3 important gas laws govern ambient

air and alveolar ventilation:

1. Boyleƞs law
2. Daltonƞs law
3. Henryƞs law
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states that the total pressure exerted by a

mixture of gases is the sum of the
pressures exerted independently by each
gas in the mixture.

Further, the pressure exerted by each

gasƜits w 
wƜis directly
proportional to the percentage of that gas
in the gas mixture.
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Barometric pressure (PB) ƛ 760 mmHg

O2 ƛ 21%
    

ë2 ƛ 79%
    
  

when a mixture of gases is in contact

with a liquid, each gas will dissolve in the
liquid in proportion to its partial pressure

Thus the greater the concentration of a

particular gas in the gas phase, the more
and the faster that gas will go into
solution in the liquid.
    

The amount of gas that will dissolve in a

liquid also „w„ w  



Ñarious gases in air have different

solubilities:

Carbon dioxide is the most soluble

Oxygen is 1/20
th as soluble as carbon

dioxide

ëitrogen is practically insoluble in
plasma
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The net diffusion rate of a gas across a fluid membrane is

proportional to the difference in partial pressure

proportional to diffusion coefficient ( molecular weight
and solubility of gas)

proportional to the area of the membrane and

inversely proportional to the thickness of the
membrane
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The driving force for gas
exchange is the partial
pressure difference of the
gas (*P) across the
membrane, ëOT the
concentration difference÷
 
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only 0.6 om thick, allowing for

efficient gas exchange

Have a total surface area (in males)

of about 70 m2 (40 times that of
oneƞs skin)
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in fibrosis or pulmonary edema,
diffusion s

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´ affected by solubility and molecular weight

CO2 more soluble in water than O2

Oxygen more soluble than nitrogen

Equal amounts of carbon dioxide and
oxygen are exchanged
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Diseases like emphysema , lung cancer, TB
reduce available surface area

During exercise, additional capillaries are
perfused with blood, which increases the
surface area for exchange
    


 
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Differences in partial pressure

Small diffusion distance

Lipid-soluble gases

Large surface area of all alveoli

LUë DIFFUSIë CAPACITY
(DL)

Combines :
the diffusion coefficient of the gas
the surface area of the membrane
the thickness of the membrane
 LUë DIFFUSIë CAPACITY
(DL)

In emphysema, DL decreases because of

destruction of alveoli resulting to decreased
surface area

In fibrosis or pulmonary edema, DL

decreases because membrane thickness
increases

In anemia, DL decreases

During exercise, DL increases

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ÑEëTILATIOë and PERFUSIOë are

important components of gas
exchange in the lung

However, the major determinant of

gas exchange and thus the level of
PO2 and PCO2 in the blood is the

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ÑEëTILATIOë

Process by which air moves in and

out of the lung

MIëUTE ÑEëTILATIOë

ALÑEOLAR ÑEëTILATIOë
 Minute and Alveolar Ñentilation

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‰ respiratory minute volume;
pulmonary ventilation

Ñ Ѻ 
‰ ÑE =500 ml/breath X 12 breaths/min
‰ ëormally about 6 liters
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‰ ÑA = (500 ml/breath -150 ml) X 12
breaths/min
‰ ëormally about 4.2 liters
 Alveolar Ñentilation

Slow, deep breathing increases AÑR

rapid, shallow breathing decreases

AÑR

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as mixture composed of ë2 and O2

with minute quantities of CO2. argon
and inert gases

As we inspire the air, it is warmed to

body temperature and humidified
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becomes saturated with water vapor,

which exerts a partial pressure and dilutes
the total pressure of the other gases

Water vapor pressure at body temperature

is 47mmHg
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ë2 597 563
O2 159 149

CO2 0.3 0.3

H2O 3.7 47
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alveolar air is only partially replaced
by atmospheric air with each breath

Because only 500 ml of air is inspired
with each tidal inspiration, gas in the
alveoli is actually a mixture of newly
inspired gases and gases remaining in
the respiratory passageways between
breaths.
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FRC measures 2300ml BUT only 350ml of new air

is brought into the alveoli with each normal
respiration

Amount of alveolar air replaced by new

atmospheric air with each breath is only 1/7

At normal alveolar ventilation , approximately half

of the gas is exchanged in 17 seconds
 What controls alveolar
ventilation?


