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Pulm Physio > Gas Exchange and Blood Gas Transport > Flashcards

Gas Exchange and Blood Gas Transport Flashcards

1
Q

Name the three Gas Laws

A
  1. Dalton’s Law
  2. Henry’s Law
  3. Fick’s Law
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2
Q

Which law states that in a mixture of gases, each gas will behave as if it were on its own?

A

Dalton’s Law

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3
Q

Which law states that there is a partial pressure caused by each gas that is INDEPENDENT of the other partial pressures for different gases?

A

Dalton’s Law

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4
Q

Abiding by Dalton’s law means, the sum of the _____________ of all the gases in a mixture will equal the ____________.

A

Partial Pressures; Total Pressure

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5
Q

The Normal Alveolar Gas Mixture Pressure is … (in mmHg)

A

760 (As a result of combining the Partial Pressures of O2 (100 mmHg), Co2 (40 mmHg), H2O (47 mm Hg), and N2 (573 mmHg)).

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6
Q

When a gas is in contact with the surface of a liquid, the amount of gas that will go into the solution is ____________ to the partial pressure of that gas. What Gas Law provides this answer?

A

Proportional; Henry’s Law

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7
Q

This law states that the rate of transfer of a gas through a sheet of tissue is proportional to the tissue area and the difference in gas partial pressure between the 2 sides and inversely proportional to the tissue thickness.

A

Fick’s Law

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8
Q

Three principles of Fick’s Law

A

Net Diffusion Rate of a Gas across a membrane is:

  1. Proportional to the difference in partial pressure between the pre- and post- tissue barrier.
  2. Proportional to the surface area of the membrane.
  3. Inversely proportional to the thickness of the membrane
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9
Q

What does P A and P a mean? (In reference to Gas Exchange in the lungs)?

A

P A = Partial Pressure of Alveoli

P a = Partial Pressure of Arteries

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10
Q

Draw the basic overview of the Gas Exchange in the Lung, WITH PO2 and PCO2 values!

A

Dried Inspired Air: PO2 = 160; PCO2 = 0
Humidified Bronchial Air: PO2 = 150; PCO2 = 0
Alveolar Air: PO2 = 100; PCO2 = 40
Mixed Venous Blood (aka Pulmonary Artery): PO2 = 40; PCO2 = 46
Systemic Arterial Blood (aka Pulmonary Vein): PO2 = 100; PCO2 = 40

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11
Q

What is the equation for the Alveolar Minute Volume Rate?

A

V(alveolar) = V(tidal) - V(deadspace)

*** Be able to manipulate this equation!

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12
Q

The total volume of gas entering the lungs per minute?

A

Tidal Volume

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13
Q

The volume of gas per unit time that reaches the alveoli?

A

Alveolar Volume

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14
Q

The volume of gas per unit time that does not reach these respiratory portions (alveoli), but does stay in the trachea/bronchi.

A

Dead Space Volume

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15
Q

What determines the partial pressure of Alveolar CO2 and arterial CO2?

A

Alveolar Ventilation Rate

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16
Q

The rate of CO2 production by the body should be _________ to the rate of the CO2 removed by the lungs at equilibrium?

A

Equal

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17
Q

The rate of alveolar ventilation is the ______ determinant of the rate of the total body CO2 excretion by the lungs.

A

SOLE

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18
Q

If you increase alveolar ventilation, then the PACO2 or the PaCO2 would __________.

A

Decrease

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19
Q

If you ________ alveolar ventilation, then the PACO2 or the PaCO2 would increase.

A

Decrease

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20
Q

Cessation of Breathing

A

Apnea

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21
Q

The rate at which gas enters or leaves the lung.

A

Ventilation

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22
Q

Shallow or slow breathing rate can give you a decreased minute ventilation rate of Alveoli (VA); However, there is NO change in PaCO2.

A

Hypopnea

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23
Q

What type of Ventilation can cause brainstem damage?

A

Hypopnea

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24
Q

Increased deep breathing rate giving an increased minute ventilation rate of Alveoli (VA); However, there is NO change in PaCO2.

A

Hyperpnea

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25
Q

What type of ventilation occurs with normal exercise or with a fever?

A

Hyperpnea

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26
Q

Increased breathing rate giving an increased minute ventilation rate of Alveoli (VA); this INCLUDES hypocapnea and Respiratory Alkalosis

A

Hyperventilation

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27
Q

“Loss of CO2 from blood.”

A

Hyperventilation

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28
Q

Hypocapnea

A

Decreased PaCO2

29
Q

Which is more important for the body?

A. Depth of breathing?
B. Breaths per minute?

A

A. Depth of breathing!

More important because the gas inhaled needs to get into the alveoli for O2 transport in the body. If you have increased breaths per minute, you won’t necessarily be giving enough O2 for the body.

30
Q

What is the Alveolar Gas Equation?

A

PAO2 = [FiO2 (760-47)] - (PaCO@ / 0.8)

PAO2 = Alveolar Partial Pressure of O2
FiO2 = Fraction of inspired air = % O2 inspired/100
Patm = Atmospheric Pressure = 760 mm Hg
PH2O = Pressure of Water = 47 mm Hg @ 100% humidity
PaCO2 = Arterial CO2 partial pressure
Respiratory Quotient = 0.8

31
Q

VCO2 eliminated / VO2 consumed

A

Respiratory Quotient

32
Q

RQ of 1.0 indicates?

A

Pure carbohydrate oxidation

33
Q

RQ of 0.7 indicates?

A

Pure Fat Oxidation

34
Q

At equilibrium, the rate of O2 consumption of the body will be _______ to the net rate of O2 entering the lungs.

