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Pulmonary Concepts > Pulmonary Assessment and Physiology > Flashcards

Pulmonary Assessment and Physiology Flashcards

1
Q

What is the clinical indicator of ventilation?

A

PaCO2

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2
Q

What is the formula for minute ventilation?

A

Tidal Volume x Respiratory Rate

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3
Q

What is normal ventilation?

A

4L/min

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4
Q

An increase in minute ventilation indicates that there is a ___ in ____.

A

increase in work of breathing

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5
Q

List examples of conditions that affect the health of the diaphragm

A

deconditioning, hypoxemia, acidosis, hypophospatemia

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6
Q

What is dead space ventilation?

A

volume of air that does not participate in gas exchange

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7
Q

what is the normal anatomic dead space?

A

2mL/kg of Tidal volume

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8
Q

What is the formula for physiologic dead space?

A

anatomic dead space + alveolar dead space

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9
Q

Increased alveolar dead space can come from ____.

A

a pulmonay embolus

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10
Q

A pulmonary embolus results in ___ in that area of pulmonary circulation

A

no blood past alveoli

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11
Q

What is alveolar dead space?

A

pathologic, non-perfused alveoli, PE

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12
Q

Why do chronic PaCO2 retainers rely on mild hypoxemia?

A

It can decrease their drive to breathe. If PaO2 is corrected to normal, it may result in decreased drive to breathe

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13
Q

What is pulmonary perfusion?

A

movement of blood through the pulmonary capillaries

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14
Q

What will a decrease in blood flow past alveoli affect?

A

ventilation/perfusion ratio and gas exchange

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15
Q

What is the normal ventilation/perfusion ratio?

A

4L V / min / 5 L Q / min

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16
Q

What is the ideal lung unit?

A

0.8 ratio; normal V/Q ratio

17
Q

Do you want the “good” lung or the “bad” lung down?

A

good lung down so that blood can be oxygenation better with gravity

bad lung down can result in hypoxemia

18
Q

Explain what PEEP is

A
  • Positive end-expiratory pressure
  • increases alveolar recruitment
  • prevents alveolar collapse by decreasing surface tension of alveoli
  • increases driving pressure, extends time of gas transfer, allows decrease in FiO2
19
Q

What is a shunt?

A

movement of blood from the right side of the heart into the left side of the heart without getting oxygenated; venous blood to the arterial side

20
Q

How do you treat a shunt?

A

Give oxygen (FiO2) and PEEP

21
Q

What happens in a normal physiologic shunt?

A

thebesian veins of the heart empty into the left atrium

22
Q

Give an examples of anatomic shunts

A

ventricular or atrial septal defect

23
Q

What happens in a pathologic shunt?

A

blood goes through the lungs but does not get oxygenated resulting in refractory hypoxemia

24
Q

At the cellular level, sufficient O2 is needed for the production of ___.

A

adenosine triphosphate (ATP) which is needed for cell energy and life

25
Q

Without sufficient oxygen, ___ is produced

A

lactic acid

26
Q

What does lactic acidosis suggest?

A

anaerobic metabolism, organ failure, eventual cell death

27
Q

What conditions cause a left shift of the oxyhemoglobin dissociation curve?

A
  • alkalosis (low H+)
  • low PaCO2
  • hypothermia
  • Low 2,3-DPG
  • high SaO2 ; low O2 to tissues
  • hemoglobin “holds on” to oxygen molecules
28
Q

What conditions cause a right shift of the oxyhemoglobin dissociation curve?

A
  • acidosis (high H+)
  • high PaCO2
  • fever
  • high 2,3-DPG
  • hemoglobin “release” oxygen easily to tissue
  • Low SaO2, higher O2 to tissue
29
Q

What is 2,3-DPG?

A
  • an organic phosphate found in RBCs that has the ability to alter the affinity of hemoglobin for oxygen
  • low 2,3-DPG = hemoglobin hold on to oxygen
  • high 2,3-DPG = hemoglobin release oxygen
30
Q

how does carbon monoxide affect oxygenation?

A
  • carbon monoxide has a greater affinity for hemoglobin than oxygen
  • in the presence of CO, oxygen cannot be carried –> tissue hypoxia
31
Q

why wouldn’t you use a pulse oximeter for oxygenation monitoring in a patient with CO poisoning

A
  • pulse oximeter cannot differentiate between CO and O2
32
Q

How is CO poisoning treated?

A
  • 100% FiO2 until sx resolve and carboxyhemoglobin level is < 10%
  • Hyperaric oxygen chamber if available, generally within 30 mins
33
Q

What is static compliance?

A

measurement of the elastic properties of the lung

34
Q

What is dynamic compliance?

A

measurement of the elastic properties of the airways

35
Q

What is normal compliance?

A

45-50 mL/ cm H2O

Pulmonary Concepts (2 decks)

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