Diffusion and Carriage of Gases pt1 Flashcards

1
Q

What is the nomenclature (short hand) for;

  • Fractional concentration
  • Partial pressure
A

Fractional pressure = FO₂ (can be expressed as a %)

Partial pressure = PO₂

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2
Q

What is the nomenclature (short hand) for;
- Barometric pressure

(Partial pressure of____ & fractional concentration of___)

  • Inspired gases
  • Alveolar
  • Arterial
A
  • Barometric pressure = Pʙ
  • Inspired gases = ɪ
    -partial pressure of ɪ
    = PɪO₂
    The fractional concentration of ɪ
    =FɪO₂
  • Alveolar = A
    PA0₂, FAO₂
  • Arterial = a
    Pao₂, FaO₂
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3
Q

What is the SI unit of pressure equal to?

A

SI= kPa (killer pascals)

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4
Q

What is Dalton’s law?

A

In a mixture of NON-reacting gases the total pressure exerted is equal to the sum of the partial pressures of the individual gases.

For example air is a gas mixture the sum of which is Pʙ, so;
Pʙ = PO₂+PCO₂+*PN₂+PH₂O

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5
Q

How would you work out the partial pressure of any gas in a gas mixture?

Use O₂ in the air as an example

A

You would need to know the total pressure of the gas mixture which in this example would be = Pʙ.

And the fraction of that gas in the mixture. so in this e.g. The FO₂ of O₂= 21% (because O₂ makes up 21% of our atmosphere)

At sea level Pʙ = 101 kPa
FO₂= 21% or 0.209.
So the dry PO₂ = 0,209 x 101 = 21kPa

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6
Q

What is Henry’s law and what does it mean?

A

C=KP
where C is the concentration of dissolved gas at equilibrium, P is the partial pressure of the gas, and K is the Henry’s law constant (its about solubility)

This means that:
The more the PO₂ of a gas above a liquid is increased the more gas will dissolve into the liquid. (and vice versa)

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7
Q

What 2 variables affect the pressure of water vapour?

A

Temperature & Saturation

Saturated water vapour pressure rises with temperature.

%saturation depends on how much water the air has been in contact with.
In the lungs air has already passed over moist surfaces in the body so is 100% saturated

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8
Q

What is the constant water vapour pressure in the lungs?

A

6.3 kPa

this is due to the constant temp at 37∘C.

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9
Q

How do you calculate the partial pressure of O₂ in the inspired air in our tracheas.

A

The air inside our lungs is moist air, we need to calculate the dry air. so we need to remove the partial pressure of water vapour. which in the body is 6.3kPa.
So we do the following:
(Pʙ-6.3) x 0.209kPa.

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10
Q

Why cant we directly measure what the partial pressure of O₂ is in our alveoli? aka (PAO₂)

How can we work around that?

A

This is because CO₂ diffuses into the alveolus to replace O₂ diffusing into the pulmonary capillaries.

So to over come this we do the following equation:
PAO₂ = PIO₂-(PACO₂÷R)

R= CO₂ production ÷ O₂ consumption

(if u don’t understand watch LC from 23mins in)

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11
Q

What is the PO₂, PCO₂ & PH₂O in atmospheric air?

A
PO₂= 21
PCO₂= 0
PH₂O= Variable
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12
Q

What is the PO₂, PCO₂ & PH₂O in the Trachea?

A
PO₂= 16
PCO₂= 3.5
PH₂O= Variable
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13
Q

What is the PO₂, PCO₂ & PH₂O in Alveolar gas.

A
PO₂= 20 
PCO₂= 0
PH₂O= 6.3
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14
Q

What is the PO₂, PCO₂ & PH₂O in expired air?

A
PO₂= 13.5 
PCO₂= 5.3
PH₂O= 6.3
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15
Q

What drives the diffusion of O₂ from the alveoli to the capillaries?

A

The Alveolar PO₂ is higher than the PO₂ in the blood entering the capillary, this partial pressure gradient is what drives the diffusion of O₂.

