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Year 1: 09. CPR Exam 2 > DSA 2: Respiratory Adaptations > Flashcards

DSA 2: Respiratory Adaptations Flashcards

1
Q

How do you calculate alveolar oxygen levels?

A

Alveolar O2 (PAO2) = Inspired Oxygen - Oxygen consumed

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2
Q

How do you calculate inspired oxygen?

A

PiO2= (Patm - 47 mm Hg)x FiO2

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3
Q

How do you calculate oxygen consumed?

A

Oxygen Consumed = [PaCO2/RQ]

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4
Q

What is the normal respiratory quotient?

A

0.8

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5
Q

What respiratory quotient for those who are using an IV glucose solution?

A

1

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6
Q

What respiratory quotient for those who are hypoglycemic?

A

0.7

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7
Q

What is the proper way to calculate alveolar oxygen levels?

A

Alveolar O2 (PAO2) = [(Patm - 47 mm Hg)x FiO2] - [PaCO2/RQ]

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8
Q

Under normal/ideal conditions, the alveolar oxygen and the arterial oxygen should be at ______.

A

Equilibrium

-consider <12 mm Hg normal

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9
Q

If alveolar oxygen and the arterial oxygen are not in equilibrium, what does that mean?

A

Diffusion Impairment

  • COPD
  • Pneumonia
  • Interstitial Fibrosis
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10
Q

What is the V/Q ratio?

A

Balance between:
Ventilation: bringing oxygen into alveoli and removing CO2 from the alveoli
Perfusion: removing O2 from the alveoli and adding CO2

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11
Q

What happens when V/Q ratio is decreased?

A
  • Alveolar (and therefore arterial) levels of oxygen will decrease
  • CO2 levels will increase
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12
Q

What happens when V/Q ratio is increased?

A
  • Alveolar (and therefore arterial) levels of oxygen will increase
  • CO2 levels will decrease
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13
Q

During hypoventilation, what happens to the alveolar/arterial gradient?

A

Stays the same

  • Hypoventilation has nothing to do with the alveolar barrier itself
  • A-a O2 gradient only increases when the process of gas exchange is impaired somehow - meaning that what happens at the alveolar barrier is impaired.
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14
Q

When we stand up, do we see a higher or lower V/Q ratio?

A

Lower: more blood reaches base of lung while less air reaches there

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15
Q

What is a physiological shunt?

A

Blood travelled to the lungs, it didn’t get any oxygen

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16
Q

What is an anatomical shunt?

A

Blood physically doesn’t enter the lungs

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17
Q

What is hypoxic vasoconstriction?

A

Low V/Q ratio:

  • blood coming into the area will be directed to other parts of the lung.
  • decreasing the perfusion of the hypoxic region will raise the V/Q ratio and bring the arterial blood gases closer to what we expect
18
Q

What is bronchoconstriction?

A

High V/Q ratio:

  • bronchi will constrict slightly to increase the resistance and decrease the amount of ventilation coming into an area that is not well perfused (although it won’t shut it down entirely).
  • limits the amount of alveolar dead space that occurs and minimizes the ‘wasted’ work that occurs with alveolar dead space.
19
Q

What is hypoxia?

A

Inadequate oxygen available for use by the tissues

20
Q

What is hypoxemia?

A

Low oxygen content in the blood

21
Q

What is hypoxic hypoxia?

A

PaO2 is below normal because:

  • alveolar PO2 is reduced (e.g environmental reasons such as altitude)
  • blood is unable to equilibrate fully with the alveolar air (e.g. as would occur in lung diseases with diffusion impairments such as emphysema or fibrosis)
22
Q

What is anemic hypoxia?

A

Lungs are in perfect working condition, but the oxygen carrying capacity of the blood has been reduced.

  • Carbon Monoxide: it binds to the Hb with high affinity, preventing oxygen from binding and reducing the oxygen carrying-capacity of blood
  • Tissues do not get sufficient oxygen to maintain their metabolic needs because the blood is not carrying it.
23
Q

What is circulatory hypoxia?

