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Respiratory

Physiology

Important lung products

• Give the equation for calculating collapsing pressure.

• Collapsing pressure = 2 × tension / radius

• In the lung, _____ (angiotensin-converting enzyme/kallikrein) inactivates bradykinin, _____

(angiotensin-converting enzyme/kallikrein) activates bradykinin.

• Angiotensive converting enzyme; kallikrein

• In addition to inactivating bradykinin, what other reaction does angiotensin-converting

enzyme catalyze?

• The conversion of angiotensin I to angiotensin II

• A deficiency of surfactant leads to what neonatal condition?

• Respiratory distress syndrome

• Name five important molecules produced by the lungs.

• Surfactant, prostaglandins, histamine, angiotensin-converting enzyme, and kallikrein

• What are the effects of surfactant secretion in the lungs?

• Decreased alveolar surface tension, increased compliance, and decreased work of inspiration

• What is the effect of histamine on the airways in the lung?

• Increases bronchoconstriction
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• Angiotensin-converting enzyme inhibitors increase bradykinin, which leads to which two

common adverse effects?

• Cough and angioedema

Lung volumes

• What is the term for the volume of air that can still be breathed out after normal expiration?

• Expiratory reserve volume

• Vital capacity equals the sum of what three lung volumes?

• Tidal volume, inspiratory reserve volume, and expiratory reserve volume

• Describe the functional reserve capacity.

• The volume left in the lungs after normal expiration

• What is the term for the volume of air in the lungs after maximal expiration?

• Residual volume

• The inspiratory reserve volume plus the tidal volume equals what?

• Inspiratory capacity

• Which lung volume cannot be measured on spirometry: inspiratory reserve volume, tidal
volume, expiratory reserve volume, or residual volume?

• Residual volume

• What is the term for the maximum volume of air that can be inhaled and exhaled?

• Vital capacity

• The residual volume plus the expiratory reserve volume equals what?
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• The functional reserve capacity

• How much is the typical tidal volume?

• 500 mL

• What is the term for the volume of air that moves into the lungs with each quiet inspiration?

• Tidal volume

• What is the term for the volume of air in excess of tidal volume that moves into the
lung on maximum inspiration?

• Inspiratory reserve volume

• The inspiratory reserve volume plus the tidal volume plus the expiratory reserve volume plus
the residual volume equals what?

• Total lung capacity

• What is the term for the lung volume that includes all capacity except the residual volume?

• Vital capacity

Determination of physiologic dead space

• What is the formula for calculating dead space volume given an arterial blood gas and a
measurement of exhaled carbon dioxide?

• Dead space volume = tidal volume × [(partial arterial pressure of carbon dioxide - partial
expiratory pressure of carbon dioxide) / partial arterial pressure of carbon dioxide]

• Physiological dead space includes the anatomical dead space of the _____
(conducting/respiratory) airways plus the functional dead space in _____
(alveoli/bronchioles).

• Conducting; alveoli
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• Which section of the healthy lung contributes more to functional dead space: the apex or the
base?

• The apex

Lung and chest wall

• What balances the inward elastic pull of the lung at the point of functional residual capacity
(i.e. at the end of a normal expiration)?

• The outward pull of the chest wall

• At the point of functional residual capacity (i.e., at the end of a normal expiration), what is the
value of the air pressure within the lungs?

• At functional residual capacity, the pressure within the lungs is equal to atmospheric pressure

• Describe the natural tendency of movement of the lung and chest wall.

• The lungs tend to collapse inward and chest wall springs outward

Hemoglobin

• Does fetal hemoglobin have a higher or lower affinity for oxygen compared with
adult hemoglobin?

• Higher; as a result, fetal blood can draw oxygen across the placenta

• Does hemoglobin have positive or negative cooperativity with respect to oxygen binding and
affinity?

• Positive; the more oxygen molecules bind, the more affinity hemoglobin has for additional
oxygen molecules

• With respect to cooperativity and affinity for oxygen, what are the differences between
hemoglobin and myoglobin?

• Myoglobin has high affinity for oxygen but does not display cooperativity of oxygen binding
because it has only a single subunit
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• What are the two conformational forms of hemoglobin?

• Relaxed and taut

• Does fetal hemoglobin have a higher or lower affinity for 2,3-biphosphoglycerate compared
with adult hemoglobin and what is the result?

