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Pulm-ICM
Pulmonary Pathophysiology
21
Medical
Graduate
10/09/2010

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Cards

Term
Calculating the PIO2
Typically
Definition
(Atmospheric-47)*(O2%)
150
Term
Calculating O2 concentration in the Body
Definition
1.36(Hb content)(Saturation)+0.003(PA02)
Term
Calculating PACO2
Definition
0.863(CO2 Minute Ventilation)/(Alveolar Minute Ventilation)
Term
Causes of CO2 Retention
Definition
V/Q Mismatch, Hypoventilation
Term
Mechanisms of V/Q mismatch causing CO2 rentention
Definition
Low ventilation areas produce more CO2 than can be cleared by the high ventilation areas.
Low perfusion areas carry less CO2 than can be cleared, where high perfusion areas carry more CO2 that can not be cleared.
Term
Causes of Hypoxemia
Which have a higher A-a Gradient
Definition
High Altitude, Hypoventilation
High A-a: V/Q Mismatch, R->L Shunt, Diffusion Limitation
Term
Causes of Hypoventilation
Definition
Impaired Drive, NMJ/Neurological Lesion, Respiratory Muscle Lesion
Term
Mecahnisms of V/Q Mismatch causing Hypoxemia
Definition
High V/Q areas provide small amounts of well oxygenated blood, Low V/Q areas provide large amounts of poorly oxygenated blood.
High V/Q regions cannot overcome the deficit bc O2 Saturation is limited
Term
Diagnostic testing for a Diffusion Limitation
Definition
Diffusion capacity of CO in one breath.
CO has high affinity for hemoglobin
Term
Working Up a Hypoxemic Patient
Definition
Blood Gas -> A-a Gradient
If normal -> Neuromuscular workup
Abnormal -> O2 Response, Spirometry, CXR, Shunt
Term
Muscles of Inspiration and Expiration
Definition
Inspiration: Diaphragm, External Intercostals, Scalenes, Sternocleidomastiod, Strap,
Expiration: Abs and Internal Intercostals
Term
What Volumes of the lung cannot be calculated by spirometry
Definition
RV, FRC, TLC
Term
Positive test in the Bronchodialator Response
Definition
12% increase in FEV-1 w 200cc overall
12% increase in FRC w 200cc overall
30% increase in FEF 25-75
Term
Methods of Diagnosing Asthma
Definition
Methacholine Challenge: <20% decrease at 16mg/ml is non-disagnostic
Cold-Air: >20% in FEV-1
Exercise Challenge: 20% in FEV-1 5-20 min post-exercise
Term
How do you measure FRC
Definition
Body box
He Inhalation
Term
What does a <70% FEV-1 Indicate
Definition
Obstructive Lung Disease
Term
What does a TLC <80% indicate
Definition
Restrictive Lung Disease
Term
How do obstrucuive and Restrictive lung diseases differ in Compliance and Elastic Recoil
Definition

Restrictive: Low Compliance, High Elastic

Obstructive: High Compliance, Low Elastic

Term
At what lung volumes is the lung most compliant
Definition
Mid Range- Resting breathing levels
Term
Diagnosis of hypoventilation
Definition
Hypercapnia with Normal A-a gradient
Term
What factors determine your alveolar Co2 pressure
Definition

Amount producced by the body

The respiration rate

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