Pulmonary Gas Pressures
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Pulmonary Gas Pressures
The factors that determine the values for alveolar pO2 and pCO2 are: *The pressure of outside air *The partial pressures of inspired oxygen and carbon dioxide *The rates of total body oxygen consumption and carbon dioxide production *The rates of alveolar ventilation and perfusion Partial pressures The partial pressures (in torr) for a human at rest: Partial pressure of oxygen (at sea level) The alveolar oxygen partial pressure is lower than the atmospheric O2 partial pressure for two reasons. * Firstly, as the air enters the lungs, it is humidified by the upper airway and thus the partial pressure of water vapour (47 mmHg) reduces the oxygen partial pressure to about 150 mmHg. * The rest of the difference is due to the continual uptake of oxygen by the pulmonary capillaries, and the continual diffusion of CO2 out of the capillaries into the alveoli. The alveolar pO2 is not routinely measured but is calculated from blood gas measurements by the alveolar gas equation. Partial ...
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Pulmonary Alveolus
A pulmonary alveolus (plural: alveoli, from Latin ''alveolus'', "little cavity"), also known as an air sac or air space, is one of millions of hollow, distensible cup-shaped cavities in the lungs where pulmonary gas exchange takes place. Oxygen is exchanged for carbon dioxide at the blood–air barrier between the alveolar air and the pulmonary capillary. Alveoli make up the functional tissue of the mammalian lungs known as the lung parenchyma, which takes up 90 percent of the total lung volume. Alveoli are first located in the respiratory bronchioles that mark the beginning of the respiratory zone. They are located sparsely in these bronchioles, line the walls of the alveolar ducts, and are more numerous in the blind-ended alveolar sacs. The acini are the basic units of respiration, with gas exchange taking place in all the alveoli present. The alveolar membrane is the gas exchange surface, surrounded by a network of capillaries. Across the membrane oxygen is diffused into th ...
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Metabolic Alkalosis
Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. The condition typically cannot last long if the kidneys are functioning properly. Signs and symptoms Mild cases of metabolic alkalosis often cause no symptoms. Typical manifestations of moderate to severe metabolic alkalosis include abnormal sensations, neuromuscular irritability, tetany, abnormal heart rhythms (usually due to accompanying electrolyte abnormalities such as low levels of potassium in the blood), coma, seizures, and temporary waxing and waning confusion. Causes The causes of metabolic alkalosis can be divided into two categories, depending upon urine chloride levels. Chloride-responsive (Urine chloride < 25 mEq/L)

* Loss of hydrogen ions – Most often occurs via two ...
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Diffusing Capacity
Diffusing capacity of the lung (DL) (also known as Transfer factor is another expression for the formerly used diffusing capacity.) measures the transfer of gas from air in the lung, to the red blood cells in lung blood vessels. It is part of a comprehensive series of pulmonary function tests to determine the overall ability of the lung to transport gas into and out of the blood. DL, especially DLCO, is reduced in certain diseases of the lung and heart. DLCO measurement has been standardized according to a position paper by a task force of the European Respiratory and American Thoracic Societies. In respiratory physiology, the diffusing capacity has a long history of great utility, representing conductance of gas across the alveolar-capillary membrane and also takes into account factors affecting the behaviour of a given gas with hemoglobin. The term may be considered a misnomer as it represents neither diffusion nor a capacity (as it is typically measured under submaxima ...
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Hyperventilation
Hyperventilation is irregular breathing that occurs when the rate or tidal volume of breathing eliminates more carbon dioxide than the body can produce. This leads to hypocapnia, a reduced concentration of carbon dioxide dissolved in the blood. The body normally attempts to compensate for this homeostatically, but if this fails or is overridden, the blood pH will rise, leading to respiratory alkalosis. The symptoms of respiratory alkalosis include: dizziness, tingling in the lips, hands or feet, headache, weakness, fainting, and seizures. In extreme cases it may cause carpopedal spasms, a flapping and contraction of the hands and feet. Factors that may induce or sustain hyperventilation include: physiological stress, anxiety or panic disorder, high altitude, head injury, stroke, respiratory disorders such as asthma, pneumonia, or hyperventilation syndrome, cardiovascular problems such as pulmonary embolisms, anemia, an incorrectly calibrated medical respirator, and adverse ...
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Hypoventilation
Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (''hypo'' meaning "below") to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis. Hypoventilation is not synonymous with respiratory arrest, in which breathing ceases entirely and death occurs within minutes due to hypoxia and leads rapidly into complete anoxia, although both are medical emergencies. Hypoventilation can be considered a precursor to hypoxia and its lethality is attributed to hypoxia with carbon dioxide toxicity. Causes Hypoventilation may be caused by: *A medical condition such as stroke affecting the brainstem *Voluntary breath-holding or underbreathing, for example, hypoventilation training or the Buteyko method. *Medication or drugs, typically when taken in accidental or intentional overdose. Opioids and benzodiazepines in particular are known to cause respiratory depress ...
