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Respiratory Regulation
Transport forms: physical dissolution (elementary substance O2, CO2) and chemical constitution (HbO2, HCO-3);
Systemic arterial and pulmonary venous blood are high in oxygen and low in carbon dioxide; Systemic venous and pulmonary arterial blood are high in carbon dioxide and low in oxygen.
CO2 exchange between the tissue cells and blood and CO2 transport
Movement of carbon dioxide and oxygen between the alveolar air and the blood and between the blood and peripheral tissue depends upon concentration gradients for these gases. As can be seen in this figure, the gradients favor the movement of oxygen from alveolar air to the tissue and movement of carbon dioxide from the tissue to alveolar air.
Oxygen transport in the blood under the low Po2 in the blood
Structure of Hemoglobin
Hemoglobin (Hb) enables the blood to carry large quantities of oxygen. Hb consists of a heme, an iron-prophyrin, bound to a globin molecule, a large polypeptide chain. Four hemeglobin complexes combine to form the whole Hb molecule. There are 4 different globin molecules that vary slightly in amino acid composition and are designated alpha, beta, gamma, and delta chains. The most common form is Hb A, which consists of 2 alpha and 2 beta chains. Oxygen binds to the iron atoms in Hb and because the molecule contains 4 iron atoms, 4 oxygen molecules can be bound.
Fe2+
Reaction: fast, reversible, no enzyme catalysis, influenced by PO2. After Fe ion combined with O2, Fe ion is still Fe2+, so it is oxygenation rather than oxidization; Absorbing ability different made by response of different Hb to various spectrum. Ability of HbO2 absorbing shortwave spectrum (e.g. blue light) is stronger; Ability of HHb absorbing long wave spectrum (e.g. red light) is stronger; Blood color is related to Hb content, quality, arterial blood: bright red; venous blood: prunosus Cyanosis: when reduced Hb (HHb) in the body surface capillary bed blood is more than 5 g /100 ml, skin and mucosa display violaceous color.
O2+ Hb
PO2 PO2
HbO2
Three terms are used to describe the amount of oxygen in the blood
Oxygen content refers to the total amount of oxygen in the blood, that is, the sum of the amount dissolved plus the amount bound to hemoglobin (Hb). Oxygen capacity is the maximum amount of oxygen that can combine with Hb. It is determined by exposing blood to a very high Po2 and calculating the amount bound to Hb after subtracting the amount dissolved. The oxygen capacity is determined by the amount of Hb in the blood and by the ability of Hb to bind oxygen. Oxygen saturation * is the proportion of the total number of oxygen binding sites that are occupied. It is determined by the Po2 and the ability of Hb to bind oxygen, but not by the amount of Hb present in the blood. Oxygen saturation = Oxygen content / Oxygen capacity 100%
100
% Hemoglobin Saturation
20
50
Po2 (mm Hg)
100
Oxygen is present in the blood in a dissolved form and is bound to Hb. The partial pressure of oxygen determines how much is in each form. Much more oxygen is bound to Hb at any partial pressure than is dissolved.
Reason Why?
pH decrease results in curve right shift which means that Hb releases more O2 to tissue cells for use.
Pco2 increase results in curve right shift which means that Hb releases more O2 to tissue cells for use.
Temperature increase results in curve right shift which means that Hb releases more O2 to tissue cells for use.
2,3-DPG increase results in curve right shift which means that Hb releases more O2 to tissue cells for use.
blood plasma
RBC
Cl-
HHb
Oxygen
0
0 50 Pco2 or Po2 (mm Hg) 100
Haldane effectO2 combining with Hb induces CO2 release, and HHb easily combines with CO2.
Pco2 (kPa)
midbrain
Two groups of chemoreceptors, medullary and peripheral, send afferent information to the medulla and influence the depth and rate of respiration. Medullary chemoreceptors are sensitive to pH and increase ventilation when pH falls ( [H+] ). Peripheral chemoreceptors are sensitive to pH, Po2 , and Pco2 with Pco2 being most effective. Sensitivity of the peripheral chemoreceptors is influenced by pH,. Po2 , and Pco2.
Medullary chemoreceptors
Chemical sensitive Area
The medullary chemoreceptors or central chemoreceptors are sensitive to pH. Since the blood-brain barrier is impermeable to H+, the medullary chemoreceptors do not directly sense the pH of the blood. However, CO2 can diffuse from the blood into the cerebral spinal fluid where it is converted to H+ and HCO3-.The hydrogen ions thus formed stimulate the medullary chemoreceptors.
The relative levels of pH, Po2 , and Pco2 influence the sensitivity of peripheral chemoreceptors to pH, Po2, or Pco2. When the Po2 or pH is low, the carotid body sensitivity to Pco2 is increased. Similarly, the carotid body sensitivity to oxygen is increased if the Pco2 is elevated. However, under some circumstances these interactions can be antagonistic. At high altitude Po2 falls because of the fall in atmospheric pressure. This stimulates ventilation but also reduces arterial Pco2 as carbon dioxide is blown off. The fall in Pco2 reduces the primary drive for ventilation and the sensitivity of the carotid body chemoreceptors to arterial oxygen. This leads to a further fall in arterial Po2 , enhancing oxygens stimulatory effect on ventilation. Ultimately, a steady state is reached between the stimulatory response to hypoxia (low oxygen) and the inhibitory effect of hypocapnia (low CO2).
Changes in Ventilation
Cheyne-stokes breathing
Pulmonary Blood
Biots breathing