Flashcards in Gas transport in the Airway Deck (62):

1

## what has to be considered when calculating air PIO2 (partial pressure of inspired air)

###
1) total pressure of inhaled air = Pa

2) sum of partial pressures of each gas in air = PB

3) each gas makes up certain percentage (dry air)

21% O2

0.03% CO2

79% N2

4) air immediately saturated with water when enter airway so water vapor pressure subtract from barometricP = 47 Torr @ 37C

2

##
Define PaO2

Normal value at sea level

Normal value at Denver

###
partial pressure of arterial O2

partial pressure of O2 in blood dissolved or bound to Hb in equilibrium with O2 in air

PaO2 = 90-100 Torr

PaO2 Denver = 80-85 Torr

3

##
air becomes ___ when it enters airway

consequences on water vapor pressure

###
saturated

so must subtract water vapor pressure from barometric pressure

4

##
what is equation for air PIO2 (Dalton's Law)

**** MEMORIZE

###
PIO2 = (PB - PH2O) x FO2

PIO2 = (PB - 47 Torr) x 0.21

5

##
what is partial pressure of water vapor

what is PB typically

###
47 torr

720 at sea level

620 at Denver

6

##
does partial pressure of water vapor vary with altitudes

### no constant

7

##
does PB vapor vary with altitudes

does PIO2 vary with altitude

###
YES

decr at higher altitudes

8

## equation for PB

### PB = PIO2 + PIN2 + PICO2 + PIH2O

9

## calculate PIO2 if patient breathing 100%

###
Use FO2 = 100%

PB = 760 Torr

PIO2 = 713 Torr

10

## a

### a

11

## define respiratory exchange ratio in words

### ratio of amount of CO2 generated per amount of O2 consumed

12

## equation for respiratory exchange ratio

### R = V(CO2) / V(O2)

13

## why is respiratory exchange ratio significant

###
exchange of CO2 for O2 NOT ALWAYS 1:1

because metabolic reactions consume more O2 compared to CO2

carbs: R = 1.1

fats: R = 0.7

avg diet: R = 0.8

14

##
what are typical R values for

carbs

fats

avg diet

###
carbs: R = 1.1

fats: R = 0.7

avg diet: R = 0.8

15

## what is factored into the calculation of alveolar PAO2

### 1) exchange of O2 for CO2 in alveoli based on R

16

## when R decr with heavy fat diet, how does PAO2 change

###
substantial decrease

based on PAO2 = PIO2 - (PACO2/R)

17

## when R decr with heavy fat diet, how does N2 change

###
increase in N2 as opposed to O2

because more N2 in air (4x more than O2)

so deficit created by low levels in CO2

made up by N2

18

## equation for PAO2

### PAO2 = PIO2 - (PACO2/R)

19

##
normal values in Denver for

PIO2

PACO2

R

R (if on 100% O2)

###
PIO2 = 120 Torr

PACO2 = 40 Torr

R = 0.8

R (if on 100% O2) = 1

20

## difference between PACO2 and PaCO2

###
PACO2 = alveolar

PaCO2 = artery

21

##
normal values at sea level for

PIO2

PACO2

R

R (if on 100% O2)

PAO2

###
PIO2 = 150 Torr

PACO2 = 40 Torr

R = 0.8

R (if on 100% O2) = 1

PAO2 = 100 Torr

22

## if patient is breathing 100% O2, why is R = 1

###
if breathe 100% O2, no N2

so deficit in CO2 made up by O2 and R drops out of equation and

PAO2 = PIO2 - PACO2

23

## 2 steps in CO2 removal

###
1) diffusion of CO2 from pulm capillaries to alveoli; THEREFORE PULM CAPILLARY EQUILIBRIUM WITH ALVEOLI CO2

2) CO2 transport from alveoli to the outside air.

24

##
what is rate limiting step between two steps of CO2 removal

why?

###
transport of CO2 to outside air (ventilation)

because diffusion of CO2 from blood to alveoli = assumed near instantaneous (FAST)

25

##
what does rate limiting step of CO2 removal depend on?

what does it affect?

###
step = transport of CO2 to outside air

depends on:

1) alveolar ventilation

affects

1) PACO2

2) PaC=O2

26

## what is significance of change in alveolar ventilation on rate limiting step in CO2 removal?

###
decr alveolar ventilation

decr CO2 removal

incr PACO2

but other step, diffusion from blood to alveoli near instant so PaCO2 (artery) equilibrate with PACO2 (alveoli)

27

##
PaCO2 and PACO2 assumed to be ____

why?

