A Comparison of Breath Management Strategies in Classical and Nonclassical Singers: Part 1

Total Page:16

File Type:pdf, Size:1020Kb

A Comparison of Breath Management Strategies in Classical and Nonclassical Singers: Part 1 Voice Pedagogy for the 21st Century A Comparison of Breath Management Strategies in Classical and Nonclassical Singers: Part 1 I -- new findings may affect our peda- Elastic Recoil gogical approach to various singing The dimensions of the lungs styles. and the rib cage are greatly influ- Before we discuss the new find- enced by elastic recoil. To under- ings, we must have an understand- stand elastic recoil, it is helpful to ing of the mechanics of the breath- think in the action of a spring. For ing system and the forces that create instance, once a spring is stretched the pressures necessary to generate and then released, it will quickly the vocal sound. recoil back to its original position. Likewise, when it is squeezed, it Mechanics of Breath will again recoil, but this time in the Management opposite direction by expanding to Three ftrces are at work on the its original position. The rib cage Thomas F cleveland breathing system at all times. These and lungs operate in a similar way forces are: to this springlike action. Once the rib cage and lungs are expanded, INTRODUCTION: 1. Gravity, 2. Elastic recoil of the breathing sys- they will recoil to their at-rest posi- Experience has shown us that tem (lungs and ribcage), and tion, and when they are "contract- classical and nonclassical singers 3. Muscle action. ed," they will expand back to their use different breath management stra- resting point. This resting point is tegies during singing. Although these The following is an examina- called the resting expiratory level, or strategies can be observed in the chest tion of the action of the three forces. the REL, and the contracting and and abdominal wall movement of expanding forces, which are entire- singers, it has been difficult to quan- Gravity ly passive, are exhalatory at lung tify the movements and discern Gravity is an important force volumes above REL, and inhalatory their importance to the management in breathing. The downward pull it at volumes below the REL. At the of breath in singing. Recently, sever- exerts on the body depends on the REL, the forces are neither inspira- al new studies have given us addi- posture of the singer. For instance, it tory nor expiratory, but are at rest tional insight regarding breath man- exerts a different influence on the and equal. agement in singing. Thomasson and rib cage of a singer who is lying It may be instructive to the Sundherg (1997) examined the breath- down from that exerted on a singer singer to experience the REL from ing dynamics of classically trained who is sitting or standing. Because both the expanded and contracted singers, and Hoit, Jenks, Watson, we live under constant gravitational rib cage positions. To experience and Cleveland (1996) considered the pull, we have little notice of its the REL from the expanded rib cage breathing habits of country singers. effect, but, in the standing position, position, take a deep breath and "let The purpose of the present article is gravity would, theoretically, be it go." Once you "let it go," the rib to examine the results of these re- antagonistic to inhalation and assist cage will relax, automatically, to the cent studies and determine how the with exhalation. resting position, and the volume of J.4 ( ?-i../J 11 47 S4, N0. S. wig N..4 4 ( Thomas F. Cleveland breath will be expelled to a position effort and the direction of that effort muscles of exhalation, contract an- approximating the REL. Note, as depends on the influence of elastic tagonistically to the diaphragm. you exhale, that the rib cage tends to recoil and gravity, as well as the task With this familiarity with the collapse rather quickly at first, but requirements. For instance, because mechanics of the breathing system, slows down as you continue to ex- the recoil forces are very strong when we need to see what research is dis- hale. This is because the force of ex- one takes a full breath, inhalatory covering about the operation of the halation is much greater at a point of muscle effort can be used to counter- breath management system during the full breath, where the "spring" act the strong recoil forces and release different singing styles. In the next is stretched the most, but gets weak- the breath more gradually, if desired. issue, we will look at several para- er as you exhale. As you approach Once the breath is used and the rib meters of breath management and REL, the recoil slows even more. cage is less expanded, the inhalatory see how they differ in classical and To discover the REL from the muscle forces may be unnecessary country singers. In addition, we will contracted position, exhale as much and exhalatoiy forces must he recruit- consider the