Physical Principles of Respiratory Care: An Overview (2023)

The respiratory system is a critical component of human physiology, enabling the essential exchange of gases—primarily oxygen and carbon dioxide—between the atmosphere and the bloodstream.

Understanding the physical principles of respiratory care is vital for clinicians, as it allows for accurate diagnosis, effective treatment planning, and optimal management of various respiratory conditions.

This guide breaks down the core concepts such as gas laws, fluid dynamics, and mechanics of ventilation, among others, that constitute the framework of respiratory care.

What are the Physical Principles of Respiratory Care?

The physical principles of respiratory care form the foundational framework for understanding how treatments and interventions function to optimize respiratory health. These principles draw upon a range of scientific disciplines, including physics, physiology, and fluid dynamics.

Here are some key physical principles commonly referenced in respiratory care:

Mechanics of Ventilation

• Compliance: This refers to the ability of the lungs and chest wall to expand. Low compliance means that greater effort is required to expand the lungs.
• Resistance: This is the opposition encountered during airflow through the respiratory tract. High resistance can be caused by factors such as bronchoconstriction.
• Work of Breathing: This is the energy expended to inflate the lungs. It is influenced by factors like resistance and compliance.

Gas Exchange Principles

• Partial Pressure Gradients: Gas moves from areas of higher partial pressure to lower partial pressure, crucial for oxygenation and removal of carbon dioxide.
• Diffusion Capacity: This refers to how efficiently gases cross the alveolar-capillary membrane. Impaired diffusion capacity can result in hypoxia.

Other Principles

• Dead Space: Volume of the respiratory system where no gas exchange occurs. Reducing dead space improves ventilation efficiency.
• Oxygen-Hemoglobin Dissociation Curve: This curve explains how oxygen binds to and is released from hemoglobin, which is crucial for tissue oxygenation.
• Fick’s Principle: Describes how the rate of gas transfer is proportional to the surface area and the difference in partial pressures, and inversely proportional to the thickness of the membrane.

Note: Understanding these physical principles is essential for healthcare professionals to diagnose, manage, and treat respiratory conditions effectively.

States of Matter

The concept of states of matter is fundamental to the understanding of physics, chemistry, and various scientific phenomena, including the physical principles of respiratory care.

The primary states of matter include:

• Solid: In a solid state, particles are closely packed together in a fixed structure. The particles vibrate but do not move freely, resulting in a fixed shape and volume. Solids have the highest density among the three classical states of matter.
• Liquid: In the liquid state, particles are less densely packed than in solids and can move freely, allowing liquids to flow and take the shape of their container. Liquids have a definite volume but no fixed shape.
• Gas: In a gaseous state, particles are much less densely packed and move freely, filling the entire volume of their container. Gases have neither a definite shape nor a definite volume, and they are easily compressible.

The concept of states of matter is particularly important in respiratory care when considering the properties and behavior of gases within the lungs.

For example, understanding the gaseous state helps clinicians make decisions about ventilator settings, gas mixtures for anesthesia, and treatments for conditions like asthma or COPD.

Moreover, the principles that govern the behavior of gases (e.g., gas laws) are derived from the study of matter’s properties, underlining the importance of states of matter in respiratory care.

Understanding states of matter helps us grasp how substances interact in different conditions, which is vital for various scientific and medical applications.

Laws of Thermodynamics

The laws of thermodynamics are fundamental rules that govern the relationship between heat and energy, playing an essential role in the physiological processes of respiration.

These laws help explain how energy is transformed and lost in the course of breathing, offering a vital framework for understanding both the capabilities and limitations of the respiratory system.

First Law of Thermodynamics

Also known as the Law of Conservation of Energy, the first law of thermodynamics states that energy cannot be created or destroyed, only transformed from one form to another.

This law explains the energy dynamics during inhalation and exhalation. Mechanical energy is used to expand and contract the lungs, facilitating the exchange of oxygen and carbon dioxide.

This energy is then converted into other forms, such as potential energy in the stretched tissues of the lungs, or lost as heat.

Second Law of Thermodynamics

The second law states that when energy is transformed, some amount of it will be lost, usually as heat. This highlights the inefficiency inherent in any biological process, including respiration.

