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Alveolar Gas Exchange
Pulmonary Artery Blood is O2-Poor, CO2-Rich
Two-Cell Thick Air-Blood Barrier
CO2 Diffuses Into Air
O2 Diffuses Into Blood
Pulmonary Vein is O2-Rich, CO2-Poor
Mucus Filters and Moistens
Larynx (Voice Box)
Cilia Expel Mucus and Dust
Physiologic Dead Space (VD)
Tidal Volume (VT)
Partial pressure of arterial CO2 (PaCO2)
Partial pressure of CO2 in expired air (PECO2)
VD = TV x (PaCO2-PECO2) / PaCO2
Partial pressure of alveolar oxygen (PAO2)
Partial Pressure of Arterial O2 (PaO2)
Normal 10 to 15 mmHg
Hypoxemia with an Abnormal A-a Gradient
Shunting (Low V/Q)
Dead space (high V/Q)
Alveolar Gas Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
Evaluates Respiratory Compensation
Used in Metabolic Acidosis
(HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
Bicarbonate (HCO3) x 1.5
= Expected Value for PCO2
Determines Transudative vs. Exudative Source of Pleural Effusion
Exudate if (At Least One of the Following):
Effusion/Serum Protein Ratio > 0.5
Effusion/Serum LDH Ratio > 0.6
Effusion LDH > Two-thirds Upper Serum LDH Range
Lung Sounds - Wheezes
Air Moving through Narrowed Airways
Lung Sounds - Crackles
Fine: Twisting Hair through Fingers
Collapsed Small Airways and Alveoli "Popping Open"
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