Gas Transport and Lung Perfusion

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Questions and Answers

What is the significance of the large surface area (SA) provided by the capillary network in the lungs?

  • It decreases the blood flow to the lungs.
  • It reduces the diffusion distance for gas exchange.
  • It ensures efficient gas exchange between alveoli and blood. (correct)
  • It increases the resistance in the pulmonary vessels.

How does gravity affect lung perfusion?

  • Gravity only affects ventilation, not perfusion.
  • Perfusion is equal throughout the entire lung, regardless of gravity.
  • Perfusion is greater at the top of the lungs due to less gravitational effect.
  • Perfusion is greater at the bottom of the lungs due to increased blood flow. (correct)

What is the primary role of chemoreceptors in the respiratory control system?

  • To detect changes in arterial $PCO_2$, $PO_2$, and pH. (correct)
  • To increase or decrease the feedback loop.
  • To control the alveolar ventilation rate.
  • To regulate the rate of breathing muscles.

How do the lungs maintain low resistance in the pulmonary vessels?

<p>By having low resistance and high compliance in the pulmonary vessels. (A)</p> Signup and view all the answers

Where does lung perfusion receive blood supply from?

<p>From the pulmonary and systemic circulation. (D)</p> Signup and view all the answers

Which factor directly impacts the efficiency of gas exchange in the lungs?

<p>Alveolar distribution and blood flow in all parts of the lungs. (D)</p> Signup and view all the answers

How do the respiratory centers respond to signals from chemoreceptors when arterial $PCO_2$ increases?

<p>By increasing ventilation rate and depth. (C)</p> Signup and view all the answers

Which of the following is NOT a function that contributes to homeostasis and control of respiration?

<p>Sensory adaptation (D)</p> Signup and view all the answers

What effect would decreased blood pH have on ventilation?

<p>It would increase ventilation. (C)</p> Signup and view all the answers

How would increased alveolar ventilation rate most directly affect arterial $PCO_2$?

<p>Decrease arterial $PCO_2$ (C)</p> Signup and view all the answers

In the context of lung perfusion, what is the consequence of low blood flow to certain regions of the lung?

<p>Reduced gas exchange efficiency in those regions (C)</p> Signup and view all the answers

Which of the following correctly describes the relationship between ventilation and perfusion in an ideal scenario?

<p>Ventilation and perfusion are matched to optimize gas exchange. (B)</p> Signup and view all the answers

How does the position of a person (e.g., standing vs. lying down) influence the distribution of ventilation and perfusion in the lungs?

<p>Posture affects both ventilation and perfusion distribution due to gravity-related factors. (C)</p> Signup and view all the answers

What is the primary function of the pulmonary circulation?

<p>To facilitate gas exchange by bringing blood to the alveoli for oxygenation. (C)</p> Signup and view all the answers

Pulmonary vessels typically have which characteristics?

<p>Thin walls and low resistance. (B)</p> Signup and view all the answers

Which of the following conditions would likely stimulate an increase in ventilation via chemoreceptors?

<p>A decrease in arterial $PO_2$. (A)</p> Signup and view all the answers

If the capillary network in the lungs were stretched out end to end, approximately how long would it be?

<p>1,600 km (D)</p> Signup and view all the answers

During exercise, what changes occur to ventilation and perfusion in order to meet the increased metabolic demands of the body?

<p>Ventilation and perfusion both increase to enhance gas exchange. (C)</p> Signup and view all the answers

In a healthy individual at rest, what is the primary determinant of the baseline ventilation rate?

<p>The level of arterial carbon dioxide ($PCO_2$). (D)</p> Signup and view all the answers

What is the role of respiratory muscles in the feedback loop of respiratory control?

<p>To carry out the changes in ventilation dictated by respiratory control centers (B)</p> Signup and view all the answers

How does the thinness of the capillaries surrounding the alveoli directly benefit gas exchange in the lungs?

<p>It reduces the distance for gas diffusion, enhancing the rate of exchange. (A)</p> Signup and view all the answers

What is the functional relationship between an arteriole and a venule within a lung lobule?

<p>Arterioles supply oxygenated blood to the lobule for gas exchange, and venules drain deoxygenated blood away. (A)</p> Signup and view all the answers

How does the release of Angiotensin-Converting Enzyme (ACE) by endothelial cells of alveolar capillaries contribute to systemic homeostasis?

