Block 1 Missed Concepts Flashcards
C3, 4, 5 ….
Keep the diaphragm alive- innervation by the phrenic nerve
For flow to occur….
There must be a pressure gradient
A normal RQ (respiratory quotient) is
0.8 (4L/min ventilation, 5L/min cardiac output perfusion)
Indications for Hyperbaric Oxygenation therapy
Diabetic, necrotizing wounds, CO poisoning, Cyanide poisoning
According to ficks law, what will decrease the diffusion of gas in the ACM
Decreased pressure gradient
Decreased surface area
Thickened ACM
Decreased diffusion coefficient
At rest, capillary blood is exposed to the alveoli for 0.75s
Equilibrium across the ACM…
Equilibration across the ACM typically takes 0.25s in healthy lungs
Calculate the alveolar gas equation (PAO2)
PAO2 = ((PB760 - PH2O47) x FIO2) - (PACO2/0.8)
PB ALWAYS IS 760
PH2O ALWAYS 47
Which of the following venous drainage systems contribute to the anatomic shunt?
Thebesian
Bronchial
Visceral pleural
Anterior cardiac vein
Surfactant function is to reduce surface tension ….
Stabilizing the alveoli so they don’t collapse
Describe the effects of stimulating the SNS, Alpha 1, Beta 1, Beta 2 receptors
Alpha 1- vasoconstriction
Beta 1 - increase heart rate and constriction
Beta 2- muscle relaxation, vasodilation, bronchodilator
If a medication is given to your patient and their HR, BP goes up and had an allergic reaction, they were given
Sympathomimetic or parasympatholytic
The primary functions of the nose are to
Heat, humidify, and filter
Discuss the difference between diffusion limitation and perfusion limitation
Perfusion limitation is limited by cardiac output, increase cardiac output, increase diffusion across ACM. Decrease cardiac output, decrease diffusion across ACM
Diffusion limitation is limited by the gas ability to move through. Increase cardiac output, thicker ACM. Decrease cardiac output, ACM thins out
When a mast cell degranulates, it releases…
SRS- A, chemotaxic signals, histamine, protease, leukotrienes, heparin, cytokines
Aspirations lead to foreign substances lodging in…
Trachea, right middle lobe, right lower lobe
The glottis separates…
Upper and lower airways
Type 2 alveolar cells..
Produce surfactant and serve as replacement for damaged type 1 cells
Set VT based on IBW
What is capillary shunt? What is Anatomic shunt?
Capillary shunt is the mixing of blood from non- ventilated areas of the lung with oxygenated blood.
Anatomic shunts introduce deoxygenated blood into the pulmonary veins
Differentiate between Cheyne-Stokes, Kussmaul’s, Biot’s and apnea
Biots: deep breath followed by apnea
Cheye-stokes: waxing and waning (deep and shallow breaths)
Kussmaul’s: deep rapid breathing at a consistent pace
Apnea: breathing is momentarily cut off
Calculate Cst
Calculate RCT
Differentiate between hypoventilation (high CO2), hyperventilation (low CO2), tachypnea (RR>20 b/min, adults), and bradypnea (RR<12 b/min)
Differentiate between deadspace ventilation and Shunt
Shunt: perfusion is greater than ventilation
Ex- consolidation; atelectasis, pulmonary edema
Deadspace: ventilation is greater than perfusion
Ex- disruption in blood flow; COPD, pulmonary embolism
Given gender, calculate IBW
To keep flow constant…
Pressure increases IF diameter decreases/length increases
If pressure is constant then FLOW will decrease
The patient with the highest RAW…
High RAW = low flow for same pressure gradient
Low RAW = high flow for same pressure gradient
Restrictive lung disease/ Obstructive lung disease association
Restrictive lung disease is associated with LOW Cst
Obstructive lung disease is associated with HIGH Raw
Calculate minute ventilation (VE)
Given the four lung volumes calculate the VC, IC, TLC, FRC
VC = IET
IC = IT
TLC = all
FRC = RE
What methods are used to measure FRC?
Helium dilution test
Nitrogen washout
Body plethysmography
MIPS and MEPS
MIP: spontaneous breathing
(-25) anything less negative is bad
Ex: -5,-10,-15
anything more negative is good
Ex: (-30,-35,-45
MEP: ability to have an effective cough
Ex: >60 is good ; <40 is bad
Indications for hyperbaric oxygen therapy
Wound healing, diabetics, necrotic tissue, cyanide poisoning, and CO poisoning
Differentiate between Normal, restrictive, obstructive PFT
FVC and FEV both greater than 80 is normal
FEV1/FC = below 70% is obstructive
FEV1/FC = above 70% is Restrictive
