RESPIRATORY SYSTEM - 3 - PowerPoint PPT Presentation

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  2. Oxygen Content of Blood

  3. Structure of Hemoglobin Normal hemoglobin contains reduced iron, Fe2+ Deoxyhemoglobin (reducedhemoglobin) also has Fe2+ Methemoglobin has Fe3+ andcannot bind O2 Carboxyhemoglobin – bound tocarbon monoxide (abnormal) Hemoglobin is normally 97%oxyhemoglobin (oxyHb)

  4. Hemoglobin Concentration • Oxygen-carrying capacity of whole blood is determined by the concentration of hemoglobin • Anemia – low hemoglobin • Polycythemia – high RBC count (high altitude) • Erythropoietin controls RBC count

  5. OXYHEMOGLOBIN DISSOCIATION CURVE • Y-axis = %oxyHb • Y-axis = ml O2 per 100 ml blood • X-axis = PO2 (mmHg) • Hb is 97% saturated at 100 mmHg • This is when O2 gets unloaded to tissues • At venules, PO2= 40 mmHg • O2 unloaded to tissues is about 5 ml/100 ml of blood • Still have 75% oxyHb • Note sigmoidal curve- • b/w 100-40 mmHg, unloading happens slowly • Below 40 mmHg, curve drops off rapidly

  6. Effect of pH and Temperature on Oxygen Transport BOHR EFFECT – As pH drops, affinity of O2 for Hb decreases Low pH  graph shifts to right  greater unloading of O2 Important during exercise

  7. Effect of 2,3-DPG on Oxygen Transport

  8. Fetal Hemoglobin – Hb-F • Hb-F cannot bind to 2,3-DPG • Therefore, Hb-F has a higher affinity for oxygen than Hb-A (adult hemoglobin) • Therfore, oxygen is more readily transferred from maternal to fetal blood through the placenta

  9. Sickle-cell Anemia

  10. Myoglobin has a higher affinity for oxygen than hemoglobin

  11. Carbon Dioxide Transport

  12. Introduction • Carbon dioxide is carried in the blood in three forms: • Dissolved in plasma (more soluble than O2) • As carbaminohemoglobin attached to an amino acid in hemoglobin • As bicarbonate ions (accounts for the majority of transport)

  13. Introduction, cont • Carbonic anhydrase • Carbon dioxide readily reacts with water in the RBC of the systemic capillaries and plasma • Carbonic anhydrase is the enzyme that catalyzes the reaction to form carbonic acid at high PCO2 H2O + CO2 H2CO3

  14. Formation of Bicarbonate and H+ Carbonic acid is a weak acid that will dissociate into bicarbonate and hydrogen ions. This reaction also uses carbonic anhydrase as the catalyst H2CO3H+ + HCO3−

  15. Chloride Shift • Once bicarbonate ion is formed in the RBC, it diffuses into the plasma • H+ in RBCs attach to hemoglobin and attract Cl−. • The exchange of bicarbonate out of and Cl− into RBCs is called the chloride shift (see next slide). (chloride moves into the RBC because it’s more positively charged due to H+)

  16. Carbon Dioxide Transport & the Chloride Shift

  17. Bohr Effect • Bonding of H+ to hemoglobin lowers the affinity for O2 and helps with unloading. • This allows more H+ to bind, which helps the blood carry more carbon dioxide.

  18. Reverse Chloride Shift • In pulmonary capillaries, increased PO2 favors the production of oxyhemoglobin. • This makes H+ dissociate from hemoglobin and recombine with bicarbonate to form carbonic acid: H+ + HCO3− H2CO3 • Chloride ion diffuses out of the RBC as bicarbonate ion enters.

  19. Reverse Chloride Shift, cont • In low PCO2, carbonic anhydrase converts carbonic acid back into CO2 + H2O: H2CO3 CO2+ H2O • CO2 is exhaled.

  20. Reverse Chloride Shift in the Lungs

  21. Acid- Base Balance of the Blood

  22. Principles of Acid-Base Balance • Maintained within a constant range by the actions of the lungs and kidneys • pH ranges from 7.35 to 7.45. • Since carbonic acid can be converted into a gas and exhaled, it is considered a volatile acid; regulated by breathing. • Nonvolatile acids (lactic, fatty, ketones) are buffered by bicarbonate; can not be regulated by breathing, but rather the kidneys

  23. Bicarbonate as a Buffer • Bicarbonate ion is a weak base and is the major buffer in the blood excess H+ + HCO3- H2CO3 • Buffering cannot continue forever because bicarbonate will run out. • Kidneys help by releasing H+ in the urine and by producing more bicarbonate.

