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Introduction to Respiratory Care > Gas Exchange > Flashcards

Gas Exchange Flashcards

1
Q

What is Respiration?

A

the process of getting air into the body for tissue utilization and removal of CO2 into the atmosphere

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2
Q

What are the 4 stages of gas exchange?

A

Breathing: air in and out of lungs
External Respiration: gas exchange with inspired air and the blood in the lungs
Transport: O2 cells to cells and Co2 away from cells
Internal Respiration: gas exchange with the internal organs

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3
Q

What are the gases normally composed in the alveoli?

A

O2, Co2, H2O, and N2

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4
Q

What is the alveolar air equation?

A

PAO2 = FiO2 x (PB - 47) - (PACO2 / 0.8)

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5
Q

What is the normal for the alveolar air equation?

A

99.73 (round to 100)

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6
Q

What is diffusion?

A

moving from high pressure to low pressure

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7
Q

what are the barriers of diffusion?

A

A/C membrane has 3
- alveolar epithelium
- interstitial space and structures
- capillary endothelium
RBC membrane (Hb)

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8
Q

Fick’s Law

A

greater the surface area, diffusion constant, and pressure gradient, the more diffusion will occur

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9
Q

For gas exchange to occur between alveoli and capillaries, a difference in ______ must exists

A

Partial Pressure

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10
Q

What is an alveolar shunt?

A

Lack of ventilation with adequate perfusion

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11
Q

what is alveolar deadspace?

A

portion of tidal volume that enters into alveoli but NO perfusion

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12
Q

What does PAO2 stand for?

A

Partial Pressure of O2 in alveoli

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13
Q

What does PaO2 stand for?

A

Partial Pressure of O2 in arterial

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14
Q

What is the A-a gradient equation?

A

P(A-a)O2

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15
Q

What is the normal PAO2?

A

100 mm Hg

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16
Q

What is the normal PaO2

A

80-100 mm Hg

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17
Q

Number above _____ is a shunt

A

300 (must use A-a gradient)

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18
Q

What are the reasons for differences in A-a gradient?

A
  • Right - to - left shunt
  • regional inequalities in ventilation and perfusion
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19
Q

If FiO2 is .60 or ___ and PaO2 is 60 mm Hg or ___, then a capillary shunt is present.

A

greater, less

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20
Q

Increasing FiO2 of a patient with a capillary shunt will not help, you must ______

A

Add pressure, like PEEP

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21
Q

True or False: PaO2 is always less than PAO2

A

True, PAO2 is always greater due to the presence of anatomical shunts

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22
Q

Blood flow is about ___ times higher at bases

A

20

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23
Q

V/Q Ratio

A

^ PAO2 v PACO2 - ^ V/Q
v PAO2 ^ PACO2 - v V/Q

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24
Q

What is the dissolved equation?

A

(0.003 x PaO2)

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25
Q

What is the combined equation?

A

(1.34 x Hb x SaO2)

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26
Q

What is Hb Saturation?

A

the measure of the proportion available Hb that is actually occupied

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27
Q

What is the normal values for combined O2 (arterial and venous)

A

aterial: 19.5
venous: 14.7

28
Q

What is the normal values for dissolved O2 (arterial and venous)

A

arterial: 0.3
venous: 0.1

29
Q

What are the normal values for total O2 content (arterial and venous)

A

arterial: 19.8
venous 14.8

30
Q

What is the total O2 content equation?

A

CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)

31
Q

What is the arterial - venous O2 content equation?

A

C(a-v)O2

32
Q

What does the arterial - venous equation do?

A

directly measures how much O2 is consumed

33
Q

What is the normal for arterial - venous content?

A

5 vol%

34
Q

Rule of Thumb for QT: if the CVO2 is decreased, cardiac output is _______

A

decreased

35
Q

What is the ventilation equation?

A

RR x Tidal Volume (VT) = min. volume

36
Q

What is the cardiac output equation (Fick equation)

A

QT = VO2 / (CaO2 - CvO2) x 10

37
Q

What is the Oxyhemoglobin Dissociation Curve?

A

curve describes relationship between available O2 and the amount of O2 carried by hemoglobin

38
Q

What is Affinity?

A

term used to describe O2s attraction to hemoglobin binding sites

39
Q

What changes with affinity?

A
  • pH
  • body temperature
  • CO2
  • 2,3 - DPG
40
Q

What are the horizontal and vertical values on a normal oxyhemoglobin dissociation curve?

A

Horizontal : PaO2 is 60
Vertical: Sao2 is 90

41
Q

Right Shift Curve

A

Decreased affinity
Decreased pH
Increased CO2
Increased body temp.
Increased 2,3 - DPG

42
Q

Left Shift Curve

A

Increased affinity
Increase pH
Decreased CO2
Decreased body temp.
Decreased 2,3 - DPG

43
Q

What is P50?

A

O2 tension at which Hb is 50% saturated (Normal P50=26.7 mm Hg)

44
Q

What is Oxygen Reserve?

A

25% of O2 available on the Hb is given to tissues (normally) Hb still carrying 75%. If tissues need more O2 in an emergency O2 starts popping off at rapid rate

45
Q

3 Methods of CO2 transport in Blood

A
  • dissolved (8%)
  • binds to Hb (12%)
  • travels as bicarbonate ion (80%)
46
Q

What is the Haldone effect?

A

Hb affinity for CO2 increases as O2 dissociates with Hb

47
Q

What is the Bohr effect?

A

Hb affinity for O2 decreased as CO2 enters blood

48
Q

What affects CO2 removal?

A
  • Inadequate VE
  • Increased deadspace
  • V/Q imbalance
49
Q

What are some abnormalities of gas exchange and transport?

A
  • impaired delivery
  • QT or perfusion decreases
  • abnormal cellular function
50
Q

What are 2 things that can lead to hypoxia

A

Arterial blood content decreases - VQ imbalance
- Hb deficiencies
Circulatory failure
- body attempts to shunt blood to vital organs
- low reduction in perfusion

51
Q

What is Physiological O2 consumption?

A

tissue extract as much O2 that is needed for what is delivered.

52
Q

What is Pathological O2 consumption?

A

delivery falls or demand increases to critical point of delivery

53
Q

What is hypoxic hypoxia?

A

decrease in PO2 levels

54
Q

What is anemic hypoxia?

A

decrease in Hb

55
Q

What is circulatory shock

A

The body attempts to shunt blood to vital organs but with massive blood loss the body attempt is limited

56
Q

What is histotoxic hypoxia?

A

inability of cells to take up or use O2

57
Q

What is hypoventilation?

A

increased VCO2
decreased pH
ventilation does NOT meet metabolic needs

58
Q

What is hyperventilation

A

decreased PaCO2
alveolar ventilation increases, lungs remove CO2 faster than being produced

59
Q

What is hyperpnea?

A

ventilation increases depth and rate due to increased metabolic rates

60
Q

What is a MI/Stroke

A

Localized loss of blood flow

61
Q

Blood is acidic

A

Decrease pH

62
Q

Blood is alkaline

A

Increase pH

63
Q

QT speed

A

0.25 - 0.75 seconds

64
Q

Normal Hb range

A

12 - 15

65
Q

What is the normal PACO2

A

40 mm hg

66
Q

Total O2 content normal

A

16 to 20 ml dl

Introduction to Respiratory Care (2 decks)

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