For instance, the energy utilized in the contraction of respiratory muscles is not fully converted into lung expansion; some is inevitably lost as heat.

This rise in entropy, or system disorder, is a fundamental constraint in the efficiency of respiratory function.

Thermal Equilibrium

When two systems are in thermal equilibrium, their temperatures and levels of entropy are equal.

This principle is relevant for the lungs, especially when considering the temperature of inhaled and exhaled air.

The concept of thermal equilibrium aids in understanding how the body works to maintain a stable internal environment, crucial for optimal respiratory function.

Summary: The laws of thermodynamics provide key insights into the energy transformations occurring during respiration. They help healthcare professionals understand how the lungs operate within the boundaries of these universal laws, informing both the development of new respiratory care technologies and the effective utilization of current therapies.

Gas Laws in Respiratory Care

Understanding the behavior of gases is essential for effective respiratory care. This includes:

• Boyle’s Law
• Charles’ Law
• Gay-Lussac’s Law

Each provides valuable insights into how gases interact under various conditions of pressure, volume, and temperature, which is particularly important when considering respiratory mechanics and ventilation strategies.

Boyle’s Law

Boyle’s Law states that the volume of a given amount of gas held at a constant temperature varies inversely with the pressure.

In simpler terms, if you increase the pressure, the volume decreases, and vice versa, as long as the temperature remains constant.

This law is highly relevant in mechanical ventilation settings, where precise adjustments to the pressure can lead to corresponding changes in lung volume.

For example, Boyle’s Law helps clinicians decide the appropriate pressure settings on a ventilator to ensure effective lung expansion and gas exchange.

Charles’ Law

Charles’ Law states that the volume of a gas is directly proportional to its temperature, provided the pressure and the amount of gas remain constant.

If you heat a gas, its volume will expand; if you cool it, its volume will contract. This principle is important for understanding how the volume of air in the lungs changes with temperature.

For example, inhaled air is warmed as it moves through the respiratory tract, and Charles’ Law helps predict how much this air will expand once it reaches the lungs, affecting overall lung compliance and capacity.

Gay-Lussac’s Law

Gay-Lussac’s Law posits that the pressure of a gas is directly proportional to its temperature when the volume is held constant.

In respiratory care, understanding this law is important when considering the pressures within the respiratory system at different body temperatures.

For instance, in cases of hyperthermia or hypothermia, the pressures within the lungs may be affected, influencing the effectiveness of mechanical ventilation or spontaneous breathing.

Summary: The gas laws play a crucial role in respiratory care by informing how gases behave under different conditions of pressure, volume, and temperature. These laws provide the theoretical underpinning for various clinical decisions, such as setting ventilator parameters and understanding the impacts of body temperature on respiratory function.

Fluid Dynamics in Respiratory Care

Fluid dynamics, the study of how liquids and gases move, is a vital concept in respiratory care.

It aids in understanding the flow patterns of air and other gases within the respiratory system, helping to diagnose and manage a wide array of conditions, from asthma to chronic obstructive pulmonary disease (COPD).

Understanding fluid dynamics is crucial for optimizing treatments involving airflow, such as mechanical ventilation and inhalation therapies.

Bernoulli’s Principle

One of the key principles of fluid dynamics relevant to respiratory care is Bernoulli’s Principle, which states that as the speed of a fluid increases, its pressure decreases.

This principle can be observed in conditions like tracheal stenosis or asthma, where narrowed airways cause increased air speed, and, consequently, decreased pressure.

Understanding this principle allows clinicians to predict and manage complications related to turbulent flow and airway resistance.

Poiseuille’s Law

Poiseuille’s Law describes the factors affecting resistance in a tube-like structure, which is applicable to airways in the respiratory system.

According to the law, resistance is directly proportional to the length of the tube and the viscosity of the fluid but inversely proportional to the fourth power of the radius.

In simpler terms, a small change in the radius of an airway can result in a significant change in resistance.

This principle is crucial in conditions like bronchoconstriction, where the airway radius may be compromised, leading to increased resistance and difficulty in breathing.

Laminar and Turbulent Flow

In the context of the respiratory system, understanding the difference between laminar (smooth) and turbulent (chaotic) flow is essential.

