BIO 669 Human Pathology - Module 6 - Pulmonology Quiz Study Guide
HUMAN PATHOPHYSIOLOGY Module 6 - Pulmonary System Quiz
PROFESSOR KEY
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Structure and Function of the Pulmonary System Teaching Focus
• The pulmonary system consists of the lungs, airways, chest wall, diaphragm, and pulmonary and bronchial circulation.
• Air is inspired and expired through the conducting airways, which include the nasopharynx, oropharynx, trachea, bronchi, and bronchioles to the sixteenth division.
• Gas exchange occurs in structures beyond the sixteenth division: the respiratory bronchioles, alveolar ducts, and alveoli. Together these structures make up the acinus.
• The pulmonary system enables oxygen to diffuse into the blood and carbon dioxide (CO2) to diffuse out of the blood.
• Ventilation is the process by which air flows into and out of the gas-exchange airways and is
involuntary most of the time. The respiratory center in the brainstem controls ventilation, and the sympathetic and parasympathetic divisions of the autonomic nervous system (ANS) adjust airway caliber (by causing bronchial smooth muscles to contract or relax) and control the rate and depth of ventilation.
• Neuroreceptors in the lungs (lung receptors) monitor the mechanical aspects of ventilation.
Irritant receptors sense the need to expel unwanted substances, stretch receptors sense lung volume (lung expansion), and J-receptors sense alveolar size.
• Chemoreceptors in the circulatory system and brainstem sense the effectiveness of ventilation
by monitoring the pH status of cerebrospinal fluid and the oxygen content of arterial blood (Pao2).
• Successful ventilation involves the mechanics of breathing: the interaction of forces and
counterforces involving the muscles of inspiration and expiration, alveolar surface tension, elastic properties of the lungs and chest wall, and resistance to airflow.
• The major muscle of inspiration is the diaphragm. When the diaphragm contracts, it moves
downward in the thoracic cavity, creating a vacuum that causes air to flow into the lungs.
• Compliance is the ability of the lungs and chest wall to expand during inspiration. The adequate production of surfactant ensures lung compliance; chest wall expansion depends on
flexibility.
• Hemoglobin, a protein contained within red blood cells, transports almost all of the oxygen that diffuses into pulmonary capillary blood. The remainder of the oxygen is transported dissolved in plasma.
• Oxygen enters the body by diffusing down the concentration gradient from high concentrations in the alveoli to lower concentrations in the capillaries. Diffusion ceases when alveolar and capillary oxygen pressures equilibrate.
• Aging affects the mechanical aspects of ventilation by decreasing chest wall compliance and elastic recoil of the lungs. Changes in these elastic properties reduce ventilatory reserve.
Alterations of Pulmonary Function Teaching Focus
• Dyspnea is a feeling of breathlessness and increased respiratory effort. Orthopnea is dyspnea when a person lies flat. Paroxysmal nocturnal dyspnea occurs at night and requires the person to sit or stand for relief.
• Coughing is a protective reflex that expels secretions and irritants from the lower airways.
• Abnormal sputum is a change in the amount, consistency, color, and odor of sputum.
• Abnormal breathing patterns are adjustments made by the body to minimize the work of
respiratory muscles. They include Kussmaul, obstructed, restricted, gasping, and/or Cheyne- Stokes respirations, and sighing.
• Hypoventilation is the decrease in alveolar ventilation caused by airway obstruction, chest
wall restriction, or altered neurologic control of breathing. It causes increased partial pressure of carbon dioxide in arterial blood (Paco2). Hyperventilation is the increase in alveolar ventilation produced by anxiety, head injury, or severe hypoxemia. It causes decreased Paco2.
• A desaturation of hemoglobin, polycythemia, or peripheral vasoconstriction causes cyanosis,
a bluish discoloration of the skin.
• Clubbing of the fingertips is associated with diseases that interfere with oxygenation of the tissues.
• Chest pain can result from inflamed pleurae, trachea, bronchi, or respiratory muscles.
• Hypercapnia is increased Paco2 caused by a decrease in minute volume (respiratory rate × tidal volume).
• Hypoxemia is reduced partial pressure of oxygen in arterial blood (Pao2) caused by (1) decreased oxygen content of inspired gas, (2) hypoventilation, (3) diffusion abnormality, (4)
ventilation-perfusion mismatch, or (5) shunting.