A

Lungs are fine and the blood can carry sufficient oxygen, but the tissue is not receiving sufficient oxygen
-Heart cannot pump the blood to the tissue (or arteries
blocked)
-Sickle cell anemia: cells sickle in the blood vessels and block them. (also produces an anemic hypoxia)

24
Q

What is histotoxic hypoxia?

A

Lungs, blood, and circulatory system are all fine but tissue cells are poisoned and cannot use oxygen

  • Cyanide: poisons systems that utilize oxygen to create energy and preventing them from using the oxygen
  • Plenty of oxygen there but cells experience a lack of oxygen
25
Q

What is direct stimulus for central chemoreceptors?

A

Hydrogen ions in CSF

26
Q

Information about what blood gas is sent to the brain from central chemoreceptors?

A

Carbon Dioxide

27
Q

If someone is suffering with a disease involving diffusion impairment, would the alveolar ventilation be greater or lesser compared to a healthy individual?

A

Greater: need more air to maintain oxygen levels

28
Q

In early lung disease, do we see low or high levels of arterial oxygen?

A

Normal or low

29
Q

In early lung disease, do we see low or high levels of arterial carbon dioxide?

A

Low

30
Q

How do central chemoreceptors deal with lower levels of carbon dioxide?

A

Current Situation: PaCO2 and hydrogen levels are low, leading to an increase in pH (less hydrogen available)

Goal: Decrease pH

How: Choroid plexus will pump out hydrogen to CSF and pump bicarbonate back to blood

31
Q

How does the body compensate for hypercapnia?

A

Due to excessive carbon dioxide in the blood, there is an acidification of CSF
-Choroid plexus shunts bicarbonate to CSF to neutralize hydrogen ions

32
Q

With increasing altitude, barometric pressure ____.

A

With increasing altitude, barometric pressure decreases.

33
Q

At higher altitudes, what are some immediate reactions the body has?

A

1) Response to hypoxia: peripheral chemoreceptors increase firing rate to increase ventilation
2) Increase in arterial oxygen means decrease in arterial carbon dioxide
3) Response to hypocapnia: central chemoreceptors increase firing rate

34
Q

How does the body acclimate to higher altitudes?

A

1) Choroid plexus is more basic than normal: pumps more hydrogen and less bicarbonate, allowing peripheral chemoreceptors to increase ventilation
2) Release of erythropoietin: stimulation of RBC production to increase oxygen carrying capacity
3) Increase size and number of mitochondria: body can be more efficient with oxygen use

35
Q

Why does altitude sickness occur?

A

Cerebral circulation in response to hypoxia

  • Cerebral blood vessels will dilate to bring more blood into the area
  • Increase in the perfusion pressure and therefore increased filtration
  • Increased net filtration from the cerebral capillaries leads to mild cerebral edema, particularly if the autoregulatory mechanisms do not cause vasoconstriction
  • Can cause headache, irritability, insomnia, etc
36
Q

Why can pulmonary edemas be seen with altitude sickness?

A

Result of an increase in pulmonary vascular permeability

37
Q

For every 10 meters below the water surface (sea water) you go, the barometric pressure increases by how much?

A

1 atm

38
Q

How do you calculate total barometric pressure?

A

Total barometric pressure = (Pressure due to water) + (Pressure due to air)
*always remember 1 atm pressure from air

39
Q

Why is too much oxygen content dangerous?

A

In excess, oxygen can be toxic due to formation of superoxide anion (O2-) and peroxide (H2O2).
-highly reactive species and are toxic to cells

40
Q

How can high oxygen content be used to treat someone?

A

Carbon monoxide poisoning and injuries resulting in or related to decreased perfusion
-can increase oxygen levels in patient

41
Q

What happens if there is too much nitrogen our system?

A

Nitrogen narcosis: similar effects of alcohol
Decompression sickness: in a quick ascent, nitrogen does not have time to reach lungs and instead stuck in body, which can be quite painful

Year 1: 09. CPR Exam 2 (24 decks)

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