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075. Cardiopulmonary Exam 1 > 9. Pulmonary Blood Flow > Flashcards

9. Pulmonary Blood Flow Flashcards

1
Q

What is the blood pressure in the right ventricle compared to the left ventricle? Why are they different?

A

They are different because the left pumps blood to the whole body, so needs more pressure while the right ventricle onle pumps to the lungs. Right ventricle is 25/0 while left ventricle is 120/0

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2
Q

What is the blood pressure in a typical left and right atria and why?

A

15/4, diastole is higher so blood can flow into the heart

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3
Q

For cardiac output, what is the BP for aortic A and the pulmonary A from the left and right ventricle respectively?

A

Aorta: 120/80
Pulmonary: 25/15

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4
Q

Where will blood back up if there is a problem between left and right ventricles?

A

In the lungs

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5
Q

Why is the volume of blood the same but the pressure is different between left and right ventricles?

A

Because the right ventricle is only pumping to the lungs, so since there is less resisitance to blood flow, there is less pressure! Opposite in left ventricle which sends to the entire body, with high resisitance to blood flow requiring high pressure to get the blood out

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6
Q

Alveolar capillaries receive blood from the right ventricle, containing blood that has low O2 and high CO2. What do alveolar capillaries do?

A

Involved in the exchange of O2 and CO2 between blood and air, there are millions of capillaries!

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7
Q

Extra-alveolar capillaries such as the trachea/bronchi need CO2 removed as well. They receive blood with O2 from the left ventricle via aorta, doing what?

A

Delivering oxygen to the tissues and taking up the CO2

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8
Q

How is the deoxygenated blood from the extra aveolar capillaries transported back to the heart to get oxygenated?

A

They are brought back via pulmonary veins, which is called venous admixture. Pulmonary veins carry oxygenated blood from lungs to heart, so the deoxygenated blood from extraveolar reduces PaO2 of the arterial blood and increases PaCO2, but minimally

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9
Q

What is the equation to calculate blood pressure through the body?

A

Cardiat output (how much blood/min (usually 5L/min) x TPR (resistance to blood flow/ how hard it is to pump blood to body: Total peripheral resisitance)

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10
Q

What is the modified equation to calculate pulmonary blood pressure ?

A

PBP= Cardiac output (CO) x PVR (pulmonary vascular resistance/resisitance to blood flow through lungs)

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11
Q

Why is pulmonary vascular resistance much lower than systemic blood pressure?

A

There are millions of capillaries for the blood to flow into. During exercise PVR drop more d/t opened capillaries d/t increased cardiac output

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12
Q

What occurs when the lung volume is very low or high?

A

pulmonary vascular resistance increases a little because of the stretch of the tissue compresses the capillaries, decreasing diameter of the capillaries

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13
Q

Why does someone faint when he/she locks his knees for an extended period of time?

A

Gravity acting on blood brought blood to his legs, and passed out because less blood was returning to his heart/brain d/t locked knees

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14
Q

What occurs at the apex of the lung regarding blood pressure and blood flow? (PA>Pa>PV)

A

BP is reduced because it is above the heart and blood flow is less, and alveoli are expanded, meaning all RBCs are oxygenated

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15
Q

What occurs at the middle of the lung regarding blood pressure and blood flow? (Pa>PA>PV)

A

BP is higher cause at heart level and blood flow is average, alveoli is average size, more Pa

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16
Q

What occurs at the base of the lung regarding blood pressure and blood flow? (Pa>PV>PA)

A

BP is high becuase below level of heart (GRAVITY) and blood flow is greater. Alveoli are smaller!

17
Q

How does nitric oxide made by endothelium, act as a chemical modulator of pulmonary blood flow?

A

Causes smooth muscle relaxation and vasodilation, plays role in normal pulmonary blood flow

18
Q

How does thromboxane A2/ endothelin 1 by endothelium act as a modulator of pulmonary blood flow?

A

Made in the lungs, acts as a vasoconstrictor under PATHOLOGICAL conditions

19
Q

How is O2 a modulator of pulmonary blood flow?

A

When there is an increase, blood vessels relax and when there is a decrease, blood vessels vasconstrict d/t needing to send blood to lungs for O2

20
Q

How does hypoxia cause periphery edema?

A

Hypoxia causes lungs to vasoconstrict, increasing PVR and BP leading to right heart failure, right ventricle hypertrophy = periphery edema cause nowhere for blood to go

21
Q

What happens if the alveoli are not kept dry, meaning water leaks into the alveoli?

A

It would impair the ability of oxygen to cross to the blood

22
Q

What keeps water from moving into the alveoli?

A

Starling forces control how much fluid moves from the capillary to the lung

23
Q

One of the starling forces is hydrostatic pressure (fluid pushing against the tissue/walls of the capillary). What are the two hydrostatic pressures?

A
  1. The capillary Pc: BP in the capillary trying to push fluid into alveoli
  2. The tissue Pt: in body, pushes fluid from capillary to alveolus
24
Q

Why does the hydrostatic pressure of tissue push fluid from capillary to alveolus?

A

Due to the same forces that make negative intrapleural pressure (lung always tring to collapse, the chest wall trying to sping away) creates a negative hydrostatic pressure (-5cmH2O)

25
Q

The second starling force is oncotic pressure (osmotic pressure of the fluids). What are the two different oncotic pressures determining if water enters the alveolus?

A
  1. The plasma capillary oncotic pressure (Pi c), tries to pull water into capillary
  2. The tissue oncotic pressure (Pi t), tries to pull water into alveolus
26
Q

What is the great force of the starling forces in the lung?

A

The hydorstatic pressure in the capillary (Pc) influencing water to go from cap to alveoli

27
Q

The starling forces favor a filtration (movement) of H20 into the alveoli, but this would deminish gas exchange, so what do we have that will pick up the water?

A

The lymphatics solve our problem and take extra fluid away from the lungs

28
Q

What enzyme converts angiotensinogen (protein added to plasma by liver) to angiotensin 1. And what does that do?

A

Renin converts to angiotensin 1, which is a weak vasoconstrictor in the blood

29
Q

How is angiotensin 1 converted to the more active angiotensin 2 in the lungs? what does AGT2 do?

A

converted by ACE angiotensin converting enzyme.

Agt2 is an extreme vasoconstrictor

30
Q

What is another important job of ACE?

A

Inactivates bradykinin, so when people are put on ACE inhibitors, the develop a cough due to an accumulation of bradykinin

31
Q

What arachidonic acid metabolites are produced by the lungs as well?

A

Leukotrienes and protaglandins/thromboxane A2

Prostaglandin E2 and F2alpha are removed by lungs

075. Cardiopulmonary Exam 1 (23 decks)

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