  24. Bicarbonate as a Blood Buffer

  25. Blood pH: Acidosis • Acidosis: when blood pH falls below 7.35 • Respiratory acidosis: caused by hypoventilation; rise of CO2 which increases H+ (lowers pH) • Metabolic acidosis: caused by excessive production of acids or loss of bicarbonate (diarrhea)

  26. Blood pH: Alkalosis • Alkalosis: when blood pH rises above 7.45 • Respiratory alkalosis: caused by hyperventilation; “blow off” CO2, H+ decreases, pH increases • Metabolic alkalosis: caused by inadequate production of acids or overproduction of bicarbonates, loss of digestive acids from vomiting • Respiratory component of blood pH measured by plasma CO2 • Metabolic component measured by bicarbonate

  27. Terms Used in Acid Base Balance

  28. Classification of Metabolic & Respiratory Components of Acidosis & Alkalosis

  29. Henderson-Hasselbalch Equation • Normal blood pH is maintained when bicarbonate and CO2 are at a ratio of 20:1. HCO3− pH = 6.1 + log ------------- 0.03PCO2 • Respiratory acidosis or alkalosis occurs with abnormal CO2 concentration • Metabolic acidosis or alkalosis occurs with abnormal bicarbonate concentration

  30. Ventilation and Acid-Base Balance • Ventilation controls the respiratory component of acid-base balance. • Hypoventilation: Ventilation is insufficient to “blow off” CO2. PCO2 is high, carbonic acid is high, and respiratory acidosis occurs. • Hyperventilation: Rate of ventilation is faster than CO2 production. Less carbonic acid forms, PCO2 is low, and respiratory alkalosis occurs.

  31. Ventilation and Acid-Base Balance, cont • Ventilation can compensate for the metabolic component. • A person with metabolic acidosis will hyperventilate; “blow off” CO2, H+ decreases, pH rises • A person with metabolic alkalosis will hypoventilate; slow respiration, build up CO2, H+ increases, pH lowers

  32. Effect of Lung Function on Blood Acid-Base Balance

  33. IX. Effect of Exercise and High Altitude on Respiratory Function

  34. Ventilation During Exercise • Exercise produces deeper, faster breathing to match oxygen utilization and CO2 production. • Called hyperpnea • Neurogenic and humoral mechanisms control this.

  35. Proposed Neurogenic Mechanisms • Sensory nerve activity from exercising muscles stimulates respiration via spinal reflexes or brain stem respiratory centers. • Cerebral cortex stimulates respiratory centers. • Helps explain the immediate increase in ventilation at the beginning of exercise

  36. Humoral Mechanisms • Rapid and deep breathing continues after exercise is stopped due to humoral (chemical) factors. • PCO2 and pH differences at sensors • Cyclic variations that are not detected by blood samples that affect chemoreceptors

  37. Effect of exercise on arterial blood gases & pH

  38. Lactate Threshold • Ventilation does not deliver enough O2 at the beginning of exercise. • Anaerobic respiration occurs at this time. • After a few minutes, muscles receive enough oxygen. • If heavy exercise continues, lactic acid fermentation will be used again. • The lactate threshold is the maximum rate of oxygen consumption attained before lactic acid levels rise.

  39. Lactate Threshold, cont • Occurs when 50−70% maximum oxygen uptake is reached • Due to aerobic limitations of the muscles, not the cardiovascular system (still at 97% oxygen saturation) • Endurance exercise training increases mitochondria and Krebs cycle enzymes in the muscles

  40. Changes in Respiratory Function During Exercise

  41. Acclimation to High Altitude • Adjustments must be made to compensate for lower atmospheric PO2. • Changes in ventilation • Hemoglobin affinity for oxygen • Total hemoglobin concentration

  42. Blood Gas Measurements at Different Altitudes

  43. Changes in Ventilation • Hypoxic ventilatory response: Decreases in PO2 stimulate the carotid bodies to increase ventilation. • Hyperventilation lowers PCO2, causing respiratory alkalosis. • Kidneys increase urinary excretion of bicarbonate to compensate. • Chronically apoxic people produce NO in the lungs, a vasodilator that increases blood flow. • NO bound to sulfur atoms (SNOs) in hemoglobin may stimulate the rhythmicity center in the medulla.

  44. Affinity of Hemoglobin for Oxygen • Oxygen affinity decreases, so a higher proportion of oxygen is unloaded. • Occurs due to increased production of 2,3-DPG • At extreme high altitudes, effects of alkalosis will override this, and affinity for oxygen will increase.

  45. Increased Hemoglobin Production • Kidney cells sense decreased PO2 and produce erythropoietin. • This stimulates bone marrow to produce more hemoglobin and RBCs. • Increased RBCs can lead to polycythemia, which can produce pulmonary hypertension and more viscous blood.

  46. Changes During Acclimatization to High Altitude

  47. Respiratory Adaptations to High Altitude