Chapter 6 Flashcards

1
Q

How many Heme Sites Does Hemoglobin Have?

A

4

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2
Q

How many chains does Globin have that can undergo Mutations?

A
  • Two a Chains
  • Two b Chains
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3
Q

What is Ferrous Iron? What happens when it is Oxidized?

A

Ferrous Iron
- Found on Adult hemoglobin A
Oxidized
- Becomes Ferric Iron
- Release of Oxygen to tissue is impaired

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4
Q

What does Fetal Hemoglobin F have? What does it help with?

A

Has
- High Oxygen Affinity
Use
- Helps Fetus tolerate hypoxic environment in Utero

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5
Q

What does Dissolved Oxygen Obey?

A

Henry’s Law

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6
Q

What is Henry’s Law?

A
  • The amount of gas dissolved is proportional to the partial pressure
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7
Q

What is the ratio of O2 dissolved in 100ml of blood to PO2?

A

For each mmHg of PO2, 0.003ml O2 dissolved per 100ml of blood.

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8
Q

What is the normal arterial O2 Content?

A

0.3ml O2/100ml

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9
Q

What is the amount of dissolved O2 in Normal Arterial Blood with a Q= 50L/min?

A

0.3ml O2/100ml (normal Arterial Blood)
3ml/1L x 50L/min = 150ml/min O2

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10
Q

What is O2 Capacity?

A
  • The maximum amount of O2 that can be combined with Hb.
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11
Q

How much O2 can 1g of Hb combine with?

A

1.39ml O2

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12
Q

How much Hb does normal blood have?

A
  • 15g of Hb/ 100ml
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13
Q

What is the O2 Capacity of Blood?

A
  • 20.8ml O2/ 100ml blood
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14
Q

What is the equation for O2 Saturation of Hb?

A

O2 Saturation of Hb = ((O2-Hb) / O2 Capacity) x 100

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15
Q

What is the normal SaO2 of Arterial Blood?

A
  • 97.5%
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16
Q

What is the normal SaO2 of Venous Blood?

A
  • 75%
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17
Q

What is the Equation to find the O2 Concentration of Blood (ml O2 / 100ml Blood)?

A

(1.39 x Hb x Sat/100) + 0.003Po2

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18
Q

What are the 5 steps that the Oxygen Transport System Cycles Between?

A
  • Pulmonary Ventilation
  • Hemoglobin Concentration
  • Blood Volume and Cardiac Output
  • Peripheral Blood Flow
  • Aerobic Metabolism
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19
Q

What is the Equation for identifying VO2? (Oxygen Usage)

A

VO2 = Q x a-vO2 difference

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20
Q

What are the Useful Anchor Points of the Oxygen Dissociation Curve?

A
  1. PO2 40 has a SO2 of 75%
  2. PO2 100 has a SO2 of 97%
  3. P50 has a PO2 of 27 and SO2 of 50%
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21
Q

What causes the Oxygen Dissociation Curve to shift to the Right?

A
  • Increase in Temperature
  • Increase in PCO2
  • Increase in H+
  • Increase in 2,3 DPG
22
Q

What does a Right Shift in the Oxygen Dissociation Curve mean?

A
  • Lower Oxygen Affinity
  • Allows for more Oxygen to be delivered to the Tissue
23
Q

What does small additions of CO to blood do to the Oxygen Dissociation Curve?

A
  • Shifts it left (impairs offloading of oxygen)
24
Q

What are the three ways CO2 is transported in the Blood?

A
  • Bicarbonate
  • Carbamino
  • Dissolved
25
Q

What are the percentages of CO2 carried in Arterial Blood?

A
  • 90% in Bicarbonate (HCO3-)
  • 5% in Carbamino
  • 5% in Dissolved
26
Q

What are the percentages of CO2 carried in Mixed-Venous Blood?

A
  • 60% in Bicarbonate (HCO3-)
  • 30% in Carbamino
  • 10% is Dissolved
27
Q

What does the Bicarbonate Reaction depend on?

A
  • Carbonic Anhydrase in the Red Cell (an enzyme)
28
Q

What enhances the CO2 carriage in the form of Carbaminohemoglobin?

A
  • Deoxygenation of the blood
29
Q

How is the CO2 curve shaped in relation to the O2 Curve?

A
  • Steeper and more linear
30
Q

What shifts the CO2 dissociation curve to the right?

A
  • An increase in SO2 (Haldane Effect)
31
Q

What is the Haldane Effect?

