CIBA Foundation Symposium on Pulmonary Structure and Function

By A. V. S. De Reuck; Maeve O'Connor | Go to book overview
Awareness of such possibilities may help in the understanding of pressure-flow relationships which would otherwise seem unaccountable.
REFERENCES
HOWELL J. B. L., PERMUTT S., PROCTOR D. F., and RILEY R. L. ( 1961). J. appl. Physiol., 16, 71.
PERMUTT S., BROMBERGER-BARNEA B., and BANE H. N. ( 1961). Fed. Proc., 20, 105.
PERMUTT S., HOWELL J. B. L., PROCTOR D. F., and RILEY R. L. ( 1961). J. appl. Physiol., 16, 64.
PROCTOR D. F., and YAMABAYAsHi H. ( 1961). Fed. Proc., 20, 107.
WEIBEL E. R., and VIDONE R. A. ( 1961). Amer. Rev. resp. Dis., 84, 856.

DISCUSSION

Hugh-Jones:Does your theory fit in with DuBois's idea that when one takes in a deep breath, say of nitrous oxide, all the pulmonary capillaries will be shut at the top of one's lungs, anyway, and then they "wink" open as the right heart temporarily exceeds the pressure within the alveoli.

Riley:Yes; I think that this is entirely consistent with cyclic flow, and that the winking is more pronounced at the top of the lung. Only the apex is high enough to get the tamponade effects of alveolar pressure.

Forster:You stated a number of times that the pressure outside the capillaries was greater than that inside. I think this is almost impossible from a physical point of view, since the capillary walls are so thin and flabby that an increase in extramural pressure would be almost entirely transmitted across the wall.

Riley:The capillary walls do not support a pressure across them. When the pressure outside is higher, the capillary collapses.

Forster:I do not think it necessary to assume the capillary walls can support an increased external pressure to explain any of your data or Dr. S. Permutt's. This point makes a great deal of difference when you consider what happens in pulmonary oedema when the intra-alveolar pressure is increased. You might say that you can force the oedema fluid back across the membrane into the capillary by increasing the

-272-

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