med lectures
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| 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?
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| List the 3 factors involved in oxygen delivery. | 1- Oxygen Loading
2- Oxygen Transport
3- Oxygen Unloading
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| Describe Oxygen Loading | The gas exchange between the alveoli, atmosphere, and pulmonary capillaries.
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| 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.
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| 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.
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| 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.
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| The normal amount of anatomic deadspace found in the airways of a 150 pound adult would be - | 150 ml
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| 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
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| The distribution of ventilation in the lung depends on regional differences in ____ and ___. | Lung compliance and Airway resistance.
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| A VD/VT ratio of 0.7 means that.. | 70% of the VT is lost to VD.
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| 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
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| At residual volume, most gas entering the lung would go to the ____ | apices.
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| Most gas inhaled during normal breathing from normal FRC enters the ____ | bases
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| Will a change in FRC affect distribution of ventilation? | Yes.
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| 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 )
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| A pulmonary embolus would increase (shunt/deadspace) in the affected area. | deadspace
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| The ( lower/higher) the V/Q, the lower is the PO2 that leaves the unit. | lower.
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| Increased VD will (increase/decrease) the WOB and 02 demand. | increase.
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| Normal anatomic shunt is approximately ___% of cardiac output. | 3%
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| List any 2 possible clinical causes of increased anatomic shunting. | 1- any cardiovascular congenital anomalies
2- ventricular septal defect
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| ____ diffuses 20 times faster than oxygen across the a-c membrane. | Carbon Dioxide
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| Name the 2 major requirements for successful pulmonary diffusion. | 1- Surface area
2- Sufficient time
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| 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? | _________________
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| At a Pa02 of 100 torr, the volume of 02 dissolved in plasma is ___ How did you arrive at your answer? | 0.3 vol%
_______
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| What does volume percent really meant? | Volume of solute/ volume of solution X 100
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| 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
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| HBG tends to combine with 4 oxygen molecules or with none. ( T/F) | True
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| Oxygen combines with the ___ sites of the HBG molecule. | heme
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| 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
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| ___ is the term used to describe either a decrease in total HGB/RBC count | Anemia
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| Name 2 types of abnormal HGB. | HGB F, HGB S, met HGB, carboxyhemoglobin, etc.
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| _____ occurs when a quantity of blood is perfused but not ventilated. | Shunting
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| ___ results from the additive effects of anatomic and capillary shunts. | Physiologic Shunting
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| ______ is the quantity of gas remaining in the airway after each breath. | anatomic deadspace
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| This form of deadspace is represented by a VQ >1. | Relative alveolar deadspace.
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| This represents the sum of all alveolar and anatomic deadspace. | Physiologic deadspace.
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| A ventilated but not perfused alveolus would represent this form of deadspace. | True alveolar deadspace.
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| 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.
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| 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.
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| The pleural, bronchial, and thesbian largely veins contribute to this form of normal shunting. | Anatomic shunting.
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| 'wasted' ventilation | deadspace
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| This type of shunting would be represented by a totally atelectatic alveolus. | true capillary shunting
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