Lecture 3

Ventilation perfusion ratio

Gas Exchange
Prof. Maessa M. Elnhas
Department of Physiology
Faculty of Medicine
Tanta University
 Intended learning outcomes

• By the end of lecture, each student should be able to,

1. Discuss Diffusion of Gases across the Pulmonary Membrane.
2. Discuss O2 Carriage, and define Normal tensions & Amounts, O2 Capacity,
O2 Content and O2 % Saturation.
3. Illustrate O2 HB Dissociation Curve.
4. Discuss CO2 Carriage, and define Normal tensions & Amounts and Tidal
CO2.
 Respiratory Membrane
1. A layer of fluid lining the alveolus and containing surfactant
2. The alveolar epithelium composed of thin epithelial cells
3. An epithelial basement membrane
4. A thin interstitial space between the alveolar epithelium and the capillary membrane
5. A capillary basement membrane that in many places fuses with the alveolar epithelial
basement membrane
6. The capillary endothelial membrane

➢Thickness of the respiratory membrane in some area is as little as 0.2 micrometer, and it
averages about 0.6 micrometer, except where there are cell nuclei.

➢The total surface area of the respiratory membrane is about 70 square meters in the
normal adult human male.
 Physics of Gas Diffusion and Gas Partial Pressures

A- Gas Exchange at the Lungs

I-Passive diffusion
O2 continuously diffuses out of air in the alveoli into the blood stream and CO2 continuously diffuses into the alveoli
from the blood.
➢ The O2 tension of alveolar air is about 100 mmHg whereas that in the pulmonary veins is 40 mmHg. the O2 passively
diffuses into the blood due to this pressure gradient. O2 diffusion is adequate to raise the O2 tension of the blood to 97
mmHg or above.
➢ The CO2 tension of the venous blood is about 46 mmHg whereas that of the alveolar air is 40 mmHg and CO2
diffuses from the blood to the alveoli along this pressure gradient
II-Chemical factors enhance the exchange of gases at the lungs
Boher effect, Halden effect, Reverse chloride shift
B- Gas Exchange at Tissues
I. Passive diffusion
The exchange of O2 and CO2 at the tissue is due to passive diffusion similar to what happened at the lungs but
in the opposite direction.
➢ The O2 tension in tissues is about 40 mmHg or less which is lower than that of arterial blood which is 100 mmHg.
➢ The CO2 tension in tissues is about 46 mmHg or above which is higher than that of venous blood 40 mmHg.
➢ These pressure gradients are sufficient for the process of diffusion.
II. Chemical factors enhance the exchange of gases at the tissues
III. Enzymatic factors affecting tissue capability of using O2
Factors That Affect the Rate of Gas Diffusion Through the Respiratory
Membrane
(1) The thickness of the membrane.
(2) The surface area of the membrane.
(3) The diffusion coefficient of the gas in the substance of the membrane.
Respiratory Membrane Diffusing Capacity of a Gas
It is the volume of the gas that will diffuse through the membrane each minute for a
partial pressure difference of 1 mmHg.
➢ The diffusing capacity for oxygen under resting conditions averages
21 ml/min/mm Hg.

➢ Diffusing capacity for carbon dioxide under resting conditions of

about 400 to 450 ml/min/mm Hg

(4) The partial pressure difference of the gas between the two sides
of the membrane.
Boher effect & Haldane effect).
 O2 transport by Blood (Respiratory Function of the Blood)
97% 3%

In chemical combination with Hb Dissolved in plasma

O2 content of blood
It is the amount of O2 present in 100ml of blood in chemical
combination with Hb.
It depends on

Hb content O2 tension
 O2 carrying capacity of the blood

*It is the maximal amount of O2 present in 100ml of blood in chemical

combination with Hb, when hemoglobin is fully saturated with O2.

One gram Hb can combine with 1.34ml O2.

Hb conc.= 15g/100ml.

The amount of O2 combined in 100ml blood when Hb is fully saturated

equals

15 X 1.34 = 20ml/100ml.
 The coefficient of O2 utilization
It is the percentage of O2 in the arterial blood which is taken by the
tissues. Arterial O content - Venous O content
2 2
x 100
It equals: Arterial O content
2

• It is about 25% during rest and it increases during exercise.

 % saturation of Hb with O2
The combination of Hb with O2 occurs gradually in 4
steps
→ Hb4O2 25% saturation
→ Hb4O4 50% saturation
→ Hb4O6 75% saturation
→ Hb4O8 100% saturation
• It is the percentage ratio of O2 content to the O2 capacity
• Equal to O2 content / O2 capacity x 100
• In mixed venous blood O2 percentage saturation equals about 70% at rest.
Oxygen-Hemoglobin Dissociation Curve
• The oxygen molecule binds loosely and reversibly with the heme portion
of hemoglobin.