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Respiratory Alkalosis
Respiratory alkalosis is a medical condition in which increased respiration elevates the blood pH beyond the normal range (7.35–7.45) with a concurrent reduction in arterial levels of carbon dioxide. This condition is one of the four primary disturbance of acid–base homeostasis. Signs and symptoms Signs and symptoms of respiratory alkalosis are as follows: * Palpitation * Tetany * Convulsion * Sweating Causes Respiratory alkalosis may be produced as a result of the following causes: Mechanism The mechanism of respiratory alkalosis generally occurs when some stimulus makes a person hyperventilate. The increased breathing produces increased alveolar respiration, expelling CO2 from the circulation. This alters the dynamic chemical equilibrium of carbon dioxide in the circulatory system. Circulating hydrogen ions and bicarbonate are shifted through the carbonic acid (H2CO3) intermediate to make more CO2 via the enzyme carbonic anhydrase according to the following reacti ...
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Respiratory Acidosis
Respiratory acidosis is a state in which decreased ventilation (hypoventilation) increases the concentration of carbon dioxide in the blood and decreases the blood's pH (a condition generally called acidosis). Carbon dioxide is produced continuously as the body's cells respire, and this CO2 will accumulate rapidly if the lungs do not adequately expel it through pulmonary alveolus, alveolar ventilation. Alveolar hypoventilation thus leads to an increased PaCO2, ''Pa''CO2 (a condition called hypercapnia). The increase in ''Pa''CO2 in turn decreases the HCO3−/''Pa''CO2 ratio and decreases pH. Types Respiratory acidosis can be acute or chronic. * In ''acute respiratory acidosis'', the ''Pa''CO2 is elevated above the upper limit of the reference range (over 6.3 kPa or 45 mm Hg) with an accompanying acidemia (pH 30 mEq/L). Causes Acute Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs. This failure in ventilation may be caused by depre ...
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Metabolic Acidosis
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35. Acidemia and acidosis are not mutually exclusive – pH and hydrogen ion concentrations also depend on the coexistence of other acid-base disorders; therefore, pH levels in people with metabolic acidosis can range from low to high. Acute metabolic acidosis, lasting from minutes to several days, often occurs during serious illnesses or hospitalizations, and is generally caused when the body produces an excess amount of organic acids (ketoacids in ketoacidosis, or lactic acid in lactic acidosis). A state of chronic metabolic acidosis, lasting several weeks to years, can be the result of impaired kidney function ( ...
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PCO2
''p''CO2, pCO2, or P_\ceis the partial pressure of carbon dioxide (CO2), often used in reference to blood but also used in meteorology, climate science, oceanography, and limnology to describe the fractional pressure of CO2 as a function of its concentration in gas or dissolved phases. The units of ''p''CO2 are mmHg, atm, torr, Pa, or any other standard unit of atmospheric pressure. The ''p''CO2 of Earth's atmosphere has risen from approximately 280 ppm (parts-per-million) to a mean 2019 value of 409.8 ppm as a result of anthropogenic release of carbon dioxide from fossil fuel burning. This is the highest atmospheric concentration to have existed on Earth for at least the last 800,000 years. Medicine In medicine, the partial pressure of carbon dioxide in arterial blood is called P_ or PaCO2. Measurement of P_ in the systemic circulation indicates the effectiveness of ventilation at the lungs' alveoli, given the diffusing capacity of the gas. It is a good indicator of res ...
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Alveolar Gas Equation
The alveolar gas equation is the method for calculating partial pressure of alveolar oxygen (PAO2). The equation is used in assessing if the lungs are properly transferring oxygen into the blood. The alveolar air equation is not widely used in clinical medicine, probably because of the complicated appearance of its classic forms. The partial pressure of oxygen (pO2) in the pulmonary alveoli is required to calculate both the alveolar-arterial gradient of oxygen and the amount of right-to-left cardiac shunt, which are both clinically useful quantities. However, it is not practical to take a sample of gas from the alveoli in order to directly measure the partial pressure of oxygen. The alveolar gas equation allows the calculation of the alveolar partial pressure of oxygen from data that is practically measurable. It was first characterized in 1946. Assumptions The equation relies on the following assumptions: * Inspired gas contains no carbon dioxide (CO2) * Nitrogen (and any other g ...
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Capillaries
A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: they convey blood between the arterioles and venules. These microvessels are the site of exchange of many substances with the interstitial fluid surrounding them. Substances which cross capillaries include water, oxygen, carbon dioxide, urea, glucose, uric acid, lactic acid and creatinine. Lymph capillaries connect with larger lymph vessels to drain lymphatic fluid collected in the microcirculation. During early embryonic development, new capillaries are formed through vasculogenesis, the process of blood vessel formation that occurs through a '' de novo'' production of endothelial cells that then form vascular tubes. The term ''angiogenesis'' denotes the formation of new capillaries from pre-existing blood vessels and already present endo ...
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