PRIN 3 - Test 3 Anes Resp Dz YSK Flashcards
Ventilation that does not participate in gas exchange
Dead Space
Pulmonary Blood Flow, what does zone 1 represent?
Represents alveolar dead space because the region is ventilated but not perfused
Distribution of pulmonary blood flow in the isolated lung in zone 1 is
alveolar pressure (PA) exceeds pulmonary artery pressure (Ppa), and no flow occurs because the vessels are collapsed.
What is the solubility coefficient of oxygen in plasma?
0.003
What is the methhemoglobin contaminiation factor (constant)?
1.36
Oxygen Dissociation curve what shifts the curve to the Left
(Increase affinity for O2) INC pH DEC 2,3 DPG DEC Temp High Saturation for given pO2 P50 decreases
Oxygen Dissociation curve what shifts the curve to the Left
(Decreased affinity to O2) DEC pH INC DPG INC Temp O2 readily diffusions to the tissues P50 increase
What is the O2 content equation?
CaO2 = ( 1.36 x Hgb x arterial Hgb saturation) + ( PaO2 X 0.003)
Where CaO2 = arterial O2 content
What is normal CaO2 when Hgb = 15g/dl and PaO2 is > 90mmHg
20mL of O2 per 100mL of arterial blood
What is the equation for calculating CvO2 (Mixed Venous Blood)
CvO2= ( 1.36 x Hgb x arterial Hgb saturation) + (PvO2 x 0.003)
What is normal CvO2 when Hgb is 15g/dL & OvO2 is 40 mmHg
15mL of O2 per 100mL of mixed venous blood
CO2 dissociation curve
When blood contains mainly oxygenated hgb, the CO2 dissociation curve shifts to the right, reducing the blood’s capacity to hold CO2.
For a give PCO2, CO2 content of blood increase as PO2 falls, this is called?
The Haldane effect.
Blood containing mainly oxygenated Hgb that has a reduced capacity to hold CO2
Causes a Right shift to the CO2 Dissociation Curve
Blood containing mainly deoxyhemoglobin blood has an INCreased capacity to hold CO2
Permits more CO2 to be carried in form of HCO3
Metabolic Acidosis
Produces a Left shift to the CO2 Dissociation curve.
Polysomnography
Polysomnography is the gold standard used to establish the diagnosis of OSA, which is based upon the number of abnormal respiratory events per hour of sleep (the apnea plus hypopnea index, AHI)
What is the “Tx” for COPD
Beta2 Agonists (bronchodilators - albuterol)
Corticosteroids
Anticholinergics (Atrovent an anticholinergic bronchodilator)
For intraoperative management of Asthma, which are the good drug choices (8)?
Ketamine DOC Propofol ok Sevoflurane Esmolol Glyco & Atropine Fentanyl Steroids
What are some drugs that should be avoided in the asthmatic pt (10)?
Isoflurane & Desflurane Morphine Atracurium & Mivicurium Ketorolac Beta Blockers Cimetidine & Ranitidine Meperidine
What are the steps 6 things you can do to treat and intraoperative bronchospasm?
1) Deepen the level of anesthesia with a volatile agent, ketamine, propofol, lidocaine, or a combination that rapidly increases anesthetic depth.
2) Administer 100% O2.
3) Administer a short-acting β2-agonist (SABA).
4) In severe cases, administer epinephrine intravenously or subcutaneously (in doses of 10 mcg/kg).
5) Administer intravenous corticosteroids—hydrocortisone 2 to 4 mg/kg.
6) Consider intravenous aminophylline if long-term postoperative mechanical ventilation is planned.
An enlargement of the right ventricle due to high blood pressure in the lungs. Usually caused by chronic lung disease (COPD)
Cor Pulmonale
When and how does Negative-Pressure Pulmonary Edema (NPPE) occur?
After extubation, if the pt experiences laryngospasm or airway obstruction & attempts a forceful inhalation against a closed glottis
A type of rapid onset post-obstructive pulmonary edema that occurs during emergence from anesthesia that is treatable
Negative-pressure pulmonary edema
Why does NPPE occur?
The drastic increase in negative intrathoracic pressure pulls fluid from the pulmonary capillaries & into lung tissue.
