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REFRESHER COURSE

Teaching ventilation/perfusion relationships in the lung

Departments of Medicine and of Physiology and Biophysics, University of Washington, Seattle, Washington

Address for reprint requests and other correspondence: R. W. Glenny, Univ. of Washington, Box 356522, Seattle, WA 98195 (e-mail: glenny{at}u.washington.edu)

Abstract

This brief review is meant to serve as a refresher for faculty teaching respiratory physiology to medical students. The concepts of ventilation and perfusion matching are some of the most challenging ideas to learn and teach. Some strategies to consider in teaching these concepts are, first, to build from simple to more complex by starting with a single lung unit and then adding additional units representing shunting, mismatch, and deadspace. Second, use simplified analogies, such as a bathtub, to help students conceptualize new ideas. Third, introduce the concept of alveolar to arterial O₂ differences and the mechanisms for increasing differences as additional lung units are added. Fourth, use the consistent thread of causes of hypoxemia through the lecture to maintain continuity and provide clinical relevance. Finally, use clinically relevant examples at each step and solidify new concepts by discussing differential diagnoses at the end of the lecture(s).

Key words: gas exchange; education