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gas exchange
RPM I
33
Medical
Graduate
05/07/2010

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Cards

Term
where is there more pressure in the lungs?
Definition
at the bottom - which is why pts with CHF need to sit up right
Term
what does surfactant do overall in the lungs?
Definition
surfactant (produced by alveolar type II cells) makes the lungs more compliant by breaking surface tension. this ultimately requires the body to do do less work
Term
how is intra-alveolar pressure decreased? what does this do?
Definition
the diaphragm goes down as the chest wall expands which creates a gradient between the outside and inside of the body - this decreases the intra-alveolar pressure and allows gas exchange to happen
Term
how can bacteria increase physiologic dead space in the lung?
Definition
WBCs release lysozymes, decrease surfactant, and the bacteria multiply - creating septicemia and pneumoniA
Term
what cells have the mucus elevators that can be harmed by smoking?
Definition
the pseudostratified columnar cells
Term
can Acute Respiratory Distress Syndrome (ARDS) be treated with surfactant?
Definition
yes - but pneumothorax may happen
Term
what happens on the CXR as alveoli collapse?
Definition
lightening of particular zones in the lungs looks like a “honeycomb”
Term
what is vital capacity?
Definition
the max amount of air you can inspire and then expire (maximum volume of air that can be voluntarily moved in and out of the respiratory system)
Term
what is tidal volume?
Definition
the amount of air normally breathed in and out of the lungs
Term
what is residual volume?
Definition
the amount of air left in the lungs after max exhalation - that which keeps the lungs from collapsing
Term
what is expiratory reserve volume?
Definition
the amount of air that can be forced out the lungs after normal expiration
Term
what is inspiratory reserve volume?
Definition
the additional amount of air that can be inhaled after normal inspiration
Term
what is the functional reserve capactity?
Definition
the amount of air in the lungs after normal tidal expiration
Term
what is inspiratory capacity?
Definition
the maximal amount of air that can be inspired after a normal tidal expiration
Term
what is the anatomical dead space?
Definition
the volume of the conducting pathways
Term
what is the physiologic dead space?
Definition
anatomic dead space plus the alveolar dead space
Term
what is the composition of air?
Definition
nitrogen: 78%, O2: 21%, and other: 1%
Term
how much O2 is exhaled into a pt in CPR?
Definition
~16%, still about 4x what a pt needs
Term
why does blood turn blue when it is deoxygenated? what can be used to monitor this?
Definition
b/c of O2 isn't getting to Hb, then it isn't absorbing light. pulse ox is used to monitor blood cyanosis
Term
what is the characteristic shape of the Hb saturation curve?
Definition
sigmoid - you want pts on the ~ 90% saturation, ascending/loading part of the curve
Term
what is normal body pH? what happens to the Hb saturation curve if you drop it?
Definition
dropping pH will lower the Hb saturation curve (to around 70%), b/c in the presence of acid, Hb will unload O2 (makes sense b/c periphery has more acid - lactic acid and Hb usually unloads O2 there). (shifts curve to the R)
Term
how does pH being higher affect Hb?
Definition
the higher the pH, the more tightly Hb holds onto O2 (shifts curve to the L)
Term
how does temperature affect Hb?
Definition
the colder the temp, the tighter Hb will hold onto O2. the warmer the temp, the easier Hb lets go of O2.
Term
how do fetal and adult Hb compare in terms of O2 affinity?
Definition
fetal Hb has a higher O2 affinity (so they can get it easier from mom)
Term
what is 2,3 DPG?
Definition
2,3 diphosphoglycerate is released during anaerobic glycolysis and helps to unload oxygen at the tissues by decreasing Hb's O2 affinity. this is helpful in anemic or ischemic situations
Term
what do pulmonary function tests assess?
Definition
how fast the breathing rate is, inspiratory reserve, expiratory reserve, vital capacity
Term
what is the area inside the pressure volume loop called?
Definition
the work of breathing
Term
how much O2 do you get per gm Hb?
Definition
1.34 mL
Term
can the food you eat affect your carbon levels, pH, and thus the ability of Hb to bind O2?
Definition
yes
Term
what is the alveolar gas equation?
Definition
PA O2 = (.21)(760-47) - PaCO2/R. where .21=21% O2 in inhaled air, (760-47 torr) is the atmospheric pressure - saturated vapour pressure of water at body temperature. PaCO2: arterial partial pressure of carbon dioxide (normal is 40). R:the carbon dioxide load from the alveolus
Term
what is the partial pressure of O2?
Definition
the pressure which the oxygen would have if it alone occupied the volume
Term
what is the henderson-hasselbach equation?
Definition
pH = pK + base/acid OR pH = pK + base/PaCO2
Term
what will slowing breathing down cause?
Definition
respiratory acidosis
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