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[PHYSIOLOGY LECTURE DR.

REVILLA]
Ventilation(V), Perfusion(Q) and V/Q relationship

PtracheaO2 = (Pb PH2O) x FO2

At normal Inspiration by Boyles law:


At increased volume, there is decreased alveolar and
intrapleural pressure

=(760-47) x 0.21
=149.73 150 mmHg
From 159, oxygen pressure is now 150

Ventilation-ingress of air from atmosphere to the lungs


Synonymous to tidal volume
Process by which air moves in and out of the lungs

Alveolar gas composition


Because of gas exchange in the alveolo-capillary units, the
fraction of oxygen and carbon dioxide in the alveoli changes

Minute ventilation-volume of air that enters or leaves the lung


per minute
Minute ventilation = Tidal Volume x Respiratory Rate

Respiratory quotient: VCO2/VO2


Production of O2 versus CO2
0.8
Normal

fx
TV

0.7
1.0

*the fraction of CO2 in the alveoli is a function of the rate of


CO2 production by the cells during metabolism and the rate at
which the CO2 is eliminated from the alveolus

Where:
= minute ventilation

*deoxygenated blood to alveoli (alveolar gas has no or


minimal CO2) RBC provides pressure gradient for gas
transfer (CO2) 150 PaO2 becomes 102 due to transfer of
gases; *40 mmHg CO2 alveolar gas exhalation
*Ambient air = O2 CO2

f= frequency of respiration
TV=tidal volume

*Alveolar ventilation is inversely proportional to

Compensatory mechanism=increase respiratory rate to


maintain minute ventilation at normal limits

PCO2

*Level of CO2 always the same with level of alveolar


ventilation
Poor ventilation = CO2 = Hypercapnea
Hyperventilationexcretion of too much CO2decreased
CO2influx of Catetany *carpopedal spasm
Management: brown bag to re-inhale excreted CO2

Alveolar ventilation
Ambient air to the alveoli
2 important principles:
1
The sum of the partial pressure of a gas must be
equal to the total pressure
(100%=100%)

Arterial gas composition


*arterial PCO2 is tightly regulated and maintained at 40mmHg
*specialized chemoreceptors
Increased PCO2-respiratory acidosis
Decreased PCO2- respiratory alkalosis

Pb= PN2(78%)+PO2(21%)+PAr and other gases


(1%which is negligible)
Pb= Barometric pressure

760 mmHg = PN2 + PO2 + Pargon and other gases


2

Exclusive fatty acid metabolism


Exclusive carbohydrate metabolism

Partial pressure of gas is equal to the fraction of that


gas in the mixture times the total or ambient air

Normal arterial blood gases


Arterial Blood
Normal Range
Gases(ABGs)

Average

760x 0.78=592.8 N2
760x 0.21=159.6 O2
760x 0.01= 7.6 Argon and other gases
= 760 mmHg total

pH
HCO3
pCO2

7.4
24
40

7.35-7.45
22-26mEq/l
35-45 mmHg

Daltons law: in a gas mixture, the pressure exerted by each


individual gas is independent of the pressure of the other
gases in the mixture
In high altitudes there is decreased barometric pressure even
though oxygen concentration is constant
Pgas = Fraction of gas x Barometric Pressure
Alveolar ventilation
*inspired gases become saturated with water vapor which
dilutes the total pressure of the other gases
*water vapor pressure at body temperature is 47 mmHg
(deducted from barometric pressure)

CO2 acid donor *More CO2, more H donated


CO2+H2O H2CO3(carbonic acid) gives off H (Hydrogen)
and HCO3 (bicarbonate)
HCO3-(unstable) + Na (sodium)NaHCO3(base,buffer)
More HCO3 - more basic body

Air enters nose humidified by water vapor dilutes all the


gases barometric pressure decreases

How to interpret ABG:


1. Know pH-read whether basic or acidic(alkalosis/acidosis)
increased pH-alkalosis
decreased pH-acidosis

Henrys law: the concentration of a gas dissolved in a liquid


is proportional to its partial pressure

[PHYSIOLOGY LECTURE DR. REVILLA]


2.
-

Know the primary abnormality


increased PCO2- respiratory acidosis
decreased PCO2-respiratory alkalosis
increased HCO3-metabolic alkalosis
decreased HCO3- metabolic acidosis

Example:
pH- 7.54 increased (alkalosis)
HCO3 - 30 mEq/l increased (metabolic alkalosis)
pCO2 - 33 mmHgdecreased (respiratory alkalosis)
PO2- 60 hypoxic
Answer: metabolic and respiratory alkalosis, with hypoxemia

3.
-

4.
-

Determine if there is compensation- imagine how a bird


flies
Increased CO2 with increased HCO3; vice versa with
compensation
Increased CO2 with decreased HCO3; vice versa mixed
problem(respiratory and metabolic)
If either CO2/HCO3 is normalno compensation
If with compensation but pH is not yet normal partial
compensation
If with compensation and pH is already normal full
compensation
Acidosis - bicarbonate sends signals to brainstem tachypnea *Kussmaul respiration reduce carbon
dioxide

Distribution of ventilation
*ventilation is not uniformly distributed in the lung due to
gravity
*alveoli near the apex
-intrapleural more negative
-alveoli larger, less complaint more expanded
-less ventilation
*alveoli near base
-alveoli smaller, more compliant
-more ventilation
*Memorize
Note takers:
Becky Abegail Chomapoy
Efigenia Gina Peralta

Partial pressure of oxygen(PO2)


Normal 80-100
Decreased-hypoxemia