Matching ventillation to perfusion requirements Flashcards

1
Q

What is Henry’s law?

A

The law that states that gasis in contact with liquid will dissolve in the liquid in proportion to its partial pressure.

At equilibrium partial pressures in alveoli and capillaries will be equal.

Alveoli - Capillary (A - a gradient) gradient determines the direction of diffusion.

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2
Q

What makes O2 and CO2 good for gas exchange?

A

They are easily able to cross cell membranes and are soluble in aqueous solution

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3
Q

What is partial pressure?

A

Percentage pressure caused by a certain gas

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4
Q

What is the total pressure of air at sea level?

A

760mmHg (partial pressures of different gases are a proportion of this number)

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5
Q

What do gases depend on in addition to partial pressure to determine how much they dissolve in a liquid?

A

Solubility (which is why very little N2 dissolves in water)

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6
Q

What is more soluble in water? CO2 or O2?

A

CO2 is 20 times more soluble in water than O2. Very little N2 dissolves in water.

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7
Q

What happens to oxygen partial pressure when air enters the alveoli?

A

It drops due to presence of residual air in the alveoli that is rich in CO2. (drops from 150 - 100 mmHg)

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8
Q

What determines the time it takes for O2 and CO2 to reach equilibrium in the alveoli?

A

Fick’s law of diffusion describes the parameters that are important for the lungs:

Distance

Solubility (CO2>O2)

Surface Area

Concentration gradient

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9
Q

How long do RBCs spend in pulmonary capillaries?

A

0.8 seconds at rest

Less time if exercising

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10
Q

How long do RBCs need to spend in the lungs to reach equilibrium with pressure in normal functioning lungs?

A

0.25 to reach maximal loading

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11
Q

What happens if distance is increased between air and capillaries?

A

Equilibration time increases dramatically

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12
Q

Which conditions cause an increase in diffusion distance?

A

Pneumonia

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13
Q

How can partial pressure of oxygen be decreased?

A

Going to higher elevations

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14
Q

What does exercise do to equilibration time?

A

It decreases time due to faster movement of blood through the pulmonary capillaries

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15
Q

What can limit pulmonary gas exchange?

A

Low inspired oxygen (PiO2)

Hypoventilation (high ventilation rate and low lung volume can cause this)

Diffusion limitations (Can be caused by anything disturbing the alveolar - arterial PO2 difference)

Ventilation - Perfusion mismatching (Right to left shunts can cause this)

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16
Q

What is the Va/Q ratio?

A

Ratio of air reaching alveoli to blood reaching alveoli

17
Q

What is normal Va/Q ratio?

A
Va= 4.2L/min of air 
Q = 5L/min

Va/Q=0.84

18
Q

What does a low Va/Q ratio tell us?

A

Impaired ventilation and so there is a shunt of blood from left to right past the alveoli without sufficient oxygenation

19
Q

What does a high Va/Q ratio tell us?

A

Impaired perfusion which indicates dead space

20
Q

How does the body solve the issue of ventilation-perfusion mismatch?

A

Autoregulation:

Alveolar change in PO2 causes change in arteriole diameter (vasodilation)

Alveolar PCO2 causes change in bronchiole diameter (Bronchodilation)

21
Q

What happens when alveolar oxygen increases?

A

Arterioles dilate to take oxygen in

22
Q

What happens when alveolar oxygen decreases?

A

Arterioles are constricted

23
Q

What happens when alveolar CO2 is increased?

A

Bronchodilation to get rid of excess CO2

24
Q

What happens to ventillation in a shunted alveolar supply?

A

No alveolar ventilation and no oxygenation of blood. Alveolar air instead equilibrates with venous blood O2 and CO2 resulting in no exchange.

25
Q

What happens to ventilation in dead space?

A

No capillary blood flow = wasted ventilation. This results in alveoli equilibrating to atmospheric air because there is no CO2 being released.

26
Q

How does the heart’s hydrostatic pressure affect Va and Q? Why does this matter?

A

Q = hydrostatic P is greater lower, so stronger flow. Lung is centered vertically around the heart. Part of the lung is above and part is below. Top part is going to be underperfused and lower part of the lung will be overperfused.. This matters because it means that parts of the heart would be problematic to remove by surgery.

27
Q

What common pathology would result in a high Va/Q ratio?

A

Pulmonary embolism

28
Q

What common pathology would result in low Va/Q?

A

Chronic bronchitis, asthma, pulmonary oedema

29
Q

What affects haemoglobin release of oxygen?

A

pH (lower pH results in more O2 release)

Temperature (higher temperature allow more release of oxygen)

Increase in CO2 results in more O2 release.

30
Q

What causes more O2 loading?

A

Alkaline pH

Low temperature

Low PCO2 (Bohr effect)

31
Q

Where is CO2 located on in the blood?

A

7% is dissolved

20% binds with proteins and is known as carbamino binding (most is bound to terminal groups of Hb. R-NH groups can always bind to CO2)

70% is bicarbonate (CO2 + H2O H2CO3 H+ + HCO3)-

32
Q

What does carbonic anhydrase do?

A

It speeds up the conversion of CO2 + H2O H2CO3 reaction

33
Q

How are the 3 methods of CO2 different to each other?

A

They are more or less labile than each other. I.e Bicarb takes time to produce so it takes a long time to release CO2 from it in the lungs. Carbonic anhydrase makes this method 5000x faster in RBCs.

34
Q

Where is most of the CO2 unloaded at the lungs?

A

In the carbamino and dissolved CO2 groups

35
Q

What is the relationship between CO2 loading and O2 bound? What is the effect called?

A

More O2 bound = less affinity for CO2 and vice versa. This is called the haldane effect (same as bohr effect but for CO2).