ramifications of these air as possible from your lungs and ed to continue the coordination for breath management strategies on then "let go." Because the rib cage is appropriate breath flow. voice pedagogy. contracted, the rib cage will now More complicated tasks create spring back in the opposite direction different requirements on the system. and expand, automatically, to the For example, if a high pitch with REFERENCES REL, drawing in air while it ex- loudness is required immediately pands. Again, note that the force to after a full breath, exhalatorv mus- Hoit, Jeanette, Christ Jenks, Watson, expand the rib cage is greater at the cle effort may be combined with the Peter. and Cleveland, Thomas. "Respira- point of full contraction, but slows passive forces of elastic recoil and tory Function During Speaking and as you approach REL. It is impor- gravity to create the amount of breath Singing in Professional Country Journal Voice. 10: 1 (1996): tant to remember that these forces pressure necessary to produce the Singers." of 39-49. are described under the condition of desired sound. It is easy to see that normal posture. A twisted torso or different conditions, that is, changes Thomasson, Monica, and Sundbcrg, otherwise malalignment of the spine in pitch and/or loudness, require al- Johan. "Lung Volume Levels in Classical can impede the expansion/contrac- terations in the degree and/or direc- Singing." Speech Transmission Laborato- tion capacity of the breathing sys- tion of muscle action. Add to these ,:ij-Quarterlg Progress and Status Report. tem, so, as mentioned before, pos- conditions the passive variation of 1 (1997): 37-50. ture can have tremendous impact on elastic recoil, body postures, and the recoil forces of the breathing gravitational pull, and the singer has system. much to coordinate in the singing Thomas F Cleveland is Associate Profes- sor of Otolai:ijngologg in the Voice Center, It is interesting to know that, process. School of Medicine, Vanderbilt Univerdtg, on average, the REL occurs at ap- Techniques of breath manage- Nashville, TN, where he teaches voice, con- proximately forty percent of the full ment vary among singers, even those ducts research, and is involved in team breathing capacity. However, the lo- who are trained in the same singing management and care of the professional cation of the REL can vary up to thir- style. For example, research indicates voice. He also serves as visiting Associate ty percent depending on the singer. that some singers employ the dia- Professor of Voice and Voice Pedagogy at phragm when they sing and others Westminster Choir Colleqe in Princeton, New Jersey. Muscle do not. For those who use the dia- Muscle action gives us the abil- phragm, which is a muscle of inhala- Before joining the Voice Center team in 1991, Dr. Cleveland was Associate Profes- ity to control the forces of gravity tion, in contraction expands the sor of Vocal Pedagogy and Voice Perfor dimensions of the lower rib cage and and elastic recoil, and decrease or -mance in the School of Music and Clinical increase the lung pressures neces- thereby increases the overall lung Associate Professor of Otolaryngology in sary to generate and maintain the volume capacity. On the other hand, the School of Medicine at the University of desired sound. The degree of muscle the abdominal muscles, which are Southern California in Los Angeles. 48 Jo(.M4 Voice Pedagogy for the 21st Century L),: Cleveland has lectured and qi ren mus- ter classes in Europe, England, France, Sweden, Portugal, Australia, and the United States. He contributes a regular cot- umn to the Journal of Singing and is the A SINGER'S GUIDE TO THE AMERICAN author of voice research that has been pub- ART SONG: 1870-1980 lished in theJournal of the Acoustical So- Victoria Etnier Villamil, Foreword by Thomas Hampson ciety of America and the Journal of 1993 480 pp. 0-8108-2774- $52.00 Voice. He is a member of the Editorial A Singer's Guide is unique in providing a biography for each entrant and a l-rnc] Board of the journal of Voice, as well as y is particularl member of the National Association of essay on that composer's song style and output, information that useful in cases of lesser-known musicians. A Singer's Guide is an extremely Teachers of Singing. thoroughly researched and well written research tool, a useful and practical Di: Cleveland holds the EM. degree fiom handbook prepared by a singer for singers. "—THE NATS JOURNAL the Universit,y of Mississippi, and the "unique and invaluable—an island of care and culture in a Philistine occwi. M.M. and Ph.!). from the University of Obviously every vocal teacher (not to say vocal student) should have a copy. Southern California, where he studied with and every music library in the land." —Ned Rorem William Vennard, Gwendolyn Koldofkit, illarnil 's remarkable book should he a really useful mid - ,nid a cii r,' (luLl and William Eddy.
