Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Spr2015_Week5 > PULM HTN LECTURE SLIDES > Flashcards

PULM HTN LECTURE SLIDES Flashcards

1
Q

Functions of bronchial circulation (2)

A

1) protects lung from infarction (PE, pneumonia)

2) can grow into diseased areas (intercostal arteries) -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Consequences of bronchial circulation

A

1) source of hemoptysis (cough up blood)

2) much of arterial flow drains into LA = shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does bronchial circulation supply?

A

conducting arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

bronchial circulation is ___ in origin

A

systemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

tissue beds have ___ to blood flow

A

resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

circulation variables
driving force

flow

resistance

A

driving force = P

Blood flow = Q/CO

vascular resistance = PVR/SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

combining pulm circulation variables into equation

A

PAP – LAP = CO * PVR

PAP: Pulmonary artery pressure
LAP: Left atrial pressure
CO: Cardiac output
PVR: Pulmonary vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

units of

CO
Pressures
PVR

A 
CO = liters/min
Pressure = mmHg
PVR = woods unit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The following measurements are made in a patient:
Mean PA pressure = 25 mmHg
Left atrial pressure = 10 mmHg
Cardiac output = 5 L/min
What’s the pulmonary vascular resistance?

A. 1 Wood Unit
B. 2 Wood Units
C. 3 Wood Units
D. Cannot be determined

A

Answer = C (3 woods units)

25-10 = 5 x PVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is function of large elastic arteries

A

absorb pulsatile flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is function of muscular pulm arteries

A

regulate blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

steps in pulm circulation

A

1) arteries (run with broncholes)
2) capillary network
3) veins run with interlobular septae (lymphatics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Difference between systemic vs. pulm circulation

A

Pulm circulation
Low resistance
Low elastance/High compliance
Low pressure

both have same CO = 5L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s DIFFERENT between the pulmonary and systemic vasculature?

A. The pulmonary circulation has lower resistance.
B. The systemic circulation has higher compliance.
C. The pulmonary artery pressure is higher.
D. The cardiac output.

A

A = The pulmonary circulation has lower resistance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you measure PA pressure
Non-invasive echocardiography

why?

equation?

errors?

A

Looking at tricuspid valve regurgitation

RV becomes dilated so you get jet of blood backwards
in normal person you can’t measure

Simplified Bernoulli equation
P = 4 x V^2
= 4 x (3 m/s)^2
= 36 mm Hg (systolic) + RA pressure

Errors = +/- 10 mmHg common (greater)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you measure PA pressure
Pulm artery catheterization with Swan-Ganz Catheter

Method?

What do you measure?

A

1) Place catheter into boy
2) catheter drift thru body into RV and then exists pulm valve into vasculature
3) obstruct a small pulm artery

Make a static water column, because no movement distal to balloon (Q = 0, dP = 0)

= Pulm capillary wedge pressure

17
Q

what is pulm capillary wedge pressure can be equal to?

A

~ LA pressure

~ LV EDP

18
Q

Modern PA catheter used to measure what?

A

1) RA pressure
2) PA pressure
3) PCP
4) CO via thermodilution or laser doppler
5) central venous O2 saturation (light absorption)

19
Q

Normal hemodynamics pressure values

RA 
RV 
PA
PCWP
CO
PVR
A 
RA = 0-5 mmHg
RV = 25/0 mmHg
PA = 25/10 mmHg; PA mean = 15-20
PCWP = 5-8 mmHg
CO = 5L/min
PVR = 1-2 WU
20
Q

Swan Ganz catheter is floated in a patient and the following tracing is seen. What does this patient have?

A. The pulmonary vascular resistance is increased.
B. Tricuspid valve regurgitation.
C. Pulmonic valve stenosis.
D. Low cardiac output.

A

Answer = C = pulm valve stenosis

RA = normal
RV = pressure incr stays low on the bottom
PA = bottom number should incr because one way valve behind you but top number should stay high

in this patient, there is a pressure gradient from RV into pulm artery (because pulm

PRESSURE DROPS FROM RV into PA

IF ANSWER WERE A, YOU WOULD SEE
if pulm vascular resistance there were a drop in diastolic pressure from pulm artery into wedge pressure

PA diastolic pressure should be same as PCWP diastolic pressure

21
Q

A

A

A

22
Q

A

A

A

23
Q

A

A

A

24
Q

CO may rapidly incr without a ___

A

significant change in the arterial system

CO incr from 5L/min to 20 L/min

25
Q

if pulm vasculature resistance is fixed, then you should see___

A

linear relationship between cardiac output and PA pressure

but pressure incr 1/2 as much

26
Q

Why does pressure incr as much as expected?

A

1) high capacitance = more distensible vesels than systemic arteries (7x more distensible)
2) recruitment of unperfused vessels

27
Q

A dehydrated patient receives an intravenous bolus of fluid. What will happen to the patient’s lung zones?

A. There will be an increase in Zone 1.
B. There will be a decrease in Zone 3.
C. Some Zone 2 lung will become Zone 3.
D. Some Zone 2 lung will become Zone 1

A

answer = C

dehydrated
so low pressure in pulm vsculature
augment pulm vasculature (incr little bit, incr CO)
some zone 3 that was intemrittently perfused will have continuous blood flow now and become zone 2

28
Q

additional regulatory mechanisms

hypoxic pulm vasoconstriction

A

Vasoconstriction in areas with alveolar
hypoxia

– Serves to preserve V/Q matching - very important to survival”

29
Q

hypoxic pulm vasoconstriction is different from ___

A

systemic system –> hypoxic vasodilation

not necessary in healthy lungs

30
Q

a

A

a

31
Q

a

A

a

32
Q

a

A

a

33
Q

normally little blood that enters interstitium leaving capillaries goes into interstitium and then into lymphatics

A

a

34
Q

when more fluid leaving capillaries into interstitium

A

alveoli begin filling up in alveolus

35
Q

A patient sustains a crush injury of the leg in a car accident, and then 6 hours later develops respiratory failure with this chest x-ray. What will help the patient?

A. Lung protective ventilation.

B. Antibiotics.

C. Diuretics.

D. Pulmonary vasodilators.

A

noncardiogenic pulm edema = acute respiratory distress syndrome

Answer = A

lung protective ventilation

pulm vessels not narrow
pulm vessels are leaky

36
Q

A patient in respiratory failure has this chest x-ray. A Swan Ganz catheter is placed and the pulmonary capillary wedge pressure is 20mmHg. What will help this patient?

A. Lung protective ventilation.

B. Antibiotics.

C. Diuretics.

D. Pulmonary vasodilators.

A

Answer = C

Diuretics because elev pulm capillary wedge pressure
normal wedge = 10
elev PCWP so pulm edema and pressure eev,

Spr2015_Week5 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions