Respiratory physiology 2: Transport and regulation of respiratory gasses Flashcards

1
Q

O2 is transported in the blood by it dissolving into plasma, why isn’t this sufficient?
How do we then meet our demands?

A

-*Protein-bound O2
The vast majority of O2 (98%) is transported bound to haemoglobin in erythrocytes

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2
Q

What is the structure and function of haemoglobin?

A
  • Quaternary structure protein (1/3 of RBC weight)
  • 4 globin proteins:
    > mostly 2 β and 2 α chains> HbA
  • 4 hemes: a Fe2+ ion bound to a porphyrin ring
  • ROLES: fully reversible binding to O2 and CO2 to allow for transport in the blood, buffering agent as it can bind and unbind H+ to ensure minimal changes in pH
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3
Q

What are the 2 confirmations of Hb?

A
  1. Tensed (T) state which has low affinity for O2
  2. Relaxed (R) state which has high affinity for O2
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4
Q

Why is the O2-Hb dissociation curve sigmoidal?

A
  1. At low pO2, Hb is in the T state which has low affinity for O2. >There is therefore a low probability for Hb to bind to an O2 molecule
  2. As the pO2 rises, the probability for O2 to bind to Hb increases
    >When eventually an O2 binds to 1 Hb subunit, this induces a conformational change within that subunit
  3. This conformational change in 1 Hb subunit pulls on the weak non-covalent salt bridges linking all the subunits together, increasing the probability that they break
  4. Disruption of the salt bridges causes all the other subunits of the Hb molecule to change to the relaxed (R) form
    >In this form, the O2 binding site is more exposed, thus increasing the O2 affinity of Hb (x150)
  5. Thus as the pO2 rises, more Hb molecules change from the low affinity T form, to the high affinity R form
    > As this happens the affinity of the overall Hb population for O2 increases
    > Thus for a given step increase in pO2, more O2 is bound to Hb and the gradient of the dissociation curve increases
  6. At high pO2, affinity of Hb for O2 is maximal and all Hb is in the R form and all O2 binding sites on Hb are occupied (saturated)
    > At this point Hb cannot bind any more O2 for any given step increase in pO2
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5
Q

Application:

  1. How is O2 loaded in pulmonary capillaries?
  2. How does Hb ensure that O2 is only delivered to metabolically active tissues?
  3. How is O2 unloaded at actively respiring tissues?
  4. What makes Hb an excellent reversible carrier?
A

1.PaO2 is “high” - Hb has high affinity for O2 → O2 rapidly and reversibly binds to Hb in erythrocytes

2.pO2 falls slowly → Hb still has high affinity →little O2 is released.

3.PO2 is “low” (PCO2 + [H+] are “high”)→ Some Hb switches
from high to low affinity form, triggering unloading of O2.

  1. Switch between high and low affinity
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6
Q

At rest/basic metabolic needs how much O2 to we need per min?

A
  • 250Ml/min
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7
Q

How can more O2 be delivered to tissues with increased
metabolic demands (e.g. skeletal muscles during exercise)?

A
  • Environmental changes in the capillaries supplying metabolically active tissues facilitate unloading of O2 from haemoglobin
    > small increase in temperature, >increase in PCO2 level and >reduction in pH
  1. H+ and CO2 individually react with Hb (not at O2 binding site) causing a decrease in Hb affinity for O2
    > This allows for increased O2 delivery in metabolically active tissues

-. This shows up as a right-sided shift in Hb-O2 dissociation curve

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8
Q

Why is ensuring efficient CO2 removal important?

A

-Maintain the pH of the blood.
>An increase in arterial pCO2 will cause a drop in arterial pH

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9
Q

Can CO2 dissolve directly into the blood?

A

-Yes :
>Limited solubility of CO2 limits the quantity of CO2 that is transported dissolved in the plasma and cytosol of erythrocyte
>Only 10%

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10
Q

Describe the 3 ways of CO2 transport from respiring tissues to the lungs.

A
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11
Q

How is CO2 released at the lungs?

A
  • Decrease PCO2 ,
  • Increase PO2 > diffuses into RBC binds with Hb at haem group
    > O2 alters Hb shape slightly , reduces Hb affinity for CO2 and H+
    » HALDANE EFFECT:
    *CO2 dissociation curve shifts downwards > total blood CO2 content decreases

-The more O2 that binds to Hb the more CO2 and H+ unbinds
-The reduction in pH causes the reaction catalysed by carbonic anhydrase (CA) to reverse
- HCO3- enters RBC from plasma down conc gradient > makes CO2
- PCO2 increases pushing CO2 down partial pressure gradient from RBC into plasma into alveoli
-CO2 expired

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12
Q

What is the difference between total ventilation rate and alveolar ventilation rate?

A
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13
Q

What do neurones in the brain stem fire?

