Gas Exchange and Transport
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| show | process of getting O2 into the body for tissue utilization and removal of CO2 into the atmosphere
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| Oxygen must be moved into the lungs where it....... | show 🗑
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| show | metabolism
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| Carbon dioxide diffuses into.... | show 🗑
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| Gas movement between lungs and tissues occure by? | show 🗑
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| What is the diffusion gradient for oxygen? | show 🗑
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| What is the final gradient for oxygen infusion into the cell? How many mm Hg? | show 🗑
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| show | highest in the cells 60 mm Hg and lowest to room air 1 mm Hg
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| show | Oxygen has a cascade gradient moving from atmosphere to Intracellular. Carbon dioxide moves from intracellular to the atmosphere.
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| The carbon dioxide diffusion gradients cascade causes..... | show 🗑
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| Alveolar partial pressure of carbon dioxide (PACO2) | show 🗑
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| What factor is used to convert VCO2 from STPD to BTPS? | show 🗑
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| what is the formula used to convert VCO2 from STPD to BTPS? | show 🗑
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| show | 35-45mm Hg
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| show | ventilation automatically increases to maintain PACO2 within normal range
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| What is the most important facto in determining the alveolar partial pressure of oxygen (PAO2)? | show 🗑
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| show | water vapor and carbon dioxide
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| What is the alveolar air equation formula? | show 🗑
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| According to Dalton's law the partial pressure of alveolar nitrogen must.... | show 🗑
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| show | PAN2= PB-(PAO2+PACO2+PH2O)
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| The only partial pressures that change int he alveolus are? Why? | show 🗑
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| show | vary inversely with PACO2
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| show | 140 mm Hg
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| Neural control mechanisms and increased work of breathing prevent decreases in PaCO2 much below? | show 🗑
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| If patient is breathing room air at sea level the RT should or shouldn't exspect to see a PaO2 any higher that 120 mm Hg during hyperventilation? | show 🗑
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| show | patient is breathing supplemental oxygen
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| show | process of gas molecules moving from an area of high partial pressure to low partial pressure
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| show | barriers
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| Alveolar capillary membrane | show 🗑
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| show | alveolar epithelium, intersitial space, capillary endothelium
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| show | the greater the surface area, diffusion constant, and pressure gradient, the more diffusion will occur
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| show | gass pressure gradients
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| What must exist in order for gas exchange to occure between the alveoli and pulmonary capillaries? | show 🗑
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| In pulmonary diffusion Alveolar PaO2 averages how many mm Hg? | show 🗑
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| show | 40 mm Hg
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| In pulmonary diffusion PvO2 is how many mm HG? | show 🗑
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| In pulmonary diffusion PvCO2 is how many mm Hg? | show 🗑
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| The pressure gradient for oxygen diffusion into the blood is approximately? | show 🗑
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| show | 20 times faster. Because of its much higher solubility in the plasma.
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| show | rate of pulmonary blood flow
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| show | 0.75 seconds
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| Low concentrations of what are used more commonly to measure diffusing capacity of the lung? | show 🗑
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| The PaO2 of healthy person breathing at sea level is approximately how much less than the calculated PaO2? | show 🗑
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| 2 factors that account for the 5-10 mm Hg difference in calculated PaO2 are? | show 🗑
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| show | 1.bronchial venous drainage 2.thebsian venous drainage
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| show | causes it to move directly into the arterial circulation, lowering the oxygen content of the arterial blood.
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| What is the ideal ventilation and perfusion ratio? | show 🗑
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| show | ventilation is greater than normal, perfusion is less than normal, or both. LOW- ventilation is less than normal, perfusion is greater than normal, or both.
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| show | alveolar PO2 lower, PCO2 higher than normal
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| show | dead space
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| Alveolar shunts | show 🗑
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| Regional differences in V/Q ratios in the normal lung are caused by? | show 🗑
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| Does perfusion increase or decrease farther down the lung? | show 🗑
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| show | increases. Four times as much ventilation than apexes.
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| show | ventilation exceeds blood flow resulting in high V/Q (3.3), high PO2 (132 mm Hg), low PCO2 (32 mm Hg).