A

Equal

35
Q

There is a ______ relationship between FiO2 and PAO2.

A

Linear

36
Q

PAO2 - PaO2

A

A-a gradient (Alveolar-arterial gradient for O2)

37
Q

What is the point of the A-a gradient?

A

Assess the alveolar to capillary gas exchange. It is used in diagnosing the source of hypoxemia.

38
Q

A large A-a gradient would indicate?

A

A more serious respiratory compromise!!!

39
Q

Estimated Normal A-a gradient

A

(Age/10) + 10

40
Q

How do we get the value of PAO2?

A

Use PaCO2 value from blood gas in the Alveolar Gas Equation

PAO2 = [FiO2 (760-47)] - (PaCO@ / 0.8)

41
Q

What can cause a Large A-a gradient?

A
  1. Alveolar Membrane Disease
  2. Shunt
  3. Intertstitial Disease
  4. V/Q mismatch

All of these are considered Respiratory Compromise!

42
Q

What is a Pulmonary Shunt?

A

A pulmonary shunt is a physiological condition which results when the alveoli of the lung are perfused with blood as normal, but ventilation (the supply of air) fails to supply the perfused region.

43
Q

What is the V/Q ratio?

A

Ventilation Perfusion Ratio

44
Q

Ideally, the oxygen provided via ventilation would be just enough to saturate the blood _______.

A

Completely. (in the V/Q ratio)

45
Q

What is the function of the Oxyhemoglobin Dissociation Curve?

A

The oxyhemoglobin dissociation curve is an important tool for understanding how our blood carries and releases oxygen. Specifically, the oxyhemoglobin dissociation curve relates oxygen saturation (sO2) and partial pressure of oxygen in the blood (pO2), and is determined by what is called “Hemoglobin affinity for oxygen”; that is, how readily hemoglobin acquires and releases oxygen molecules into the fluid that surrounds it.

46
Q

How do we measure the O2 % Saturation of Hb (SpO2 aka SO2)?

A

Pulse Oximeter

47
Q

What is the normal PO2 value for healthy venous return?

A

40 mm Hg

48
Q

What is the normal healthy PaO2 for systemic arterials?

A

100 mm Hg

49
Q

What does the NORMAL Oxyhemoglobin Dissociation Curve mean?

A

Important Steps to Know:

  1. At 0 mm Hg PO2, you have 0% Sat of O2.
  2. At 40 mm Hg PO2, you have about 70% Sat of O2. Why? Because the venous blood is returning from the tissues to the lungs and O2 is binding to the Hb due to an increased affinity.
  3. From 40-100 mm Hg PO2, the Hb affinity for O2 decreases making it harder to fully saturate due to previous binding (0-40 mm Hg).
  4. At 100 mm Hg, blood has enough % Sat to go out as “oxygenated” blood to the heart and systemic circulation.
50
Q

What are the factors that affect the Standard Oxyhemoglobin Dissociation Curve?

A
  1. Blood pH
  2. Effects of CO2
  3. Temperature and Exercise
  4. 2,3-DPG
  5. Carbon Monoxide (CO)
  6. Methemoglobinemia
  7. Fetal Hemoglobin
51
Q

A decrease in blood pH (more acidic) will cause the Oxyhemoglobin Dissociation Curve to shift to the _________.

A

Right

52
Q

An increase in blood pH (more basic) will cause the Oxyhemoglobin Dissociation Curve to shift to the _________.

A

Left

53
Q

If the Oxyhemoglobin Dissociation Curve is shifted to the Right, what does this mean?

A

Decreased affinity for O2 (release of O2)

54
Q

What causes a shift to the right on the Oxyhemoglobin Dissociation Curve?

A 
CADET
CO2 increase
Acidity increase
DPG increase
Exercise increase
Temperature increase
55
Q

If the Oxyhemoglobin Dissociation Curve is shifted to the Left, what does this mean?

A

Increased affinity for O2 (loading of O2)

56
Q

The amount of CO2 in can influence the ____.

A

pH

57
Q

What type of blood carries more CO2?

A

Deoxygenated blood

58
Q

Warmer muscles will hold O2 longer or release it quicker?

A

Release O2 quicker

59
Q

Hyperthermia will cause a ______ shift

A

Right

60
Q

Hypothermia will cause a ______ shift

A

Left

61
Q

What is 2,3-DPG?

A

2,3 diphosphoglycerate. Created in erythrocytes during glycolysis.

Not needed to know, but this molecule interacts with the beta subunits of Hb which is why it causes decreased affinity for O2! So more will shift it right.

62
Q

What abnormal hemoglobin will increase O2 affinity?

A

Methemoglobinemia

63
Q

Fetal Hemoglobin has a _________ affinity for O2. What type of shift would this have RELATIVE to Normal Adult?

A

Increased. Left.

64
Q

In the blood plasma, CO2 is

A

Mostly bound to bicarbonate. But has some dissolved, and some bound to plasma albumin forming a carbamino-protein complex.

65
Q

Function of Bicarbonate?

A

Buffers H+

66
Q

In RBCs, CO2 forms

A

Carbamino-Hb complex

67
Q

What does the Carbamino-Hb complex do?

A

When O2 binds to Hb, it reduces affinity for CO2. Which is why venous blood carries more CO2 than arterial blood.

68
Q

Chloride shifts into the RBCs to increase _____.

A

mOsm (milliOsmole)

69
Q

70% of Bicarb from the RBCs goes into the ______ to do what?

A

Blood Plasma and serves as a buffer.

Pulm Physio (5 decks)

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