RESPIRATION DURING EXERCISE

Dr. Wasif Ali (PT)

 Respiration

◦ (1) pulmonary respiration

◦ (2) cellular respiration.
◦ Pulmonary respiration refers to ventilation (breathing) and the exchange of
gases (O2 and CO2) in the lungs.
◦ Cellular respiration relates to O2 utilization and CO2 production by the
tissues
STRUCTURE OF THE RESPIRATORY
SYSTEM
STRUCTURE OF THE RESPIRATORY SYSTEM

◦ The human respiratory system is composed of a group of passages that

filter air and transport it into the lungs, where gas exchange occurs within
tiny air sacs called alveoli.
◦ The upper portion of the respiratory tract includes the nose, nasal
cavity, and the pharynx.
◦ The lower respiratory zone comprises the trachea, bronchus, and
bronchioles; the respiratory bronchioles lead into the alveoli where gas
exchange occurs
◦ The pressure in the pleural cavity (intrapleural pressure) is less than
atmospheric and becomes even lower during inspiration, causing air from
the environment to move into the lungs.
◦ The fact that intrapleural pressure is less than atmospheric is important
because it prevents the collapse of the fragile air sacs (i.e., alveoli) within
the lungs.
Functional zones

◦ The airways leading to and from the lung are divided into two functional
zones:
◦ (1) Conducting zone
◦ (2) Respiratory zone
Conducting Zone

◦ The conducting zone includes all those anatomical structures (e.g., trachea,
bronchial tree, bronchioles) that air passes through to reach the respiratory
zone.
◦ The conducting zone of the respiratory system not only serves as a
passageway for air, but also functions to filter and humidify the air as it
moves toward the respiratory zone of the lung.
Respiratory Zone

◦ The respiratory zone is the region of the lung where gas exchange occurs
and includes the respiratory bronchioles, alveolar ducts, and alveolar sacs.
◦ Respiratory bronchioles are included in this region because they contain
small clusters of alveoli.
◦ Gas exchange in the lungs occurs across about 300 million tiny alveoli.
◦ The enormous number of these structures provides the lung with a large
surface area for diffusion, estimated 60 to 80 square meters (i.e., size
of a tennis court).
◦ The rate of gas diffusion is further assisted by the fact that each alveolus is
only one cell layer thick, so the total blood–gas barrier is only two
cell layers thick (alveolar cell and capillary cell).
MECHANICS OF BREATHING
◦ Movement of air from the environment to the lungs is called pulmonary
ventilation and occurs via a process known as bulk flow.
◦Bulk flow refers to the movement of molecules along a passageway due
to a pressure difference between the two ends of the passageway.
◦ Thus, inspiration occurs due to the pressure in the lungs (intrapulmonary)
being reduced below atmospheric pressure.
◦ Conversely, expiration occurs when the pressure within the lungs exceeds
atmospheric pressure.
Inspiration

◦ The diaphragm is the most important muscle of inspiration and is essential

for normal breathing to occur.
◦ When the diaphragm contracts, it forces the abdominal contents downward
and forward. Further, the ribs are lifted outward.
◦ The outcome of these two actions is to reduce intrapleural pressure, which
in turn causes the lungs to expand.
◦ This expansion of the lungs results in a reduction in intrapulmonary
pressure below atmospheric, which allows airflow into the lungs.
◦ During normal, quiet breathing, the diaphragm performs most of the work
of inspiration.
◦ However, during exercise, accessory muscles(external intercostal muscles,
pectoralis minor, the scalene muscles, and the sternocleidomastoids) of
inspiration are called into action to assist in breathing.
Expiration
◦ Expiration is passive during normal, quiet breathing(no muscular effort is
necessary for expiration to occur at rest), because both the lung and chest
wall are elastic and return to their equilibrium position after expanding
during inspiration.
◦ However, during exercise, expiration becomes active.
◦ The most important muscles involved in expiration are the rectus
abdominus, the external oblique and internal intercostal muscles.
◦ When these muscles contract, the diaphragm is pushed upward (ascends)
and the ribs are pulled downward and inward. This results in a decrease in
the volume of the chest and expiration occurs.
Airway Resistance

◦ Airflow through the airways of the respiratory system can be explained by

the following relationship:
◦ Airflow = P1 – P2/Resistance
◦ where P1 − P2 is the pressure difference at the two ends of the airway, and
resistance is the resistance to flow offered by the airway.
PULMONARY
VENTILATION
◦ Pulmonary ventilation refers to the movement of gas into and out of the
lungs.
◦ The amount of gas ventilated per minute is the product of the frequency of
breathing (f) and the amount of gas moved per breath (tidal volume): V̇ =
VT × f
◦ In a 70-kg man, the V̇ at rest is generally around 7.5 liters/minute, with a
tidal volume of 0.5 liter and a frequency of 15 breaths per minute.
◦ During maximal exercise, ventilation may reach 120 to 175 liters per
minute, with a frequency of 40 to 50 breaths per minute and a tidal volume
of approximately 3 to 3.5 liters.
◦ This “unused” ventilation is called dead space ventilation (VD), and
the space it occupies is known as anatomical dead space.

