V/Q ratio Flashcards
1
Q
Partial Pressure of:
Inspired Air
Alveolar Air
Venous Blood
Arterial Blood
A
- Inspired AIr
- O2=150
- H20=47
- Alveolar Air
- PAo2=100
- PAco2=40
- Venous Blood:
- PVo2=40mmHg
- PVco2=47
- Arterial Blood:
- PaO2=90
- Paco2=40
2
Q
V/Q ratio
A
- Alveolar Ventilation and Alveolar Perfusion should MATCh, BUT DONT
- V=4.2 L/min
- Q=6.0 L/min
- Ideal V/Q=1
- average=0.8
- V/Q is greater at Apex
- Both Ventilation and perfusion increase from Apex to Base
- But Q increases more than V
- @ apex: V/Q>1
- @ base: V/Q<1
- V/Q matching is a proportion not an absolute
3
Q
At the Whole body level:
A
- O2 Delivery (Ventilation)=CO2 production (Perfusion)
- Total Ventilation=CO
4
Q
V/Q>1
A
- Ventilation exceeds perfusion
- no hypoxemia
- Hyperventilation
- Pco2<40mmHg
- Increase Po2
- Decrease Pco2
- Pco2<40mmHg
5
Q
V/Q<1
A
- When perfusion exceeds ventilation
- Hypoventilation
- PaCO2>40mmHg
- Decrease Po2
- Increase Pco2
- PaCO2>40mmHg
6
Q
Dead Space vs Shunt
A
- Dead space
- ventilation with no perfusion
- Extreme of hyperventilation
- Acts like inspired air
- Po2=150mmHg
- Pco2=0mmHg
- Shunt
- perfusion without ventilation
- extreme of hypoventilation
- Acts like Venous blood
- PO2=40mmHg
- PCO2=47mmHg
- Both represent the extremes of V/Q imbalance or mismatch
7
Q
V/Q ratio determines
A
- alveolar and arterial pressure of O2 and CO2
8
Q
Autoregulation of V/Q
A
- Autoregulation of both:
- airway resistance
- vascular resistance
- Self-correct local V/Q mismatch
9
Q
Autoregulation of Low V/Q
A
- Hypoventilation–>Decreased V/Q
- Increased Pco2
- Bronchodilation–> Increase V
- Decreased Po2
- Vasoconstriction–> Decrease Q
- Hypopoxic Pulmonary Vasoconstriction (HPV)
- Increase V/Q
Global Lung Hypoxia=Cor Pulmonale
- chronic hypoxia
10
Q
Autoregulation of High V/Q
A
-
Hyperventilation–>Increase V/Q
- self limiting
- Decrease Pco2
- Bronchoconstriction–>Decrease V
- Increase Po2
- Vasodilation–>Increase Q
- Decrease V/Q
11
Q
Normal Range for Pao2 and PaCo2
A
- Pao2
- 80-105mmHg
- PaCo2
- 35-43
12
Q
Hypoxemia vs Hypoxia
A
- Hypoxemia
- Low PaO2 (<80mmHg)
- arterial blood
- most common cause of hypoxia
- Hypoxia:
- O2 delivery to tissues do not meet metablic demand
- not the same as hypoxemia
13
Q
Hypercapnia vs Hypocapnia
A
- Hypercapnia:
- High Paco2 (>43mmHg)
- Hypocapnia
- Low Paco2 (<35mmHg)
14
Q
A-a O2 gradient
A
- A-a O2 gradient=PAo2-Pao2
- normal=(age/4)+4
- 10mmHg usually
- normal=(age/4)+4
- Hypoxemia + Normal A-a gradient
- low barometric pressure (altitude)
- Hypoventilation (Increase Paco2)=Hypercapnia
- Hypoxemia + increased A-a gradient
- V/Q mismatch-O2 helps
- Shunt(R to L)=No O2 helps
- Impaired diffusion-O2 helps
15
Q
Pulmonary Embolism
A
- occlusion of pulmonary arterial vessel by a clot (thrombus) formed following venous stasis
- EXAMPLE OF Dead space: V/Q ratio=infinite
- ventilated but no perfusion
- Blood goes to other areas
- V/Q in other areas would decrease
16
Q
O2 Transport
A
- To exit Alveoli
- O2 must dissolve into liquid on surface of airways
- diffuse into plasma
- diffuse into RBC
- bind to HB
17
Q
Diffusion formula
A
- Diffusion=(A/dX)*dC
- A=Surface area
- dX=thickness
- dC=concentration difference across barrier
- where dC=dPxS
- S=solubility
- SO2=0.3
- SCO2=0.6
- 20x more soluble than O2
- S=solubility
18
Q
O2 Perfusion Limited vs O2 Diffusion limited
A
- O2 perfusion limited
- Nitrous oxide (N2O)
- O2 Diffusion Limited:
- Carbon Monoxide (CO)
19
Q
Single Breath DLco Determination
A
- Diffusion capacity of the lung for CO
- Normal Range=20-30
- Exhales to RV
- Takes deep breathe
- alveoli filled with 0.3% CO and 10% He
- Holds breathe for 10 seconds
- Fraction of CO will diffuse into blood
- He will stay in lungs=determine RV
- Exhale
- 1st=air from conducting airways
- Last=alveolar air=CO measurement
20
Q
Lung Diffusing Capacity (DL)
A
- Measure of gas diffusion in the lungs
- CO binds to Hb keeps plasma Pco low, so only have to know concentration in alveoli
- Determine if hypoxemia is explained by impaired diffusion
- <20=alveolar impaired diffusion
- Controls:
- Surface Area
- lung volume=corrected
- HB level
- -corrected for Hb
- Surface Area
21
Q
PO2
A
partial pressure of oxygen gas