PHS 202 (Respiratory
Physiology)
ADEGBITE L.O.
Ventilation-Perfusion
Ratio
Introduction
• Ventilation: is the rate at which air enters or leaves the lungs
• There are two types of ventilation:
1) Pulmonary ventilation: this is the volume of air moving in and out of the
respiratory tract per unit time during normal breathing.
Value = 6 Litres/minute
2) Alveolar ventilation: is the volume of air utilized for gaseous exchange
Value ≈ 4 Litres/ minute
Perfusion: simply signifies the rate of pulmonary blood flow
Ventilation/perfusion Ratio or V/Q
• On average, alveolar ventilation is about 4 L/min and pulmonary
capillary blood flow, or cardiac output, is about 5 L/min, making the
overall ratio of ventilation to perfusion 4:5, or 0.8.
• This relationship is called the ventilation-perfusion ratio (V/Q ratio).
• The V/Q ratio varies throughout the lung.
How the V/Q Ratio affects Alveolar Gas
• Ventilation and Perfusion (V/Q) has a profound effect on the partial
pressures of O2 and CO2 in the alveolus
• PO2 and PCO2 levels average about 100 mmHg and 40 mmHg
respectively
• Only in a small portion of the lungs are those numbers true. They are
actually an average
How the V/Q Ratio affects Alveolar Gas
• PO2 is determined by the amount of O2 entering the alveoli and its
removal by capillary blood flow
• If capillary blood flow is low, PO2 will remain high
• This occurs in the apices; Ventilation with very little perfusion results
in a high PO2
How the V/Q Ratio affects Alveolar Gas
• PCO2 is determined by:
• the amount of capillary blood perfusing an alveolus, allowing the CO2 to
diffuse out of the capillary bed and into the alveolus and the amount of
ventilation that alveolus receives.
• Areas of high perfusion and low ventilation have higher PCO2 i.e: The bases.
• Functionally:
• Alveoli at
apex are underperfused
(overventilated).
• Alveoli at the base are
• underventilated (overperfused).
Effects of Increased V/Q
• When the V/Q ratio increases, the PO2 rises and the PCO2 falls.
• The PCO2 decreases because it washes out of the alveoli faster than it
is replaced by venous blood.
• The PO2 increases because it does not diffuse into the blood as fast as
it enters the alveolus.
• This V/Q relationship is present in the upper segments of the upright
lung. (zone I)
Effects of Decreased V/Q
• When the V/Q ratio decreases, the PO2 falls and the PCO2 rises.
• The PO2 decreases because oxygen moves out of the alveolus and into
pulmonary blood faster than it is replenished by ventilation.
• The PCO2 increases because it moves out of the blood and into the
alveolus faster than it is washed out.
• This is seen in the lower lung segments.(zone III)
How the V/Q ratio Affects end
capillary gases
• The O2 and CO2 pressures in the end capillary blood mirror the PO2
and PCO2 changes that occur in the lungs
• Therefore, as the PO2 decreases and the PCO2 increases from the top
of the lung to the bottom, so does the capillary PO2 and PCO2
respectively.
• The different capillary PO2 and PCO2 levels mix together in the
pulmonary veins, under normal circumstances, produce a PO2 of 100
and a PCO2 of 40 mm Hg.
Respiratory Quotient (RQ)
• Gas exchange between the systemic capillaries and the cells is called
internal respiration.
• About 250 ml of O2 are consumed by the tissues during 1 minute.
• The cells produce about 200 ml of CO2.
• The ratio between the volume of O2 consumed and the volume of CO2
produced is called the respiratory quotient.
Respiratory Exchange Ratio
• Gas exchange between the pulmonary capillaries and the alveoli is
called external respiration.
• The quantity of O2 and CO2 exchanged during a period of 1 minute is
called the respiratory exchange ratio (RR)
• Under normal conditions, the RR equals the RQ.
Respiratory Disorders and the V/Q
• In respiratory disorders, the V/Q ratio is always altered.
• Disorders that diminish pulmonary perfusion cause the affected lung
areas to receive little or no blood flow in relation to ventilation,
thereby, increasing V/Q ratio.
• This phenomenon leads to wasted or dead space ventilation.
Respiratory Disorders and the V/Q
• In disorders that diminish pulmonary ventilation, the affected lung
area receives little or no ventilation in relation to blood flow causing a
decreased V/Q ratio.
• The pulmonary blood flow in this area of the lung to be
physiologically ineffective in terms of gas exchange, and is said to be
shunted blood.
