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respiratory hubert ly

I have added "respiratory tract" to the list under "See also". I think the respiratory tract is part of the respiratory system: The respiratory system is not a part of the respiratory tract, but comparing the two articles it seens they would have you believe that the respiratory system is part of the respiratory tract and that the respiratory tract is not completely encluded by the term "respiratory system". Alec - U.K.

Entrance of Air

Air can enter the respiratory system through the mouth or oral cavity as well as the nostrils and nasal cavity, it doesn't seem to acknowledge this...

Medical treatment, surgical procedures and equipment?

How should medical articles related to the Respiratory system be linked to the category? I just did a change on Flutter valve to this category from where it was inexplicably pointed to Digestive system. Hmm, there doesn't seem to actually be a Respiratory system *category*, just this article.

Internationally accepted notation for partial pressures

Hi Cruithne9, You mention an internationally accepted scientific notation for partial pressure in your recent edit summary at Respiratory system. Do you have a link to a reference for this? Cheers, • • • Peter (Southwood) : 18:53, 2 June 2017 (UTC)

Hi Peter (Southwood). There is great variation in the notation used in the various Physiology textbooks. A very common form is pO₂, but a lower case p such as this means "the negative logarithm of the molar oxygen concentration” as in "pH" and “pK_a” for the negative logarithm of an acid’s dissociation constant. This is clearly completely inappropriate and misleading when referring to the partial pressure of a gas; but like many of the other incorrect notations is simply copied from textbook to textbook without thinking. Others use PO₂, or simply PO₂ or P(O₂). These are improvements on the pO₂ theme, but although still strictly speaking incorrect, are one's only option when using MS Word, or other text editing computer program. But note that PO₂ suggests a chemical formula, denoting an oxide of phosphorus! The correct notation is P_O2 as indicated in <Scientific Tables (Seventh Edition), Edited by K. Diem and C Lentner. pp. 544-545. Published by Ciba-Geigy Ltd, Basle, Switzerland>. This is the notation used in the article on the Henderson-Hasselbalch equation and the article on Partial pressure, and probably elsewhere in Misplaced Pages where the authors have written chemistry and physics articles, making sure they use the internationally correct notation. The ppO₂ used in Respiratory system article (which was actually originally entered as ppO, but changed by me to ppO₂) is an extremely rarely used notation, which the editor who changed all the P_O2s into this format deemed “simpler”, though many readers of the article, if they do not notice "pp" definition in the “Control” subsection of the article are likely find confusing. Cruithne9 (talk) 08:20, 3 June 2017 (UTC)

Thanks Cruithne9, most obliging. I generally use the ppO₂ notation in diving related articles and this is one of the notations I often find in the industry literature. It is simpler to code, but I don't see that it is any different in simplicity to read. I have also seen P_O2 used, which I assume is a kludge for the <math> option. ppO is simply wrong, even ppO2 is better Cheers, • • • Peter (Southwood) : 08:34, 3 June 2017 (UTC)

Factual and other problems

Hi Iztwoz. I am aware that you have received numerous awards for your contributions to the medical, physiological and anatomical article in Misplaced Pages. Congratulation on such an outstanding record. It therefore puzzles me that your recent editing of the Breathing and, to a lesser extent, the Respiratory system articles contain numerous inconsistencies, contradictions, misunderstandings and inaccuracies.

For instance, you use four different (undefined) notations for “partial pressure of oxygen” in different parts of the two articles: PO2, P_O2, PaO2, and ppO₂. The correct notation is P_O2 as indicated in <Scientific Tables (Seventh Edition), Edited by K. Diem and C Lentner. pp. 544-545. Published by Ciba-Geigy Ltd, Basle, Switzerland>. This is the notation used in the article on the Henderson-Hasselbalch equation and the article on Partial pressure, and probably elsewhere in Misplaced Pages where the authors have written chemistry and physics articles, making sure they use the internationally correct notation. If any of the other notations is used instead, then the “2” should at least be a subscript “2”, But then PO₂ could easily be confused with a chemical formula of an oxide of phosphorus. PaO₂ is the most confusing of all the alternatives, even if it is explained that this refers to the partial pressure of oxygen in arterial blood (or is it the partial pressure of oxygen in the alveoli?). That basically leaves a choice between P_O2 and ppO₂, although elsewhere in the article you define “pp” as “parts per …..” (as in parts per million). P_O2 is no more “complex” or confusing than any of the other notations, and has the advantage of being unambiguous. So I would use that throughout.

