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Physiology

Oxygen Uptake in the Lungs is Increased About 70X by Hemoglobin in the Red Cells

  • In the lungs oxygen must enter the blood
  • A small amount of oxygen dissolves directly in the serum, but 98.5% of the oxygen is carried by hemoglobin
  • All of the hemoglobin is found within the red blood cells (RBCs or erythrocytes)
  • The hemoglobin content of the blood is about 15 gm/deciliter (deciliter = 100 mL)
  • Red cell count is about 5 million per microliter

Each Hemoglobin Can Bind Four O2 Molecules (100% Saturation)

  • Hemoglobin is a protein molecule with 4 protein sub-units (2 alphas and 2 betas)
    • Each of the 4 sub-units contains a heme group which gives the protein a red color
    • Each heme has an iron atom in the center which can bind an oxygen molecule (O2)
    • The 4 hemes in a hemoglobin can carry a maximum of 4 oxygen molecules
  • When hemoglobin is saturated with oxygen it has a bright red color; as it loses oxygen it becomes bluish (cyanosis)

The Normal Blood Hematocrit is Just Below 50%

  • Blood consists of cells suspended in serum
  • More than 99% of the cells in the blood are red blood cells designed to carry oxygen
    • 25% of all the cells in the body are RBCs
  • The volume percentage of cells in the blood is called the hematocrit
  • Normal hematocrits are about 40% for women and 45% for men

At Sea Level the Partial Pressure of O2 is High Enough to Give Nearly 100% Saturation of Hemoglobin

  • As the partial pressure of oxygen in the alveoli increases the hemoglobin in the red cells passing through the lungs rises until the hemoglobin is 100% saturated with oxygen
    • At 100% saturation each hemoglobin carries 4 O2 molecules
    • This is equal to 1.33 mL O2 per gram of hemoglobin
  • A person with 15 gm Hb/deciliter can carry:
    • Max O2 carriage = 1.33 mL O2/gm X 15 gm/deciliter = 20 mL O2/deciliter
  • A plot of % saturation vs pO2 gives an S-shaped "hemoglobin dissociation curve"
  • At 100% saturation each hemoglobin binds 4 oxygen molecules

At High Altitudes Hemoglobin Saturation May be Well Below 100%

  • At the alveolar pO2 of 105 mm Hg at sea level the hemoglobin will be about 97% saturated, but the saturation will fall at high altitudes
  • At 12,000 feet altitude alveolar pO2 will be about 60 mm Hg and the hemoglobin will be 90% saturated
  • At 29,000 feet (Mt. Everest) alveolar pO2 is about 24 mm Hg and the hemoglobin will be only 42% saturated
  • At very high altitudes most climbers must breath pure oxygen from tanks
  • During acclimatization to high altitude the hematocrit can rise to about 60%- this increases the amount of oxygen that can be carried
  • Hematocrits above 60% are not useful because the blood viscosity will increase to the point where it impairs circulation

Exchange of gases:

  • External respiration:
    • exchange of O2 & CO2 between external environment & the cells of the body
    • efficient because alveoli and capillaries have very thin walls & are very abundant (your lungs have about 300 million alveoli with a total surface area of about 75 square meters)
  • Internal respiration - intracellular use of O2 to make ATP
  • occurs by simple diffusion along partial pressure gradients

The Posterior Lobe

The posterior lobe of the pituitary releases two hormones, both synthesized in the hypothalamus, into the circulation.

  • Antidiuretic Hormone (ADH).
    ADH is a peptide of 9 amino acids. It is also known as arginine vasopressin. ADH acts on the collecting ducts of the kidney to facilitate the reabsorption of water into the blood.
    • A deficiency of ADH
      • leads to excessive loss of urine, a condition known as diabetes  nsipidus.
  • Oxytocin
    Oxytocin is a peptide of 9 amino acids. Its principal actions are:
    • stimulating contractions of the uterus at the time of birth
    • stimulating release of milk when the baby begins to suckle

Blood Pressure

Blood moves through the arteries, arterioles, and capillaries because of the force created by the contraction of the ventricles.

Blood pressure in the arteries.

