Module 13: The Respiratory System

Lesson 5: Respiratory Physiology: Transport of Gases

Sinh Lý Hệ Hô Hấp: Vận Chuyển Khí

Nội dung bài học:
Mỗi bài học (lesson) bao gồm 4 phần chính: Thuật ngữ, Luyện Đọc, Luyện Nghe, và Bàn Luận.
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Dưới đây là danh sách những thuật ngữ Y khoa của module The Respiratory System.
Khái quát được số lượng thuật ngữ sẽ xuất hiện trong bài đọc và nghe sẽ giúp bạn thoải mái tiêu thụ nội dung hơn. Sau khi hoàn thành nội dung đọc và nghe, bạn hãy quay lại đây và luyện tập (practice) để quen dần các thuật ngữ này. Đừng ép bản thân phải nhớ các thuật ngữ này vội vì bạn sẽ gặp và ôn lại danh sách này trong những bài học (lesson) khác của cùng một module.

Medical Terminology: The Respiratory System

acclimatization
process of adjustment that the respiratory system makes due to chronic exposure to high altitudes
acute mountain sickness (AMS)
condition that occurs a result of acute exposure to high altitude due to a low partial pressure of oxygen
ala
(plural = alae) small, flaring structure of a nostril that forms the lateral side of the nares
alar cartilage
cartilage that supports the apex of the nose and helps shape the nares; it is connected to the septal cartilage and connective tissue of the alae
alveolar dead space
air space within alveoli that are unable to participate in gas exchange
alveolar duct
small tube that leads from the terminal bronchiole to the respiratory bronchiole and is the point of attachment for alveoli
alveolar macrophage
immune system cell of the alveolus that removes debris and pathogens
alveolar pore
opening that allows airflow between neighboring alveoli
alveolar sac
cluster of alveoli
alveolus
small, grape-like sac that performs gas exchange in the lungs
anatomical dead space
air space present in the airway that never reaches the alveoli and therefore never participates in gas exchange
apex
tip of the external nose
apneustic center
network of neurons within the pons that stimulate the neurons in the dorsal respiratory group; controls the depth of inspiration
atmospheric pressure
amount of force that is exerted by gases in the air surrounding any given surface
Bohr effect
relationship between blood pH and oxygen dissociation from hemoglobin
Boyle’s law
relationship between volume and pressure as described by the formula: P1V1 = P2V2
bridge
portion of the external nose that lies in the area of the nasal bones
bronchial bud
structure in the developing embryo that forms when the laryngotracheal bud extends and branches to form two bulbous structures
bronchial tree
collective name for the multiple branches of the bronchi and bronchioles of the respiratory system
bronchiole
branch of bronchi that are 1 mm or less in diameter and terminate at alveolar sacs
bronchoconstriction
decrease in the size of the bronchiole due to relaxation of the muscular wall
bronchodilation
increase in the size of the bronchiole due to contraction of the muscular wall
bronchus
tube connected to the trachea that branches into many subsidiaries and provides a passageway for air to enter and leave the lungs
carbaminohemoglobin
bound form of hemoglobin and carbon dioxide
carbonic anhydrase (CA)
enzyme that catalyzes the reaction that causes carbon dioxide and water to form carbonic acid
cardiac notch
indentation on the surface of the left lung that allows space for the heart
central chemoreceptor
one of the specialized receptors that are located in the brain that sense changes in hydrogen ion, oxygen, or carbon dioxide concentrations in the brain
chloride shift
facilitated diffusion that exchanges bicarbonate (HCO3–) with chloride (Cl–) ions
conducting zone
region of the respiratory system that includes the organs and structures that provide passageways for air and are not directly involved in gas exchange
cricoid cartilage
portion of the larynx composed of a ring of cartilage with a wide posterior region and a thinner anterior region; attached to the esophagus
Dalton’s law
statement of the principle that a specific gas type in a mixture exerts its own pressure, as if that specific gas type was not part of a mixture of gases
dorsal respiratory group (DRG)
region of the medulla oblongata that stimulates the contraction of the diaphragm and intercostal muscles to induce inspiration
dorsum nasi
intermediate portion of the external nose that connects the bridge to the apex and is supported by the nasal bone
epiglottis
leaf-shaped piece of elastic cartilage that is a portion of the larynx that swings to close the trachea during swallowing
expiration
(also, exhalation) process that causes the air to leave the lungs
expiratory reserve volume (ERV)
amount of air that can be forcefully exhaled after a normal tidal exhalation
external nose
region of the nose that is easily visible to others
external respiration
gas exchange that occurs in the alveoli
fauces
portion of the posterior oral cavity that connects the oral cavity to the oropharynx
fibroelastic membrane
specialized membrane that connects the ends of the C-shape cartilage in the trachea; contains smooth muscle fibers
forced breathing