• Acute respiratory failure is caused by inadequate gas exchange or ventilation (Pao2, ≤50 mm Hg or Paco2 ≥50 mm Hg and pH ≥7.25).
• Obesity and kyphoscoliosis, which compress the lungs, and neuromuscular diseases, which
impair chest wall muscle function, diminish chest wall compliance. Flail chest results from rib or sternal fractures that disrupt the mechanics of breathing.
• Pneumothorax is the accumulation of air in the pleural space and can be caused by
spontaneous rupture of weakened areas of pleura. Pneumothorax can be secondary to pleural damage caused by disease, trauma, or mechanical ventilation.
• Pleural effusion is the accumulation of fluid in the pleural space, usually resulting from
disorders that promote transudation or exudation from capillaries underlying the pleura but occasionally resulting from blockage or injury that causes lymphatic vessels to drain into the pleural space.
• Empyema is the presence of pus in the pleural space (infected pleural effusion). The source
of the pus is usually lymphatic drainage from sites of bacterial pneumonia.
• Aspiration is the passage of fluid and solid particles into the lung, usually from impaired swallowing and coughing. It frequently results in pneumonitis and pulmonary infection.
• Atelectasis is the collapse of alveoli as a result of compression of the lung tissue or absorption of gas from obstructed alveoli.
• Bronchiectasis is the abnormal dilation of the bronchi, secondary to another pulmonary disorder, usually infection or inflammation.
• Bronchiolitis is the inflammatory obstruction of small airways and is most common in children.
• Pulmonary fibrosis is an excessive amount of connective tissue in the lung. It diminishes lung compliance and may be idiopathic or caused by disease.
• Pulmonary edema is excess water in the lung caused by disturbances of capillary hydrostatic pressure, capillary oncotic pressure, or capillary permeability. A common cause is left-sided
heart failure that increases the hydrostatic pressure in the pulmonary circulation.
• ARDS is the result of an acute, diffuse injury to the alveolocapillary membrane and decreased surfactant production, which increases membrane permeability and causes edema and atelectasis.
• Airway obstruction that causes difficult expiration is characteristic of obstructive pulmonary disease. Obstructive disease can be acute or chronic and includes asthma, chronic bronchitis, and emphysema.
• Asthma is a chronic inflammatory disorder of the bronchial mucosa that causes bronchial hyperresponsiveness, mucosal edema, airway constriction, and variable obstruction to airflow. Obstruction is caused by episodic attacks of bronchospasm, bronchial inflammation, mucosal edema, and increased mucus production.
• Chronic obstructive pulmonary disease (COPD) is the coexistence of chronic bronchitis and emphysema. Chronic bronchitis is a chronic inflammation of the bronchi that causes airway obstruction, resulting from bronchial smooth muscle hypertrophy and the production of thick, tenacious mucus. Emphysema results from the destruction of the alveolar septa and loss of passive elastic recoil, leading to airway collapse and obstruction to gas flow during expiration and air trapping.
• Upper respiratory tract infections are the most common cause of short-term disability in the United States and include rhinitis (the common cold), pharyngitis, and laryngitis.
• Pneumonia can be categorized as community acquired (CAP), health care–associated (HCAP), hospital acquired (HAP), or ventilator associated (VAP).
• Tuberculosis is a lung infection caused by Mycobacterium tuberculosis (tubercle bacillus).
• Acute bronchitis is an acute infection or inflammation of the airways or bronchi, usually caused by a virus.
• Embolism or hypertension in the pulmonary circulation causes pulmonary vascular diseases.
• Pulmonary embolism is occlusion of a portion of the pulmonary vascular bed by a thrombus (most common), a tissue fragment, or an air bubble. Depending on its size and location, the
embolus can cause hypoxic vasoconstriction, pulmonary edema, atelectasis, pulmonary hypertension, shock, and even death.
• Pulmonary artery hypertension (pulmonary artery pressure 5 to 10 mm Hg greater than
normal) is caused by (1) elevated left ventricular pressure, (2) increased blood flow through the pulmonary circulation, (3) obliteration or obstruction of the vascular bed, or (4) active constriction of the vascular bed produced by hypoxemia or acidosis.
• Cor pulmonale is right ventricular enlargement caused by chronic pulmonary hypertension.
Cor pulmonale progresses to right ventricular failure if the pulmonary hypertension is not reversed.
