Respiratory 7 Flashcards

1
Q

Amount of oxygen bound to Hb depends on

A

Plasma O2 (RBC and cytosol PO2) and amount of hemoglobin

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2
Q

What does plasma O2 determine

A

% saturation of Hb

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3
Q

Plasma O2 is determined by

A

Alveolar PO2

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4
Q

What does alveolar PO2 depends on

A

1, composition of inspired air
2. Alveolar ventilation rate
3. Efficiency of gas exchange (normal for healthy)

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5
Q

What does the amount of hemoglobin determine

A

Amount of Hb binding sites

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6
Q

What is the total number of Hb binding sites calculated from

A

Hb content per RBC x Number of RBCs

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7
Q

What is anemia

A

Reduced carrying capacity of O2 in blood

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8
Q

What is the amount of O2 bound to Hb at any given PO2 expressed as

A

Percent saturation of hemoglobin (for any given pO2, Hb is a certain % saturated)

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9
Q

What determined the % saturation of Hb

A

PO2 that Hb is exposed to

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10
Q

What type of cells can have a lower PO2

A

Active cells (curve steep)
Can be as low as 20mmHg but larger release of O2

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11
Q

If PO2 100 how saturated us Hb

A

98.5%

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12
Q

When does more significant changes in saturation begin

A

Po2 below 60 mmHg

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13
Q

What physical factors alter hemoglobin’s affinity for O2

A

Levels of CO2, pH, temperature, 2,3-BPG

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14
Q

Shift in hemoglobin saturation as a result in pH or CO2 change

A

Bohr effect

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15
Q

What causes fast decreasing shift in pH

A

Active cells (max exertion)
- produces excess CO2, results in increased H+ and lactic acid in cytoplasm and extracellular space
- decrease pH, high acid, slight conformation in Hb

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16
Q

What does high pH cause

A

Reduced H+ and structural change in Hb and change affinity

17
Q

What is CO2 readily converted into

A

Acid
H+ + HCO3

18
Q

What does increased CO2 production cause

A
  1. CO2 readily binds Hb altering conformation (O2 released)
  2. CO2 readily converted to acid
19
Q

What does increased heat at level of tissues cause

A

Conformational change in Hb leading to decreased affinity and more O2 dropped at active muscles

20
Q

What is the metabolic compound 2,3-BPG

A

A by-product of glycolysis in RBC’s

21
Q

What increases 2,3 DPG

A

Chronic hypoxia
RBCs release ATP during hypoxia

22
Q

How does ascent to high altitude (low PO2) and anemia affect 2,3 BPG

A

Increases production

23
Q

What oxygen binding properties do fetuses have to increase binding affinity of Hb

A

Two alpha, two gamma globin subunits

24
Q

What does the different oxygen binding properties facilitate

A

Uptake of O2 into fetus even when exposed to lower PO2

25
Q

Why is there lower PO2 fro fetus

A

No direct connection between mother and fetus
O2 lost in intervillous space

26
Q

What is the importance of removing CO2 from body

A
  1. Elevated PCO2 causes acidosis
  2. Abnormally high PCO2 depresses CNS causing confusion, coma, or death
27
Q

What does acidosis cause

A

Low pH leads to interruptions in hydrogen bonds and denaturing of proteins

28
Q

How much CO2 carried by venous blood is dissolved in plasma

A

7%
Even though co2 very soluble, cells produce too much for plasma to be capable of carrying

29
Q

Where does remaining 93% CO2 diffuse

A

Red blood cells
- 23% binds to hemoglobin HbCO2 (open sites after O2 released)
- 70% is converted to HCO3- (bicarbonate)

30
Q

What are 3 ways CO2 is transported

A
  1. Dissolved in plasma 7%
  2. Bound to hemoglobin 23% (in RBCs)
  3. Converted to bicarbonate 70% (in RBCs)
31
Q

What does carbonic anhydrase do

A

Converts CO2 when in excess to HCO3 and H+
Hb picks up H+

32
Q

When HCO3 enters plasma why does in exchange for Cl

A

Ensures charge of RBC remains normal

33
Q

What is happens to CO2 in reverse reaction

A

CO2 unbind Hb and diffuses out of RBC
Carbonic acid reaction reverses, pulls HCO3 back into RBC converting back to CO2

34
Q

What 2 purposes does the conversion of CO2 to HCO3 serve

A
  1. Provide additional means of CO2 transport from cells to lungs (can take up as much as possible without contributing to partial pressure)
  2. HCO3 is available to act as buffer for metabolic acids, stabilizing body’s pH (binds to acids)
35
Q

What is the reaction involving carbonic anhydrase

A

CO2 + H20 <-> H+ + HCO3-
Excess CO2 ——>
Low CO2 <—————-

36
Q

What does the conversion of CO2 to HCO3 and H+ continue until

A

Equilibrium

37
Q

What mechanisms exist to ensure equilibrium is not reached for CO2 to HCO3 and H+

A

Remove HCO3 from RBC (Chloride exchanger)
Mop up excess H+. (Hb binds and buffers acid)

38
Q

What does Hb binding to excess H+ as buffer do

A
  • prevents large changes in body’s pH
39
Q

What causes Hb to not be able to carry out as buffer

A

If blood CO2 too high Hb cannot soak up all the H+ and respiratory acidosis can result