CHAPTER 4.

PROPOSAL

A model for systematic study of the New Theory of Respiratory Dynamics and the Dynamic Functional Integration of the Living Beings in their adaptation to the Atmosphere


NEW KNOWLEDGE ABOUT DYNAMICS OF THE RESPIRATORY FUNCTION. CONTRAST WITH TRADITIONAL PREVAILING CONCEPTS.

 

The Content:

 

INTRODUCTION.

CONTRASTING GLOBAL CONCEPTS:

1. The Lung is an autonomic active organ.
versus
"The Lung is a passive organ"

 

2. The Diaphragm is the main reflex active support of Lung's structure
versus
" The Diaphragm is the motor of the Lung".

 

DEPARTING POINT FOR STUDY:

Major physical features of the Respiratory Apparatus to be taken into account for a better understanding of its cyclic actions performed in achieving each Ventilo-Respiratory Cycle.

1. The Lung, as viscera, is a complex functional unit, resulting from the physical and functional integration of five lobes, three in the right hand side and two in the left.

2.The lobes in each side are adhered to themselves, as well as to the thorax walls, by surface tension forces created between their contacting visceral and, parietal pleural lining, to conform, in junction with the upper-airways, a visceral functional unit: The Respiratory Apparatus.

3. The bronchial tree of each lobe is rooted in its corresponding right or left main bronchus.

4.The pulmonary lobes, including their pleural lining, are innervated by the autonomic neural system. Hence, Acetilcholine and Adrenaline are the transmitters of their Vagus-Sympathetic nerve-action.

5. The Diaphragm is a striated muscle, whose central part is innervated by the Phrenic nerve, while its peripheral portion, inserted in the costal border, is innervated by the four or five last intercostal nerves. These nerves also innervate the corresponding intercostal muscles, and the upper part of the muscles of the abdominal wall.

6. The Diaphragm and rib cage conform the whole external support of the pulmonary structure.

 

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PART I

DYNAMICS IN THE PLEURAL SPACE
Method. Analysis of the graphs. Interpretation. Compared analysis. Conclusions.

 

I.1 "THE RESPIRATORY PULSE":

Resultant of the Lung's dynamics at its pleural surface during each Respiratory Cycle. (Discovered by Américo González-Bogen in 1978.)

Two kinds of simultaneous and integrated dynamics are identified in the Respiratory Pulse:

1. A macro-dynamics, with Ventilatory (Breathing) rhythm, for the whole cycle of air renovation.

2. A micro-dynamics, with Cardiac rhythm, for small cycles of gas exchange with the blood.

 

I.2 PLEURAL PRESSURE or cyclic variations of pressure in the pleural content.

 

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PART II.

PULMONARY KYNEMATICS.
Analysis and interpretation of the neural co-ordination of visceral and viscero-somatic actions to accomplish a total VENTILATORY CYCLE and the Vagus-Sympathetic co-ordination of actions to accomplish the small Respiratory cycles comprised in each Ventilatory (Breathing) Cycle.

II.1 Vagus nerve discharge for the visceral response: constriction-retraction of the airways leading to ejection of the air-mass contained in the main bronchi of each lobe, towards their periphery and, simultaneous traction of the Diaphragm, for stimulation of the Phrenic nerve..

II.2. Pulmo-Diafragmatic reflex (viscero-somatic reflex): mechanical stimulation of the Phrenic nerve, for diaphragmatic contraction, favouring the expansion of the previously ejected mass of air, also leading to balance the general fluids circulation.

II.3. Diaphragm-Intercostals reflex (somato-somatic reflex) for simultaneous intercostal and abdominal muscles contraction, completing a thoraco-abdominal mechanical integration

II.4. Vagus-Sympathetic integration for gas exchange at the alveolo-capillary units.

 

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PART III.

AIR SPACES AND AIR CIRCULATION. (Ventilatory cycle)

III.1 AIR SPACES.

III.1.1 Five lobar bronchial-trees.

III.1.2 Multiple lobular bronchiolar-trees and alveolar spaces.

III.1.3 Partial circuits of the right and left main bronchi, as reservoirs of the air-masses to be acclimatised and offered to the lobes. These take their corresponding fractions of air-masses, for each ventilatory cycle, (by aspiration), and after being used by fractions, in the lobuli in gas exchange with the blood, receive a similar mass of air, to be carried out to the Trachea and Larynx.

III.1.4 The Trachea and Larynx represent the largest partial, functional capacity of airways, as a transient reservoir. These reservoirs supply the total mass of air that will be demanded by the five lobes, for each ventilatory cycle and, receives by fractions, a similar mass of air after being used by the lobuli and alveoli. This used, warmed stream of air, will be collected at the upper part of the Trachea and Larynx, then expelled in an act known as Expiration.

Therefore, there can be considered eight sectorial, functional capacities in the autonomic airways, with different partial objectives, mainly concerned with ventilation. Hence, they complete a grand circuit for ventilation or supply of air to the lobuli and alveoli, for gas exchange with the blood, or respiration strictus sense, followed by exhalation of the used air.

 

III.2 AIR CIRCULATION.

III.2.1. Ejection of the contained mass of air, in each lobe, towards its periphery, vagal action, (first step of the lobar circuit), followed by:

III.2.2. Expansion of the previously ejected masses of air, (towards the peripheral bronchi of the lobes), helped by the Diaphragm, the contraction of which diminishes the resistance, widening the potential capacity of the thorax. This air expansion completes the first phase of the lobar ventilatory circuit, or delivery of the air mass to the lobuli, for the process of gas exchange with the blood.

III.2.3. Steady decrease in the lobar air pressure, due to use and ejection, by the lobuli, of small fractions of air masses (Lobular bronchiolar-alveolo-capillary circuits), up to exhaustion of the available mass of air for this cycle.

The small masses of air ejected at the end of each lobular cycle, after their use in gas exchange with the blood, follow the converse way to that of the ejection mentioned above, as far as the main bronchus.(second phase of the lobar bronchial circuit)

 

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PART IV.

YATROGENIA.
Review of the effects produced by physiological and pharmacological products on Respiration: Adrenaline. Acetilcholine. d.tubocurarine etc.

 

PART V.

PROPOSED CONCLUSIONS.

V.1. The pulmonary lobes are anatomo-functional units for air renovation from the Atmosphere, and gas exchange with the blood.

V.2 The lobar airways are concerned with renovation and transportation of air to the lobuli.

V.3. The lobuli are anatomo-functional units for gas exchange with the blood.

V.4. The common airways: right and left bronchi, the Trachea and Larynx are active reservoirs to supply acclimatised air and to receive worm used air.

V.5. Inspiration and Expiration, as two phases of a ventilatory (breathing) cycle are only valid for the appearance at the nose, as it is currently interpreted; they do not correspond to the real physiological facts; therefore, they must give place to the new scientifically proven realities.

V.5.1 Inspiration is the phase for lobar aspiration of acclimatised air supplied by the right and left main bronchi, followed by a descent of the air contained in the Trachea, Larynx and upper airways and finally from the Atmosphere. Corresponds to the relaxation of the airway’s muscles.

V.5.2 Expiration is simultaneous with air ejection by the bronchial trees of the lobes towards their periphery, since vagal contraction of the smooth muscles of the airways is simultaneous in the whole ventilatory tract; hence, the total amount of air contained in the airways is ejected by muscular contraction, the only difference being that a fraction of that contained air, the used air retained in the Trachea and Larynx are expelled to the exterior, while the fresh air retained in the lobar tree, from the former cycle, is ejected towards the lobuli; hence, a sphincter or valve must be placed in the divergent point for the direction of the displaced air.

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