Recommended publications
  • Epidemiology and Pulmonary Physiology of Severe Asthma
    Epidemiology and Pulmonary Physiology of Severe Asthma a b Jacqueline O’Toole, DO , Lucas Mikulic, MD , c, David A. Kaminsky, MD * KEYWORDS Demographics Phenotype Health care utilization Pulmonary function Lung elastic recoil Ventilation heterogeneity Gas trapping Airway hyperresponsiveness KEY POINTS The definition of severe asthma is still a work in progress. The severity of asthma is predictive of higher health care utilization. Cluster analysis is useful in characterizing severe asthma phenotypes. Airway hyperresponsiveness in severe asthma is a result of abnormal airflow, lung recoil, ventilation, and gas trapping. Patients with severe asthma may have a reduced perception of dyspnea. INTRODUCTION Severe asthma is a characterized by a complex set of clinical, demographic, and physiologic features. In this article, we review both the epidemiology and pulmonary physiology associated with severe asthma. DEMOGRAPHICS OF SEVERE ASTHMA Asthma has long been recognized as a worldwide noncommunicable disease of importance. Within the population of individuals with asthma, there is a subgroup of individuals at high risk for complications, exacerbations, and a poor quality of life. The authors have nothing to disclose. a Department of Medicine, University of Vermont Medical Center, 111 Colchester Avenue, Bur- lington, VT 05401, USA; b Division of Pulmonary and Critical Care Medicine, University of Ver- mont Medical Center, Given D208, 89 Beaumont Avenue, Burlington, VT 05405, USA; c Division of Pulmonary and Critical Care Medicine, University of Vermont College of Medicine, Given D213, 89 Beaumont Avenue, Burlington, VT 05405, USA * Corresponding author. E-mail address: [email protected] Immunol Allergy Clin N Am 36 (2016) 425–438 http://dx.doi.org/10.1016/j.iac.2016.03.001 immunology.theclinics.com 0889-8561/16/$ – see front matter Ó 2016 Elsevier Inc.
    [Show full text]
  • Lung Elastic Recoil and Ventilation Heterogeneity of Diffusion-Dependent Airways in Older People with Asthma and Fixed Airflow Obstruction
    AGORA | RESEARCH LETTER Lung elastic recoil and ventilation heterogeneity of diffusion-dependent airways in older people with asthma and fixed airflow obstruction To the Editor: Small airways are abnormal in asthma [1]. One measurement of small airway function is Sacin, derived from the multiple-breath nitrogen washout (MBNW) test. Sacin reflects ventilation heterogeneity in diffusion-dependent airways, and is correlated with airway hyperresponsiveness [2] and asthma control [3]. Theoretically, heterogeneity of diffusion-dependent ventilation can arise due to the heterogeneity of cross-sectional areas of airway openings in terminal airways and the acini [4]. Therefore, Sacin may be affected by structural changes in those airways. The elastic properties of the lung may also affect Sacin,as the phase III slope, a marker of ventilation heterogeneity derived from the single-breath nitrogen washout, correlates with lung compliance in explanted lungs of smokers and in healthy lungs [5]. Reduced lung elastic recoil makes a large contribution to airflow obstruction in asthma [6], particularly in older individuals who may develop fixed airflow obstruction (FAO). FAO typifies chronic obstructive pulmonary disease (COPD) but can occur in older asthmatics who have never smoked and despite adequate treatment [7, 8]. Since FAO is associated with age and Sacin is more abnormal in older asthmatics compared to younger [2], we hypothesised that the increase in Sacin in older people with asthma was due to loss of lung elastic recoil. Therefore, the aim of this study was to examine the relationships between Sacin and elastic recoil pressure and compliance. We enrolled subjects from tertiary hospital clinics who were >40 years old, had ⩽5-pack-year smoking history and a physician diagnosis of asthma.
