Section two

Physical principles of gas exchange;

Diffusion of oxygen and carbon dioxide
Through the respiratory membrane
 External gaseous
exchange involves
the movement of
gases between the
alveoli and blood
in the lungs.
 Internal gaseous
exchange is the
movement of
gases between the
blood and the
body cells bathed
in tissue fluid
一 . principle of gas exchange
（一） gas diffusion
Gas molecules move freely among one
another. The result is gas molecules diffuse
from high-pressure area toward low-pressure
area. The process is called gas diffusion.
External gaseous exchange and tissues
ventilation are physical diffusion processes .
 gas diffusion obeys the following
physical principles
1. Gas diffuses from the high-pressure area to
the low-pressure area.
2. The diffusion direction and volume of gas
is decided by its own partial pressure
difference, diffusion rate and the solubility
in fluid.
3. In the fluid or at the interface of gas and fluid, the diffusion
rate of gas is correlate closely to its solubility in fluid. The
gas which solubility is higher diffuses quicker.

4. Diffusion rate of gas ： The volume of gas diffusion in

unit time is called diffusion rate.

It is effected by the following factors

△P*T*A*S
D∝
d*√MW

MW ： molecular weight
1 ） . Gas partial pressure difference: gas partial
pressure difference is larger—diffuses faster
2 ） . Gas molecular weight and solubility:
when solubility is high, it diffuses fast
when molecular weight is large, it diffuses
slowly.
△P*T*A*S
D∝
d*√MW
3 ） . Diffusion area of alveolar membrane :
when diffusion area of alveolar membrane
is large, it diffuses fast.
1) diffusion area of alveolar membrane
is 40m2 in normal quiet state.
2) diffusion area of alveolar membrane
is 70m2 during sports.
diffusion area of alveolar membrane
decreases in disease.
△P*T*A*S
D∝
d*√MW
1.Fluid and surfactant layer
2.Alveolar epithelium
3. Epithelium
basement membrane
4 .Interstitial space
5. Capillary
basement membrane
6. Capillary endothelium
Mean thickness is only 0.2
to 0.6µ m.
4. Diffusion distance—thickness of alveolar
membrane ( inverse ratio relationship )
Pulmonary fibrosis ---Thickness increases
Pulmonary edema---Diffusion decreases
5. Temperature
Temperature of fluid increases
Solubility increases —Diffuses fast

△P*T*A*S
D∝
d*√MW
6. Pulmonary Perfusion and Ventilation / Perfusion
Ratio

If blood flow decreases and gas exchange are

normal--the exchange total amount decreases. So
alveolar ventilation and blood flow must keep an
appropriate ratio.
Ventilation/perfusion ratio
VA/Q (value of normal quiet state) ＝ 4.2L/5L ＝
0.84
VA alveolar ventilation per minute
Q pulmonary perfusion per minute
 When normal adult is standing, every part of
lung VA/Q is not well-distributed
Apex of lung VA descent/Q descent Q descenting is more obvious.
ratio rises(more than 3)
Base of lung VA descents/Q rises ratio descents(0.6)
 Local Control of
Ventilation & Perfusion
 Ventilation in the alveoli is matched
to perfusion through pulmonary
capillaries.
 If ventilation decreases in a group
of alveoli, PCO 2 increases and PO2
decreases. Blood flowing past
these alveoli does not get
oxygenated. (ration<0.84)
 Decreased tissue PO2 around
under-ventilated alveoli constricts
their arteries and diverts blood to
better ventilated alveoli.
 V/Q>0.84 V/Q<0.84

Physiological dead space functional shunt

7. When all kinds of gas is under unit partial
pressure difference,the gas volume(ml) passing
through respiratory membrane per minute is
called pulmonary diffusion capacity. It is the
physiological index to test the diffusion ability
of respiratory membrane.
（二） partial pressure of respiratory air and gas of
different human body tissues

