KIN 3304 1nd Edition Lecture 23Outline of Last Lecture I. AirwaysII. Airway GenerationsIII. Physiology of RespirationIV. Structure of ThoraxV. Pleural SpaceVI. Pneumothorax VII. Gas ExchangeVIII. Elastic FibersIX. Structural InterdependenceX. Type 1 and Type 2 Alveolar CellsXI. Type 2XII. Respiratory Mechanics PictureOutline of Current Lecture I. Pulmonary Physiology in PregnancyII. Difference Between Adult and FetusIII. Partial PressureIV. Important NumbersV. O2 TransportThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.VI. 2,3 – DPGVII. At High Altitude (diagram)VIII. Carbon MonoxideIX. Normal Arterial O2 ContentX. Fick’s EquationXI. Gas DiffusionCurrent LectureI. Pulmonary Physiology in Pregnancya. Tidal volume change increases because mother is breathing for twob. Residual volume decreasesc. Total lung capacity decreasesd. When you’re a fetus, you don’t use lungs, you get O2 from the placentaII. Difference Between Adult and Fetus:a. Adult Arteriesi. Carries oxygenated blood away from heartb. Fetal Arteriesi. Carries non oxygenated blood away from heartc. Adult Veinsi. Carries non oxygenated blood toward heartIII. Partial Pressure **TQ about these numbersa. PATM = PCO2 + PN2 + PH2Ob. Usually measured “dry”i. Water vapor removed when comparing ii. Allows for universal comparisonsc. Sea Level – PP ambient air = 760 mmHgd. At 37 degrees C, water vapor PP = 47 mm Hgi. Does not vary with changes in PATMIV. Important Numbers **TQ about these numbersa. 760-47= 713 mm Hgb. 760 (ambient air) – 47 (water vapor, in trachea) = 713 mm Hgi. O2 = 20.93% (0.2093)ii. CO2 = 0.03% (0.0003)iii. N2 = 79.0% (0.79)iv. Remainder (0.04%) = inert gasesv. These numbers will not change whether you are in Denver or HoustonV. O2 Transporta. Hemoglobin (Hb)i. One mole carries 4 moles of O2ii. 15g/100mL of bloodiii. 20mL O2 per 100mL blood (as oxyhemoglobin)b. Decrease in pH, increase in Pco2, temp:i. Helps to unload O2 at tissuesii. Think of exerciseVI. 2,3 – diphosphoglycerate (2,3 – DPG)a. Increase [2,3 – DPG] Decrease O2 affinity to Hbi. Increase affinity for 2,3 – DPG than oxygenated Hbii. Releases O2 to tissuesb. Within hours to days of hypoxia (altitude, airway obstruction, heart failure)i. [2,3 – DPG] increasesVII. At high altitude (diagram)a. Low PO2i. Immediate1. Hyperventilation increase in proportion of fresh air to alveoliii. Days1. Increase 2,3 – DPG in RBCs increase oxygen unloading to tissuesiii. Days to weeks1. Increase in erythropoietin increase oxygen content of bloodVIII. Carbon Monoxidea. Affinity for Hb is 200-250x that of O2b. Can fully = saturate Hb at very low [ ] i. Blocks Hb sites for O2c. Carbon Monoxide binds very tightly to hemoglobind. Oxygenated CO2 can no longer be carriedIX. Normal Arterial O2 ContentParameterValveArterial pressure of O2 90-100 mm HgArterial saturation of O2 97%Hb content 15g/100mLO2-carrying capacity of Hb 1.39mL/g HbArterial O2 content O2 bound to Hb + dissolved O2X. Fick’s Equationa. VO2 = Q x (a – VO2 difference)Parameter Symbol Normal Values at RestO2 consumption VO2 250 mL.minCardiac output (heart rate and stroke volume)Q 5mL/minDifference between alveolar and mixed venous O2 contentCaO2-CvO2 50ml/L of blood (or 5mL/100mL)Arterial O2 content CaO2 200mL/L blood (20mL/100mL)Mixed venous O2 content CvO2 150mL/L blood (15mL/100mLMixed venous Pp of O2 PVO2 ~40 mmHg*If you exercise, HR decreases at restXI. Gas Diffusiona. Simply, from high to low (concentration)i. In lungs – between alveolar gas and capillary bloodb. We call this diffusion capacity (DL)i. Total DL of lung made up of:1. Diffusion process through alveolar membrane2. Resistance of RBC + chemical combination with Hb**TQ Know slide number 5 on the Lung PP on blackboard. This will be on the exam and the
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