Section 5 Lecture 5 Flashcards Preview

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Flashcards in Section 5 Lecture 5 Deck (134):
1

True or False? f and tidal volume impact effectiveness of ventilation.

T

2

Boyle's Law:

P1V1 = P2V2

3

What is Dalton's Law?

Partial pressure in a gas mixture is the pressure that the gas would exert if it occupied the total volume.

4

Henry's Law:

concentration of a gas dissolved in a liquid is proportional to its partial pressure

5

What is the gas composition of air?

78% N2 and 21% O2

6

How to find the pressure of a gas:

Fraction of that gas X barometric pressure (check)

7

What is water pressure at sea level and saturation?

47

8

Gases in alveoli:

O2, N2, H2O, CO2, Argon

9

Ideal alveolar gas equation:

Pressure of oxygen in alveoli = (inspired pressure of oxygen - alveolar oxygen pressure) / Respiratory Quotient

10

Respiratory Quotient =

(R) (VCO2/VO2)

11

What does PACO2 have a huge impact on?

ventilation and brain blood flow

12

How are brain blood flow and CO2 levels affected by hyperventilation?

blood flow to brain decreases, hypocapnic

13

Will hypercapnia increase or decrease brain blood flow?

increase

14

What arterial pressure of CO2 will chemoreceptors sense?

above or below 40 mm Hg, tightly regulated value

15

High PACO2:

Resp acidosis

16

Respiratory alkylosis:

Low PACO2

17

This will lead to the exceeding of CO2 elimination need:

Hyperventilation

18

How does the PaCO2 vary between men and women?

it doesn't. EVERYONE has the same PaCO2

19

Will dead space ventilation be bigger or smaller with more frequent ventilation?

bigger

20

As frequency of ventilation increases the alveolar ventilation

decreases

21

Are muscles more or less efficient with high frequency?

less

22

High frequency ventilation increases alveolar ventilation, and increases the work and energy cost of breathing

F. decreases alveolar ventilation, all else is T

23

Amount of alveolar dead space in the average person:

0

24

If the tidal volume is double the frequency of breathing is:

halved

25

If the breathing rate is increase 3 fold how is the tidal volume affected?

decreases 3 fold

26

How are tidal volume and breathing frequency related?

inversely (check)

27

Which patient will have a larger dead space ventilation, a patient with a tidal volume of 1000ml or a patient with a tidal volume of 200ml?

tidal volume of 200. This patient will have 5 times more dead space (dead space ventilation is inversely proportional to tidal volume) (check)

28

Increasing Vdot CO2 leads to:

an increases in alveolar ventilation and, therefore, V dot E

29

Increases oxygen consumption leads to:

proportional increase in ventilation as a result of changes in both TV and frequency

30

What od increases in V dot CO2 require?

an increase in V dot A

31

V dot A =

V dot E - dead space V dot

32

Volume of gas must match

perfusion

33

What has a profound effect on gas distribution in the lung?

Gravity pulls lung down to the diaphram, distended downward, changes in pr caused bystrectch , air volume at base is much less than the gas levels at the base

34

What is distribution of gas in the lung dependent upon?

Gravity

35

Maximum translung pressure in cm H2O:

30ish cm H2O

36

Average tidal volume at rest:

500ml, 3-5 ml/kg

37

Another name for physiological dead space:

functional dead space

38

Is there more blood flow at the bottom or top of the lung?

bottom

39

VA/Q of lung:

0.8

40

Arteries in contact with the alveolar for gas exchange get what % of blood flow?

98% the other % is shunted

41

limitation to diffusion of perfusion or a shunt:

difference of ? can be much bigger

42

PO2 less than __ is considered arterial hypoxemia:

less than 80

43

Hypoxia:

PO2 less than 60

44

Hypercapnia:

PCO2 above 40 (due to ventilation, perfusion abnormality)

45

Where is the anatomical shunt?

pulmonary a to v

46

How does the anatomical shunt affect the inspired O2

not affected

47

what can cause low ventilation

lung not fully inflated

48

physiological shunt:

venous mixture low vet with normal blood flow caused by atelectasis

49

Arterial hypoxemia:

blood comes thru without coming in contact with the alveoli

50

Is mismatch greater for O2 or CO2?

O2

51

True or False? increase in ventilation can quickly fix the mismatch in ventilation perfusion.

F

52

Relationship between CO2 disoscion is:

linear (check)

53

Effect of changing cardiac output?

decreases O2 and increases CO2 and vice versa

54

Abdnormal PaCO2

if is outside the normal limits for gas exchanges ?

55

When is there no inequality in ventilation perfursion

eliminate gravity, lie down, go in space, water

56

increase exercise leads to:

increase VaQ (check)

57

complete physiological shunt:

all blood goes through, zero ventilation, no oxygen pickup

58

blocked blood flow

ventilation = 1, blood flow = 0

59

Venous O2 =

40

60

Venous CO2 =

46

61

Normal right to left anatomical shunt:

carotid and bronchial circulation

62

Abnormal right to left anatomical shunt:

atrial-septal defect

63

True or False? The blood that goes through the shunt participates in gas exchange.

