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Principles III > OLV- (Ventilation & Perfusion) Millers fast paced ppt. Newby > Flashcards

OLV- (Ventilation & Perfusion) Millers fast paced ppt. Newby Flashcards

1
Q

Ventilation and Perfusion:

Ventilation and perfusion are often times compared to try an dunderstand what can be altered during pt care for optimization of the patient.

What is normal Ventilation?

What is normal Perfusion?

What is normal V/Q ratio?

A
  • V- 4 L/min
  • Q- 5 L/min
  • V/Q ratio- 0.8

(4/5=0.8)

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2
Q

Ventilation and Perfusion:

what is equation for MV?

A

VT x RR = MV

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3
Q

Ventilation and Perfusion:

what is Alveolar ventilation?

A

amount of ventilation to/from alveoli

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4
Q

Ventilation and Perfusion:

alveolar ventilation is r/t what 2 factors?

A

physiological deadspace

anatomical dead space

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5
Q

Ventilation and Perfusion:

what is normal alveolar ventilation

A

4 L/ min

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6
Q

Ventilation and Perfusion:

verage CO?

A

5 L/min

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7
Q

Ventilation and Perfusion:

different areas of the lungs have different V/Q ratios the ratio of 0.8 is the average of all the areas in the lungs.

this is just a fact no question here

A

whoooooo finally a break

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8
Q

Ventilation and Perfusion:

theoretically V/Q ratios can be from ____ to _____

A
  • 0 (V=O/Q)
  • infinity (V/Q=O)
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9
Q

Ventilation and Perfusion:

during spontanous respiration upright or standing

  • Ventilation will be greatest where?
  • Ventilation will be the least where?
  • Perfusion is he greatest where?
A
  • Base (r/t greatest pressure change)
  • Apex (r/t near 0 pressure change)
  • bases (r/t gravity)

This facilitates optimization of ventilation and perfusion

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10
Q

Ventilation and Perfusion:

Causes for V/Q mismatch

A
  • positon changes
  • Anesthesia (General, PPV, Muscle paralysis)
  • Blunt force trauma
  • Heart Dz (heart failure, MI)
  • Lung Dz (dead space, shunting, atelectasis)
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11
Q

Ventilation and Perfusion:

What is dead space

A

Ventilation with no perfusion

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12
Q

Ventilation and Perfusion:

what is shunt

A

perfusion with no ventilation

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13
Q

Ventilation and Perfusion:

shunting is conteracted by what process?

A

Hypoxic Pulmonary Vasoconstriction (HPV)

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14
Q

Ventilation and Perfusion:

Deadspace or shunt

PE

A

Dead space

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15
Q

Ventilation and Perfusion:

Deadspace or shunt

asthma (acute)

A

shunt

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16
Q

Ventilation and Perfusion:

Deadspace or shunt

OLV

17
Q

Ventilation and Perfusion:

Deadspace or shunt

COPD (hyperinflation)

18
Q

Ventilation and Perfusion:

Deadspace or shunt

Atelectasis

19
Q

Ventilation and Perfusion:

  • V/Q=0
  • V/Q=1
  • V/Q=infinity
A
  • Shunt
  • Normal
  • Dead space
20
Q

Ventilation and Perfusion:

What is Hypoxic Pulmonary Vasoconstriction?

A
  • pulmonary vasculature is sensitive to hypoxia
  • increased mediators such as leukotriens compared to vasodilatory prostaglandins
  • Hypercarbia in lungs = vasoconstriction
21
Q

Ventilation and Perfusion:

with HPV what actually causes vasoconstriction

A

hypercarbia

22
Q

Ventilation and Perfusion:

GA changes the dynamics of how the body works as we all know. what do VAAs do inparticular

A
  • Dilate airways
  • Alter respiratory dynamics (RR, TV, musculature)
  • Atelectasis formation with in 5 min
  • Blunts HPV
23
Q

Ventilation and Perfusion:

how does GA alter Gas exchange? (4)

A
  • Position changes
  • VAA
  • PPV
  • Post op
24
Q

Ventilation and Perfusion:

What factors does posaition affect with GA and position changes?

A
  • FRC
  • V/Q mismatch
  • WOB
  • Zones 1,2,3
25
Q

Ventilation and Perfusion:

what factors does VAA alter r/t gas exchange

A
  • HPV
  • Diaphragmatic Breathing (sppont)
26
Q

Ventilation and Perfusion:

what factors does PPV alter r/t gas exchange

A
  • Gas flow path to path of least resistance
  • Zones 1,2,3
27
Q

Ventilation and Perfusion:

what factors does post-op pain alter r/t gas exchonge

A
  • Pain & splinting
  • Smokers and obese at higher risk
28
Q

Ventilation and Perfusion:

how does mechanical ventilation affect V/Q

A
  • Air/Gas follows path of least resistance
29
Q

Ventilation and Perfusion:

what does Lapaces law tell us about V/Q r/t to mechanical ventilation

A
  • Alveoli in apex r.t size require lower pressure to increase air/gas uptake
  • Alveoli in bases will require a higher pressure for distensibility
30
Q

Ventilation and Perfusion:

what is Laplaces law r/t lungs?

A

2T=PR

  • T= wall (surface) tension
  • P= distending pressure within alveolus
  • R= radius of alveolus
31
Q

Ventilation and Perfusion:

what is LaPlaces law rearranged to fit better and what is proportional and inversly proportional

A

P=2T/R

  • surface tension is proprtional
  • Radius is inversly proportional
32
Q

that is for this section

Principles III (24 decks)

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