###
equal

because rapid diffusion of CO2 from blood to alveoli

28

## what do PaCO2 and PACO2 depend on?

### amount of CO2 being produced relative to alveolar ventilation rate

29

## alveolar ventilation equation ***MEMORIZE

###
PACO2 = PaCO2 = (VCO2dot/VAdot) x k

k = constant

VCO2 dot = Co2 production per minute

VAdot = alveolar ventilation per minute

30

## what is ideal PaCO2

### 40 Torr

31

## why do we care about having particular PaCO2 = 40 Torr

### affects pH

32

## define hypoventilation

###
Low VAdot and High PaCO2

Constant VCO2dot

--> incr PaCO2

33

## normal value of PaCO2 in Denver with hypoventilation

### > 40 Torr

34

## Causes of hypoventilation

###
1) severe Obstructive diseases = because if mild-moderate obstructive disease, decr VAdot body has compensatory mechanism to maintain total ventilation to maintain normal PaCO2 and pH

2) restrictive diseases

3) metabolic alkalosis

4) CNS depression

35

## define hyperventilation

###
High VAdot and Low PaCO2

Constant VCO2 dot

--> decr PaCO2

36

## Causes of hyperventilation

###
1) high altitude - ventilating more to compensate for low enviorn O2, decr CO2

2) acute hypoxemia

3) metabolic acidosis

4) CNS stimulation

37

## define hyperpnia

###
High VAdot and normal PaCO2

--> PaCO2 unchanged

38

## Causes of hyperpnia

### moderate exercise (incr CO2, incr VACO2dot, to match incr VAdot)

39

##
what is partial pressure of water vapor

what is PB typically

###
47 torr

720 at sea level

620 at Denver

40

##
does partial pressure of water vapor vary with altitudes

### no constant

41

##
does PB vapor vary with altitudes

###
YES

decr at higher altitudes

42

## difference between PAO2 and PaO2

###
A= alveoli

a = arterial

43

## why does respiratory exchange occur

###
1) Air entry mainly N2 and O2

2) Air in alveolus also has N2 and O2 BUT ALSO HAS CO2 because pulm capillaries

feeding CO2 into alveolus

3) for total pressure of air in alveolus similar to air coming in, with incr CO2 in alveolus then less N2 and O2

4) therefore, alveolar O2 less than PIO2 because CO2 replaces and exchanges

44

## define respiratory exchange ratio in words

### ratio of amount of CO2 PRODUCED to amount of O2 CONSUMED in metabolic reactions

45

## equation for respiratory exchange ratio

### R = V(CO2) / V(O2)

46

##
why is respiratory exchange ratio significant

*** memorize R for normal diet

###
exchange of CO2 for O2 NOT ALWAYS 1:1

because metabolic reactions consume more O2 compared to CO2

avg diet: R = 0.8

47

##
what are typical R values for

carbs

fats

avg diet

###
carbs: R = 1.0

fats: R = 0.7

avg diet: R = 0.8

48

## what is factored into the calculation of alveolar PAO2

### 1) exchange of O2 for CO2 in alveoli based on R

49

##
equation for PAO2 (alveolar GAS EQUATION)

**** MEMORIZE

###
PAO2 = PIO2 - (PACO2/R)

therefore, PAO2 less than PACO2 because more CO2 in alveolus

50

##
normal values in Denver for

PIO2

PACO2

R

R (if on 100% O2)

###
PIO2 = 120 Torr

PACO2 = 40 Torr

R = 0.8

R (if on 100% O2) = 1

51

## difference between PACO2 and PaCO2

###
PACO2 = alveolar

PaCO2 = artery

52

##
PaCO2 and PACO2 assumed to be ____

why?

###
equal

because rapid diffusion of CO2 from blood to alveoli

53

## what do PaCO2 and PACO2 depend on?

### amount of CO2 being produced relative to alveolar ventilation rate

54

## Path for O2 transport

###
1) O2 entry into lungs

2) entry into pulm capillaries

3) pulm capillaries diffuse into arterial blood

55

## Is PaCO2 inversely related to alveolar ventilation?

###
if 50% drop in scoop-out rate or 50% decr in CO2 concentration, then you reach new equilibrium where CO2 concentration is doubled (50% drop in scoop out)

so now pull out 2 CO2 molec per scoop

56

## What is PaCO2 if VAdot decr by 50%

###
PaCO2 = (VCO2dot) / (VAdot) x k

PaCO2 will double

57

## General solution for change in VAdot

### PaCO2(new) / PaCO2 (old) = VAdot (old) / VAdot (new)

58

## why can we substituTe PACO2 for PaCO2

###
amount of CO2 essentially same because diffusion is RAPID

DECR IN PAO2 WITH CHANGE IN VENTILATION

59

## Blood CO2 is ___ regulated by alveolar ventilation

### directly

60

## ___ is directly regulated by alveolar ventilation

### Blood CO2

61

## Blood O2 is ___ regulated by alveolar ventilation via its effects on alveolar CO2

### indirectly

62