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EMRG 1230 > Gas Exchange & Transport And V/Q Mismatch > Flashcards

Gas Exchange & Transport And V/Q Mismatch Flashcards

1
Q

Increased thickness of lung membrane =

A

Decreased diffusion (e.g pulmonary edema)

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2
Q

O2 and CO2 diffusion

A

Oxygen enters blood from alveolar air because PO2 is greater than that of the blood
Simultaneously CO2 molecules exit blood bc PCO2 of venous blood is much higher than alveolar air

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3
Q

Amount of O2 diffused into the blood each minutes depends on what factors

A
  1. Alveolar pressure gradient
  2. Total functional SA of membrane
  3. Respiratory minute volume
  4. Alveolar air
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4
Q

As altitude increases

A

Alveolar PO2 decreases, thus less O2 enters the blood, eventually the PO2 in air = PO2 of blood

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5
Q

Functional Surface area

A

Anything that decreases the functional SA of the respiratory membrane decreases amount of oxygen diffused into blood
E.g emphysema

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6
Q

Resp minute volume

A

Anything that decreases respiratory rate, tends to decrease blood oxygenation
E.g morphine slows resps

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7
Q

Hemoglobin

A

Contains iron and O2 has an affinity for Iron atoms allowing the iron to act as a sponge for O2 molecules

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8
Q

Alpha and beta amino acid chains in hemoglobin

A

CO2 has an affinity for these chains allowing HB to sponge CO2 and carry it well

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9
Q

How much does a fully saturated hemoglobin molecule unload

A

At rest - 25%
Exercise - 75%

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10
Q

O2 Disassociation curve

A

Describes the relationship between PO2 and O2 saturation

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11
Q

Rightward shift

A

Indicates the HB has a decreased affinity for O2
Means higher PO2 would be required to reach the same O2 saturation
Also easier for HB to release O2

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12
Q

Typical causes of a right shift

A

Exercise, stress, shock

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13
Q

CADET

A

C- CO2
A- Acid
D- DPG
E- Exercise
T- Temperature

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14
Q

What is DPG

A

this molecule stabilizes the deoxygenated form of hemoglobin. Decreased BPG concentrations create increased oxygen affinity

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15
Q

Left shift

A

HB has increased affinity for O2

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16
Q

Temperature

A

Higher - Right
Lower - Left

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17
Q

DPG

A

Higher - Right
Lower - Left

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18
Q

PCO2

A

Higher - Right
Lower- Left

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19
Q

Acidity

A

Higher pH (alkaline) - LEFT shift
Lower pH (acidosis) - RIGHT shift

20
Q

Why CO2 needs to be transported

A

CO2 is very acidic and is transport in the blood to be eliminated by the lungs or kidneys

21
Q

What ways is CO2 transported

A

Form of bicarbonate
Combined with hemoglobin
Dissolved in plasma

22
Q

Dissolved CO2

A

Small amount of CO2 dissolves in plasma and is transported
This creates PCO2 of blood plasma

23
Q

Carbamino compounds

A

25% of CO2 unites with hemoglobin to make Carbamino hemoglobin
Higher PCO2 - accelerates the binding process

24
Q

Bicarbonate

A

2/3 of CO2 is carried in bicarbonate (HCO3-)
- CO2 dissolves in plasma and molecules bind with H2O to form carbonic acid
- some then split to form H+ and bicarbonate (H2CO3)

25
Q

Higher levels of carbonic acid =

A

Pulls the system towards the bicarbonate ions, increasing rate of bicarbonate formation

26
Q

Bohr effect

A

Increased PCO2 decreases the affinity between hemoglobin and O2 causing a “right shift”

27
Q

Bohr effect explained

A
  • when we blow off CO2 our blood gets alkaline and gains a stronger affinity for O2
  • results in O2 being drawn toward hemoglobin
  • CO2 diffuses into blood making it acidic
  • resulting in a weak HB/O2 bond and it releases its O2 into blood
28
Q

Tracheal breath sounds

A

Directly over trachea, harsh like air though a pipe

29
Q

Bronchial breath sounds

A

Present over large airways anteriorly, loud and high pitched

30
Q

Bronchovesicular breath sounds

A

Posterior chest between scapulae, softer than bronchial sounds

31
Q

Vesicular breath sounds

A

Over lung tissues, soft blowing

32
Q

Crackles

A

Light cracking produced by air passing through moisture

33
Q

Wheezes

A

High pitched sounds produced when air moves through smaller partially obstructed airways

34
Q

Stridor

A

High pitched inspiratory sound from partial obstruction pf larynx or trachea

35
Q

Ventilation problems

A

Airway obstruction
chest wall impairment
Neurological impairment

36
Q

Treatments for ventilation problems

A

Vitals/monitoring
Fix obstruction
OPA/NPA/SGA/CPAP
BVM

37
Q

What is diffusion

A

Process of gas exchange between capillaries and alveoli

38
Q

Diffusion problems

A

Inadequate oxygen concentrations
Alveolar pathologies
Interstitial space pathologies
Capillary bed pathologies

39
Q

Perfusion

A

Circulation of blood through the pulmonary bed

40
Q

Perfusion Problems

A

impaired blood flow
Capillary bed pathologies
Inadequate blood volumes

41
Q

Normal V/Q

A

1
When functioning properly 4L of air enter resp tract and 5L of blood go through capillaries so there is ideally just enough O2 to fully saturate blood

42
Q

Shunt math

A

Vent 0.5L O.5L
Perfusion 1L

43
Q

Dead space math

A

Vent 1L. 2.
Perfusion 0.5L

44
Q

What is a shunt

A

An area with perfusion but no ventilation

45
Q

What is dead space

A

Alveoli are ventilated but no perfused

46
Q

When can cyanosis become present

A

SPO2 less than 90%

47
Q

Factors that can affect SPO2 reading

A

Light
Shivering
Pulse volume
Vasoconstriction
Carbon monoxide poisoning
Nail polish
Loss of blood

EMRG 1230 (15 decks)

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