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CRRAB II Week 7 > Respiratory System Under Stress > Flashcards

Respiratory System Under Stress Flashcards

1
Q

What is O2 and CO2 at baseline?

A 
O2 = 250 mL
CO2 = 200 mL
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2
Q

How high can O2 climb in exercise?

A

3000-6000 ml/min

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3
Q

How high can CO2 climb in exercise?

A

3000 ml/min

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4
Q

What increases in exercise in order to help increase O2 and CO2?

A

VENTILATION

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5
Q

What happens to the respiratory quotient during exercise?

A

It increases to 1 or higher.

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6
Q

How could the respiratory quotient get higher than 1?

A

You are producing more CO2 than needing oxygen. The hydrogen ion is combining with bicarbonate –> this indicates that you’re in the anaerobic zone (in VO2 max) and moving into anaerobic metabolism where you produce H+ ions.

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7
Q

When is Vo2 max?

A

When there is no greater rise in O2 consumption even with increased exercise load.

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8
Q

How does diffusion capacity change during exercise?

A

It typically increases 3 fold (measured as CO uptake per partial pressure gradient)

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9
Q

How does cardiac output change with exercise?

A

It increases 3-4 fold.

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10
Q

How does heart rate and stroke volume change with exercise?

A

They both increase!

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11
Q

How do you increase HR and SV in exercise?

A

You elevate these by increasing sympathetic activation (to get HR over 100) and decreasing parasympathetic (will only get HR up to 100)

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12
Q

What is the Ideal Alveolar Equation?

A

Alveolar O2 = Expired O2 - (CO2/R)

[PAo2 = PIo2 - (CO2/R)]

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13
Q

What happens to Systolic pressure during exercise?

A

It increases!

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14
Q

What happens to diastolic pressure during exercise?

A

It decreases or stays the same.

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15
Q

Since cardiac output is increased, this means what happens to resistance when you exercise?

A

Resistance falls dramatically during exercise!

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16
Q

What happens to PO2 during exercise?

A

It is usually unchanged or rises slightly.

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17
Q

What happens to PCO2 during exercise?

A

PCO2 is usually decreased slightly

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18
Q

What happens to pH during exercise?

A

It is usually decreased (lactic acid buildup)

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19
Q

According to the Fick principle, if you have 3000 ml O2/min and the arterial -venous O2 concentration difference is 150 mL O2/L, what is the cardiac output?

A

CO = 3000/150 = 20 L/min

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20
Q

Why do you start extracting more O2 out of the blood (same volume - just more efficient at pulling out O2) during exercise?

A

So your Cardiac output (flow) doesn’t have to increase as much as your ventilation!

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21
Q

What is the stimuli for respiration normally?

A

CO2 and H+ ion build up.

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22
Q

What is the stimuli for respiration at high altitudes?

A

Hypoxia (low O2)

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23
Q

What declines with altitude?

A

Atmospheric pressure

24
Q

What happens to people living at the highest altitudes in the world?

A
  • RR is cranked up here so Pco2 is much smaller and people are burning carbohydrate to elevate their Pco1.
  • They also may have polycythemia or ore red blood cells –> means more cell available to carry oxygen
25
Q

What is the atmospheric pressure and PIo2 at the highest human habitation?

A

400 mmHg

PIo2 = 60

26
Q

What is the most critical adaptation to high altitude?

A

Hyperventilation

27
Q

What drives Hyperventilation at high altitudes?

A

Low Po2

28
Q

How does hyperventilation change PaCO2?

A

It reduces PaCO2 to as low as 8 mmHg.

29
Q

What is another critical adaptation to high altitude?

A

Polycythemia

30
Q

What happens in polycythemia?

A
  • RBC numbers in blood increase in response to hypoxia
  • This increases the oxygen carrying capacity of blood
  • Hypoxia induces the production of EPO (erythropoietin)
31
Q

What are other adaptations to high altitude?

A
  • Shifts in oxygen dissociation curve
  • Increased vascularization of tissues
  • Increased oxidative enzymes (part of HIF response)
  • Pulmonary vasoconstriction in response to hypoxia (BAD adaptation)
32
Q

What causes Acute Mountain Sickness?

A

Respiratory alkalosis (hyperventilation) and hypoxia

33
Q

What toxicity can oxygen induce??

A

Oxygen is damaging to tissues!!

  • Dec. vital capacity
  • pulmonary edema
  • Atelectasis
34
Q

What can breathing 100% oxygen chronically do?

