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CP Fall19 Final > Pulmonary Equations > Flashcards

Pulmonary Equations Flashcards

(66 cards)

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1
Q

Boyles Law

A

P1V1 = P2V2 (pressure gradient that drives gas flow)

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2
Q

Charles Law

A

V1/V2 = T1/T2

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3
Q

Dalton’s Law

A

P total = P gas (x)

DSA:

Px = (Pb - Pw) x F

Pb: barometric pressure
Pw: water vapor pressure (74mmHg)

F values: O2 = 21% ; N2 = 79%

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4
Q

Henry’s Law

A

Cx = kPx ; Pgas (in fluid) = [gas] / solubility

C: content of dissolved gas proportion to partial pressure
k: solubility constant
P: partial pressure

Example: If arterial blood PCO2 = 40mmHg + k (solubility constant) = .06mL CO2/dL blood/mmHg

C CO2 = .06 x 40 = 2.4mL/dL

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5
Q

Transpulmonary pressure (PL)

A

PL = PA - PPL

PA: intrapulmonary pressure
PL: intra pleural pressure

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6
Q

Across chest wall (PW)

A

PW = PPL - PBS

PPL: intra pleural pressure
PBS: pressure at body surface

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7
Q

Pressure across respiratory system (PRS)

A

PRS = PA - PBS

PA: intrapulmonary pressure
PBS: pressure at body surface

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8
Q

Transairway pressure (PTA)

A

PTA = PAW - PPL

PAW: air way pressure
PPL: intra pleural pressure

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9
Q

Transpulmonary pressure

Pneumothorax Example

A

PL = PA - PPL

PA: intrapulmonary pressure
PPL: intra pleural pressure

2 ways to to re-inflate lung clinically:

PPL = 0 ; PA = +5 ; PL = +5 - 0 = +5 (add + pressure in air way)

PPL = -5 ; PA = 0 ; PL = 0 - (-5) = +5 (recreate (-) intrapleural pressure)

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10
Q

End of Exhalation

Transpulmonary pressure

A

PA - PPL = 0 - (-5) = +5 cm H2O

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11
Q

During Inspiration

Transpulmonary pressure

A

PA - PPL = -2 - (-8) = +6 cm H2O

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12
Q

Lung Volumes during inspiration/expiration

A

End of inhalation: Lung volume = FRC + Vt

Start of Exhalation: Lung volume = FRC

FRC: functional residual capacity

Vt: tidal volume

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13
Q

Vital Capacity (VC)

A

VC = IRV + Vt + ERV ; VC = IC + ERV

IRV: inspiratory reserve volume (normal: 3000mL)
Vt: tidal volume (normal: 500mL)
ERV: expiratory reserve volume (normal: 1000mL)
IC: inspiratory capacity

Example: VC = 3000 + 500 + 1000 = 4500mL (normal)

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14
Q

Total lung capacity (TLC)

A

TLC = VC + RV ; TLC = IC + FRC ; TLC = Vt + ERV + IRV + RV

VC: vital capacity (normal: 4500mL)
RV: residual volume (normal: 1200mL)
IC: inspiratory capacity (normal: 3500mL)
FRC: functional residual capacity (normal: 2200mL)

Example: TLC = 4500 + 1200 = 5700mL (normal)

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15
Q

Functional residual capacity (FRC)

A

FRC = ERV + RV

ERV: expiratory residual volume (normal: 1000mL)
RV: residual volume (normal: 1200mL)

Example: FRC = 1000 + 1200 = 2200mL (normal)

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16
Q

RV/TLC’s

A

Normal < .25

Emphysema (increased RV)

Fibrosis (decreased TLC)

Pathology > .25

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17
Q

Compliance

A

C = ∆V / ∆P (units: mL/ cm H2O)

reflection of distensibility, measure of elastic properties of lung (higher compliance = easier to stretch)

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18
Q

Recoil

A

R= 1/C

tendency of an object to oppose stretch (lung)

High compliance = less recoil; low compliance = more recoil

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19
Q

La Place’s Law

A

P = 2T / r

P: net pressure in gas filled sphere

T: surrounding surface tension

r: radius of sphere

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20
Q

Respiratory system compliance (Crs)

A

Crs = 1/Cl + 1/Ccw

Cl: compliance of lung

Ccw: compliance of chest wall

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21
Q

Airflow through tube due to a pressure difference between 2 ends of tube

A

AF = ∆P / R

AF: airflow
R: resistance to AF
∆P: difference between barometric pressure (Pb) at open mouth and pressure at alveolus (PA): ∆P= Pb - PA