(also, hyperpnea) mode of breathing that occurs during exercise or by active thought that requires muscle contraction for both inspiration and expiration
foregut
endoderm of the embryo towards the head region
functional residual capacity (FRC)
sum of ERV and RV, which is the amount of air that remains in the lungs after a tidal expiration
glottis
opening between the vocal folds through which air passes when producing speech
Haldane effect
relationship between the partial pressure of oxygen and the affinity of hemoglobin for carbon dioxide
Henry’s law
statement of the principle that the concentration of gas in a liquid is directly proportional to the solubility and partial pressure of that gas
hilum
concave structure on the mediastinal surface of the lungs where blood vessels, lymphatic vessels, nerves, and a bronchus enter the lung
hyperpnea
increased rate and depth of ventilation due to an increase in oxygen demand that does not significantly alter blood oxygen or carbon dioxide levels
hyperventilation
increased ventilation rate that leads to abnormally low blood carbon dioxide levels and high (alkaline) blood pH
inspiration
(also, inhalation) process that causes air to enter the lungs
inspiratory capacity (IC)
sum of the TV and IRV, which is the amount of air that can maximally be inhaled past a tidal expiration
inspiratory reserve volume (IRV)
amount of air that enters the lungs due to deep inhalation past the tidal volume
internal respiration
gas exchange that occurs at the level of body tissues
intra-alveolar pressure
(intrapulmonary pressure) pressure of the air within the alveoli
intrapleural pressure
pressure of the air within the pleural cavity
laryngeal prominence
region where the two lamine of the thyroid cartilage join, forming a protrusion known as “Adam’s apple”
laryngopharynx
portion of the pharynx bordered by the oropharynx superiorly and esophagus and trachea inferiorly; serves as a route for both air and food
laryngotracheal
bud forms from the lung bud, has a tracheal end and bulbous bronchial buds at the distal end
larynx
cartilaginous structure that produces the voice, prevents food and beverages from entering the trachea, and regulates the volume of air that enters and leaves the lungs
lingual tonsil
lymphoid tissue located at the base of the tongue
lung
organ of the respiratory system that performs gas exchange
lung bud
median dome that forms from the endoderm of the foregut
meatus
one of three recesses (superior, middle, and inferior) in the nasal cavity attached to the conchae that increase the surface area of the nasal cavity
naris
(plural = nares) opening of the nostrils
nasal bone
bone of the skull that lies under the root and bridge of the nose and is connected to the frontal and maxillary bones
nasal septum
wall composed of bone and cartilage that separates the left and right nasal cavities
nasopharynx
portion of the pharynx flanked by the conchae and oropharynx that serves as an airway
olfactory pit
invaginated ectodermal tissue in the anterior portion of the head region of an embryo that will form the nasal cavity
oropharynx
portion of the pharynx flanked by the nasopharynx, oral cavity, and laryngopharynx that is a passageway for both air and food
oxygen–hemoglobin dissociation curve
graph that describes the relationship of partial pressure to the binding and disassociation of oxygen to and from heme
oxyhemoglobin
(Hb–O2) bound form of hemoglobin and oxygen
palatine tonsil
one of the paired structures composed of lymphoid tissue located anterior to the uvula at the roof of isthmus of the fauces
paranasal sinus
one of the cavities within the skull that is connected to the conchae that serve to warm and humidify incoming air, produce mucus, and lighten the weight of the skull; consists of frontal, maxillary, sphenoidal, and ethmoidal sinuses
parietal pleura
outermost layer of the pleura that connects to the thoracic wall, mediastinum, and diaphragm
partial pressure
force exerted by each gas in a mixture of gases
peripheral chemoreceptor
one of the specialized receptors located in the aortic arch and carotid arteries that sense changes in pH, carbon dioxide, or oxygen blood levels
pharyngeal tonsil
structure composed of lymphoid tissue located in the nasopharynx
pharynx
region of the conducting zone that forms a tube of skeletal muscle lined with respiratory epithelium; located between the nasal conchae and the esophagus and trachea
philtrum
concave surface of the face that connects the apex of the nose to the top lip
pleural cavity
space between the visceral and parietal pleurae
pleural fluid
substance that acts as a lubricant for the visceral and parietal layers of the pleura during the movement of breathing
pneumotaxic center
network of neurons within the pons that inhibit the activity of the neurons in the dorsal respiratory group; controls rate of breathing
pulmonary artery
artery that arises from the pulmonary trunk and carries deoxygenated, arterial blood to the alveoli
pulmonary plexus
network of autonomic nervous system fibers found near the hilum of the lung
pulmonary surfactant
substance composed of phospholipids and proteins that reduces the surface tension of the alveoli; made by type II alveolar cells
