Ch.1 Oxygenation Physiology

Question 1

Cellular aerobic metabolism is depended on adequate O2 delivery. What three abilities and mechanisms?

Answer 1

Move O2 (cardiac output), carry O2 (hemoglobin), and ability to extract O2 and deliver it to cells

Question 2

Aerobic metabolism utilize what three processes?

Answer 2

glycolysis, Krebs cycle, electron transport chain

Question 3

Anaerobic metabolism utilize what three processes?

Answer 3

glycolysis, pyruvic acid, lactic acid

Question 4

PO2

Answer 4

partial pressure of O2 in the environment

Question 5

PAO2

Answer 5

partial pressure of O2 in the alveoli

Question 6

PaO2

Answer 6

partial pressure of O2 in the blood

Question 7

what are the four types of hypoxia

Answer 7

hypoxic, hypemic, histotoxic, stagnant

Question 8

hypoxic hypoxia

Answer 8

deficiency of O2 exchange in the alveoli

Question 9

hypemic hypoxia

Answer 9

hemorrhage, anemia, and certain drugs causes reduction in blood’s O2 carrying capacity

Question 10

histotoxic hypoxia

Answer 10

cyanide, ETOH, and carbon monoxide poisoning cause poisoning or metabolic D/O

Question 11

stagnant hypoxia

Answer 11

caused by reduced cardiac output or pooling of blood like heart failure, PE, or shock states

Question 12

Hyperlactatemia Classification. 3.

Answer 12

asymptomatic (less than or equal to 2.5 with no symptoms [pH is normal])
symptomatic (lactate > 2.5, with symptoms associated with an anaerobic state [pH is normal])
lactic acidosis (lactate >5 with pH <7.35 and patient symptoms)

Question 13

alveolar hypoventilation

Answer 13

PaCO2 >45 mmHg

Question 14

alveolar hyperventilation

Answer 14

PaCO2 <45mmHg

Question 15

the body’s regulation and maintenance of CO2 could also be summed up as

Answer 15

ventilation

Question 16

Oxyhemoglobin Dissociation Curve (normal curve)

Answer 16

Hgb has a high affinity but will not remain attached because homeostasis guarantees resupply of O2 due to proper perfusion standards

Question 17

left shift

Answer 17

high affinity and poor drop off; a left shift is bad for the patient; O2 release, acid, temperature, 2,3-DPG, PaO2 are all low

Question 18

right shift

Answer 18

decreased affinity and no attachment; O2 unloading, acid, temperature, 2,3-DPG, PaO2 are all raised

Question 19

a right shift in the Oxyhemoglobin Dissociation Curve depends on these three states

Answer 19

1) perfusion 2) tissue diffusion potential, and 3) overall shock states

Question 20

Haldane Effect

Answer 20

oxygen concentration determine Hgb’s affinity for CO2

Question 21

Bohr Effect

Answer 21

Co2 and H+ affect the Hgb’s affinity for O2

Question 22

ABG trends show high PaO2, what kind of a shift is it and what can we expect of the patient’s condition?

Answer 22

Right shift. This isn’t normal but it’s okay for the patient.

Question 23

ABG trends show low PaO2, what kind of a shift is it and what can we expect of the patient’s condition?

Answer 23

Left shift. Patient is in a fragile state.

Question 24

Vital Capacity

Answer 24

Tv+ERV+IRV

Question 25

Residual Volume

Answer 25

the amount of air left in the respiratory tract following forceful exhalation

Question 26

Total Lung Capacity (TLC)

Answer 26

VC+RV

Question 27

dead space

Answer 27

the surfaces of the airway that are not involved in gaseous exchange, ie not alveoli. approx. 2mL/kg

Question 28

Central Chemoreceptors

Answer 28

located in the medulla/pons

driven by CO2 and H+

Question 29

Peripheral Chemoreceptors

Answer 29

located in the aortic arch/carotid bodies

driven by O2, CO2, H+

Question 30

Fick Formula

Answer 30

used to calculate how much O2 a person is using

Question 31

apneustic respiratory pattern

Answer 31

deep, gasping inspiration with a pause at full inspiration followed by brief, insufficient release

seen in decerebrate posturing

Question 32

ataxic respiratory pattern

Answer 32

complete irregularity of breathing, with irregular pauses and increasing periods of apnea

seen in damage to medulla secondary to trauma or stroke

Question 33

Biots

Answer 33

groups of quick, shallow inspirations followed by regular or irregular periods of apnea

damage to the medulla by stroke or trauma, or pressure on the medulla secondary to brainstem herniation

Question 34

Cheyne-Stokes

Answer 34

progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in temporary apnea

associated with decorticate posturing, Cushings Triad, brainstem herniation

Question 35

Kussmaul’s respiratory pattern

Answer 35

gradually become deeper, labored, and gasping

Question 36

high pressure ventilator alarms

Answer 36

kinked line, coughing, secretions or mucus, biting of the tube, reduced lung compliance ie pneumothorax, ARDS, increased airway resistence

Question 37

low pressure ventilator alarms

Answer 37

chest tube leaks, circuit leaks, airway leaks, hypovolemia, patient disconnection from machine

Question 38

DOPE

Answer 38

displaced
obstruction
pneumothorax
equipment