<p>It regulates blood pressure, influencing overall cardiovascular function. (A)</p> Signup and view all the answers

Tracing a red blood cell's path through the heart and lungs, which sequence accurately describes its journey?

<p>RHA → right heart valve → RHV → pulmonary artery → lungs → LHA → left heart valve → LHV (A)</p> Signup and view all the answers

What is the primary mechanism by which carbon dioxide ($CO_2$) moves from the tissues into the lungs for exhalation?

<p>Diffusion down a concentration gradient, from areas of high $CO_2$ concentration in the tissues to areas of low $CO_2$ concentration in the lungs. (A)</p> Signup and view all the answers

Why is carbon dioxide ($CO_2$) considered to be more easily diffused across the alveolar membrane compared to oxygen ($O_2$)?

<p>$CO_2$ is approximately 24 times more soluble in blood than $O_2$, enhancing its diffusion rate. (A)</p> Signup and view all the answers

How does the cooperative binding of oxygen to hemoglobin enhance the efficiency of oxygen transport in the blood?

<p>It makes the binding of each subsequent oxygen molecule easier, increasing hemoglobin's affinity for oxygen as more molecules bind. (A)</p> Signup and view all the answers

What role does the iron core within each heme group of hemoglobin play in oxygen transport?

<p>It provides the binding site for one oxygen molecule, with each hemoglobin molecule containing four such sites. (D)</p> Signup and view all the answers

What is the approximate percentage of oxygen ($O_2$) that binds to hemoglobin (Hb) to form oxyhemoglobin ($HbO_2$)?

<p>98% (D)</p> Signup and view all the answers

If a patient has a condition that reduces the number of functional hemoglobin molecules in their blood, how would this directly impact oxygen delivery to the tissues?

<p>It would decrease the total number of oxygen binding sites, reducing the amount of oxygen that can be transported. (A)</p> Signup and view all the answers

Which sequence accurately represents the flow of blood through the heart and pulmonary system?

<p>Right Atrium → Right Ventricle → Pulmonary Artery → Lungs → Pulmonary Vein → Left Atrium (B)</p> Signup and view all the answers

How does the concentration gradient facilitate the movement of carbon dioxide ($CO_2$) from cells into the bloodstream?

<p>Cells produce $CO_2$ as a byproduct of metabolism, resulting in higher concentrations compared to the blood, driving diffusion into the bloodstream. (B)</p> Signup and view all the answers

What would be the immediate effect on oxygen transport if a drug competitively binds to the iron core of hemoglobin?

<p>Reduced oxygen binding capacity of hemoglobin. (D)</p> Signup and view all the answers

Which of the following correctly describes the relationship between plasma oxygen, % saturation of Hb, and total number of Hb binding sites?

<p>Plasma oxygen alongside the amount of hemoglobin determines % saturation of Hb which multiplied by the total number of Hb binding sites allows us to calculate amount of $O_2$ bound to Hb. (D)</p> Signup and view all the answers

How might significant damage to lung tissue, reducing the surface area available for gas exchange, impact the cardiovascular system's function?

<p>Increased workload on the heart to circulate blood more efficiently to compensate for reduced oxygenation. (B)</p> Signup and view all the answers

How does stenosis (narrowing) of the pulmonary artery influence gas exchange in the lungs?

<p>Reduces blood flow to the alveoli, potentially impairing both oxygen uptake and carbon dioxide removal. (C)</p> Signup and view all the answers

What compensatory mechanism might the body employ if the carrying capacity of hemoglobin for oxygen is significantly reduced due to chronic anemia?

<p>Increased cardiac output and ventilation to deliver more oxygen to tissues. (A)</p> Signup and view all the answers

In a scenario where a person is hyperventilating, what is the likely effect on the oxygen saturation of hemoglobin, assuming initially normal lung function?

<p>Minimal change in oxygen saturation because hemoglobin is already close to fully saturated at normal ventilation rates. (B)</p> Signup and view all the answers

How would an increase in the concentration of plasma proteins affect the movement of oxygen from the alveoli into the blood?

