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Pulm Physio > Ventilation, Perfusion, Shunt > Flashcards

Ventilation, Perfusion, Shunt Flashcards

1
Q

Blood Flow

A

Perfusion (Q)

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2
Q

Air Flow

A

Ventilation (V)

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3
Q

At rest, your perfusion (Q) will be ______ in the reserve capillaries.

A

Slower

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4
Q

At rest, what type of blood flow is present throughout the lungs?

A

Gradient Blood Flow

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5
Q

At rest, the reserve capillaries will be toward the _____ of the lung

A

Apex

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6
Q

At rest, the recruited capillaries will be toward the ____ of the lung

A

Base

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7
Q

At rest, your perfusion (Q) will be ______ in the recruited capillaries of the lung.

A

Fast

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8
Q

At rest, in an individual capillary you have slow transit of blood in ______ capillaries and fast/rapid transit of blood in the _____ capillaries.

A

Reserve; Recruited

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9
Q

In other words, at rest, the blood flow in one minute will be lower in _______ capillaries than ______ capillaries.

A

Reserve; Recruited

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10
Q

During exercise, what type of blood flow is present throughout the lungs?

A

Even Blood Distribution; apex and base of the lung are the same.

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11
Q

In other words, during exercise, the blood flow in one minute will be _______ in reserved capillaries and recruited capillaries.

A

THE SAME

** Higher blood flow overall than at rest **

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12
Q

At rest, the mean arterial pressure will be ________.

A

Pretty low

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13
Q

V and Q are going to be greater at which part of the lung during rest?

A

Base of the lung

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14
Q

At rest, some of the alveoli at the BASE of the lung will be _______.

A

Collapsed

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15
Q

At rest, some of the alveoli at the APEX of the lung will be _______.

A

Inflated

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16
Q

At rest, V or Q is more evenly distributed?

A

V - Ventilation

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17
Q

At rest, why is perfusion (Q) more distributed at the base of the lung?

A

Below the heart and due to gravity.

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18
Q

At rest, a high obstruction of the heart can cause a decreased _____V or Q______.This can lead to what condition?

A

V (Ventilation). Could lead to Pulmonary Arterial Hypertension (>125 mm Hg)

** Common cause of obstruction in the lung is bronchitis **

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19
Q

During exercise, you are using all capillaries (Fully recruited capillaries). Why?

A

Because of the high/rapid perfusion that needs to get all over the lungs.

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20
Q

During exercise, your mean arterial pressure is roughly ______ mmHg.

A

30

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21
Q

At rest, your mean arterial pressure is roughly ____ mm Hg.

A

15

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22
Q

Lung zones locally modulare Q and V by what two actions?

A
  1. Gravity

2. Regional Metabolic Status

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23
Q

When the V/Q ratio is 0, what does this mean?

A

There is no VENTILATION! Does not matter if there is any perfusion!

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24
Q

Where in the body would you yield a V/Q of 0?

A

Mixed Venous Blood in the heart

25
Q

Mixed Venous Blood usually has a PO2 of?

A

45 mm Hg

26
Q

Mixed Venous Blood usually has a PCO2 of?

A

40 mm Hg

27
Q

When the V/Q ratio is infinity, what does this mean?

A

There is no VENTILATION!

28
Q

Where in the body would you yield a V/Q of infinity?

A

Inspired Air

29
Q

Inspired Air usually has a PO2 of?

A

150 mm Hg

30
Q

Inspired Air usually has a PCO2 of?

A

0 mm Hg

31
Q

At the apex of the lung, at rest, the V/Q Ratio will be expected to be ______. Why?

A

HIGH!
Because there is a relatively high rate of ventilation RELATIVE to the perfusion. Remember perfusion rates are higher (with more recruited capillaries) at the BASE of the lung.

32
Q

At the base of the lung, at rest, the V/Q Ratio will be expected to be ______. Why?

A

LOW!
Because there is a relatively low rate of ventilation RELATIVE to the perfusion. Remember perfusion rates are higher (with more recruited capillaries) at the BASE of the lung.

33
Q

The _______ is the average blood flow between the apex and the base

A

Arterial Blood Flow

34
Q

Arterial blood flow typically has a PCO2 of?

A

40 mm Hg

35
Q

Arterial blood flow typically has a PO2 of?

A

100 mm Hg

36
Q

What are the two main sources of V/Q mismatches?

A
  1. Shunt (due to obstruction)

2. Alveolar Dead Space (embolism or vasoconstriction of blood flow to alveolus.

37
Q

When there is a shunt, what is the value of PO2?

A

40 mm Hg

normally 100 mm Hg

38
Q

When there is a shunt, what is the value of PCO2?

A

45 mm Hg

slightly higher than normal [40 mm Hg] because of gas being trapped by obstruction

39
Q

The V/Q ratio in a Shunt will be close to?

A

0

40
Q

What is happening to V and Q in a shunt?

A

No inspired air is coming in (V=0), and the gas entering and leaving the alveoli remains the same as it was in the mixed venous blood.

41
Q

What causes a shunt?

A

Obstruction

42
Q

What causes Alveolar Dead Space?

A

Embolism or Vasoconstriction of blood flow to the alveolus

43
Q

When there is an alveolar dead space, what is the value of PO2?

A

150 mm Hg

44
Q

When there is an alveolar dead space, what is the value of PCO2?

A

0 mm Hg

45
Q

Is there going to be perfusion with dead alveolar space?

A

NO! Q = 0

46
Q

What is happening in Alveolar Dead Space

A

Inspired Air enters the alveoli, but there is no perfusion occuring.

47
Q

The V/Q ratio of the Alveolar Dead Space

A

Infinity

48
Q

In the Ventilation/Perfusion Test, what do they do to check ventilation? What is normally seen?

A

Radioactive Compound is inhaled into the airspace of the lung. If normal, it will distribute evenly to all regions.

49
Q

In the Ventilation/Perfusion Test, what do they do to check perfusion? What would dictate an issue?

A

Radioactive Compound is injected into a vein that then travels into the lung and tissues in the blood vessels.
A clot/embolus would be preset if we see the injected material stopping somewhere.

50
Q

What is a Pulmonary Embolus

A

Blood clot in the Pulmonary Artery

51
Q

When comparing the two different parts of the test, if you see the inhaled compound but no perfusion, what is this?

A

Alveolar Dead Space

52
Q

When comparing the two different parts of the test, if you see the injected compound but no ventilation, what is this?

A

Shunt

53
Q

In an area of alveolar dead space, what would happen to the perfusion at OTHER locations in the lung?

A

Increased perfusion at other areas.

54
Q

When there is a decreased blood flow, what happens in the alveoli?

A

Alveolar Type II Pneumocytes (Surfactant Producers) produce less, which causes a decreased compliance and ventilation.

In other words, the alveoli shrink.

55
Q

What can cause bronchial constriction?

A

Increased PO2
Decreased PCO2
Increased pH

56
Q

In a shunt, the ventilation in other parts of the lung will _____.

A

Increase

57
Q

Hypoxia will be similar to a _____ due to the loss of O2.

A

Shunt

58
Q

What compensatory response will occur in the alveoli with hypoxia?

A

Arterioles feeding the alveoli will constrict

59
Q

Giving oxygen to a patient with a bad shunt will cause % saturation of O2 in the arterial blood to increase/decrease/stay the same.

A

Stay the same, there is no benefit in giving a patient with a bad shunt O2.

Pulm Physio (5 decks)

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