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PHGY 1030 EXAM 3 > 16. Pulmonary Circulation > Flashcards

16. Pulmonary Circulation Flashcards

1
Q

Where does Pulmonary circulation arise from?

A

Embryonic mesoderm

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2
Q

What is the only organ to receive ENTIRE cardiac output ?

A

The lung

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3
Q

Capillary loops arise to meet __________ developing from ________,create _________

A

Alveoli,2o crests, Alveolar net

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4
Q

Pulmonary artery and larger (conduit ) vessels are ________

A

elastic

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5
Q

Pulmonary arterioles(resistance vessels) are highly ______________

A

muscular

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6
Q

Pre-ascinar and ascinar vessels are ___________, ____________

A

Thin walled, non-muscular

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7
Q

Why is the 30% thickness of aorta in the wall and large branches of pulmonary artery?

A

Because it is important to regulate blood flow

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8
Q

Pulmonary arteries are flexible and ____________

A

Distensible

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9
Q

What happens to your arteries when you are exercising?

A

More and more arteries start to open up and it helps with blood flow.

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10
Q

What do these abbreviations stand for, RAP,RVP,PAP,PCWP,LAP?

A

-Right atrium pressure
-Right ventricle pressure
-pulmonary artery pressure
-Pulmonary capillary wedge pressure
-Left atrium pressure

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11
Q

What is the function of gas exchange in pulmonary circulation ?

A

O2 and CO2

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12
Q

What is the function of filter in pulmonary circulation?

A

Capture emboli/clots

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13
Q

What is the function of Blood reservoir for LV in the pulmonary circulation?

A

-Mostly within the thin-walled , distensible pulmonary veins

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14
Q

What is the function of Nutrient Supply in the pulmonary circulation?

A

Pulmonary circulation-Alveolar duct & alveoli
Bronchial- Rest of lung

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15
Q

pulmonary circulation is route for administration of which drugs?

A

-Epinephrine
-Prostacyclin
-Nitric Oxide

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16
Q

What are 5 Physiological factors help determine the effect of inhaled drug therapy ?

A

-Aerosol particle size and permeability
-Airway geometry
-Pulmonary circulation
-Lung clearance
-Underlying lung disease

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17
Q

What does V stand for and what does it mean?

A

V is for Ventilation, and it is how much air you are passing through the alveolar over minute

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18
Q

What does Q stand for and what does it mean?

A

Q is for Perfusion. and it is how much blood is flowing past that alveolar unit per minute.

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19
Q

In which situation do you have a V/Q of 1?

A

-Pneumonia
-Pulmonary Edema
-Atelectasis

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20
Q

What is Shunted ventilation?

A

A perfused part of the lung is not adequately ventilated

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21
Q

What is Alveolar dead space ventilation?

A

A ventilated part of the lung is not adequately perfused.

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22
Q

In which situations do you have a V/Q value of infinite ?

A

-Pulmonary embolism
-Pulmonary Hypertension

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23
Q

How is pressure calculated?

A

Pressure=Force/area

24
Q

Resistance relates to which physical properties of circuit?

A

-Vessel size
-Series versus parallel circuit organization
-Fluid viscosity, laminar vs turbulent flow
-Extravascular mechanical forces

25
Q

If your resistance increases, what effect does it have on the pressure?

A

-The pressure has to also increase

26
Q

Pulmonary arterial pressure is more Flow sensitive in the ___________ lung.

A

-Hypoxic

27
Q

How do you calculate Systemic Vascular Resistance(SVR) ?

A

SVR=(MAP-CVP)/CO
MAP:Mean arterial pressure
CVP:Central Venous Pressure
CO: Cardiac Output

28
Q

How do calculate Pulmonary Vascular Resistance (PVR)?

A

PVR=(Ppa-Pla)/CO
Ppa=Pressure pulm artery
Pla=pressure left atrium

29
Q

What is an indirect measure of pulmonary arterial resistance?

A

Right to left shunting across ductus arteriosus

30
Q

Whats happens in the shunt fraction in adults with closed ductus?

A

Shunt occurs across foramen oval and pre-capillary arteriovenous connections

31
Q

What are 3 instances of shunts?