<p>It would negligibly affect oxygen transfer as oxygen primarily binds to hemoglobin inside red blood cells. (C)</p> Signup and view all the answers

What homeostatic challenges would the body face if the endothelial cells of alveolar capillaries were unable to produce Angiotensin-Converting Enzyme (ACE)?

<p>Uncontrolled blood pressure leading to potential cardiovascular instability. (B)</p> Signup and view all the answers

In the context of the oxygen dissociation curve, how does a decreased blood pH (increased acidity) affect hemoglobin's affinity for oxygen and the curve's position?

<p>Decreases hemoglobin's affinity for oxygen, shifting the curve to the right. (D)</p> Signup and view all the answers

How does the sigmoidal shape of the hemoglobin-oxygen dissociation curve contribute to oxygen delivery in the body?

<p>It buffers changes in oxygen concentration in the blood, so small changes in $PO_2$ have minimal impact on oxygen saturation. (B)</p> Signup and view all the answers

What is the likely effect of chronic hypoxia on the oxygen dissociation curve, and why?

<p>Shifts the curve to the right, decreasing hemoglobin's affinity for oxygen to promote oxygen unloading in oxygen-deprived tissues. (D)</p> Signup and view all the answers

Under what conditions would the exchange of carbon dioxide from the tissues into the blood be maximized, according to the principles governing the oxygen dissociation curve?

<p>Low $PO_2$ and low pH in the tissue. (A)</p> Signup and view all the answers

How does the body maintain steady-state alveolar ventilation in relation to partial pressure of carbon dioxide ($PCO_2$)?

<p>Steady-state alveolar ventilation aims to match $PCO_2$ to maintain acid-base balance. (A)</p> Signup and view all the answers

What is the primary implication of a ventilation/perfusion (V/Q) ratio approaching infinity (∞) in a region of the lung?

<p>Ventilation is occurring, but there is no perfusion. (D)</p> Signup and view all the answers

What does a ventilation/perfusion (V/Q) ratio of zero indicate about the conditions in a specific region of the lung?

<p>There is perfusion but no ventilation. (B)</p> Signup and view all the answers

How do small fluctuations in the partial pressure of oxygen ($PO_2$) in the lungs affect the oxygen concentration in the blood, and what characteristic of hemoglobin binding contributes to this?

<p>Small $PO_2$ fluctuations have minimal impact on blood oxygen concentration due to the cooperative binding of oxygen to hemoglobin. (B)</p> Signup and view all the answers

If a person's respiratory quotient (RQ) is consistently around 0.7, what does this suggest about their primary source of energy?

<p>They are primarily metabolizing fats. (D)</p> Signup and view all the answers

How would a higher-than-normal metabolic rate affect the relationship between carbon dioxide production and oxygen absorption in the lungs?

<p>It would increase both carbon dioxide production and oxygen absorption. (B)</p> Signup and view all the answers

Which of the following sets of conditions would result in a shift of the oxygen dissociation curve to the right?

<p>Increased temperature, increased $PCO_2$, decreased pH. (D)</p> Signup and view all the answers

How would you interpret an arterial blood gas result showing a pH of 7.30, $PCO_2$ of 50 mmHg, and a temperature of 38°C, in the context of oxygen binding to hemoglobin?

<p>Decreased hemoglobin affinity for oxygen. (A)</p> Signup and view all the answers

How do hydrogen ions ($H^+$) affect hemoglobin's affinity for oxygen, and what is the underlying mechanism?

<p>$H^+$ decreases hemoglobin's affinity by binding to $Hb$, causing a conformational change. (C)</p> Signup and view all the answers

A patient presents with metabolic alkalosis. How might this condition acutely affect the oxygen dissociation curve and oxygen delivery to the tissues?

<p>Shift to the left, increasing oxygen affinity. (A)</p> Signup and view all the answers

How does an increase in body temperature during strenuous exercise directly influence the release of oxygen from hemoglobin to the muscle tissues?

<p>It decreases hemoglobin's affinity for oxygen, promoting oxygen unloading. (A)</p> Signup and view all the answers

How does the Bohr effect facilitate the release of oxygen specifically in metabolically active tissues like exercising muscle?