• Laryngeal cancer occurs primarily in men and represents 2% to 3% of all cancers. Squamous
cell carcinoma of the true vocal cords is most common and exhibits the clinical symptom of progressive hoarseness.
• Cigarette tobacco smoking commonly causes lung cancer, the most frequent cause of cancer
death in the United States.
PEER NOTES:
Two types of airways in the pulmonary system:
1. conducting airways.
2. gas exchange.
The conducting airways are involved in:
ventilation; mechanical movement of air in/out of the lungs. Involves much of the initial airways.
The gas exchange airways involve what function?
respiration and exchange of gas across membranes resulting in O2/CO2 gas exchange.
3 major airways of the conducting airway:
1. upper airways.
2. larynx (laryngopharynx).
3. lower airways.
Two components of the upper airways:
1. nasopharynx.
2. oropharynx.
What is the purpose if the larynx?
connects the upper and lower airways.
Has a switching mechanism that only allows airway to be available in the breathing portion. Also functions for voice production.
3 components of the lower airways in the conducting airways:
1. trachea.
2. bronchi.
3. terminal bronchioles.
The trachea deviates into:
the right and left main stem bronchus.
The split between the main bronchi is called:
carina.
Terminal bronchioles have small amounts of:
cartilage.
Most of the bronchioles are involved in:
the respiration/gas exchange airway rather than the conducting airways.
3 major components of the gas-exchange airways:
1. respiratory bronchioles.
2. alveolar ducts.
3. alveoli.
Describe alveoli:
small balloon like structures where the air ends; the smallest unit of respirations.
What cells make up alveoli walls?
epithelial cells.
Types of epithelial cells:
1. Type 1 alveolar cells.
2. Type 2 alveolar cells.
Difference between type 1 and type 2 alveolar cells:
Type 1 - alveolar structure components like endothelial cells in capillaries that allows for exchange across capillaries (part of the alveoli capillary membranes).
Type 2 - produces surfactant.
Why is surfactant important?
Surfactant is a protein that helps to reduce surface tension.
surface tension in the lungs is a result of:
result of H+ binding to water or other substances, like binding of lots of magnetic forces to pull everything tighter and closer together.
Surfactant acts like a:
detergent as it interferes with H+ bonds, loosens everything and allows for easier inflation of alveoli.
What occurs if a baby is born before surfactant is produced?
The baby will have difficulty inflating its alveoli.
Tx for baby born before surfactant production:
Give mother steroids to enhance maturation process of these cells if known baby coming early.
The alveoli also contain these cells:
alveolar macrophages that engulf pathogens, particles and debris causing an immune reaction.
The combination of the respiratory bronchioles, alveolar ducts, and alveoli is called:
acinus.
Function of the pharynx:
combined eating, drinking and respiratory section.
Esophagus fxn:
eating and drinking only.
As bronchi divide, they have what mimicry?
Arteries and arterioles that mimic division to alveoli.
Veins do not follow this pattern.
What are generations when discussing bronchi, bronchioles and alveolar ducts?
how many times the unit divides.
What is lost as anatomy progresses down the conducting airways?
more and more cartilage is lost. The respiratory unit does not have cartilage.
What type of cartilage does bronchioles possess?
incomplete cartilage as it does not form complete rings like segmental bronchi.
What is the benefit of incomplete cartilage in the bronchioles?
The bronchioles can close off airways and shut them down to help prevent pollutants and irritants from reaching the lower airways.
The upper airways must remain open at all times.
Alveoli have the ability to communicate with one another through:
The pores of Kohn that cause equalization of pressure, exchange of small amounts of gas and increase efficiency of ventilation b/t alveoli.
HERE starts the teaching focus concepts:
The pulmonary system consists of:
1. the lungs.
2. airways.
3. chest wall.
4. diaphragm.
5. pulmonary and bronchial circulation.
Air is inspired and expired through the airways:
conducting.
The conducting airways includes which components:
1. nasopharynx.
2. oropharynx.
3. trachea.
4. bronchi.
5. bronchioles to the sixteenth division.
What occurs beyond the sixteenth division and what structures are involved here?
Gas exchange occurs beyond the sixteenth division.
1. respiratory bronchioles.
2. alveolar ducts.
3. alveoli.
Together, the respiratory bronchioles, alveolar ducts and alveoli make up the:
acinus.
