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CPR Test 2 > Gas Transport and Erythrocyte Physiology > Flashcards

Gas Transport and Erythrocyte Physiology Flashcards

1
Q

What are the functions of blood

A

Deliver nutrients and oxygen

Removes waste products

Maintain Homeostasis

Circulation

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2
Q

what is the hematocrit of a women, men, newborn, and 2 mo old

what is the functions of the erythrocytes

A

40% women
45% men
55% newborn
35% 2 mo old

Carrying O2 from lungs to the body
Carrying CO2 from body to lung
Acid/base buffering

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3
Q

What is the process of Erythropoiesis

A

start as Hematopoietic Stem cells then will turn to a Proerythroblast
then will go to a Normoblast
Reticulocyte
finally a Erythrocyte

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4
Q

what is the principle regulator, where is it produced and what is the transcription factor to produce red blood cells

A

Erythropoietin (EPO) is the principle regulator

Produced by kidneys in response to anemia, low Hb, decreased renal blood flow (RBF), central hypoxia, low blood volume

Erythropoietin is regulated by the transcription factor Hypoxia inducible factor (HIF)
-impaired regulationn can lead to anemia, mutations in polycythemia, and also (too many RBC)

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5
Q

take me through the Erythrocyte life cycle, and the outcome of Heme

A

Red blood will rupture in the spleen and then will get ingested by monocyte-macrophage immediately

Fe3+ is removed from the Heme making it biliverdin, then converted to bilirubin

Bilirubin then circulates to the liver where it is sent to the small then large intestine where it is converted to Uroblinogen

some Uroblinogen will stay in large intestine and convert to stercoblin where it is pooped out

some Uroblinogen goes to the kidney where it is peed out as Uroblin

as far as the Fe3+ it is carried on transferrin to liver where it is converted to Ferritin

then taken to the bone marrow where it is converted back to Fe2+ and used by body

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6
Q

what are the two ways that oxygen is transported in the blood? which one is more significant

A

Dissolved into the blood
-only gets about 3ml O2/L Blood

or

Bound to the Hemoglobin (majority is done this way)
-since body can need up to 3000ml O2/L Blood

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7
Q

what are the types of hemoglobin chains and which ones are found in adults and fetal form? how much hemoglobin are in an adult?

A

Types of hemoglobin chains: alpha, Beta, delta, gamma

Adult form: 2 alpha and 2 beta chains called hemoglobin A

fetal: 2 alpha and 2 gamma chains
Hemoglobin F

these can carry 4 O2 molecules

Normal blood hemoglobin 14.0 g/dL in adult female and 15.5 g/dL in adult male will round avg to 15

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8
Q

what are the axis of the oxygen dissociation curve

A

x axis: PO2 mmHg of blood

y axis right: O2 concentration in blood

y axis left: Oxygen saturation or % Hb saturation
-% available binding sites in Hb that have oxygen bound

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9
Q

what is the normal Oxygen concentration in the blood?

A

15g Hb x 1.34 mL O2 = 20.1 mL of O2/dL blood

the 1.34 mL is a constant that Hb can bind too

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10
Q

what is the Oxygen saturation and PO2 for the venous and arterial blood

A

Arterial: PaO2 100 mmHg, O2 saturation about 97.5%

Venous: PvO2 40 mmHg, O2 satuuration is 75%

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11
Q

If the PaO2 is greater than 60 mmHg what is the % Hb saturation at or above on an oxygen dissociation curve

A

if the PaO2 is greater than 60 mmHg then the O2 saturation is at least 85 percent or higher

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12
Q

where does the location of shift normal occur on the oxygen dissociation curve

A

P50 = 50% Hb saturation

Normally 27 mmHg

can shift left or right depending on the situation

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13
Q

what is the advantage of how the Oxygen dissociation curve works

A

At normal or high levels of PO2 (60 or higher) the oxygen readily binds to Hb and Hb readily hangs on to oxygen really tight (top of the curve)

at tissue level PO2 levels when the oxygen levels are much lower, the oxygen readily jumps off Hb and Hb readily releases oxygen (good for giving oxygen to O2 hungry tissue)

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14
Q

how does the Hb concentration affect the oxygen dissociation curve?

A

if there is an Hb concentration decrease the oxygen carrying capacity will decrease regardless of O2 saturation

if there is an Hb concentration increase the oxygen carrying capacity will increase regardless of O2 saturation

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15
Q

what represents a left shift in the Oxygen dissociation curve?