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| V/Q at bases of lungs | show 🗑
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| show | 1.dissolved in plasma and erythrocyte fluid. 2. majority is carried in combination with hemeglobin inside the RBC
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| Formula for Dissolve oxygen in blood? | show 🗑
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| show | important blood buffer for hydrogen ions, important in carbon dioxide transport
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| show | oxygen molecules bind to Hb by way of ferrous iron ion and coverted to it's oxygenated state
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| show | 1.34 ml
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| show | 70 fold as compared to plasma alone
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| show | measure of proportion of available Hb that is actually carrying oxygen
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| show | SaO2=[HbO2 / Total Hb]*100
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| show | relationship btw PaO2 and SaO2 is S shaped
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| show | total oxygen content of bloo equals the sum of that dissolved and chemically combined with Hb
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| Formula for Total oxygen content of blood | show 🗑
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| show | 16-20 ml/dl
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| show | 5 ml/dl
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| show | arteriovenous oxygen contents difference. Amount of O2 given up by every 100mL of blood on each pass through thet tissues
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| show | The C(a-v)O2 combined with total-body oxygen to calculate cardiac output
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| Normal range for cardiac output | show 🗑
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| show | increase the C(a-v)o2
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| show | C(a-v)O2 will decrease
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| What are some factors other than HbO2 curve that affect oxygen unloading and loading? | show 🗑
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| show | impact of changes in blood pH on Hb affinity for O2. It alters the position of the HbO2 dissociation curve.
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| show | right
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| A high pH shifts a curve to the? | show 🗑
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| When blood ph drops and shifts the curve to the right the Hb saturation for a given PO2... | show 🗑
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| show | rises
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| As blood in the tissue picks up CO2, pH falls and the HbO2 curve shifts to the? Does it increase or decrease the affinity of Hb for oxygen? | show 🗑
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| With a lower of the affinity of Hb for O2 Hb readily gives up what to the tissues? | show 🗑
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| Venous blood returns to the lungs and the pH does what? This shifts the curve to the? Does this increase or decrease the affinity of Hb for oxygen? | show 🗑
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| A drop in body temperature shifts the HbO2 cureve to the? | show 🗑
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| show | right, affinity of Hb for O2 decreases.
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| show | metabolic rate
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| show | found in abundance in the RBC's and forms a loose chemical bond with the globin chains of deoxygenated Hb.
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| 2,3-DPG does what to the molecule in it's deoxygenated state? | show 🗑
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| What would happen if we didn't have 2,3-DPG? | show 🗑
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| show | right. Oxygen unloading
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| Low 2,3-DPG concentrations shift the curve to the? And does what to the Hb affinity for O2? | show 🗑
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| Alkalosis, chronic hypoxemia, and anemia all increase or decrease 2,3-DPG concentrations? | show 🗑
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| show | lowers the level of DPG and a greater affinity of Hb for O2.
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| show | It decreases in concentration over time and after a week of storage there is less than 1/3 of the normal value of DPG. This shifts the HbO2 curve to the left decreasing availability of oxygen to the tissues.
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| What happens with large transfusions of banked blood that is more that a few days old? | show 🗑
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| show | when the amino acid swquence in the molecule's polypeptide chains varies from normal.
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| What percent of the circulating hemoglobin are abnormal in a healthy individual? | show 🗑
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| show | abnormal hemoglobin that is less soluable and causes the hemoglobin to become suceptible to polymerization and precipitation when deoxygenated
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| What events cause the hb to crystalize and the RBC to become hardened and curved like a sickle? | show 🗑
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| show | vaso-occlusive disease and anemia.
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| Acute chest syndrome? Symptoms? | show 🗑
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| show | abnormal form of the molecule where the heme-complex normal ferrous iron ion loses an electron and oxidizes to its ferric state.
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| What happens in the ferric state of methemoglobin? | show 🗑
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| What happens as a result of the iron ion not being able to combine with oxygen in the ferric state of methemoglobin? | show 🗑
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| What is the most common cause of methemoglobinemia? | show 🗑
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| What color is the blood of a patient who has methemoglobin? | show 🗑
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| How do we confirm that a patient has methemoglobin? | show 🗑
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| show | reducing agents such as methylene blue or absorbic acid when the blood level exceeds app. 40%
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| Carboxyhemoglobin | show 🗑
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| Hemeglobins affinity for carbon monoxide is how much more greter than it is for oxygen. | show 🗑
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| show | left. Impeding oxygen delivery to the tissues
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| show | giving the patient as muxh oxygen as possible because oxygen reduces the half-life of carboxyhemoglobin. Sometimes a hyperbaric chamber is used
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| show | blood having a high proportion of an Hb varian during fetal life and for up to 1 year after birth
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| Fetal hemoglobin causes a shift to the? | show 🗑
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| show | aids oxygen loading at the placenta
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| show | low
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| show | this enhanced oxygen affinity is less advantageous after birth. Over the first year of life HbF is gradually replaced with normal Hb.
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| P50 | show 🗑
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| show | 26.6 mm Hg
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| show | right.