I will deal with other problems sentence by sentence more or less in the order of importance. The sentences in italics are quotes from the articles

• The sentence that reads: Exercise also increases the breathing rate due to the extra demands for oxygen, makes no mention of how this is determined, thus reducing this to a teleological statement, with no scientific value. Everyone knows that your breathing rate increases during exercise; the physiological question is HOW does this come about?

• The same mistake is made elsewhere in the article: The rate and depth of breathing is controlled by the respiratory centers, according to the changing needs of the body. How do the respiratory centers work out what the changing needs of the body are?

• The sentence about the effect of exercise on the breathing rate is immediately followed, in the same line by: Information received from stretch receptors in the lungs limits the depth of inhalation and exhalation as if this is the physiological answer to the increased rate of breathing during exercise.

• You state that Diaphragmatic breathing involves the use of the main muscles of respiration whilst "abdominal breathing" shown in Fig.3 involves the use of the abdominal muscles to increase the thoracic capacity. Firstly which are the “main muscles of respiration” apart from the diaphragm? But more seriously, the abdominal muscles CANNOT “increase the thoracic capacity”. During inhalation they ALWAYS relax, whether breathing at rest or during exercise. The sentence that follows on from there reads: However, both of theses terms are often used interchangeably as diaphragmatic breathing also involves the abdominal muscles, and abdominal breathing also involves the diaphragm. This is as confusing as it is incorrect. The correct sentence should read Diaphragmatic breathing is often termed “abdominal breathing” because the movement seen (on the outside) when the diaphragm contracts is a bulging of the abdomen; whereas when the diaphragm relaxes the stretched abdominal muscle squeeze the abdomen back to its resting position. This makes it appear as if the breathing is carried out by the abdomen.

• The sentence Breathing is one of the few autonomic bodily functions that within limits, can also be controlled consciously. is incorrect as the autonomic nervous system is not involved in breathing. The word you are looking for is “automatic” or “reflex”. The motor nerves serving the muscles of inhalation and exhalation go to skeletal muscles (otherwise known as “voluntary muscles”!) The autonomic nervous system has a very specific anatomical and physiological meaning, serving smooth muscles, various parts of the heart, and various types of glands. The autonomic nervous system does not innervate skeletal muscles, and therefore none of the muscles of ventilation.

• The sentence: At sea level, where the ambient pressure is about 100 kPa, oxygen contributes 21% of the atmosphere and the partial pressure of oxygen PO2 is 19.7 kPa. is self-contradictory. If the ambient pressure is 100 kPa and 21% of that air is oxygen then the partial pressure of oxygen in the ambient air is 21 kPa (i.e. 21% of 100 kPa).

• Further down in the article you state that the PO2 at sea level is 21.0 kPa. which is correct, but contradicts your earlier claim that it is 19.7 kPa.

• When describing the diving reflex, it is stated that The metabolic rate slows right down and has the effect of transferring oxygen from other parts of the body. Slowing the metabolic rate doers not TRANSFER oxygen from one part of the body to another. The redistribution of the circulation is effected by intense vasoconstriction to the limbs (skin and muscle), and the abdominal visceral organs, while dilating the arterioles to the heart and brain. The slowing of the metabolic rate is a CONSEQUENCE or RESULT of this redistribution of blood to only a small part of the body. It is NOT A CAUSE of the redirection of the available oxygen to “other parts of the body”.

• …rise in the pH of the arterial plasma leading to respiratory alkalosis. Cause and effect have once again been switched in this sentence. The accumulation of CO₂ in the blood causes a “respiratory alkalosis” which in turn (if it is not compensated by the renal excretion of H ions in the urine) leads to a rise in the pH of the arterial plasma. Not the other way around.

• With each breath only about 350 ml, less than 15% of the residual air is expelled. The term “residual air” has a very specific meaning in respiratory physiology. The word you are looking for is Functional residual capacity.