A

Represents an increased affinity of Hb for O2

  • associated with:
  • Polycythemia
  • Methemoglobinemia
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16
Q

what represents a right shift in oxygen dissociation curve

A

Represents a decreased affinity for Hb for O2
associated with:
-anemia
-advantageous for unloading oxygen
-excersise
(acidic, warm, high CO2 production (hypercarbic) all cause right shift)
(2,3-DPG/BPG, end point of RBC metabolism )
-more of it during chronic hypoxia

17
Q

what are some general red blood cell disorders

A 
Anemia of blood loss
Anemia of chronic disease
Hemolytic anemias
Anemias of diminished erythropoiesis
Polycythemia
18
Q

what is required for erythropoiesis

A

Adequate nutrition

Vitamin B12 (cynocobalamin, cobalamin) and folate (B9) required for DNA synthesis

Iron availabillity- absorption, transport, and storage

19
Q

what does a Folate or B12 deficiency result in?

what does Poor B12 absorption lead to

A

Folate or B12 deficiency results in Megalobastic macrocytic anemia

poor B12 absorption leads to Pernicious anemia

20
Q

Microcytic anemia

A

Deficiency in Iron

  • circulates in plasma as transferrin
  • need absorption of approximately 1mg/d in men and 1.4 mg/d in women from diet to maintain homeostasis
21
Q

Hypochromic anemia

A

Deficient transport of transferrin to developing erythrocytes

22
Q

how does ATP contribute to Iron

A

ATP contributes to the membrane flexibility

Maintains iron if FE+2 (ferrous state) rather than Fe+3 (ferric state)

helps in Ion transport and will help prevent oxidative damage

23
Q

Hemachromatosis and the 3 types of causes

A

Iron overload leading toliver cirrhosis, skin pigmentation, and diabetes mellitus

Primary/genetic

Secondary:

  • multiple blood transfusions
  • ineffective erythropoiesis
  • increased iron intake

Neonatal:

  • develops in utero
  • unknown cause
24
Q

How does anemia affect the oxygen dissociation curve

A

Anemia will decrease oxygen carrying capacity

this causes a right shift due to the less carrying capacity

the Hemoglobin concentration is proportional to blood oxygen content
-1/2 hemoglobin concentration means roughly 1/2 blood oxygen content

However, % Hb saturation does not change

25
Q

what are the three different types of Polycythemia and their corresponding characteristics

A

Primary Polycythemia

  • Genetic (low EPO)
  • Extra RBCs
  • increased total blood volume (2x)
  • Increased Viscosity (10x water)
  • Normalish cardiac outpuut

Secondary Polycythemia

  • Hypoxia (high EPO)
  • Extra RBCs
  • Cardiac output may be abnormal

Physiologic Polycythemia

  • High altitude adaptation
  • extra RBCs
  • Normal cardiac output
26
Q

Methemoglobinemia

A
  • Increased met-hemoglobin
  • Iron is ferric form (Fe3+)
  • Decreased oxygen availabillity to tissues
  • Leftward shift of oxygen-hemoglobin disassociation curve
  • Blood is chocolate colored
  • Caucasian skin appears blue
27
Q

what is the A-V O2 difference used for

A

difference between arterial blood O2 content versus venous blood O2 content

used to describe the oxygen consumption for the tissue

difference is how much O2 was used

28
Q

what are the three ways that carbon dioxide is transported

A

Dissolved CO2

  • not enogh to rely on dissolved transport alone
  • 2.7ml CO2/dL Blood
  • we produce 200 ml CO2

Carbamino compounds

  • CO2 binds plasma proteins or Hb (amine group)
  • Haldane shift: presence of O2 reduces affinity of amine chain for CO2
  • 3ml CO2/dL Blood

as HCO3
-44 ml CO2/dL BLood

29
Q

how is CO2 transported and converted to Bicarbonate

A

CO2 is produced and exits from the tissue and enters the RBC

Carbonic anhydrase in RBC hydrates CO2 to form H2CO3

H2CO3 dissociates H+ and HCO3-

H+ is buffered in RBCs by deoxyhemoglobin ad carried in venous blood here

HCO3- produced is exchanged for Cl- across RBCs and carried to lungs (chloride shift/hamburg shift)

30
Q

what happens to the CO2 at the lungs

A

Dissolved CO2 moves down its concentration gradient into the alveoli

CO2 dissociates from proteins

HCO3- is converted back to CO2 at the lungs

31
Q

Volume carried in blood, Major form transported, Volume dissolved, and other forms: O2 transport

A

Volume carried in blood: 20ml O2/dL blood

Major form transported: Bound to heme in Hb

Volume dissolved: O.3 ml O2/dL blood

Other forms: None

32
Q

Volume carried in blood, Major form transported, Volume dissolved, and other forms: CO2 transport

A

Volume carried in blood: 50ml O2/dL blood

Major form transported: HCO3

Volume dissolved: 3 ml O2/dL blood

Other forms: Carbamino compounds

CPR Test 2 (25 decks)

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