Acid Base disorders Flashcards
How many lobes does the right lung have?
3
The left lung has ____lobes
2
The _______ and ______ are the major muscles of inspiration
diaphragm and external intercostals
What is perfusion?
Blood flow second to ventilation, distribution of blood flow at the alveolar level to allow exchange
of O2 and CO2
What is diffusion?
ventilation, moving air into the lungs and distributing air within the lungs to gas exchange units (alveoli) for maintaining of O2 and removal of CO2
The _______ and ______ are the accessary muscles of inspiration
sternocleidomastoid and scalene muscles
What are the accessary muscles of expiration?
abdominal and internal intercostal muscles
What is Total lung capacity?
how much air you can inhale in maximum inspiration effort
What is vital capacity?
amount of air that can be expelled in resting state (exhale)
What is functional residual capacity/ volume?
after exhalation, how much air left in alveoli to keep them open
What is inspiratory capacity?
volume of gas that can be taken in in a full inhale
What are the neurological controls of ventilation?
respiratory center (medulla-primary and pons-secondary)
What are the chemical controls of ventilation?
pH, O2, CO2
What are the mechanical controls of ventilation?
stretch receptors in bronchi, irritant receptors throughout the epithelium, temperature
What is the V/Q ratio?
Ventilation/ Perfusion ratio, matching adequate volume of air in alveoli to adequate pulmonary blood flow
What would a V/Q of 80% mean?
normal/ideal: 4L/ minute of alveoli ventilation to 5L/ min of capillary blood flow in the lungs
What effet does standing have on the V/Q ratio?
increases V and thus increases V/Q
What effet does lying down have on the V/Q ratio?
increases perfusion and this decreases V/Q ratio
What might cause a low V/Q?
Chronic bronchitis, low V
What might cause a very low V/Q?
a shunt or hole in the heart that is bypassing ventilation
What might cause a high V/Q?
Low perfusion, COPD
What might cause shifting in oxyhemoglobin dissociation curve?
CADET: CO2 changes, Acidosis Condition, DPG- measure of eurthrocytes, Exercise, Temperature
Would you rather see a left or right side shift in the oxyhemoglobin dissociation curve? Why?
Right, if there is a left shift it means that Hg has a high affinity to O2 and is reluctant to let it go to the tissues
What is resperatory insufficiency?
gas exchange maintained at an acceptable level with increased work from the cardiopulmonary system.
What might cause resperatory insufficiency?
emphasema, asthma flare up, COPD at terminal stage
What might cause respiratory failure?
COPD with severe pneumonia
What could the etiology of a decreased CNS drive to breath be?
narcotics, head/neck trauma, sleep apnea
What could the etiology of impaired ventilation d/t obstruction be?
bronchial edema, obstructed airway, pneumothorax, popped lung
What could casue impaired ventilation/perfusion?
COPD, restricted lung disease, atelectasis, pneumonias, pulmonary edema, anemias
What is the difference between hypoxia and hypoxemia?
Hypoxia-lack of O2 hypoxemia- result of severe low O2 , no blood perfussion, at rist for tissue necrosis
What is hypoxemia a direct consequence of?
respiratory failure
How does hypoxemia effect the CNS?
restlessness, agitation, incordination, coma and death
What are the clinical presentations of respiratory distress?
tachycardia, coolness, diaphoresis, pallor-cyanosis, initial increases in BP, HR, failed hypotension, bradycardia
What is hypercapnea?
increased level of CO2 in blood, direct vasodilator (cerebral vessels leading to headache, flushed skin, conjunctiva- hyperemia)
How does the neumonic ROME help us to understand acid base balance?
Respiratory Opposite Metebolic Equal CO2 increases and pH is low then it is respiratory acidosis (opposite) HCO3 is high and pH is high then it is metabolic alkalosis (they go in the same direction)
What is the normal value for pH?
7.35-7.45