Intro: Critical Care PPTx ✅

Question 1

what are the 3 functions of the body in regards to critical care?

Answer 1

ventilation
pulmonary perfusion
diffusion

Question 2

what is ventilation?

Answer 2

gas distribution into and out of the pulmonary airways

Question 3

what is pulmonary perfusion?

Answer 3

blood flow from the right side of the heart, through the pulmonary circulation, & into the left side of the heart, then to the body

Question 4

what is diffusion?

Answer 4

gas movement from an area of greater to lesser concentration through a semipermeable membrane

Question 5

what does ventilation assess?

Answer 5

the status of CO2

Question 6

the alveoli receive O2 at about how many L/min?

Answer 6

4 L/min

Question 7

the capillary blood supply is at about how many L/min?

Answer 7

5 L/min

Question 8

if the alveoli receive O2 at about 4L/min and the capillary blood supply is about 5L/min, what does this make the V/Q ratio?

this is only an average because why?

Answer 8

4:5 or 0.8

bc the V/Q ratio varies based on the body position and regions of the lung

Question 9

what does V/Q stand for?

Answer 9

V → ventilation
Q → perfusion

Question 10

what do less compliant alveoli mean?

Answer 10

we just don’t get as good of ventilation at the top of our lungs

Question 11

why do we sit people up in bed in regards to ventilation?

Answer 11

want to get the ventilation down to the base of the lungs

Question 12

Explain the difference of intrapleural pressure between the apex & base of the lung

Answer 12

Apex → more negative pressure
Base → less negative pressure

Question 13

Explain the difference of transmural pressure gradient between apex & base of the lungs

Answer 13

Apex → greater
Base → smaller

Question 14

Explain the difference between alveoli in the apex & base of the lungs

Answer 14

Apex → larger & less compliant
Base → smaller & more compliant

Question 15

Explain the difference in ventilation between the apex & base of the lungs

Answer 15

Apex → less ventilation
Base → more ventilation

Question 16

what does hypoxemia mean?

Answer 16

Low arterial oxygen tension (in the blood)

Question 17

hypoxemia adversely affects what?

Answer 17

every tissue in the body

Question 18

what type of mismatch does hypoxemia cause?
give 2 examples

Answer 18

A supply and demand mismatch

Examples:
1. Poor perfusion such as in ischemia
2. Decreased arterial oxygen such as anemia

Question 19

skeletal muscle can recover after how long of hypoxemia?

Answer 19

30 mins

Question 20

brain cells can only tolerate how long of hypoxemia?

Answer 20

4-6 mins

Question 21

until hypoxemia can be reversed, what must be provided?

Answer 21

oxygen

Question 22

shunting means there is a problem with what?

Answer 22

decreased ventilation

Question 23

when shunting occurs, the alveoli are _______ but are not _______

Answer 23

Alveoli perfused but are not ventilated

Question 24

shunting allows deoxygenated blood to go where?

Answer 24

to go into left side of the heart and into the body

Question 25

what conditions can we see shunting? (6)

Answer 25

Congenital Airway obstruction ARDS Pneumonia Atelectasis Pulmonary edema

Question 26

when dead space occurs, what is the problem?

Answer 26

decreased perfusion (think trachea)

Question 27

When there is NOT enough perfusion or there is a problem with blood in the lung becoming oxygenated, what can happen? (2)

Answer 27

Pulmonary embolism Pulmonary infarction

Question 28

silent unit means there is a problem with what?

Answer 28

both ventilation & perfusion **there is shunting and dead space**

Question 29

what conditions can we see silent unit? (2)

Answer 29

ARDS Pneumothorax

Question 30

hypoxemia can be caused by depletion of what?

Answer 30

ATP

Question 31

hypoxemia can be caused by damage to cells from _______ _______

Answer 31

noxious stimuli (i.e. poison)

Question 32

hypoxemia can be caused by abnormal ________ inside the cell

Answer 32

calcium **Calcium is supposed to go in the cell & come right back out → if it stays in the cell it will cause problems (this can happen when the cells are damaged)**

Question 33

hypoxemia can be caused by the _________ response

Answer 33

inflammatory