A

Haldane Effect
- Deoxygenated Hemoglobin can carry more CO2

32
Q

How much more soluble is CO2 than O2?

A

20x

33
Q

What are the steps in CO2 being changed to Bicarbonate?

A

CO2 + H20 –(CA)– H2CO3 — H+ + HCO3-
1. Slow, in Plasma. Fast in Red Blood Cell because of Carbonic Anhydrase (CA) enzyme.
2. Dissociation of Carbonic Acid, Fast without enzyme

34
Q

What happens when Ions Rise within the RBC?

A
  • HCO3- diffuses out, but H+ cannot.
35
Q

How does the RBC maintain electrical Neutrality after CO2 converts to Bicarbonate?

A

– Cl- ions move into the cell from plasma to offset the H+ buildup
– Called the Chloride Shift

36
Q

How does the product of H+ from the CO2 to Bicarbonate reaction help with CO2 offloading?

A
  • H+ ions bind to hemoglobin and reduce it
  • Reduced hemoglobin contributes to the Haldane Effect, which helps with offloading of CO2
37
Q

What is the Reaction that causes CO2 to become part of a Carbamino Compound?

A

Hb.NH2 + CO2 — Hb.NH.COOH
- CO2 combines with a Terminal Amine Group of Blood PRotein

38
Q

Describe the Reaction of CO2 and a Terminal Amine Group of Blood Protein.

A
  • Product is a Carbamino Compound
  • Occurs rapidly without an enzyme
  • Reduced Hb can bind with more CO2 as Carbamino-hemoglobin than with HbO2
  • Unloading of O2 in peripheral capillaries facilitates the loading of CO2, whereas oxygenation has the opposite effect
39
Q

What are the 4 Causes of Primary Acid-Base Abnormalities?

A
  • Respiratory Acidosis
  • Respiratory Alkalosis
  • Metabolic Acidosis
  • Metabolic Alkalosis
40
Q

What are the Causes of Respiratory Acidosis?

A
  • Opiate Overdose
  • Severe Chronic Obstructive Pulmonary Disease
  • Neuromuscular Disease
  • Obesity Hypoventilation Syndrome
41
Q

What are the Causes of Respiratory Alkalosis?

A
  • Anxiety Attack
  • High Altitude
  • Hypoxemic Lung Disease
42
Q

Metabolic Acidosis

A
  • Lactic Acidosis
  • Diabetic, Starvation, or Alcoholic Ketoacidosis
  • Uremia
  • Renal Tubular Acidosis
  • Severe Diarrhea
43
Q

What are the Causes of Metabolic Alkalosis?

A
  • Vomiting
  • Loop Diuretics
  • Excess Alkali Ingestion
  • Hyperaldosteronism
44
Q

What is the Henderson-Hasselbatch Equation?

A

CO2 + H2O –(CA)– H2CO3 – H+ + HCO3-
- Ka = [H+][A-] / [HA]
- HA = molar concentration of weak acid
- A- = molar concentration of the acid’s conjugate base
- HA = H2CO3
- A-= HCO3-
- pH = pKa + log([HCO3-]/0.03PCO2)

45
Q

What are the physiological changes that cause Respiratory Acidosis?

A
  • Increase in PCO2, which reduces the HCO3-/PCO2 ratio
  • Depresses pH
  • Body Conserves HCO3- to help stabilize ratio
46
Q

What are the Physiological changes that cause Respiratory Alkalosis?

A
  • Decrease in PCO2
  • Increases HCO3-/PCO2 ratio
  • Elevates pH
  • Body Excretes HCO3- to stabilize ratio (pH)
47
Q

What are the physiological changes that result in Metabolic Acidosis?

A
  • Ratio of HCO3- to PCO2 falls
  • Depresses pH
  • Body increases VE to lower PCO2 and stabilize pH
48
Q

How does the body regulate Acid-Base ratio?

A
  • Chemical Buffers
  • Pulmonary Ventilation
  • Renal Function
49
Q

What are some Chemical Buffers used to regulate body pH?

A

H+ + Buffer — H-Buffer
- Bicarbonate Buffer
- Phosphate Buffer
- Protein Buffer

50
Q

How does the body regulate pH using Ventilation?

A

Ventilatory Buffer
- increase in ventilation reduces PACO2, which causes CO2 to be blown off, which will accelerate H+ + HCO3-

51
Q

How does the body use kidneys to regulate pH?

A
  • Excretion of H+ by kidneys