The surge of blood that occurs at each contraction is transmitted through the elastic walls of the entire arterial system where it can be detected as the pulse. Even during the brief interval when the heart is relaxed — called diastole — there is still pressure in the arteries. When the heart contracts — called systole — the pressure increases.

Blood pressure is expressed as two numbers, e.g., 120/80.

Blood pressure in the capillaries

The pressure of arterial blood is largely dissipated when the blood enters the capillaries. Capillaries are tiny vessels with a diameter just about that of a red blood cell (7.5 µm). Although the diameter of a single capillary is quite small, the number of capillaries supplied by a single arteriole is so great that the total cross-sectional area available for the flow of blood is increased. Therefore, the pressure of the blood as it enters the capillaries decreases.

Blood pressure in the veins

When blood leaves the capillaries and enters the venules and veins, little pressure remains to force it along. Blood in the veins below the heart is helped back up to the heart by the muscle pump. This is simply the squeezing effect of contracting muscles on the veins running through them. One-way flow to the heart is achieved by valves within the veins

Exchanges Between Blood and Cells

With rare exceptions, our blood does not come into direct contact with the cells it nourishes. As blood enters the capillaries surrounding a tissue space, a large fraction of it is filtered into the tissue space. It is this interstitial or extracellular fluid (ECF) that brings to cells all of their requirements and takes away their products. The number and distribution of capillaries is such that probably no cell is ever farther away than 50 µm from a capillary.

When blood enters the arteriole end of a capillary, it is still under pressure produced by the contraction of the ventricle. As a result of this pressure, a substantial amount of water and some plasma proteins filter through the walls of the capillaries into the tissue space.

Thus fluid, called interstitial fluid, is simply blood plasma minus most of the proteins. (It has the same composition and is formed in the same way as the nephric filtrate in kidneys.)

Interstitial fluid bathes the cells in the tissue space and substances in it can enter the cells by diffusion or active transport. Substances, like carbon dioxide, can diffuse out of cells and into the interstitial fluid.

Near the venous end of a capillary, the blood pressure is greatly reduced .Here another force comes into play. Although the composition of interstitial fluid is similar to that of blood plasma, it contains a smaller concentration of proteins than plasma and thus a somewhat greater concentration of water. This difference sets up an osmotic pressure. Although the osmotic pressure is small, it is greater than the blood pressure at the venous end of the capillary. Consequently, the fluid reenters the capillary here.

Control of the Capillary Beds

An adult human has been estimated to have some 60,000 miles of capillaries with a total surface area of some 800–1000 m2. The total volume of this system is roughly 5 liters, the same as the total volume of blood. However, if the heart and major vessels are to be kept filled, all the capillaries cannot be filled at once. So a continual redirection of blood from organ to organ takes place in response to the changing needs of the body. During vigorous exercise, for example, capillary beds in the skeletal muscles open at the expense of those in the viscera. The reverse occurs after a heavy meal.

The walls of arterioles are encased in smooth muscle. Constriction of arterioles decreases blood flow into the capillary beds they supply while dilation has the opposite effect. In time of danger or other stress, for example, the arterioles supplying the skeletal muscles will be dilated while the bore of those supplying the digestive organs will decrease. These actions are carried out by

  • the autonomic nervous system.
  • local controls in the capillary beds

Ventilation simply means inhaling and exhaling of air from the atmospheric air into lungs and then exhaling it from the lung into the atmospheric air.
Air pressure gradient has to exist between two atmospheres to enable a gas to move from one atmosphere to an other.
 

During inspiration: the intrathoracic pressure has to be less than that of atmospheric pressure. This could be achieved by decreasing the intrathoracic pressure as follows:
 

Depending on Boyle`s law , the pressure of gas is inversely proportional to the volume of its container. So increasing the intrathoracic volume will decrease the intrathoracic pressure which will allow the atmospheric air to be inhaled (inspiration) . As decreasing the intrathoracic volume will increase the intrathoracic pressure and causes exhaling of air ( expiration)

 

So. Inspiration  could be actively achieved by the contraction of inspiratory muscles : diaphragm and intercostal muscles. While relaxation of the mentioned muscles will passively cause expiration.
 