In healthy airways, airflow is generally laminar. However, obstructions, high flow rates, or certain diseases can create turbulent flow, which is less efficient and can result in a higher work of breathing.

Turbulent flow is also more likely to distribute particles unevenly, which has implications for inhaled therapies.

Reynold’s Number

The Reynold’s Number is a dimensionless value used to predict the type of flow (laminar or turbulent) in a fluid system.

It takes into account factors such as velocity, density, and viscosity of the fluid, and the diameter of the tube.

In respiratory care, Reynold’s Number can help in assessing the likelihood of turbulent airflow in obstructive lung conditions.

Summary: The principles of fluid dynamics are integral to understanding and managing the complexities of respiratory care. They provide insights into airflow patterns and resistance within the respiratory system, guiding clinicians in the diagnosis and treatment of respiratory conditions. By leveraging the principles of fluid dynamics, healthcare professionals can make more informed decisions, improving both the efficacy and safety of respiratory therapies.

Practice Questions on the Physical Principles of Respiratory Care

1. What is absolute humidity?
The mass of water vapor contained in a certain volume of air.

2. What is absolute zero?
No kinetic energy

3. What is adhesion?
The attractive force between unlike molecules.ff

4. What does ATPS stand for?
Ambient temperature, pressure, saturated

5. What is Avogadro’s Law?
Equal volumes of gases contain the same number of molecules.

6. What is the Bernoulli effect?
Fluid passing through a tube that meets a constriction experiences a significant pressure drop. Fluid that flows through the constriction increases its velocity while the lateral wall pressure decreases.

7. What is boiling?
Heating a liquid to a temperature at which its vapor pressure equals atmospheric pressure.

8. What is buoyancy in liquids?
This occurs because the pressure below a submerged object always exceeds the pressure above it.

9. What is Boyle’s Law?
The volume of gas varies inversely with its pressure.

10. What does BTPS stand for?
Body temperature, pressure, saturated.

11. What is the calculation to convert Celsius to Fahrenheit?
F = (C x 1.8) + 32

12. What is Charles’ Law?
The volume of gas varies directly with its temperature.

13. What is cohesion?
It is the attractive force between like molecules.

14. What is condensation?
Change from gas to liquid.

15. What is conduction?
Transfers heat in solids.

16. What is convection?
Transfers heat in liquids and gases.

17. What is the calculation to convert Celsius to Kelvin?
K = C + 273

18. What is critical temperature?
The temperature above which the substance cannot exist in the liquid state.

19. What is Dalton’s Law?
The partial pressure of a gas in a mixture is proportional to its percentage in the mixture.

20. What is the density of a gas?
The ratio of its mass to its volume.

21. What is the dew point?
The temperature at which the water vapor in the air becomes saturated and condensation begins.

22. What is evaporation?
When water enters the atmosphere at a temperature below its boiling point.

23. How to convert Fahrenheit to Celsius?
C = (F – 32) x 5/9

24. What is the first law of thermodynamics?
Energy cannot be created nor destroyed. Energy gain by a substance = energy lost by surroundings.

25. What is fluid dynamics?
The pressure exerted by a liquid in motion depends on the nature of the flow itself.

26. What is gaseous diffusion?
The movement of molecules from areas of high concentration to areas of lower concentration.

27. What is Graham’s Law?
The rate of effusion of a gas is inversely proportional to the square root of its molar mass.

28. What is Guy-Lussac’s Law?
The pressure exerted by a gas varies directly with its absolute temperature.

29. What is Henry’s Law?
At a given temperature, the solubility of a gas in a liquid is directly proportional to the pressure of the gas above the liquid. The volume of gas dissolved in a liquid is a function of its solubility coefficient and its partial pressure.

30. What is the kinetic activity of gases?
Gas molecules travel at high speeds in random fashion with frequent collisions. The velocity of gas molecules is directly proportional to its temperature.

31. What is kinetic energy?
Energy an object has due to its motion.

32. What is laminar flow?
Fluid moving in discrete cylindrical layers or streamlines.

33. What is the melting point?
The temperature at which melting occurs.

34. What is partial pressure?
The pressure exerted by a single gas in a gas mixture.

35. What is Pascal’s law?
Pressure depends on depth and density.

36. What is percent body humidity?
The ratio of the amount of water vapor in a volume of gas compared to the amount of water in gas saturated at a normal body temperature of 37* C.

