Access Anesthesiology

[gasorrad]

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Hello everyone. Beginning Anesthesia resident here. Have this question for you guys

In lateral decubitus position, the lung relationships
1. are the same as in the semirecumbent position i.e. the apex is in zone 1 and the bases are in zone 3
2. ventilation is highest at apex
3. perfusion is greater in the upper lung
4. compliance is unequal in the two lungs

A. if only 1,2, and 3 correct
B if only 1 and 3 are correct
C if only 2 and 4 are correct
D if only 4 is correct
E if all are correct

 

[pgg]

Hello everyone. Beginning Anesthesia resident here. Have this question for you guys

In lateral decubitus position, the lung relationships
1. are the same as in the semirecumbent position i.e. the apex is in zone 1 and the bases are in zone 3
2. ventilation is highest at apex
3. perfusion is greater in the upper lung
4. compliance is unequal in the two lungs

A. if only 1,2, and 3 correct
B if only 1 and 3 are correct
C if only 2 and 4 are correct
D if only 4 is correct
E if all are correct

1 is wrong, zone 1 is in the upper lung
2 is wrong, ventilation is greater in the upper lung
3 is wrong, perfusion is greater in the lower lung
4 is right

 

[gasorrad]

Thank you. I had chosen that as well. This question is from access anesthesiology self assessment. And for some reason it went on to give all of the above as the answer but in its explanation it contradicts itself. So I am not sure if that was a mistake. Has anyone used access anesthesiology and what do you think of the self assessment. Thank You

 

[ashkenazi1234]

2 is wrong, ventilation is greater in the upper lung

I thought ventilation and perfusion were both greater in the lower lung, but the RATIO of v/p is greater in upper. Am I wrong?

 

[gasorrad]

Thats right. In a upright lung..ventilation increases as you go from apex to base..so does perfusion however perfusion increases more than ventilation from apex to base so V/Q ratio decreases as you go from top to bottom. I am assuming in this situation it would be a similar where ventilation and perfusion would be greater in the lower lung and so V/Q ratio will be higher in the upper lung.