Flashcards in Resp - Pulmonary Q/V Deck (28):
1
normal V/Q
4/5 = 0.8
2
normal V/Q with abnormal V and Q
lobar pneumonia
V in lobe decreased
hypoxia --> vasoconstriction
Q decreased
3
ventilation and lung regions
highest in base (Pa>Pv>PA)
lowest in apex (PA > Pa)
4
flow and lung regions
highest @ base
lowest @ apex
5
V/Q in lung regions
high in apex (>1)
low in base (<1)
6
Pip in lung regions
more negative @ apex (distend alveoli)
less negative @ base (don't distend as much)
7
normal P(A-a) O2
< 20 mm Hg
age/4 + 4
(increase w/ age)
8
causes of hypoxemia
hypoventilation
low inspired O2
R/L shunt
V/Q mismatch
diffusion impairment
(first 2 have normal P(A-a)O2
9
hypoxemia
PaO2 < 80
10
hypoventilation causes
depressed respiration (morphine, sedatives)
neuromuscular diseases
11
hypoventilation Ps
PAO2 down (RR down)
P(A-a)O2 normal (PAO2 and PaO2 lower qually - no lung problem)
12
hypoventilation Tx
supplemental O2
13
low inspired O2 causes
Patm down (altitude)
FIO2 down (improper anesthesia)
14
low inspired O2 Ps
PAO2 down (PIO2 down)
P(A-a)O2 normal (O2 equilibrium normal)
15
low inspired O2 Tx
supplemental O2
16
R/L shunt causes
congenital defect
foramen ovale open
alveolar filling/atelectasis
17
R/L shunt Ps
P(A-a)O2 up (A same, a down)
PaO2 down (added deoxygenated blood)
PaCO2 normal or up
18
R/L shunt Tx
NOT O2
19
V/Q mismatch causes
pneumonia
pulmonary embolism
COPD
20
V/Q mismatch
usually Q normal
P(A-a)O2 increased
21
V/Q mismatch Tx
supplemental O2
22
physiologic response to low V/Q
PaO2 down --> regional pulm vasoconstriction
put blood in good spots
Q goes down to match V
23
physiologic response to high V/Q
PaCO2 down --> regional bronchconstriction
put air in good spots
V goes down to match Q
24
low V/Q and PaO2/CO2
low V/Q - high ventilation or low perfusion --> low PaO2, high PaCO2
25
high V/Q and PaO2/CO2
high V/Q - low ventilation or high persusion --> high PaO2, low PaCO2
26
diffusion impairment cause
interstitial lung disease (scarring
pulmonary fibrosis
** during exercise
27
diffusion impairment Ps
P(A-a)O2 normal @ rest
P(A-a)O2 increased during exercise
PaCO2 is normal
28