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Critical Care > Cardiorespiratory Physiology > Flashcards

Cardiorespiratory Physiology Flashcards

1
Q

Tidal volume

1) Definition
2) Normal value

A

1) volume of normal inspiration and expiration
2) 7ml/kg

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2
Q

Minute ventilation

1) Definition
2) Normal value

A

1) volume of air inspired in 1 minute
2) Tidal volume x RR

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3
Q

Physiological dead space

1) Definition
2) Normal value

A

1) Total volume of gas not involved in gas exchange
2) Anatomical dead space + alveolar dead space

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4
Q

Anatomical dead space

1) Definition
2) Normal value

A

1) Volume of conducting airways not involved in gast exchange
2) 150ml

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5
Q

Lung compliance

A

Unit change in lung volume per unit change in pressure

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6
Q

Factors that lead to increase lung compliance

A

Emphysema

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7
Q

Factors leading to decrease lung compliance

A

Age
Supine
Increase ACS
Restrictive lung disease
Hydro/pneumothorax

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8
Q

Central chemoreceptors

1) location
2) mechanism

A

1) ventral surface of medulla
2) increase PaCO2 -> decrease pH of CSF -> increase ventilation

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9
Q

Peripheral chemoreceptors

1) location
2) mechanism

A

1) carotid body
2) stimulated to increaes ventilation when decrease PaO2/pH/increase PacO2

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10
Q

Oxygen Hb dissociation curve

1) x-axis
2) y-axis
3) Shape and why

A

1) Oxygen tension (PO2, mmHg)
2) Oxyhemoglobin (% saturation)
3) sigmoid, positive cooperativity of Hb

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11
Q

What shifts oxygen Hb dissociation curve to left?

A

increase pH
decrease temp
decrease DPG

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12
Q

What shifts oxygen Hb dissociation curve to the right?

A

decrease pH
increase temp
increase DPG

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13
Q

In pulse oximetry, absorption wavelength of

1) deoxyHb
2) oxyHb

A

1) 660nm
2) 940nm

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14
Q

Beer’s law

A

the concentration of a given solute in a solvent is determined by the amount of light that is absorbed by the solute at a specific wavelength

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15
Q

Lambert’s law

A

equal parts in the same absorbing medium absorb equal fractions of the light that enters them.

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16
Q

How is oxygen saturation calculated via pulse oximetry

A

Ratio of max/min absorption of infrared and red light

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17
Q

False readings

A

bilirubin (low)
carboxyHb (high)
MetHb (static 85%)
Nail varnish
Flickering light
Diathermy
Patient movement

18
Q

Name the phases of the cardiac cycle

A
  • Phase 1: Isovolumetric relaxation
  • Phase 2: Inflow
  • Phase 3: Isovolumetric contraction
  • Phase 4: Ejection
19
Q

Equation for Cardiac Output

A

CO = Stroke Volume x Heart Rate

20
Q

Starling’s Law

A

Force of contraction is proportional to initial length of muscle fibers

21
Q

What factors does stroke volume depend on?

A
  • Preload
  • Afterload
  • Contractility
22
Q

What is cardiac index?

A

Cardiac Output / Body surface area

2.2-2.5 L/min/m2

23
Q

Describe the important features of arterial waveform

A
  • Anacrotic and dicrotic limb
  • Systolic uptake
  • Peak systolic pressure
  • Dicrotic notch
  • Pulse pressure
  • MAP (area under curve)
24
Q

Draw the arterial waveform

A
25
Q

How is arterial pressure different from the aortic root?

A

SBP is 10mmHg higher

DBP is 10mmHg lower

MAP is 5 mmHg lower

26
Q

Pulsus paradoxus

A

exaggerated (>10 mmHg) reduction of the arterial pressure brought on by inspiration, and may be seen in cardiac tamponade

27
Q

Pulsus alternans

A

random variation in the amplitude of the arterial pressure tracing with each cardiac cycle, and is seen with left ventricular failure / congestive heart failure

28
Q

Draw the CVP waveform

A
29
Q

Explain the components of the CVP waveform

A
  • a : atrial contraction
  • c: upward movement of tricuspid valve in isovolumetric contraction
  • x: atrial relaxation and downward movement of tricuspid
  • v: venous return filling atrium
  • y: ventricular filling in early diastole
30
Q

Causes of widening pulse pressure

A

Aortic regurgitation

31
Q

Causes of narrowing pulse pressure

A
  • Low output states:
    • Cardiac tamponade
    • Massive PE
    • Severe cardiogenic shock
    • Tension pneumothorax
32
Q

Kussmaul sign

A

Paradoxical rise in JVP during inspiration, indicates right heart failure or constrictive pericarditis

33
Q

Fick’s principle

A

Total uptake or release of any substance by an organ is the product of blood flow to the organ and the arteriovenous concentration difference of that substance (aka. oxygen used =oxygen in - oxygen out)

Used to measure cardiac output

34
Q

Equation for cardiac output based on Fick’s principle

A

CO = Oxygen consumption / ([O2]pulmonary vein - [O2] pulmonary artery)

35
Q

Types of BP monitoring

A
  • Non-invasive
    • Sphygmomanometer
  • Invasive
    • A-line
36
Q

Types of cardiac output monitoring

A
  • Non-invasive
    • LidCo
    • PiCCo
    • Thoracic impedance techniques
    • Echocardiography
  • Invasive
    • Swan-Ganz catheter
    • Transesophageal echocardiography
37
Q

Types of narrow complex tachcyardia

A
  • Regular
    • Sinus tachycardia
    • pSVT
  • Irregular
    • Atrial fibrillation
    • Atrial flutter
38
Q

Types of broad complex tachycardia

A
  • Ventricular tachycardia
  • Ventricular fibrillation
  • SVT with abberant conduction
  • PVC
39
Q

Management of SVT

A
  • ABC
  • Vagal maneuver, if. fail
  • Push IV 10mg ATP, if fail
  • Push IV 20mg ATP
  • Check BP, if normal
    • IV Verapamil 5-10mg over 2 min
  • If BP low or adverse signs (chest pain, HF, altered mental status)
    • Synchronized DC cardioversion (start at 50 J, with 50J increments)
40
Q

Management of bradycardia

A
  • ABC
  • Secure airway, IV lines
  • Give O2
  • Close monitoring
  • ECG
  • Portal CXR
  • Bloods x electrolytes
  • If stable: atropine 0.5-1mg + transcutaneous pacing
  • If unstable: Transcutaneous pacing
41
Q

Types of bradycardia

A
  • Sinus
    • Sinus bradycardia
    • Sinoatrial block
    • Sinus arrest
  • AV block
    • 1st degree: prolonged PR
    • 2nd
      • type 1: gradual failure
      • type 2: intermittent failure
    • 3rd: complete heart block

Critical Care (12 decks)

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