OLV- (Ventilation & Perfusion) Millers fast paced ppt. Newby Flashcards Preview

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Flashcards in OLV- (Ventilation & Perfusion) Millers fast paced ppt. Newby Deck (32):
1


Ventilation and Perfusion:

Ventilation and perfusion are often times compared to try an dunderstand what can be altered during pt care for optimization of the patient.

What is normal Ventilation?

What is normal Perfusion?

What is normal V/Q ratio?

  • V- 4 L/min
  • Q- 5 L/min
  • V/Q ratio- 0.8

(4/5=0.8)

2


Ventilation and Perfusion:

what is equation for MV?


VT x RR = MV

3


Ventilation and Perfusion:

what is Alveolar ventilation?


amount of ventilation to/from alveoli

4


Ventilation and Perfusion:

alveolar ventilation is r/t what 2 factors?


physiological deadspace

anatomical dead space

5


Ventilation and Perfusion:

what is normal alveolar ventilation


4 L/ min

6


Ventilation and Perfusion:

verage CO?


5 L/min

7


Ventilation and Perfusion:

different areas of the lungs have different V/Q ratios the ratio of 0.8 is the average of all the areas in the lungs.

this is just a fact no question here


whoooooo finally a break

8


Ventilation and Perfusion:

theoretically V/Q ratios can be from ____ to _____

 

  • 0 (V=O/Q)
  • infinity (V/Q=O)

9


Ventilation and Perfusion:

during spontanous respiration upright or standing

  • Ventilation will be greatest where?
  • Ventilation will be the least where?
  • Perfusion is he greatest where?

 

  • Base (r/t greatest pressure change)
  • Apex (r/t near 0 pressure change)
  • bases (r/t gravity)

This facilitates optimization of ventilation and perfusion

10

Ventilation and Perfusion:

Causes for V/Q mismatch

 

  • positon changes
  • Anesthesia (General, PPV, Muscle paralysis)
  • Blunt force trauma
  • Heart Dz (heart failure, MI)
  • Lung Dz (dead space, shunting, atelectasis)

11


Ventilation and Perfusion:

What is dead space


Ventilation with no perfusion

12


Ventilation and Perfusion:

what is shunt


perfusion with no ventilation

13


Ventilation and Perfusion:

shunting is conteracted by what process?


Hypoxic Pulmonary Vasoconstriction (HPV)

14


Ventilation and Perfusion:

Deadspace or shunt

PE


Dead space

15



Ventilation and Perfusion:

Deadspace or shunt

asthma (acute)

shunt

16



Ventilation and Perfusion:

Deadspace or shunt

OLV

shunt

17



Ventilation and Perfusion:

Deadspace or shunt

COPD (hyperinflation)

Deadspace

18



Ventilation and Perfusion:

Deadspace or shunt

Atelectasis

Shunt

19

Ventilation and Perfusion:

  • V/Q=0
  • V/Q=1
  • V/Q=infinity

 

  • Shunt
  • Normal
  • Dead space

20


Ventilation and Perfusion:

What is Hypoxic Pulmonary Vasoconstriction?

 

  • pulmonary vasculature is sensitive to hypoxia
  • increased mediators such as leukotriens compared to vasodilatory prostaglandins
  • Hypercarbia in lungs = vasoconstriction

21


Ventilation and Perfusion:

with HPV what actually causes vasoconstriction


hypercarbia

22


Ventilation and Perfusion:

GA changes the dynamics of how the body works as we all know. what do VAAs do inparticular

 

  • Dilate airways
  • Alter respiratory dynamics (RR, TV, musculature)
  • Atelectasis formation with in 5 min
  • Blunts HPV

23


Ventilation and Perfusion:

how does GA alter Gas exchange? (4)

 

  • Position changes
  • VAA
  • PPV
  • Post op

24


Ventilation and Perfusion:

What factors does posaition affect with GA and position changes?

 

  • FRC
  • V/Q mismatch
  • WOB
  • Zones 1,2,3

25


Ventilation and Perfusion:

what factors does VAA alter r/t gas exchange

 

  • HPV
  • Diaphragmatic Breathing (sppont)

26


Ventilation and Perfusion:

what factors does PPV alter r/t gas exchange

 

  • Gas flow path to path of least resistance
  • Zones 1,2,3

27


Ventilation and Perfusion:

what factors does post-op pain alter r/t gas exchonge

 

  • Pain & splinting
  • Smokers and obese at higher risk

28


Ventilation and Perfusion:

how does mechanical ventilation affect V/Q

 

  • Air/Gas follows path of least resistance

29


Ventilation and Perfusion:

what does Lapaces law tell us about V/Q r/t to mechanical ventilation

 

  • Alveoli in apex r.t size require lower pressure to increase air/gas uptake
  • Alveoli in bases will require a higher pressure for distensibility

30


Ventilation and Perfusion:

what is Laplaces law r/t lungs?


2T=PR

  • T= wall (surface) tension
  • P= distending pressure within alveolus
  • R= radius of alveolus

31


Ventilation and Perfusion:

what is LaPlaces law rearranged to fit better and what is proportional and inversly proportional


P=2T/R

  • surface tension is proprtional
  • Radius is inversly proportional

32


that is for this section


yeah!!!!