pulmonary ventilation
exchange of gases between the lungs and the atmosphere; breathing
quiet breathing
(also, eupnea) mode of breathing that occurs at rest and does not require the cognitive thought of the individual
residual volume (RV)
amount of air that remains in the lungs after maximum exhalation
respiratory bronchiole
specific type of bronchiole that leads to alveolar sacs
respiratory cycle
one sequence of inspiration and expiration
respiratory epithelium
ciliated lining of much of the conducting zone that is specialized to remove debris and pathogens, and produce mucus
respiratory membrane
alveolar and capillary wall together, which form an air-blood barrier that facilitates the simple diffusion of gases
respiratory rate
total number of breaths taken each minute
respiratory volume
varying amounts of air within the lung at a given time
respiratory zone
includes structures of the respiratory system that are directly involved in gas exchange
root
region of the external nose between the eyebrows
thoracic wall compliance
ability of the thoracic wall to stretch while under pressure
thyroid cartilage
largest piece of cartilage that makes up the larynx and consists of two lamine
tidal volume (TV)
amount of air that normally enters the lungs during quiet breathing
total dead space
sum of the anatomical dead space and alveolar dead space
total lung capacity (TLC)
total amount of air that can be held in the lungs; sum of TV, ERV, IRV, and RV
total pressure
sum of all the partial pressures of a gaseous mixture
trachea
tube composed of cartilaginous rings and supporting tissue that connects the lung bronchi and the larynx; provides a route for air to enter and exit the lung
trachealis muscle
smooth muscle located in the fibroelastic membrane of the trachea
transpulmonary pressure
pressure difference between the intrapleural and intra-alveolar pressures
true vocal cord
one of the pair of folded, white membranes that have a free inner edge that oscillates as air passes through to produce sound
type I alveolar cell
squamous epithelial cells that are the major cell type in the alveolar wall; highly permeable to gases
type II alveolar cell
cuboidal epithelial cells that are the minor cell type in the alveolar wall; secrete pulmonary surfactant
ventilation
movement of air into and out of the lungs; consists of inspiration and expiration
ventral respiratory group (VRG)
region of the medulla oblongata that stimulates the contraction of the accessory muscles involved in respiration to induce forced inspiration and expiration
vestibular fold
part of the folded region of the glottis composed of mucous membrane; supports the epiglottis during swallowing
visceral pleura
innermost layer of the pleura that is superficial to the lungs and extends into the lung fissures
vital capacity (VC)
sum of TV, ERV, and IRV, which is all the volumes that participate in gas exchange
Nội dung này đang được cập nhật.
Dưới đây là các bài văn nằm ở bên trái. Ở bên phải là các bài luyện tập (practice) để đánh giá khả năng đọc hiểu của bạn. Sẽ khó khăn trong thời gian đầu nếu vốn từ vựng của bạn còn hạn chế, đặc biệt là từ vựng Y khoa. Hãy kiên nhẫn và đọc nhiều nhất có kể, lượng kiến thức tích tụ dần sẽ giúp bạn đọc thoải mái hơn.
The other major activity in the lungs is the process of respiration, the process of gas exchange. The function of respiration is to provide oxygen for use by body cells during cellular respiration and to eliminate carbon dioxide, a waste product of cellular respiration, from the body. In order for the exchange of oxygen and carbon dioxide to occur, both gases must be transported between the external and internal respiration sites. Although carbon dioxide is more soluble than oxygen in blood, both gases require a specialized transport system for the majority of the gas molecules to be moved between the lungs and other tissues.
Even though oxygen is transported via the blood, you may recall that oxygen is not very soluble in liquids. A small amount of oxygen does dissolve in the blood and is transported in the bloodstream, but it is only about 1.5% of the total amount. The majority of oxygen molecules are carried from the lungs to the body’s tissues by a specialized transport system, which relies on the erythrocyte—the red blood cell. Erythrocytes contain a metalloprotein, hemoglobin, which serves to bind oxygen molecules to the erythrocyte (Figure 1). Heme is the portion of hemoglobin that contains iron, and it is heme that binds oxygen. Each hemoglobin molecule contains four iron-containing heme molecules, and because of this, one hemoglobin molecule is capable of carrying up to four molecules of oxygen. As oxygen diffuses across the respiratory membrane from the alveolus to the capillary, it also diffuses into the red blood cell and is bound by hemoglobin. The following reversible chemical reaction describes the production of the final product, oxyhemoglobin (HbO2), which is formed when oxygen binds to hemoglobin. Oxyhemoglobin is a bright red-colored molecule that contributes to the bright red color of oxygenated blood.

