Lecture 2 Pt 1 Exam 1 Material Flashcards
1
Q
Pulmonary system provides perfusion for ____
A
Gas exchange
2
Q
Bronchial system provides perfusion to ____
A
Certain respiratory structures
3
Q
The pulmonary artery carries ____
A
Deoxygenated blood to the lungs
4
Q
The pulmonary vein carries ___
A
Oxygenated blood to the heart/body
5
Q
What two are opposite (in terms of oxygenation) of every other artery and vein in the body?
A
Pulmonary artery & pulmonary vein
6
Q
Superior vena cava, coronary sinus, and inferior vena cava go to the ____
A
Right atrium
7
Q
What veins lead into the right atrium? (3)
A
Superior vena cava
Coronary sinus
Inferior vena cava
8
Q
Right atrium –>
A
Right ventricle
9
Q
Right ventricle –>
A
Pulmonary artery
10
Q
Pulmonary artery <–
A
Right ventricle
11
Q
Right ventricle <–
A
Right atrium
12
Q
Pulmonary artery –>
A
Lungs
13
Q
Lungs –>
A
Pulmonary vein
14
Q
Pulmonary vein <–
A
Lungs
15
Q
Lungs <–
A
Pulmonary artery
16
Q
Pulmonary vein –>
A
Left atrium
17
Q
Left atrium –>
A
Left ventricle
18
Q
Left ventricle –>
A
Aorta
19
Q
Aorta –>
A
Bronchial artery (oxygenated)
20
Q
Bronchial artery <–
A
Aorta
21
Q
Aorta <–
A
Left ventricle
22
Q
Left ventricle <–
A
Left atrium
23
Q
Left atrium <–
A
Pulmonary vein
24
Q
Pulmonary artery contains
A
Mixed venous blood
25
Bronchial artery (oxygenated) -->
Lungs
26
Lungs -->
Bronchial vein
27
Mixed venous blood contains the
Sum of all the venous inputs
28
Mixed venous blood (sum of all venous inputs) 3:
Inferior vena cava
Superior vena cava
Coronary sinuses
29
Mixed venous sample is taken from the
Pulmonary artery
30
Mixed venous reflects the final balance of ____
Body's O2 supply and demand
31
What does decreased MVO2 indicate about oxygen use?
Body is using more oxygen (ie sepsis)
32
Venous admixture is created by ____
Venous drainage of the bronchial system
33
Venous admixture happens in the
Pulmonary vein
34
Venous admixture has already circulated through the ____
Lungs
35
Venous admixture is venous return to the ___ side of the heart
Left
36
What is venous return to the left side of the heart?
Venous admixture
37
Venous admixture dilutes ____ blood with ___ blood
Oxygenated blood with deoxygenated blood
38
Because of admixture, left ventricular output is ____
NOT maximally oxygenated
39
When blood leaves the ventricle, it is _____ as when it leaves the lungs
Less oxygenated
40
Blood that goes through the right atrium, right ventricle and into the pulmonary artery is oxygenated/deoxygenated?
Deoxygenated
41
Blood that goes through the pulmonary vein, left ventricle, and aorta is oxygenate/deoxygenated?
Oxygenated
42
Venous admixture and mixed venous differ how:
Venous admixture = poorly oxygenated blood mixing with normally oxygenated blood (pulmonary vein blood and left atrium blood)
Mixed venous = combined blood from all the body's veins (from pulmonary artery)
43
Venous admixture is a combination of blood from the ____ and the ____
Pulmonary vein (highly oxygenated) and left atrium blood which came from the bronchial vein system (deoxygenated)
44
Bronchial artery carries ____ blood
Oxygenated
45
Bronchial vein carries ____ blood
Deoxygenated
46
Pulmonary artery carries ____ blood
Deoxygenated
47
Pulmonary vein carries ____ blood
Oxygenated
48
______ _____ and ______ are _____ than systemic arteries
Pulmonary arteries and arterioles are larger than systemic arteries
49
Pulmonary arteries and arterioles accommodate ____ volumes under _____
Large volumes under low pressure
50
What provides hydrostatic pressure for perfusion of the respiratory membrane?
Pressure in pulmonary arteries
51
Normal RV value:
25/0
52
Normal PA value:
22/8
53
Normal pul cap value:
10
54
Normal LA value:
4
55
When is the pressure the lowest when placing a pulmonary artery catheter? (WHERE at in the heart)
Right atrium
56
The right atrium pressure is ____
0
57
What vessels have very low pressure?
