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PHYSIOLOGY Cases and Problems

Answers and Explanations

1. Although the barometric pressure on Mont Blanc is much lower than that at sea level, the FiO2 is
the same (0.21, or 21%). We calculate the Po2 in humidified air by correcting the barometric pres-
sure (Pb) for water vapor pressure (Ph2o) and then multiplying this figure by FiO2 (as described in
Case 22).
Po2 (Mont Blanc) = (Pb − Ph2o) × FiO2
= (420 mm Hg − 47 mm Hg) × 0.21
= 78.3 mm Hg
Po2 (sea level) = (Pb − Ph2o) × FiO2
= (760 mm Hg − 47 mm Hg) × 0.21
= 149.7 mm Hg
Thus, the Po2 of humidified air on Mont Blanc is much lower than the Po2 of humidified air at sea
level because of the lower barometric pressure at the higher altitude.

2. Dan’s Pao2 would be greatly reduced (hypoxemia) on Mont Blanc because, as demonstrated in the
previous question, the air he breathed on Mont Blanc had a much lower Po2 (78.3 mm Hg) than
the air he breathed at sea level (149.7 mm Hg).
Such a decrease in inspired Po2 would be reflected in a decreased alveolar Po2 (PaO2). How can
we estimate what his PaO2 might have been? One approach is to assume that O2 equilibrates
between alveolar gas and pulmonary capillary blood (systemic arterial blood). If Dan’s measured
Pao2 was 50 mm Hg, then his PaO2 can be assumed to be 50 mm Hg.

3. On Mont Blanc, the following changes are predicted:

• Dan’s breathing rate would be increased (hyperventilation) because decreased Pao2 stimulates
peripheral chemoreceptors in the carotid bodies located near the bifurcation of the common
carotid arteries. When Pao2 is less than 60 mm Hg, these chemoreceptors are strongly stimulated.
This information is then relayed to medullary respiratory centers (the dorsal respiratory group)
that direct an increase in breathing rate. In other words, the body is calling for more O2!
• Percent saturation of hemoglobin would be decreased because Pao2 is decreased. Figure 3–5 shows
the effect of Po2 on percent saturation of hemoglobin.

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