37. What is Poiseuille’s Law?
Predicts the pressure required to produce a given flow.

38. What is potential energy?
Stored energy

39. What is relative humidity?
The ratio of the amount of water in the air at a given temperature to the maximum amount it could hold at that temperature.

40. What is resistance?
Causes a progressive decrease in fluid pressure as the fluid flows through a tube.

41. What does STPD stand for?
Standard Temperature Pressure Dry.

42. What is surface tension?
A force exerted by like molecules at a liquid’s surface. It is a measure of how difficult it is to stretch or break the surface of a liquid.

43. What is thermal conductivity?
The ability of an object to transfer heat.

44. What are the three states of matter?
Solid, Liquid, and Gas.

45. What is turbulent flow?
Loss of regular streamlines; fluid molecules form irregular currents in a chaotic pattern.

46. What is vaporization?
The change of state from a liquid to a gas.

47. What is the viscosity of liquids?
Force opposing a fluid’s flow (blood has 5x viscosity of water)

48. What is water vapor pressure?
The atmospheric pressure exerted by the water vapor in the air. It increases as the water vapor in the air increases.

49. What are the subjects of thermodynamics?
(1) Science – studying the properties of matter at various temperatures. 2. Kinetics – (speed) of reactions of matter at various temperatures.

50. What are the two types of vapor?
(1) Boiling Point, and (2) Evaporation.

51. What are the three physical principles that describe how energy is handled and transferred?
(1) Conservation of energy. (2) Thermodynamic equilibrium. (3) Impossibility of achieving absolute zero.

52. What is absolute zero?
It is the lowest temperature theoretically attainable (at which the kinetic energy of atoms and molecules is minimal). The temperature at which no kinetic energy exists. Molecules cease to vibrate; the object has no measurable heat. It has not actually been achieved.

53. What is Archimedes’ Principle?
The buoyant force on an object is equal to the weight of the fluid displaced by the object. The property of something weightless and insubstantial. This occurs because pressure below submerged objects always exceeds the pressure above the object. Gases also exert buoyant forces. Helps keep solid particles suspended in gases (aerosols).

54. What is the Bernoulli Effect?
As the velocity of airflow increases, pressure decreases with total energy remaining constant. Fluid passing through a tube that meets constriction experiences a significant pressure drop. Fluid that flows through constriction increases its velocity while lateral wall pressure decreases.

55. What is Boyle’s Law?
The relationship between the pressure and volume of a gas at constant temperature; when volume increases, pressure decreases.

56. What is Celsius?
Metric unit for measuring temperature. On this scale, water freezes at zero and boils at 100. At -273 degrees C, kinetic molecular activity stops, which is equal to 0 K.

57. What is Charles Law?
A principle that describes the relationship between the temperature and volume of a gas at constant pressure. The volume of a gas varies directly with its temperature. If the temperature goes up, so does volume. If it goes down, so does the volume.

58. What is convection?
Mixing of fluid molecules at different temperatures. Transfers heat in liquids and gases (e.g. forced air heating in homes-fluid movements carry heat).

59. What is density?
The ratio of a gas’ mass to its volume.

60. What is entropy?
A thermodynamic quantity that represents the amount of energy in a system that is no longer available for doing mechanical work. Amount of energy in a system not available for work. The lowest amount of organization system can achieve.

61. What is Fahrenheit?
A temperature scale where 32 is freezing, and 212 is boiling.

62. What are flow patterns?
The pattern that flow occurs, along with its shape.

63. What is fluid dynamics?
The pressure exerted by a liquid in motion depends on the nature of the flow itself. A progressive decrease in fluid pressure occurs as fluid flows through the tube due to resistance.

64. Fluid’s viscosity is directly proportional to what?
The cohesive forces between its molecules.

65. What are gases?
They have no fixed volume or shape; and weak attractive forces. Gas molecules exhibit rapid, random motion with frequent collisions. When these molecules collide, they tend to bounce off of each other rather than attach to one another.

