Section two

Physical principles of gas exchange;

Diffusion of oxygen and carbon dioxide
Through the respiratory membrane
 External gaseous
exchange involves
the movement of
gases between the
alveoli and blood
in the lungs.
 Internal gaseous
exchange is the
movement of
gases between the
blood and the
body cells bathed
in tissue fluid
一 . principle of gas exchange
（一） gas diffusion
Gas molecules move freely among one
another. The result is gas molecules diffuse
from high-pressure area toward low-pressure
area. The process is called gas diffusion.
External gaseous exchange and tissues
ventilation are physical diffusion processes .
 gas diffusion obeys the following
physical principles
1. Gas diffuses from the high-pressure area to
the low-pressure area.
2. The diffusion direction and volume of gas
is decided by its own partial pressure
difference, diffusion rate and the solubility
in fluid.
3. In the fluid or at the interface of gas and fluid, the diffusion
rate of gas is correlate closely to its solubility in fluid. The
gas which solubility is higher diffuses quicker.

4. Diffusion rate of gas ： The volume of gas diffusion in

unit time is called diffusion rate.

It is effected by the following factors

△P*T*A*S
D∝
d*√MW

MW ： molecular weight
1 ） . Gas partial pressure difference: gas partial
pressure difference is larger—diffuses faster
2 ） . Gas molecular weight and solubility:
when solubility is high, it diffuses fast
when molecular weight is large, it diffuses
slowly.
△P*T*A*S
D∝
d*√MW
3 ） . Diffusion area of alveolar membrane :
when diffusion area of alveolar membrane
is large, it diffuses fast.
1) diffusion area of alveolar membrane
is 40m2 in normal quiet state.
2) diffusion area of alveolar membrane
is 70m2 during sports.
diffusion area of alveolar membrane
decreases in disease.
△P*T*A*S
D∝
d*√MW
1.Fluid and surfactant layer
2.Alveolar epithelium
3. Epithelium
basement membrane
4 .Interstitial space
5. Capillary
basement membrane
6. Capillary endothelium
Mean thickness is only 0.2
to 0.6µ m.
4. Diffusion distance—thickness of alveolar
membrane ( inverse ratio relationship )
Pulmonary fibrosis ---Thickness increases
Pulmonary edema---Diffusion decreases
5. Temperature
Temperature of fluid increases
Solubility increases —Diffuses fast

△P*T*A*S
D∝
d*√MW
6. Pulmonary Perfusion and Ventilation / Perfusion
Ratio

If blood flow decreases and gas exchange are

normal--the exchange total amount decreases. So
alveolar ventilation and blood flow must keep an
appropriate ratio.
Ventilation/perfusion ratio
VA/Q (value of normal quiet state) ＝ 4.2L/5L ＝
0.84
VA alveolar ventilation per minute
Q pulmonary perfusion per minute
 When normal adult is standing, every part of
lung VA/Q is not well-distributed
Apex of lung VA descent/Q descent Q descenting is more obvious.
ratio rises(more than 3)
Base of lung VA descents/Q rises ratio descents(0.6)
 Local Control of
Ventilation & Perfusion
 Ventilation in the alveoli is matched
to perfusion through pulmonary
capillaries.
 If ventilation decreases in a group
of alveoli, PCO 2 increases and PO2
decreases. Blood flowing past
these alveoli does not get
oxygenated. (ration<0.84)
 Decreased tissue PO2 around
under-ventilated alveoli constricts
their arteries and diverts blood to
better ventilated alveoli.
 V/Q>0.84 V/Q<0.84

Physiological dead space functional shunt

7. When all kinds of gas is under unit partial
pressure difference,the gas volume(ml) passing
through respiratory membrane per minute is
called pulmonary diffusion capacity. It is the
physiological index to test the diffusion ability
of respiratory membrane.
（二） partial pressure of respiratory air and gas of
different human body tissues

1. Composition and partial pressure of respiratory

air and alveolar air.
In the respiratory cycle, composition of O2 and
CO2 in alveolar air fluctuates a little.
1) Dalton’s Law:
Total pressure of a gas mixture is = to the sum of
the pressures that each gas in the mixture would
exert independently.
PATM = PN2 + P02 + PC02 + PH20 = 760 mm Hg.
2) Partial pressure:
The pressure that an particular gas exerts
independently.
partial pressure of each composition=the total pressure of mixed gas
×volume percentage of the gas
N2 600mmHg = 760mmHg × 79%
O2 159mmHg = 760mmHg×21 ％

02 is humidified = 105 mm Hg.