• The partial pressures of the gases in the blood flowing through the alveolar capillaries equilibrate with the partial pressures of the gases in the FRC, ensuring that the partial pressures of carbon dioxide, and oxygen of the arterial blood, and therefore its pH, remain constant. How does the equilibration of the gases pulmonary capillary blood with those in the alveoli ENSURE that the partial pressures of oxygen and carbon dioxide in the arterial blood remain CONSTANT? The equilibration only ensures that the partial pressures of these gases are the same in the alveoli and arterial blood. Keeping them constant (unchanged) under a wide variety of circumstances requires fairly complex control mechanisms, which measure the gas pressures and institute corrective measure if they deviate from their “set points”.

• increased pressure (of CO₂) is sensed by the peripheral chemoreceptors which stimulate the respiratory centers. They respond by stimulating motor neurons at the muscles of respiration increasing the rate and depth of the breathing rate, and thereby increasing the supply of oxygen. This keeps the partial pressures of carbon dioxide and oxygen in equilibrium. Firstly the partial pressure of CO₂ is measured primarily by the CENTRAL blood gas chemoreceptors on the surface of the brain stem. The peripheral blood gas chemoreceptors are more sensitive to the partial pressure of oxygen than they are to that of carbon dioxide. But more seriously, what does the sentence This keeps the partial pressures of carbon dioxide and oxygen in equilibrium. mean? and how is this achieved?

Some minor points:

• Muscles of forceful inspiration are the: scalenes, the sternocleidomastoid, the serratus anterior and posterior, pectoralis major and minor, the levatores costarum, and the quadratus lumborum. The serratus anterior and serratus posterior are not accessory muscles of inhalation as their fibres run along the ribs (i.e parallel to them), and therefore do not help to lift them.

• Similarly, the latissimi dorsi are not accessory muscles of exhalation, as stated in the sentence: Muscles of forceful expiration are the transverse thoracic muscles, the rectus abdominis, the abdominal external oblique, and the internal oblique muscles, the latissimi dorsi, and the serratus posterior inferior muscles.

• In the sentence that reads anatomical features of the respiratory system include the trachea, bronchi, bronchioles, lungs, and diaphragm, the word features should be replaced with organs. Organs have “features” such as lobes, indentations, ligament attachments etc. But “features” do not have organs. The words are not synonyms. Furthermore the list of organs is strangely incomplete. Should “alveoli” not be included? and if the diaphragm is listed, then mention should also be made of the other muscles of ventilation.

• In the Respiratory system article, the statement that The right side of Fig. 2 shows that during exhalation, at rest is incorrect. In fact it shows FORCED EXHALATION.

• The statement in the Respiratory system article, that the so-called pump handle and bucket handle movements of the ribs as shown in Fig. 2. is also incorrect. I think you mean Fig. 1; and that figure only shows the operation of the “pump handle movement”.

There are still a number of items in both articles that need correction or re-wording, but they are of relatively minor importance, and can easily be dealt with when the other problems are sorted out.

Cheers Cruithne9 (talk) 15:17, 11 June 2017 (UTC)

Have responded to same input on Breathing talk page.--Iztwoz (talk) 19:41, 11 June 2017 (UTC)

Use of unconventional symbols for pressures and partial pressures

Iztwoz, Please use currently conventional symbols for pressures and partial pressures to minimise confusion. Please do not change from the more acceptable format previously used in the article to the system now used which is, as far as I am aware, incorrect. Cheers, • • • Peter (Southwood) : 06:05, 16 June 2017 (UTC)

Hi Peter (Southwood) the 'ordinary' format is used on many pages including the entry page of PCO2 - should all these other pages be changed too? Cheers --Iztwoz (talk) 06:24, 16 June 2017 (UTC)

I think they should. As far as I know they are wrong, not 'ordinary', and things that are wrong should be corrected. Things that are right should not be changed without discussion. I am currently trying to find out if there is any MOS guidance on this point. In the meanwhile I would appreciate if you would restore the correctly subscripted chemical symbols. I will cheerfully accept it if you change to the IUPAC approved symbols. • • • Peter (Southwood) : 06:53, 16 June 2017 (UTC)

Have just looked at the Blood gas tension page and that uses ordinary format and conventional symbols when an equation is used. There are no equations on this page. ? --Iztwoz (talk) 06:28, 16 June 2017 (UTC)

and likewise Breathing gas.--Iztwoz (talk) 06:44, 16 June 2017 (UTC)