<p>By decreasing pH and increasing $PCO_2$, which reduce hemoglobin's oxygen affinity and enhance oxygen unloading. (C)</p> Signup and view all the answers

Consider a scenario where a patient has a condition causing increased levels of hydrogen ions ($H^+$) in their blood. How does this directly impact the hemoglobin saturation curve?

<p>Shifts the curve to the right, enhancing oxygen unloading at the tissues. (D)</p> Signup and view all the answers

A person performing heavy exercise increases both oxygen consumption and carbon dioxide production. How does this affect the oxygen dissociation curve, and why?

<p>Shifts to the right due to increased temperature, $PCO_2$ and decreased pH. (C)</p> Signup and view all the answers

In a scenario where an individual's arterial $PCO_2$ is chronically elevated, how does this impact the delivery of oxygen to peripheral tissues?

<p>Decreases oxygen delivery due to reduced hemoglobin affinity. (C)</p> Signup and view all the answers

How does modifying the temperature from 37°C to 25°C and increasing the pH from 7.40 to 7.55 affect the position of the oxygen dissociation curve and hemoglobin's affinity for oxygen?

<p>Shifts the curve to the left, increasing oxygen affinity. (A)</p> Signup and view all the answers

What is the primary mechanism by which the majority of carbon dioxide is transported from the tissues to the lungs?

<p>Converted into bicarbonate ions within red blood cells. (A)</p> Signup and view all the answers

What is the function of carbonic anhydrase in red blood cells during carbon dioxide transport?

<p>It facilitates the conversion of carbon dioxide and water into bicarbonate and hydrogen ions. (C)</p> Signup and view all the answers

Why does fetal hemoglobin have a higher affinity for oxygen than adult hemoglobin?

<p>Fetal hemoglobin has a different protein structure, resulting in weaker binding to 2,3-DPG. (A)</p> Signup and view all the answers

What effect does an increase in 2,3-diphosphoglycerate (2,3-DPG) levels have on hemoglobin's affinity for oxygen and the oxygen dissociation curve?

<p>Decreases hemoglobin's affinity for oxygen and shifts the curve to the right. (C)</p> Signup and view all the answers

Which of the following conditions would shift the hemoglobin-oxygen dissociation curve to the right?

<p>Increased levels of 2,3-DPG (A)</p> Signup and view all the answers

How does the chloride shift maintain electrochemical neutrality during carbon dioxide transport?

<p>By exchanging bicarbonate ions ($HCO_3^−$) for chloride ions ($Cl^−$) across the red blood cell membrane. (C)</p> Signup and view all the answers

Under what physiological condition would you expect to see an increased production of 2,3-DPG?

<p>During exercise (C)</p> Signup and view all the answers

How does a drop in blood pH affect the binding affinity of hemoglobin for oxygen?

<p>Decreases the binding affinity, causing a rightward shift of the oxygen dissociation curve. (C)</p> Signup and view all the answers

What percentage of carbon dioxide is transported dissolved in the blood?

<p>7% (A)</p> Signup and view all the answers

Through which mechanism is carbon dioxide able to bind to hemoglobin?

<p>Binds to a different site than oxygen. (B)</p> Signup and view all the answers

What is the chemical formula for carbaminohemoglobin, the compound formed when carbon dioxide binds to hemoglobin?

<p>$Hb + CO_2$ (D)</p> Signup and view all the answers

How do increased levels of thyroid hormones and growth hormone potentially influence oxygen delivery to tissues?

<p>By promoting conditions that shift the oxygen dissociation curve to the right, facilitating oxygen release. (C)</p> Signup and view all the answers

How would an increase in blood pH directly affect the oxygen dissociation curve and hemoglobin's affinity for oxygen?

<p>Shift the curve to the left, increasing hemoglobin's affinity. (A)</p> Signup and view all the answers

A patient with chronic hypoventilation is likely to experience which of the following compensatory mechanisms related to oxygen transport?

<p>Increased production of 2,3-DPG. (A)</p> Signup and view all the answers

Which of the following represents the correct ionic exchange that occurs during the chloride shift?

<p>Influx of $Cl^−$ and efflux of $HCO_3^−$. (A)</p> Signup and view all the answers

What condition is directly associated with an increase in thyroid hormones and growth hormone that may affect the oxygen dissociation curve?

