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Adult Health I > T2: Pulmonary System (1) > Flashcards

T2: Pulmonary System (1) Flashcards

1
Q

The role of the respiratory system is to provide O2 to the _____.

A

tissues

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2
Q

Where does gas exchange take place?

A

the alveoli-capillary membrane

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3
Q

What are the 3 steps in the gas exchange process?

A

1) ventilation
2) respiration
3) transport of gases in the circulation

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4
Q

The process of moving air between atmosphere and lung alveoli and distributing air within the lungs to maintain appropriate concentrations of O2 and CO2 in the alveoli…

A

ventilation

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5
Q

The process by which alveolar air gases are moved across the alveolar-capillary membrane to the pulmonary capillary bed…

A

respiration

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6
Q

Movement of oxygen and carbon dioxide to and from the tissue cells…

A

transport of gases in the circulation

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7
Q

What are the 3 areas of ventilation?

A

Lung
Conducting airways
Gas exchange airways

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8
Q

Ventilation:

What is part of the lung?

A

Lobes

Mediastinum

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9
Q

Ventilation:

What is part of the conducting airways?

A

Upper airways
Trachea
Bronchial tree

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10
Q

Ventilation:

What is part of the gas exchange airways?

A

Bronchioles

Alveoli

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11
Q

What are the 2 types of alveoli?

A

Type I

Type II

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12
Q

What do Type I alveoli do?

A

gas exchange

They are squamous cells

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13
Q

What do Type II alveoli do?

A

secrete surfactant

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14
Q

Respiration:

What 5 things determine diffusion?

A

Remember: The gases are SHIPD to the tissues

1) Surface area
2) Hemoglobin
3) Integrity
4) Pressures
5) Diffusion co-efficient

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15
Q

Respiration:

“Surface area” refers to

A

SURFACE AREA available for gas exchange

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16
Q

Respiration:

“Integrity” refers to

A

INTEGRITY of alveolar-capillary membrane

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17
Q

Respiration:

“Hemoglobin” refers to

A

Amount of HEMOGLOBIN in the blood (anemia can interfere with this)

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18
Q

Respiration:

“Diffusion co-efficient” refers to

A

DIFFUSION CO-EFFICIENT of gas, amount of contact time

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19
Q

Respiration:

“Pressures” refers to

A

Driving PRESSURES

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20
Q

V stands for _____.

Q stands for _____.

A 
V = ventilation
Q = perfusion
21
Q

1.0 ratio, _____ of each alveolus is accompanied by adequate _____.

A

ventilation

perfusion

22
Q

Alveolar ventilation is ____ L/min.

A

4 L/min

remember, A in alveolus and 4 look similar

23
Q

Pulmonary capillary perfusion is ____ L/min.

A

5 L/min

remember, turn the P in pulmonary upside down - it looks similar to 5

24
Q

If there is 4 L ventilation and 5 L perfusion, how do I find the V/Q ratio? What does this mean?

A

V / Q = ratio
4 / 5 = 0.8
(Means there is 0.8 more perfusion than ventilation)

25
Q

What is normal V/Q ratio?

A

0.8

26
Q

What does a V/Q ratio of LESS THAN 0.8 indicate?

A
  • decrease in VENTILATION in relation to perfusion
  • similar to right to left shunt
  • more deoxygenated blood is returning to the LEFT heart
27
Q

What does a V/Q ratio of MORE THAN 0.8 indicate?

A
  • decrease in PERFUSION in relation to ventilation

- pulmonary emboli, cardiogenic shock

28
Q

Gas Transport:

Gases are dissolved in the _____.

A

plasma

29
Q

PaO2 means ____.
SaO2 means ____.
(the “a” = arterial)

A 
PaO2 = percentage of O2 dissolved in the plasma
SaO2 = O2 saturation...percentage bound to Hgb molecules
30
Q

What is the normal percentage of O2 dissolved in plasma?

A

~ 3%

31
Q

What is the normal percentage of O2 bound to Hgb?

A

97%

32
Q

What 6 factors shift the oxyhemoglobin dissociation curve to the LEFT?

A

(Remember: Left = LOW CO2)

1) increased pH
2) decreased PCO2
3) decreased temp
4) decreased 2,3-DPG
5) some congenital hemoglobinopathies
6) Carboxyhemoglobin

33
Q

What can lead to a DECREASE in 2,3-DPG?

A
  • hexokinase deficiency
  • HYPOthyroidism
  • bank blood
34
Q

What are some congenital hemoglobinopathies that move the curve to the LEFT?

A
  • Hgb Ranier
  • Hgb Hiroshima
  • Hgb San Francisco
35
Q

What 5 factors shift the oxyhemoglobin dissociation curve to the RIGHT?

A

1) decreased pH
2) increased PCO2
3) increased temp
4) increased 2,3-DPG
5) some congenital hemoglobinopathies

36
Q

What can lead to an INCREASE in 2,3-DPG?

A
  • pyruvate kinase deficiency
  • HYPERthyroidism
  • anemia
  • chronic hypoxemia
37
Q

Does 2,3-DPG move with or opposite O2 levels?

A

Opposite:
High O2 = Low 2,3-DPG
Low O2 = High 2,3-DPG

38
Q

What 2 things lead to chronic hypoxemia?

A
  • high altitude

- congenital heart disease

39
Q

What are some congenital hemoglobinopathies that move the curve to the RIGHT?

A
  • Hgb Kansas

- Hgb Seattle

40
Q

What is the oxyhemoglobin dissociation curve?

A

Describes the ability of Hgb to bind to oxygen at normal arterial O2 tension levels and release it at lower PO2 levels

41
Q

The upper flat portion of the oxyhemoglobin dissociation curve indicates what?

A

Arterial association which protects the body by enabling Hgb to load O2, despite large decreases in PaO2

42
Q

The lower steep portion of the oxyhemoglobin dissociation curve indicates what?

A

Venous dissociation portion. Protects the body by allowing the tissues to withdraw large amounts of O2

43
Q

When I “shift to the right”…

A

Hgb has LESS affinity for O2

44
Q

Right shift = remember the Rs:

A
  • Reduced pH
  • hypeRcapneia
  • feveR
  • incRease levels of 2,3-DPG
45
Q

Shift to the right = acidosis or alkalosis

A

acidosis

46
Q

When I “shift to the left”…

A

Hgb has MORE affinity for O2

47
Q

Left shift = remember the Ls:

A
  • alkaLosis
  • Low CO2
  • coLd
  • Low levels of 2,3-DPG
  • increased Level of CO poisoning
48
Q

An organic phosphate found primarily in RBCs:

A

2,3-Diphosphoglycerate

49
Q

What is the stimulus for 2,3-DPG production?

A

tissue hypoxia

Adult Health I (10 decks)

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