Chapter 6- Cardiopulmonary A&P

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Oxygen is carried in the blood in what two forms?

1) as dissolved oxygen in the blood plasma 2) Chemically bound to the hemoglobin

What is the definition of dissolve?

when a gas like oxygen enters the plasma, it maintains its precise molecular structure and moves freely throughout the plasma in its normal gaseous state

About ______ mL of oxygen will dissolve in 100 mL of blood for every 1 mm Hg of P02

0.003 mL

A relatively small percentage of oxygen is transported in the form of what?

dissolved oxygen

Each RBC contains approximately how many hemoglobin molecules?

280 million

Normal adult hemoglobin consists of what?

1) four heme groups 2) four amino acid chains

hemoglobin that is bound with oxygen

oxyhemoglobin

hemoglobin not bound with oxygen

reduced hemoglobin or deoxyhemoglobin

Normal hemoglobin value for adult male

14 to 16 g/100 mL

The average adult female hemoglobin value

12 to 15 g%

To determine the total amount of oxygen in 100 mL of blood what must be added together?

the dissolved oxygen and the oxygen bound to hemoglobin

What is the formula for CaO₂? (oxygen content of aterial blood)

(Hb×1.34×SaO2)+(PaO2×0.003)

What is the formula for CVO₂? (Oxygen content of mixed venous blood)

(Hb×1.34×SvO2)+(PvO2×0.003)

What is the formula for CcO₂? (Oxygen content of pulmonary capillary blood)

(Hb×1.34)+(PAO2×0.003)

What is the normal P50?

about 27 mmHg

List the factors that cause the oxygen dissociation curve to shift to the left.

1)increase pH 2) decreased PCO2 3) decreased temperature 4) Decrease DPG 5) HbF 6) COHb

List the factors that cause the dissociation curve to shift to the right.

1)decreased pH 2)Increased PCO2 3)increased temperature 4) increased DPG

What happens when the curve shifts to the right?

more O2 is being released into the tissues

What happens when the curve shifts to the left?

less O2 is being released into the tissue

The total amount of O2 delivered or transported to the peripheral tissues is dependent on what three things?

1)The body's ability to oxyygenate blood 2)the hemoglobin concentration 3)the cardiac output Do2= QT ×(CaO2×10)

What is the normal total amount of O2 delivery?

1000 mL of O2 per minute

Oxygen delivery decreases when there is a decline in what 3 things?

1)blood oxygenation 2)hemoglobin concentration 3)cardiac output

What is the normal oxygen content difference between arterial and venous blood?

5 vol%

Normal CaO2 is_________. Normal CvO2 is_________.

20 vol%; 15 vol%

The amount of oxygen extracted by the peripheral tissues during the period of 1 minute

Oxygen Consumption

Normal O2 Consumption

250 mLO2/min

the amount of oxygen extracted by the peripheral tissues divided by the amount of O2 delivered to the peripheral cells

Oxygen extraction ratio

normal O2 extraction ratio

25%

the portion of cardiac output that moves from the right side to the left side of the heart without being exposed to alveolar O2

Pulmonary Shunting

exists when blood flows from the right side of the heart to the left side without coming in contact with an alveolus for gas exchange

Anatomic Shunts

What abnormalities cause anatomic shunting?

Congenital heart disease, Intrapulmonary fistula, and vacular lung tumors

A Capillary shunt is commonly caused by what?

Alveolar collapse or atelectasis, alveolar fluid accumulation, or alveolar consolidation

Common causes of a relative shunt

hypoventilation, ventilation/perfusion mismatches, and alveolar-capillary diffusion defects

The end result of pulmonary shunting and is the mixing of shunted, non-reoxygenated blood with reoxygenated blood distal to the alveoli

Venous Admixture

Pulmonary shunting below ____% reflects normal lung status. A shunt between_______% is indicative of an intrapulmonary abnormality,but is seldom of clinical significance. Pulmonary shunting between _______% denotes significant intrapulmonary disease and may be life threatening.

10; 10 and 20; 20 and 30

What are the four main types of hypoxia?

1)hypoxic 2) anemic 3)circulatory 4) histotoxic

an abnormally low arterial O2 tension

Hypoxemia

Low or inadequate O2 for cellular metabolism

Hypoxia

Common causes of a decreased PaO2

1) a low alveolar oxygen tension 2) diffusion defects 3) ventilation-perfusion mismatchses 4) pulmonary shunting

Anemia Hypoxia can develop from what?

1) a low amount of hemoglobin in the blood 2) a deficiency in the ability of hemoglobin to carry oxygen

Circulatory Hypoxia ( also called stagnant or hypoperfusion hypoxia)

the arterial blood that reaches the tissue cells may have a normal oxygen tension and content, but the amount of blood and, therefore, the amount of oxygen is not adequate to meet tissue needs

Causes for Circulating hypoxia

1) slow or stagnant peripheral blood flow and 2) arterial-venous shunting

Develops in any condition that impairs the ability of tissue cells to utilize oxygen

Histotoxic Hypoxia

What may appear whenever the blood contains at least 5 g% of reduced hemoglobin?

Cyanosis

What is an increased level of RBCs?

polycythemia

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