<p>Increased metabolic rate. (A)</p> Signup and view all the answers

Which of the following physiological changes occurs during exercise that directly facilitates increased oxygen release from hemoglobin to active muscle tissues?

<p>Decreased blood pH (A)</p> Signup and view all the answers

How does an increase in metabolic activity during exercise directly affect the oxygen dissociation curve?

<p>Shifts the curve to the right due to increased $CO_2$ levels and decreased pH. (B)</p> Signup and view all the answers

What direct effect does an increased concentration of hydrogen ions ($H^+$) in the blood have on the oxygen-hemoglobin saturation curve?

<p>It shifts the curve to the right, decreasing oxygen affinity. (B)</p> Signup and view all the answers

In a scenario where a person is undergoing intense physical activity, which combination of factors would MOST likely promote the unloading of oxygen from hemoglobin in muscle tissues?

<p>Decreased pH, increased temperature, increased $PCO_2$ (C)</p> Signup and view all the answers

Flashcards

Lung perfusion

Blood supply from both pulmonary and systemic circulation to the lungs.

Gas Exchange Efficiency

Efficiency of gas exchange depends on alveolar distribution and blood flow throughout all parts of the lungs.

Capillary Network Size

The extensive capillary network in the lungs has a large surface area (SA); if stretched end to end, it would extend to 1600km.

Pulmonary Resistance

Lungs exhibit low resistance due to low-pressure pulmonary vessels with high compliance.

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Gravity's Effect on Lungs

Gravity affects the lungs, resulting in less perfusion at the top (lower blood flow) and more perfusion at the bottom (higher blood flow).

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Arterial Blood Gases

Arterial levels of PCO2, PO2, and pH are sensed and regulated to maintain homeostasis.

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Chemoreceptors

Structures that detect changes in the concentration of chemicals, such as PCO2, PO2 and pH.

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Respiratory Centers

Areas in the brainstem that control the rate and depth of breathing.

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Respiratory Muscles

Muscles involved in the physical process of breathing, such as the diaphragm and intercostals.

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Ventilation

The process of moving air into and out of the lungs.

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Alveoli Capillaries

Network of capillaries surround alveoli, which are 1 cell thick, allowing for rapid gas diffusion.

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Lung Lobule Supply

Each lung lobule receives blood supply from an arteriole and a venule.

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ACE Enzyme Function

Endothelial cells in alveolar capillaries release angiotensin-converting enzyme (ACE), regulating blood pressure.

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Path of Blood in Heart

Blood enters the right atrium (RA) via the vena cava, then moves to the right ventricle (RV), and exits via the pulmonary artery to the lungs. From the lungs, blood enters the left atrium (LA) via the pulmonary vein, moves to the left ventricle (LV), and exits via the aorta to the rest of the body.

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CO₂ Transport

CO₂ is transported from tissues to the lungs via diffusion.

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CO₂ Diffusion Gradient

CO₂ diffuses from cells to blood across the alveolar membrane due to a concentration gradient.

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CO₂ vs O₂ Solubility

CO₂ is 24 times more soluble than O₂.

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Blood Control

Blood is carried and controlled by the lungs and cardiovascular system.

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Oxyhemoglobin Formation

Hemoglobin binds 98% of oxygen, forming oxyhemoglobin (HbO₂).

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Cooperative O₂ Binding

Oxygen binding to hemoglobin is cooperative, increasing carrying capacity by 70%; the binding of one O₂ molecule facilitates subsequent bindings.

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pO₂ and O₂ Binding

Partial pressure of oxygen (pO₂) determines O₂-Hb binding; higher pO₂ makes binding easier.

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Hemoglobin Structure

Hemoglobin has an iron core and four heme groups, each capable of binding one O₂ molecule.

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Oxygen bound to Hemoglobin

The amount of oxygen bound to Hemoglobin depends on the Plasma O2 and amount of hemoglobin.

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Hemoglobin Saturation

Percentage of hemoglobin that is saturated with oxygen.

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Oxygen Dissociation Curve

A graph showing the relationship between oxygen partial pressure (pO₂) and hemoglobin saturation, influenced by pCO₂, pH, and temperature.

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Typical Blood Values

The partial pressure of carbon dioxide (pCO₂) is at 45 mmHg, pH ranges from 7.35 to 7.45, and temperature is at 37°C within the oxygen dissociation curve.

