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Resp 3 Flashcards

1
Q

Outward forces (mmHg)

A

Capillary 7;
Interstitial osmotic pressure 14;
Negative interstitial fluid pressure 8;
Total 29

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2
Q

Inward forces (mmHg)

A

Plasma protein osmotic pressure 28

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3
Q

Elevated PO2 levels are associated with

A

Increased O2 levels in the inhaled air;

Polycythemia

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4
Q

Decreased PO2 levels are associated with

A 
Decreased O2 levels in air;
Anemia;
Heart decompensation;
COPD;
Restrictive pulm dz;
Hypoventilation
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5
Q

The amount of gas dissolved in a solution is proportional to its partial pressure

A

Henry’s Law

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6
Q

Equation for dissolved oxygen in blood

A

PaO2 x 0.003

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7
Q

Diffusion of a gas is directly proportional to:

A

Pressure gradient, membrane area, & gas solubility

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8
Q

Diffusion of a gas is inversely proportional to:

A

Membrane thickness and square root of molecular weight

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9
Q

A-a gradient

A

PAO2 - PaO2. Difference b/w alveolar PO2 and arterial PO2

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10
Q

A-a gradient normal range for PO2 & PCO2

A

5-15 mmHg;

2-10 mmHg

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11
Q

Alveolar gas equation (calculates PAO2)

A 
PAO2= PIO2 - PACO2/R
R = resp quotient (0.8)
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12
Q

Hypoxemia d/t V/Q mismatch, diffusion block, or right-to-left shunt would effect A-a gradient how?

A

Increased

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13
Q

Hypoxemia d/t hypoventilation effects A-a gradient how?

A

Normal

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14
Q

Supplemental O2 is helpful in all causes of Hypoxemia except?

A

Right-to-left shunt

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15
Q

What form does iron carry O2?

A

Ferrous (Fe++)

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16
Q

O2 binding capacity of blood

A

20.1ml O2/100ml

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17
Q

O2 content of blood equation

A

O2 content = (O2 binding capacity x %Sat) + dissolved O2

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18
Q

Normally 1 g Hb can bind _____ ml O2

A

1.34

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19
Q

Cyanosis results when deoxygenated Hb _____

A

> 5g/100 ml

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20
Q

______ of arterial blood decreases as Hb falls, but _____ & _____ do not

A

O2 content;

O2 sat & arterial PO2

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21
Q

Arterial PO2 decreases w/ chronic lung dz b/c physiological shunt decreases _______

A

O2 extraction ratio

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22
Q

Causes defective O2 transport > low sat

A

methemoglobinemia

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23
Q

Causes of Methemoglobinemia?

