Oxygen Transport

Question 1

What are the goals of cardiopulmonary physical therapy?

Answer 1

1. Reverse of mitigate insults to O2 transport

2. Reduce the need for medical interventions

Question 2

___% of oxygen is dissolved in blood plasma.

Answer 2

1.5

Question 3

___% of O2 is combined with Hb.

Answer 3

98.5

Question 4

Hb molecules can transport up to ___ O2 molecules.

Answer 4

4

Question 5

Hb affinity for O2 ______ as it’s saturation increases.

Answer 5

increases

Question 6

Resting organs have a PO2 of ___ mmHg and is ___% saturated.

Answer 6

40; 75

Question 7

Lungs at sea level have a PO2 of ____mmHg and Hb is ___ % saturated.

Answer 7

100; 98

Question 8

Actively contracting muscles has a PO2 of ___mmHg and Hb is only ___% saturated.

Answer 8

20;35

Question 9

In addition to PO2, what other 4 factors alter Hb?

Answer 9

1. pH
2. Temp
3. PCO2
4. 2,3-DPG

Question 10

What is the Bohr effect?

Answer 10

Hb saturation curve shifting to the RIGHT

Question 11

Hb saturation curve shifting to the right causes (increased/decreased) O2 unloading?

Answer 11

increased

Question 12

What are the 8 steps in the O2 cascade?

Answer 12

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

Question 13

Chronic irritation of the lungs can lead to what 4 things?

Answer 13

1. Allergies
2. Chronic inflammatory reactions
3. Fibrosis
4. Alveolar-capillary membrane thickening

Question 14

Edema, mucus, foreign, objects, particulate matter, lesions and hyperactivity of bronchial smooth muscles can all lead to?

Answer 14

Increased resistance to airflow

Question 15

Air entry into the lungs depends on the integrity of what 3 things?

Answer 15

1. Respiratory muscles
2. Lung parenchyma
3. Chest wall

Question 16

Obstructed airways, increased lung compliance and increases in airway resistance all increase the time needed for _______ _______.

Answer 16

alveolar filling

Question 17

Gas exchange is compromised if there is inadequate time for alveolar _________ or ________.

Answer 17

filling; emptying

Question 18

Lung unit with a _____ time constant is slow to fill and empty, and it can continue filling when surrounding units are emptying.

Answer 18

long

Question 19

In upright lungs, are the bases or apices better perfused?

Answer 19

bases

Question 20

_________ regulate blood flow through regional vascular beds and maintain peripheral vascular resistance and thus systemic blood pressure.

Answer 20

arterioles

Question 21

What are the 9 steps in the intervention hierarchy to manage O2 transport limitations?

Answer 21

1. Mobilization and exercise
2. Body positioning
3. Breathing control maneuvers
4. Coughing maneuvers
5. Relaxation and energy conservation techniques
6. ROM exercises
7. Postural drainage positioning
8. Manual techniques
9. Suctioning

Question 22

The respiratory system (does/does not) adapt to exercise training.

Answer 22

DOES NOT

Question 23

Does the respiratory system limit exercise?

Answer 23

In highly trained men and women, possibly

Question 24

What are 2 potential respiratory system limitations?

Answer 24

1. Exercise induced arterial hypoxemia

2. Respiratory muscle fatigue and steal of skeletal muscle blood flow

Question 25

EIAH = arterial O2 desaturation of >__-__% below resting levels during exercise.

Answer 25

3-4

Question 26

EIAH is observed in ~___% of elite male endurance athletes with a VO2 max > 65mL/kg/min.

Answer 26

50

Question 27

EIAH is characterized by a _______ PaO2 and an _______ alveolar to arterial O2 difference.

Answer 27

decreased; increased

Question 28

PaCO2 >___ mmHg = inadequate compensatory hyperventilation.

Answer 28

35

Question 29

What are 2 possible mechanisms of inadequate hyperventilatory compensation?

Answer 29

1. Blunted drive to breath (reduced chemrsensitivity) | 2. Mechanical ventilatory constraints (expiratory flow limitation)

Question 30

_____ mismatching is the primary contributor to the development of EIAH.

Answer 30

Va/Q

Question 31

What is an extra-pulmonary shunt?

Answer 31

deoxygenated blood returning from the exercising muscles bypasses the lungs completely through bronchial and thebesian veins and is dumped into the left atrium of the heart

Question 32

What is an intra-pulmonary shunt?

Answer 32

deoxygenated blood that passes through the lunges but does not participate in pulmonary gas exchange; venous blood mixes with and dilutes arterial blood

Question 33

Shunts play a _____ role in exercise gas exchange.

Answer 33

minor

Question 34

What are the two major determinants of alveolar capillary diffusion during exercise?

Answer 34

1. decreased transit time of the RBC's in the pulmonary capillary 2. increased distance for diffusion

Question 35

What are the 2 functions of the blood gas barrier?

Answer 35

1. pulmonary gas diffusion (must be thin) | 2. Withstand high capillary wall stressed with exercise (must be strong)

Question 36

The threshold of EIAH to influence exercise performance occurs when SaO2 decreases by ___-___% below resting levels., Beyond this threshold, each further 1% decrease in SaO2 results in a __-__% decrease in VO2 max.

Answer 36

3-4;1-2