Anatomy and physiology of respiratory system relevant to anaesthesia

• Published in: Indian journal of anaesthesia Vol. 59; no. 9; pp. 533 - 541
• Main Authors: Patwa, Apeksh, Shah, Amit
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.09.2015; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Anatomy; Anesthesia; bronchomotor tone; functional residual capacity; Mechanical ventilation; Medical research; Methods; Physiological aspects; physiology; Precision medicine; Respiratory system; Review; tracheobronchial tree; ventilation-perfusion; respiratory system; bronchomotor tone; physiology; tracheobronchial tree; ventilation-perfusion; Anatomy; functional residual capacity
• ISSN: 0019-5049; 0976-2817
• DOI: 10.4103/0019-5049.165849

Clinical application of anatomical and physiological knowledge of respiratory system improves patient's safety during anaesthesia. It also optimises patient's ventilatory condition and airway patency. Such knowledge has influence on airway management, lung isolation during anaesthesia, management of cases with respiratory disorders, respiratory endoluminal procedures and optimising ventilator strategies in the perioperative period. Understanding of ventilation, perfusion and their relation with each other is important for understanding respiratory physiology. Ventilation to perfusion ratio alters with anaesthesia, body position and with one-lung anaesthesia. Hypoxic pulmonary vasoconstriction, an important safety mechanism, is inhibited by majority of the anaesthetic drugs. Ventilation perfusion mismatch leads to reduced arterial oxygen concentration mainly because of early closure of airway, thus leading to decreased ventilation and atelectasis during anaesthesia. Various anaesthetic drugs alter neuronal control of the breathing and bronchomotor tone.