• Lower; increased affinity for oxygen

• An increase in which five factors will favor the taut form of hemoglobin over the relaxed form
and decrease affinity for oxygen?

• Chloride, hydron, carbon dioxide, 2,3-bisphosphoglycerate, and temperature

• How many polypeptide subunits make up hemoglobin?

• Four

• Which form of hemoglobin will lead to decreased oxygen unloading?

• The relaxed form (remember: "When you're Relaxed, you do your job better [carry oxygen]")

• Which form of hemoglobin has a low affinity for oxygen, relaxed or taut?

• Taut

• Which form of hemoglobin has a high affinity for oxygen, relaxed or taut?

• Relaxed

• Fetal hemoglobin is composed of two ____ subunits and two ____ subunits.

• α; γ

• Adult hemoglobin is formed from two _____ subunits and two _____ subunits.

• α; β

Hemoglobin modifications
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• Does carbon monoxide or oxygen have a greater affinity for hemoglobin?

• Carbon monoxide has 200 times the affinity of oxygen

• What is the treatment for toxic levels of methemoglobin?

• Methylene blue (remember: METHemoglobinemia can be treated with METHylene blue)

• Does methemoglobin contain iron in the oxidized state or the reduced state; Fe2+ or Fe3+; ferric
iron or ferrous iron?

• The oxidized state; Fe3+; ferric iron

• Which has a higher affinity for cyanide, hemoglobin or methemoglobin?

• Methemoglobin

• Does hemoglobin contain iron in the oxidized state or in the reduced state; Fe2+ or Fe3+; ferric
iron or ferrous iron?

• The reduced state; Fe2+; ferrous iron

• What are the mechanisms of action of nitrites and thiosulfate in the treatment of cyanide
poisoning?

• Nitrites oxidize the iron in hemoglobin to form methemoglobin; methemoglobin then binds to
cyanide ions, which in turn allows cytochrome oxidase to function; after administering
nitrites, thiosulfate is used to bind to the cyanide-methemoglobin complexes, to form
thiocyanate, which is renally excreted

• In treating cyanide poisoning, ______ is the compound used to bind cyanide, forming _____
which is a renally excretable compound.

• Thiosulfate; thiocyanate

• What is the treatment for cyanide poisoning?

• Nitrites, and subsequently thiosulfate

• What is the name of a form of hemoglobin in which carbon monoxide is bound instead of
oxygen?
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• Carboxyhemoglobin

• Which has a higher affinity for oxygen, hemoglobin or methemoglobin?

• Hemoglobin

• Hemoglobin contains _____ (ferric/ferrous) iron, whereas methemoglobin contains _____

(ferric/ferrous) iron.

• Ferrous; ferric

• When another molecule, such as CO, binds to hemoglobin in place of oxygen, what are the
systemic effects?

• This leads to tissue hypoxia from decreased oxygen saturation and decreased oxygen content
in the blood

Oxygen-hemoglobin dissociation curve

• An increase in 2,3-diphosphoglycerate causes a _____ (left/right) shift in the oxygen-
hemoglobin dissociation curve.

• Right

• An increase in the partial pressure of carbon dioxide causes a _____ (left/right) shift in the
oxygen-hemoglobin dissociation curve.

• Right

• When the oxygen-hemoglobin dissociation curve shifts to the left, what happens to the
affinity of hemoglobin for oxygen?

• A left shift increases the affinity of hemoglobin for oxygen

• High altitude induces what change in the oxygen-hemoglobin dissociation curve?

• A right shift

• A decrease in pH causes a _____ (left/right) shift in the oxygen-hemoglobin dissociation curve.

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• Right

• Hemoglobin can bind four oxygen molecules and has a higher affinity for each subsequent
oxygen molecule bound. What is the term for this phenomenon?

• Positive cooperativity

• When the oxygen-hemoglobin dissociation curve shifts to the right, what happens to the P50?

• A right shift increases the P50, indicating that higher oxygen pressure is required to saturate
hemoglobin

• An increase in the amounts of which six factors causes a right shift of the oxygen-hemoglobin
dissociation curve?

• CO2, hydrogen ions (therefore acidity), altitude, 2,3-DPG, metabolic needs (eg, exercise), and
temperature (remember: CADET face right: CO2, Acid/Altitude, DPG [2,3-DPG], Exercise,
Temperature)

• A decrease in temperature causes a _____ (left/right) shift in the oxygen-hemoglobin

dissociation curve.

