Cardiopulmonary Anatomy & Physiology: Essentials of Respiratory Care: Final Exam Flashcards

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1

Functions of the upper airway

  • Act as a conductor of air
  • Humidify & warm or cool the inspired air
  • prevent foreign materials from entering the tracheobronchial tree
  • serve as an important area involved in speech & smell

2

Anatomy of the airway

Nose, oral cavity, pharynx & larynx

3

Anatomy of the lungs

...

4

Hemoglobin O2 & CO2 binding

...

5

Lung compliance and Resistance and Elastance

  • How the body responds to increased/ decreased compliance and resistance

...

6

Ventilation-Perfusion relationships and Deadspace

  • Causes of increased ventilation-perfusion ratio

Deadspace(is perfusion with little to no ventilation)

Increased V/Q (PAO2 rises & PACO2 falls)

  • Increase in ventilation
  • Decrease in perfusion 1. PACO2-decrease because its washed out alveoli faster than its replaced [increased RR] 2. PAO2- increased because it doesn't diffuse into blood as fast as it enters the alveoli & because the PACO2 is decrease) seen in upper segment of upright lung

7

Ventilation-Perfusion relationships and Deadspace

  • Causes of decreased ventilation-perfusion ratio

Decreased V/Q (PAO2 falls & PACO2 rises)

  • Decrease in ventilatio
  • Increase in perfusion (1. PAO2 falls because O2 is removed faster than it's replenished by ventilation 2. PACO2 rises because CO2 is removed out of blood faster than it it washed out of alveoli. seen in upper segment of upright lung

8

Oxygen dissociation curve

  • What causes right shift

Right Shift (decreased affinity)

  • Decrease in pH
  • Increase in PaCO2
  • Increase in temp
  • Increase in 2,3 DPG

(2,3 DPG=diphoshoglyceric acid; end product of glucose metabolism; can bind Hb causing structure to change & decreasing affinity)

9

Oxygen dissociation curve

  • What causes left shift

Left Shift (increased affinity)

  • Increase in pH
  • Decrease in PaCO2
  • Decrease in temp
  • Decrease in 2,3 DPG
  • Hb Fetal
  • COHb

10

Alveolar gas equation

PA0 2=[PB - PH2O] Fio2 - PaCO2 (1.25)

PA0 2=[760 - 47] Fio2 - PaCO2 (1.25)

PA0 2=[PB - PH2O] Fio2 - PaCO2 (1.25)

Example:

=[755-47]0.40-55(1.25)

=[708]0.40-68.75

=[283.2]-68.75

=214.45

11

ABG Interpretation

pH 7.35-7.45 BE +2

PaCO2 35-45

PaO2 85-100

HCO- 3 22-26

7.30/65/80/24/5 =uncompensated respiratory acidosis w/normal O2

7.50/38/60/34/3=uncompensated metabolic alkalosis w/mild hypoxemia

7.35/49/78/29/0= fully compensated respiratory acidosis w/mild hypoxemia

7.18/34/79/5/-10=partially compensated metabolic acidosis w/mild hypoxemia

12

Hemodynamic normals values

Central Venous Pressure

CVP

0-8 mm Hg

13

Hemodynamic normals values

Mean Pulmonary Artery Pressure

mPAP

9-18 mm Hg

14

Hemodynamic normals values

Pulmonary Capillary Wedge Pressure

Pulmonary Artery Wedge

Pulmonary Artery Occlusion

PCWP | PAW | PAO

4-12 mm Hg

15

Hemodynamic normals values

Cardiac Index

CI

2.5-4.2 L/min/m2

16

Hemodynamic normals values

Cardiac Output

CO

4-8 L/min

17

Hemodynamic normals values

Systemic Vascular Resistance

SVR

800-1500 dynes * sec * cm-5

18

Hemodynamic normals values

Pulmonary Vascular Resistance

PVR

20-120 dynes * sec * cm-5

19

Hemodynamic normals values

Right Atrial Pressure

RAP

0-8 mm Hg

20

Hemodynamic normals values

Stroke Volume

SV

60-130 mL

21

Hemodynamic normals values

Stroke Volume Index

SVI

30-60 mL/beat/m2

22

Hemodynamic normals values

Right Ventricular Stroke Work Index

RVSWI

7-12 g m/m2

23

Hemodynamic normals values

Left Ventricular Stroke Work Index

LVSWI

40-60 g m/m2

24

Hyperbaric oxygenation indications

HBO indications

  • Gas embolism
  • Burn patients
  • Carbon monoxide patients
  • Necrotizing infections such as gangrene

25

Effects of high altitudes on cardiopulmonary system

Barometric pressure & PO2 in the atmosphere decrease with altitude

body does several things to compensate (term is called- acclimatization)

8ways

  • Increase in alveolar ventilation V.A (PAO2 decreases to 60mmHG)
  • Polycythemia (increase in RBC low O2 over time)
  • Acid Base status (PACO2 decreases because of increased ventilation causing respiratory alkalosis)
  • Oxygen diffusion capacity (only with ppl who live in high altitude areas[mountains])
  • PA-a difference [alveolar minus arterial] (oxygen diffusion is limited at high altitudes resulting in an increased PA-a difference)
  • V/Q relationships (ratio improves because of increased pulmonary arterial BP)
  • Cardiac output (with decreased oxygen in the environment it causes increased cardiac output)
  • Pulmonary vascular system (decreased oxygen causes pulmonary vasoconstriction which leads to pulmonary hypertension)

26

Effects of high pressure on cardiopulmonary system

  • Diving (for every 33ft below surface pressure increases by 1 ATM)
  • Breath hold diving (a delicate balance between oxygen and CO2 levels exist)
  • Hyperbaric medicine (patients are placed in hyperbaric chamber & O2 is administered while ambient pressure is increased) this increases tissue oxygenation