F

64

How is pulmonary capillary different than systemic?

lower pressure

65

How are lung volume and blood pressure affected with left heart failure?

increases pulmonary pressure, lung volume increase, lungs blood pressure increases, increases capillary pressure

66

Increase in venous pressure and increase in arterial pressure

lots of filtration, lung will fill with fluids, can't exchange oxygen and patient dies. (changes in pulmonary edema)

67

loss of plasma proteins:

decreases oncotic pressure, starvation, increase permeability - fire-hot air, bacterial toxins - toxic shock syndrome

68

What would a pulmonary embolism lead to?

alveolar dead space

69

What can cause hypoxia?

decreased fraction of inspired oxygen (suffocation, high altitude), hyperventilation, decrease blood flow past alveoli, thickening of alveolar/capillary membrane, right to left shunt (without getting oxygenated)

70

Anatomic shunt:

atrial septal defect or ventricular septal defect

71

Physiological shunt:

ventilation to perfusion mismatch, (alveoli usually filled with pus or fluid)

72

Most common hypoxia:

V - Q mismatch (pulmonary edema or infection)

73

What makes up the physiological dead space?

Anatomical + Alveolar dead space

74

How much anatomical dead space does the average person have?

150ml

75

What % of the air in the normal person is wasted?

30%

76

What % of the total blood volumes is in the pulmonary circulation?

10% (50mL)

77

mL of blood in the alveolar-capillary network:

75mL

78

How much time is required for a passing red blood cell for full saturation?

1 sec

79

Surface area of the microcirculation:

70 m^2 (tennis court)

80

Bronchial circulation returns what % of cardiac output?

1%

81

Which can have less perfusion, lungs or muscles?

muscles

82

Why can perfusion to muscles be less than the lungs?

because of the lower resistance

83

How much less pulmonary vascular resistance is there than systemic?

10 times less

84

How much of a pressure drop is there with every 1 cm increase in height in pulmonary blood flow/

0.74 mHg or 5 cm

85

Is there more blood in apex or base of heart?

apex

86

True or False? If perfusion goes to apex, there will be no interface for exchange.

T

87

How will every 1 cm decrease in height effect pressure in the pulmonary system?

3.7 mm Hg muscles Waterfall effect

88

Describe hypoxic pulmonary vasoconstriction;

If there is a blockage of the lung (chocking) the alveoli will send a signal that there is not enough oxygen, leading to vasoconstriction of the arterioles. Blood will flow much more to the other side of the heart.

89

Is too much oxygen dangerous to the lungs?

yes

90

How is NO content altered with Increased airflow?

increases NO release

91

Why is NO released when there is higher blood flow

to lower resistane of arterioles

92

NO modifies the resistance to what?

higher flow rate of blood or gas, acts in both pulmonary and vascular systems

93

What neurotransmitter controls arterial vasoconstriction/

norepinephrine - alpha receptors

94

True or False? Ventilation and perfusion are distributed evenly throughout the lungs.

F

95

Pulmonary capillaries can can go from ___mL at rest up to _ mL.

75mL, 200mL

96

Functions of lung perfusion

reoxygenate blood and dispense CO2, fluid balance in lung, distribute metabolic products to and from the lungs

97

How do pulmonary arteries compare to systemic arteries?

less muscular and more compliant

98

What does the fact that the pulmonary arteries are less muscular and more compliant allow for?

lower resistance and pressure

99

Factors that affect blood flow (perfuson) through the lungs:

pulmonary vascular resistance, gravity, alveolar pressure, arterial to venous pressure gradient

100

Mean pressure of __ in the pulmonary arteries

14 mm Hg

101

True or False? systemic flow = pulmonary flow

T

102

Is there a lower pressure gradient in the pulmonary system or the arterial?

pulmonary

103

Is a left to right shunt favored or a right to left shunt?

left to right

104

Highest to lowest pressure above the heart: arterial, alveolar, venous?

alveolar, then arterial, then venous

105

Highest to lowest pressure at level of heart: arterial, alveolar, venous?

arterial, alveolar, venous

106

Highest to lowest pressure below heart: arterial, alveolar, venous?

arterial, venous, alveolar

107

Which portion of the lungs has the highest transmural pressure, the top, the middle, or the bottom?

bottom, distends vessels, high perfusion

108

Does the top or bottom of the lung have a higher volume?

bottom

109

Does the top or bottom of the lung have a higher V dot A?

bottom

110

Does the top or bottom of the lung have a higher Q dot?

bottom

111

Does the top or bottom of the lung have a higher V dot A/ Q dot?

top (apex)

112

Does the top or bottom of the lung have a higher PO2?

bottom

113

Does the top or bottom of the lung have a higher PCO2?

bottom

114

Does the top or bottom of the lung have a higher p H?

top

115

Does the top or bottom of the lung have a higher O2?

bottom

116

Does the top or bottom of the lung have a higher CO2?

bottom

117

How many times greater is the V dot A in the bottom of the lungs than the top?

3.4 times

118

How many times greater is the V dot A/ Q in the bottom of the lungs than the top?

18 times

119

Vol in apex is (greater than/less than) mid region.

less than

120

What decreases at a greater rate when going from the bottom of the lungs to the top, ventilation or perfusion?

perfusion

121

Shape of V dot A/ Q dot graph:

right half of a shallow "U"

122

poor VA/Q means what?

arterial hypoxemia

123

Total flow is __ and alveolar flow is __.

5, 4

124

Normal VA/Q:

0.8

125

When does the alveolar-arterial PO2 difference increase?

with age and in lung disease

126

What % of cardiac output is shunt?

2-3%

127

Which is higher, alveolar or arterial PO2?

alveolar

128

PO2 less than 80:

arterial hypoxemia

129

PO2 less than 60:

Hypoxia

130

PCO2 above 40:

Hypercapnia

131

PCO2 less than 35:

hypocpnia

132

How is inspired O2 affected with an anatomical shunt?

it's not

133

Is ventilation normal, high, or low with a physiological shunt?

low

134

is blood flow normal, high, or low with a physiological shunt?

normal