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22
Q

Resistance (laminar)

A

R = ∆P / flow (units: cm H2O/L/sec)

R = 8 L n / π r^4

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23
Q

Laminar flow / Turbulent flow

A

Re (Reynolds # < 1000) = laminar ; P = flow rate x R

Re (Reynolds #> 2000) = turbulent ; P ∝ (flow rate)^2

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24
Q

Reynolds number

A

Re = 2rvd / n

r: radius
n: viscosity
v: velocity
d: diameter

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25
Airway Resistance
In parallel... 1/R total = 1/R1 + 1/R2 + 1/R3...
26
Work of breathing (W)
W = P x ΔV
27
Metabolic Acidosis
Primary disorder: increased production of H+ by tissues Compensatory response: hyperventilation expires CO2 [H+] increased; pH decreased pCO2 decreased; HCO3- decreased
28
Metabolic Alkalosis
Causes: prolonged vomiting, potassium deficiency Primary disorder: excessive loss of H+ and ovum depletion [H+] decreased; pH increased pCO2 increased; HCO3- increased
29
Respiratory Acidosis
Causes: choking, bronco-pneumonia, acute exacerbation of asthma, chronic obstructive airways disease Primary disorder: insufficient expiration of CO2 from lungs [H+] increased; pH decreased pCO2 increased; HCO3- increased
30
Respiratory Alkalosis
Causes: hysterical over breathing, mechanical over ventilation, hypoxia Primary disorder: excessive expiration of CO2 by hyperventilation [H+] decreased; pH increased pCO2 decreased; HCO3- decreased
31
Alveolar Gas Equation
PAO2 = PIO2 - PaCO2 / R R= .8
32
Normal Lung Volume Values
Vt (Tidal volume) = 500mL IRV (inspiratory reserve volume) = 3000mL ERV (expiratory reserve volume = 1000mL RV (residual volume) = 1200mL
33
Inspiratory capacity (IC)
IC = Vt + IRV IC = 500mL + 3000mL = 3500 mL (normal value)
34
Clinical Spirometry
simple lung function test (Forced vital capacity) most informative; measured directly from spirogram FVC: total air exhaled during forced exhalation; TLC spirometry test: patient forcibly exhales from TLC level Does not measure RV (RV + TLC) ; FEV1 / FVC = 80% (normal); obstruction of airway = 47% FEV1: forced expiratory volume in 1 second
35
Alveolar pressure (PA)
PA = P tp + P pl P tp: transpulmonary pressure P pl: pleural pressure
36
Force expiratory volume (FEF) OR mid-maximal expiratory flow (MMEF)
25-75% of vital capacity (VC)
37
FVC maneuver (healthy person vs. person w/ asthma)
Healthy person: FEV1 = 3.41 ; FVC = 3.81 ; 3.41/3.81 = .86 Person w/ asthma: FEV1 = 2.1 ; FVC = 3.7 ; 2.1/3.7 = .57
38
Interpreting FVC maneuver
RD: restrictive disease (fibrosis) ; OD: obstructive disease (COPD) RD: VC decreased; TLC decreased; RV decreased; FEV1/FVC normal or increased; FEF normal OD: VC normal or decreased; TLC normal or increased; RV increased; FEV1/FVC decreased; FEF decreased
39
Inert gas dilution and nitrogen washout technique
measures FRC V1C1 = (V1 + Vfrc) x C2
40
Plethysmography
measures lung volumes and FRC ; based on Boyle's law
41
Diffusion capacity test (DLCO)
measure CO diffusion capacity; decreased w/ thickening of barrier interstitial or alveolar edema (fibrosis) ; decreases surface area for gas exchange (emphysema, tumor) ; decreased uptake by RBCs (anemia) ; V/Q mismatch
42
Lung Capacity test (Plethysmography & Helium dilution methods and nitrogen washout)
measures amount of air that you breathe in and out (Vt) and max amount of air you can breath in and out (VC)
43
Flow meter