Hb + O2 ↔ HbO2

In this formula, Hb represents reduced hemoglobin, that is, hemoglobin that does not have oxygen bound to it. There are multiple factors involved in how readily heme binds to and dissociates from oxygen, which will be discussed in the subsequent sections.

A. Function of Hemoglobin

Hemoglobin is composed of subunits, a protein structure that is referred to as a quaternary structure. Each of the four subunits that make up hemoglobin is arranged in a ring-like fashion, with an iron atom covalently bound to the heme in the center of each subunit. Binding of the first oxygen molecule causes a conformational change in hemoglobin that allows the second molecule of oxygen to bind more readily. As each molecule of oxygen is bound, it further facilitates the binding of the next molecule, until all four heme sites are occupied by oxygen. The opposite occurs as well: After the first oxygen molecule dissociates and is “dropped off” at the tissues, the next oxygen molecule dissociates more readily. When all four heme sites are occupied, the hemoglobin is said to be saturated. When one to three heme sites are occupied, the hemoglobin is said to be partially saturated. Therefore, when considering the blood as a whole, the percent of the available heme units that are bound to oxygen at a given time is called hemoglobin saturation. Hemoglobin saturation of 100 percent means that every heme unit in all of the erythrocytes of the body is bound to oxygen. In a healthy individual with normal hemoglobin levels, hemoglobin saturation generally ranges from 95 percent to 99 percent.

B. Oxygen Dissociation from Hemoglobin

Partial pressure is an important aspect of the binding of oxygen to and disassociation from heme. An oxygen–hemoglobin dissociation curve is a graph that describes the relationship of partial pressure to the binding of oxygen to heme and its subsequent dissociation from heme (Figure 2). Remember that gases travel from an area of higher partial pressure to an area of lower partial pressure. In addition, the affinity of an oxygen molecule for heme increases as more oxygen molecules are bound. Therefore, in the oxygen–hemoglobin saturation curve, as the partial pressure of oxygen increases, a proportionately greater number of oxygen molecules are bound by heme. Not surprisingly, the oxygen–hemoglobin saturation/dissociation curve also shows that the lower the partial pressure of oxygen, the fewer oxygen molecules are bound to heme. As a result, the partial pressure of oxygen plays a major role in determining the degree of binding of oxygen to heme at the site of the respiratory membrane, as well as the degree of dissociation of oxygen from heme at the site of body tissues.