A

-Congenital cardiac anomalies with intracardiac arteriovenous mixing
-Pulmonary hypertension
-Acute hypoxic episodes in lung disease patients

32
Q

What is the Pulmonary shunt fraction?

A

The ratio of shunt flow to the total flow or cardiac output

33
Q

2-8% is Normal Bronchopulmonary circulation, so when it is greater than 15%, what does it suggest?

A

-Pathological perfusion of non ventilated regions.

34
Q

What are passive factors that elevate PVR?

A

-Increasing Left Atrial Pressure
-Increasing Pulmonary Artery Pressure
-Increased Pulmonary blood volume
-Increased blood viscosity

35
Q

What are Active factors that elevate PVR?

A

-Alveolar Hypoxia
-Acidemia
-Alveolar Hypercarbia
-Many humeral substances

36
Q

How does Hypoxia effect the pulmonary and systemic vascular resistance?

A

The PVR increases a lot and SVR decreases

37
Q

Which vessel increases in pressure when you expand the lung and which one decreases in pressure when you expand the lung

A

Alveolar vessels increase in pressure
Extra Alveolar vessels decrease in pressure

38
Q

What happens at the Apex(top of the lung) of the lung?

A

Good ventilation ; prefusion poor due to gravity and pressure effect of alveolar inflation

39
Q

What happens at the mid lung?

A

ventilation + perfusion well matched

40
Q

What happens at the lower lung?

A

Perfusion better due to gravity

41
Q

What happens at the basal lung?

A

Perfusion squashed by high interstitial pressure

42
Q

What occurs in the Zone 1 of the lung?

A

-Alveolar pressure(PA)>arterial pressure(Pa)>Venous pressure(Pv)
-Large Alveoli
-Vessels collapse
-No blood flow
-Large alveoli squishes the vessels causing no blood flow

43
Q

What occurs In the Zone 2 of the lung ?

A

arterial pressure(Pa)>Alveolar pressure(PA)>Venous pressure(Pv)
-As your heart contracts the pressure increases and forces it open and then the capillary closes again

44
Q

What occurs in the Zone 3 of the lung?

A

arterial pressure(Pa)>Venous pressure(Pv)>Alveolar pressure(PA)
-In this blood flow increases and vessels are open and this is the vast majority of a person

45
Q

When would you see zone 1 of a lung in a person ?

A

-You only see this when you are on a ventilator and are forcing pressure up to zone 1

46
Q

Where would you see Zone 2 of a lung in a person ?

A

-This only exists above the heart and its only exist in the heart area

47
Q

Where do you see Zone 3 of a lung?

A

-Majority of the healthy lung

48
Q

When do you only see Zone 4 and what is it called, and what happens?

A

It is Intersitital pressure and it is only seen in edmia or pneumonia or low lung volumes. This causes the compression of alveolar vessels resulting in decreased perfusion

49
Q

At rest what tidal volume do we breathe at ?

A

500mL

50
Q

These alveoli do not need perfusion and so should be rerouted to other more ventilated alveoli.How?

A

-Hypoxic vasoconstriction leading to a shrinking zone 3 and expanding of Zone 2.( you are actively restricting blood flow and redirecting it.)

51
Q

With larger breaths,More alveoli fill up and less _____________________

A

Vasoconstriction

52
Q

Why is Hypoxic Pulmonary Vasoconstriction necessary for ventilation/prefusion matching ?

A

Because without this you would have a problem with oxygenated blood and wouldn’t have proper V/Q matching.

53
Q

Hypoxic vasoconstriction reduces flow to ares of lower _______ tension by increasing ___________-

A

O2, local vascular tone

54
Q

If the whole lung is hypoxic, what could happen?

A

You can overload the right ventricle and you will get right sides heart failure.

55
Q

What are the Benefits of Prone Positioning ?

A

-no change in basic respiratory mechanics; work of breathing has not changed with body position
-No change in tidal volume
-No change in pulmonary circulating volume
-Only change must be effective ventilation-(better matching of ventilation to perfusion)

56
Q

How does hypoxia cause problems in end stage diseases?

A

the whole lung can can become hypoxic and cause heart failure

PHGY 1030 EXAM 3 (8 decks)

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