RT Test 5

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RT Test 5
2010-09-17 18:12:29
RT Test

RT Test 5
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  1. What is respiration?
    Process of getting O2 into the body for tissue utilization and removing CO2
  2. Where does CO2 build up? Where does it go after?
    CO2 is built up in the tissues because of metabolism then diffuses into the capillary blood before being carried to the lungs for exchange with alveolar gases
  3. What is gas movement between the lungs and tisse called?
    Simple diffusion: The diffusion gradient for CO2 is the opposite of O2
  4. Where is partial pressure of CO2the highest? Lowest?
    • Highest in the cells, approx 60mmHg
    • Lowest in Room Air, 1mmHg
  5. What is the normal PaCO2?
  6. What is the primary determinant of PAO2?
  7. What is the equation for PAO2?
    PAO2 = FIO2 x (PB - 47) - (PACO2/0.8)
  8. If a PT is breathing 60% or more O2 what happens to the 0.8 or RQ?
    RQ will be dropped
  9. What is the equation for Pan2?
    Pan2 = PB - (PAO2 + PACO2 + PH2O)
  10. What mmHg should never exceed during hyperventilation?
    Should never be higher then 120mmHg when breathing room air or it will be called, an error.
  11. What are the 3 barriers of gas diffusion?
    • Alveolar epithelium
    • Interstitial space
    • Capillary endothelium
  12. What is Fick's Law?
    The greater the surface area, diffusion constant and pressure gradient, the more diffusion.
  13. CO2 diffuses 20x faster across the A/C membrane than O2 because?
    It's higher solubility in plasma
  14. How long is pulmonary blood exposed to alveolar gas normally? during exercise?
    • 0.75 secs normally
    • With exercise, 0.25 secs
  15. How long does it take for normal equilibriation?
    0.25 secs
  16. PaO2 is normally ______ less than calculated PAO2 due to the presence of anatomic shunts.
  17. What are the 2 right-to-left anatomical shunts called?
    • Bronchial Venous Drainage
    • Thesbian Venous Drainage
  18. What are anatomical shunts for?
    Picks up poorly oxygenated blood and moves it into arterial circulation, called venous admixture. This action lowers the O2 content of arterial blood.
  19. What accounts for 3/4's of the normal difference between PAO2 and PaO2?
    Anatomical shunts: Bronchial and Thesbian Venous Drainage
  20. What are 2 ways O2 is carried in the blood?
    • Dissolved: in plasma
    • Bound: in hemoglobin
  21. What is the normal value for hemoglobin saturation?
    SaO2 is 95%-100%
  22. Why does the steep portion drop happen in capillaries during hemoglobin saturation?
    A small drop in PO2 causes a large drop in SaO2 indicating a lessening affinity for O2.
  23. What is the normal O2 content of blood?
  24. What is the normal adult QT or cardiac output for Fick's equation?
  25. What are the 3 types of abnormal hemoglobins?
    • Sickle cell HbS
    • Methemoglobin metHb
    • Carboxyhemoglobin HbCo
  26. What can sickle cell (HbS) lead to?
    Hemolysis, Thrombi and acute chest syndrome can be the most common cause of death
  27. What has abnormal iron, cannot bind with O2 and alters HbO2 affinity Left shift?
  28. What is methemoglobin commonly caused by?
    Nitric Oxide (NO), nitroglycerin and lidocaine
  29. Which abnormal Hb binds with CO, having a 200x greater Hb affinity than O2?
  30. What is the treatment for Carboxyhemoglobin?
    Hyperbaric therapy
  31. What is it called when HCO3- (bicarbonate) diffuses out of RBCs in exchange for Cl- (chloride)?
    Chloride shift or Hamburger phenomenon
  32. What happens when HbO2 increases and Caco2 decreases?
    Haldane effect
  33. What does DO2 stand for?
    Impaired O2 delivery
  34. When DO2 is inadequate, what starts to ensue?
    Tissue Hypoxia
  35. What does hypoxemia mean?
    Abnormally low or inadaquate PaO2
  36. The most common cause of V/Q mismatch is?
  37. What can occur with a normal CaO2 if Qt is low?
  38. What is a form of hypoxia which the cellular uptake of O2 is abnormally decreased?
  39. What is acid base balance?
    Refers to phsoilogic mechanisms that keep the H+ of body fluids in a range of compatible life
  40. What is the normal pH to sustain life?
  41. What are volatile acids made out of?
    Carbonic acid (H2CO3) and HCO3
  42. What are fixed or nonvolatile acids made up of?
    Phosphates and proteins including Hb
  43. What is the avg fixed acid production?
    50-70 mEq/day
  44. Define Acid?
    Compound that yields H+ ions when placed in an aqueos solution
  45. Define Base?
    • A compound that yields OH (Hydroxide) when placed into an aqueos solution.
    • AKA substance that is capable of inactivating acids
  46. Why is Bicarbonate buffer system also called, Open Buffer system?
    H2CO3 is in equilibrium with dissolved CO2 which is readily removed by ventilation
  47. Why does Bicarbonate buffer or Open system have the greatest buffering capacity?
    It functions in an open system
  48. What is the back up buffer system called?
    Nonbicarbonate buffer or closed system
  49. Why is nonbicarbonate also called, Closed buffer system?
    All of the components of acid-base reactions remain in the system
  50. What is the Henderson-Hasselbach equation? Think pH
    pH = HCO3- (kidneys) / PaCO2 (lungs)
  51. When pH is low it will be?
  52. When pH is high is will be?
  53. How much acid excretion do lungs remove daily?
    ~24000 mmol/L CO2 removed daily
  54. How much acid do the kidneys excrete daily?
    < 100mEq fixed acid per day