• Left

• What is the shape of the oxygen-hemoglobin dissociation curve?

• Sigmoidal

• A shift of the oxygen-hemoglobin dissociation curve to the right facilitates what process in
tissue?

• The unloading of oxygen to tissue

• In the oxygen-hemoglobin dissociation curve, what values are represented by the x and y
axes?

• The partial pressure of oxygen represents the x axis, while hemoglobin saturation represents
the y-axis

• An increase in pH causes a ______ (left/right) shift in the oxygen-hemoglobin dissociation

curve.
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• Left

• The oxygen-hemoglobin dissociation curve for fetal hemoglobin is shifted in what direction?

• Left; fetal hemoglobin has higher affinity for oxygen than adult hemoglobin

• A decrease in 2,3-diphosphoglycerate causes a _____ (left/right) shift in the oxygen-

hemoglobin dissociation curve.

• Left

• When the oxygen-hemoglobin dissociation curve shifts to the right, what happens to the
affinity of hemoglobin for oxygen?

• A right shift decreases the affinity of hemoglobin for oxygen

• An increase in temperature causes a _____ (left/right) shift in the oxygen-hemoglobin

dissociation curve.

• Right

• When the oxygen-hemoglobin dissociation curve shifts to the right, what happens to the
affinity of hemoglobin for oxygen?

• A right shift decreases the affinity of hemoglobin for oxygen

• When the oxygen-hemoglobin dissociation curve shifts to the left, what happens to the P50?

• A left shift decreases the P50; hemoglobin is saturated at lower pressures of oxygen

• A decrease in the partial pressure of carbon dioxide causes a _____ (left/right) shift in the
oxygen-hemoglobin dissociation curve.

• Left

Pulmonary circulation

• Within the lungs, hypoxic vasoconstriction serves what physiologic function?

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• It shifts blood away from the poorly ventilated regions of the lung to the well-
ventilated regions of the lung

• Under perfusion-limited conditions, how can gas exchange be increased?

• By increasing blood flow

• Under conditions of strenuous exercise, is oxygen a perfusion-limited gas or a

diffusion-limited gas?

• Diffusion-limited gas

• In the equation for gas diffusion, which variable is affected by emphysema and how?

• Area of membranes available for gas transfer is decreased in emphysema, causing a

decrease in diffusion

• Under perfusion-limited conditions, where along the length of the pulmonary capillary
do the partial pressures of a gas equilibrate?

• Early; gas exchange is not limited by its ability to cross the membrane, only by the
supply of blood

• Is carbon dioxide a perfusion-limited gas or a diffusion-limited gas?

• Perfusion-limited gas

• What are three signs of right ventricular heart failure due to cor pulmonale?

• Jugular venous distention, edema, and hepatomegaly

• Within the lungs, a decrease in the partial pressure of oxygen in arterial blood causes
what process to occur within the vasculature in the area?

• Hypoxic vasoconstriction; in the rest of the body hypoxia causes vasodilation

• Normally, pulmonary circulation is a _____ (high/low) resistance, _____ (high/low)

compliance system.

• Low; high
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• Is nitrous oxide a perfusion-limited gas or a diffusion-limited gas?

• Perfusion-limited gas

• Under normal, healthy conditions, is oxygen a perfusion-limited gas or a diffusion-

limited gas?

• Perfusion-limited gas

• Under diffusion-limited conditions, where along the length of the pulmonary capillary
does the gas equilibrate?

• It does not equilibrate; the characteristics of the gas cause it to diffuse slowly across
the alveolar membrane

• What is the equation for diffusion of a gas across a membrane?

• Vgas = A/T × Dk(P1 - P2), where A = area, T = thickness, and Dk(P1 - P2) = difference in
partial pressures

• In the equation for gas diffusion, which variable is affected by pulmonary fibrosis and
how?

• Thickness of the membrane is increased in pulmonary fibrosis, causing a decrease in

diffusion

• Is carbon monoxide a perfusion-limited gas or a diffusion-limited gas?

• Diffusion-limited gas

• Under what three conditions is oxygen a diffusion-limited gas?

• Exercise, emphysema, and fibrosis

• What are the cardiac complications of pulmonary hypertension?

• Cor pulmonale and right ventricular failure

Pulmonary hypertension
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• How do sleep apnea or living at high altitudes cause pulmonary hypertension?