◦ The volume of inspired gas that reaches the respiratory zone is referred to
as alveolar ventilation (V̇ A).
◦ Thus, total minute ventilation can be subdivided into dead space
ventilation and alveolar ventilation: V ̇ = V̇ A + V̇ D
◦ The bottom of the lung receives more ventilation than the apex (top
region), particularly during quiet breathing.
◦ This changes during exercise, with the apical (top) regions
of the lung receiving an increased percentage of the
total ventilation.
PULMONARY VOLUMES AND CAPACITIES
◦ Pulmonary volumes can be measured via a technique known as spirometry.
◦ Using this procedure, the subject breathes into a device that is capable of
measuring inspired and expired gas volumes.
◦ Spirometry is useful in diagnosing lung diseases such as chronic
obstructive pulmonary disease (COPD).
◦ For example, because of increased airway resistance, COPD patients will
have a diminished vital capacity and a reduced rate of expired airflow
during a maximal expiratory effort
◦ vital capacity (VC) is the maximum amount of gas that can be expired after a
maximum inspiration.
◦ Residual volume (RV) is the volume of gas remaining in the lungs after a
maximum expiration.
◦ Total lung capacity (TLC) is the volume of gas in the lungs after a maximum
inspiration; it is the sum of the two lung volumes (VC + RV).

◦ Note that exercise training does not affect any of these lung volumes or
capacities.
◦ One of the easiest lung function tests to detect airway blockage is the
measurement of forced expiratory volume and vital capacity (VC).
◦ The forced expiratory volume (called FEV1) is the volume of gas
expired in 1 second during a forced (maximal effort) expiration from a full
inspiration.
◦Vital capacity is the total amount of gas that can be expired during a
maximal expiration following a full inspiration.
◦ In the normal individual, the vital capacity is 5.0 liters and the FEV1 was
4.0 liters. Therefore, the FEV in this healthy individual is 80% of the VC
(i.e., 4.0/5.0 × 100 = 80%).
◦ Indeed, the normal ratio of FEV1 to VC in healthy individuals is 80% or
higher.
DIFFUSION OF GASES
◦ Diffusion of a gas across tissues is described by Fick’s law of diffusion,
which states that :
◦ “the rate of gas transfer (V gas) is proportional to the tissue area, the
diffusion coefficient of the gas (i.e., how easily a molecule diffuses), and
the difference in the partial pressure of the gas on the two sides of the
tissue, and is inversely proportional to the thickness”
◦ : V gas = A /T × D × (P1 – P2)
◦ where A is the area, T is the thickness of the tissue, D is the diffusion
coefficient of the gas, and P1 – P2 is the difference in the partial pressure
between the two sides of the tissue.
◦ The lung is well designed for the diffusion of gases across the alveolar
membrane into and out of the blood.
◦ First, the total surface area available for diffusion is large.
◦ Second, the alveolar membrane is extremely thin.
◦ Together, this design makes the lung the ideal organ for gas exchange; this
is important because during maximal exercise, the rate of O2 uptake and
CO2 output can increase 20 to 30 times above rest.
◦ The amount of O2 or CO2 dissolved in blood obeys Henry’s law and is
dependent on the:
◦ Temperature of blood
◦ The partial pressure of the gas
◦ The solubility of the gas
◦ Because the temperature of the blood does not change a great deal during
exercise (i.e., 1–3°C) and the solubility of the gas remains constant, the
major factor that determines the amount of dissolved gas is the partial
pressure.
◦ The PCO2 and PO2 of blood entering the lung are approximately 46 and 40
mm Hg, respectively.
◦ In contrast, the PCO2 and PO2 in alveolar gas are around 40 and 105 mm
Hg, respectively.
◦ As a consequence of the difference in partial pressure across the blood–gas
interface, CO2 leaves the blood and diffuses into the alveolus, and O2
diffuses from the alveolus into the blood.
◦ Blood leaving the lung has a PO2 of approximately 95 mm Hg and a PCO2
of 40 mm Hg.
BLOOD FLOW TO THE LUNG
◦ The pulmonary circulation begins at the pulmonary artery, which receives
venous blood from the right ventricle (recall that this is mixed venous
blood).
◦ Mixed venous blood is then circulated through the pulmonary capillaries
where gas exchange occurs, and this oxygenated blood is returned to the
left atrium via the pulmonary vein to be circulated throughout the body.
◦ The rates of blood flow in the pulmonary and systemic circulation are equal.
◦ However, the pressures in the pulmonary circulation are relatively low when
compared to those in the systemic circulation.
◦ This low-pressure system is due to low vascular resistance in the pulmonary
circulation.
◦ An interesting feature of pulmonary circulation is that during exercise, the
resistance in the pulmonary vascular system falls due to the distension of
vessels and the recruitment of previously unused capillaries. This decrease in
pulmonary vascular resistance results in increased lung blood flow during
exercise with relatively small increases in pulmonary arterial pressure.
◦ When we are standing, considerable inequality of blood flow exists within
the human lung due to gravity.
◦ For example, in the upright position, blood flow decreases almost linearly
from bottom to top, reaching very low values at the top (apex) of the lung.
◦ This distribution is altered during exercise and with a change in posture.
◦ During low intensity (e.g., ~40% VO2 max) exercise, blood flow to the top
of the lung is increased, This will improve gas exchange
◦ When individuals lie on their backs (supine), blood flow becomes more
uniform within the lung.
◦ In contrast, measurements of blood flow in humans who are suspended
upside down show that blood flow to the apex (top) of the lung greatly
exceeds that found in the base.
VENTILATION–PERFUSION RELATIONSHIPS
◦ Normal gas exchange requires a matching of ventilation to blood flow
(perfusion, Q).
◦ An alveolus can be well ventilated, but if blood flow to the alveolus does
not adequately match ventilation, gas exchange does not occur.
◦ Indeed, mismatching of ventilation and perfusion is responsible for most of
the problems of gas exchange that occur due to lung diseases.
◦ The ideal ventilation-to-perfusion ratio (V/Q) is 1.0 or slightly greater.
◦ That is, there is a one-to-one matching of ventilation to blood flow, which
results in optimum gas exchange.
◦ However, the V/Q ratio is generally not equal to 1.0 throughout the lung,
but varies depending on the section of the lung being considered
◦ Effect of exercise on V/Q ratio:

