CVPR Week 5: Ventilation Flashcards

1
Q

Objectives

A
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2
Q

Question

A
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3
Q

How is ventilation determined?

A

tidal volume and frequency

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4
Q

What is dead space ventilation?

A

referred to as wasted ventilation because it doesn’t contribute to gas exchange

in the conducting zones

pharynx larynx, trachea, bronchi

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5
Q

Conduction zones of the airway

A
  • Pharynx
  • Larynx
  • Trachea
  • Bronchi
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6
Q

Respiratory zones of the airway

A
  • Terminal bronchioles
  • Alveolar ductts
  • Alveolar sacs
  • Alveoli
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7
Q

What is alveolar ventilation?

A

the fraction of tidal volume that participates in gas exchange not in the conduction zones

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8
Q

Breathing pattern can affect?

A

VD to VA ratio

dead space to the alveolar ratio

increase in frequency increases VD

increase in TV increases VA

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9
Q

Total Dead space AKA

A

Physiologic dead space

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10
Q

Total Dead space =

A

Anatomic dead space + Alveolar dead space

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11
Q

Physiologic dead space

A

anatomic dead space and alveolar dead space (where air fills the alveoli but there is no blood flow going there so ventilated but not perfused)

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12
Q

Partial pressure review

A
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13
Q

Bohr Equation

A

VD / VT = PaCO2 - PECO2

PaCO2

Where VD = dead space

VT = Tidal volume

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14
Q

How to calculate physiologic dead space

A
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15
Q

Alveolar ventilation equation

A
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16
Q

Question

A
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17
Q

Alveolar ventilation can be calculated from?

A

PCO2

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18
Q

Equations to know

A
  • Alveolar ventilation equation
  • Alveolar gas equation
  • Oxygen content equation
  • Henderson-Hasselbach equation
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19
Q

Interpretation of the alveolar ventilation equation

A

V of CO2 expired = VA x Fractional [CO2}

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20
Q

All the expired CO2 must come from?

A

must come from CO2 delivered to the alveoli from the blood

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21
Q

PACO2 (alveoli) in relation to PaCO2 (arteries)

A
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22
Q

What happens when VA does not match the metabolism (CO2 production)

A

Hypercapnia PaCO2> 45 mmHg Hypoventilating

Hypocapnia PaCO2< 35 mmHg Hyperventilating

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23
Q

Hypercapnia

A
24
Q

Hypocapnia

A
25
Q

Risks for hypercapnia

A
  • Chest wall compliance (obesity/kyphoscoliosis)
  • Sedatives
  • Nerve conduction blocks
  • muscle weakness (hypothyroid, myasthenia gravis)
26
Q

Risks for hypoventilating

A
  • Chest wall compliance (obesity/kyphoscoliosis)
  • Sedatives
  • Nerve conduction blocks
  • muscle weakness (hypothyroid, myasthenia gravis)
27
Q

Risks for Hypocapnia

A
  • Panic Attack
  • Hypoxia (high altitude)
  • overdose of aspirin or cocaine
  • pregnancy (progesterone)
  • compensation for metabolic acidosis
28
Q

Risks for hyperventilating

A
  • Panic Attack
  • Hypoxia (high altitude)
  • overdose of aspirin or cocaine
  • pregnancy (progesterone)
  • compensation for metabolic acidosis
29
Q

Question

A
30
Q

How gravity alters Ppl and the distribution of VA

A
31
Q

In normal breathing what region of the lung is better ventilated?

A

Alveoli in the lower region of the lung are better ventilated during normal breathing

32
Q

At FRC most of the air is in the?

A

upper lung (larger volume)

33
Q

At low lung volumes the upper lung contains

A

most of the residual volume (and most of the ERV)

34
Q

Where are most of the IRV and IC?

A

in the lower regions of the lung

35
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39
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40
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42
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43
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44
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45
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46
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48
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49
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50
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51
Q

Factors that increase alveolar dead space

3 listed

A
  • ↑ with low CO (hemorrhage)
  • ↑ with high alveolar pressure
  • ↑ pulmonary embolus
52
Q

If Ventilation is doubled what happens to PACO2

A

PACO2 is cut in half

53
Q

Muscles of inspiration

4 listed

A
  • Diaphragm
  • external intercostals
  • Scalene
  • Sternomastoids
54
Q

Muscles of forced expiration

2 listed

A
  • Rectus abdominus
  • Intercostal muscles
55
Q

Where lung and chest recoil forces are in equilibrium

A
  • functional reserve capacity
56
Q

What is the significance of having an FRC substantially greater than RV?

4 listed

A
  • prevents large swings in arterial blood gas
  • minimizes the work of breathing
  • prevents atelectasis (alveoli collapse)
  • lowers airway resistance