    [Show full text]
  • “Children Are Not Small Adults!” Derek S
    4 The Open Inflammation Journal, 2011, 4, (Suppl 1-M2) 4-15 Open Access “Children are not Small Adults!” Derek S. Wheeler*1,2, Hector R. Wong1,2 and Basilia Zingarelli1,2 1Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, The Kindervelt Laboratory for Critical Care Medicine Research, Cincinnati Children’s Research Foundation, USA 2Department of Pediatrics, University of Cincinnati College of Medicine, USA Abstract: The recognition, diagnosis, and management of sepsis remain among the greatest challenges in pediatric critical care medicine. Sepsis remains among the leading causes of death in both developed and underdeveloped countries and has an incidence that is predicted to increase each year. Unfortunately, promising therapies derived from preclinical models have universally failed to significantly reduce the substantial mortality and morbidity associated with sepsis. There are several key developmental differences in the host response to infection and therapy that clearly delineate pediatric sepsis as a separate, albeit related, entity from adult sepsis. Thus, there remains a critical need for well-designed epidemiologic and mechanistic studies of pediatric sepsis in order to gain a better understanding of these unique developmental differences so that we may provide the appropriate treatment. Herein, we will review the important differences in the pediatric host response to sepsis, highlighting key differences at the whole-organism level, organ system level, and cellular and molecular level. Keywords: Pediatrics, sepsis, shock, severe sepsis, septic shock, SIRS, systemic inflammatory response syndrome, critical care. THE PEDIATRIC HOST RESPONSE TO SEPSIS Sepsis is exceedingly more common in children less than 1 year of age, with rates 10-fold higher during infancy Key Differences at the Whole-organism Level compared to childhood and adolescence [2].
    [Show full text]
  • Physiologic Changes in the Elderly Michael C
    Theme 1: Physiologic Changes in the Elderly Michael C. Lewis, MD Associate Professor of Clinical Anesthesiology This unit forms the second part of a series of teaching modules on Anesthesia for the Elderly. It will guide you step-by-step through some salient physiologic differences between the aged and the younger adult population. It is our hope that on completing this component you will appreciate why understanding physiologic differences between these age groups guides us in our anesthetic management. Introduction This section describes significant physiologic changes between the aged and younger populations as defined in longitudinal studies of healthy people. It will be seen that aging results in significant anatomic and functional changes in all the major organ systems. Aging is marked by a decreased ability to maintain homeostasis. However, within the elderly population there is significant heterogeneity of this decline. This unit introduces facts in a systemic fashion, and then asks you some questions testing your mastery of the information. Each section is self-contained and leads to the next. One should not progress until one has fully understood the material in the previous section. Goals After completing this unit the resident should be able to: Understand the main structural and functional changes associated with normal aging Understand how these changes will impact the practice of anesthesiology 1 Cardiovascular System (CVS) “In no uncertain terms, you are as old as your arteries.” — M. F. Roizen, RealAge It is controversial whether significant CVS changes occur with aging. Some authors claim there is no age-related decline in cardiovascular function at rest.
    [Show full text]
  • Physiology of Respiratory System Lokesh Guglani, Emory University
    Physiology of Respiratory System Lokesh Guglani, Emory University Book Title: Essential Pediatric Pulmonology Publisher: Jaypee Brothers, Medical Publishers Pvt. Limited Publication Date: 2018-04-30 Edition: 3 Type of Work: Chapter | Final Publisher PDF Permanent URL: https://pid.emory.edu/ark:/25593/sds4j Final published version: http://www.jaypeebrothers.com/ Copyright information: © Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/). Accessed October 3, 2021 12:43 AM EDT Physiology of the 2 Respiratory System CHAPTER Lokesh Guglani KEY POINTS • Developmental changes in the respiratory system continue to occur from newborn period through childhood as the alveoli continue to develop. Several prenatal and postnatal processes may affect growth of the lungs • Breathing is initiated by contraction of the inspiratory muscles, which leads to an increase in the thoracic volume • Changes in pressure and volume that occur with breathing can be plotted on a pressure-volume curve and the slope of that curve represents the change in volume per unit change in pressure, which is the compliance • Elastance is the tendency for stretch or distortion, as well as the ability to return to its original configuration after the distorting force is removed • Airway resistance can be measured during a forced expiratory maneuver into a spirometer • The alveolar ventilation, oxygen consumption, and carbon dioxide production of the body determine the levels of oxygen and carbon dioxide in alveolar gas. At constant carbon dioxide production, alveolar partial pressure of carbon dioxide (PCO2) is approximately inversely proportional to alveolar ventilation INTRODUCTION and maturation of type II pneumocytes.