1. Composition and partial pressure of respiratory

air and alveolar air.
In the respiratory cycle, composition of O2 and
CO2 in alveolar air fluctuates a little.
1) Dalton’s Law:
Total pressure of a gas mixture is = to the sum of
the pressures that each gas in the mixture would
exert independently.
PATM = PN2 + P02 + PC02 + PH20 = 760 mm Hg.
2) Partial pressure:
The pressure that an particular gas exerts
independently.
partial pressure of each composition=the total pressure of mixed gas
×volume percentage of the gas
N2 600mmHg = 760mmHg × 79%
O2 159mmHg = 760mmHg×21 ％

02 is humidified = 105 mm Hg.

H20 contributes to partial pressure (47 mm Hg).
P02 (sea level) = 150 mm Hg.
PC02 = 40 mm Hg.
2. Partial Pressures of Gases in Inspired Air
and Alveolar Air
二 . Pulmonary gas exchange
PO2 of mixed venous blood is 40mmHg is lower than
104mmHg of alveolar gas. O2 in alveolar gas diffuses to
blood. PO2 in blood rises gradually until it is almost equal
to PO2 in alveolar gas.
PCO2 of mixed venous blood is 46mmHg, It is higher than
40mmHg of alveolar gas . CO2 in blood diffuses to alveolar
gas. PCO2 in blood descents gradually until it is almost
equal to PCO2 in alveolar gas.
1. Intrapleural pressure
2. elastic resistance of lung
surface tension Surfactant
3. lung ventilation volume and
alveolar ventilation
4. alveolar membrane
5. Ventilation/perfusion ratio
 Section three
Transport of Gas in the Blood
一 . Existing pattern of O2 and CO2 in the blood

physical dissolving
two kind of patterns
combination
 二 . oxygen transportation

98.5 ％ binding to Hb
oxygen transportation

1.5 ％ physical resolution

A small percentage remains dissolved in the plasma.

The majority of oxygen combines with the
hemoglobin
Combination with Hemoglobin

 Hemoglobin is found in red blood cells

Hemoglobin+Oxygen Oxyhemoglobin
PO2
Hb + O2 HbO2
 Each hemoglobin molecule contains 4 iron
molecules that can each bind an O2
molecule. Therefore each hemoglobin
molecule is capable of carrying 4 O2
molecules.
Hb + 4O2 HbO8
 Hemoglobin loads/unloads one O2
molecule at a time so Hb can exist as Hb
(deoxyhemoglobin), HbO2, HbO4, HbO6
or HbO8 (fully saturated
oxyhemoglobin).
1. Maximum capacity of hemoglobin binding
with O2 in every 100ml blood is called
oxygen capacity.
When normal Hb is in 15g/100ml blood ,
1g Hb binds with 1.34ml O2.
Oxygen capacity= 15×1.34 ＝ 20ml
2. The volume of hemoglobin binding
with oxygen is called oxygen content.
arterial blood: 20ml O2
venous blood: 15ml O2
3. The percentage of oxygen content to
oxygen capacity is called oxygen
saturation.
1). In arterial blood, oxygen content equals
20ml and oxygen saturation is 100%.
2). In venous blood , oxygen content equals
15ml and oxygen saturation is 75%.
（一） Reversible binding of Hb and O2

partial pressure is higher(lung)

Hb ＋ O2 HbO2
partial pressure is lower(tissues)