The pulmonary system enables what to occur to oxygen and CO2?
enables oxygen to diffuse into the blood and CO2 to diffuse out of the blood.
is the process by which air flows into and out of the gas-exchange airways.
ventilation
Ventilation is most of the time.
involuntary.
What component of the brain controls ventilation?
The respiratory center in the brainstem.
What components of the brain adjust airway caliber and control the rate and depth of ventilation?
SNS and PNS by causing bronchial smooth muscles to contract or relax.
What type of receptors in the lungs monitor the mechanical aspects of ventilation?
neuroreceptors (lung receptors).
Types of neuroreceptors and what they sense:
1. irritant receptors - sense the need to expel unwanted substances.
2. stretch receptors - sense lung volume/lung expansion.
3. J-receptors - sense alveolar size.
What type of receptors sense the effectiveness of ventilation?
chemoreceptors.
where are chemoreceptors located?
in the circulatory system and brainstem.
How do chemoreceptors sense the effectiveness of ventilation?
by monitoring the pH status of CSF and the oxygen content of arterial blood (PaO2).
Successful ventilation involves what 4 mechanics of breathing?
1. interaction of forces & counterforces involving the muscles of inspiration & expiration.
2. alveolar surface tension.
3. elastic properties of the lungs and chest wall.
4. resistance to airflow.
What is the major muscle of inspiration?
the diaphragm.
What occurs when the diaphragm contracts?
it moves downward in the thoracic cavity creating a vacuum that causes air to flow into the lungs.
Compliance is the ability of the lungs and chest wall to:
expand during inspiration.
The adequate production of ensures lung compliance.
surfactant.
Chest wall expansion depends on:
flexibility.
Important protein contained within RBCs
hemoglobin.
How much oxygen does hemoglobin normally transport that diffuses into pulmonary capillary blood?
almost all.
The remainder of O2 is transported dissolved in plasma.
Within the pulmonary capillaries, one hemoglobin molecule binds up to four oxygen molecules in a cooperative manner
How does oxygen enter the body?
By diffusing down the concentration gradient from high concentrations in the alveoli to lower concentrations in the capillaries.
When does diffusion of oxygen cease?
when alveolar and capillary oxygen pressures equilibrate.
How does aging affect the mechanical aspects of ventilation?
by decreasing chest wall compliance and elastic recoil of the lungs.
Changes in the elastic properties associated with aging reduces:
ventilatory reserve.
A feeling of breathlessness and increased respiratory effort.
dyspnea.
What is orthopnea?
dyspnea when a person lies flat.
What is paroxysmal nocturnal dyspnea?
This occurs at night and requires the person to sit or stand for relief.
A protective reflex that expels secretions and irritants from the lower airways.
coughing.
Abnormal sputum is a change in 4 potential characteristics of sputum?
1. color.
2. consistency.
3. odor.
4. amount.
Abnormal breathing patterns are adjustments made by the body to:
minimize the work of respiratory muscles.
Types of abnormal breathing patterns:
1. Kussmaul.
2. obstructed.
3. restricted.
4. gasping.
5. Cheyne-Stokes respirations.
6. sighing.
Hypoventilation is the decrease in alveolar ventilation caused by:
1. airway obstruction.
2. chest wall restriction.
3. altered neurologic control of breathing.
Hypoventilation causes increased:
PaCO2.
Hyperventilation is increased alveolar ventilation produced by:
1. anxiety.
2. head injury.
3. severe hypoxemia.
Hyperventilation causes PaCO2.
decreased PaCO2.
What causes cyanosis?
1. desaturation of hemoglobin.
2. polycythemia.
3. peripheral vasoconstriction.
What physical assessment is associated with diseases that interfere with oxygenation of the tissues?
clubbing of the fingertips.
Chest pain can result from:
1. inflamed pleurae.
2. trachea.
3. bronchi.
4. respiratory muscles.
Hypercapnia is increased PaCO2 caused by:
a decrease in minute volume (respiratory rate X tidal volume).
Hypoxemia is reduced:
PaO2 (in arterial blood).
What caused hypoxemia?
1. decreased oxygen content of inspired gas.
2. hypoventilation.
3. diffusion abnormality.
4. V/Q mismatch.
5. shunting.
Acute respiratory failure is caused by:
inadequate gas exchange or ventilation.