• Sleep apnea and living at high altitudes cause hypoxia, which in turn causes
pulmonary vasoconstriction

• What is normal pulmonary arterial pressure?

• 10-14 mm Hg

• How can autoimmune disease cause pulmonary hypertension?

• Processes such as systemic sclerosis lead to inflammation, then to intimal fibrosis,

which in turn leads to medial hypertrophy in the pulmonary vasculature

• How do recurrent thromboemboli cause pulmonary hypertension?

• By decreasing the total cross-sectional area of the pulmonary vascular bed

• What pulmonary artery pressures define pulmonary hypertension?

• 25 mm Hg or greater during rest and >35 mm Hg during exercise

• What are some of the potential causes of secondary pulmonary hypertension?

• Chronic obstructive pulmonary disease, left-to-right shunt, mitral stenosis, recurrent

thromboemboli, autoimmune disease (ie, systemic sclerosis), sleep apnea, or living at
high altitudes

• What are three pathological changes in the vasculature are caused by

pulmonary hypertension?

• Atherosclerosis, medial hypertrophy, and intimal fibrosis of the pulmonary arteries

• How does left-to-right shunt cause pulmonary hypertension?

• By causing increased shear stress (due to increased blood volume in the pulmonary
vasculature) and thus endothelial injury

• What is the prognosis for a patient diagnosed with primary pulmonary hypertension?
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• Very poor; the disease is progressive and fatal

• How does chronic obstructive pulmonary disease cause pulmonary hypertension?

• By the destruction of lung parenchyma and subsequent vasoconstriction due to

hypoxia

• Primary pulmonary hypertension is caused by what?

• An inactivating mutation in the BMPR2 gene, which normally functions to inhibit

vascular smooth muscle proliferation

• What are the sequelae of pulmonary hypertension if left untreated?

• Severe respiratory distress, causing right ventricular hypertrophy and cyanosis . This
results in decompensated cor pulmonale which leads to death

• How does mitral stenosis cause pulmonary hypertension?

• By increasing resistance to blood flow in the left heart; thus causing a build-up of
pressure starting in the left atrium and backing up to the pulmonary vasculature

Pulmonary vascular resistance (PVR)

• How is left atrial pressure measured?

• It is approximated by wedge pressure

• How is pulmonary vascular resistance calculated?

• Pulmonary vascular resistance = (pressure in the pulmonary artery minus pressure in the left
atrium) divided by the cardiac output

• What is the equation for resistance, given vessel length, diameter, and blood viscosity?

• R = (8ηl) / (πr4), where η = viscosity of blood, l = vessel length, and r = vessel radius

• Pulmonary vascular resistance is _____ (directly/inversely) related to vessel length and _____
(directly/inversely) related to vessel radius.
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• Directly; inversely

Oxygen content of blood

• A decrease in hemoglobin will have what effect on partial oxygen pressure: decrease,
increase, or no change?

• No change

• When the hemoglobin level rises, the oxygen content of the blood _____ (rises/falls).

• Rises, because oxygen-binding capacity depends on the total amount of hemoglobin

• Visible cyanosis typically results when deoxygenated hemoglobin is at what level?

 5 g/dL

• What is the formula for oxygen delivery to tissues?

• Oxygen delivery to tissues = cardiac output × oxygen content of blood

• How much oxygen can 1 g of hemoglobin bind?

• 1.34 mL

• How is the oxygen content of the blood calculated?

• Oxygen content of the blood = (oxygen-binding capacity × percent saturation) + dissolved

oxygen

• Why does arterial partial pressure of oxygen decrease with chronic lung disease?

• Physiologic shunt decreases the oxygen extraction ratio

• When the hemoglobin level falls, the percent oxygen saturation of the blood ______
(rises/falls/remains stable).

• Remains stable; the blood can still be 100% saturated but there will be less oxygen-binding
capacity and therefore lower total oxygen content
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• Will a patient with anemia become cyanotic at a higher or lower oxygen saturation than a
normal patient?

• An anemic patient will have a lower oxygen saturation by the time she appears cyanotic; the
blue coloration of cyanosis is proportional to the concentration of deoxyhemoglobin, which is
lower in anemic patients (as are the concentrations of all types of hemoglobin)

• What is the normal oxygen-binding capacity of the blood?