measures airway resistance (Raw) and lung compliance (CL); uses esophageal balloon (Ppl) Normal Raw: 1-3cm H2O/Lsec Healthy normal tidal breathing: C = ΔV/ Ppl CL (static) about equal to CL (dynamic) = .150 - .250 L/cm H2O
44
Pulmonary Vascular resistance (PVR)
R = ΔP / F
45
Ventilation perfusion ratio (V/Q) / Healthy Lung parameters
Normal healthy lung: V/Q: .8 PaO2 = 100mmHg PaCO2 = 40mmHg Arterial pH = 7.4
46
Hypoxemia PaO2 / Hypoventilation PaCO2
PaO2 < 80mmHg PaCO2 > 45mmHg
47
Anatomical Shunt (R to L)
PAO2 - PaO2 = AaDO2 = 15mmHg AaDO2: alveolar-arterial oxygen gradient
48
Henderson Hasselbach equation
-pH = pK + log [HCO3-] / (.03 x PCO2)
49
Fick's Law
D = ΔP x area / thickness
50
O2 dissolved in blood plasma
VO2 = 5000ml/min x .3mL O2/100mL = 15mLO2/min Avg. 70kg human consumes 250mLO2/min at rest
51
Hemoglobin O2 capacity
in RBC about 15g/100mL blood, 1.35mL O2/g Hb Max O2 bound to Hb = Hb O2 capacity x Hb content 1.35mLO2/gHb x 15gHb/dL blood = ~20.3 mLO2/dL blood
52
Hemoglobin saturation
%SO2 = (O2 bound to Hb / Hb O2 capacity) x100 %SO2 = 0% PO2 = 0mmHg %SO2 = 25% PO2 = 15mmHg %SO2 = 50% PO2 = 25 mmHg %SO2 = 75% PO2 = 40mmHg %SO2 = 100% PO2 = 100mmHg %SO2 = 100% PO2 = 500mmHg (hyperoxia)
53
Blood Flow
BF = HR x SV
54
Positive allosteric effectors of HB (P50 reduced; left shift)
``` ↑ pH ↓ PCO2 ↓ 2,3 BPG ↓ Temperature ↑ HbF ↑ CO ↑ MetHb ```
55
Negative allosteric effectors of HB (P50 increased; right shift)
``` ↓ pH ↑ PCO2 ↑ 2,3 BPG ↑ Temperature ↑ Altitude ```
56
Bohr effect (right shift)
At lung alveoli, O2 binding releases H+ due to high pO2, O2 binding to Hb releases H+ At tissue capillary beds, increased [H+], decreased pH, oxyHb acquires H+ which enhances release of O2 for aerobic metabolism
57
CO2 transportation
gaseous and dissolved CO2 in plasma Carbamino compounds: Hb-NH-COO- + CO2 Bicarbonate (HCO3-) CO2 + H2O → H2CO3 → H+ + HCO3-
58
Haldane effect
when O2 binds Hb, CO2 released w/o Haldane CO2Δ = 52-50 = 2 volume % w/ Haldane CO2Δ = 52-48 = 4 volume % ↑ %SO2 = right shift ↓ %SO2 = left shift
59
Partial pressure of lung gases at 37°C (body temp)
100°C Wvp = 760mmHg 0°C = 5mmHg PH2O = 47mmHg air-lungs interface: PTotal = 760 - 47 =713mmHg (reduces partial pressure of all gases at lung surface) ``` PN2 = 713 x .79 = 563.3 PO2 = 713 x .21 = 149.7 PCO2 = 713 x .0004 = .28 ```
60
Minute ventilation (Ve)
Ve = Vt x f Vt: tidal volume (500mL/breath) f: flow rate (15 breaths/min*) 500 x 15 = 7500 ml/min* *for avg. 70kg male
61
Alveolar Ventilation (Va)
Va = Vt - Vd x f Vd: anatomic dead space (150mL for 150lb male) Vt: 500mL f: 15 breaths/min Va = (500 - 150) x 15 = 5250 mL/min exchanged in alveoli
62
Alveolar Ventilation (after surgery)
Vt: 200mL/breath Vd: anatomic dead space (150mL for 150lb male) f: 40 breaths/min Ve: 8000mL/min Va = (200 - 150) x 40 = 2000 mL/min Normal: 5250mL/min
63
Determinants of alveolar PA O2
PAO2 = 102 mmHg (normal steady state) PAO2 = [O2] entering - [O2] leaving O2 entering determined by: PIO2 and Va PAO2 directly proportional to PIO2 and Va
64
Alveolar gas equation (PO2)
PAO2 = PIO2 - (PACO2 / R) ``` R = respiratory gas quotient (VCO2/VO2) If fuel is: Carbohydrate, R = 1 Fat, R = .7 Normal, R = .8 ```
65
Alveolar gas equation (PCO2)
PACO2 = VCO2 / Va Normal: 40mmHg PACO2 = [CO2] entering - [CO2] leaving PACO2 inversely proportional to Va
66
O2 content
(Hb g/dL x 1.34) x SaO2 +. (PaO2 x .003)

CP Fall19 Final (2 decks)

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