What are the PaO2, PaCO2 and pH values for acute respiratory failure?
PaO2 <= 50.
PaCO2 >= 50.
pH >= 7.25.
What types of diseases can diminish chest wall compliance?
1. obesity.
2. kyphoscoliosis.
3. neuromuscular dz.
The top two compress the lungs. #3 impairs chest wall muscle function.
What causes flail chest?
rib or sternal fractures that disrupt the mechanics of breathing.
What is the accumulation of air in the pleural space?
Air = pneumothorax. accumulation of fluid? fluid = pleural effusion accumulation of pus? pus = empyema.
What causes a pneumothorax?
spontaneous rupture of weakened areas of pleura.
but also secondary to pleural damage caused by disease, trauma, or mechanical ventilation.
What causes pleural effusions?
disorders that promote transudation or exudation from capillaries underlying the pleura.
but also sometimes d/t blockage or injury that causes lymphatic vessels to drain into the pleural space.
How is an empyema r/t a pleural effusion?
It is an infected pleural effusion.
The source of pus in an empyema is usually:
lymphatic drainage from sites of bacterial pneumonia.
The passage of fluid and solid particles into the lung.
aspiration.
aspiration usually occurs d/t:
impaired swallowing and coughing.
aspiration frequently results in:
1. pneumonitis.
2. pulmonary infection.
Atelectasis is the collapse of as a result of:
collapse of alveoli as a result of compression of the lung tissue or absorption of gas from obstructed alveoli.
Abnormal dilation of the bronchi
bronchiectasis.
Usually cause of bronchiectasis:
usually secondary to another pulmonary disorder such as infection or inflammation.
What is bronchiolitis?
inflammatory obstruction of small airways.
Bronchiolitis is most common in:
children.
Pulmonary fibrosis is:
an excessive amount of connective tissue in the lung that diminished lung compliance.
Causes of pulmonary fibrosis:
can be idiopathic or caused by disease.
Increasing evidence suggests that mechanical ventilation can cause lung fibrosis
Excess water in the lungs:
pulmonary edema.
Causes of pulmonary edema:
disturbances of capillary hydrostatic pressure, oncotic pressure or permeability.
common cause = left-sided HF that increases hydrostatic pressure in the pulmonary circulation.
ARDS is the result of:
an acute, diffuse injury to the alveolocapillary membrane and decreased surfactant production which increase membrane permeability and cause edema and atelectasis.
Airway obstruction that causes difficult expiration is characteristic of:
obstructive pulmonary disease.
obstructive diseases can be:
acute or chronic.
obstructive diseases include:
1. asthma.
2. chronic bronchitis.
3. emphysema.
Asthma is a chronic inflammatory disorder of:
the bronchial mucosa.
The chronic inflammation of the bronchial mucosa causes:
1. bronchial hyperresponsiveness.
2. mucosal edema.
3. airway constriction.
4. variable obstruction to airflow.
Obstruction to airflow in asthma is caused by:
1. episodic attacks of bronchospasm.
2. bronchial inflammation.
3. mucosal edema.
4. increased mucus production.
COPD is coexistence of:
chronic bronchitis and emphysema.
Chronic bronchitis is a chronic inflammation of:
the bronchi
Chronic inflammation of the bronchi causes:
airway obstruction resulting from bronchial smooth muscle hypertrophy and the production of thick, tenacious mucus.
Emphysema results from:
the destruction of the alveolar septa and loss of passive elastic recoil.
This leads to airway collapse and obstruction to gas flow during expiration and air trapping.
What is the most common cause of short-term disability in the US?
URIs.
Examples of URIs:
1. rhinitis (common cold).
2. pharyngitis.
3. laryngitis.
4 categories of pneumonia:
1. community acquired (CAP).
2. healthcare associated (HCAP).
3. hospital acquired (HAP).
4. ventilator associated (VAP).
TB is a lung infection caused by:
mycobacterium tuberculosis (tubercle bacillus).
Acute infection or inflammation of the airways or bronchi.
acute bronchitis.
typical cause of acute bronchitis:
virus.
What two things cause pulmonary vascular diseases?
1. embolism.
2. HTN in the pulmonary circulation.
PE is occlusion of:
a portion of the vascular bed by a thrombus (most common), tissue fragment or air bubble.
Depending on its size and location, the embolus can cause:
1. hypoxic vasoconstriction.