• When Po2 is high, as in the pulmonary capillaries, oxygen binds with the
hemoglobin, but when Po2 is low, as in the tissue capillaries, oxygen is
released from the hemoglobin.

• This is the basis for almost all oxygen transport from the lungs to the
tissues.
 Oxygen Dissociation Curve

Physiological significance of the S shaped curve

 Hb affinity for O2
• Shift to the right: Present in increase of: CO2 (Bohr's effect) , 2-3 DPG , and
H+ concentration).
• This is marked in the blood of pregnant women.
It means decreased affinity of Hb to O2.

• Shift to the left: In decrease of CO2 , 2-3 DPG ,and H+ concentration.

• This is marked in fetal Hb in the blood of fetus. It means increased

affinity of Hb to O2.

• Curve of myoglobin is extremely shifted to left. This helps skeletal muscle

to get O2 from bl.
 Factors affecting 2,3-DPG concentration in RBC
Increase Decrease
Exposure to chronic hypoxia Decrease in blood pH
at high altitude and certain (acidosis)
pulmonary diseases
Anaemia Stored blood (acid citrated
buffer used for storage
inhibits glycolysis in RBC
leading to decreased
2,3-DPG)
Exercise
Hormones: Thyroxin,
androgen and growth
hormone
Rise of body temperature
 II.CO2 Carriage CO2 in the arterial blood

The arterial CO2 content is about 50 ml /100 m1 arterial blood.

The CO2 tension in the arterial blood is 40 mmHg.
The arterial CO2 is present in the following forms
1-Physical solution
As CO2 or carbonic acid in both plasma and RBCs. It is called the free form of CO2.It determine the CO2 tension. It is
about 5% of total CO2.
2-Chemical combination
(a) Bicarbonate(89%)
As Na HCO3 in plasma and KHCO3 in RBCs, the CO2 that diffuses into RBCs is rapidly hydrated to H2CO3 because of
the presence of carbonic anhydrase. The H2CO3 dissociates to H+ and HCO3. The bicarbonate form KHCO3 inside the
cell or diffuses into plasma to form NaHCO3. This represents the major form of CO2 transport.
(b)Direct combination with protein (2%).
(c) Carbamino compounds (4%)
Direct combination with the amino groups of proteins, principally Hb to form carbamino compounds. This combination
is independent on CO2 tension.
 Tidal CO2
Definition In the tissues 5 m1 of CO2 per 100 m1 of blood is added during rest.
In this fashion 250 m1 of CO2 per minute at rest and much larger amounts during exercises are transported from the tissues
to the lungs and excreted.
➢ Hb plays the most important role in buffering of the tidal CO2.
Carriage of tidal CO2
1-Physicl solution equals about 5%.
2-Chemicl combination equals about 95%
(a) Chemical combination with plasma proteins and phosphate: It equals 10%.
(b) Chemical combination by haemoglobin either directly or indirectly
Hb is responsible for the transport of 85% of the tidal CO2 in the following forms
i) 20% is carried in the form of carbamino compounds. The union is very rapid. It does not need carbonic anhydrase or
CO2 tension. The reduced Hb forms carbamino compounds much more readily than oxy Hb.
ii) 40% of tidal CO2 are buffered by combination with K released secondary to reduction of oxy Hb into reduced Hb. It
becomes a weaker acid and therefore part of K combined with it is set free.
iii) 25% are buffered by direct reaction between carbonic acid which is a stronger acid than either oxy Hb or reduced Hb.
Therefore, carbonic acid combined with the K base of Hb to form KHCO3 and the Hb set free from the base. Hb acids are
weak acids and therefore not disturb the pH.
 Chloride Shift or (Hamburger’s Phenomenon)

1- On exposure to a high tension of CO2 at the tissues

(1) CO2 diffuses inside the RBCs in which carbonic anhydrase enzyme is found which catalysis the
reaction between CO2 and H2O accelerating its rate about 5000 fold in a small fraction of a second instead of
minutes.
(2) Carbonic acid formed in the red cells dissociates into H+ and bicarbonate ions.
(3) Most of H+ then combines with Hb. So, the pH is slightly decreased
(4) The bicarbonate content increase inside red cells. Therefore bicarbonate passes form red cell to plasma by its
concentration gradient while CI- diffuses into the red cells. This is possibly made by counter current carrier
diffusion by the presence of a special bicarbonate-chloride carrier protein in the cell wall membrane. So, the
bicarbonate content increases in both the red cells and the plasma.
(5) The chloride content of red cells increase while that of plasma decreases.
(6) Water shift: the osmotic pressure of the red cells increases. The water is shifted from plasma to the cells
which swell and the haematocrite value increases on the venous side.
Chloride Shift or (Hamburger’s Phenomenon)
Thank You