> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/pulmonary/07-co2.md).

# 07 CO 2

## Transportation

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/CO2%20transported%20how,%20enzyme%20responsible,%20where%20is%20enzyme%20located/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/r02ZvQI.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/4z2tUF0.jpg)

* CO2 stored as HCO3 to be transported to lungs

### Bohr Effect

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/Bohr%20effect,%20result%20on%20O2%20curve/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/4YNdSiJ.jpg)

* conversion produces H+ ion that binds to globin chain to form HHb

![](https://f001.backblazeb2.com/file/wikiFiles/k2d4C6b.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/wXrK5CY.jpg)

* instead of dropping from 100 to 75% at tissue PO2 50 mmHg, drop to 50%, better unloading
* Bohr effect helps unload O2 via H ion binding to Hb

### Cl Shift

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/Cl%20shift/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/4phtB6k.jpg)

* high bicarb inside cell diffuse out, in exchange for Cl

### Haldane

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/Haldane%20effect/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ilmGT5K.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/qhwxl6M.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/yxyNWjo.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/LfkVx5E.jpg)

* x: level of CO2
* y: amount CO2 bound to Hb
* purple line: normally, more PCO2 in blood = more bound to Hb 
* in reality, blue line: even more bound to Hb at low O2 level

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/Tissue%20vs%20lungs.%20Significance%20of%20Bohr%20and%20Haldane%20effect)..

![](https://f001.backblazeb2.com/file/wikiFiles/l4Z0Iy0.jpg)

* B**o**hr for **O**2

## High Altitude

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/high%20altitude%20and%20blood%20gas,%20dissociation%20curve,%20other%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kvpjtfO.jpg)

* small box: someone living at high altitude

![](https://f001.backblazeb2.com/file/wikiFiles/lo5xoRs.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/RqNye13.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/Q26Nkmh.jpg)

* mild polycythemia

## Exercise

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/exercise%20and%20blood%20gas.%20Arterial%20vs%20venous)..

![](https://f001.backblazeb2.com/file/wikiFiles/UdhURcm.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/x7IWb0o.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/v25ieak.jpg)

* arterial side maintain normal rate: not hypoxic or hypercapnea

![](https://f001.backblazeb2.com/file/wikiFiles/dap2GjR.jpg)

## Cerebral blood flow

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/cerebral%20blood%20flow%20control.%20Panic%20attack%20result)..

![](https://f001.backblazeb2.com/file/wikiFiles/sUtZlQO.jpg)

* cerebral vasodilator
* left, O2: at normal range, O2 does not change cerebral blood flow much
* right, CO2: at normal range, powerful effect on blood flow

![](https://f001.backblazeb2.com/file/wikiFiles/i5To1EK.jpg)

## Breathing

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/breathing%20stimulus%20central%20and%20peripheral/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/LFrtDQK.jpg)

* CO2 in blood stream major stimulus, not O2
* PNS chemoreceptor: only kick in under severe hypoxia, normally CNS working 

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/COPD,%20ventilator,%20ALS%20common%20blood%20gas,%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/K9IKJnq.jpg)

* hypoxemia stimulate respiratory rate, can get low with O2 = high CO2, confusion

![](https://f001.backblazeb2.com/file/wikiFiles/ZU5duJE.jpg)

* in hospital on ventilation, O2 can make O2 saturation high and mask hypoventilation
* put on ventilator

![](https://f001.backblazeb2.com/file/wikiFiles/0WldW2x.jpg)

* hypo ventilating, CNS symptoms