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Sigmoidal Curve Shape

The sigmoidal shape of the oxygen dissociation curve is due to the nature of hemoglobin binding to oxygen.

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Respiratory Quotient (RQ)

The ratio of carbon dioxide produced to oxygen absorbed (VCO₂/VO₂).

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Steady State Ventilation

Alveolar ventilation when steady state equals the partial pressure of carbon dioxide (pCO₂).

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Chronic Hypoxia

Extended period of low oxygen availability (and pH).

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H+ effect on oxygen affinity

Hydrogen ions bind to hemoglobin, causing a shape change that reduces hemoglobin's affinity for oxygen.

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pH effect on oxygen binding

Decreasing pH caused by carbon dioxide (and H+ ions) reduces oxygen binding.

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Oxygen Release Effect

As hemogobin releases oxygen more readily into tissues, saturation increases.

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VA/Q (Ventilation-Perfusion ratio)

Describes the relationship between the amount of carbon dioxide (CO2) produced and the amount of oxygen (O2) absorbed.

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CO₂ Diffusion Location

CO₂ diffuses out of cells into systemic capillaries, facilitating its transport.

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Dissolved CO₂ in Plasma

About 7% of CO₂ remains dissolved directly in the blood plasma.

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CO₂ binding to Hemoglobin

Approximately 23% of CO₂ binds to hemoglobin, forming carbaminohemoglobin.

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CO₂ conversion to Bicarbonate

Around 70% of the CO₂ load is converted into bicarbonate ions (HCO₃⁻) and H⁺, buffering the blood.

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Chloride Shift

Bicarbonate (HCO₃⁻) that is produced enters the plasma in exchange for chloride ions (Cl⁻).

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CO₂ Diffusion at the Lungs

At the lungs, dissolved CO₂ diffuses out of the plasma, reversing the process.

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Hemoglobin Binding H⁺

Hb binds to H⁺, helping to buffer the blood.

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Carbonic Anhydrase Function

The enzyme carbonic anhydrase catalyzes the reaction that converts CO₂ and H₂O into bicarbonate (HCO₃⁻) and H⁺.

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2,3-DPG Origin

2,3-diphosphoglycerate (2,3-DPG) is a metabolite of carbohydrate metabolism produced in erythrocytes.

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2,3-DPG Effect on Hemoglobin

2,3-DPG acts as an inhibitor that binds to Hb, decreasing hemoglobin's affinity for O₂.

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2,3-DPG and Curve Shift

An increase in 2,3-DPG causes the oxygen dissociation curve to shift to the right, indicating decreased saturation.

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Factors Causing Right Shift

Exercise, drop in blood pH, and increased thyroid hormones/growth hormone levels.

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Fetal Hemoglobin Affinity

Fetal hemoglobin (HbF) has poor binding to 2,3-DPG, resulting in a greater affinity for O₂ than maternal hemoglobin.

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Study Notes

  • Haemoglobin saturation is related to the oxygen dissociation curve
  • Oxygen dissociation curve occurs at: pCO₂ = 45mm Hg; pH = 7.35-7.45; temperature = 37°C
  • The oxygen dissociation curve is sigmoidal due to the nature of Hb binding to O₂
  • Oxygen concentration in blood is unaffected by small pO₂ fluctuations in lungs at pO₂ of tissues; the curve is very steep, affecting gas exchange
  • Exchange to release CO₂ from tissues is larger than O₂ release
  • The respiratory quotient relates the amount of CO₂ produced to the amount of oxygen absorbed (VA/Q)
  • At a steady state, alveolar ventilation = pCO₂
  • ∞ = ventilation but no perfusion
  • 0 = no ventilation but perfusion
  • At a steady state, actual values are 0.7-1.0 (fat metabolism - carbohydrate metabolism)
  • The Bohr effect is a shift in the Hb saturation curve resulting from pH change
  • Chronic hypoxia is an extended period of low O₂ (↑pH)
  • H+ ions bind Hb, causing a shape change, which reduces Hb's affinity for O₂; CO₂ also binds to Hb
  • Decreasing pH caused by CO₂ (↑H+ ions) causes decreased O₂ saturation, releases it more readily into tissues
  • Changes in pH shifts the dissociation curve to the right

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