A

Nitrites, benzocaine, metabolites of prilocaine

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24
Q

S/sx of cyanide poisoning

A

Tachycardia, hypotension, coma, acidosis, increased venous O2, rapid death

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25
Tx of cyanide poisoning
sodium nitrite & amyl nitrites oxidize Hb to metHb which binds cyanide. Thiosulfate binds this cyanide forming thiocynate which is excreted by kidneys
26
Cyanide blocks what enzyme that is needed for ATP?
Cytochrome oxidase
27
_________ is the driving force for the chemical reaction that creates oxyhemoglobin
O2 tension
28
P50
Indicates the partial pressure of oxygen required to achieve 50% of Hb saturation
29
Positive cooperativity
The sigmoid shape of oxygen-Hb curve that is a result of a change in affinity of Hb as each successive O2 molecule binds to a heme site
30
PO2 if Hgb sat is 100%
100 mmHg
31
PO2 if Hgb sat is 75%
40 mmHg (mixed venous blood)
32
PO2 if Hgb sat is 50%
25 mmHg
33
Below a PO2 of ____ there will e a free fall of sat
60 mmHg
34
Right shift causes:
Release of O2 from Hb
35
Causes shift to the right of O2-Hb curve:
``` Increased CO2; Increased Acidity (Bohr effect); Increased DPG (diphophoglycerate a byproduct of glycolysis); Increased Exercise; Increased Temperature; CADET ```
36
Left shift causes:
Loading of O2 in Lungs | “Less O2 delivered”
37
Normal value of P50
26-28 mmHg
38
If P50 is increased there is a _____ shift. If P50 is decreased, there is a _____ shift
Right; Left
39
Administration of 100% O2 is most effective in flat or steep portion?
Steep portion
40
The shift of oxyHb curve in response to increase or decrease PCO2 is
Bohr effect
41
Opioids shift the curve to the ____? Why?
Right; resp depression = more CO2
42
At _______ CO2 diffuses into the blood that shifts the curve to the right > more release of O2
Tissue level
43
At ______ CO2 diffuses from blood into alveoli that shift the curve to left > more loading of O2
Lungs
44
What happens at 0.4 mmHg on the carbon monoxide-hgb dissociation curve?
No space would be left for oxygen
45
The affinity of Hb for CO is _____ times higher than O2
250
46
Functional anemia
Carboxyhemoglobin cannot carry O2
47
What happens to PaO2 with carbon monoxide poisoning
It is normal/ no cyanosis. (PO2 is dissolved portion of O2)
48
What happens to pulse ox during carbon monoxide poisoning?
It is normal b/c cannot differentiate
49
CO at 1 Hb site increases O2 affinity of remaining 3 sites causing Hb to retain O2. This causes curve to shift?
To the left
50
Tx for CO poisoning
100% O2 (will bump off CO from Hb)
51
CO2 is produced in tissues & carried to the lungs in 3 forms:
1. HCO3 (90% MAJOR FORM); 2. Carbaminohemoglobin (Hb.CO2- small amt); 3. Dissolved CO2 - small amt
52
Equation to determine amt of CO2 dissolved in blood
PaCO2 x. 0.067
53
IN lungs, oxygenation of Hb promotes dissociation of CO2 from Hb (therefore CO2 is released from RBCs)
Haldane effect
54
______ chemoreceptors in carotid and aortic bodies mediate ____ of the CO2 response
Peripheral; 30%
55
______ chemoreceptors in the medulla respond to H in brain ECF and mediate ___ of the CO2 response
Central; 70%
56
Sensory information (PCO2, lung stretch, irritants, etc) is coordinated in _______ which sends signals to respiratory muscles
Brainstem
57
Where is the medullary respiratory center located?
In reticular formation
58
(Pacemaker); Inspiration control; Receives inputs via vagus (X) & glossopharyngeal (IX); Output to diaphragm via phrenic nerve & external intercostals
Dorsal Respiratory Group
59
Expiratory control; Efferent via internal intercostal nerve; Work only during exercise, when expiration becomes an active process
Ventral Respiratory Group
60
Glossopharyngeal (IX) carries signals from _______ and vagus (X) from _______ and lung stretch receptors
Carotid bodies; | Arch of aorta
61
Located in lower pons; | Stimulates inspiration, producing deep and prolonged inspiration gasp
Apneustic center
62
Located in upper pons; Inhibits respiration & therefore inspiratory volume and resp rate; Adjust rate & depth of respiration
Pneumotaxic center
63
Voluntary breathing; | Hypoventilation or hyperventilation
Cerebral cortex
64
In the central chemoreceptors in the medulla ____ does NOT cross the BBB, but ____ does.
H+; CO2
65
____ PCO2 and H+ stimulate breathing
Increased
66
_____ PCO2 and H+ inhibit breathing
Decreased
67
Why do acidosis & alkalosis not effect central chemoreceptors?
Bc acid ions cannot cross the BBB to go to the central receptor
68
Peripheral chemoreceptors in the carotid and aortic bodies are stimulated by:
Decreased PO2; Increased PCO2; Decreased pH
69
When these receptors are stimulated by dissension of the lungs, they produce a reflex decrease in breathing frequency
Hering-Breuer Reflex
70
What is the resp drive of a normal healthy adult?
CO2 drive
71
What is resp drive of a pt w/ 15yr hx of COPD?
Hypoxic drive (CO2 is blunted)
72
Why is O2 administered w/ caution in COPD pts?
Too much O2 will drop hypoxic drive & they will stop breathing
73
Right-to-left shunts always result in _______ bc of the admixture of venous blood w/ arterial blood
Decreased arterial PO2
74
PO2 will be elevated on the right side of the heart with what type of shunt?
Left-to-right

Patho (13 decks)

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