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A and P 2.2 > 2.1 > Flashcards

2.1 Flashcards

1
Q

What arteries does the bronchial circulation arise?

A

Aorta or 3rd right posterior intercostal artery

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2
Q

The superior left bronchial artery and inferior left bronchial artery arise from the?

A

aorta

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3
Q

the right bronchial artery arises from the ?

A

3rd right posterior intercostal artery

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4
Q

what tissues does the bronchial circulation not supply?

A

parietal pleura

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5
Q

What tissues does the bronchial circulation supply?

A
  1. trachea to terminal bronchioles
  2. arterial supply to all the conducting systems
  3. visceral pleura
  4. hilar lymph nodes
  5. pulmonary arteries and veins
  6. vagus
  7. esophagus
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6
Q

What causes the anatomical shunt when see in pulmonary circulation?

A

bronchial deoxygenated veins empty into oxygenated pulmonary veins.

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7
Q

the anterior intercoastal arteries branch from what?

A

internal thoracic artery

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8
Q

pulmonary and systemic blood flow are equal. What is the L/Min

A

5

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9
Q

describe the wall structure of the pulmonary vessels in comparison to the systemic vessels.

A

Pulmonary arteries rapidly branch into small arteries with thin walls, large diameter lumens, less smooth muscle, increased compliance, flimsy, more stretch, easier to compress, distend when filled

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10
Q

bronchial circulation is _____pressure while pulmonary circulation is _____pressure.

A

high

low

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11
Q

what is the average pressure drop across pulmonary circulation

A

98 (100)systemic 10 (15)pulmonary

depending on your textbook

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12
Q

PVR =____SVR resistance

A

1/10th

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13
Q

what are the passive factors that influence pulmonary vascular resistance

A
  1. lung volume
  2. body position
  3. gravity
  4. alveolar, interpleural, and intravascular pressures
  5. right ventricle output
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14
Q

if transmural pressure difference increases what happens to pulmonary vessel resistance and diameter?

A
  • Increased transmural pressure difference
  • increased vessel diameter
  • decreased resistance
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15
Q

if transmural pressure difference decreases what happens to pulmonary vessel resistance and diameter?

A
  • decreased transmural pressure difference
  • decreased vessel diameter
  • increased resistance
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16
Q

_______can lead to compression and collapse of pulmonary vessels

A

negative transmural pressure

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17
Q

pulmonary capillaries/alveolar vessels are tethered to the alveolar. What happens to these vessels when when the alveoli expand?

A

when alveoli expand alveolar vessels elongate and decrease in radius(get pinched by the alveoli) which increases resistance

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18
Q

increased lung volumes =________ alveolar vessel/pulmonary capillary resistance

A

increased lung volumes =increased alveolar vessel/pulmonary capillary resistance

19
Q

decreased lung volumes =______ alveolar vessel/pulmonary capillary resistance

A

decreased lung volumes =decreased alveolar vessel/pulmonary capillary resistance

20
Q

extra-alveolar vessels/small branches of pulmonary artery are affected by inspiration(high lung volume) how?

A
  1. increased (more negative) intrapleural pressure
  2. increased transmural pressure difference
  3. increased vessel expansion of extra-alveolar vessels/small branches of pulmonary artery
  4. decreased resistance
21
Q

which vessels also have radial traction that correlates with alveolar ducts?

A

extra-alveolar vessels/small branches of pulmonary artery

22
Q

extra-alveolar and alveolar vessels are in series with each other, how do their resistances sum to produce the total pulmonary resistance?

A

its additive

23
Q

total pulmonary vascular resistance is highest and lowest at what lung volumes ?

why?

A

PVR highest at RV

PVR lowest at FRC

vessels are in series

24
Q

during inspiration(high lung volume) alveolar vessels are ________ while extra-alveolar _______

A

during inspiration(high lung volume) alveolar vessels are compressed while extra-alveolar distended

25
Q

during expiration(low lung volume) alveolar vessels are_______ while extra-alveolar_______

A

during expiration(low lung volume) alveolar vessels are distended while extra-alveolar compressed

26
Q

during PPV both types of vessels are compressed. Why?

A
  • Alveolar vessels are compressed by expanding alveolus
  • extra-alveolar vessels are compressed as intrapleural pressure becomes less negative, transpulmonary pressure decreases, vessel is compressed
27
Q

If you add peep to PPV what happens to the vessels?

A

they stay compressed even at rest. makes compression worse

28
Q

lung structures distal to the terminal bronchioles such as respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli, receive O2 how?

A
  • respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli, receive O2 directly by diffusion from the alveolar air and receive nutrients from the mixed venous blood in the pulmonary circulation
29
Q

what two mechanism decrease PVR when CO increases?

A
  1. distention of pulm capillaries-increased co, increased pulm artery pressure, increased radius, decreased PVR
  2. recruitment of pulm capillaries-increased in perfused vessels in parallel
30
Q

histamine vasodilates the vascular beds but does what in the pulmonary vascular resistance?

A

vasoconstricts

31
Q

name 3 things that vasodilate the lungs?

A

nitric oxide, bradykinin, ach

32
Q

in regards to why does the base of the lungs have more blood flow;

the higher pressures in the base of the lungs due to higher hydrostatic pressure induce more ______ and ______leading to decreased resistance.

A

distention and recruitment

33
Q

where is blood flow highest when you’re supine?

A

posterior

34
Q

In regards to this goofy lung zone shit, if alveolar pressure is higher than pulmonary vein pressure and pulmonary artery pressure PA>Pa>Pv you would get zone ___ and ___ blood flow.

A

zone 1 and no blood flow.

35
Q

In regards to this goofy lung zone shit,

Pa>PA>Pv=

pulmonary artery >alveolar>pulmonary vein -what zone? what type of blood flow?

A

high alveolar flow is pitching off venous flow to the artery

zone 2

low flow

36
Q

In regards to this goofy lung zone shit,

Pa>Pv>PA

pulmonary artery >pulmonary vein>alveolar -what zone? what type of blood flow?

A

zone 3

high blood flow

increased work/exercise-high transmural pressure, distention of capillaries, decreased resistance

37
Q

What would increase the likely hood of creating zone 1?

4

A
  1. PEEP
  2. PPV
  3. Hemorrhagic or other types of shock
  4. inhaled anesthetics
38
Q

zone 1 would become zone 2 if ______was administered to patient of ventilator peep.

A

inotropic agent

39
Q

What is the stimulus for HPV?

A

response to decreased P02 by the pulmonary vasculature within the alveoli

40
Q

Is HPV locally or neuronally controlled?

A

locally

pulmonary vascular smooth muscle

41
Q

The pulmonary arterial smooth muscles cells contain ______sensitive ____ channels that open when oxidized by _____ ____ ____ and close when reduced during________.

vasodilation

A

The pulmonary arterial smooth muscles cells contain oxygen sensitive K channels that open when oxidized by reactive oxygen species and closed when reduced during hypoxia

42
Q

During hypoxia closure of the k channel inhibits ____of the vascular smooth muscle cell, ____ _____ ____channels open , vascular smooth muscle contracts, __________

A

During hypoxia closure of the k channel inhibits depolarization of the vascular smooth muscle cell, voltage gated Ca channels open , vascular smooth muscle contracts, vasoconstriction

43
Q

what can interfere with the HPV response?

A

high pulmonary artery pressure

HTN

stenosis

44
Q

what is the purpose of the HPV response?

A

To shunt blood to better ventilated areas and improve VQ mismatch

A and P 2.2 (3 decks)

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