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AP2 > Lecture 3/27 > Flashcards

Lecture 3/27 Flashcards

Test 3

1
Q

There is ______ml of CO2 dissolved in 1dL of arterial blood with a PCO2 of 40 mmHg

A

2.4

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2
Q

The partial pressure of the gas in a solution is _____ gas in the surrounding environment

A

about the same

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3
Q

CO2 attaches to the ______ on the protein and a ____ is liberated to form a carbamino compound.

A

amine group

proton

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4
Q

What are the proteins in the blood that can buffer protons dropped off of carbonamino groups?

A

Hemoglobin
Immunoglobulins
Clotting factors

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5
Q

Why is the venous CO2 makeup different?

A

Dissolved 10%
Carbamino compounds 30%
Bicarbonate 60%

Bicarbonate will be in lower proportion because we have more protons (venous blood more acidic)

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6
Q

What is the normal CO2 content in arterial blood?

A

48 ml CO2 per dl

(at PCO2 = 40 mmHg)

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7
Q

What is the normal CO2 content in venous blood?

A

52.5 ml CO2 per dl

(at PCO2 = 45 mmHg)

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8
Q

For each dL of blood that passes through the lungs, we have _____ of CO2 unloading and ______ of O2 loading

A

4.5 ml

5 ml

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9
Q

What is the Haldane effect?

A

Relates to the fact that deoxygenated blood has more room to transport CO2 (venous blood)

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10
Q

CO2 is a byproduct of _____

A

Metabolism

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11
Q

CO2 + H2O =

A

H2CO3 (Carbonic acid)

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12
Q

H2CO3 (Carbonic acid) —-> _________- + ___________

A

Bicarb

Proton

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13
Q

What is carbonic anhydrase?

A

Enzyme located in RBC

Help speed up bicarb/carbonic acid reactions

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14
Q

All RBC have a ________ exchanger

A

Bicarb/chloride

bicarb out/chloride in (opposite in lungs)

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15
Q

Deoxyhemoglobin is a _____ acid than oxyhemoglobin. What does this mean?

A

weaker

accepts a proton easier = good proton buffer
(strong: wants to donate)

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16
Q

How does CO2 unloading work in the lungs?

A

A pressure gradient is created from the blood into the alveoli

PAO2 = 40
PaO2 = 45

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17
Q

What happens when CO2 is blown off?

A

Protons are removed from RBCs
Hb affinity for O2 increases

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18
Q

How long does it take for gas exchange to happen in the pulmonary capillaries?

A

0.25 seconds

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19
Q

Decrease in PO2 in pulmonary capillary = ______ time for gas exchange. What else can cause this?

A

increased

Heavy exertion

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20
Q

How long does blood stay in the alveolus at rest?

A

0.75 seconds

21
Q

Nitrous oxide is _____ soluble than oxygen

22
Q

How is carbon monoxide used as a diagnostic gas?

A

Looks at diffusion capabilities of the lungs
Absorbing carbon monoxide fast = can absorb O2 fast

23
Q

What is perfusion limited gas?

A

Gas that has equilibration between the blood, moving through the capillaries and the alvelar air

Happens with PO2

24
Q

What is perfusion flow dependent?

A

The amount of O2 that we’re absorbing is entirely dependent on how much blood is moving through the lungs

The only way to increase O2 absorption is the pump more, the oxygenated blood through the lungs

Not equilibrated unlimited by the rate of diffusion

25
Diffusion limited does not have a ______
Plateau phase
26
Nitrous and O2 are perfusion __________
Limited
27
What are factors that contribute to how fast gas is going to move across a barrier?
1. Thickness of the barrier (T): thicker = slower; thinner = faster 2. Surface area (A): increase = increase gas diffusion --- could be dependent on perfusion (increases distention and recruitment) 3. Diffusivity (D): includes solubility & sqrt of molecular wt of gas 4. Pressure gradient
28
CO2 is ____x more soluble than O2 & _____x more diffusible than O2. Which has a lower molecular wt?
24x 20x O2
29
Equation: Diffusion of Gas: Fick's Law
Vgas = (A x D x (P1 - P2)) / T **Vgas = volume of gas/time = ml/min** A = surface area D = Diffusivity P1 & P2 = PP gradient T = membrane thickness
30
Equation: Diffusivity =
D = Solubility / sqrt(molecular wt)
31
Equation: Diffusion of Gas: Henry's Law
sqrt(Mw of O2) / sqrt(Mw of CO2) **This gives us normal V/Q**
32
Equation: V/Q
Alveolar Vent / Alvolar perfusion **DO NOT INCLUDE DEADSPACE**
33
What is normal V/Q?
0.85
34
What does the L side of a V/Q chart show? What happens to you ratio?
less/no ventilation Decrease in PO2/Increase in PCO2 **Mimics systemic** Ratio decreases
35
What does the R side of a V/Q chart show? What happens to your ratio?
less/no perfusion Increase in PO2/Decrease in PCO2 **Mimics environment** Ratio increases (can go to infinity/0 in denominator which means no blood flow)
36
A _____ is blood flow to a non vented area of the lung and _____ is venting an area with no blood flow
shunt dead space
37
With V/Q, there is more variability with __________ than ___________. What does this cause?
Blood flow ventilation This causes the base of the lung to be underventilated & apex to be overventilated
38
Describe the V/Q ratios in the base & apex of the lung
Base: **Shifts to L of normal** (underventilated) ratio lowered Apex: **shifts to R of normal** (over ventilated) ratio higher
39
T/F: Base of lung has more O2 than CO2
F Has more CO2 than O2
40
Ventilation is going to be higher at the ______ and lower at the ______
base apex
41
Perfusion is going to be lower at the _____ and higher at the _______
apex base
42
What does Laplace's Law describe?
When alveoli share a common pathway and they are not at maximum capacity, air is going to want to go into the alveoli with the lower pressure/higher volume than lower volume/higher pressure pressure is directly related to size of radius/diameter This causes uneven ventilation Closed/higher pressure alveoli wont get fresh air
43
What prevents Laplace's law, under healthy conditions?
Surfactant Larger volume alveoli --> dilutes surfactant --> increased surface tension --> air goes into smaller volume alveoli--> even ventilation Small volume alveoli --> concentrated surfactant --> decreased surface tension --> more willing to accept air than larger volume with dilute surfactant
44
What are factors that influence alveolar deadspace?
Age GA Environmental exposure PPVentilation
45
How much is anatomical deadspace?
1ml/lb of body weight PER POUND!!!!!!
46
What do you have to do if you have more alveolar dead space?
Put more fresh air into the lungs
47
How will you know if you have alveolar dead space?
ME gas composition will be changed Lower expired PCO2
48
How do you find the Mixed expired gas of O2?
Deadspace: 150 cc PICO2: 149 mmHg 149/760 =0.196 0.196 x 150 =29.40789 ml Alveoli: 350 cc PACO2: 100mmHg 100/760 =0.1315789 mmHg 0.1315789 x 350 =46.0526 ml 46.0526 ml + 29.40789 ml = 75.4605 ml 75.4605 ml/500ml =0.151 0.151 x 760 =**114.76 mmHg**

AP2 (17 decks)

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