Describe the factors that affect airways resistance. (99B3, 03B13)
Normal value of airway resistance are variable because of large changes with lung volume and methodological differences.
According to Nunn p.75, normal total respiratory resistance (include airway resistance and pulmonary resistance) at FRC
is < 0.84kPa.L-1.sec
Most pressure drops (i.e. greatest resistance) occurs in the medium-sized bronchi up to Z7.
<20% of the pressure drop can be attributed to smaller (<2mm) airways (i.e. Z8 and below)
The bronchi are supported by radial traction of the surrounding lung tissues, and their calibre is increased as lung expands.
Conversely, at low lung volumes, compression of the airways and increased airway collapse lead to increased airway resistance.
=> At residual capacity, airway resistance is at its greatest
=> At total lung capacity, airway resistance is at its lowest
=> i.e. airway resistance is inversely proportional to the lung volume
Conductance (1/resistance) is directly proportional to the lung volume.
[See diagram Nunn p67 fig4.5]
NB: because of this inverse relationship between airway resistance and lung volume
=> the lower the volume,
=> the lower the flow rate
(adding the effect dynamic compression of airway)
=> the maximum flow rate is determined by lung volume
NB: The curve of Lung volume vs AWR is downward curve
NB: The curve of Lung volume vs PVR is a U curve
The higher the density
=> Re increases
=> turbulent flow more likely
The higher the viscosity
=> Re decreases
=> laminar flow more likely
In practice, density is a lot more significant
=> flow is not very laminar at medium-sized airway (where most resistance is)
(but may be more laminar at very small airways)
=> The higher the density of gas, the greater the resistance
NB. At diving, Helium-O2 mixture is used to reduce the density, and thus reduced the AWR-increasing effect of breathing compressed air.
Innervation of bronchial smooth muscles:
[Need to add: dynamic compression]
Need to add dynamic compression.
Details on small airway calibre