lect 23- Pulmonary circulation Flashcards

1
Q

what is the circulation for high pressure, low flow

A

thoracic aorta–> bronchial arteries–> trachea, bronchial tree, adventitia, CT

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2
Q

what is the circulation for low pressure, high flow

A

pulmonary artery and branches–> alveoli

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3
Q

what is the value for the pulmonary arterial pressure

A

24/9 mm Hg

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4
Q

what is the value for mean pulmonary arterial pressure

A

15 mm Hg

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5
Q

what is the pressure gradient in pulmonary system

A

7 mm Hg

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6
Q

what is the mean pressure in the left atrium

A

2 mm Hg

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7
Q

what happens to pulmonary circulation if there is a failure in the life side of the heart

A

increases blood volume as much as 100%
increases blood pressure
mild systemic effect because systemic blood volume is 9 times that of the pulmonary system

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8
Q

what is “dirty blood”

A

blood coming from the lung parenchyma and life side of the heart (it bypasses the pulmonary capillaries)

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9
Q

what happens when oxygen concentration in alveoli is 70& or more below normal

A

adjacent blood vessels constrict

caused by unknown vasoconstrictor that is possibly released by alveolar epithelial cells

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10
Q

describe zone 1 of the lungs

A

no blood flow; local alveolar cap. pressure never rises higher than alveolar air pressure

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11
Q

describe zone 2 of the lungs

A

intermittent blood flow (only during systole)

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12
Q

describe zone 3 of the lungs

A

continuous blood flow

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13
Q

how is blood flow normally distributed into the zones

A

apices have zone 2 flow

lower areas have zone 3 flow

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14
Q

what happens to the zones in the lungs during exercise

A

convert apices from zone 2 to zone 3 flow

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15
Q

what leads to general circulation when a person stands up

A

the fact that the pulmonary veins are a blood reservoir, increasing pulmonary blood volume by up to 400 ml

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16
Q

what results from obstructing blood supply to one normal lung

A

blood flow through other lung is doubled

because of passive dilation of pulmonary vessels, the pulmonary pressure in the other lung is only slightly increased

17
Q

what agents constrict pulmonary arterioles

A

norepinephrine
epinephrine
angiotensin II
some prostaglandins

18
Q

what agents dilate pulmonary arterioles

A

isoproterenol

acetylcholine

19
Q

what agents constrict pulmonary venules

A

serotonin
histamine
E. coli endotoxin

20
Q

what does sympathetic vasoconstrictor nerve fibers do

A

outflow from cervical sympathetic ganglia
decrease pulmonary blood flow by as much as 30%
mobilize blood from pulmonary reserve

21
Q

what happens to blood from through the lungs during exercse

A

it increases 4X to 7X
number of open capillaries increases up to 3X
distends all capillaries and increases flow rate up to 2X
increase in pulmonary arterial pressure

22
Q

why is it important that pulmonary arterial pressure rises little even during max exercise

A

it conserves energy of right side of heart

prevents significant rise in pulmonary capillary pressure

23
Q

what happens during left heart failure

A

blood begins to dam up in left atrium

left atrial pressure rises from 1-5 mm Hg to 40-50 mm Hg

24
Q

when is pulmonary edema likely to occur

A

when left atrial pressure rises above 25-30 mm Hg

25
how does colloid osmotic pressure in pulmonary interstitial tissue compare to that in peripheral tissue
in pulmonary interstitial tissues it is about 2X as high
26
how is alveolar epithelium ruptured
by any positive pressure in the interstitial spaces greater than alveolar air pressure
27
what is the total outward force for capillaries (pulmonary interstitial forces)
29
28
what is the mean filtration pressure
28
29
how can excess fluid in the lung capillary be carried away
pulmonary lymphathics
30
what are the most common causes of pulmonary edema
left-sided heart failure or mitral valve disease | damage to pulmonary blood capillary membranes (infections, breathing noxious substances)
31
at what pressure will lungs usually collapse
-4 mm Hg
32
what is pleural effusion
edema of the pleural cavity
33
what are causes of pleural effusion
blockage of lymphathic drainage form pleural cavity cardiac failure considerably reduced plasma colloid osmotic pressure infection/inflammation
34
what does hypoxia do to pulmonary arteries
increases the pressure in them, possibly because of the release of prostaglandin
35
what is the result of bronchial obstruction
constriction of vessels supplying the poorly ventilated alveoli
36
what does reduction of blood flow to a portion of the lung do to alveolar PCO2
lowers alveolar PCO2, resulting in a constriction of the bronchi supplying that portion of the lung