Lecture 3: Pulmonary Blood Flow Flashcards

1
Q

Where does blood entering alveolar capillary come from?

Is this oxygenated or deoxygenated?

A

Right ventricle via pulmonary artery

deoxygenated

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2
Q

What is the function of an alveolar capillary?

A

Gas exchange

  • get rid of the carbon dioxide
  • receive oxygen from alveoli
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3
Q

Where does blood entering extra-alveolar capillary come from?
Is this oxygenated or deoxygenated?

A

Left ventricle via aorta

oxygenated

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4
Q

What is the function of an extra-alveolar capillary?

A

Provide nutrients to and remove waste from airways

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5
Q

How does blood from an extra-alveolar capillary return to the heart?

A

Pulmonary vein
-came from feeding the airways, so it has lower oxygen and mixes with newly oxygenated blood that exchanged with the alveoli

Basically blood that returns to heart is less oxygenated compared to the blood that literally just came from the alveoli because of this venous admixture

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6
Q

How do you calculate pulmonary blood pressure?

What is the normal PBP?

A

Pulmonary BP = Cardiac Output x Pulmonary Vascular Resistance
-25/15 mm Hg

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7
Q

Why is pulmonary vascular resistance so low?

A

High number of capillaries and reduced SNS control increases surface area and lowers PVR

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8
Q

During exercise, does PVR increase or decrease? Why?

A

Decreases since more pulmonary capillaries open up (thus increasing the surface area) to accommodate the need for more blood flow

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9
Q
In the apex of the lung, there is:
\_\_\_\_ alveolar pressure
\_\_\_\_ blood pressure
\_\_\_\_ blood flow
\_\_\_\_ size of alveoli
A
In the apex, there is:
HIGH alveolar pressure
LOW blood pressure
LOW blood flow
LARGE size of alveoli
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10
Q
In the base region of the lung, there is:
\_\_\_\_ alveolar pressure
\_\_\_\_ blood pressure
\_\_\_\_ blood flow
\_\_\_\_ size of alveoli
A
In the base region of the lung, there is:
LOW alveolar pressure
HIGH blood pressure
HIGH blood flow
SMALL size of alveoli
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11
Q

How does gravity and muscle activity affect blood flow?

A

Gravity pulls blood down = pooling in the LEs

Muscle activity = helps fight gravity pull and aid venous return by “pushing” blood up

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12
Q

What is the role of nitric oxide in regulation of pulmonary blood flow?

A

released from endothelium due to shear stress on vascular walls > smooth muscle relaxation and vasodilation increasing blood flow (as in slowing it down to increase gas exchange interactions)

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13
Q

What is the role of endothelin 1 and thromboxane A2 in regulation of pulmonary blood flow?

A
  • vasoconstrictors that shunts blood away from diseased alveoli
  • having these are indicators of increase in dead space (disease)
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14
Q

In the lungs, what forces are pushing fluid out of the capillaries into the alveoli?

A
  1. Pc (hydrostatic pressure of capillaries): push fluid out of capillaries
  2. Pt (hydrostatic pressure of tissue - unique in lungs): Negative pressure in lung tissue favors fluid pushed out of capillaries
    πt (oncotic pressure of tissue): pulls water into alveoli
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15
Q

How does the starling forces result in a “wet” alveoli?

A

Net force = (Pc + Pt + Ot) - (Oc)

Forces pulling fluid out of the capillary overcome forces pulling fluid flowing into capillary, so net force favors leaking fluid unto alveoli

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16
Q

Why is a “wet” alveoli not good for oxygen diffusion?

How does the body compensate for this?

A

O2 is insoluble in H2O and cannot diffuse properly if alveoli is too wet

Lymphatics drain water in alveoli. If lymphatics are not functional, alveoli isn’t “drained” and impairs O2 exchange

17
Q

What enzyme converts angiotensinogen to angiotensin 1?

A

Renin

18
Q

Where is renin made?

A

jxtg cells of the kidneys

19
Q

What converts angiotensin 1 to angiotensin 2?

A

ACE

20
Q

Where is ACE found and what does it do?

What is a side-effect of ACE inhibitors?

A

Lungs and kidneys. Converts angiotensin I to angiotensin II and activates bradykinin.

bradykinin accumulation

21
Q

What does angiotensin do?

A

Vasoconstrictor (increases BP)

22
Q

Why do some people with high BP and are placed on ACE inhibitors develop a cough?

A

Accumulation of bradykinin

23
Q

Lungs participate in the metabolism of what?

A

Arachidonic Acid Metabolites

  • leukotrienes
  • prostaglandins E2 and F2α
  • thromboxane A2 (arachidonic acid metabolite)
24
Q

At too low or too high lung volumes, what happens to PVR?

A

stretches capillaries causing compression, decrease in capillary radius > increase in PVR

25
Q

What does Pulmonary HTN mean?

A

losing capillary network, so decreased gas exchange surface area > increased PVR > Pulmonary HTN

26
Q

How does PVR compare with TPR ?

A

similar blood volume, lower blood pressure and total resistance compared to systemic circulation