H20 contributes to partial pressure (47 mm Hg).
P02 (sea level) = 150 mm Hg.
PC02 = 40 mm Hg.
2. Partial Pressures of Gases in Inspired Air
and Alveolar Air
二 . Pulmonary gas exchange
PO2 of mixed venous blood is 40mmHg is lower than
104mmHg of alveolar gas. O2 in alveolar gas diffuses to
blood. PO2 in blood rises gradually until it is almost equal
to PO2 in alveolar gas.
PCO2 of mixed venous blood is 46mmHg, It is higher than
40mmHg of alveolar gas . CO2 in blood diffuses to alveolar
gas. PCO2 in blood descents gradually until it is almost
equal to PCO2 in alveolar gas.
Pulmonary gas exchange
 三 . Tissues Gas
Exchange
 Section three
Transport of Gas in the Blood
一 . Existing pattern of O2 and CO2 in the blood

physical dissolving(medium)
two kind of patterns
combination (primary)
O2 CO2 dissolve combination
Tissues or
lung resolution coefficient
O2 0.022 ml/1ml in blood
CO2 0.511ml/1ml in blood
 二 . oxygen transportation

98.5 ％ binding to Hb
oxygen transportation

1.5 ％ physical resolution

 Combination with Hemoglobin
 Haemoglobin is found in red blood cells
 Oxygen is transported in combination with
the iron molecule of the haem group (this is
an oxygenation reaction, not an oxidation)

Hemoglobin+Oxygen Oxyhemoglobin
PO2
Hb + O2 HbO2
PCO2
 Each hemoglobin molecule contains 4 iron
molecules that can each bind an O2
molecule. Therefore each hemoglobin
molecule is capable of carrying 4 O2
molecules.
Hb + 4O2 HbO8
 Hemoglobin loads/unloads one O2
molecule at a time so Hb can exist as Hb
(deoxyhemoglobin), HbO2, HbO4, HbO6
or HbO8 (fully saturated
oxyhemoglobin).
1. Maximum capacity of ferrohemoglobin
binding with O2 in every 100ml blood is
named oxygen capacity.
When normal Hb is in 15g/100ml blood ,
1g Hb binds with 1.34ml O2.
Oxygen capacity= 15×1.34 ＝ 20ml
2. The volume of ferrohemoglobin binding
with oxygen is called oxygen content.
arterial blood: 20ml O2
venous blood: 15ml O2
1. The percentage of oxygen content to oxygen
capacity is called oxygen saturation.
2. In arterial blood, oxygen content equals
20ml and oxygen saturation is 100%.
3. In venous blood , oxygen content equals
15ml and oxygen saturation is 75%.
（一） reversible binding of Hb and O2

partial pressure is higher(lung)

Hb ＋ O2 HbO2
partial pressure is lower(tissues)
reduction ， royal blue oxygenation ， red
break
T R
（ tension ） form （ relaxation ）
character
1. Reversible binding. Without enzyme. Fast.
Effected by PO2.
2. O2 binds with Fe2+ of ferrohemoglobin . The
ion value is permanent. So the process is
called oxygenation but not oxidation.
3. Globin of ferrohemoglobin is made up of two
αpeptide chains and two β peptide chains .
There is a protoheme molecular on each
peptide chain including a Fe2+ . Each Fe2+
binds with an O2 . So each ferrohemoglobin
can bind with four O2. （ HbO2 ） 1gHb can
bind with 1.34 － 1.39mlO2.
4. Conjugation of peptide chains α 、 βof
ferrohemoglobin and O2 can facilitate
binding or dissociation(releasing).
In lungs, increasing of PO2 promotes combination.
In tissues, decreasing of PO2 promotes releasing.
5. The binding or dissociation curves of Hb and
O2 appear S form.This is related to the
allosterism effect of Hb.
Hb binds with O2—salt bond breaks, R form
Hb dissociates with O2—salt bond forms,T form
The affinity of T form to O2 is smaller.
The affinity of R form to O2 is larger.
（二） oxygen dissociation curve

