lab 8 quiz on lab 7

Pulmonary ventilation

Air moves in and out of lungs

Alveolar respiration

Gas exchange between lungs and blood

Tissue respiration

Gas exchange between blood and tissues

Cellular respiration

Cells use O₂ to make energy (mitochondria)

Is it air movement?

→ ventilation

Is it lungs ↔ blood?

→ alveolar

Is it blood ↔ tissues?

→ tissue

Is it inside cells?

→ cellular

Pulmonary ventilation problems (air can’t move)

• Choking

• Asthma (bronchospasm)

• Spinal cord injury (diaphragm stops)

• Swollen tongue (anaphylaxis)

Alveolar respiration problems (lungs ↔ blood issue)

• Pneumonia (fluid in alveoli)

• Emphysema (damaged alveoli)

• Pulmonary embolism

Tissue respiration problems (blood ↔ tissue issue)

• Blocked arteries

• Poor blood flow

• Infarction (dead tissue)

Cellular respiration problems (mitochondria issue)

• Cyanide poisoning

• Missing enzymes (CoQ10)

• Genetic mitochondrial disorder

PULMONARY FUNCTION TESTS:

What they measure:

• Lung volume

• Airflow

• Gas exchange

PULMONARY FUNCTION TESTS:
Obstructive disease

→ Hard to get air OUT (elasticity issue)

PULMONARY FUNCTION TESTS:
Obstructive disease examples

• Asthma

• COPD

• emphysema

PULMONARY FUNCTION TESTS:
Obstructive diseases key idea

Air trapped

PULMONARY FUNCTION TESTS:
Restrictive disease

→ Lungs can’t expand

PULMONARY FUNCTION TESTS:
Restrictive disease examples

• Fibrosis

• Pneumonia

• Chest wall issues (scoliosis)

PULMONARY FUNCTION TESTS:
Restrictive diseases key idea

Low lung volume

SPIROMETRY VALUES:
TV (tidal volume)

Normal breaths

SPIROMETRY VALUES:
IRV (Inspiratory Reserve Volume)

Extra inhale

SPIROMETRY VALUES:
ERV (Expiratory Reserve Volume)

Extra exhale

SPIROMETRY VALUES:
RV (Residual Volume)

Air left in lungs (cannot remove)

SPIROMETRY FORMULAS:
Vital Capacity?

TV + IRV + ERV

SPIROMETRY FORMULAS:
Total Lung Capacity?

VC + RV

Forced values?

FVC and FEV1

FVC

forced exhale

FEV1

air out in 1 second

KEY TEST RATIO?

FEV1 / FVC

OBSTRUCTIVE:

“signs”

• FEV1 ↓↓↓

• FVC normal/slightly ↓

• Ratio ↓

RESTRICTIVE:

“signs”

• FEV1 ↓

• FVC ↓↓↓

• Ratio normal or ↑

Minute Ventilation Formula

TV × RR

Alveolar Ventilation formula:

(TV − 0.15) × RR

Alveolar Ventilation (AVR) = 0.15

dead space

PULSE OXIMETRY

noninvasive, painless test that measures the percentage of oxygen saturation in the blood (SpO₂) and heart rate

SpO₂ measures?

% of hemoglobin with oxygen

SpO₂ normal values

95–100%

SpO₂ ok values

90%

SpO₂ dangerous values

≤88%

PULSE OXIMETRY:
Cause of
If no pulse detected → reading = 0
(even if heart is beating)

• Poor blood flow

• Shock

• Vasoconstriction

HEMOGLOBIN Structure:

• 4 subunits

• 4 iron (Fe)

Each Hb carries 4 O₂

Deoxygenated HEMOGLOBIN

no O₂ attached

Oxygenated HEMOGLOBIN

O₂ attached

What does O₂ actually bind to

iron (Fe)

CO₂ transport:

Binds to protein part → carbaminoHb

BLOOD VALUES:
WBC

5,000–10,000

BLOOD VALUES:
RBC

4.8-5.4 million

BLOOD VALUES:
Platelets

150k–400k

BLOOD VALUES:
O₂ saturation

95–100%

STEP 1: Look at FVC

• FVC ≥ 80%

NOT restrictive

STEP 1: Look at FVC

• FVC < 80%

could be restrictive

STEP 2: If NOT restrictive → check ratio

• FEV1/FVC ≥ 0.7

Normal

STEP 2: If NOT restrictive → check ratio

• FEV1/FVC < 0.7

OBSTRUCTIVE

STEP 3: If FVC < 80 → check TLC

• TLC ≥ 80

obstructive

STEP 3: If FVC < 80 → check TLC

• TLC < 80

restrictive

Low ratio

OBSTRUCTIVE

Low volume

RESTRICTIVE

VC PERCENT formula:

(measured VC / expected VC) × 100

VC PERCENT Interpretation:

• 80–120%

NORMAL

VC PERCENT Interpretation:

• <80%

weak lungs

VC PERCENT Interpretation:

• >120%

strong lungs

PLEURAL / LUNG CONDITIONS:

Pneumothorax

air in chest → lung collapses

PLEURAL / LUNG CONDITIONS:

Pleural effusion

fluid → lung collapses

PLEURAL / LUNG CONDITIONS:

Hemothorax

blood in chest → lung collapses

PLEURAL / LUNG CONDITIONS:

Atelectasis

collapsed alveoli

OXIMETRY Values:

• 95–100%

normal

OXIMETRY Values:

• <90%

bad

OXIMETRY Values:

• <88%

emergency

CARBON MONOXIDE key signs

• “cherry red lips”

• “false 100%”

Reason for CARBON MONOXIDE signs

CO binds stronger than O₂ → pulse ox reads normal

• Patient looks oxygenated

• But actually dying

Methemoglobin

iron in red blood cells is oxidized to 𝐹𝑒3+, preventing oxygen release to tissues

Sulfhemoglobin

a rare condition where sulfur binds to hemoglobin, creating a stable, green-pigmented molecule that cannot transport oxygen.

Peripheral pulse

from wrist

Pulse

pressure wave from heart

Normal Blood of healthy male

CaO2 = 20.4mL/dL

Hb = 15

Low iron anemia in male who is cold, pale, and fatigued

CaO2 = 13.7mL/dL

Hb = 10

Polycythemia of a male

CaO2 = 40.5mL/dL

Hb = 30

covid

Restrictive

Obstructive

Blood Hb in males

12-17g/dL

Blood Hb in females

11-16g/dL

Atelectasis and Pleural Effusion

Hemothorax