The mechanisms behind the oxygen–hemoglobin saturation/dissociation curve also serve as automatic control mechanisms that regulate how much oxygen is delivered to different tissues throughout the body. This is important because some tissues have a higher metabolic rate than others. Highly active tissues, such as muscle, rapidly use oxygen to produce ATP, lowering the partial pressure of oxygen in the tissue to about 20 mm Hg. The partial pressure of oxygen inside capillaries is about 100 mm Hg, so the difference between the two becomes quite high, about 80 mm Hg. As a result, a greater number of oxygen molecules dissociate from hemoglobin and enter the tissues. The reverse is true of tissues, such as adipose (body fat), which have lower metabolic rates. Because less oxygen is used by these cells, the partial pressure of oxygen within such tissues remains relatively high, resulting in fewer oxygen molecules dissociating from hemoglobin and entering the tissue interstitial fluid. Although venous blood is said to be deoxygenated, some oxygen is still bound to hemoglobin in its red blood cells. This provides an oxygen reserve that can be used when tissues suddenly demand more oxygen.

Factors other than partial pressure also affect the oxygen–hemoglobin saturation/dissociation curve. For example, a higher temperature promotes hemoglobin and oxygen to dissociate faster, whereas a lower temperature inhibits dissociation (see Figure 2, middle). However, the human body tightly regulates temperature, so this factor may not affect gas exchange throughout the body. The exception to this is in highly active tissues, which may release a larger amount of energy than is given off as heat. As a result, oxygen readily dissociates from hemoglobin, which is a mechanism that helps to provide active tissues with more oxygen.

Certain hormones, such as androgens, epinephrine, thyroid hormones, and growth hormone, can affect the oxygen–hemoglobin saturation/disassociation curve by stimulating the production of a compound called 2,3-bisphosphoglycerate (BPG) by erythrocytes. BPG is a byproduct of glycolysis. Because erythrocytes do not contain mitochondria, glycolysis is the sole method by which these cells produce ATP. BPG promotes the disassociation of oxygen from hemoglobin. Therefore, the greater the concentration of BPG, the more readily oxygen dissociates from hemoglobin, despite its partial pressure.

The pH of the blood is another factor that influences the oxygen–hemoglobin saturation/dissociation curve (see Figure 2). The Bohr effect is a phenomenon that arises from the relationship between pH and oxygen’s affinity for hemoglobin: A lower, more acidic pH promotes oxygen dissociation from hemoglobin. In contrast, a higher, or more basic, pH inhibits oxygen dissociation from hemoglobin. The greater the amount of carbon dioxide in the blood, the more molecules that must be converted, which in turn generates hydrogen ions and thus lowers blood pH. Furthermore, blood pH may become more acidic when certain byproducts of cell metabolism, such as lactic acid, carbonic acid, and carbon dioxide, are released into the bloodstream.

C. Hemoglobin of the Fetus

The fetus has its own circulation with its own erythrocytes; however, it is dependent on the pregnant person for oxygen. Blood is supplied to the fetus by way of the umbilical cord, which is connected to the placenta and separated from maternal blood by the chorion. The mechanism of gas exchange at the chorion is similar to gas exchange at the respiratory membrane. However, the partial pressure of oxygen is lower in the maternal blood in the placenta, at about 35 to 50 mm Hg, than it is in maternal arterial blood. The difference in partial pressures between maternal and fetal blood is not large, as the partial pressure of oxygen in fetal blood at the placenta is about 20 mm Hg. Therefore, there is not as much diffusion of oxygen into the fetal blood supply. The fetus’ hemoglobin overcomes this problem by having a greater affinity for oxygen than maternal hemoglobin (Figure 3). Both fetal and adult hemoglobin have four subunits, but two of the subunits of fetal hemoglobin have a different structure that causes fetal hemoglobin to have a greater affinity for oxygen than does adult hemoglobin.
Carbon dioxide is transported by three major mechanisms. The first mechanism of carbon dioxide transport is by blood plasma, as some carbon dioxide molecules dissolve in the blood. The second mechanism is transport in the form of bicarbonate (HCO3–), which also dissolves in plasma. The third mechanism of carbon dioxide transport is similar to the transport of oxygen by erythrocytes (Figure 4).

