79 - The Physiological Consequences of Disruption or Destruction of the Alveolar Capillary Membrane Flashcards
Number of alveoli in lungs
~200-300 million
Interstitium in lungs
Space between alveolar membranes and capillaries
What is the alveolar-capillary membrane composed of? 1 2 3 4
Layer of surfactant
Type I alveolar cells (forms alveolar membrane)
Basement membrane
Vascular endothelial cell
Features of A-C membrane 1 2 3 4
Thin (0.5 microns)
Large surface area (50-100M2)
Alveolar volume is ~3-6L
Capillary volume is ~80L (increases is increased cardiac output)
Examples of diseases/processes that can disrupt A-C membrane 1 2 3 4 5 6
Acute H1N1 (pandemic influenza) Emphysema Lymphangitis carcinomatosis (infiltrating cancer) Drug-induced pneumonitis Idiopathic pulmonary fibrosis Tuberculosis
Pneumonitis
Inflammation of alveoli (also called alveolitis).
Pneumonia is a subtype of pneumonitis (implies an infectious aetiology)
Likely physiological effects of disrupting A-C membrane
1
2
3
Abnormal gas exchange
Abnormal lung mechanics
Pulmonary vascular complications
What affects partial pressures of gasses in the alveoli?
Ventilation of alveoli
Equation that describes rate of diffusion of a gas
Fick’s law
Fick’s law
Rate of ventilation is proportional to (surface area x gas constant x (difference in partial pressures)) / Thickness of membrane
Amount of time that an average RBC spends in contact with alveolar membrane at rest
~0.75 second
Amount of time that an average RBC spends in contact with alveolar membrane at rest
~0.25 second
Rough amount of time required for RBC Hb molecules to become oxygenated
~0.25 second
What doesn’t limit gas exchange in a normal person?
Diffusion (only takes ~0.25 second to oxygenate Hb in an RBC)
When is O2 transfer diffusion-limited at rest?
Only when there is a gross abnormality of the AC membrane (EG: thickening).
With exercise, can become apparent with less-severe disease).
Can desaturate O2 with exercise
Effect of thickened A-C membrane on O2 saturation
Takes a longer time to saturate RBC Hb