Transport Physiology

Question 1

Boyle’s Law

Answer 1

At a constant temperature, a volume of gas is inversely proportional to pressure. Example: The volume of pneumothorax will increase as altitude increases due to the decrease in barometric pressure.

Question 2

Dalton’s Law

Answer 2

Relates to pressure of a mixture of gases. Gases in a mixture exert pressure equivalent to the pressure each would exert if present alone in the volume of a total mixture. Example: a tank with 1900psi with a mixture of 20% O2 and 80% nitrogen, has pressure exerted inside of it where the O2 exerts 20% of the pressure and the nitrogen exerts 80% of the pressure.

Question 3

Charles’ Law

Answer 3

When pressure is constant, volume of a gas very nearly proportional to its absolute temperature. Example: TV of air at room temperature increases in size inside the body as it reaches body temperature.

Question 4

Gay-Lussac’s Law

Answer 4

Pressure of a gas when volume is maintained constant is directly proportional to the absolute temperature for a constant amount of gas. Example: pressure in an oxygen tank decreases as the temperature decreases.

Question 5

Henry’s Law

Answer 5

Solubility of gases in liquids and states. The quantity of gas dissolved in 1cm3 (1 ml) of a liquid is proportional to the partial pressure of the gas in contact with the liquid. Example: decompression sickness - diver that ascends too rapidly nitrogen bubbles form in the blood.

Question 6

Graham’s Law

Answer 6

Rate of diffusion of a gas through a liquid is directly related to the solubility of the gas, inversely proportional to the square root of its density or gram molecular rate. Example: gas exchange at the cellular level.

Question 7

Night loss vision occurs at….

Answer 7

5000 ft

Question 8

Hypoxia: Indifferent stage

Answer 8

Sea level to 10,000 ft. Body will increase HR, ventilation slightly

Question 9

Hypoxia: Compensatory stage

Answer 9

10,000-15,000 ft. Increase in BP, HR, depth/rate of ventilation occurs.

Question 10

Hypoxia: Disturbance stage

Answer 10

15,000-20,000 ft. Dizziness, sleepiness, tunnel vision, cyanosis.

Question 11

Hypoxia: Critical stage

Answer 11

20,000-30,000 ft. Mental confusion, incapacitation, followed by LOC within minutes.

Question 12

Hypoxic Hypoxia

Answer 12

Deficiency in alveolar exchange. Decreased barometric pressure at high altitudes causes a reduction in alveolar partial pressure of oxygen (PaO2). O2 sat at sea level 98% —> 87% at 10,000’ —> 60% at 20,000’.

Question 13

Hypemic Hypoxia

Answer 13

Reduction in oxygen carrying capacity of blood. # of RBC’s reduced per unit volume of blood, oxygen-carrying capacity thus oxygen content of blood is reduced. Anemia, blood loss, carbon monoxide, etc…

Question 14

Stagnant Hypoxia

Answer 14

Condition that exists w/ reduction in total CO. Heart failure, shock, PE.

Question 15

Histotoxic Hypoxia

Answer 15

Tissue poisoning that results in a cell’s inability to use molecular oxygen. Carbon monoxide, cyanide, ETOH…

Question 16

Decompression Sickness

Answer 16

Supersaturation of the tissues w/ Nitrogen. Gives rise to the formation of bubbles. Henry’s law. Primary treatment is recompression to ground level, 100% O2

Question 17

Revised Trauma Score 4

Answer 17

GCS 13-15
SBP>89
RR 10-29

Question 18

Revised Trauma Score 3

Answer 18

GCS 9-12
SBP 76-89
RR >29

Question 19

Revised Trauma Score 2

Answer 19

GCS 6-8
SBP 50-75
RR 6-9

Question 20

Revised Trauma Score 1

Answer 20

GCS 4-5
SBP 1-49
RR 1-5

Question 21

Revised Trauma Score 0

Answer 21

GCS 3
SBP 0
RR 0

Question 22

Rhabdomyolysis

Answer 22

Increased CK, K, BUN, Creat, phos, uric acid, AST, ALT. Low pH, metabolic acidosis.

Question 23

Decrease ICP

Answer 23

HOB 30*, neutral alignment, ? remove c-collar

Question 24

Hypokalmeia - EKG

Answer 24

Flattened T, prominent U wave

Question 25

Hyperkalemia - EKG

Answer 25

Peaked T

Question 26

When should MIVF’s be changed to a dextrose source in a DKA PT?

Answer 26

Serum BG reaches 200-250mg/dL

Question 27

SVR - low or high in distributive shock

Answer 27

Low - seen in neurogenic, septic, anaphylactic. Normal 800-1200 dynes/sec. Afterload low d/T massive vasodilation.

Question 28

Calculate P:F ratio. What is normal?

Answer 28

<200 mmHg indicates ARDS. 201-300 indicates acute lung injury. >400 ideal.
PaO2 divided by FiO2 (expressed as a decimal).

Question 29

What parameter increases in early shock?

Answer 29

Increased DBP d/T the initial vasoconstriction. Pulse pressure narrows d/T the increase in DBP and decrease in SBP.

Question 30

Describe early shock

Answer 30

Tachycardia, widened pulse pressure, increased CO, decreased BP.

Question 31

Describe late (cold/hypodynamic) shock

Answer 31

Decreased CO, decreased BP

Question 32

In what order do the phases of distributive shock from sepsis occur?

Answer 32

Hyperdynamic (warm), hypodynamic (cold), normodynamic (following adequate fluid resuscitation), and vasodynamic (referring to hemodynamic parameters such as CO)

Question 33

Which law explains why a rotor wing aircraft may be able to lift off with a heavier patient in cold weather?

Answer 33

Charles’s Law. Cold, dense air contract as temperature decreases. Contracting of gases illustrates decreasing volume which can produce a greater lift.

Question 34

How should a laboring PT be prepared for transport?

Answer 34

Place PT’s w/ >4cm dilation in a side-lying trendelenburg position w/ safety belts below the uterus, pillow under hips for pelvic tilt

Question 35

Initial management of pancreatitis…

Answer 35

Adequate fluid resuscitation

Question 36

Which of the following electrolytes is more often affected w/ PT w/ acute pancreatitis?

Answer 36

Hypocalcemia d/T fluid loss. Cardiac and neurological impact can be severe.

Question 37

Gay-Lussac’s Law

Answer 37

As altitude increases, pressure and temperature decrease.

Question 38

Reduction in oxygen carrying capacity of blood:

Answer 38

Hypemic hypoxia

Question 39

Zone considered most acceptable to PT transport R/T normal physiological functioning?

Answer 39

Efficient zone

Question 40

Time of useful consciousness at X feet…when rapid decompression occurs

Answer 40

18,000 - 30 minutes
25,000 - 3-5
30,000 - 90 seconds
35,000 - 30-60
40,000 - 15 or less

Question 41

Medication class prolonged by presence of liver disease

Answer 41

Benzodiazepines

Question 42

System most affected by compensatory mechanisms and hypoxia R/T shock

Answer 42

Integumentary, neurological, urinary/excretory

Question 43

An infection exposure that may require chemo prophylaxis

Answer 43

Neisseria meningitides