hyperpnea: Increase in pulmonary ventilation due to increase
in rate or force of respiration. Increase in rate and force of
respiration occurs after exercise. It also occurs in abnormal
conditions like fever or other disorders.
Alterations in Pattern of Breathing
– 6. Hyperventilation: Abnormal increase in rate and
force of respiration
– 7. Hypoventilation: Decrease in rate and force of
respiration
– 8. Dyspnea: Difficulty in breathing. It is otherwise
called the air hunger.
– 9. Periodic breathing: Abnormal respiratory rhythm
eg, Cheyne-Stokes breathing, which is the periodic
breathing characterized by rhythmic waxing and
waning hyperpnea and apnea. Biot breathing is
another form of periodic breathing characterized by
period of apnea and hyperpnea, but waxing and
waning of breathing do not occur.
Definition of some terms and Conditions
• Hypercapnea: is the increased carbon-dioxide content of
blood.
• Hypocapnea: is the decreased carbon-dioxide content in
blood.
• Cyanosis: means blueness of the skin and it is caused by
excessive amounts of deoxygenated. Hb in blood capillaries
of the skin. It occurs whenever arterial blood contains
more than 5grams deoxygenated Hb/ 100ml blood
• Atelectasis: refers to partial or complete collapse of lungs.
• Pneumothorax: is the presence of air in pleural space.
Intrapleural pressure, which is always negative, becomes
positive in pneumothorax and it causes collapse of lungs.
Definition of some terms and Conditions
• Pneumonia: is the inflammation of lung tissues, followed
by the accumulation of blood cells, fibrin and exudates in
the alveoli. Affected part of the lungs becomes
consolidated.
• Bronchial asthma: is the respiratory disease characterized
by difficult breathing with wheezing.
• Pulmonary edema is the accumulation of serous fluid in the
alveoli and the interstitial tissue of lungs.
• Pleural effusion is the accumulation of large amount of
fluid in the pleural cavity.
• Emphysema: is one of the obstructive respiratory diseases
in which lung tissues are extensively damaged hence
gaseous exchange is impaired.
HYPOXIA
• Hypoxia is defined as reduced availability of
oxygen to the tissues. Hypoxia is oxygen
deficiency at tissue level.
• Based on the Cause, Hypoxia is classified into
4 types
– Hypoxic Hypoxia
– Anaemic Hypoxia
– Stagnant/Ischaemic Hypoxia
– Histotoxic Hypoxia
Hypoxic Hypoxia
• Hypoxic hypoxia means decreased oxygen content in
blood. It is also called arterial hypoxia.
• Caused by:
– i. Low oxygen tension in inspired (atmospheric) air, which
does not provide enough oxygen
– ii. Respiratory disorders associated with decreased
pulmonary ventilation, which does not allow intake of
enough oxygen
– iii. Respiratory disorders associated with inadequate
oxygenation in lungs, which does not allow diffusion of
enough oxygen
– iv. Cardiac disorders, in which enough blood is not pumped
to transport oxygen
Hypoxic Hypoxia
• The Oxygen carrying capacity of blood is
normal
• The flow of blood is normal
• Utilization of Oxygen in tissue is normal
• Oxygen therapy is very beneficial
Anaemic Hypoxia
• Anemic hypoxia is the condition characterized by
the inability of blood to carry enough amount of
oxygen.
• Oxygen availability is normal. But the blood is not
able to take up sufficient amount of oxygen due to
anemic condition
• Caused by:
– i. Decreased number of RBCs
– ii. Decreased hemoglobin content in the blood
– iii. Formation of altered hemoglobin
– iv. Combination of hemoglobin with gases other than
oxygen and carbon dioxide.
Anaemic Hypoxia
• The Oxygen carrying capacity of blood is
reduced
• The flow of blood is normal
• Utilization of Oxygen in tissue is normal
• Oxygen therapy is quite beneficial
Stagnant/Ischaemic Hypoxia
• Stagnant hypoxia is the hypoxia caused by
decreased velocity of blood flow. Also called
hypokinetic hypoxia.
• Caused by:
– i. Congestive cardiac failure
– ii. Hemorrhage
– iii. Surgical shock
– iv. Vasospasm
– v. Thrombosis
– vi. Embolism.
Stagnant/Ischaemic Hypoxia
• The Oxygen carrying capacity of blood normal
• The flow of blood is impeded
• Utilization of Oxygen in tissue is normal
• Oxygen therapy is mildly beneficial
Histotoxic Hypoxia
• Histotoxic hypoxia is the type of hypoxia
produced by the inability of tissues to utilize
oxygen.
• Hypoxia due to inhibition of tissue oxidative
process.
• Seen in Cyanide poisoning
• Poisonous substances destroy the cellular
oxidative enzymes and there is a complete
paralysis of cytochrome oxidase system
Histotoxic Hypoxia
• The Oxygen carrying capacity of blood normal
• The flow of blood is normal
• Utilization of Oxygen in tissue is affected
• Oxygen therapy is not beneficial
Effects of Hypoxia
• In mild hypoxia, Individual is depressed, apathetic,
talkative, quarrelsome, ill-tempered and rude. There
is disorientation and loss of discriminative ability
and loss of power of judgment. Memory is impaired
and fatigue of muscles are common in hypoxia.
• If hypoxia severe, there is a sudden loss of
consciousness. If not treated immediately, coma
occurs, which leads to death.
• The person can develop the symptoms of mountain
sickness, such as nausea, vomiting, depression,
weakness and fatigue
• Also has effects on different organs/systems
Treatment of Hypoxia
• Best treatment for hypoxia is oxygen therapy – Pure oxygen or
oxygen combined with other gases is administered.
• Oxygen therapy can be given either under normal atmospheric
pressure or under high pressure (hyperbaric oxygen).
• In hypoxic hypoxia, the oxygen therapy is 100% useful. In anemic
hypoxia, oxygen therapy is moderately effective to about 70%. In
stagnant hypoxia, the effectiveness of oxygen therapy is less than
50%. In Histotoxic hypoxia, the oxygen therapy is not useful at all.
• OXYGEN TOXICITY (POISONING)
– Oxygen toxicity is the increased oxygen content in tissues, beyond
certain critical level. It is also called oxygen poisoning. It occurs because
of breathing pure oxygen with a high pressure of 2 to 3 atmosphere
(hyperbaric oxygen).
