Exercise physiology
Respiratory Regulation
DR. Nivin Sharawy
Professor of Clinical Physiology
Regulation of ventilation 01
during exercise
02 Oxygen supply to muscle
Oxygen transport by the blood 03
Differences between oxygen
04
content, capacity and saturation
hemoglobin O2 dissociation 05
curves
Carbon dioxide transport by
06 the blood
Introduction
• The total amount of O 2 consumption and CO 2 production by the cells during
muscle exercise can increase as much as 20-fold.
• Pulmonary ventilation and perfusion increase to supply the extra amounts of O 2
and removes the extra amounts of CO 2.
Regulation of ventilation during muscle exercise:
• Pulmonary ventilation is stimulated by a variety of neurogenic impulses reaching the respiratory centers in the
brain stem
A. Blood gases
Pulmonary ventilation is so well matched with the metabolic demands
During light to moderate exercise the arterial PO2 and PCO2 and H + values remain unchanged
Severe and sustained exercise, lactic acid accumulates in the blood and pH may drop to 7.2. The lactic acidosis
causes hyperventilation
B. Muscle, tendon and joint receptors
Impulses from proprioceptors in muscles, tendons and joints stimulate the respiratory centers during movement
of joints
Regulation of ventilation during muscle exercise:
C. Higher brain centers
As exercise begins, brain transmits motor impulses to the muscles and collateral impulses to
stimulate RC, causing the immediate increase in ventilation.
Experienced athletes increase their respiration even before the start of exercise. (conditioned
reflexes)
D. Increased tissue metabolism and temperature: stimulate breathing by impulses reaching the
RC from hypothalamus.
E. Increased Venous Return:
stimulate cardiac mechanoreceptors in the right atrium which reflex stimulate respiration.
F. Norepinephrine: released from the sympathetic nervous system stimulates RC
Oxygen supply to muscle could also increased by
In addition to hyperventilation there is
An increase in rate of gas diffusion
Shift of O2 dissociation curve to the right
Increase cardiac output which ensure increased O2 supply to the tissues
Oxygen Diffusing Capacity of Athletes
• The oxygen diffusing capacity is a measure of the
rate at which oxygen can diffuse from the pulmonary
alveoli into the blood.
• This is expressed in terms of milliliters of oxygen
that will diffuse each minute for each millimeter of
mercury difference between alveolar partial pressure
of oxygen and pulmonary blood oxygen pressure
Oxygen transport by the blood
O2 is transported in the blood in two forms:
A. Physically dissolved. [0.3 ml/100 ml arterial blood]
• Determines PO2 that determined the direction of
diffusion of O2 and O2 carried by hemoglobin
• PO2 at the lung and in arterial blood is 100 mmHg
• PO2 in tissues during rest is 40 mmHg
• PO2 in tissues during exercise is 20 mmHg
Oxygen transport by the blood
B. Attached in chemical combination with
hemoglobin.
• In the whole blood volume (5 liters) pumped by
heart per minute, the O2 present in physical
solution supplied to tissues per min is 15 ml.
• In adult man the total tissue O2 requirements /
minute is 250 ml.
• An additional form of O2 is transported by
Hemoglobin
• O2 carried by hemoglobin is 19.5 ml of O2 /I00 ml
arterial blood. (98% of transported O2)
• It constitutes the main supply for the O 2 need of
the tissues.
Oxygen content, capacity and hemoglobin
saturation
• O2 content is the volume of O2 carried by blood combined with
hemoglobin / 100 ml blood.
The O2 content depends on:
1. Amount of hemoglobin present.
2. O2 tension.
3. O2 affinity of hemoglobin.
4. Metabolic state of the organ
Oxygen content, capacity and hemoglobin
saturation
• The O2 capacity is the maximum volume of O2 that can be carried by
hemoglobin, when hemoglobin is fully saturated with O2.(19.5 ml of O2
/I00 ml arterial blood)
• The percentage saturation of hemoglobin with O2, (% HbO2) equals:
𝑂2 𝑐𝑜𝑛𝑡𝑒𝑛𝑡
X100
𝑂2 𝑐𝑎𝑝𝑎𝑐𝑖𝑡𝑦
The hemoglobin O2 dissociation curves
• Represent the relationship between PO2 and % HbO2
saturation .
• At 100 mmHg PO2 , Hb is approximately 97% saturated
• At 60 mmHg PO2, Hb is approximately 90% saturated
• Consequently arterial PO2 can decrease from 100mmHg to
60 mmHg with little change in % HbO2 as at high altitudes
• The flat portion of the oxyhemoglobin dissociation curve
means that Hb has high affinity to O2 (loading), and
complete saturation with O2.
The hemoglobin O2 dissociation curves
At 40 mmHg PO2 :
in tissues during rest, blood is 70% saturated. So, tissues
take about 27% of O2 of arterial blood.
The curve becomes vertical. This means that Hb has low
affinity to O2 (unloading), this allows easy and rapid
desaturation of Hb and enables the tissues to extract large
amounts of O2 from blood.
The hemoglobin O2 dissociation curves
At 20 mmHg PO2 :
in tissues during exercise, Hb is about
20% saturated with O2.
So, tissues take about 50% of O2 of
arterial blood
The hemoglobin O2 dissociation curves
• Factors that shift the oxyhemoglobin dissociation curve to the
right ( during exercise)
a. Increase of PCO2
b. Increase of temperature
c. Decrease of pH and increase H+ concentration
d. Increase 2,3-diphosphoglycerate (2,3-DPG), it is an end
product of the RBCs metabolism. It binds to hemoglobin
,changing its conformation and facilitating the off-loading of
O2 and shifting the oxyhemoglobin dissociation curve to the
right.
• A right ward shift of the curve means that, at a given PO2 there
is less O2 bound to hemoglobin and more O2 is available to the
active muscle
The hemoglobin O2 dissociation curves
• Factors that shift the oxyhemoglobin
dissociation curve to the Left
• A decrease in temperature and PCO2 and an
increase in pH shift the curve to the left.
• A leftward shift means that there is more O2
bound to hemoglobin (Increased affinity of
hemoglobin to O2)
• So, it gives its O2 with difficulty to tissues.
this occurs at rest and during sleep.
Carbon dioxide transport by the blood
CO2 is present in two forms:
A. Physically dissolved
—3 ml CO2/100 ml.
—It is responsible for the PCO2 in the blood.
—The arterial PCO2 is 40 mmHg.
Carbon dioxide and oxygen transport
Carbon dioxide transport by the blood
B. Chemical combination (bicarbonate, carbamino compounds)
— Bicarbonate
Some of the dissolved CO2 reacts with water forming carbonic acid which readily
ionizes to bicarbonate and H+.
This reaction is very slow in plasma, but several thousand times faster in red blood cells
due to carbonic anhydrase enzyme.
HCO3- present in RBCs as KHCO3 and in plasma as NaHCO3(alkaline reserve).
— Carbamino compounds
They are formed by the reaction of CO2 with terminal amine groups on hemoglobin and
on plasma protein
Tidal CO2
• It is CO2 which is given by tissues to 100ml blood.
• At rest, the tidal CO2 is 4ml./100ml. blood.
• Tidal CO2 is mainly carried in chemical combination, so that the pH of blood does
not markedly change.
• Hb plays an important role in buffering the tidal CO2.
Key Points
• Oxygen supply to muscle
• Regulation of ventilation during muscle exercise
• Oxygen transport by the blood
• Oxygen content, capacity and hemoglobin saturation
• hemoglobin O2 dissociation curves (Normal and shifted)
• Carbon dioxide transport by the blood
• Tidal carbon dioxide
