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My Patho Cards > Resp 2 > Flashcards

Resp 2 Flashcards

1
Q

What is the delta PaO2 between PaO2 in the lungs?

A

110mmHg (high delta)

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2
Q

What is the PaO2 in the blood that is driving gas exchange?

A

40mmHg

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3
Q

What must hgb go through to before binding to Hgb in RBCs?

A

Several fluids and epithelial layers

That is why it is important to maintain a high PaO2 in the alveoli to ensure it dissolves.

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4
Q

What are some diseases that causes changes in the PaO2 in the alveoli or in Delta PaO2 and therefore cause a drop in the Diffusion Limit of O2?

A

Fibrosis
COPD
Emphysema

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5
Q

How does Fibrosis drop the diffusion limit?

A

Increases the thickness of the membrane

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6
Q

How does COPD drop the diffusion limit?

A

Reduces the SA to volume ratio

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7
Q

How does Emphysema drop the diffusion limit?

A

Decrease the surface area

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8
Q

Excess fluid, excess thickness will affect diffusion of O2 and therefore O2 and therefore O2 ___________ in the blood.

A

Tension

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9
Q

How is the diffusion of O2 and O2 tension measured in the blood?

A

DLCO (Carbon Monoxide tracer)

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10
Q

T/F: Changes in overall morphology in lungs causes a reduced DIFFUSION capacity of O2.

A

True

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11
Q

What is being measured in the oxyhemoglobin dissociation curve?

A

PO2:Partial pressure of oxygen
VO2: Volume of O2
SaO2: Oxygen saturation

How well we exchange gases

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12
Q

What causes a R shift?

A

Acidosis
Inc temp
Inc 2,3 DPG

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13
Q

What happens during a Right shift?

A

Oxygen will readily RELEASE from hgb

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14
Q

What causes a L shift?

A

Alklalosis
Dec temp
Dec 2,3 DPG

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15
Q

What happens during a L shift?

A

Oxygen will LATCH to hgb

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16
Q

What happens to the alveolar capillaries as the lungs expands?

A

Stretch of the alveolar wall compresses the alveolar capillaries and elevates PVR.

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17
Q

What happens to the extra alveolar vessels as the lungs expands?

A

They are pulled open due to recoil forces. The opposite is true at low lung volumes.

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18
Q

The net result is that perfusion of the pulmonary vasculature is ____________ at or near _____________.

A

Optimal; FRC

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19
Q

The compression of alveolar capillaries causes increased pulmonary pressures with ___________ & _________. This will create a back up causing Pulm HTN.

A

Emphysema;COPD

20
Q

What is perfusion of the lungs dependent upon?

A

The driving pressure (pulmonary artery pressure-pulmonary vein pressure) and the resistance of the regional vascular bed.

21
Q

What lung zone will you have big alveoli (high ventilation) and low resistance?

A

Zone 1.

D/t being above the heart, more gravity->less perfusion

22
Q

What lung zone are alveoli well ventilated and will also have good perfusion?

A

Zone 2

“Normal” working parameters of the lungs

23
Q

What happens in zone 3 of the lungs?

A

Alveoli are poorly ventilated, d/t gravity, good perfusion.
Low V/Q ratio
Gets a mixture of deoxygenated blood with oxygenated blood (Shunt)

24
Q

What happens during during zone 1 mismatch?

A

To prevent dead space, the body will bronchoconstrict areas that are being ventilated and not perfused->shunting away from there.

Dependent on Bronchodynamics: Ince or Dec air resistance or bronchiolar resistance.

25
Q

What happens during Zone 3 mismatch?

A

A shunt normally means low O2 in the venous blood

Hypoxia: regulator for vasoconstriction

26
Q

What is considered a shunt in Zone 3?

A

Shunt=hypoxic vasoconstriction, which reduces perfusion to areas not well ventilated.

Improvement: Control of blood flow and PVR

27
Q

During PNA, edema, etc, what causes vasodilation?

A

Inflammatory cytokines

Reduced PVR>don’t get hypoxic

28
Q

Describe what happens during Obstructive DO.

A

Increased compliance
Decrease in resistance
Drop in FEV1/FVC ratio

Dif getting air out

29
Q

Where does Obstructive DO occur?

A

Alveolar Space

30
Q

Name examples of Obstructive DO

A

COPD
Asthma
Chronic bronchitis
Emphysema
Bronchiectasis

31
Q

Where do Restrictive DO occur?

A

Interstitial space

32
Q

Name examples of Restrictive DO?

A

“Osis” diseases
Interstitial pneumonias
Granuloma diseases
Carcinomas
TB

33
Q

Where do Vascular DO take place?

A

Capillaries/blood vessels of the lungs

34
Q

Name examples of Vascular DO

A

Pulm edema
Pulm HTN
Pulm emboli

35
Q

Name examples of Combo DO

A

ALI/Resp Distress
Bacterial PNA

36
Q

What happens during Combo DO?

A

Infection in lungs->fluid shifts (interstitial edemas, pulm edema)->leads to obstruction and restrictive patterns

37
Q

Are Combo DO acute or chonic?

A

Most of the time they are Acute

Not doing PFTs on them
Rely on physical exam, labs, and CXR

38
Q

What do you see in infective disorders?

A

Fever, WBCs

39
Q

What do you see in PNA?

A

Opacifications

40
Q

What is an example of an inspiratory disorder in children?

A

Extrathoracic Obstructions (child aspirated something)

41
Q

What curve does most process diseases processes occur?

A

Expiratory Curve

Measures peak flow

42
Q

What happens to the FEV1/FVC ratio in Restrictive D/O?

A

It is above normal, usually high

43
Q

What occurs during Restrictive DO?

A

Hard time getting air IN

Total volume change is lower, but flow rate is really high

They can get air out in the first second

44
Q

What happens to the diaphragm in COPD?

A

It flattens

45
Q

What is the Meniscus sign?

A

Fluid in the pleural space

My Patho Cards (6 decks)

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