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Linda Test 2

med lectures

Name 3 factors which the efficiency of external respiration is dependent on. 1- VA - is it adequate? 2- V/Q - is it well-matched? 3- Membrane diffusion across alveolar capillary membrane - are there issues? Destruction of alveolar surface?
List the 3 factors involved in oxygen delivery. 1- Oxygen Loading 2- Oxygen Transport 3- Oxygen Unloading
Describe Oxygen Loading The gas exchange between the alveoli, atmosphere, and pulmonary capillaries.
Describe Oxygen Transport You must factor in 1: Cardiac Output, a function of HR and 2: Stroke volume, the volume of blood that is ejected from ventricles per contraction.
Describe Oxygen Unloading Internal Respiration: The exchange of gases between systemic capillary level, blood and cells. The oxygen unloaded is the oxygen available for metabolism.
Why does V/Q mismatching occur even in the normal lung? Even in normal people, V/Q mismatching occurs because in a normal upright position there is still mismatching at the bases of the lungs ( due to gravity), and perfusion is greatly dependent.
The normal amount of anatomic deadspace found in the airways of a 150 pound adult would be - 150 ml
The normal VD/VT ratio in a spontaneously breathing individual is approximately ____, with a somewhat (higher/lower) ratio being acceptable for patient on mechanical ventilatory support. (which is ? ) < 0.4 higher < 0.6
The distribution of ventilation in the lung depends on regional differences in ____ and ___. Lung compliance and Airway resistance.
A VD/VT ratio of 0.7 means that.. 70% of the VT is lost to VD.
Calculate the cardiac output. Stroke Volume - 80 cc Heart Rate - 85 BPM Is this within normal range? SV X HR = CO 80 X 85 = 6800 cc = 6.8 L Yes, normal range is 4-8
At residual volume, most gas entering the lung would go to the ____ apices.
Most gas inhaled during normal breathing from normal FRC enters the ____ bases
Will a change in FRC affect distribution of ventilation? Yes.
A pt's minute ventilation is 101 l/m, RR is 22, PaCO2 is 55 torr. Which of the following is she NOT experiencing : 1- increased shunting 2- Increased deadspace ventilation 3- Increased WOB 4- Decreased compliance 5- Decreased Alveolar ventilation 1- Increased shunting ( with the data given, there is no way to tell )
A pulmonary embolus would increase (shunt/deadspace) in the affected area. deadspace
The ( lower/higher) the V/Q, the lower is the PO2 that leaves the unit. lower.
Increased VD will (increase/decrease) the WOB and 02 demand. increase.
Normal anatomic shunt is approximately ___% of cardiac output. 3%
List any 2 possible clinical causes of increased anatomic shunting. 1- any cardiovascular congenital anomalies 2- ventricular septal defect
____ diffuses 20 times faster than oxygen across the a-c membrane. Carbon Dioxide
Name the 2 major requirements for successful pulmonary diffusion. 1- Surface area 2- Sufficient time
List the 2 major factors which determine oxygen's ability to dissolve in plasma. Which of these factors determine the volume of oxygen that dissolves in plasma? _________________
At a Pa02 of 100 torr, the volume of 02 dissolved in plasma is ___ How did you arrive at your answer? 0.3 vol% _______
What does volume percent really meant? Volume of solute/ volume of solution X 100
Diffusion of oxygen throughout the body as well as in the cells and on the hgb is controlled by the ( oxygen's solubility coefficient/ the Pa02/ neither of these) the PaO2
HBG tends to combine with 4 oxygen molecules or with none. ( T/F) True
Oxygen combines with the ___ sites of the HBG molecule. heme
Name the normal HGB value/range for males and females. Males - 15 g / 100 ml of blood Females - 13-14 g/ 100 ml of blood
___ is the term used to describe either a decrease in total HGB/RBC count Anemia
Name 2 types of abnormal HGB. HGB F, HGB S, met HGB, carboxyhemoglobin, etc.
_____ occurs when a quantity of blood is perfused but not ventilated. Shunting
___ results from the additive effects of anatomic and capillary shunts. Physiologic Shunting
______ is the quantity of gas remaining in the airway after each breath. anatomic deadspace
This form of deadspace is represented by a VQ >1. Relative alveolar deadspace.
This represents the sum of all alveolar and anatomic deadspace. Physiologic deadspace.
A ventilated but not perfused alveolus would represent this form of deadspace. True alveolar deadspace.
Represented by the volume of exhaled gas remaining within a ventilator circuit or an oxygen mask which is then inspired on the next breath. Mechanical deadspace.
This form of shunting would be represented by an alveolus at which the volume of perfusion exceeds the volume of ventilation to the alveolus. Relative capillary shunting.
The pleural, bronchial, and thesbian largely veins contribute to this form of normal shunting. Anatomic shunting.
'wasted' ventilation deadspace
This type of shunting would be represented by a totally atelectatic alveolus. true capillary shunting
Created by: qccrespiratory