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Physiology > 5.2 Pulmonary > Flashcards

5.2 Pulmonary Flashcards

1
Q

for gas exchange to occur, we must have WHAT at same place?

A

1) ventilation (air)

2) perfusion (blood)

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2
Q

what is pulmonary vascular resistance?

A

the resistance to blood flow going thru pulmonary circulation AND how it is related to R ventricular cardiac output

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3
Q

what happens as R. ventricular output increases? (pumps more out)

A

resistance to outflow in pulmonary vasculature goes down

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4
Q

the more blood that goes into pulmonary vasculature, the ____ resistance to blood flow

A

less

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5
Q

as more blood goes into pul. vessels, why does resistance go down?

A

1) resistance in parallel add receprically
- -so when you have an increae inparallel pathways, total resistance goes down
2) increase in R. cardiac output bc they can distend ( or increase their vessel radius)

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6
Q

increasing cardiac output ____ resistance to bloodflow

A

decreases

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7
Q

what is physiological dead-space?

A

anatomic + alveolar deadspace

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8
Q

define alveolar dead-space?

A
  • ventilation but no perfusion

* wasted gas in alveolar, typically due to a clot stopping blood flow

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9
Q

define anatomic dead-space?

A

conducting pathways blocked so no gas exchange

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10
Q

1) what happens if you have both ventilation and perfusion at same spot?
2) one and not the other?
3) both at different spots?

A

1) Gas exchange!
2) no gas exchange
3) no has exchange

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11
Q

how can you get vent and perfusion mismatch?

A
  • clots and embolace = vent and no per

* mucus plug or objects inwindpipe= per but no vent

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12
Q

how much alveolar dead-space is in a healthy person?

A

very very low

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13
Q

what does your body do to an area of no gas exchange over a long period of time?

A

brachioconstriction!

bc why support air if there is no exchange

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14
Q

what is L to R shunting?

A
  • impacts large area of blood
  • when R deoxygenated blood dumps right into the L ventricle
  • low O2 and high CO2 in blood
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15
Q

what is hypoxic pulmonary vasoconstriction

A

something is blocking an airway and you do NOT have ventilation (become hypoxic)

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16
Q

define hypoxic

A

can’t get enough oxygen

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17
Q

what happens with no ventilation?

A

O2 keeps getting used but NOT resupplied. So alveolar gas becomes hypoxic and sends a signal to the upstream vessel to vasoconstrict
*hypoxic pulmonary vasoconstriction response

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18
Q

body response to an area of no ventilation?

A

decrease perfusion

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19
Q

is hypoxic pulmonary vasoconstriction a normal response?

A

Yes!

*segmented effect

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20
Q

when is hypoxic pulmonary vasoconstriction NOT a normal response?

A

high altitude with lower partial pressure of oxygen in the atmosphere. This can lead all of your alveolar to read as ‘hypoxic’ thus causing constriction

  • global effect
  • increase altitude= decrease partial pressure of oxygen
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21
Q

increase altitude= decrease _______ of oxygen

A

partial pressure

22
Q

what is edema?

A

movement of fluid from a vascular space into tissue

23
Q

filtration forces?

A

tend to move fluids from capilaries into tissue

*CPH and TOP

24
Q

reabsorption forces?

A

movement of tissue fluid into vessels

*COP and THP

25
Q

what are the types of filtration/reabsorption forces?

A

pulling and pushing

26
Q

oncotic vs hydrostatic pressure?

A
  • oncotic (aka osmotic or colloid)= pull

* hydrostatic (aka blood pressure)= push

27
Q

other names for oncotic and hydrostatic pressure?

A
  • oncotic (aka osmotic or colloid)

* hydrostatic (aka blood pressure)

28
Q

what happens to plasma proteins in burn injuries?

A
  • drop dramatically

- so if everything else stayed the same the filtration forces would be greater than reabsorption

29
Q

a lot of circulating plasma proteins means?

A

more capillary oncotic pressure

*fluid moved from tissues into vessels

30
Q

the higher the pulmonary capillaries, the greater?

A

the driving force of fluid thru fenestration (holes) into tissues

31
Q

What IS oncotic pressure? comes from? common protein?

A
  • comes from proteins= proteins PULL water towards them
  • typically albumin in blood/plasma= so draw water into vessels
  • PULL fluids
32
Q

edema causes separation of?

A

capillary and tissues

33
Q

what is Fick’s law of diffusion tell? T means?

A

tells you what is going on, how thick the barrier is between capillary and tissues
*T=thickness, INverse relation

34
Q

increase in barrier thickness= _____ diffusion

A

decrease

edema decreases diffusion

35
Q

does the R or L heart eject more?

A

eject the same amount!

36
Q

what is most common cause for pulmonary edema?

A
  • left heart failure (something is going on with left ventricle)
  • doesn’t take much of a mismatch to have a drastic result
37
Q

what is R CO is greater than L CO by one drop of blood (0.1 mL) for each heart beat?

A
  1. 1 mL/beat * 80 beats/min= 8mL of blood would back up in the pulmonary vasculature every minute
    * *shows how FAST a small change (congestive heart failure) can lead to a back-up of blood leading to an increase filtration leading to edema
38
Q

what can happento alveoli with pulmonary edema?

A
  • fluid can get into alveoli

- even worse, as fluid pressure increases outside of alveoli it can close off the alveoli sacs

39
Q

CAD?

A

coronary artery disease

40
Q

MI?

A

mycardial infarction

41
Q

myopathy

A

bacterial or viral infection

42
Q

hypertension

A

L vent keeps trying to pump blood out, but there is high aortic back pressure

43
Q

aortic stenosis

A

L vent works even harder to get stuff out. EVERY time it ejects over time it’ll have to work harder and harder. becomes over worked and starts to dysfunction

44
Q

regurgitation?

A

every time it ejects blood, some comes back into ventricle

45
Q

describe left heart failure?

A

R CO > L CO

  • pulmonary edema
  • dyspnea
46
Q

causes of left heart failure?

A

1) hypertension
2) weakened L ventircle= CAD, MI, myopathy
3) valve disease= stenosis and regurgitation

47
Q

describe right heart failure?

A

L CO > R CO

*peripheral, dependent edeme

48
Q

causes of right heart failure?

A

pulmonary hypertension

valve disease

49
Q

what happen if the left is pumping out more than the R can eject?

A

causes edema throughout the body

*standing causes ankles to swell and laying down means the lover back will swell

50
Q

if you hear peripheral edema, you should think?

A

right heart failure

51
Q

edema REALLY causes problems with?

A

gas exchange! at the alveolar/pulmonary capillary interface

Physiology (42 decks)

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