    [Show full text]
  • Elastic Recoil Changes in Early Emphysema
    Thorax: first published as 10.1136/thx.35.7.490 on 1 July 1980. Downloaded from Thorax, 1980, 35, 490-495 Elastic recoil changes in early emphysema G WAYNE SILVERS, THOMAS L PETTY, AND RAY E STANFORD From the Division of Pulmonary Sciences, the Webb- Waring Lung Institute, and the Laboratory Service, Veterans Administration Hospital, University of Colorado Health Sciences Center, Denver, Colorado, USA ABSTRACT An attempt was made to determine if emphysema and static lung recoil were related in a group of 65 excised human lungs. We studied 23 normal lungs, 24 lungs with an emphysema score of 5 or less, and 18 lungs with an emphysema score greater than 5. A comparison of the percentage of predicted elastic recoil revealed that both emphysema groups were significantly different from normal lungs. In addition, the total lung capacities were significantly different between the three groups. In the group with an emphysema score greater than 5 we found a linear negative correlation between the extent of emphysema and percent of predicted elastic recoil at 90 O/% total lung capacity (r=-0-696, p<0 01). We found a negative correlation between the percentage of predicted elastic recoil and the lung volume (r=-0-612, p<0 01). We conclude that a significant loss of elastic recoil and a significant increase in total lung capacity occurs in the early stages of emphysema. It is generally believed that the anatomical Leaks were repaired by ligature. Only specimens destruction of pulmonary tissue in emphysema that could be made airtight were used in this is closely related to the functional loss of elastic study.
    [Show full text]
  • Why We Need PEEP Valves
    Rationale for including PEEP valves in extended care of critically ill casualties Phillip Mason, MD Under normal circumstances, the pressure in the lung at the end of expiration is equal to the atmospheric pressure. PEEP refers to the application of additional pressure at the end of expiration to maintain pressure in the lung slightly above atmospheric pressure. Lung volume at end exhalation is determined by the interplay between the elastic recoil of the lung (trying to collapse the lung) and the elastic recoil of the chest wall (acting to pull the lung open). Under normal circumstances these forces are in balance and the lung does not collapse completely when it reaches its smallest volume at end expiration. Many disease processes make the lung stiffer (Physiologically this is known as decreased compliance. Practically speaking it is analogous to a balloon that is very difficult to inflate versus one that is very easy to inflate). This increased lung stiffness makes the lung more prone to collapse completely at the end of expiration. The tendency to collapse is worsened by the fact that the chest wall recoil is also adversely impacted, meaning its ability to pull the lung open is impaired. Anything that increases intra‐abdominal pressure will also favor lung collapse at end expiration by pushing up on the diaphragm. This may be gaseous distention of the G.I. tract, hemorrhage, excessive edema of the abdominal wall/abdominal contents, etc. Spontaneously breathing patients may be able to overcome this to some extent by closing the glottis and trapping air inside the lung at end expiration and by engaging their muscles of respiration.