I have not yet checked the blood gas tension article, (or breathing gas) so not sure that I understand you correctly. However that may also simply be wrong. There is no good reason to use formatting that causes confusion when the facilities to use correct, unambiguous formatting are readily available. Cheers, • • • Peter (Southwood) : 06:53, 16 June 2017 (UTC)

Both Blood gas tension and Breathing gas use subscripts for the chemical formulae. Breathing gas uses pp for partial pressure, as this article did until you changed it. I do not get your point. Cheers, • • • Peter (Southwood) : 07:01, 16 June 2017 (UTC)

My point is that the use is not uniform or consistent, and in my view not needed on pages being read by a general reader where the use of symbols to the uninitiated is clumsy and off-putting.--Iztwoz (talk) 07:58, 16 June 2017 (UTC)

The correct alternative to using the correct symbols would be to not use symbols and use the correct term in full. Use of kludge symbols does not clarify to the uninformed reader, and makes the article look unprofessional to the informed reader, so that confidence in the overall quality of the article is eroded. We should strive for more consistency as we strive for better referencing, correct information, consistent formatting, correct spelling and grammar and all the other things that make a quality article. As long as changes consistently improve an article they are good.

I see that you have improved the article by both using correct terms and correct symbols. Thanks for this. It looks much better already. Cheers, • • • Peter (Southwood) : 12:12, 16 June 2017 (UTC)

By looking at various relevant pages - they all (ALL) use ordinary font for use in prose and use symbols for use in formulas and equations. Is there any good reason to deviate from this? The featured article Oxygen toxicity uses 'partial pressures' 32 times with not one use of symbols. Likewise Oxygen saturation (medicine), Pulmonary gas pressures, Blood gas test, Pressure, PCO2 and on and on. Are you really suggesting all these pages should be changed? By the way I disagree with your ref to kludge symbols - they are merely abbrevs as commonly used in all articles. --Iztwoz (talk) 20:58, 18 June 2017 (UTC) Sorry it's been a long day - i've only just read your comments on 'symbols' used and ref to kludge symbols - I agree with your preferred choice if that was the way to go. --Iztwoz (talk) 21:05, 18 June 2017 (UTC)

Full text is always acceptable, and ordinary font is as far as I am aware, normal usage. I refer to when a symbolic representation is used, where at absolute minimum, the correct subscripts must be used in chemical furmulae, and either a recognised symbolic system used as recommended by a reliable source, such as IUPAC, or the symbology must be defined in the article. The symbology should remain consistent throughout the article, and a recognised system should not be replaced without discussion. There does not appear to be a MoS agreement on the details, but I think this complies with the general philosophy in MoS. Cheers, • • • Peter (Southwood) : 10:25, 7 July 2017 (UTC)

Human physiology

I concur that for the most part, the general explanation uses human physiology for examples and details. There are a few examples of non-human physiology referred to in the section, but probably not a problem. The Other animals section could use a section on mammalian physiology to include the two special cases mentioned - horses and elephants - which explains that human respiratory system is very middle of the road for mammals, and that the two examples mentioned are there as exceptional cases. • • • Peter (Southwood) : 10:32, 7 July 2017 (UTC)

Revision

The article as it stands consists of a confused, unorganized, fragmented jumble of headings, some of which contain nothing more than an uninformative sentence or a disconnected, incomplete table of data no one is likely to make sense of, or use. The content under some of the headings contradict the content of others. In other words there is no continuity of thought or the presentation of information. There are are also numerous inaccurate, misleading and confusing non-statements, many of which are listed above. There is no consistency in nomenclature, or symbols used.

I have therefore revised the entire article ensuring that there is a proper hierarchy in the headings, and that things that belong together are grouped together. I have eliminated all the inaccuracies I could identify, and made the content that is presented as generally understandable as possible, ensuring that cause always comes before effect - and that that link is obvious. Eliminated all the symbols that have a mathematical flavor, sticking to prose throughout, and proper grammar. All the figures are numbered sequentially, for easy reference (including back reference). Cruithne9 (talk) 11:51, 16 July 2017 (UTC)

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