2. pulmonary edema.
3. atelectasis.
4. pulmonary HTN.
5. shock.
6. death.
Pulmonary artery HTN is PA pressure greater than normal.
5-10 mmHg greater than normal, or above 20.
PA HTN is caused by:
1. elevated left ventricular pressure.
2. increased blood flow thru the pulmonary circulation.
3. obliteration or obstruction of the vascular bed.
4. active constriction of the vascular bed produced by hypoxemia or acidosis.
What is Cor Pulmonale?
an alteration in the structure and function of the right ventricle (RV) of the heart caused by a primary disorder of the respiratory system. Right ventricle enlargement from increased afterload.
what causes this?
Most commonly, right ventricular enlargement caused by chronic pulmonary HTN
Cor pulmonale progressed to:
right ventricular failure if the pulmonary HTN is not reversed.
Laryngeal Ca occurs primarily in:
Men
Laryngeal Ca represents % of all Ca.
2-3%.
What is the most common laryngeal Ca?
squamous cell carcinoma of the true vocal cords.
The most common laryngeal Ca exhibits the clinical Sx of:
progressive hoarseness.
Most frequent cause of Ca death in US?
Lung Ca.
What is the typical cause of lung Ca?
cigarette tobacco smoking.
EXTRA CREDIT QUESTIONS:
1. A 35-year-old man develops worsening dyspnea on exertion, occurring over the last few weeks. He has no cardiac risk factors. A chest radiograph reveals bilateral hilar adenopathy. Labs show an elevated erythrocyte sedimentation rate and an elevated angiotensin converting enzyme (ACE) level. What is this person’s likely diagnosis?
(A) Lymphoma
(B) Silicosis
(C) Sarcoidosis
(D) Tuberculosis
(E) Caplan’s syndrome
Answer - C. Although many of the answers could demonstrate bilateral hilar adenopathy on a chest radiograph as well as an elevated sed rate (nonspecific), only sarcoidosis, Choice (C), is associated with an elevated ACE level. Remember that Choice (E), Caplan’s syndrome, is a combination of rheumatoid arthritis plus lung nodules.
2. Which one of the following is a cause of a respiratory alkalosis?
(A) Neuromuscular disease
(B) Pulmonary embolism
(C) Kyphosis
(D) Diarrhea
(E) Nasogastric section
Answer - B. Pulmonary embolism can cause respiratory alkalosis. Choices (A) and (C), neuromuscular disease and kyphosis, are causes of a respiratory acidosis. Diarrhea, with loss of bicarbonate in the stool, is a cause of a metabolic acidosis. Choice (E), nasogastric section, causes a metabolic alkalosis. Other causes of a metabolic alkalosis include vomiting and diuretic use.
3. Hemoglobin is a protein in red blood cells (RBCs) that carries oxygen. Almost 30% of the mass of RBCs is made up by hemoglobin. This allows RBCs to carry much more oxygen than could otherwise be dissolved into blood.
A researcher studies the oxygen dissociation curves of normal adult hemoglobin (HbA), fetal hemoglobin (HbF), and myoglobin (Mb), a related compound. He dissolves samples of each protein in a cup of water, and places each cup in a sealed canister in contact with a gas. He changes the partial pressure of oxygen (PO2) in the gas. For each measured PO2 he measures the saturation of oxygen in the proteins in the fluid. The saturation is the percentage of total binding sites on the HbA, HbF, or Mb, which are bound to oxygen. The results are shown below.
Which of the following is INCORRECT regarding the HbA solution in equilibrium with a gas at PO2 = 80 mmHg.
(A) The amount of oxygen leaving the solution will be equal to the amount of oxygen entering the solution.
(B) The partial pressure of oxygen in the HbA solution will be 80 mmHg
(C) The concentration of oxygen in the HbA solution will be the same as in the gas.
(D) Over 95% percent of the HbA oxygen-binding sites will be binding oxygen.
Hints:
If a gas and solution are in equilibrium, there is not a net flux of gas from one to the other.
Oxygen might be more comfortable in a gas than in a solution.
A solution in equilibrium with a gas does NOT mean that both have the same concentration of gas molecules. A gas usually prefers not to enter solution, so usually there will be less gas in solution than in the gas, even if they are in equilibrium.
Answer – C. The concentration of oxygen in the HbA solution will be the same as in the gas. [Show Less]