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MAP II Midterm > Introduction of CVP > Flashcards

Flashcards in Introduction of CVP Deck (60):
1

What vein is used to bypass a blockage during a CABG?

saphenous vein

2

What kind of prevention is it if the patient has the impairment and you are directly addressing the impairment?

Primary prevention

3

What kind of prevention is it when the PT addresses any other additional impairments or diseases?

Secondary prevention

4

formula for oxygen delivery (DO2)?

DO2 = arterial O2 x cardiac output

5

formula for oxygen consumption (VO2)?

VO2 = (arterial O2 - venous O2) x cardiac output

6

formula for oxygen extraction ratio (OER)?

OER = consumption/delivery = VO2/DO2

7

Oxygen transport is normally based on what?

demand of tissues

8

At rest, oxygen transport is how much greater than the actual demand?

3-4x

9

How much of the body's oxygen is transported through hemoglobin?

98%

10

What is the primary mechanism for how we transport oxygen throughout the body?

Blood

11

Why is the balance between intravascular and extravascular fluid volume is important?

imbalance of electrolytes and water can affect the blood's ability to transport oxygen which can impact organ function

12

What 3 things impacts delivery of oxygen from outside air to tissues?

1) atmospheric air
2) air quality
3) humidity

13

What effect does poor quality air have on the lungs?

it increases thickness of membrane in lungs making it more difficult to diffuse oxygen

14

How does nitrogen impact the lungs?

plays a role in keeping the alveoli open in the lungs

15

How does humidity impact the lungs?

humidity keeps up the mucus lining in the lungs -- lack of humidity leads to erosion of the airways and possible infection from losing the mucus lining

16

Function of cilia?

catches debri and helps get it out

17

What does smoking do to cilia?

paralyzes cilia

18

small airways have more of what kind of muscle?

smooth muscle

19

large airways are ______ elastic?

less

20

Muscles of inspiration?

- external intercostals
- diaphragm

21

Muscles of expiration?

- internal intercostals
- abdominals

22

Function of the external intercostals during inspiration?

elevate the ribs and therefore increase the volume of the pleural cavities

23

Function of the diaphragm during inspiration?

depress the inferior wall of the thoracic cavity and, therefore, increase the volume of the pleural cavities

24

Function of the internal intercostals during expiration?

compress and lower the ribs and therefore decrease the volume of the pleural cavities

25

Function of the abdominals during expiration?

compress the abdominal cavity which elevates the abdominal organs and passively elevates the diaphragm and, therefore, decreases the volume of the pleural cavities

26

Expiration is normally passive or active?

passive

27

How is oxygen transferred from alveolar sacs to pulmonary circulation?

diffusion

28

What 5 things is diffusion based on?

1) surface area of alveolar capillary membrane
2) diffusing capacity of alveolar-capillary membrane
3) pulmonary capillary blood volume
4) ventilation/perfusion ratio
5) transit time of blood in alveolar capillary membrane

29

What is the optimal ventilation/perfusion ratio? (how much air you breathe out/how much blood is there)

0.8

30

Amount of oxygen that diffuses across alveolar-capillary membrane varies DIRECTLY with _______ and INVERSELY with ________.

Directly - size (surface area)
Indirectly - thickness

31

high or low perfusion at the apical end of the lungs?

low perfusion

32

high or low perfusion at the base of the lungs?

perfusion increased due to gravity

33

alveoli are expanded or compressed at the apical end of the lungs?

alveoli expand fully

34

alveoli are expanded or compressed at the base of the lungs?

compressed alveoli from enlarged vessels

35

Optimal area for ventilation perfusion is where?

in the middle of the lungs

36

Optimal function of the heart depends on what?

synchronized coupling of electrical conduction and mechanical contraction

37

What is preload?

the amount the ventricle stretches in able to hold the blood

38

What is afterload?

the amount of resistance needed to overcome by the left ventricle to get the blood to the body

39

Preload and afterload tells you what?

tells you how well your heart is functioning

40

What does oncotic pressure do?

pulls fluid in from the periphery into the blood vessel

41

What does hydrostatic pressure do?

pushes fluid out into the periphery from the blood vessel

42

What two pressures creates a fluid balance in the blood vessels?

hydrostatic and oncotic pressures

43

Amount of O2 extracted at rest?

23%

44

What is the rate of O2 extraction regulated by?

oxygen demand NOT oxygen availability

45

Is partial pressure higher in arterial blood or venous blood?

arterial blood

46

Why should partial pressures be higher in the arteries than the tissues?

so the oxygen pops off the hemoglobin and goes into the tissues

47

partially desaturated blood and CO2 are removed from the cells into what?

the venous circulation

48

9 steps of O2 Transport?

1) Inspired O2 and quality of ambient air
2) airways
3) lungs and chest wall
4) diffusion
5) perfusion
6) myocardial function
7) peripheral circulation
8) tissue extraction and use of O2
9) return of partially desaturated blood and CO2 to the lungs

49

Which step of oxygen transport would be affected during a myocardial infarction?

step 6: myocardial function

50

Which step of oxygen transport would be affected during pneumothorax from a stab wound?

step 3: lungs and chest wall

51

Which step of oxygen transport would be affected during asthma?

step 2: airways OR step 4: diffusion

52

Which step of oxygen transport would be affected during a pulmonary embolus?

step 5: perfusion

53

Which step of oxygen transport would be affected during hypertension?

step 7: peripheral circulation

54

Which step of oxygen transport would be affected during anemia?

step 8: tissue extraction and use of O2

55

Which step of oxygen transport would be affected during a deep vein thrombosis?

step 7: peripheral circulation

56

What 3 normal factors "shake up" oxygen transport?

activity, position, emotional stress

57

What has the greatest influence on O2 transport?

Gravity

58

How does restricted activity impacted CO, VO2, and OER?

lack of exercise decreases how well you are utilizing the oxygen you do have -- decreases CO, VO2, and OER

59

Loss of gravitational stress causes what?

astronaut "puffy face and bird legs"
-- loss of gravity allows for fluid to shift to thorax/head

60

External and internal signs of oxygen transport dysfunction?

External signs:
- skin: pale, cyanotic, cold
- speech: short of breath
- diaphoresis
Internal signs:
- vital signs
- respiratory patterns
- hypoxia/low pulse oximetry
- poor peripheral circulation -- decreased capillary refill ( > 3 sec)