66. The heart must use more energy when?
When blood viscosity increases, as occurs in polycythemia (increase in red blood cell concentration).

67. What are the four ways that heat transfer can occur?
Conduction, convection, radiation, or evaporation/condensation.

68. What are the patterns of flow?
Laminar flow and turbulent flow

69. Plasma is a combo of what?
Neural atoms, free electrons, and atomic nuclei

70. What is Poiseuille’s Law?
The relationship between the pressure, volume, and temperature of a fixed amount of gas; predicts the pressure required to produce a given flow.

71. What is polycythemia?
A disorder characterized by an abnormal increase in the number of red blood cells in the blood.

72. What is potential energy?
The energy of position (attractive forces between molecules). Weak in gas state. Makes up most of the internal energy in solids and liquids.

73. The Second Law of Thermodynamics is called conservation of energy and is described as?
The energy cannot be created nor destroyed.

74. Is air a compound or a mixture?
Air is a mixture, not a compound.

75. The stronger the cohesive forces, the greater the what?
Fluid viscosity

76. What is thermal conductivity?
The ability of an object to transfer heat. A measure to quantify heat transfer between objects.

77. What is radiation heat transfer?
Heat transfer that occurs without direct physical contact

78. Air that is fully saturated with water vapor at 37 degrees Celsius has a water vapor pressure of 47 mmHg and an absolute humidity of what?
43.8

79. The degrees Kelvin = degrees Celsius + what?
273

80. What is the lowest possible temperature that can be achieved when there is no kinetic energy?
Absolute zero

81. What is the attractive force between unlike molecules?
Adhesion

82. What is the law that states that the 1-g atomic weight of any substance contains exactly the same number of atoms, molecules, or ions?
Avogadro’s law

83. When a fluid flows through a tube of uniform diameter, pressure decreases progressively over the tube length. What effect is this?
Bernoulli effect

84. What is the temperature at which the vapor pressure of a liquid exceeds the atmospheric pressure?
Boiling point

85. Archimedes’ principle explains the difference in liquid pressure that creates an upward or supporting force. What is this called?
Buoyancy

86. A phenomenon in which liquid in a small tube moves upward against gravity?
Capillary action

87. What is the change of state from a gas to a liquid called?
Condensation

88. What is the transfer of heat by direct contact?
Conduction

89. What is the law stating that the total pressure of a mixture of gases must equal the sum of the partial pressures of all component gases?
Dalton’s law

90. What is the ratio of the mass of a substance to its volume?
Density

91. What is the term for the amount of energy in a system that is unavailable for work?
Entropy

92. What is the law that states that the rate of diffusion of a gas is inversely proportional to the square root of its gram molecular weight?
Graham’s Law

93. The pressure exerted by a liquid depends on what two factors?
Height and weight density (weight per unit volume)

94. What is the law that states the volume of a gas that dissolves in a liquid is equal to its solubility coefficient times its partial pressure?
Henry’s law

95. What is the study of fluids in motion?
Hydrodynamics.

96. What is the energy of motion?
Kinetic energy

97. Which type of flow occurs when fluid moves in cylindrical layers or streamlines?
Laminar flow

98. According to this law, the pressure varies directly with the surface tension of the liquid and inversely with its radius?
Laplace’s law

99. What principle explains that the pressure of a given liquid is the same at any specific depth regardless of the container’s shape because the pressure of a liquid acts equally in all directions?
Pascal’s principle

100. The volume of a gas that will dissolve in 1 mL of a given liquid at standard pressure and specified temperature is called what?
Solubility coefficient

Final Thoughts

The physical principles underlying respiratory care are not merely theoretical constructs; they are crucial for the clinical efficacy of treatments that sustain life and improve its quality for patients with respiratory disorders.

Concepts such as Boyle’s Law, Bernoulli’s Principle, and alveolar ventilation rates serve as foundational pillars upon which diagnostic measures and treatment modalities are developed.

Therefore, a thorough comprehension of these principles is indispensable for healthcare professionals who are involved in respiratory care.

By bridging the gap between theory and practice, we can ensure a more robust, evidence-based approach to respiratory healthcare that can adapt and evolve as new challenges and technologies emerge.