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Exchanging Oxygen and Carbon Dioxide

By Noah Lechtzin, MD, MHS, Johns Hopkins University School of Medicine

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The primary function of the respiratory system is to exchange oxygen and carbon dioxide. Inhaled oxygen enters the lungs and reaches the alveoli. The layers of cells lining the alveoli and the surrounding capillaries are each only one cell thick and are in very close contact with each other. This barrier between air and blood averages about 1 micron (1/10,000 of a centimeter, or 0.000039 inch) in thickness. Oxygen passes quickly through this air-blood barrier into the blood in the capillaries. Similarly, carbon dioxide passes from the blood into the alveoli and is then exhaled.

Oxygenated blood travels from the lungs through the pulmonary veins and into the left side of the heart, which pumps the blood to the rest of the body (see Function of the Heart). Oxygen-deficient, carbon dioxide-rich blood returns to the right side of the heart through two large veins, the superior vena cava and the inferior vena cava. Then the blood is pumped through the pulmonary artery to the lungs, where it picks up oxygen and releases carbon dioxide.

To support the exchange of oxygen and carbon dioxide, about 5 to 8 liters (about 1.3 to 2.1 gallons) of air per minute are brought in and out of the lungs, and about three tenths of a liter of oxygen is transferred from the alveoli to the blood each minute, even when the person is at rest. At the same time, a similar volume of carbon dioxide moves from the blood to the alveoli and is exhaled. During exercise, it is possible to breathe in and out more than 100 liters (about 26 gallons) of air per minute and extract 3 liters (a little less than 1 gallon) of oxygen from this air per minute. The rate at which oxygen is used by the body is one measure of the rate of energy expended by the body. Breathing in and out is accomplished by respiratory muscles.

Gas Exchange Between Alveolar Spaces and Capillaries

The function of the respiratory system is to exchange two gases: oxygen and carbon dioxide. The exchange takes place in the millions of alveoli in the lungs and the capillaries that envelop them. As shown below, inhaled oxygen moves from the alveoli to the blood in the capillaries, and carbon dioxide moves from the blood in the capillaries to the air in the alveoli.

Three processes are essential for the transfer of oxygen from the outside air to the blood flowing through the lungs: ventilation, diffusion, and perfusion.

  • Ventilation is the process by which air moves in and out of the lungs.

  • Diffusion is the spontaneous movement of gases, without the use of any energy or effort by the body, between the gas in the alveoli and the blood in the capillaries in the lungs.

  • Perfusion is the process by which the cardiovascular system pumps blood throughout the lungs.

The body's circulation is an essential link between the atmosphere, which contains oxygen, and the cells of the body, which consume oxygen. For example, the delivery of oxygen to the muscle cells throughout the body depends not only on the lungs but also on the ability of the blood to carry oxygen and on the ability of the circulation to transport blood to muscle.

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