• Approximately 20.1 mL oxygen/dL of blood

• What is the average amount of hemoglobin in normal blood?

• Approximately 15 g/dL

Alveolar gas equation

• How can the alveolar gas equation be simplified and approximated (assuming that the patient
is breathing ambient air)?

• Alveolar partial pressure of oxygen = 150 - (arterial partial pressure of carbon dioxide / 0.8)

• What three pathological processes can lead to increased A-a gradient?

• Shunting, ventilation/perfusion mismatch, and fibrosis of the lungs

• What is the alveolar gas equation?

• Alveolar partial pressure of oxygen (in mm Hg) = the partial pressure of oxygen in inspired air
minus (alveolar partial carbon dioxide pressure divided by the respiratory quotient); or, PAO2
= PIO2 - (PACO2/R)

• By using the alveolar gas equation, what important measure of pulmonary function can be
determined?

• The alveolar-arterial gradient (the A-a gradient)

• What is the normal alveolar-arterial gradient?

• 10-15 mmHg
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Oxygen deprivation

• Which 3 processes can lead to hypoxemia with an increased A-a gradient?

• Ventilation/perfusion mismatch, diffusion limitation, and right-to-left shunt

• Which 2 processes lead to hypoxemia with a normal A-a gradient?

• High altitude and hypoventilation

• What is the difference between hypoxemia and hypoxia?

• Hypoxemia refers to decreased arterial partial pressure of oxygen and can lead to hypoxia,
which is defined as decreased oxygen delivery to tissue

• Name two processes that can lead to ischemia (i.e. loss of blood flow).

• Impeded arterial flow, and reduced venous drainage

• Name five processes that can lead to hypoxemia (ie, decreased arterial oxygen).

• High altitude, hypoventilation, ventilation/perfusion mismatch, diffusion limitation, and right-

to-left shunt

• Name five processes that can lead to hypoxia (ie, decreased oxygen delivery to tissue).

• Decreased cardiac output, hypoxemia, anemia, cyanide poisoning, and carbon monoxide
poisoning

V/Q mismatch

• A ventilation/perfusion ratio that approaches 0 for a given area of lung indicates that what is
occurring in that area?

• Airway obstruction, creating a shunt of blood flow that does not participate in gas exchange

• What is the ideal ratio of ventilation to perfusion to maximize gas exchange?

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• 1 to 1

• What process causes the ventilation at the apex of the lungs to be considered "wasted?"

• The high alveolar pressure at the apex causes compression of the capillaries, and thus an
inability to undertake gas exchange with the blood vessels

• Within what part of the lung does ventilation/perfusion equal approximately 0.6?

• The base of the lung

• In the lung base (zone 3), arrange the following in order of increasing pressure: artery, vein,
alveolus.

• Alveolus < vein < artery

• Within what part of the lung does ventilation/perfusion equal approximately 3?

• The apex of the lung

• Microorganisms that thrive in high-oxygen environments, such as tuberculosis, flourish in

which part of the lungs?

• The apex

• Is perfusion greater at the base of the lung or the apex of the lung?

• The base of the lung

• Is ventilation greater at the base of the lung or the apex of the lung?

• The base of the lung

• In the apex of the lung, there is wasted _____ (perfusion/ventilation).

• Ventilation

• The vasodilation of the apical capillaries of the lung that occurs with exercise results in what
change to the ventilation/perfusion ratio?
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• The ventilation/perfusion ratio approaches 1, maximizing gas exchange to meet the metabolic
demands of exercise

• When blood flow (but not airflow) into an area of the lungs is obstructed such that the
ventilation/perfusion ratio approaches infinity, the area can be considered what type of
space?

• Physiologic dead space

• In zone 2 of the lung, arrange the following in order of increasing pressure: artery, vein ,
alveolus.

• Vein < alveolus < artery

• In the base of the lung, there is wasted _____ (perfusion/ventilation).

• Perfusion

• In hypoxia due to _____ (dead space/shunting), 100% oxygen does not improve the partial
pressure of oxygen in the blood; while in hypoxia due to increased _____ (dead
space/shunting), there is an improvement in the partial pressure of oxygen in the blood.

• Shunting; dead space

• Which zone of the lung is associated with wasted perfusion?

• Zone 3

• Which zone of the lung is associated with wasted ventilation?

• Zone 1

• What is the name for the process whereby airway obstruction leads to perfusion with no
ventilation within an area of the lungs?