The curve reacts the relationship of PO2

and saturation of oxygenation Hb .
(figure 40-9)
Oxygen Dissociation Curve
 The binding of oxygen to
hemoglobin is dependent on
the partial pressure of oxygen.
 S-shaped (sigmoidal) curve
that shows the partial pressures
of oxygen (PO2) in relation to
the % saturation of Hb.
 At 50 % saturation (indicated
on the curve by p50), half of
the Hb binding sites contain
oxygen molecules.
oxygen dissociation curve
character
1. Superior segment of curve:
PO2 60 － 100mmHg . Slope is flat.
1 ） Partial pressure of oxygen changes greatly.
But saturation changes little—even PO2
of environment or alveoli descents,
oxygenation saturation will maintain
high level.
2 ） When PO2 ＞ 100mmHg , rising
of oxygenation saturation is not obvious .
Rising of blood oxygen volume is little.
2. Middle segment of curve PO2 60 － 40mmHg
is the part that HbO2 releases O2.
At this time Hb oxygen saturation is 75%,
oxygen content in blood is 14.4mL ％ . In the
other words, every 100ml blood releases
5mlO2 when it flows over tissues.
The percentage of oxygen capacity released
when blood flows over tissues to oxygen
content in arteria is called oxygen utilization
coefficient. It is 25% in normal quiet state
and it increases to 75% in sports.
3. Inferior segment of curve .
PO2 10 － 40mmHg . The slope is steep.
PO2 descents a little. It makes oxygen
dissociation saturation descent. This is
benefit to supplying oxygen for tissue
activity. Oxygen utilization coefficient
increases to 75%. Mechanism: when
αβpeptide chains of
ferrohemoglobin bind with oxygen, they
interact.
 PO2 descents in plateau Significance :
amortization function of Hb tissue activity
O2 5ml/ （ 100ml*min ） Ferrohemoglobin
amortization function :
even blood itself of enviroment oxygen change
greatly, tissue PO2 still remain in normal range. O2
5ml/ （ 100ml*min ）
（三） factors effect oxygen
dissociation
Usually we use P50 as the affinity of Hb and O2.
Normal P50: PO2 26.5mmHg 。
when P50 rises ： affinity descents and curve
moves to right.
when P50 descents ： affinity rises and
curve moves to left.
factors effect oxygen dissociation curve
1. Effect of Pco2 or H+

Bohr effect
PH descents and PCO2 rises—make salt bond form.
Molecular configuration of Hb changes to T form. Curve
move to right. P50 increases. Oxygen saturation descents
and dissociation increases.

PH rises and PCO2 descents—make salt bond break.

Molecular configuration of Hb changes to R form. Curve
move to left. P50 descents. Oxygen saturation increases
and dissociation descents.
2. Effect of temperature
T increases—affinity of Hb
to O2 descents . Oxygen
saturation descents.
Curve moves to right.
Activity of H+ increases.
T descents—affinity of Hb
to O2 increases . Oxygen
saturation increases.
Curve moves to left. HbO2
can not dissociate O2
easily
3. Effect of 2,3 - diphosphoglycerate
2,3 － DPG is a kind of organophosphate in RBC.
hypoxia anemia
2,3--DPG long time sports
increases anaerobic metabolism
βchain deoxyhemoglobin form salt bond.
Hb miss oxygenation ability (T form)
Oxygen dissociation curve move to right,
make oxygen dissociate .
 Summary
 Left Shifts  Right Shifts
– increased pH – decreased pH
– decreased Temp – increased Temp
– increased 2,3 DPG
– decreased 2,3 DPG
– Hypoxia
– hemoglobin variants
– Anemia
– decreased carbon
– Decreased O2 content
dioxide
– Increased O2 content
– increased carbon
dioxide
transportation of CO2

physical dissolution （ 6 ％）

bicarbonate pattern
（ 87 ％）

combination （ 94
％）
Carbaminohemoglobin
（ 7％ ）
transportation of CO2
（一） Transport in bicarbonate pattern
character:
1. Reaction is reversible. But it need the help of
enzyme.
2. Conjugation or dissociation is decided by
partial pressure difference of CO2.
3.There is the transfer of Cl － in the reaction.
 （二）
Transport in carbaminohemoglobin pattern

in tissues
HbNH2+CO2 HbNHCOOH
lung
HbNHCOO － ＋ H ＋
Character
1. Reaction is reversible and need not the help
of enzyme.
2. Conjugation or dissociation is decided by
the oxygenation effect of Hb.
Much Deoxy Hb binds with CO2.
Little Hb binds.dissociation is much.
3. The effect of partial pressure difference is not
obvious.
（三） carbon dioxide dissociation curve

1 . Transport volume of CO2 in blood is

decided by partial pressure of CO2.
PCO2 increases—transport volume increases .
They appear linear relationship.
carbon dioxide dissociation curve
2. Haldane effect
O2 ＋ Hb promotes the releasing of CO2(lung)

intakes CO2 in the tissues

releases CO2 in lungs
The ability of deoxyhemoglobin taking along
CO2 is larger than oxyhemoglobin. So the
volume of CO2 taken along in arterial blood is
less than that in venous blood.
3. The content and activity of
carbonic anhydrase

Activity of carbonic anhydrase in RBC

increasing--transportation ability
increasing

Content of carbonic anhydrase in RBC

increasing--transportation ability
increasing