◦ Light-to-moderate exercise improves the V/Q relationship

◦ Whereas heavy exercise may result in a small V/Q inequality and thus, a
minor impairment in gas exchange (56). Whether the increase in V/Q
inequality is due to low ventilation or low perfusion is not clear.
O2 AND CO2 TRANSPORT IN BLOOD
◦ Although some O2 and CO2 are transported as dissolved gases in the
blood, the major portion of O2 and CO2 transported via blood is done by O2
combining with hemoglobin and CO2 being transformed into bicarbonate
(HCO3).
Hemoglobin and O2 Transport

◦ Approximately 99% of the O2 transported in the blood is chemically bound

to hemoglobin.
◦ Each molecule of hemoglobin can transport four O2 molecules.
◦ The binding of O2 to hemoglobin forms oxyhemoglobin
◦ Hemoglobin that is not bound to O2 is referred to as deoxyhemoglobin.
◦ When completely saturated with O2, each gram of hemoglobin can
transport 1.34 ml of O2.
Oxygen–Hemoglobin Dissociation Curve

◦ The quantitative relationship between the partial pressure of O2 (PO2) and

the binding of O2 to hemoglobin in blood is called the oxygen–hemoglobin
disassociation curve.
◦ The combination of O2 with hemoglobin in the lung (alveolar capillaries) is
often called loading
◦ The release of O2 from hemoglobin at the tissues is commonly called
unloading.
◦ Deoxyhemoglobin + O2 ⟷ Oxyhemoglobin (reversible reaction).
◦ The factors that determine the direction of this reaction are:
◦ (1) the PO2 of the blood
◦ (2) the affinity or bond strength between hemoglobin and O2.
◦ A high PO2 drives the reaction to the right (i.e., loading)
◦ Whereas low PO2 and a reduced affinity of hemoglobin for O2 moves the
reaction to the left (i.e., unloading).
◦ The percent hemoglobin saturated with O2 (% HbO2) increases sharply up
to an arterial PO2 of 40 mm Hg.
◦ At PO2 values above 40 mmHg, the increase in % HbO2 rises slowly to a
plateau around 90 to 100 mm Hg, at this point the % HbO2 is
approximately 97%.
◦ At rest, the body’s O2 requirements are relatively low, and only about 25%
of the O2 transported in the blood is unloaded to the tissues.
◦ In contrast, during intense exercise, the mixed venous PO2 can be lowered
to 18 to 20 mm Hg, and the peripheral tissues can extract up to 90% of
the O2 carried by hemoglobin.
◦Effect of pH on O2–Hb Dissociation Curve
◦ The strength of the bond between O2 and hemoglobin is weakened by a
decrease in blood pH (increased acidity), which results in increased
unloading of O2 to the tissues.
◦Temperature Effect on O2–Hb Dissociation Curve
◦ At a constant pH, the affinity of hemoglobin for O2 is inversely related to
blood temperature.
◦ An increase in blood temperature weakens the bond between O2 and
hemoglobin, which assists in the unloading of O2.
Assignment

◦ O2 Transport in Muscle
◦ CO2 Transport in Blood
THANK YOU