A

-Intrinsic periodic action potential firing
> subconscious & rhythmical coordinated activation of respiratory skeletal muscle

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14
Q
  1. What is ventilation controlled by?
  2. What does the respiratory centre consist of?
  3. What is the *medullary respiratory centre responsible for?
  4. What are the Pons responsible for?
  5. What else modules ventilation?
A
  1. Somatic nervous system
  2. Medulla + Pons
  3. Neurons in the respiratory centre in the medulla are essential for ventilation:
    ➢Dorsal Respiratory Group (DRG) neurons – active during normal inspiration
    ➢Ventral Respiratory Group (VRG) neurons – active during forced expiration and inspiration
  4. Areas in pons modulates ventilation
  5. Sensory inputs to DRG and voluntary behaviours modulate ventilation
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15
Q

What factors stimulate/inhibit ?
-Voluntary behaviour
-Emotions
-Sensory input

A

> Sensory inputs
- Chemoreceptors (peripheral and central (medullary)) +
- Receptors in muscles and joints +
- Stretch receptors in lungs to limit overextension of lungs -
- Mechanoreceptors and irritant receptors -

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16
Q

What are the 2 types of sensors?

A
  1. Central chemoreceptors
  2. Peripheral chemoreceptors
    >Carotid bodies
    >Aortic bodies
17
Q
  1. Where are Central chemoreceptors found?
  2. What does it respond to changes in?
  3. What are the central chemoreceptors responsible for?
A
  1. Medulla oblongata
  2. Respond to changes in arterial PCO2 via alteration in pH of the cerebrospinal fluid (CSF) - indirectly :
    -HOW?
    1.Dissolved CO2 diffuse through the blood-brain-
    barrier (while blood H+ and HCO3- cannot)
    2.Carbonic anhydrase in the CSF catalyses the formation of HCO3- and H+ from CO2 and H2O
    3.H+ derived from this reaction increase the AP firing rate of chemosensitive neurons
  3. Tonic ventilatory drive, meaning that they are always firing, and the firing rate changes according to amount of H+ detected
    65-80% of the ventilatory response to changes in blood gases is mediated by central chemoreceptors in the medulla …> 10min for response tho
18
Q
  1. Where are peripheral receptors found?
  2. What sensory neurons are they innervated by?
A

> Carotid bodies:
1. Bilaterally at the bifurcation of each common carotid artery
2.Afferent fibres of glossopharyngeal nerve (CN IX)

> Aortic bodies
1. Underside of the aortic arch
2.Afferent fibres of the vagus nerve (CN X)

19
Q

What are some features of peripheral receptors?

A
  • Small
  • High metabolic rate
  • Very high arterial blood flow
  • Complex structures made of glomus cells, arterioles, sinusoids, afferent and efferent neurones
20
Q

How do peripheral receptors respond to change?

A
  1. Glomus cells detect changes in arterial pO2
  2. Unknown receptor activated by decreased arterial pO2
  3. K+ channels close
  4. Depolarisation
  5. Opening of VG Ca2+ channels
  6. Increased Influx of Ca2+ in glomus cells
  7. Exocytosis of neurotransmitter
  8. Increased AP firing in sensory neurones
21
Q

What do peripheral chemoreceptors mainly sense?

What if they sense decreased pH and increased pCO2?

A

-A decrease in pO2 of the blood → hypoxaemia

-Increase sensitivity of carotid bodies (upward shift) > Contributes significantly to respiratory drive when PaO2 is quite low (~50mmHg)

22
Q

What is the key function of the control centre?

A

-Reference set point is compared to information from sensor
»Error signal is calculated and sent from control centre

23
Q

How is ventilation rate adjusted through negative feedback?

A
24
Q

What is the effect of ventilation rate on alveolar PCO2 and PO2 ?
- Alveolar ventilation increases

A
  • Alveola PACO2 decreases and so Capillary PaCO2 decreases
  • Alveola PAO2 increases and so capillary PaO2 increases
25
Q

Why does increasing the alveolar ventilation, for a normoxic patient who requires more O2 due to having a higher metabolic demand, have a limited effect?

So how can you enhance the rate of O2 uptake and delivery instead?

A

-Hard to transport more O2 as it has a low solubility in plasma, and there is limited extra carrying capacity of Hb as it is already 98% saturated

-Increase cardiac output (the volume of blood pumped by the heart in 1 minute)

26
Q

Short term compensation for fall in arterial pO2/ and or rise in pCO2?

A
  1. Increased firing of chemoreceptors
  2. Increased ventilation
  3. Decreased arterial pCO2 and increased lung stretch
  4. Inhibition of the cardio-inhibitory centre in the medulla
  5. Tachycardia to increase HR
  6. Increase cardiac output
27
Q

Long term adaptation to low pO2
-2 ADAPTATIONS

A