Contraction of diaphragm will pull the diaphragm down the abdominal cavity ( will move inferiorly)  , and then increase the intrathoracic volume ( vertically)  . Contraction of external intercostal muscle will pull the ribs upward and forward which will additionally increase the intrathoracic volume ( transversely  , the net result will be increasing the intrathoracic volume and decreasing the intrathoracic pressure.
 

Relaxation of diaphragm will move it superiorly during expiration, the relaxation of external intercostal muscles will pull the ribs downward and backward , and the elastic lungs and chest wall will recoil. The net result is decreasing the intrathoracic volume and increasing intrathoracic pressure.
 

All of this occurs during quiet breathing. During forceful inspiration an accessory inspiratory muscle will be involved ( scaleni , sternocleidomastoid , and others) to increase negativity in the intrathoracic pressure more and more.
 

During forceful expiration the accessory expiratory muscles ( internal intercostal muscles and abdominal muscles ) will be involved to decrease the intrathoracic volume  more and more and then to increase  intrathoracic pressure more and more.

The pressure within the alveoli is called intralveolar  pressure . Between the two phases of respiration it is equal to the atmospheric pressure. It is decreased during inspiration ( about 1 cm H2O ) and increased during expiration ( about +1 cm H2O ) . This difference allow entering of 0.5 L of air into the lungs.

Intrapleural pressure is the pressure of thin fluid between the two pleural layers . It is a slight negative pressure. At the beginning of inspiration it is about -5 cm H2O and reachs -7.5 cm H2O at the end or inspiration.

At the beginning of expiration the intrapleural pressure is -7.5 cm H2O and reaches -5 cmH2O at the end of expiration.
The difference between intralveolar pressure and intrapleural pressure is called transpulmonary pressure.

 

 

Factors , affecting ventilation :
 

Resistance : Gradual decreasing of the diameter of respiratory airway increase the resistance to air flow.
 

Compliance : means the ease , which the lungs expand.It depends on both the elastic forces of the lungs and the elastic forces , caused by the the surface tension of the fluid, lining the alveoli.
 

Surface tension: Molecules of water have tendency to attract each other on the surface of water adjacent to air. In alveoli the surface tension caused by the fluid in the inner surface of the alveoli  may cause collapse of alveoli . The surface tension is decreased by the surfactant .

 

Surfactant is a mixture of phospholipids , proteins and ion m produced by type II pneumocytes.

Immature newborns may suffer from respiratory distress syndrome , due to lack of surfactant which is produced during the last trimester of pregnancy.
 

The elastic fibers of the thoracic wall also participate in lung compliance.

 

Exchange of gases takes place in Lungs

  • A person with an average ventilation rate of 7.5 L/min will breathe in and out 10,800 liters of gas each day
  • From this gas the person will take in about 420 liters of oxygen (19 moles/day) and will give out about 340 liters of carbon dioxide (15 moles/day)
  • The ratio of CO2 expired/O2 inspired is called the respiratory quotient (RQ)
    • RQ = CO2 out/O2 in = 340/420 = 0.81
    • In cellular respiration of glucose CO2 out = O2 in; RQ = 1
    • The overall RQ is less than 1 because our diet is a mixture of carbohydrates and fat; the RQ for metabolizing fat is only 0.7
  • All of the exchange of gas takes place in the lungs
  • The lungs also give off large amounts of heat and water vapor

Lung volumes and capacities: 
I. Lung`s volumes
1. Tidal volume (TV) : is the volume of air m which is inspired and expired during one quiet breathing . It equals to 500 ml.
 

2. Inspiratory reserve volume (IRV) : The volume of air that could be inspired over and beyond the tidal volume. It equals to 3000 ml of air.
 

3. Expiratory reserve volume (ERV) : A volume of air that could be forcefully expired after the end of quiet tidal volume. It is about 1100 ml of air.
 

4. Residual volume (RV) : the extra volume of air that may remain in the lung after the forceful expiration . It is about 1200 ml of air.
 

5. Minute volume : the volume of air that is inspired or expired within one minute. It is equal to multiplying of respiratory rate by tidal volume = 12X500= 6000 ml.
It is in female  lesser than that in male.
II. Lung`s capacities :
1. Inspiratory capacity: TV + IRV
2. Vital capacity : TV+IRV+ERV
3. Total lung capacity : TV+IRV+ERV+RV

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