Fick's law, effect of disease on alveolar gas exchange, matching ventilation and perfusion, oxygen transport, hemoglobin, oxygen unloading, carbon monoxide, hypoxia, carbon dioxide

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Biomedical Science
BMS 360
Douglas Ishii

24 AprilFigure 1323Oxygen diffusion along the length of the pulmonary capillaries quickly achieves diffusional equilibrium unless disease processes in the lung reduce the rate of diffusionAbout 1 sec for RBC to flow through pulmonary capillaryAboutsec for alveolar O to bind to hemoglobin within 13 length of capillary2Reserve pulmonary capillary capacityAt rest capillaries are closed at the apex top of lungs due to low blood pressure standingThese capillaries provide reserve capacityDue to gravity the transit time for blood is fastest at the lower lungs and slower at the upper lungsDuring exercise the blood pressure in apex of lungs increases the capillaries open so more capillaries are participating in gas exchangeFicks Law of Gas DiffusionThis law determines gas exchange across the respiratory membraneA greater partial pressure of the gas or a greater surface area results in a greater volume of gas that diffusesThe thicker the membrane the less gas diffusionEffect of Disease on Alveolar Gas ExchangePulmonary edema Increased pulmonary vein pressure causes fluid accumulation in interstitial space lung cells and alveoliAlveoli are compressed and respiratory membrane thicker reducing gas exchangeEmphysema The loss of lung tissues and decrease in total number of working alveoli would decrease the total area available for diffusion reducing gas exchangeDiffuse interstitial fibrosis Alveolar cell walls thicken fibrotic the diffusing distance is increased and gas exchange is reducedLung cancer Surface area available for gas diffusion can be substantially decreased
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