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Flashcards in Gas Transport Deck (48)
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1
Q

Fick’s Law equation

A
2
Q

How can the diffusion constant of a particulary gas be calculated?

A
3
Q

What is the normal diffusion distance?

A

0.2-0.5 microns

4
Q

Which conditions can cause a thickened barrier?

A

Fibrosis

Intersitial edema

NOTE: Patients with diffusion deficits often have decreases in blood O2 occur more early than CO2 increases in the blood.

5
Q

What are the methods of O2 transport?

A
  • Dissolved in plasma- 2%
  • Chemically bound to hemoglobin in erythrocytes - 98%
6
Q

What is the oxygen concentration in air?

A

21%

7
Q

Partial pressure of O2 in air

A

160 mmHg

8
Q

Pressure of oxygen in trachea

A

150 mmHg

*The decrease is due to dilution with water

9
Q

The concentration of DISSOLVED oxygen in the blood is _________ (directly/indirectly) proportional to the partial pressure of oxygen (the PO2) in the gas.

A

Directly

10
Q

What’s the normal amount of dissolved oxygen in plasma?

A

0.3 mL O2 per 100 mL of blood

*This is 10% of the body’s metabolic demand. So, dissolved O2 alone does not come close to meeting the body’s O2 demands

11
Q

Transport of O2 from the lungs to the peripheral tissues is dependent on _____ and ________.

A

Diffusion; perfusion

12
Q

What is the effect of venous mixture on changes in PO2?

A

Mixing of blood occurs in the pulmonary capillaries which cause a decrease in the O2 entering the left heart to about 95-100 mmHg. This occurs for 2% of the blood entering the left atrium

NOTE: The other 98% of blood enters the left atrium with a PO2 of 104 mmHg.

13
Q

Mixing of blood that reduces oxygen pressure in pulmonary capillaries is do to what?

A

Thebesian veins of the myocardium allow the bypassing of lung bronchial circulation

14
Q

The iron found in hemoglobin is in its ________ state.

A

Ferrous (Fe2+)

15
Q

What is the total carrying capacity of hemoglobin?

A

197 mL O2/ L og blood

*This satisfies 90% of O2 consumption at the tissue level

16
Q

Oxygen- Hemoglobin Dissociate Curve

A
17
Q

What are the three anchor points of the oxygen hemoglobin dissociation curve?

A
  1. PO2 at approximately 100 mmHg for the arterial blood
  2. PO2 at approximately 40 mmHg for the mixed venous blood
  3. At 50% saturation, PO2 is approximately 27 mmHg in arterial blood and approximately 29 mmHg for mixed venous blood
18
Q

On the flat portion of the oxygen-hemoglobin dissociation curve, a drop in PO2 from 100 mmHg down to 60 mmHg still results in 90% saturation of Hb. At what PO2 is oxygen delivery compromised?

A

Below 60 mmHg

19
Q

Which factors shift the dissociation curve to the right?

A
  • Increase in CO2
  • Increase in H+
  • Increase in 2,3-BDG
  • Increase in Temp

*This is Bohr’s law

20
Q

Which factors shift the dissociation curve to the left?

A
  • Decrease H+
  • Decrease CO2
  • Decreased temp
  • Decrease 2,3 DPG

*This is the Haldane effect

21
Q

Will exercise shift the dissociation curve to the right or the left?

A

Right

*Shift to the right reduces hemoglobin’s affinity for O2, which is perfect because the tissues need more oxygen to be released during exercise

22
Q

In what conditions are 2,3 DPG elevated?

A
  • Obstructive pulmonary disease
  • Cystic fibrosis
  • Congestive heart failure and some congenital heart defects
  • Most types of anemia
  • High altitudes
  • In pregnancy
  • Hyperthyroidism
  • After vigorous exercise

NOTE: 2,3-DPG in RBCs increases in response to anemia/hypoxia and causes a rightward shift of the oxygen dissociation curve, allowing a more effective oxygen delivery.

23
Q

H+ rises in response to entry of _______.