    [Show full text]
  • Lung Distensibility and Airway Function in Asthmatic Children
    1154 KRAEMER AND GEUBELLE 003 1-3998/84/18 1 1 - 1 154$02.00/0 PEDIATRlC RESEARCH Vol. 18, No. 1 1, 1984 Copyright O 1984 lnternational Pediatric Research Foundation, Inc. Printed in U.S.A. Lung Distensibility and Airway Function in Asthmatic Children RICHARD KRAEMER AND FERNAND GEUBELLE Pulmonary Function Laboratories, Departments of Pediatrics, University of Berne [R.K.], Switzerland, and Liege [F. G.], Belgium ABSTRACT. Lung distensibility and airway mechanics TGV, thoracic gas volume were evaluated in 24 asthmatic children and adolescents, TLC, total lung capacity ages between 7 and 21 years, by quasi-static pressure- VC, vital capacity volume curves and by the static recoil-lung conductance VL, lung volume relationship. The measurements were obtained by the step- wise inflation technique and the pressure-volume curves were analyzed by a new sigmoid exponential curve-fitting model of the form: VL = Vm + [VM/(l + be-K.P*~)],where VL is lung volume, PstLis static recoil pressure, VM and Vm One of the epidemiological aspects of childhood asthma is the are the upper and lower asymptotes, and K and b are shape question of the reversibility of functional abnormalities (23) and constants. The shape constant K serves as index for lung in particular how this factor relates to the potential to develop distensibility, whereas the slope of 0 of the static recoil- chronic obstructive lung disease. In this paper, we describe some lung conductance plot represents the flow-resistive behav- functional features which may serve as indicators of later lung ior of the airways. The combined evaluation of these two damage.
    [Show full text]
  • Lung Elastic Recoil and Reduced Airflow in Clinically Stable Asthma
    Thorax: first published as 10.1136/thx.35.4.298 on 1 April 1980. Downloaded from Tl.orax, 1980, 35, 298-302 Lung elastic recoil and reduced airflow in clinically stable asthma D S McCARTHY AND M SIGURDSON From the Department ofMedicine, University ofManitoba, Respiratory Division, Clinical Investigation Unit, Winnipeg, Manitoba, Canada ABSTRACT Lung volumes, maximum expiratory flow rates, and static volume-pressure curves were measured in 16 patients with clinically stable asthma. It was found that flow rates were reduced in such patients because of the combined effects of reduced elastic recoil (transpulmonary pressure) and intrinsic diseases of the airways. In nine patients treated with an aerosol of isoprenaline, flow rates improved as a result of reduction in airways resistance as the static recoil pressure of the lungs fell further in those patients. The possibility is suggested that muscle tone in peripheral airways or alveolar ducts contributed to the elastic recoil measurements. Table 1 Age, sex, and diagnostic criteria used to A number of studies have demonstrated that select 16 patients with asthma acute exacerbations of asthma may be ac- companied by shifts in the pressure-volume Criteria Total group Isoprenaline group curve of the lungs indicating reduction of elastic (n = 16) (n =9) recoil. For example, Gold et all found that lung Male 11 6 Female 5 3 http://thorax.bmj.com/ elastic recoil was decreased in 12 asthmatic Age (yr) (mean and range) 46 (25-65) 46 (20-70) patients before treatment. Later, Finucane et Positive skin tests (type 1) 11 (69%) 6 (67%) Eosinophil counts > 400/ml 11 (69%) 5 (56 Y.) at2 reported that elastic retraction was decreased 16 9 in 10 asthmatic subjects with reduced forced Paroxysmal episodes expired volume in the first second (FEVy).
    [Show full text]
  • Physiotherapy and Bronchial Mucus Transport. C.P
    Copyright #ERS Journals Ltd 1999 Eur Respir J 1999; 13: 1477±1486 European Respiratory Journal Printed in UK ± all rights reserved ISSN 0903-1936 SERIES 'CHEST PHYSIOTHERAPY' Edited by S. Hill Number 2 in this series Physiotherapy and bronchial mucus transport C.P. van der Schans*+, D.S. Postma**, G.H. KoeÈter**, B.K. Rubin1 Physiotherapy and bronchial mucus transport. C.P. van der Schans, D.S. Postma, G.H. *Dept of Rehabilitation University Hos- KoeÈter, B.K. Rubin. #ERS Journals Ltd 1999. pital, Groningen, and +Pulmonary Rehab- ABSTRACT: Cough and expectoration of mucus are the best-known symptoms in ilitation Centre Beatrixoord, Haren, the patients with pulmonary disease. The most applied intervention for these symptoms is Netherlands. **Dept of Pulmonary Medi- cine University Hospital, Groningen, the the use of chest physiotherapy to increase bronchial mucus transport and reduce Netherlands. $Bowman Gray School of retention of mucus in the airways. Chest physiotherapy interventions can be evaluated Medicine, Winston-Salem, USA. using different outcome variables, such as bronchial mucus transport measurement, measurement of the amount of expectorated mucus, pulmonary function, medication Correspondence: C.P. van der Schans, use, frequency of exacerbation and quality of life. University Hospital Groningen, Dept of Measurement of the transport rate of mucus in the airways using a radioactive Rehabilitation, Hanzeplein 1, PO Box 30. tracer appears to be an appropriate outcome variable for short-term studies. 001, 9700 RB Groningen, the Nether- Evaluation of chest physiotherapy only with pulmonary function tests appears to be lands. Fax: 31 503619243 inadequate in short-term studies. The popularity of using pulmonary function tests is Keywords: Chest physiotherapy, hospitali- probably based more on the availability of the instruments than on a theoretical basis zation, mucus, pulmonary function, qual- related to the question of chest physiotherapy improving mucus transport.
