Académique Documents
Professionnel Documents
Culture Documents
4 Separate Processes
1. Pulmonary Ventilation (VE)
2. Pulmonary Diffusion
Lung Volumes
Inspiration (muscular) & Expiration (passive)
External respiration vs. internal respiration
Cellular Respiration ?
Average lung volume = 4-6 Liters
Dynamic lung volumeability to move air quickly
VE minute ventilation= tidal volume x breathing frequency
Alveolar ventilation=VE - Dead space
Lung Volumes (cony)
Tidal Volume TV
Inspiratory Reserve Volume IRV
Expiratory Reserve Volume ERV
Residual Volume RV
Total Lung Capacity TLC
2. Pulmonary Diffusion
Alveolar Gas Exchangeacross the respiratory membrane, the
aveolar-capillary membrane
O2 Diffusion
CO2 Diffusionpartial pressure gradient is much smaller (.03
%), but membrane solubility is greater
PP changes with inspiration and gas delivery
Alveolar air: PO2 = 100 mmHg
PCO2 = 40 mmHg
Arterial blood: PO2 = 100 mmHg
PCO2 = 40 mmHg
Tissue Capillary: PO2 = 40 mmHg
PCO2 = 46 mmHg
Venous blood: PO2 = 40 mmHg
PCO2 = 46 mmHg
O2 and CO2 Transport and Exchange
O2 Transport
1. Attached to Hemoglobin: 98.5%
2. Dissolved in plasma: 1.5%
O2 and hemoglobin saturation: affected by PO2, temperature, and pH
Oxy-hemoglobin dissociation curve
Bohr Effect
Ventilatory Breakpoint
^ VE disproportionate to ^ VO2 (attempt to clear CO2)
Reflects respiratory response to ^ CO2 in the plasma
Dyspnea
SOB (shortness of breath)
Hyperventilation
Decrease in ventilatory drive secondary to ^ CO2 unloading
Hyperventilation does NOT ^ O2 stores Why?
Valsalva Maneuver
VE and VO2 (reflects energy transfer)
Ventilatory breakpoint or Breakaway Breathing
Anaerobic Threshold ~ Lactate Threshold
AT represents ^ CO2 which reflects anaerobic metabolism
VE usually NOT the limiting factor for performance
WHY?
(maybe in elite distance runners)
Oxygen Toxicity
Oxygen toxicity means having too much oxygen in one's body. Too much?
Aren't we able to breathe even 100% oxygen? Yes, but only under certain
conditions. When diving, the rising water pressure increases, according to
Dalton's Law, the partial pressure of oxygen. Oxygen represents about 20% of air
at sea level. However, while that percentage stays the same at depth, we inhale
many more oxygen molecules. At the 130 feet dive limit for recreational divers,
the number of oxygen molecules we inhale would represent 100% oxygen at the
surface! Under pressure, oxygen atoms don't always combine with something
else, and roam as free radicals.
Oxygen toxicity may occur at much shallower depths if a diver uses Nitrox, a breathing
gas that contains a larger percentage of oxygen and a lower percentage of nitrogen than air.
Nitrox is increasingly popular as it decreases the risk of nitrogen narcosis and excessive nitrogen
absorption, thus reducing the risk of decompression sickness and allowing a diver to stay down
longer. Proponents of Nitrox report less fatigue after diving and a greater degree of
"clearheadeness" while diving with Nitrox in addition to its other benefits. Nitrox is available with
various levels of oxygen, and Nitrox air tanks usually have a bright green and yellow band. Nitrox
1 consists of 32% oxygen, Nitrox 2 36% oxygen, and some advanced divers go as high as 40%.
Hey, the motto of our very own Carol Cotton Walker is, "Air sucks, Nitrox rocks!"
At depth, while the partial pressure of carbon monoxide remains the same,
the diver inhales many more carbon monoxide molecules, enough for poisoning
symptons such as headaches, confusion, tunnel vision and worse. Divers may
pass out because there is no longer enough oxygen. Signs of carbon monoxide
poisoning are flushed lips and cheeks. First aid treatment is pure oxygen and
fresh air. In serious cases recompression in a chamber with 100% oxygen may
bee necessary to reduce, or eliminate, longterm damage.
Smokers already inhale carbon monoxide and are therefore at greater risk
for hypoxicity (being low on oxygen).
Decompression Sickness (DCS)
It is vitally important to understand Decompression Sickness and what
causes it. We again have Henry's and Dalton's laws at work: More gas will
dissolve in body tissues under pressure (Henry), and there will be more of each
gas under pressure, though the percentages stay the same (Dalton). So as we
descend, nitrogen gets absorbed into our body tissues. Those tissues high in fat
absorb a lot, other tissues less. And tissues that have a large blood flow will
absorb and release gas more quickly than tissues with less blood flow, such as
tendons, cartilage, or fat.
So what happens is that we absorb a bunch of nitrogen that will then have
to be released again as we come back up. If the pressure is released slowly, the
nitrogen "out-gasses" slowly and will safely travel to the lungs where we breathe
it out. However, if the pressure drops too quickly, nitrogen bubbles form in the
blood and that can be very bad. While tiny little bubbles, generated by slow,
controlled acent, are harmless, large bubbles can get stuck and create
blockages. They may block circulation, and compress nerves because those are
surrounded by fatty tissue that absorbs a lot of nitrogen, or create dangerous
chemical reactions.
There is Type I DCS and Type II DCS. Type I - the non-neuralgic type - is
less severe and may manifest itself as rashes on the skin or joint pain, plus
sometimes fatigue and vertigo. The more serious Type II neuralgic DCS, caused
by larger bubbles that block blood flow can result in weakness, paralysis,
nausea, vomiting, tingling sensations, personality change and worse. First aid in
mild cases is 100% oxygen, drinking lots of fluid, aspirin as a blood thinner, and
plenty of rest. Type II DCS requires recompression in a hyperbaric chamber, and
the faster the better. That way, the bubbles dissolve again and are properly and
slowly eliminated through slow recompression