RESPIRATORY SYSTEM
 Review anatomy

Lung Capacity   F 16

Total lung capacity  -  sums of defined volumes

  Inspiratory capacity
    Resting tidal volume - normal vol in and out, are = ; at rest about 500ml
    Inspiratory reserve vol -  deepest inspiration
  
    Functional residual capacity - at resting position, vol remaining in 
     lungs,  2500ml
        
  Expiratory reserve vol -  max contraction expels 1500ml
  Residual vol  -  1000ml still left

  Vital capacity  -  RTV + IRV + ERV
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Alveolar ventilation - vol of fresh air entering alveoli/min  F 17, T 4

  Alv. vent. (ml/min) = 
    Tidal vol (ml/breath) - Dead space (ml/breath) X  resp. rate (br/min)  
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Exchange of gases     F  18, 19

Assuming normal metabolism:  250ml/min
  O2 consumption and 200ml/min CO2 prod.

Air entering alveoli - 21% of 4000ml  =  840ml/min  
  O2 - 250ml crosses alveoli and enters capillaries
  O2 transported to tissues - 250ml/min leaves blood into interstitial 
       fluid and cells

Reverse for CO2

What drives this?     Fig 19
   Net diffusion down pressure gradient  [Partial pressure of O2 and CO2]

   Atmospheric gas pressures:     O2    160  mmHg;  CO2 0.03 mmHg
   Normal alveolar gas pressures: PO2 = 105 mm Hg;  PCO2  =  40 mmHg
   Interst. fl/cell gas pressures: O2   < 40 mmHg;  CO2 > 46 mmHg
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How are gases transported?

Oxygen

   1 L arterial blood contains: 3 ml dissolved O2    (1.5%)
                              197 ml  bound to Hb    (98.5%)
                    Total    200  ml  O2
  
   Cardiac output 5L/min
   O2 carried to tissues/min =  5 ml/min  X 200ml O2/L = 1000 ml O2/min 

   Erythrocytes contain the oxygen binding protein - hemoglobin (280 
     million molecules per cell)
        Deoxyhhemoglobin: no O2 bound
        Oxyhemoglobin:  4 Heme groups - contain Fe++  each iron binds a 
         mol of O2
        Carboxyhemoglobin:  iron may also bind CO

    Oxygen-hemoglobin dissociation curve  F23
-------------
Factors affecting oxygen transport:  [increase in variable shifts dissoc. 
                                      curve to rt]

     pH   7.4   -  normal affinity
          7.6   -  increased affinity
          7.2   -  decreased affinity

     temp  37 C  -  normal affin
           lower -  incr. affin
          higher - decr. affin

     DPG  - a byproduct of glycolytic pathway made by erythrocytes 
                lower conc.   -  incr affin
                higher conc   -  decr affin
-----------------
Carbon dioxide

      10% dissolved in H2O of plasma and erythrocyte
       30% carbamino Hb

       60% production of bicarbonate:
                carbonic anhydrase in erythrocyte
                reacts with H2O to form H2CO3 (carbonic acid), 
                dissociates onto HCO 3 - and H+
                chloride shift - antitransport moves HCO3 out of cell

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Regulation of the Resp System

Ventilation
     Skel. muscles involved require stimulation by somatic motor neurons
     Network of neurons in medulla oblongata [brain stem] communicate with 
motor  
          neurons to diaphragm and intercostals [sk muscles] 
     Two sets of neurons in medulla:
                dorsal resp group - normal inspiration - I neurons
                ventral resp group - active expiration - E neurons
                                                deep inhalation (exercise)  
- I+ neurons
     Protective reflexes
          Irritant receptors trigger brain 
          Stim bronchiolar smooth muscles via parasympathetic neurons -       
          Response bronchoconstriction, coughing
      
     Stim by limbic system during emotional or autonomic activities
     Some conscious control

     Responsive to changes in Pco2 and Po2, pH

How are blood parameters sensed?    What is response?

     Chemoreceptors

         Peripheral: carotid and aortic bodies  [remember these sites also 
contain 
             baroreceptors]
             Receptor cells gather sensory info on Po2 and pH,  
             Stim by decrease in  Po2  (high alt or disease) or rise in pH 
             Send info to medulla via afferent pathways
             Excite inspiratory neurons 
             Efferent pathway - to muscles, increase ventilation

        Central: located in medulla ob.
             Sensitive to increase in H+ from CO2 in cerebrospinal fluid 
[not metabolic H+]
             Excite inspiratory neurons - incr ventilation
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Acidosis and alkalosis  

Ventilation                 pH                 Pco2       Condition

  Normal                  7.35 - 7.45      39 - 41 mmHg
  Hypoventilation          low                 high       Resp. acidosis

  Compensatory             low                 low        Metabolic acidosis         
        hypervent.      
  Hyperventilation         high                low        Resp. alkalosis
  Compensatory             high                high       Metabolic alkalosis         
        hypovent.