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16
Q

Is Gas transfer is determined by the partial pressure gradient or the concentration gradient?

A

Partial pressure gradient

17
Q

What factors affect diffusion across a membrane?

A

Area, Thickness and Partial pressure gradient. = A÷T x (P1-P2)

18
Q

What is diffusing capacity? (DLg)

A

Combination of Area and Thickness

the physical characteristics of the lung

19
Q

How do you calculate the rate of transfer of a gas?

A

DLg x (PA-Pc)

20
Q

Why do we use the diffusing capacity of CO as a surrogate marker for gas exchange?
Why not use the diffusing capacity of O₂ or CO₂?

A

We can’t use O₂ or CO₂ because:

we would need to know the partial pressure gradient of O₂ between the alveoli and the capillary.

and we cannot easily measure the capillary partial pressure of O₂.

Its much easier to use CO
as Hb has 240x the affinity for CO>O₂. so when CO hits the blood almost all of it will be taken up by Hb, so you can assume that there will be O partial pressure of CO in your blood, which massively simplifies the equation.

, so the
(VIMP)
lung function measurements for gas exchange in the lung is the Lung transfer factor for carbon monoxide

21
Q

What would be the consequences of reduced surface area for exchange and what are the 3 possible causes?

A

The diffusing capacity of the lung would go down.

Caused by

  • Emphysema
  • Lung resection (removal of a lung/ part of a lung)
  • Reduced venous return ( e.g. low cardiac output means less blood flow over alveoli so less Gas exchange/ diffusion).
22
Q

What would be the consequences of increased thickness of alveolar capillary membrane thickness and what are the 3 possible causes?

A

Will reduce the gas exchange properties of the lung. / reduce the transfer factor of the lung.

  • Interstitial or alveolar fibrosis (which can be idiopathic/occupational/allergic)
  • Collagen vascular diseases (scleroderma/lupus)
  • Congestive heart failure (interstitial oedema)
23
Q

What does the DLCO measurement mean/ stand for?

A

Lung diffusing capacity for CO. / lung transfer factor

24
Q

What is DLCO reduced by?

A
  • Reduction in alveolar/capillary membrane area. (e.g. Emphysema, pulmonary emboli etc)
  • Increased thickness of alveolar/capillary membrane. (e.g. Pulmonary oedema, In pulmonary fibrosis diffusion is impaired by both thickening and by the reduced area caused by reduced lung volume)
  • Anaemia ( Less Hb to take up CO & O₂)
25
Q

What is DLCO increased by?

A
  • Increased pulmonary blood volume, as occurs in exercise (increases the effective area for gas exchange)
  • Polycythaemia (increase in Red blood cell concentration)
26
Q

What is the effect on the tissues if capillary PO₂ falls too low?

A

Tissues may become hypoxic ( not enough O₂)

27
Q

How many sub units is Hb made up of?

A

4

28
Q

What are the subunits made up of / what do they contain?

A

Each sub unit contains a protein chain (either alpha or beta), a haem group and a globin.

29
Q

What are the 2 chains Hb sub units may contain and how many of each chain is present in one Hb molecule?

A

2 α-chains

2 β-chains

30
Q

What is the haem group found in Hb?

A

The haem group is an iron-porphyrin compound, the iron atom is in the ferrous form and each will bind to an O₂ molecule.

31
Q

How many O2₂ molecules can 1 Hb molecule bind to?

A

4

32
Q

Why is the ‘co-operative’ binding mechanism of O₂ to Haemoglobin?

A

This because binding of the 1st O₂ to a haem group causes a conformational change in its globin sub-unit.

This influences adjacent globin molecule, increasing affinity of its haem group for O₂ binding, etc…

33
Q

What happens when the O₂ dissociation curve is shifted to the right (Bohr shift)?
And when does this normally occur?

A

It means the O₂ that’s bonded to Hb is more ready to dissociate and be released to tissues.

This normally happens during exercise with the increase of temperature, CO₂, and formation of lactic acid leads to a rise in Ph, which alter the shape of Hb which causes this shift.