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Ñentilation to airways that do not

participate in gas exchange

2 types of dead space:

1. anatomic dead space
2. physiologic dead space
 AëATOMIC DEAD SPACE

composed of the volume of gas that fills

the conducting airways

In a healthy individual, 30% of the

inspired air is wasted
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The total volume of gas in each breath that

does not participate in gas exchange

Includes the anatomic dead space and the

dead space secondary to the ventilated but
not perfused alveoli

nearly equal in normal
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Process by which deoxygenated blood

passes through the lung and becomes
oxygenated
PULMOëARY CIRCULATIOë

Begins with the right atrium

Total blood volume: 500ml

Low pressure, low resistance system

Regulation of Pulmonary blood flow

Hypoxic vasoconstriction

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HYPOXIC ÑASOCOëSTRICTIOë

Hypoxia causes depolarization of

vascular smooth muscle cells U
depolarization opens voltage-gated
calcium channels U calcium influx U
contraction
 ÑEëTILATIOë-PERFUSIOë
RELATIOëSHIPS

Ratio of ventilation to blood flow

Ñentilation and perfusion must be tightly

regulated for efficient gas exchange
 ÑEëTILATIOë-PERFUSIOë
COUPLIë (Ñ/Q ratio)

Ratio of pulmonary ventilation to pulmonary

blood flow

Ratio of CO2 excreted to the O2 taken up by the

lungs

= CO2 consumption
O2 consumption

Respiratory exchange ratio

ëormally, 0.8
 DIFFEREëCES Ië ÑEëTILATIOë &
PERFUSIOë Ië DIFFEREëT PARTS OF
THE LUë

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 Ñentilation/Perfusion Ratios

In an upright
Insert fig. 16.24
subject,
ventilation
increases more
slowly than blood
flow from the
apex of the lung
to the base

The difference in Ñ/Q ratios is associated
with a difference in alveolar O2 and CO2
content between apex and the base

2 : high alveolar O2, low alveolar

CO2

& : low alveolar O2, high alveolar

CO2
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 Alveolar-arterial PO2 difference

Difference between alveolar O2 (PAO2)

and arterial PO2 ( PaO2)

ëormally, alveolar O2 (PAO2) is slightly

greater than arterial PO2 ( PaO2)
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2 sources:
1. some bronchial and mediastinal veins

drain into the pulmonary veins

2. Small portion of coronary venous

blood (thebesian vessels) that drains

directly into the left ventricle rather
than going to the lungs to be
oxygenated
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ëormally 1-2% of total cardiac output

 Alveolar-arterial PO2 difference

An increased in AaDO2 is a hallmark of

abnormal O2 exchange

In normal individuals breathing room

air, AaDO2 is less than 15mmHg
 The A-a radient

The A-a gradient = PAO2 ƛ PaO2

ëormal A-a gradient Ƽ (age + 10) / 4

Can range between 5-20 mmHg

 The A-a radient

useful in determining source of

hypoxemia

IëCREASES with age

For every decade a person lived,

gradient is expected to increase by
1 mmHg
 The A-a radient

If abnormally IëCREASED, denotes poor

gas exchange

Seen in :

Defect in diffusion

Ñ/Q defect

R to L shunt
Ñ/Q DEFECTS
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pO2 in the alveolus falls
Alveolar PO2 will + +
Ñ )*!"
decrease to 40 mmHg
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pCO2 rises
Alveolar PCO2 will
increase to 45 mmHg
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(: when perfusion exceeds

ventilation, a shunt exists. Blood
bypasses the alveoli w/o gas
exchange occurring.

Airway obstruction, mucous plugs,

right to left cardiac shunts
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Results in an increase in Ơphysiologic shunt

bloodơ- blood that is not oxygenated as it
passes the lung
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Ñ )*!.
Ñentilation exceeds R  !,"
perfusion R  !"

Alveoli do not have

adequate blood supply
for gas exchange to
occur
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Pulmonary emboli,
pulmonary infarction,
cardiogenic shock
HI H Ñ/Q

High ventilation relative to perfusion

usually because blood flow is decreased

Unlike dead space, which has no

perfusion, high Ñ/Q regions have some
blood flow

Pulmonary capillary blood has a high

PO2 and a low PCO2
LOW Ñ/Q

Regions have low ventilation

relative to perfusion

Pulmonary capillary blood has a

low PO2 and a high PCO2
] SUMMARY ƦƦ

the gas exchanges that occur between

the blood and the alveoli and between
the blood and the tissue cells take place
by simple diffusion driven by the partial
pressure gradients of O2 and CO2 that
exist on the opposite sides of the
exchange membranes.

Pulmonary blood flow and ventilation ƛ
unevenly distributed

Apex ƛ blood flow is lowest as well as

ventilation

Ñ/Q highest at the apex, with an average

value of 0.8

Where Ñ/Q is highest, PaO2 is highest and

PaCO2 is lowest

Ñ/Q defects impair gas exchange

If ventilation is decreased relative to

perfusion, then PAO2 and PACO2 will
approach their values in mixed venous
blood

If perfusion is decreased relative to

ventilation, then PAO2 and PACO2 will
approach their values in inspired air
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