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CABS pulmonology > Respiratory drive > Flashcards

Respiratory drive Flashcards

1
Q

What is blood PH controlled by

A

H+ concentration

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2
Q

What is a normal Ph concentration

A

7.35-7.45

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3
Q

What is the result of too much H+

A

acidosis

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4
Q

How much CO2 do we produce each minute

A

200mL/min

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5
Q

Where does carbon dioxide come from

A

H2CO3 (waste product of cellular metabolism)

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6
Q

What is normal PaCO2

A

40mmHg

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7
Q

How much more soluble is CO2 than O2

A

20x more soluble

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8
Q

What does it mean for something to be a weak acid

A

more easily dissociates

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9
Q

What are the main determents of PH in the body

A

carbonic acid and pCO2

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10
Q

What is bicarbonate controlled by

A

the kidneys

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11
Q

What is a normal Bicarb level

A

22-26 mEq/L

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12
Q

What is hypoxia

A

low O2 in the peripheral tissue

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13
Q

What can cause hypoxia

A

increased O2 demand
Decreased Hgb carrying capacity

Decreased ability of O2 to reach specific tissue

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14
Q

What things are considered voluntary breathing

A

talking
singing
laughing
breath holding

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15
Q

Where are chemoreceptors located

A

centrally within the medulla

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16
Q

Where are O2 receptors located

A

in the periphery

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17
Q

Where are CO2 receptors located

A

periphery and centrally

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18
Q

What is hypercapnia

A

CO2 increases
pH becomes more acidic

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19
Q

What is hypocapnnia

A

CO2 drops
pH becomes alkalotic

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20
Q

What are the main chemoreceptors

A

O2
CO2

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21
Q

What do central chemoreceptors detect

A

pH of CSF

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22
Q

What can cause the chemoreceptors to become less sensitive

A

With chronic hypoxia (COPD)

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23
Q

At what level does are body care about the O2 level

A

PaO2<60mmHg

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24
Q

What are the respiratory centers within the brainstem

A

pneumotaxic center (pons)
Apneustic (pons)

Dorsal and ventral resp. group (Medulla)

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25
Q

What can trigger involuntary breathing

A

Pain
Emotion
disease

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26
Q

What does the pneumotaxic center do

A

modify breathing rhythm that is set forth by the dorsal and ventral respiratory groups

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27
Q

What helps with inspiration / expiration transition

A

pneumotaxic center

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28
Q

What does the Apneustic center do

A

Modify breathing rhythm that is set forth by the dorsal and ventral respiratory groups

Input from stretch receptors
primarily involved with inspiration

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29
Q

What does the dorsal respiratory group do

A

primary control of respiratory drive

30
Q

Where things trigger the dorsal respiratory group

A

lungs
carotid
neural
(Chemical, mechanical, neuro)

*Drop in pH and PaCO2

31
Q

What structure signals the calm breathing muscles to begin expiration

A

Dorsal respiratory group

32
Q

What are the calm breathing muscles

A

diaphragm
external intercostals

33
Q

When is the ventral respiratory group activated

A

times of increased effort

34
Q

What group is the breathing pacemakers

A

ventral respiratory group

35
Q

What hormone stimulates ventral respiratory group

A

dopamine

36
Q

What stimulates the VRG to increase frequency of ventilation

A

DRG

37
Q

How do the carotid chemoreceptors send respiratory stimuli to the medulla

A

glossopharyngeal nerve

38
Q

How will aortic chemoreceptors send respiratory stimuli to the medulla

A

the vagus nerve

39
Q

What do the lung receptors do

A

send AFFERENT stimuli to the dorsal respiratory group

40
Q

When do the irritant receptors react

A

to noxious stimuli

41
Q

Where are irritant receptors found and how do they work

A

conducting airway epithelium
trigger cough reflex
cause bronchoconstriction

42
Q

What do stretch receptors do

A

assist with ventilatory rate/volume as the smooth muscle sense/react to over inflation/deflation

43
Q

Who are the lung receptors most important in

A

babies and exercising results

44
Q

What is the herring Breuer reflex

A

Stopping of inspiration

45
Q

What do J receptors do

A

sense pulmonary capillary pressure

*Rapid shallow breathing

46
Q

Which nervous system determines the diameter of the airway

A

ANS

47
Q

What does the parasympathetic system do to the airways

A

constriction

48
Q

What does the sympathetic system do to the airway

A

relaxation

49
Q

What happens if a patient has a depressed CNS

A

pH will decrease because we are retaining CO2

50
Q

What happens if a patient has anxiety

A

pH will increase because we are breathing off more CO2

51
Q

What happens if a person has a neuromuscular disorder

A

pH will decrease because we are retaining CO2

52
Q

What happens if a patient has diabetic ketoacidosis

A

pH decrease ill trigger respiratory center to breath faster/harder to breathe of CO2 to buffer the pH and bring pH closer to normal

53
Q

what is FiO2

A

The amount of oxygen someone is receiving through different devices (%)

54
Q

How much oxygen is in sea level / room air

A

21%

55
Q

What is the partial pressure of oxygen

A

pressure exerted by a gas within the confined container

56
Q

What is the PaO2 in the pulmonary artery

A

40mmHg

57
Q

What is the PaO2 of the pulmonary vein

A

100mmHg

58
Q

What is SaO2

A

percentage of hemoglobin sites bound to O2

59
Q

How much oxygen can hemoglobin carry

A

4 O2 molecules

60
Q

What is responsible for changing the Hgb form to open the overall configuration for O2 to bind

A

oxyhemoglobin

61
Q

What is the most powerful respiratory stimuli

A

partial pressure O2 (especially <60mmHg)

62
Q

What factors effect PaO2

A

Barometric pressure (760mmHg)
FiO2
How well ventilation occurs
humidity

63
Q

What is an ABG the gold standard for evaluating

A

acid-base balance
oxygenation
ventilation

64
Q

What are the indications for an ABG

A

Critically ill
respiratory conditions
metabolic disorders

65
Q

What is an ABG sensitive to

A

Time (analyze ASAP)
Temp (Ice after draw)

66
Q

What does the ABG tell us

A

pH
PO2
PCO2
HCO3
SaO2
degree of excess/deficit of base in blood

67
Q

How do you calculate the anion gap

A

BMP/CMP

68
Q

What are alternatives to an ABG

A

Venous blood gas
End-tidal CO2/capnography

69
Q

What info do you get with a VBG

A

pH
HCO3 concentration

70
Q

Why is pH control important

A

to maintain integrity of cells and enzymatic function

CABS pulmonology (8 decks)

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