Pulmonary Blood Flow, Gas Exchange and Transport Flashcards
Bronchial circulation
- Bronchial arteries arise from thoracic aorta
- Nutritive (airway smooth muscle, nerves and lung tissue)
Pulmonary circulation
- Pulmonary artery carries entire CO from RV and supplies dense capillary network around alveoli
- Pulmonary vein returns oxygenated blood to the LA of the heart
- High flow, low pressure (25/8mmHg)
Dalton’s Law
Sum of pressures of individual gases = total pressure of gas mixture
Charles’ Law
Volume occupied by gas is directly related to the absolute temperature
Henry’s Law
Volume of gas dissolved in liquid is determined by:
- Pressure of gas
- Solubility of gas in liquid
Difference between partial pressure and gas content
Partial pressure of a gas is related to the concentration of that gas in the gas content
Diffusion
Air diffuses across a permeable membrane down partial pressure gradient until equilibrium is reached
Alveolar PO2
100 mmHg
13.3 kPa
Alveolar PCO2
40 mmHg
5.3 kPa
Arterial PO2
100 mmHg
- 3 kPa
- determined by diffusion
Arterial PCO2
40 mmHg
5.3 kPa
Venous PO2
40 mmHg
5.3 kPa
Venous PCO2
46 mmHg
6.2 kPa
4 factors affecting gas exchange
Directly proportional to:
- Partial pressure gradient
- Gas solubility
- Available surface area
Indirectly proportional to:
4. Thickness of the membrane
Oxygen diffusion
Large partial pressure gradient (100->40)
Low solubility
Carbon dioxide diffusion
Small partial pressure gradient (46->40)
High solubility so faster than oxygen
Thickness of the membrane
- Type I pneumocytes (simple squamous epithelium)
- Alveolar macrophages ingest foreign material in alveoli
Oxygen demand of resting tissues
250 ml/min
Oxygen carrying capacity of plasma
3 ml/min
- 15ml/min to tissues
Oxygen carrying capacity of haemoglobin
200 ml/min
- 1000ml/min to tissues (only 25% is extracted)
Haemoglobin
- Co-operatively binds 4 molecules of oxygen
- 1.34ml oxygen per gram
- 92% HbA
- 8% HbA2, HbF and glycosylated Hb
Determinant of oxygen saturation of haemoglobin
Partial pressure of oxygen in arterial blood (plasma)
- 0.25s (0.75s transmit time)
- Haemoglobin sequesters oxygen from plasma maintaining the partial pressure gradient
Oxyhaemoglobin dissociation curve
Curve that plots the proportion of haemoglobin in its saturated form against the partial pressure of oxygen
PO2 of 100mmHg (normal systemic arterial PO2)
Haemoglobin is almost 100% saturated
PO2 of 60mmHg
Haemoglobin is 90% saturated
PO2 of 40mmHg (normal venous PO2)
Haemoglobin is 75% saturated
Causes of anaemia
Compromised oxygen-carrying capacity of blood
- Iron deficiency
- Haemorrhage
- B12 deficiency
PaO2 in anaemic patient
Normal (roughly 100%), despite total blood oxygen low
Decreased haemoglobin affinity for oxygen
- Decreased pH
- Increased PCO2
- Increased temperature
- Added 2,3-DPG
Increased haemoglobin affinity for oxygen
- Increased pH
- Decreased PCO2
- Decreased temperature
- No 2,3-DPG
2,3-DPG: Production and Function
- By erythrocytes
- In situations associated with inadequate oxygen supply
- It helps maintain oxygen unloading in tissues
Foetal haemoglobin
Greater affinity for oxygen that HbA
- Necessary for extracting maternal blood
Myoglobin (protein in oxidative muscle fibres) haemoglobin
Greater affinity for oxygen than HbA (and HbF)
Carbon dioxide transport: tissues to blood
- 7% in plasma
- 23% combines with deoxyhaemoglobin to form carbamino compounds
1. 70% combines with water (+carbonic anhydrase) in RBC to form carbonic anhydrase
2. Carbonic anhydrase dissociates to bicarbonate and H+
3. Bicarbonate moves out of RBC (chloride shift)
Carbon dioxide transport: pulmonary capillaries
- Bicarbonate moves into RBC in exchange for Cl-
- Bicarbonate + H+ combine forming carbonic acid
- Carbonic acid dissociates
- CO2 moves down its partial pressure gradient from blood to alveoli
Ventilation
Air getting to alveoli (L/min)
Perfusion
Local blood flow (L/min)
Distribution of pulmonary circulation: 2 factors
- Hydrostatic (blood) pressure
- Alveolar pressure
Lung base: high blood flow
- Arterial pressure exceeds alveolar pressure
- Vascular resistance is low
Lung apex: low blood flow
- Alveolar pressure exceeds arterial pressure
- Vascular resistance is high (compression of arterioles)
Surface anatomy where ventilation and perfusion are matched
Rib 3
Ventilation < Perfusion
“shunt”
- Pulmonary vasoconstriction (divert to better ventilated areas)
- Mild bronchodilation (increased PCO2)
Ventilation > Perfusion
“Alveolar dead space” - alveoli are ventilated but not perfused.
- Pulmonary vasodilation
- Bronchoconstriction (decreased PCO2)
Anatomical dead space
Air in conducting zone of respiratory tract unable to participate in gas exchange
Physiological dead space
Alveolar dead space + anatomical dead space