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bmsc 208 > Respiratory 6 > Flashcards

Respiratory 6 Flashcards

1
Q

If perfusion remains constant and hypoxia is not caused by hypoventilation or alterations in atmospheric PO2 then what causes the problem

A

Issue with gas exchange between the alveoli and blood
- issue at exchange barrier with diffusion

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2
Q

What causes an issue with gas exchange

A

Alterations in a layer
Water layer, or interstitial space

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3
Q

What are the layers between alveoli and capillary

A

Alveolar air - water layer - interstitial space - alveolar type 1 epithelial cell - interstitial space with matrix - blood plasma - cytoplasm of RBC

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4
Q

What happens to oxygen once diffuse into cytoplasm of RBC

A

Attaches to hemoglobin

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5
Q

Diffusion

A

Random movement of molecules from a region of high concentration to a region of low concentration

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6
Q

What are 4 things that will affect the random movement of gas molecules between the alveoli and capillaries

A
  1. Concentration gradient
  2. Surface area
  3. Barrier permeability
    - solubility of gas
  4. Diffusion distance
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7
Q

What is the only thing that changes in healthy individuals to affect diffusion

A

Concentration gradient

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8
Q

What is directly proportional to diffusion

A

Surface area, concentration gradient, barrier permeability

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9
Q

What is inversely proportional to rate of diffusion

A

Distance

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10
Q

What is constant under normal conditions in relation to diffusion

A

Surface area, diffusion distance and barrier permeability

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11
Q

What is the main determinant of diffusion

A

Concentration grradien

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12
Q

Emphysema

A

PO2 normal or low
- destruction of alveoli
- decreased surface area

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13
Q

What diseases cause hypoxia

A

Emphysema, fibrotic lung disease, pulmonary edema, asthma

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14
Q

Pulmonary fibrosis

A
  • PO2 normal or low
  • thickened fibrous connective tissue slows gas exchange
  • loss of lung compliance
  • decreased barrier permeability
    Restrictive
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15
Q

Pulmonary edema

A

Fluid in interstitial space increases diffusion distance
- PO2 normal

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16
Q

Asthma

A

Increased airway resistance, bronchioles constrict
- PO2 low
- decreased concentration gradient

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17
Q

What is alveolar gas exchange influenced by

A

O2 reaching alveoli and gas diffusion between the alveoli and blood

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18
Q

What is O2 reaching alveoli determined by

A

Composition of inspired air
Alveolar ventilation

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19
Q

What is alveolar ventilation determined by

A

Rate and depth of breathing, airway resistance, lung compliance

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20
Q

What is gas diffusion between alveoli and blood determined by

A

Surface area and diffusion distance/permeability

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21
Q

What is diffusion distance/permeability determined by

A

Barrier thickness, amount of fluid

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22
Q

Why must respiratory gases be soluble in liquids

A

Alveoli lined with liquid, space between alveoli and capillaries liquid and plasma is liquid

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23
Q

What is the movement of gas molecules form air to liquid directly proportional to

A
  1. Pressure gradient of the gas
  2. Solubility of gas in liquid
  3. Temperature- relatively constant
24
Q

Why do we need hemoglobin to carry O2

A

O2 not very soluble in liquid

25
Q

What is equilibrium

A

Gas moving in =gas moving out
PO2 matched

26
Q

CO2 solubility

A

Very soluble
Increased diffusion distance (pulmonary edema) doesn’t affect PCO2

27
Q

What happens to 02 and CO2during pulmonary edema

A

Fluid in interstial space decreased diffusion because O2 not very soluble in liquid
PCO2 is normal because higher solubility

28
Q

What is mass flow

A

Movement of X per minute
Measurement of movement of substance into, out of, or within body

29
Q

What is mass balance

A

Any substance in body must remain constant

30
Q

What shows mass flow and mass balance in body

A

Oxygen transport in circulation and oxygen consumption by tissues

31
Q

Equation for mass flow

A

O2 transport = cardiac output (L blood/min) x O2 concentration (mL O2/L blood)

32
Q

Equation for mass balance

A

Arterial O2 transport - venous O2 transport = QO2

33
Q

Fick equation (mass flow and mass balance)

A

CO x (arterial O2 - venous O2) = QO2
O2 consumption by systemic tissues

34
Q

Arterial O2 transport
200 ml O2/L blood and CO is 5L/min

A

ML O2/min to cells= 200ml 02/L blood x 5L blood/min
= 1000 ml O2/min delivered to tissues

35
Q

Venous O2 transport
Venous blood 150ml O2/L blood, CO 5L/min

A

ML O2 taken away from cells= 150 ml blood x 5L blood/min
= 750 ml O2 taken away

36
Q

Fick equation
CO= 5L
Arterial O2 200ml
Venous O2 150ml

A

5L/min (200ml - 150ml)
=250 ml O2/min

37
Q

How much O2 is bound to hemoglobin

A

More than 98%

38
Q

How much O2 is dissolved in plasma

A

Less than 2%

39
Q

How many Hb molecules in one RBC and how much O2 carried

A

~250 million Hb in one RBC = 1 billion O2

40
Q

What is the process of O2 moving from alveoli to cells

A
  1. O2 diffuses into plasma where <2% dissolves
  2. O2 diffuses into RBC, binds to Hb
  3. Transport to cells
  4. Process reverses and HbO2 broken down
  5. O2 dissolves in plasma and into cells
41
Q

Oxygen binding obeys what law

A

Law of mass action

42
Q

What is law of mass action

A

When PO2 high Hb will bind to O2
When PO2 low Hb will start to release O2
Binding is reversible

43
Q

What does oxygen binding to Hb produce

A

HbO2

44
Q

How long does RBC spend in pulmonary capillary at rest and how long for it to become saturated

A

~0.75 sec and ~.40 secs

45
Q

What is the transfer of O2

A

Alveolar air to plasma to RBCs onto hemoglobin

46
Q

What happens when deoxygenated blood reaches lungs

A

Amount of O2 around Hb increases so Hb will start to bind O2

47
Q

Where type of tissues does blood travel to

A

Low PO2 tissues
- draws O2 out of plasma, which disrupts the equilibrium and causes Hb to release its O2 into plasma
- O2 can diffuse into tissues

48
Q

When is equilibrium reached

A

When P02 is matched in alveoli, plasma and cytoplasm and Hb no longer capable of taking up anymore o2

49
Q

For any given PO2 what happens

A

Certain number of Hb binding sites will be saturated

50
Q

Why does O2 diffuse from alveoli to plasma

A

Alveoli 100mmHg
Plasma 40 mmHg

51
Q

When plasma starts to increase PO2 until 100mmHg

A

Start binding to Hb

52
Q

How does Hb ensure the partial pressure gradient continues

A

O2 bound to Hb no longer contribute to partial pressure gradient
02 will continue to move across until equilibrium reached

53
Q

At rest how much oxygen is consumed

A

250 ml O2/min

54
Q

What is the O2 content of plasma and total O2 carrying capacity

A

3mL O2/L blood
3 mL x 5L blood/min = 15 ml O2/min

55
Q

What is total O2 carrying capacity with RBC

A

O2 content of RBC= 197 ml O2/L blood
200 ml O2/L blood
200 ml x 5 L blood/min = 1000 ml O2/min

bmsc 208 (20 decks)

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