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Apex Review > Respiratory physiology 6 > Flashcards

Respiratory physiology 6 Flashcards

1
Q

The Haldane effect states that in the presence of deoxygenated hemoglobin, the carbon dioxide dissociation curve shifts:
a. to the right
b. to the left
c. up
d. down

A

b. to the left

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2
Q

The Haldane effect describes

A

CO2 carriage
it says that oxygen causes the erythrocyte to release CO2

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3
Q

With the carbon dioxide dissociation curve right is ________ & left is ____________

A

release; love

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4
Q

The presence of oxygenated hemoglobin shifts, the CO2 dissociation curve to the

A

right

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5
Q

The presence of deoxygenated hemoglobin shifts the CO2 dissociation curve to the

A

left

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6
Q

What is the difference between the Haldane effect and the Bohr effect?

A

Bohr effect- describes oxygen carriage
Haldane effect- describes CO2 carriage

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7
Q

Where in the body is the CO2 dissociation curve right-shifted?

A

at the lungs (facilitates Co2 elimination)

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8
Q

Where in the body is the CO2 dissociation curve left-shifted?

A

at the systemic capillaries (facilitates CO2 loading and transport by Hgb)

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9
Q

Consequences of hypercapnia include: (select 2):
a. hypokalemia
b. increased myocardial oxygen demand
c. increased oxygen carrying capacity
d. hypoxemia

A

b. increased myocardial oxygen demand
d. hypoxemia

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10
Q

Hypercapnia is defined as

A

a PaCO2 greater than 45 mmHg

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11
Q

Etiologies of hypercapnia can be classified in 3 ways:

A
  1. increased CO2 production
  2. decreased CO2 elimination
  3. rebreathing
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12
Q

Causes of increased CO2 production include

A

sepsis, MH, thyroid storm, burns, overfeeding, prolonged seizure activity, & shivering

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13
Q

Causes of decreased CO2 elimination include

A

airway obstruction, ARDS, COPD, increased dead space, respiratory center depression, inadequate NMB reversal, increased Vd/Vt, and opioid overdose

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14
Q

Causes of rebreathing include

A

exhausted soda lime
faulty unidirectional valve in a circle system
inadequate FGF in a Mapleson circuit

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15
Q

Consequences of hypercarbia include

A

hypoxemia, acidosis, cardiac depression, hyperkalemia, increased pulmonary vascular resistance, increased Ca2+, SNS stimulation, & increased ICP

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16
Q

PaCO2 is equal to

A

CO2 production/ alveolar ventilation

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17
Q

During respiratory acidosis, the kidneys excrete

A

hydrogen and conserve bicarbonate to return to normal pH
may take several days for full compensation to occur

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18
Q

For every 10 mmHg increased above 40 mmHg in PaCO2 (acute), pH will

A

decrease by 0.08

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19
Q

For every 10 mmHg increase above 40 mmHg (chronic), pH will

A

decrease by 0.03 (due to bicarb retention by the kidneys)

20
Q

Which conditions increase minute ventilation for a given PaCO2? (select 3)
a. surgical stimulation
b. salicylates
c. hypoxemia
d. sevoflurane
e. carotid endarterectomy
f. respiratory alkalosis

A

a. surgical stimulation
b. salicylates
c. hypoxemia

21
Q

The carbon dioxide ventilatory response curve describes the relationship between

A

PaCO2 and minute ventilation

22
Q

The __________________ is the primary monitor of PaCO2

A

central chemoreceptor in the medulla

23
Q

The _____________________________________ play a secondary role in monitoring PaCO2

A

peripheral chemoreceptors in the carotid bodies and transverse aortic arch

24
Q

Conditions that shift the CO2 response curve down and to the right include

A

volatile anesthetics
opioids
NMBs
metabolic alkalosis
carotid endarterectomy

25
Q

Conditions that shift the CO2 response curve to the left include

A

hypoxemia
metabolic acidosis
surgical stimulation
intracranial hypertension

26
Q

The apneic threshold is

A

the highest PaCO2 at which a person will not breathe; once the PaCO2 exceeds the apneic threshold, the patient will begin to breathe

27
Q

The slope of the CO2 ventilatory response curve represents

A

the sensitivity of the entire respiratory apparatus to PaCO2

28
Q

Minute ventilation _____________ with PaCO2 in a __

A

increases; linear fashion when PaCO2 is between 20-80 mmHg

29
Q

CO2 is a respiratory depressant when PaCO2 exceeds

A

80-100 mmHg

30
Q

MAC of CO2 is

A

200 mmHg

31
Q

A left shift of the CO2 ventilatory response curve implies that the apneic threshold has

A

decreased

32
Q

A right shift of the CO2 ventilatory response curve implies that the apneic threshold has

A

increased

33
Q

What is the pacemaker for normal breathing?
a. pneumotaxic center
b. apneustic center
c. dorsal respiratory center
d. ventral respiratory center

A

c. dorsal respiratory center

34
Q

The respiratory center is located in the

A

reticular activating system in the medulla & the pons

35
Q

The respiratory center’s primary job is to

A

determine how fast and deep you breathe (this regulates PaCO2 & PaO2)

36
Q

The respiratory center receives afferent input from

A

the central and peripheral chemoreceptors as well as stretch receptors in the lungs

37
Q

The respiratory center integrates the incoming signals with its

A

intrinsic respiratory pattern and sends a coordinated response to the diaphragm, intercostals, & accessory muscles

38
Q

The ___________________ can modify the respiratory center responses.

A

cerebral cortex

39
Q

What are the medullary respiratory centers?

A

dorsal respiratory group
ventral respiratory group

40
Q

What are the pontine respiratory centers?

A

pneumotaxic center
apneustic center

41
Q

What does the dorsal respiratory group do?

A

active during inspiration

42
Q

What is the role of the ventral respiratory group?

A

active during expiration

43
Q

What is the role of the pneumotaxic center?

A

(upper pons): inhibits the DRG

44
Q

What is the role of the apneustic center?

A

(lower pons): stimulates the DRG

45
Q

The respiratory rate and pattern are determined by these 4 things:

A
  1. neural control in the respiratory center- medulla
  2. chemical control in the central chemoreceptors- medulla
  3. chemical control in the peripheral chemoreceptors- carotid bodies and aortic arch
  4. baroreceptors- lungs
46
Q

Newer evidence says that the respiratory pacemaker function is performed by

A

the central pattern generator which includes the DRG, pre-Botzinger complex (in the VRG), and other medullary structures

Apex Review (224 decks)

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