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| Conditions with an increase in affinity cause a shift to the? What happens to P50? | show 🗑
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| How much carbon dioxide is carried in the blood? | show 🗑
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| In what three forms is carbon dioxide carried in the blood? | show 🗑
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| Dissolved carbon dioxide plays an important role in? How much is released at the lungs? | show 🗑
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| show | carbamino compound
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| what is carbaminohemoglobin? what percentage does it transport? | show 🗑
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| Approximately what percent of the blood carbon dioxide is transported as bicarbonate? | show 🗑
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| Hydrolysis | show 🗑
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| show | carbonic acid
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| What enzyme enhances the hydrolysis reaction? | show 🗑
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| Where does the majority of hydrolysis occur? | show 🗑
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| show | Bicarbonate begins to accumulate in teh RBC
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| show | by the chloride shift
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| Chloride shift | show 🗑
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| show | influence of oxyhemoglobin saturation on CO2 dissociation
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| What is the Haldane effect a result of? | show 🗑
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| show | Decreases. unloading
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| show | DO2=CaO2*Qt
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| Hypoxia | show 🗑
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| In what three ways will hypoxia occur? | show 🗑
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| show | when partial pressure of O2 in the arterial blood (PaO2) is decreased to lower than normal.
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| show | low ambient PO2, hypoventilation, impaired diffusion, V/Q imbalances, right to left anatomical or physiological shunting, aging, altitude
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| show | 85 mm Hg
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| Mountain sickness | show 🗑
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| show | indirectly
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| Even when alveolar PO2 is normal disorders of the alveolar capillary membrane may limit diffuion of oxygen into the pulmonary bed thereby lowering the? Diseases that do this are? | show 🗑
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| What is the most common cause of hypoxemia in patients with lung disease? | show 🗑
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| show | there is wasted ventilation, alveolar dead space
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| What happens when ventilation is less than perfusion? | show 🗑
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| show | both excess wated ventilation and poor oxygentation. Because the imbalance impairs O2 exchange and PaO2 is reduced
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| show | there is blood flow but no ventilation and is equivalent to a right to left anatomical shunt
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| show | If the O2 is more than 50% and the PaO2 is less than 50% significant shunting is present. otherwise it is a V/Q imbalance
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| Formula for estimating the expected PaO2 in older adults | show 🗑
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| show | enough normal Hb in the blood
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| show | Yes. Because of low oxygen content in the arterial blood
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| What are the 2 hemoglobin deficiencies? | show 🗑
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| show | occurs when Hb concentration is lower than normal due to a low blood Hb concentration by either loss from hemorrhage or inadequate erythropoesis.
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| show | caused by either displacement of O2 from normal Hb or prescence of abnormal Hb variants.
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| What can a low Hb content do to the oxygen carrying capacity of the blood? | show 🗑
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| Hypoxia can still occur when the CaO2 is normal if? | show 🗑
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| show | circulatory failure(shock), local reduction in perfusion(ishemia)
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| What happens with prolonged shock? | show 🗑
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| show | anaerobic metabolism, metabolic acidosis, eventual death of tissue
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| show | form of hypoxia in which cellular uptake of O2 is abnormally decreased
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| show | cyanide poisoning. It disrupts intracellular system preventing cellular use of oxygen
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| Dysoxia also may occur when... | show 🗑
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| show | tissue extraction reaches a maximum and decreases delivery of O2 resulting in a oxygen debt due to oxygen demand exceeding oxygen delivery
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| In sepsis and ARDS oxygen debt may occur at normal levels of? | show 🗑
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| Any disorder that lowers alveolar ventilation relative to metabolic need impairs? | show 🗑
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| show | hypercapnia and respiratory acidosis
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| show | minute ventilation is inadequate, dead space ventilation per minute increases, or a ventilation perfusion imbalance exists
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| Inadequate minute ventilation is caused by? | show 🗑
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| show | restrictive conditions: atelectasis, neuromuscular disorders, or conditions that impede thoracic expansion (kyphoscoliosis)
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| show | drug overdose
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| show | rapid shallow breathing, or increased physiologic dead space (V/Q 0)
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| show | the proportion of wasted deadspace increases and lowers alveolar ventilation and impairs CO2 removal
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| IN theory V/Q imbalance should cause a rise in PACO2. However many patients who are hypoxemic because of a V/Q imbalance have a low or normal PaCO2. What does this suggest? | show 🗑
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| show | patients minute ventilation must increase
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| Patients who can increase their minute ventilation with V/Q imbalance then to have? | show 🗑
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| show | hypercapnic. This occurs only when V/Q imbalance is severe and chronic like with COPD
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| When a patient is hypercapnic what must happen for them to maintain a normal PaCO2? | show 🗑
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