Lung distensibility. The static pressure-volume curve of the lungs and its use in clinical assessment. 1976

G J Gibson, and N B Pride

The main points of interest in the static expiratory PV curve are the changes in TLC (and to a lesser extent in RV), Pst(L) at standard volumes and particularly at TLC,and compliance (delta V/delta P) particularly close to FRC. More subtle changes in curvature may be present but have not as yet achieved any clinical or diagnostic significance. Although any presentation short of the whole PV curve inevitably conceals information a useful summary of the major changes can be obtained by considering only three points--the changes in TLC, Pst(L)max and compliance close to FRC (Fig. 22). In conditions associated with an increased TLC, four distinct patterns of change in the PV curve have been recognized resulting in different combinations of changes in Pst(L)max and compliance at FRC (Fig. 22, a, b, c, d). There are two main patterns of PV curve in restrictive lung disorders--one due to stiffening of the lung (Fig. 22, g, i, j) and the second due to extrapulmonary factors which prevent a normal distending pressure being applied to the pleural surface of the lung (Fig. 22, h). In practice it appears that lack of distending pressure leads to a secondary reduction in lung compliance. Nevertheless differences in Pst(L)max remain. The general patterns of abnormality may be summarized as follows: 1. Increases in TLC are almost always associated with a normal or increased compliance but Pst(L)max may be increased, normal or decreased. 2. Decreases in TLC are almost always associated with a decreased compliance but again Pst(L)max may be increased, normal or decreased. 3. When TLC is normal, it is theoretically possible that the whole PV curve may be displaced on the pressure axis and compliance may be altered (as in ageing) but such changes have not been identified in clinical practice.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008170 Lung Compliance The capability of the LUNGS to distend under pressure as measured by pulmonary volume change per unit pressure change. While not a complete description of the pressure-volume properties of the lung, it is nevertheless useful in practice as a measure of the comparative stiffness of the lung. (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p562) Compliance, Lung,Compliances, Lung,Lung Compliances
D008176 Lung Volume Measurements Measurement of the amount of air that the lungs may contain at various points in the respiratory cycle. Lung Capacities,Lung Volumes,Capacity, Lung,Lung Capacity,Lung Volume,Lung Volume Measurement,Measurement, Lung Volume,Volume, Lung
D008946 Mitral Valve Stenosis Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause. Mitral Stenosis,Mitral Stenoses,Mitral Valve Stenoses,Stenoses, Mitral,Stenoses, Mitral Valve,Stenosis, Mitral,Stenosis, Mitral Valve,Valve Stenoses, Mitral,Valve Stenosis, Mitral
D010993 Plethysmography, Whole Body Measurement of the volume of gas in the lungs, including that which is trapped in poorly communicating air spaces. It is of particular use in chronic obstructive pulmonary disease and emphysema. (Segen, Dictionary of Modern Medicine, 1992) Whole Body Plethysmography,Body Plethysmographies, Whole,Body Plethysmography, Whole,Plethysmographies, Whole Body,Whole Body Plethysmographies
D011187 Posture The position or physical attitude of the body. Postures
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D011650 Pulmonary Alveoli Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place. Alveoli, Pulmonary,Alveolus, Pulmonary,Pulmonary Alveolus
D011656 Pulmonary Emphysema Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions. Emphysema, Pulmonary,Centriacinar Emphysema,Centrilobular Emphysema,Emphysemas, Pulmonary,Focal Emphysema,Panacinar Emphysema,Panlobular Emphysema,Pulmonary Emphysemas,Centriacinar Emphysemas,Centrilobular Emphysemas,Emphysema, Centriacinar,Emphysema, Centrilobular,Emphysema, Focal,Emphysema, Panacinar,Emphysema, Panlobular,Emphysemas, Centriacinar,Emphysemas, Centrilobular,Emphysemas, Focal,Emphysemas, Panacinar,Emphysemas, Panlobular,Focal Emphysemas,Panacinar Emphysemas,Panlobular Emphysemas

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