A. Dissolved Carbon Dioxide

Although carbon dioxide is not considered to be highly soluble in blood, a small fraction—about 7 to 10 percent—of the carbon dioxide that diffuses into the blood from the tissues dissolves in plasma. The dissolved carbon dioxide then travels in the bloodstream and when the blood reaches the pulmonary capillaries, the dissolved carbon dioxide diffuses across the respiratory membrane into the alveoli, where it is then exhaled during pulmonary ventilation.

B. Bicarbonate Buffer

A large fraction—about 70 percent—of the carbon dioxide molecules that diffuse into the blood is transported to the lungs as bicarbonate. Most bicarbonate is produced in erythrocytes after carbon dioxide diffuses into the capillaries, and subsequently into red blood cells. Carbonic anhydrase (CA) causes carbon dioxide and water to form carbonic acid (H2CO3), which dissociates into two ions: bicarbonate (HCO3–) and hydrogen (H+). The following formula depicts this reaction:

CO2 + H2O + (CA) ↔ H2CO3 ↔ H+ + HCO3−

Bicarbonate tends to build up in the erythrocytes, so that there is a greater concentration of bicarbonate in the erythrocytes than in the surrounding blood plasma. As a result, some of the bicarbonate will leave the erythrocytes and move down its concentration gradient into the plasma in exchange for chloride (Cl–) ions. This phenomenon is referred to as the chloride shift and occurs because by exchanging one negative ion for another negative ion, neither the electrical charge of the erythrocytes nor that of the blood is altered.

At the pulmonary capillaries, the chemical reaction that produced bicarbonate (shown above) is reversed, and carbon dioxide and water are the products. Much of the bicarbonate in the plasma re-enters the erythrocytes in exchange for chloride ions. Hydrogen ions and bicarbonate ions join to form carbonic acid, which is converted into carbon dioxide and water by carbonic anhydrase. Carbon dioxide diffuses out of the erythrocytes and into the plasma, where it can further diffuse across the respiratory membrane into the alveoli to be exhaled during pulmonary ventilation.

C. Carbaminohemoglobin

About 20 percent of carbon dioxide is bound by hemoglobin and is transported to the lungs. Carbon dioxide does not bind to iron as oxygen does; instead, carbon dioxide binds amino acid moieties on the globin portions of hemoglobin to form carbaminohemoglobin, which forms when hemoglobin and carbon dioxide bind. When hemoglobin is not transporting oxygen, it tends to have a bluish-purple tone to it, creating the darker maroon color typical of deoxygenated blood. The following formula depicts this reversible reaction:

CO2 + Hb ↔ HbCO2

Similar to the transport of oxygen by heme, the binding and dissociation of carbon dioxide to and from hemoglobin is dependent on the partial pressure of carbon dioxide. Because carbon dioxide is released from the lungs, blood that leaves the lungs and reaches body tissues has a lower partial pressure of carbon dioxide than is found in the tissues. As a result, carbon dioxide leaves the tissues because of its higher partial pressure, enters the blood, and then moves into red blood cells, binding to hemoglobin. In contrast, in the pulmonary capillaries, the partial pressure of carbon dioxide is high compared to within the alveoli. As a result, carbon dioxide dissociates readily from hemoglobin and diffuses across the respiratory membrane into the air.

In addition to the partial pressure of carbon dioxide, the oxygen saturation of hemoglobin and the partial pressure of oxygen in the blood also influence the affinity of hemoglobin for carbon dioxide. The Haldane effect is a phenomenon that arises from the relationship between the partial pressure of oxygen and the affinity of hemoglobin for carbon dioxide. Hemoglobin that is saturated with oxygen does not readily bind carbon dioxide. However, when oxygen is not bound to heme and the partial pressure of oxygen is low, hemoglobin readily binds to carbon dioxide.

