CABS/ Clin Med: Regulation of respiration, respiratory drive/ PFT and ABG Flashcards

1
Q

pH is determined by

A

H+ concentration

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2
Q

Increased H+ =

A

acidosis

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3
Q

Decreased H+ =

A

alkalosis

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4
Q

pH = _____ / _____

A

HCO3- / pCO2

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5
Q

What is the bloods pH

A

7.35 - 7.45

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6
Q

pH of blood is determined/ balanced by

A

CO2 and HCO3- concentrations

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7
Q

Henderson Hasleback equation

A

CO2 + H2O – H2CO3 – HCO3- + H+

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8
Q

Typical PaCO2 =

A

40 mmHg

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9
Q

Carbonic Acid is the combination of

A

CO2 and H2O

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10
Q

Carbonic acid is a weak acid that readily

A

dissociates

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11
Q

Bicarbonate is controlled by what organ

A

kidney

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12
Q

Normal bicarb level =

A

24-26 mEq/L

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13
Q

Low O2 =

A

hypoxia

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14
Q

Insufficient O2 dissolved into plasma =

A

hypoxemia

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15
Q

What two molecules are needed to survive

A

O2 and glucose

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16
Q

Voluntary breathing =

A

talking, singing, laughing, breath holding, etc

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17
Q

involuntary breathing =

A

CO2
H+
H2CO3 = carbonic acid
HCO3- = bicard
pO2 = partial pressure O2

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18
Q

Chemoreceptors are

A

sensory cells that will trigger response based on chemical activation
centrally located in the medulla

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19
Q

CO2 increases =

A

hypercapnia (pH becomes more acidic)

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20
Q

CO2 drops =

A

hypocapnia (pH more alkalotic)

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21
Q

Hypercapnia stimulates

A

respiration

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22
Q

Hypocapnia inhibits

A

respiration

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23
Q

As CO2 increased pH will

A

decrease

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24
Q

When pH is decreased due to increased CO2 this will stimulate respiratory centers to

A

stimulate and blow off CO2 to return pH to normal

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25
Q

When the pH is increased due to low CO2 the respiratory centers are

A

inhibited and will cause H+ to accumulate and pH to drop back to normal levels

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26
Q

Chemoreceptors can be disrupted in pts with

A

chronic hypoxia

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27
Q

Pneumotaxic center is found in the

A

pons

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28
Q

Pneumotaxic center modifies

A

breathing rhythm that is set forth by the dorsal and ventral respiratory groups

helps with inspiration/ expiration transition

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29
Q

Pneumotaxic center receives input from

A

peripheral receptors

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30
Q

Apneustic center modifies

A

breathing rhythm that is set forth by the dorsal and ventral respiratory groups

primarily involved in inspiration

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31
Q

Apneustic center receives input from

A

stretch receptors

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32
Q

Apneustic center is found within the

A

pons

33
Q

Dorsal respiratory group primary control of

A

respiratory drive

34
Q

Dorsal respiratory group signals

A

the calm breathing muscles (diaphragm and external intercostals) to begin inspiration

35
Q

Typical driver; that influences respiratory rate =

A

CO2

36
Q

Ventral respiratory group is activated

A

during times of increased effort

37
Q

Ventral respiratory group controls

A

the rhythm of breathing
assists with both inspiration and expiration

38
Q

DRG stimulates VRG to increase

A

frequency of ventilation

39
Q

Phrenic nerve is at what level in the spine

A

C3-C5

40
Q

intercostal nerves are at what level in the spine

A

T1-T11

41
Q

Baroreceptor will note increased ___ and cause vagal stimulation to _____

A

BP
decrease

42
Q

Chemoreceptors will detect change in

A

CO2 (and O2, if low) and pH

43
Q

Carotid chemoreceptors will send respiratory stimuli to _____ via ______

A

medulla
glossopharyngeal

44
Q

Aortic chemoreceptors will send respiratory stimuli to ____ via ____

A

medulla
vagus

45
Q

Lung receptors will all send afferent stimuli to the ______ of the medulla

A

DRG
dorsal respiratory group

46
Q

Irritant receptors react to

A

noxious stimuli and trigger cough reflex

47
Q

Irritant receptors are located on

A

the conducting airway epithelium

48
Q

Stretch receptors assist

A

with ventilatory rate/volume as the smooth muscles sense/ react to over inflation and deflation

(will stopped continued inhalation to prevent barotrauma)

49
Q

Stretch receptors are located

A

within the pleura and bronchioles

50
Q

Herring Breuer reflex is

A

stimulation of stretch receptors activate vagus –> inhibition of the DRG, VRG –> stop inspiration and trigger expiration

51
Q

J-receptors sense

A

pulmonary capillary pressure

52
Q

J-receptors react to

A

pulmonary edema, shallow/rapid breathing

53
Q

Lung innervation: Parasympathetic causes

A

constriction of the airways

54
Q

Lung innervation: Sympathetic causes

A

relaxation of the airways

55
Q

FiO2 is

A

the setting on ventilators - how much O2 we are breathing in

56
Q

PaO2 =

A

partial pressure of O2 (pressure exerted by a gas within the confined container)

57
Q

Pressure in the pulmonary artery

A

40 mmHg

58
Q

Pressure in the pulmonary vein

A

100 mmHg

59
Q

Each hemoglobin can carry ___ O2 molecules

A

4

60
Q

Oxyhemoglobin will change the form of ______ to open the overall configuration

A

hemoglobin

61
Q

Left shift is called

A

Haldane effect

62
Q

Right shift is called

A

Bohr effect

63
Q

During a left shift the affinity for O2 will

A

increase

64
Q

During a right shift the affinity for O2 will

A

decrease

65
Q

ABG are

A

arterial blood gas

66
Q

ABG is gold standard test for evaluating

A

Acid-base balance
oxygenation
ventilation

67
Q

ABG indications

A

critically ill pts, respiratory conditions, metabolic disorders

68
Q

ABGs need to be done _____

A

ASAP
sensitive to temp and time (must place on ice after draw)

69
Q

ABG alternative

A

VBG (venous blood gas)

70
Q

Thing you can’t get from a VBG that you can from a ABG

A

O2 level

71
Q

pH abnormalities on cardio system:
Acidosis can lead to

A

hyperkalemia
decreased CO
vasodilation - hypotension

72
Q

pH abnormalities on cardio system:
Alkalosis can lead to

A

ventricular tachyarrhythmias
SVT
hypokalemia

73
Q

pH on pulm system:
acidosis can lead to

A

tachypnea
drop CO2

74
Q

pH on pulm system:
alkalosis can lead to

A

low resp rate

75
Q

Metabolic acidosis means we are losing too much

A

bicarb

76
Q

Resp acidosis means we are retaining too much

A

CO2

77
Q

Resp alkalosis means we are losing too much

A

CO2

78
Q

Metabolic alkalosis means we are retaining too much

A

Bicarb

79
Q

The ROME criteria means

A

respiratory are opposite
metabolic is equivalent