Exam 2 big points

Question 1

Pa, Pv, PA
-Zone 1

Answer 1

PA > Pa > Pv1

Question 2

Pa, Pv, PA
-Zone 2

Answer 2

Pa > PA > Pv

Question 3

Pa, Pv, PA
-Zone 3

Answer 3

Pa > Pv > PA

Question 4

V is greatest at lung _ from _ _ and Q is greatest there because of _

Answer 4

base
alveolar compliance
gravity

Question 5

Most of the Vt distributed to the _ alveoli

Answer 5

dependent

Question 6

Alveolar volume difference at end expiration and end inspiration is greastest at the _ (base/apex) and smallest at the _ (base/apex)

Answer 6

greatest difference at base

smallest difference at apex

Question 7

Compliance = change in _ / change in _

Answer 7

change in volume / chnge in pressure

Question 8

Awake lateral position:

Answer 8

abdominal content displaces dipahragm cephalad on the dependent side

on inspiration, diaphragm contraction makes more Vt (more ventilation) fill the dependent lung and perfusion is greater in the dependent lung

gas exchange remains efficient

Question 9

What is HPV in regards to lungs?

Answer 9

hypoxic pulmonary vascoconstriction

-alveolar hypoxia causes pulm arteries to vasoconstrict and shunt blood from poorly ventilated area to the best ventilated areas = good, helps us do OLV effectively

Question 10

Things that inhibit HPV:

Answer 10

-Mstenosis - increases pulm vasc pressure

MAC >1 - vasodilates pulm arteries and goes against HPV

Volume overload - peripheral vasodilation

HYPOthermia - increases pulm vasc resistance

Vasodilators -vasodilates

infection - vasodilates

metabolic alkalemia - vasodilates

vasoconstrictors- increase pulm blood flow to non ventilated lung tissue

Question 11

TLC =

Answer 11

TLC = IRV + Vt + ERV + RV

Question 12

FRC =

Answer 12

ERV + RV

Question 13

VC =

Answer 13

IRV + Vt + ERV

Question 14

FVC and FEV1 are low with low TLC = _ disease

Answer 14

obstructive

Question 15

FVC and FEV1 low with high TLC = _ disease

Answer 15

restrictive

Question 16

FEV1/FVC ratio normal =

Answer 16

0.7 or 0.8L
basically 4/5

Question 17

Obstructive disease would have a FEV1/FVC ratio of _ (greater/less) than 0.7L

Answer 17

Less or = 0.7

Question 18

Restrictive disease would have a FEV1/FVC ratio of _ (greater/less) than 0.7L

Answer 18

greater or = to 0.7

Question 19

FVC =

Answer 19

volume of gas expired rapidly and forcefully after 1 breath

N= 5L

Question 20

FEV1 =

Answer 20

volume of gas expired forcefully in 1sec

N=4L

Question 21

DLCO =

Answer 21

CO diffusion capacity
-measures all factors affecting diffusion across alveolar-capillary membrane

Question 22

_ test is the single strongest predictor of risk of complications and mortality after lung resection

Answer 22

DLCO
-predicted postop DLCO < 40% = increased risk

Question 23

Increased risk of postop complications and mortality after lung resection if postop predicted DLCO is < _ %

Answer 23

<40%

Question 24

What happens to lung volumes with anesthesia?
-VC
-ERV
-TV
-FRC
pulm compliance

Answer 24

decreases almost everything from loss of muscle tone

Question 25

What happens to lung volumes with aneshesia -ERV

Answer 25

decreases

Question 26

Which of the following are examples of absolute indications for OLV? a. infection (abscess/cyst) b. massive hemorrhage c. bronchopleural fistula d. unilateral cyst or bullae e. unitlateral lung lavage f. video assisted thoracoscopic surgery g. thoracic aneurysm h. pneumonectomy i. esophageal surgery

Answer 26

a-f

Question 27

Average size for DLT for women is _ fr and men is _ or _ fr

Answer 27

women = 37fr **men = 39 or 41fr **

Question 28

Bronchial cuff on a DLT shouldnt be filled with more than _ mL of air and should be left down until isolation is needed

Answer 28

3mL

Question 29

If having a sudden change in ventilation during a case with a DLT, suspect _, which is one of the most common issues with DLT

Answer 29

malpositioning

Question 30

If peak pressure > 40cm H2O during OLV, suspect _ of the DLT/bronchial blocker

Answer 30

malpositioning

Question 31

If the DLT is placed on the L sd and the tracheal lumen is clamped, the _ lung will be inflated

Answer 31

Left

Question 32

If the L DLT is placed too deep in the L bronchus, only the _ lung will be inflated

Answer 32

left

Question 33

If a L DLT has the bronchial lumen clamped, the _ lung will be inflated

Answer 33

right

Question 34

Most effective maneuver to increase PaO2 during OLV is the application of _ to the _ (dependent/nondependent) lung

Answer 34

CPAP nodependent

Question 35

If adding CPAP to the nondependent lung isn't helping when hypoxemic during OLV, you can add _ to the _ (ventilated/nonventilated) lung

Answer 35

PEEP (5-10cm H2O) ventilated