• Shunt

• A ventilation/perfusion ratio that approaches infinity for a given area of lung indicates that
what is occurring in that area?

• Blood flow obstruction (ie, pulmonary embolus)

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• In the lung apex (zone 1), arrange the following in order of increasing pressure: artery, vein,
alveolus.

• Vein < artery< alveolus

CO2 transport

• What is the name for the effect in which the oxygenation of hemoglobin within the lungs
promotes the dissociation of carbon dioxide from hemoglobin?

• The Haldane effect

• In peripheral tissues, the right shift of the oxygen dissociation curve that results from
decreased pH causes an unloading of oxygen. What is this effect called?

• The Bohr effect

• Other than as bicarbonate, in what two other ways is carbon dioxide transported from the
tissues to the lungs?

• Bound to hemoglobin as carbaminohemoglobin and dissolved in blood

• In the lungs, the oxygenation of hemoglobin promotes what?

• The dissociation of a proton from hemoglobin and therefore a decrease in pH, which favors
formation of carbon dioxide from bicarbonate

• What percentage of carbon dioxide gets transported from the tissues to the lungs as
carbaminohemoglobin; as dissolved carbon dioxide?

• Approximately 5%; approximately 5%

• After it is inside a red blood cell, each carbon dioxide molecule combines with which molecule
in a reaction catalyzed by carbonic anhydrase?

• Water

• What enzyme catalyzes the conversion of carbon dioxide and water into carbonic acid?

• Carbonic anhydrase
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• In which forms is carbon dioxide transported from the tissues to the lungs?

• Three forms: (1) as bicarbonate, (2) bound to hemoglobin as carbaminohemoglobin, and (3)
dissolved

• Ninety percent of the carbon dioxide transported from the tissues to the lungs is in what
form?

• Bicarbonate, the creation of which is catalyzed by carbonic anhydrase

• Within a red blood cell, the carbonic acid formed from the combination of carbon dioxide and
water dissociates into what two compounds?

• Hydrogen and bicarbonate ions

• What is the fate of the bicarbonate that results from the deprotonation of carbonic acid
within an red blood cell?

• It gets exchanged out of the red blood cell for a chloride molecule that enters the red blood
cell

• Regarding carbon dioxide transport, in which direction will the lower pH of peripheral tissues
(compared to the lungs) shift the oxygen dissociation curve?

• To the right, favoring dissociation of oxygen from hemoglobin

Response to high altitude

• What substance binds to hemoglobin so that hemoglobin releases more oxygen as a

physiologic response to high altitude?

• 2,3-Diphosphoglycerate; increased concentrations shift the hemoglobin dissociation curve to

the right

• What happens to ventilation as a response to high altitude in acute situations; chronic

situations?

• Ventilation is increased in both cases

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• In response to high altitude, chronic hypoxic pulmonary vasoconstriction results in what

condition?

• Right ventricular hypertrophy

• What happens to erythropoietin levels as a response to high altitude?

• Erythropoietin levels are increased as are hematocrit and hemoglobin

• The increased renal excretion of bicarbonate that is seen in response to high altitude can be
augmented using what?

• Acetazolamide; the drug is a carbonic anhydrase inhibitor that makes the urine more basic

• What cellular changes occur in response to high altitude?

• There is an increase in mitochondria

• What happens to the level of 2,3-diphosphoglycerate in response to high altitude?

• The 2,3-diphosphoglycerate level increases

• Increased renal excretion of what substance occurs in response to high altitude?

• Bicarbonate

• The increased renal excretion of bicarbonate that is seen in response to high altitude
compensates for what?

• The respiratory alkalosis that occurs as a result of increased ventilation

Response to exercise

• What happens to the V/Q ratio as a response to exercise?

• It becomes more uniform from apex to base; hence gas exchange is more efficient

• PaO2 and PaCO2 _____ (increase/decrease/remain stable) in response to exercise, whereas

venous CO2 content _____ (increases/decreases/remains stable).

• PaO2 and PaCO2 do not change in response to exercise but venous CO2 content increases
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• What happens to pulmonary blood flow as a response to exercise?

• It increases due to increased cardiac output

• As a result of exercise, what happens to carbon dioxide production in muscles; oxygen

consumption?

• Both are increased

• How does the pH of the body change during strenuous exercise?

• pH decreases during strenuous exercise due to lactic acidosis