Gas Exchange (Sinclair) Flashcards
Some of this is info from other lectures.
What are the 2 causes of hypoxemia present with a normal A-a difference?
- Decreased PIO2 (altitude change)
2. Hypoventilation
What are the 3 causes of hypoxemia present with a widened A-a difference?
- Diffusion limitation
- R-to-L shunt
- Ventilation/Perfusion (V/Q) mismatch
What does a normal A-s DO2 determine?
*
What does an increased A-s DO2 determine?
*
Lungs Functionally Divided into 2 ZONES:
conducting and respiratory
Respiratory unit served by single terminal bronchiole
Acinus
Several adjacent acini with incomplete septa
Lobule
What is the calculation of partial pressure for inspired gas?
= (PB - PH2O) x FIGas
VE (total ventilation) =
tidal vol x resp rate
What air does not participate in gas exchange?
Air which remains in the Conducting airways at end inspiration (anatomic dead space)
If a 500mL breath is taken, the amount of fresh gas delivered to alveoli will be:
500 - anat dead space
Alveolar Ventilation =
Minute Ventilation - Dead space
Alv Gas Equation =
CO2 Excretion
PACO2 = VCO2/VA (PB-47)
Alv Gas Equation =
O2
PIO2-PAO2 = VO2/VA (PB-47)
Alv gas equation =
complete
PAO2 = PIO2-(PaCO2/R)
A-a difference (A-aDO2) is calculated by
subtracting PaO2 from PAO2
Widened A-a difference signifies
presence of lung disease
Normal A-a gradient signifies
no lung disease
_____ oxygen tension is readily measured by ABG
arterial
How does age affect arterial oxygen?
- decreased oxygen transfer to blood due to declingin lung function
- Arterial oxygen tension decreases with age
Formula for normal A-a gradient
(age + 4)/4
A-a difference (increases/decreases) with age because:
increases
alveolar oxygen tension remains the same which arterial oxygen tension declines
Decreased oxygen tension in the circulating blood compared to normal
hypoxemia
PaCO2 is a good measure of:
alveolar ventilation
In terms of diffusion, hypoxemia only occurs if:
diffusion capacity severely decreased
transit time decreased
Hypoxemia caused by _____ does NOT correct with increased FIO2
R to L shunt
Ventilation and Perfusion are higher at the (apices/bases)
bases
- V/Q > 1 are called
2. V/Q < 1 are called
- dead space-like units
2. shunt-like units
T/F: Most lung diseases cause VQ mismatch
T
Which causes of hypoxemia correct with O2
- V/Q mismatch
- diffusion limitation
- decreased FIO2
- hypoxemia?