A

CO2

24
Q

Diffusion-limited Gas Exchange

A

Describes the scenario in which the rate at which gas is transported away from functioning alveoli and into tissues is principally limited by the diffusion rate of the gas across the alveolar membrane.

*Results in incomplete equilibration

25
Q

Perfusion-limited gas exchange

A

the rate of gas transport from the lung can only be increased by increasing pulmonary blood flow

*The result is complete equilibration

26
Q

Transfer of CO is limited by the _________.

A

RATE OF DIFFUSION

*Not the amount of blood available (perfusion)

27
Q

What are some common sources of CO?

A

Cigarette

Car exhaust

28
Q

Treatment for CO poisoning

A
  • Administration of high concentration of supplemental O2 to displace CO from the Hb
    • Hyper-barometric chamber
29
Q

At what pressures is O2 highly soluble?

A

20-60 mmHg

*Relatively insoluble at 100 torr because more Hb binding sites are already bound

30
Q

CO solubility is very large at a partial rpessure of _____.

A

1-2 torr

31
Q

Why is CO so toxic to the oxygen transport system?

A

CO binding affinity for Hb results in a decrease in O2 content of arterial blood by 50%

32
Q

How do you calculate O2 consumption?

A

VO2= O2 consumption

Qt= Cardiac output

CaO2= Delivery to tissues

CvO2= Amount remaining after release to tissues

33
Q

What is the normal amount of O2 delivered per minute?

A

1000 mL O2/ min

34
Q

How oxygen delivery calculated?

A
35
Q

Clinical Calculation of Total O2 content

A

Dissolved O2 + Hb O2

36
Q

Normal SaO2

A

98%

37
Q

Types of Hypoxia

A
  • Circulatory (Stagnant) Hypoxia
    • Result of diminished blood flow to an organ
  • Hypoxic hypoxia
    • Reduced PaO2 and or CaO2 with a subsequent decrease in O2 delivery
  • Histotoxic Hypoxia
    • Block of electron transport chain system, which prevents utilization of oxygen
  • Anemic Hypoxia
    • Reduction in the ability to transport O2
38
Q

Causes of Hypoxic hypoxia

A

High altitude

  • Reduced FIO2, Reduced PAO2, Reduced PaO2

Emphysema

  • Deterioration of alveolar Type I cell membrane and loss of gas exhange surface area

Fibrosis

  • Thickening of alveolar membrane

NOTE: COPD and Neuromuscular disease could lead to hypoxic hypoxia as well

39
Q

Causes of stagnant hypoxia

A

Vascular disease

Arterial-venous shunt

Sickle cell anemia crisis

Blood clots

40
Q

Causes of anemic hypoxia

A

Reduced hemoglobin

CO poisoning

41
Q

Causes of histologic hypoxia

A

CN- poisoning

Sodium Azide poisoining

Pesticide Rotenone

42
Q

What are the three ways that CO2 is transported?

A
  • Physically dissolved in plasma- 7%
  • Bound to hemoglobin - 23%
  • Bicarbonate ions in RBCs- 70%

NOTE: CO2 is more soluble in blood than O2

43
Q

Uptake of carbon dioxide by the blood in the tissue capillaries is dependent on ___ and ____________.

A

Passive diffusion; partial pressure gradients

44
Q

PCO2 of blood entering is ________ torr. PCO2 of blood exiting is ________ torr.

A

45; 40

45
Q

What do the blood CO2 equilibrium curves are different hemoglobin saturation levels reveal?

A
  1. Deoxygenated mixed venous blood can transport more CO2
  2. CO2 curves are essentially straight lines between a PCO2 of 20-80 mmHg linear relationship
46
Q

Haldane approximately __________ the amount of CO2 release from blood in the lungs and doubles the amount picked up in the tissues.

A

Doubles

47
Q

The rate of CO2 output to O2 uptake is referred to as the _________.

A

Respiratory exchange ratio

Normal ratio= 0.825, based on average diet amounts of protein, fats, and carbohydrates

48
Q

CO2 diffuses _____ times faster than O2.

A

20