SM_156a: Diffusion and Gas Transport Flashcards

(40 cards)

1
Q

The oxygen cascade is driven by a ________ gradient

A

The oxygen cascade is driven by a partial pressure gradient

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2
Q

What is Fick’s Law of diffusion?

A

V·= (A/t) * D * ∆P

where D is proportional to solubility / √molecular weight

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3
Q

The diffusion coefficient D for CO2 is ____ times that of O2

A

The diffusion coefficient D for CO2 is 20 times that of O2

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4
Q

The diffusion path from alveolus to RBC includes the ______, _______, and _______

It is a ______ barrier to diffusion

A

The diffusion path from alveolus to RBC includes the alveolus, respiratory (alveolar-capillary) membrane, and capillary

It is a minimal barrier to diffusion

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5
Q

What are the two general categories of gas transfer between alveolus and capillary?

A
  • Diffusion limited
  • Perfusion limited
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6
Q

What is diffusion limited gas transfer between alveolus and capillary?

A

Gas transfer limited by rate of diffusion

Related to the Fick equation, V· = A/t * D * ∆P, which depends on the surface area available for diffusion and the diffusion distance

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7
Q

What is perfusion limited gas transfer between alveolus and capillary?

A

Gas transfer limited by the ability of the blood flow to deliver gas to the tissue

Related to rate of blood flow

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8
Q

What is diffusion limitation?

A

PA, g ≠ Pc’g where A is alveolar and c’ is end capillary

(example: rate of diffusion from alveolus to capillary is not sufficient to rase Pc‘O2 to PAO2 in a single pass through the lung)

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9
Q

What are the limiting factors to gas exchange described by Fick’s law of diffusion?

A
  • Surface area (pus, water, atelectasis)
  • Diffusion distance (emphysema, pulmonary fibrosis)
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10
Q

A patient briefly inhales 2 different gases, X and Y. Partial pressures of X and Y are then determined in alveoli, mixed venous blood, and end pulmonary capillary blood.

A

Y is diffusion limited, X is not

No equilibration between alveolus and capillary for Y, if increase surface area can increase diffusion rate

(X is perfusion limited)

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11
Q

For a gas (Y), that is diffusion limited, increasing cardiac output will __________

A

Decrease Pc’Y

Increasing cardiac output will decrease the amount of time blood spends in a pulmonary capillary, decreasing Pc’Y

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12
Q

What is perfusion limitation?

A

Rate of diffusion is sufficient so that end capillary partial pressure equals alveolar partial pressure (Pc’ = PA)

Example: nitrous oxide (PN20)

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13
Q

For a gas (Y), that is perfusion limited and with a constant PAY, a small increase in cardiac output will _______

A

For a gas (Y), that is perfusion limited and with a constant PAY, a small increase in cardiac output will have no effect on Pc’Y

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14
Q

Describe the diffusion of oxygen

A

Equilibration rate is between N2O and CO

Normally perfusion limited

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15
Q

What is the formula for diffusion capacity (DL)?

A

DL = V· / (PA - Pc)

1 / DL = resistance

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16
Q

What are the two components of resistance with regards to diffusing capacity?

A

1 / DL = 1 / Dm + 1 / (θ * Vc)

1 / Dm is resistance of alveolar-capillary membrane

1 / (θ * Vc) is resistance due to chemical reactions

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17
Q

What is the resistance due to chemical reactions for O2?

A

Binding of oxygen to hemoglobin

18
Q

What is the resistance due to chemical reactions for CO2​?

A

Conversion of bicarbonate to carbon dioxide

19
Q

Diffusion rate of CO2 ______ that of O2

A

Diffusion rate of CO2 is about equal to that of O2

20
Q

Describe the diffusion of carbon dioxide

A

Chemical reactions slow equilibration

Perfusion limited

21
Q

How is oxygen transported through the blood?

A
  • Dissolved O2
  • Bound to hemoglobin (HbO2) - more common
22
Q

Which formula describes the transport of dissolved O2?

A

Henry’s Law, C(O2, dissolved) = K * PO2

23
Q

What is the formula for O2 delivery?

A

O2 delivery = O2 dissolved * cardiac output

24
Q

Describe the oxygen dissocation curve

A
  • Amount of O2 dissolved rises linearly w/ PO2 but is a small portion of total O2 (only dissolved O2 gives rise to partial pressure of oxygen)
  • HbO2 rises quickly
25
What is the effect of hypoxia on HbO2 equilibrium?
Equilibrium: Hb + 4O2 ⇔ Hb(O2)4 At equilibrium: * Free [O2] on left = free [O2] on right * PO2 on left = PO2​ on right * Free [O2] on left \< total [O2] on right Hypoxia shifts the equilibrium
26
What is the blood O2 capacity?
Amount of O2 bound to Hb when Hb is saturated One gram Hb maximally binds 1.34 mL O2 and Hb is 15 gm% O2 O2 capacity is 1.34 mL/gm \* 15 gm/100mL = 20.1 mL/dL
27
What is oxygen content?
Amount of O2 carried by the blood, which varies with PO2
28
What is the formula for % saturation?
%O2 saturation (SO2) = (O2 content / O2 capacity) \* 100
29
What is the HbO2 characterized by?
* O2 binding capacity * P50, which is an expression of affinity of Hb for O2
30
Altering [Hb] changes _______ but not ______ or \_\_\_\_\_\_\_
Altering [Hb] changes O2 capacity but not P50 or % saturation at any given PO2
31
Which factors increase P50?
Curve shifted to the right by increases in * Temperature * H+ or PCO2 (Bohr effect) * 2,3-BPG
32
What is the Bohr effect?
Deoxyhemoglobin is a weaker acid than oxyhemoglobin, so deoxyhemoglobin readily accepts H+, which lowers affinity of Hb for O2 in the tissue
33
What is the Haldane effect?
Oxyhemoglobin is a stronger acid than deoxyhemoglobin, so oxyhemoglobin has a lower affinity for H+ and CO2, so addition of O2 causes H+ to be released from Hb in the lungs
34
Where does the Bohr effect act?
In tissue
35
Where does the Haldane effect act?
In lungs
36
Compare O2 versus CO2 in the blood
* CO2 curve is much more linear (never plateaus at physiological levels of CO2) * Much more CO2 than O2 in the blood * Hb is about 90% saturated w/ O2 at about 60 mmHg
37
How is CO2 transported in the blood?
* Dissolved CO2 * HCO3- (mainly) * Carbamino CO2
38
What is carbamino CO2?
CO2 bound to blood proteins (mostly hemoglobin)
39
Higher O2 corresponds to the ______ line for carbamino CO2
Higher O2 corresponds to the arterial line for carbamino CO2
40
Lower O2 corresponds to the ______ line for carbamino CO2​
Lower O2 corresponds to the venous line for carbamino CO2​