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Car/Pul Unit 4
SPC Cardiopulmonary Physiology Unit 4 Exam 2
Question | Answer |
---|---|
What is the Normal V/Q ratio and at what region? | 4/5 = 0.8 Medial Region of U/R Lung |
What is the ABG for Normal V/Q ratio? | pH- 7.40 PaCO2- 40mmHg PaO2- 100mmHg |
What is the High V/Q ratio and at what region? | 4/4 = 1.0 Apical Region of U/R Lung |
What is the ABG for Low V/Q ratio? | pH- 7.45 PaCO2- 30mmHg PaO2- 110 mmHg |
What is the Low V/Q ratio and at what region? | 3/5 = 0.6 Basal Region of U/R Lung |
What is the ABG for Low V/Q ratio? | pH- 7.35 PaCO2- 50mmHg PaO2- 80mmHg |
High V/Q is known as what? | Deadspace (4/1) |
What diseases are associated with Dead Space? | Pulmonary Emboli & Circulatory Shock |
Low V/Q is known as what? | Shunt (2/5) |
What diseases are associated with shunt? | Atelectasis, Pulmonary Edema, & Pneumonia |
In Fick's Law, gas diffusion across a tissue (A/C) Membrane is DIRECTLY Proportional to what? | 1. Membrane Surface Area 2. Gas Pressure Gradient ((P1-P2) PA-PC 3. Gas's Diffusion Coefficient (Henry's & Grahams Law) |
In Fick's Law, gas diffusion across a tissue (A/C) Membrane is INVERSELY Proportional to what? | 1. Membrane Thickness |
What 3 factors increase diffusion? | 1. Recumbent Body Position- 15-20% 2. Exercise- Increase Ventilation, Cardiac Output, Perfusion 3. Body Size- Height NOT Weight |
What 2 factors decrease diffusion? | 1. Decrease Surface Area- Most dramatic with Emphysema 2. Increase Membrane Thickness- Most dramatic with Interstital Lung Disease such as IIPF & Pneumoconiosis. |
What two ways is O2 transported? | 1. Dissolved (PaO2 x .003) 2. Hb Bound (Hb x 1.34 x SaO2) |
What 3 factors affect the amount of dissolved O2 in plasma? | 1. Henrys Law 2. Partial Pressure (Direct) 3. Temperature (Inverse) |
Hemoglobin (A) is protein base composed of what? | 1. 2 Alpha Polypeptide Chains 2. 2 Beta Polypeptide Chains |
Hemoglobin (A) is globin base composed of what? | 4 Heme (Iron) groups- Each heme combines w/ an O2 molecule. |
What is P50? | The partial pressure required to saturate the Hb to a 50% level. |
What is the normal value for P50? | 27mmHg |
Decrease P50 is what? | Left Shift: (Load) 20mmHg |
P50 Left shift would mean what? | 1. Increase affinity between the O2 & Hb 2. Oxygen loading is easier in the LUNG 3. But unloading is harder to the tissues |
What are the 6 factors of P50 Left Shift? | 1. Increase pH (Alkalemia) 2. Low CO2 3. Low Temp (Hypothermia) 4. Low 2,3 DPG 5. Promotes Oxygen Loading 6. Polycythemia, Stored Blood |
Increase P50 is what? | Right Shift: (Release) 35mmHg |
P50 Right shift would mean what? | 1. Decrease affinity between O2 & Hb 2. Oxygen loading is harder in the LUNG 3. But unloading is easier to the tissues |
What are the 6 factors of P50 Right Shift? | 1. Decrease pH (Acidemia) 2. Increase CO2 3. Hyperthermia (Fever) 4. Increase 2,3 DPG 5. Promotes Oxygen Unloading 6. Anemia, Hypomemia |
What is Methemoglobin? | A congenital or chemically induced alteration of the HEME portion of Hb |
T/F Methemoglobin will decrease P50 | True O2 loads on Hb, but will not unload to tissues |
What is Carboxyhemoglobin? | Caused by (CO)Carbon Monoxide poisoning or cigarette smoking |
T/F Carboxyhemoglobin will decrease P50? | True O2 loads on Hb, but will not unload to tissues |
What is Fetal Hemoglobin? | Seen in the fetus and neonate, converted to HbA by 6 months Altered 2,3 DPG binding noted with HbF |
T/F Fetal Hemoglobin will decrease P50? | True O2 loads on Hb, but will not unload to tissues |
What 4 factors increase O2 consumption? | 1. Exercise 2. Seizures 3. Shivering 4. Hyperthermia |
What 3 factors decrease O2 consumption? | 1. Peripheral Shunting 2. Cyanide Poisoning 3. Hypothermia |
What is the normal value for Ca-vO2? | 20-15 = 5 volumes %, 5ml O2/dL |
What is the increase a-v value? | 20-10 = 10 volumes %, 10ml O2/dL |
What is the decrease a-v value? | 20-17 = 3 volumes %, 3ml O2/dL |
T/F With increase O2 consumption comes decreased C.O.? | True |
T/F With decrease O2 Consumption comes increased C.O.? | True |
What 3 values share identical factors? | a-v & O2ER & O2 Consumption |
What value has opposite factors compared to (a-v), (O2ER), & (O2 Consumption)? | SvO2 |
What is a the abbreviation for Shunted Blood & Total Blood Flow? | Qs & Qt |
What are the values that give clinical significance to a pulmonary shunt? | <10% is Normal 10-20% is Mild 20-30% is Moderate >30% Severe |
What 3 ways is CO2 transported? | 1. Dissolved 10% 2. Carbamino 20% 3. Bicarbonate 70% |
What is the factors of chloride shift at tissue level? | Chloride In, Bicarbonate Out, CO2 Loaded, O2 Unloaded |
What is the factors of chloride shift at lung level? | Chloride Out, Bicarbonate In, CO2 Unloaded, O2 Loaded |
What is the Haldane Effect at Tissue Level? | As SaO2 decreases, CO2 loading on Hb is enhanced. |
What is the Haldane Effect at Lung Level? | As SaO2 increases, CO2 unloading off Hb is enhanced. |