Determinants and Assessment of Pulmonary Function Flashcards
What does the surfactant layer consist of and what does it do?
Type 2 cells secrete surfactant which is a lipoprotein that lines the inner wall of alveoli, reducing surface tension to precent alveolar collapse. SURFACTANT KEEPS ALVEOLI OPEN
What is anaerobic metabolism?
The making of energy (glucose) in an environment absent of O2
What happens to our muscles when anaerobic metabolism occurs?
Our muscles get sore because there is not enough air which leads to lactic acid build up
Define Ventillation
It is the actual work of breathing and movement of air from outside to inside the lung tissues. (the amount go gas reaching alveoli)
Define Diffusion
Exchange of gases at the alveolar membrane
Define Perfusion
Pumping of blood to organs and tissues, systemic and pulmonary systems. (the blood flow in pulmonary capillaries)
What are the 3 determinants of O2 status?
PaO2, SaO2, Hemoglobin
What is PAO2
partial pressure of oxygen in alveoli
normal range 100-105 mmHg
What is PaO2
partial pressure of O2 dissolved in arterial blood
normal range 75-100 mmHg
What is PvO2
partial pressure of O2 dissolved in venous blood
normal range 40 mmHg
What is tidal volume
amount of air that moves in and out of lungs with each normal breath
What is vital capacity
maximum amount of air expired after a maximal inspiration
What is SaO2
O2 saturation; the measure of the % of O2 combined with hemoglobin
Why is SaO2 important
degree of saturation is important in determining amount of O2 available for delivery to tissues
What is hemoglobin
major carrier of O2 in blood and an important factor in tissue oxygenation - composed of protein and heme and a major component of RBC
What is the normal range for hemoglobin?
females 12-15 g/dL
males 13.5-17 g/dL
What does abnormally low hemoglobin indicate?
that tissue perfusion is also low
In the oxyhemoglobin dissociation curve what is a left shift?
- alkalosis; increase pH, decrease PaCO2 (hypocapnia)
- increased affinity to hmg in O2; in lungs hmg binds to O2
- at tissues hmg does not readily release O2
- ABG increased SaO2, O2 sat increased, increased SvO2
In the oxyhemoglobin dissociation curve what is a right shift?
- acidosis; decrease pH, increased PaCo2 (hypercapnia)
- decreased affinity of hmg for O2; in lungs hmg does not easily bind with O2
- at tissues hmg readily releases O2
- ABG decreased SaO2, decreased SpO2, decreased SvO2
Pulmonary Vascular Resistance
measures the resistance to blood flow in pulmonary vascular system, a low-resistance system
What 3 main factors determine pulmonary resistance
length of vessels
radius of vessels
viscosity
Cor Pulmonae
R ventricular hypertrophy and dilation secondary to pulmonary disease - is a complication of both restrictive and obstructive pulmonary diseases
Oxygenation occurs as a result of what 3 processes
O2 intake
O2 delivery
use of O2 for metabolic processes
what is the VQ ratio
ventilation (v) must match perfusion (Q)
What happens when VQ ratio is mismatched
impaired gas exchange
Why is nutritional history important when assessing respiratory system
malnutrition can contribute to developing respiratory failure
where do you hear vesicular sounds on auscultation
peripheral fields
where do you hear bronchial sounds on auscultation
trachea and larynx
where do you hear bronchovesicular sounds on auscultation
all lobes near major airways
What is orthopnea
state in which pt assumes a head up position to relieve dyspnea
Difference between cardiogenic pain and pleuritic chest pain
Cardiogenic pain is unaffected by breathing, pleuritic pain is sharp pains on inhalation
What is capnography
noninvasive measurement of CO2 concentration in expired gases
Arterial Blood Gases
provide valuable information on pts acid-base and oxygenation status
Kidney function
is a slow but powerful response
Lung function
is a rapid but limited response
normal pH
7.35-7.45
normal PaCO2
35-45
normal HCO3
24-28
normal PaO2
80-100
normal SaO2
greater than 95%
Compensation occurs when
another value is outside its normal range
No compensation occurs when
other value is within normal range
buffer systems prevent
major changes in H+
in respiratory/metabolic acidosis increased ____ is attempt to get rid of _____
respiration; CO2
in respiratory/metabolic alkalosis decreased ___ is to retain _____
respirations; CO2
kidneys regulate ____ level in ECF
HCO3-