Cardiopulm - Pulmonary A&p

Front 1

• What is dead space?
  
• Anatomical dead space?
  
• Physiological dead space?

Back 1

• Areas within lungs where gas exchange does not occur
• Normal; nose, mouth, larynx, conducting zones to axis 16 (no alveoli)
• Non-fixed, potential for gas exchange exists, such as in alveoli sacs unused at rest (IRV)

Front 2

• What is normal TV and RR? Thus, what is normal minute ventilation?
• What is normal alveolar ventilation and RR? Thus, what is normal alverloar ventilation?
• Why are these different?
• What is average CO? Thus, what is normal V/Q ratio?

Back 2

• 500-600 mL/breath x 12-18 breaths/min; Normal minute ventilation is ~6 L/min (range 5-8)
• 400 mL/breath x 10 breaths/min = alveolar ventilation of 4000 mL/min
• Because minute ventilation involved ventilation of dead space; alveolar ventilation does not
• 5 L/min; 0.8

Front 3

• What is MVV? How is it calculated?
• What is VE? How is it calculated?
• How is ventilatory index calculated?
• What is dyspnea on the ventilatory index? Fatigue? VO₂max?

Back 3

• Maximum voluntary ventilation (TVmax x RRmax)
• Minute ventilation (TV x RR)
• VE/MVV
• 50% = dyspnea; 70% = fatigue; 80% = VO₂max

Front 4

What 4 factors effect gas exchange?

What factors may disease affect?

Back 4

1. Partial pressures
2. Surface area**
3. Permeability of membrane**
4. Time (.25 sec)

Front 5

• What is the hypercapnic drive? What senses this?
  
• What is the hypoxic drive? What senses this?

Back 5

• The drive to breath via sensation of CO₂ levels from central chemoreceptors (medulla of brainstem)
• The drive to breath via sensation of O₂ levels from peripheral (common carotid bifurcation and aortic arch)

Front 6

• What is dyspnea?
  
• Tachypnea
• Apnea

Back 6

• Awareness of breathing
  
• > 20-24 breaths/min
• Cessation of breathing

Front 7

• How much HgB does the typical male have? Female?
• How much O₂ does HgB carry at full saturation?
• What is typical saturation?
• What proportion of O₂ does the body extract from the blood at rest?

Back 7

• 14-18 g/dL; 12-16 g/dL
• 1.34 mL O₂/g HgB
• 98%
• 25%

Front 8

What factors decrease HgB affinity for O₂?

Back 8

• Lack of O₂ presence at other binding sites on HgB
• Higher temperature
• Greater acidity
• 2-3-BPG
• PCO₂

Front 9

What are 3 ways CO₂ is transported in the circulation?

Back 9

1. Dissolved in blood
2. Bound to hemoglobin
3. As bicrabonate (HCO₃⁻)

Front 10

What impacts work of breathing?

Back 10

• VO₂ demand
• Respiratory muscle function
• Resistance to airflow, including compliance (resistance to air in) and elasticity (resistance to air out)
• Availability of intact alveoli

Front 11

• How does the SNS affect the lungs?
  
• PNS?

Back 11

• ↓ mucous production, bronchodilates
  
• The reverse

Front 12

Arterial Blood Gases

• pH
• PaCO₂
• PaO₂
• HCO₃⁻

Back 12

• 7.35-7.45
• 35-45
• >80
• 22-26

Front 13

Mixed Venous Blood Gases

• pH
• PaCO₂
• PaO₂
• HCO₃⁻

Back 13

• 7.31-7.41
• 41-51
• 35-40
• 22-26

Front 14

What are four changes to pulmonary function as a result of aging?

Back 14

• ↓ strength of respiratory muscles (restrictive change)
• ↓ chest wall compliance (restrictive change)
• ↑ alveolar compliance (obstructive change)
• ↓ pulmonary vasculature (alters V/Q ratio)