T R
（ tension ）
（ relaxation ）
The affinity of T form to O2 is smaller.
The affinity of R form to O2 is larger.
 （二） oxygen dissociation
curve
1.The binding of oxygen
to hemoglobin is
dependent on the partial
pressure of oxygen.
2.S-shaped (sigmoidal)
curve that shows the
partial pressures of
oxygen (PO2 ) in relation
to the % saturation of
Hb.
The curve reacts the relationship of PO2
and saturation of oxygenation Hb
character
1. Superior segment of curve:
PO2 60 － 100mmHg . Slope is flat.
1 ） Partial pressure of oxygen changes greatly.
But saturation changes little—even PO2
of environment or alveoli descents,
oxygenation saturation will maintain
high level.
2 ） When PO2 ＞ 100mmHg , rising
of oxygenation saturation is not obvious .
Rising of blood oxygen volume is little.
2. Middle segment of curve PO2 60
－ 40mmHg is the part that HbO2
releases O2.
At this time Hb oxygen saturation is
75%, oxygen content in blood is 14.4mL ％ .
In the other words, every 100ml blood
releases 5mlO2 when it flows over tissues.
3. Inferior segment of
curve .
PO2 20 － 40mmHg .
The slope is steep.
PO2 descents a little. It
makes oxygen
dissociation saturation
descent. This is benefit to
supplying oxygen for
tissue activity.
 （三） factors effect oxygen dissociation
Usually we use P50 as the affinity of Hb and O2.
At 50 % saturation (indicated on the curve by p50 ),
half of the Hb binding sites contain oxygen molecules.
Normal P50 : PO2 26.5mmHg.
when P50 rises ：
affinity descents and
curve moves to right.
when P50 descents ：
affinity rises and
curve moves to left.
factors effect oxygen dissociation curve
1. Effect of Pco2 or H+

Bohr effect
pH descents and PCO2 rises—
Molecular configuration of Hb changes to T form. Curve
move to right. P50 increases. Oxygen saturation descents
and dissociation increases.

pH rises and PCO2 descents—

Molecular configuration of Hb changes to R form. Curve
move to left. P50 descents. Oxygen saturation increases
and dissociation descents.
2. Effect of temperature
T increases—affinity of Hb
to O2 descents . Oxygen
saturation descents.
Curve moves to right.
Activity of H+ increases.
T descents—affinity of Hb
to O2 increases . Oxygen
saturation increases.
Curve moves to left. HbO2
can not dissociate O2
easily
3. Effect of 2,3 - diphosphoglycerate
2,3 － DPG is a kind of organophosphate in RBC.
hypoxia anemia
2,3--DPG long time sports
increases anaerobic metabolism
Hb miss oxygenation ability (T form)
Oxygen dissociation curve move to right,
make oxygen dissociate .
 Summary
 Left Shifts  Right Shifts
– increased pH – decreased pH
– decreased Temp – increased Temp
– decreased 2,3 DPG – increased 2,3 DPG
– hemoglobin variants – Hypoxia
– decreased carbon
– Anemia
dioxide – Decreased O2
– Increased O2 content content
– increased
carbon dioxide
transportation of CO2

1 It is dissolved in the blood plasma and

transported as carbonic acid.
2 It dissociates into hydrogen ions (H+)
and bicarbonate ions (HCO3- ).
3 It chemically combines with hemoglobin in
the red blood cells to form
carbaminohaemoglobin
 This reaction occurs in the RBC
because the enzyme that catalyzes
it (carbonic anhydrase) is in
abundance there. Once generated,
the bicarbonate ion exits the RBC
and enters the plasma. In order to
maintain the balance of charge
within the RBC, a chloride ion
enters the RBC from the plasma.
transportation of CO2 This is known as the chloride shift.
character:
1. Reaction is reversible. But it need the help of
enzyme.
2. Conjugation or dissociation is decided by
partial pressure difference of CO2.
3.There is the transfer of Cl － in the reaction.
（二） carbon dioxide dissociation curve

1 . Transport volume of CO2 in blood is

decided by partial pressure of CO2.
PCO2 increases—transport volume increases .
They appear linear relationship.
carbon dioxide dissociation curve
2. Haldane effect
O2 ＋ Hb promotes the releasing of CO2(lung)

intakes CO2 in the tissues

releases CO2 in lungs
The ability of deoxyhemoglobin taking along
CO2 is larger than oxyhemoglobin. So the
volume of CO2 taken along in arterial blood is
less than that in venous blood.