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Clinical Monitoring > pulmonary anatomy and physiology > Flashcards

pulmonary anatomy and physiology Flashcards

1
Q

Ventilation is _

A

the exchange of air between lungs and atmosphere; air goes sin, air goes out; diaphragm contraction

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2
Q

Respiration:

A

the movement of respiratory gases across the cell membrane (diffusion)

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3
Q

Internal Respiration

A

gas exchange between the capillaries and cells

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4
Q

External Respiration

A

takes place between alveoli and blood vessels

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5
Q

We ___ to ventilate, We ventilate to ___

A

breathe, respire

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6
Q

Phrenic Nerve.

A

originate in neck and innervates though subclavian artery, around the outside of heart and terminate in the diaphragm

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7
Q

The diaphragm movement is controlled by the ____

A

medulla

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8
Q

The respiratory rate is controlled by the ___

A

pons

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9
Q

Gas exchange events for cellular respiration

A
  • Ventilation
  • Distribution
  • Diffusion
  • Transport (Perfusion)
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10
Q

Ventilation:

A

movement of air in and out of lung

-

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11
Q

Distribution

A

gases moves from upper airways to alveoli

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12
Q

Diffusion

A

transfer of respiratory gas from alveoli to RBCs

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13
Q

Transport (Perfusion)

A

movement of oxygenated blood to the periphery

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14
Q

Normal breaking is spontaneous or nonspontaneous?
Negative or positive pressure?
thorax works like an ____

A

spontaneous
negative
accordion

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15
Q

Mechanical Ventilation is positive or negative pressure?

  • mechanically pushes gas mixture into lungs
  • used in patients with: (3)
A

positive

- apnea, inability to eliminate CO2

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16
Q

Partial Pressure of Nitrogen:

A

593.4 mmHg; 78%

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17
Q

Partial Pressure of Oxygen

A

159.3 mmHg; 21%; “room air”

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18
Q

Partial Pressure of Argon

A

7.1 mmHg; 1%

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19
Q

Partial Pressure of Co2

A

0.2 mmHg; .03%

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20
Q

1 atm = ? mmHg

A

760 mmHg

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21
Q

_____ responds to changes of PaCO2 and oxygen content

A

chemoreceptors

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22
Q

Hering Breur reflex:

A

promotion of expiration with lung inflation beyond 1.0L

Stimulated by decreased lung compliance (pulmonary fibrosis, embolism, and edema)

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23
Q

Other factors the affect ventilation:

A

stretch receptors, pain, voluntary control, body temperature, sepsis

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24
Q

Upper airway

A

nose, pharynx, larynx

25
Q

Lower airway

A

conducting airways: trachea, bronchioles, terminals

26
Q

3 types of Dead space

A

Anatomic dead space, alveolar dead space, physiologic dead space

27
Q

Alveolar dead space

A

inhaled gas delivered to non-functioning alveoli capillaries; most common cause- cardiac failure- low pulmonary blood flow,

28
Q

Anatomic dead space:

A

wasted ventilation normally about 1 ml per lb

29
Q

Physiologic dead space

A

both anatomic dead space + alveolar dead space

30
Q

Diffusion

A

movement of gases from areas of high to low concentrations; occurs at the alveolar-capillary membrane (tissue level)

31
Q

Factors that govern rate of diffusion

A
  • diffusion coefficient (CO2 20x more soluble than O2)
  • surface area of the membrane
  • thickness of the membrane
  • partial pressures differences
32
Q

Perfusion:

A

venous blood-> alveolar membrane-> CO2 removal-> sustenance of lung tissue-> delivery to left ventricle

33
Q

Pulmonary circulation

A

respiratory gas exchange occurs

34
Q

Bronchial circulation

A

1-2% cardiac output, perfusion to lung tissue

35
Q

Arterial mean (mmHg): systemic vs pulmonary

A

120/80. (90) ; 25/8 (15)

36
Q

Pressure Gradient (mmHg) Systemic vs. Pulmonary

A

90 ; 9

37
Q

Mean Capillary (mmHg) systemic vs Pulmonary

A

18 ; 8

38
Q

Mean venoms (mmHg) Systemic vs Pulmonary

A

0-8 ; 4-12

39
Q

Blood Flow mmHg Systemic vs Pulmonary

A

5 ; 5

40
Q

Vascular resistance Systemic vs Pulmonary

A

high ; low

41
Q

Pulmonary Vascular Resistance:

A

Resistance to blood flow through the pulmonary circulation

42
Q

Pulmonary Vascular Resistance is largely influenced by

A
  • vasoactive drugs
  • hypoxemia
  • hypercapnia
  • pulmonary blood flow
43
Q

Formula to calculate Pulmonary Vascular Resistance (PVR)

A

PVR= 80 x (mean plum artery pressure mmH - left atrial pressure mmHg) / (cardiac output (LPM)

PVR = 80(PAP -LAP)/CO

44
Q

Normal value of PVR

A

20- 120 dynes/sec/ cm^-5

45
Q

Extra -alveolar vessels (arteries and veins) are surrounded by _____ and increase during ____, due to pull of surrounding tissues

A

elastic lung tissue; increase; exhalation

46
Q

alveolar vessels (capillaries) are surrounded by _____; ______ does not strongly influence patency

A

alveolar air; atmospheric air

47
Q

West’s zone Model Zone 1

A

pulmonary art pressures are exceeded by alveolar pressures

: capillaries compresses during all cycles, unavailable for gas exchange, usually not significant in normal conditions

48
Q

West’s zone model zone 2

A

7-10mm above heart to apex level ;
intermittent compression/flow
- open during systole, not diastole, “waterfall”

49
Q

West’s Zone model zone 3

A

-pulmonary arteries and veins exceed alveolar pressure; matching of perfused capillaries and ventilated alveoli

50
Q

Ventilation to Perfusion (V/Q ratio):
V=
Q=
normal ratio:

A

V= alveolar ventilation (4-6LPM)
Q= Pulmonary blood flow (4.6 LPM)
Normal ratio: 0.8-1.2

51
Q

oxygen is transported to the pulmonary capillary blood in two forms:

A

dissolved in plamsa (2%)

  • .3 ml / 100ml
  • must be dissolved before attaching to hemoglobin
Bound to hemoglobin (98%)
- 4 polypeptide chains (2 alpha 2 beta)
-transforms into oxyhemoglobin
-capable o carrying 4 O2 molecules 
Normal heb conc. = 16g/ 100 ml
52
Q

(Oxygen Affinity)

p50 =

A

PO2 level when foxy saturation is 50%

53
Q

Oxygen content : amount of O2 in whole blood

formula:

A

CaO2 = 1.36 x Hgb x SaO2 + 0.0031 X PaO2

Normal value = 17-20ml / 100 ml blood or 17-20 vol%

54
Q

Oxygen transport formula=

A

CO x CaO2 x 10

55
Q

Oxygen Consumption formula=

A

CO x 10 x Hgb x 1.36 x (SaO2 -SvO2)

Normal Values= 200-290 ml/min

56
Q

Factors influencing O2 Consumption

A
  • physical activity
  • nervous or endocrine system function
  • body temp
57
Q

Hypoxia

A

-deficiency in the amount of oxygen reaching the tissues

-

58
Q

factors that induce hypoxia

A
  • decreases in Cardiac output
  • decreases in hemoglobin saturation
  • severe anemia
  • excessive tissue O2 requirements

Clinical Monitoring (2 decks)

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