Diffusion across the alveolar membrane follows VgasโโT Emphysema destroys surface area ; fibrosis and edema thicken ; supplemental oxygen raises the pressure gradient to compensate.
Ventilation, gas exchange, and respiratory regulation
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Aโ Dโ (P1โโP2โ)
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A
T
Alveolar PO2โโ is about 100 mmHg vs. 40 mmHg in venous blood, driving oxygen loading.
Oxygen and Carbon Dioxide Transport
About 98.5 percent of O2โ rides hemoglobin; cooperative binding makes the dissociation curve sigmoidal โ a flat loading plateau in the lungs and a steep unloading region in tissues (P50โโ26 mmHg).
Bohr effect: high CO2โ, low pH, heat, and 2,3-BPG right-shift the curve, releasing O2โ where metabolism is high; fetal hemoglobin and CO shift it left.
CO2โ travels mostly as bicarbonate via carbonic anhydrase: CO2โ with the chloride shift preserving charge balance in RBCs.
Control of Ventilation
Central chemoreceptors in the medulla sense CSF pH as a proxy for arterial CO2โ โ the primary drive; peripheral chemoreceptors respond to PO2โโ below about 60 mmHg. Hyperventilation causes respiratory alkalosis; hypoventilation causes acidosis.
Key Takeaways
Fick's law variables map directly onto lung diseases.
Right shift releases oxygen; left shift hoards it.
Bicarbonate is the main CO2โ vehicle, linked to acid-base balance.
CO2โ, not O2โ, is the master regulator of breathing.