OpenStax. (2022). Anatomy and Physiology 2e. Rice University. Retrieved June 15, 2023. ISBN-13: 978-1-711494-06-7 (Hardcover) ISBN-13: 978-1-711494-05-0 (Paperback) ISBN-13: 978-1-951693-42-8 (Digital). License: Attribution 4.0 International (CC BY 4.0). Access for free at openstax.org.

Hemoglobin consists of four subunits, each of which contains one molecule of iron.

These three graphs show (a) the relationship between the partial pressure of oxygen and hemoglobin saturation, (b) the effect of pH on the oxygen–hemoglobin dissociation curve, and (c) the effect of temperature on the oxygen–hemoglobin dissociation curve.

Fetal hemoglobin has a greater affinity for oxygen than does adult hemoglobin.

Carbon dioxide is transported by three different methods: (a) in erythrocytes; (b) after forming carbonic acid (H2CO3 ), which is dissolved in plasma; (c) and in plasma.

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Dưới đây là video và các luyện tập (practice) của bài này. Nghe là một kĩ năng khó, đặc biệt là khi chúng ta chưa quen nội dung và chưa có nhạy cảm ngôn ngữ. Nhưng cứ đi thật chậm và đừng bỏ cuộc.
Xem video và cảm nhận nội dung bài. Bạn có thể thả trôi, cảm nhận dòng chảy ngôn ngữ và không nhất thiết phải hiểu toàn bộ bài. Bên dưới là script để bạn khái quát nội dụng và tra từ mới.
Script:
  1. Oxygen is primarily transported through the blood by erythrocytes.
  2. These cells contain a metalloprotein called hemoglobin, which is composed of four subunits with a ring-like structure.
  3. Each subunit contains one atom of iron bound to a molecule of heme.
  4. Heme binds oxygen so that each hemoglobin molecule can bind up to four oxygen molecules.
  5. When all of the heme units in the blood are bound to oxygen, hemoglobin is considered to be saturated.
  6. Hemoglobin is partially saturated when only some heme units are bound to oxygen.
  7. An oxygen–hemoglobin saturation/dissociation curve is a common way to depict the relationship of how easily oxygen binds to or dissociates from hemoglobin as a function of the partial pressure of oxygen.
  8. As the partial pressure of oxygen increases, the more readily hemoglobin binds to oxygen.
  9. At the same time, once one molecule of oxygen is bound by hemoglobin, additional oxygen molecules more readily bind to hemoglobin.
  10. Other factors such as temperature, pH, the partial pressure of carbon dioxide, and the concentration of 2,3-bisphosphoglycerate can enhance or inhibit the binding of hemoglobin and oxygen as well.
  11. Fetal hemoglobin has a different structure than adult hemoglobin, which results in fetal hemoglobin having a greater affinity for oxygen than adult hemoglobin.
  12. Carbon dioxide is transported in blood by three different mechanisms: as dissolved carbon dioxide, as bicarbonate, or as carbaminohemoglobin.
  13. A small portion of carbon dioxide remains.
  14. The largest amount of transported carbon dioxide is as bicarbonate, formed in erythrocytes.
  15. For this conversion, carbon dioxide is combined with water with the aid of an enzyme called carbonic anhydrase.
  16. This combination forms carbonic acid, which spontaneously dissociates into bicarbonate and hydrogen ions.
  17. As bicarbonate builds up in erythrocytes, it is moved across the membrane into the plasma in exchange for chloride ions by a mechanism called the chloride shift.
  18. At the pulmonary capillaries, bicarbonate re-enters erythrocytes in exchange for chloride ions, and the reaction with carbonic anhydrase is reversed, recreating carbon dioxide and water.
  19. Carbon dioxide then diffuses out of the erythrocyte and across the respiratory membrane into the air.
  20. An intermediate amount of carbon dioxide binds directly to hemoglobin to form carbaminohemoglobin.
  21. The partial pressures of carbon dioxide and oxygen, as well as the oxygen saturation of hemoglobin, influence how readily hemoglobin binds carbon dioxide.
  22. The less saturated hemoglobin is and the lower the partial pressure of oxygen in the blood is, the more readily hemoglobin binds to carbon dioxide.
  23. This is an example of the Haldane effect.
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