Pulmonology Flashcards
Capnograph: ETCO2 remains totally off of bottom
- incompetent expiratory valve 2. exhausted absorbent
Capnograph: Increased ETCO2 during second phase
Incompetent inspiratory valve
Capnograph: Loss of smooth plateau
Obstructive Disease
Capnograph: First Flat Part
Dead Space Expiration
Capnograph: Sharp Uptake Second Part
Mixed Gas Exhalation
Capnograph: Plateau Phase
Alveolar Gas Exhalation
Capnograph: End of Plateau Phase
ETCO2!
West Zone Secret
PA (alveolar) corresponds with the number of the zone. Pa is always greater than Pv
Which Zone is Dead Space
Zone 1
Which Zone is Shunt
Zone 3
Which of West’s zones of the lung is dependent and which is non-dependent?
West’s zone 1 is non-dependent lung whereas West’s zone 3 is dependent lung.
What is a right -to-Ieft shunt?
A right -to-Ieft shunt occurs when some portion of the right heart’s output is shunted past the alveoli to the left ventricle.
What is an intrapulmonary shunt? Is an intrapulmonary shunt a right-to-left or left-to-right shunt?
An intrapulmonary shunt is present when blood passes from the pulmonary artery to the pulmonary vein through capillaries of unventilated or poorly ventilated alveoli. This is a right-to-Ieft shunt.
The PAO2-PaO2 gradient reflects what? The PaCO2-PACO2 gradient reflects what?
The PAO2-PaO2 gradient reflects the degree of right-to-left shunt. There normally is a small right-to-Ieft shunt, which is reflected by a small PAO2-PaO2 gradient of 5-15 mmHg. The PaCO2-PACO2 gradient reflects deadspacing. Normally, there is a small PaCOZ-PACO2 gradient of 2-10 mmHg, when breathing room air.
What is indicated by an abnormally large alveolar-arterial partial pressure difference (PAO-PaO2)?
A pathological right-to-left shunt (intrapulmonary or intracardiac).
What measurement is better than the PAO2-PaO2 gradient for assessing right-to-Ieft shunt when the patient is breathing a high FiO2?
he PaO2/PAO2 ratio
Increase in PaC02: 1st minute of Apnea
6 mm Hg
Increase in PaC02: Each Subsequent Minute
3 mm Hg
Greatest Amount of Ventilation: Apex or Base?
Base
Nasal Cannula, starts at room air, and goes up by what percent per liter?
1-2% with a max of 50%
What pollutant gives an artificially high SP02? What wavelength does it absorb?
Carbon Monoxide, 660 nm
What pollutant reads 85% on SPO2? What wavelength does it absorb?
Methemoglobin, 660, 990
What is Carbon Monoxides mechanism of action?
- Extreme Left Shift 2. Mitochondrial toxin
Methemoglobin occures when what chemical change happens?
Iron is Oxidized! from FE2 to FE3