A
  • Decrease vital capacity
  • Cause pulmonary edema
  • Cause Atelectasis
35
Q

What does sleeping in a hyperbaric oxygen chamber do?

A

Increases reactive oxygen species available

36
Q

How can breathing 100% oxygen chronically cause Atelectasis?

A
  • Pressures in alveoli are Po2 668, Pco2 45 and Ph2o 47.
  • Pressures in venous blood are Po2 55, Pco2 45, Ph2o 47.
  • This means the diffusion gradient is ENORMOUS for air movement into the blood and collapse of alveoli
37
Q

What is Atelectasis?

A

Complete or partial collapse of the lung resulting in impaired gas exchange.
-Alveoli are deflated

38
Q

What thing things does Space Flight do to the body??

A
  1. Reduced perfusion inequality of lung (no gravity)
  2. Calcium loss from bone
  3. Postural hypotension on return to earth (not used to gravity)
39
Q

How does pressure increase as you dive?

A
  • Pressure increases 1 atm (760 mmHg) every 10 m

- Gas containing structures can expand on ascent or compress on descent (inner ear, lungs)

40
Q

What happens when someone gets the “bends”?

A
  • It is N2 bubbles in the blood
  • Nitrogen is poorly soluble in blood but high pressures force it into solution
  • Nitrogen equilibrates with tissues at high pressures but is returned to the blood at lower pressures
  • If decompression is too quick, nitrogen escapes forma eh blood as bubbles causing pain and neurological damage if bubbles form in the cranial circulation
  • Can avoid by replacing nitrogen with helium
41
Q

When is Hyperbaric Oxygen useful for treatment?

A
  • Useful in carbon monoxide poisoning
  • -> Can increases O2 content of blood to 6 ml/dL by increasing pressure to 3 atm (0.003 ml O2/dL/1 mmHg)
  • Can be used to treat gas gangrene
42
Q

Why is the pressure in the respiratory system higher than systemic in the fetus?

A

Hypoxia induced vasoconstriction in lungs! –> causes increased resistance in vascular bed
–> may see similar circumstances in COPD patients

43
Q

How much of the systemic circulation goes through the respiratory system in the fetus?

A

15%

44
Q

Where does the fetus get oxygen?

A

Umbilical circulation picks up oxygen from the placenta.

45
Q

What happens in fetal circulation?

A
  • Umbilical artery is deoxygenated and the vein is oxygenated
  • Returns to the right atrium
  • Most goes through the foramen ovale to the left ventricle and oxygenates tissues
  • Po2 of aortic blood is 22-30 mmHg
46
Q

What does most of the blood being pumped to the lung go through to get into the systemic circulation?

A

Most goes through the ductus arteriosus.

47
Q

What does the first breath require?

A

Enormous pressures to overcome surface tension and lungs partially filled with fluid
–> as large as -100 cmH2O have been recorded

48
Q

What happens to pulmonary vascular resistance at birth?

A

Enormous drop in pulmonary vascular resistance.

–> probably caused by oxygenation of alveoli

49
Q

What two structures should close at birth?

A
  • Ductus arteriosus (closes after birth)

- Foramen ovale (should be closed by increased pressure in the left atrium shortly after birth)

50
Q

What does exercise increase?

A
  • Amount of oxygen consumed
  • Carbon dioxide produced
  • Hydrogen ion produced
  • Heart rate
  • Stroke volume
  • Cardiac output
  • Aterio-venous oxygen content difference
  • Alveolar ventilation
  • Systolic blood pressure
51
Q

What does high altitude increase?

A

Ventilation & Hematocrit (EPO)

52
Q

What does high altitude decrease?

A

Pco2 and Po2

53
Q

What drives high altitude changes?

A

Hypoxia!

54
Q

What should you know about pure oxygen?

A

It can be harmful and can cause atelectasis.

55
Q

What can diving do the the body?

A
  • It can result in compression or expansion of gas containing organs.
  • Can result in decompression sickness if nitrogen escapes from blood too fast
56
Q

What is hyperbaric oxygen useful for?

A

Treating carbon monoxide poisoning

57
Q

What should you know about fetus oxygen and respiration?

A
  • Fetus exists at extremely low oxygen tension
  • Has an unusual circulation (ductus arteriosus, foramen ovale)
  • Has extremely high pulmonary artery resistance

CRRAB II Week 7 (8 decks)

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