Oxygen Transport

 O2 carried in blood in 2 form : dissolved or bound to

Hb.
 O2 binding capacity of blood is max amount of O2
that can be bound to Hb in blood and it depends on
Hb concentration in blood.
 O2 content of blood is total amount of O2 carried in
blood, including bound and dissolved O2 depends
on PO2 and P50 of Hb.
 O2 content = (O2 – binding capacity x %
saturation) + Dissolved O2
 Hb combine rapidly and reversibly with O2 to form
oxyhemoglobin.
 Hb-O2 dissociation curve is a plot of percent
saturation of Hb as a function of PO2.
- At PO2 of 100mmHg : hb is 100% saturated ,O2 is
bound to all 4 heme group on all Hb molecules.
- At PO2 of 40mmHg : Hb is 75% saturated in which
means on average, 3 of the 4 heme group of Hb
molecules hv O2 bound.
- At Po2 of 25mmHg : Hb is 50% saturated, which
means average of 2 out of 4 heme groups of each Hb
molecules hv O2 bound.
CO2 Transport
 CO2 is produced in the tissues and carried to the lungs
in the venous blood in 3 forms :

i) Dissolved CO2 ( small amount)

ii) Carbaminohemoglobin ,Co2 bound to Hb.
iii) Bicarb ion ( from hydration if CO2 in RBC ) about
90%.
Pulmonary Circulation
 Zone 1 : Alveolar pressure > arterial pressure > venous
pressure . High alveolar pressure may compress the
capillaries and reduce blood flow in this zone.

 Zone 2 : Arterial pressure > alveolar pressure > venous

pressure. Blood flow is driven by the difference
between arterial and alveolar pressure.

 Zone 3 : Arterial pressure > venous pressure > alveolar

pressure .Blood flow driven by the difference between
arterial and venous pressure.
 Right to left shunts
- Small extend as 2% of cardiac output bypasses the
lung.
- May be about 50% in congenital abnormalities, most
commonly seen in Tetralogy of Fallot.
- Always result in decrease in arterial PO2 because of
mixture of venous and arterial blood.
 Left to right shunts.
- Are more common than right to left shunt cz pressure
higher on left side of heart.
- Usually caused by congenital abnormalities ( Patent
ductus arteriosus ) or traumatic injury.
- Do not result in decreased arterial PO2, instead PO2 is
elevated on the right side of the heart because there is
mixture of arterial blood with venous blood.
V/Q Defects
 Is the ratio of alveolar ventilation (V) to pulmonary
blood flow (Q).

 If the frequency, tidal volume and cardiac output are

normal, the V/Q ratio is approximately 0.8. This V/Q
ratio is result of an arterial Po2 of 100mmHg and
arterial Pco2 of 40mmHg.
 Blood flow is lowest at apex and highest at the base
due to gravitational effects.
 Ventilation is lower at apex and higher at base.
 Therefore, the V/Q ratio is higher at the apex and
lower at the base of lung.
 At apex (higher V/Q), Po2 is highest and pco2 is lower
because gas exchange is more efficient.
 At base ( lower V/Q), Po2 is lowest and Pco2 is higher
because gas exchange is less efficient.
Ventilation
Inspiration = the movement of air into the respiratory tracts (upper &
lower)

Expiration = movement of air out of the respiratory tracts

• Respiratory cycle is one inspiration followed by an expiration.

• Cause of Inspiration
• Contraction of the inspiratory muscles causes an increase
in the thoracic cavity size, thus allowing air to enter the
respiratory tract.
• As the volume in the thoracic cavity increases (due to
inspiratory muscle action) the pressure within the
respiratory tract drops below atmospheric pressure,
creating a pressure gradient which causes molecular
movement to favor moving into the respiratory tract
• Inspiration
• Occurs as alveolar pressure drops below atmospheric
pressure
• For convenience atmospheric pressure = 0 mm Hg
• A (-) value then indicates pressure below atmospheric P
• A (+) value indicates pressure above atmospheric P
• At the start of inspiration (time = 0),
• atmospheric pressure = alveolar pressure
• No net movement of gases!
• At time 0 to 2 seconds
• Expansion of thoracic cage and corresponding pleural
membranes and lung tissue causes alveolar pressure to drop to
-1 mm Hg
• Air enters the lungs down the partial pressure gradient
• Expiration
• Occurs as alveolar pressure elevates above atmospheric
pressure due to a shrinking thoracic cage
• At time 2-4 seconds
• Inspiratory muscles relax, elastic tissue of corresponding structures
initiates a recoil back to resting state
• This decreases volume and correspondingly increases alveolar pressure to
1 mm Hg
• This is above atmospheric pressure, causing…?

• At time 4 seconds
• Atmospheric pressure once again equals alveolar pressure and there is no
net movement
• Both inspiration and expiration can be modified
• Forced or active inspiration
• Forced or active expiration

• The larger and quicker the expansion of the thoracic cavity, the
larger the gradient and
• The faster air moves down its pressure gradient