Gas Exchange/Diffusion Flashcards

1
Q

Gas exchange across alveolar membrane is by?

A

diffusion down partial press gradient

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2
Q

Fick’s Law says diffusion rate affected by? (3)

A

membrane area and thickness

solubility of molecule

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3
Q

2 Partial Pressure Gradients in respiration are?

A

PA - PV

(PA = alveoli, PV = venous)

Pa - Ptissue

(Pa = arterial, Ptissue = cell tissue)

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4
Q

Pressure gradient for O2 compared to CO2?

A

O2 is 10x CO2

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5
Q

Rate of diffusion for O2 compared to CO2?

A

CO2 diffuses 2x faster than O2

(CO2 more soluble)

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6
Q

PAco2 compared to Paco2?

A

about equal due to rapid diffusion

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7
Q

PAo2 compared to Pao2?

A

PAo2 > Pao2

(5-20 mmHg)

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8
Q

Po2 in mitochondria =

A

1-2 mmHg

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9
Q

Oxygen Cascade is?

A

pressure ∆ of O2 from atmosphere to cells

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10
Q

What happens to Po2 during inspiration?

A

drops

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11
Q

Step 1 of O2 Cascade?

A

Humidification: air saturated w/ H2O

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12
Q

Partial pressure of humidified air eqn?

A

PIo2 = (PB - Ph2o) FIo2

I = inspiration

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13
Q

Water vapor pressure at body temp =

A

Ph2o = 47 mmHg

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14
Q

PB=

A

760 mmHg

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15
Q

Fgas =

A

0.21

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16
Q

Step 2 of O2 Cascade?

A

O2 depletion of alveolar gas: O2 extracted from inspired gas in alveoli

17
Q

Estimate PAo2 how?

A

Alveolar Gas Eqn:

relationship b/w PAo2 and PAco2, O2 removed from alveolar air, CO2 added

**PAco2 is about = to Paco2. If Paco2 is given, use it.

18
Q

Alveolar Gas Eqn

A

PAo2 = PIo2 - (Paco2/RQ)

PIo2 = (PB - Ph20) x FIo2

PB = 760

Ph20 = 47

FIo2 = 0.21

RQ = 0.8

BOTTOM LINE: PAo2 = 150 - (Paco2/0.8)

19
Q

Purpose of Alveolar Gas Eqn? (4)

A

1) gives average for whole lung
2) tells us PB and FIo2 affect PAo2
3) use to calculate A-a gradient
4) shows PAo2 and PAco2 inversely related

20
Q

Step 3 of O2 Cascade?

A

Alveolar - arterial O2 Gradient

(A-a gradient)

21
Q

Factors contributing to A-a Gradient? (2)

A

1) diffusion of O2 across A membranes
2) shunting of blood to respiratory areas of lungs

22
Q

A-a calculated how?

A

measure Pao2, calc PAo2

23
Q

Fick’s Law in lungs?

A

Vo2 = (AD/T) (P1 - P2)

A = area of diffusion (75 m2)

D = diffusivity of molecule

T = memb thickness (0.5 μm)

P1 -P2 = pressure gradient

24
Q

D (diffusitivity of molecule) eqn

A

solubility/√molecular weight

25
Q

Diffusion Capacity (DL) =

A

AD/T

26
Q

What happens to DL during exercise?

How? (2)

A

↑ during exercise

1) surface area ↑ (more capillaries open and more stretch on alveoli)
2) thickness ↓ (stretch thins membrane)

27
Q

What does emphysema do to DL ?

How?

A

↓ DL

breaks down A wall ->

↓ surface area (A)

28
Q

What does Pulm Fibrosis do to DL ?

How?

A

↓ DL

↑ fibrous tissue ->

↑ diffusion distance (T)

29
Q

What does Pneumonia do to DL ?

How?

A

↓ DL

fluid in A ->

↑ diffusion distance (T)

30
Q

What does CHF do to DL ?

How?

A

↓ DL

edema ->

↑ diffusion distance (T)

31
Q

DL estimated w/ what test?

A

single breath CO test

32
Q

What ultimately limits the O2 take-up in the lungs?

A

perfusion:

blood Po2 quickly equalizes PAo2 at start of capillary (0.25 sec),

happens well before diffusion comes into play (0.75 sec)

33
Q

When would O2 become diffusion limited instead of perfusion limited? (2)

A

1) insufficient time for equilibrium
2) low DL