    [Show full text]
  • Sell Example
    Topic 1: Lung Volumes and Gas Transport Tidal Volume: volume of air inspired and expired with a normal breath Vt Residual volume: volume of air remaining after a maximal expiration effort Total Lung Capacity: volume of gas contained within the lungs at the end of a max inspiration Total Dead Space: volume of gas that does not eliminate CO2 and is made up of: - Anatomical Dead Space: volume of the conducting airway - Alveolar Dead Space: volume in the alveoli that are not or poorly perfused Alveolar Volume: volume of gas per unit of time that reaches the alveoli, the respiration portions of the lungs where gas exchange occurs. Minute Volume: amount of gas expired per minute Inspiratory Reserve Volume: extra volume of air that can be inspired after a normal Vt inspiration Expiratory Reserve Volume: extra volume of air that can be expired after a normal Vt expiration Vital Capacity: volume of air that can be expired following a max inspiration Functional Residual Capacity: volume of gas remaining in the lungs at the end on a normal expiration Inspiratory capacity: the maximum volume of gas that can be inspired from resting end-expiratory level Topic 2: Functions of the Lung and Lung Mechanism Basic functions of the lung 1. Gas exchange: simple diffusion of oxygen from atmosphere into bloodstream and CO2 from bloodstream into atmosphere: high partial pressure to low partial pressure 2. Defence: protective function, able to deal with particles and microorganism 3. Reservoir for blood 4. Filtering of blood 5. Metabolism Lung Mechanism – Chest Wall The properties of the rib cage and abdomen (elastic walls) determine the mechanical characteristics of the chest wall as a whole.
    [Show full text]
  • Physiology of Ventilation
    Physiology of Ventilation Lecturer: Sally Osborne, Ph.D. Department of Cellular & Physiological Sciences Email: [email protected] Useful link : www.sallyosborne.com Required Reading: Respiratory Physiology, A Clinical Approach, Schwartztein & Parker, Ch. 1; Ch. 2 (pp.9-17; Ch. 3 Objectives 1. Diagram the relationship between tidal volume (V T), residual volume (RV), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), vital capacity (VC), total lung capacity (TLC) and functional residual capacity (FRC). 2. Describe the respiratory system as a two structure, three-compartment model, and describe the pressure in each compartment at rest. 3. Describe how the balance between the elastic recoil of the lungs & the chest wall determines FRC. 4. Describe how the relationship between alveolar (P A), intrapleural (P pl ), atmospheric(P atm ) & transpulmonary pressure (P L) determines airflow during a normal respiratory cycle. 5. Describe how lung volume, tissue elastance and alveolar surface tension affect the static compliance of the lungs. 6. Describe the static compliance of the normal lung with reference to the pressure-volume curve of the lung obtained during deflation from TLC to FRC. Contrast this relationship to the pressure-volume curves encountered in disease states that increase or decrease pulmonary compliance. 1. Lung Volumes & Capacities Lung volume and its subdivisions can change under a variety of circumstances including disease. Total lung capacity (TLC) is the maximum amount of air the lungs can hold. The total lung capacity is divided into four primary volumes: inspiratory reserve (IRV), tidal volume (V T), expiratory reserve volume (ERV) and residual volume (RV). It is useful to know that the "capacities" consist of the sums of two or more "volumes".
    [Show full text]