Effect of Gravity
As shown in the figure, the V/Q is 3.3 at the top of the lungs and 0.63 at the base of the lungs. Arterial PO2 is lower at the base of the lungs because of the low V/Q ratio at the base. Low V/Q is essentially hypoventilation; i.e., it produces higher PCO2 and lower PO2.
The reason for the differences in ventilation/perfusion ratio from top to bottom is that gravity has a greater effect on blood flow than on air flow. This is shown in the figure below:
A 3-compartment model is useful to understand the effect of V/Q on oxygen values. In areas of lung with low V/Q; e.g., 1/10, the oxygen of air in the alveoli and in blood leaving the area (bottom of the lung) is low in oxygen. In areas of the lung with evenly matched V/Q; e.g., 10/10 or 1, the oxygen level is high in the alveolar air and blood leaving that area (middle of the lung). In areas of the lung with high V/Q; e.g., 10/1, the oxygen level is slightly higher in blood (due to flat upper portion of hemoglobin -O2 binding curve) and higher in alveolar air. This would apply to the top of the upright lung.
Clincical correlate for infectious diseases:
Mycobacterium tuberculosis is an obligate[1] pathogenic bacterial species in the family Mycobacteriaceae and the causative agent of tuberculosis.[2]The physiology of M. tuberculosis is highly aerobic and requires high levels of oxygen. Lesions normally found in the upper lung where oxygen levels are higher.
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