Capillaries
58
A normal physiologic response to poor ventilation of alveolus:
Hypoxic pulmonary vasoconstriction
59
Adequate gas exchange requires both _____ and _____
Ventilation and perfusion
60
Alveoli that are underventilated do NOT contribute to ______
Gas exchane
61
Vessels to the alveoli (hypoxic pulmonary vasoconstriction) slowly ____
Constrict
62
HPV (hypoxic pulmonary vasoconstriction) is the body's attempt to match _____ and _____
Ventilation and perfusion
63
The purpose of vasoconstriction during HPV is to help keep oxygen higher/lower than what it would be otherwise.
How?
Higher
Blood supply around alveoli constrict to decrease blood flow so blood can be available to go elsewhere
64
HPV (hypoxic pulmonary vasoconstriction) is inhibited by (2):
Inhalation agents
Vasodilators
65
When HPV is inhibited, _____ suffers
Oxygenation
66
Hypoxic pulmonary vasoconstriction occurs to _______ and the compensation is when supplying blood vessels _____
Poorly ventilated alveoli
Compensates by blood vessel constriction
67
What factors increase blood flow to lungs?
HPV
68
What factors decrease blood flow to lungs?
Nitric oxide (dilator)
Prostacyclin
69
What factors can increase or decrease blood flow to lungs?
Endothelin
70
How does ANS affect pulmonary blood flow?
It does not
**Local effects predominate
71
PVR is increased by: (6)
Nagelhout reading
Norepi
Serotonin
Histamine
Hypoxia
Endothelin
Leukotrenia
72
PVR is decreased by: (4)
Prostacyclin
Endothelin receptor antagonist
Phosphodiasterase 5 inhibitors
Acetylcholine
73
Sympathetic activity causes _____ of blood vessels
Vasoconstriction
74
Less sympathetic activity causes _____ of blood vessels
Vasodilation
75
Sympathetic activity causes _____ of pulmonary circulation
Bronchodilation
**Think of fight or flight, opens lungs so you can breathe better during a fight or running
76
Parasympathetic activity causes ____ of pulmonary circulation
Bronchoconstriction
77
Is blood distribution uniform throughout the lung?
No
78
The idea that blood distribution is affected/influenced by gravity correlates with the ____ zones
West
79
In Zone 1: list the pressure greatest to least
PA > Pa > Pv
Alveolar, arterial, then venous
80
In Zone 2: list the pressure greatest to least
Pa > PA > Pv
Arterial, alveolar, then venous
81
In Zone 3: list the pressure greatest to least
Pa > Pv > PA
Arterial, venous, alveolar
***Think Zone 3 is closest to gravity, so there is going to be constant blood flow
Constant blood flow = higher pressure (pressure occurs in arteries and veins, so it is higher than alveolar pressure)
82
Which zone is pathological?
What is a common cause?
Zone 4
Wet lungsI
83
Which zone is ABNORMAL?
Zone 4
84
In Zone 4: list the pressure greatest to least
Pa > Pi (interstitial) > venous > PA
85
Which common zone is not always present?
Zone 1
86
Zone 1 can be created by: (2)
Increased Pa (arterial pressure)
Decreaed Pa
87
In relation to the creation of a Zone 1, what will cause a decreased Pa?
Low perfusion
Hypovolemia
88
In relation to the creation of a Zone 1, what will cause an increased Pa?
Overventilation, air trapping
89
True or false: Ventilation distribution is uniform through the lung
False
It is not uniform
90
True or false: Ventilation distribution is affected by gravity
True
91
Are alveoli more expanded at the top or at the base?
Top
(resting volume at base is smaller than at apex)
92
During inspiration, which alveoli can be opened more?
Lower alveoli can be opened more than the upper alveoli DURING INSPIRATION
93
In the lung: Comparing blood flow, what area has greater blood flow than every other areas of blood flow?
Lower lung
94
In the lung: Where is the greatest ventilation?
Lower lung
95
What are the causes of a PE?
Air, tumor, bone, fat, clot, amniotic fluid, catheter fragment
96
The most common cause of a PE is a ____
Clot
97
Risk factors of a PE include the _____ triad. What 3 things make up this triad?
Virchow's
1. Hypercoagulability
2. Vessel wall abnormalities
3. Venous stasis
98
With a PE... what happens to:
Deadspace (increases/decreases)
PaCO2 (increases/decreases)
ETCO2 (increases/decreases)
Deadspace increases
PaCO2 increases
ETCO2 increases
99
Zone 1 PE would increase/decrease dead space?
Increase
100
A PE will ____ ETCO2. Why?
PaCO2 increases because they cannot blow it off, if the CO2 is not blown off, then the ETCO2 will decrease
101
PE hemodynamics:
Increased PVR
Decreased pulmonary venous return to LV
...leads to Decreased SV
102
Pulmonary hypertension (elevated pulmonary vascular pressures) etiology:
Essential (Uncommon)
COPD (causes heart strain)
PE (acute, specific cause of elevated pressure)
103
Pulmonary hypertension can lead to ____
Cor Pulmonale-RV failure
