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CPR Exam 2 > Pulmonary Blood Flow > Flashcards

Pulmonary Blood Flow Flashcards

1
Q

Which side of the heart does the pulmonary circulation receive blood from?

A

Right side whereas systemic receives from left

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2
Q

What is the source of blood going to the pulmonary circulation?

A

Systemic veins

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3
Q

What is the source of blood going to the systemic circulation?

A

Pulmonary veins

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4
Q

What is the pressure in the ventricle in the pulmonary circulation?

A

25/0

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5
Q

What is the pressure in the ventricle in the systemic circulation?

A

120/0

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6
Q

What is the pressure in the artery in the pulmonary circulation?

A

25/15

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7
Q

What is the pressure in the artery in the systemic circulation?

A

120/80

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8
Q

What is the CO for both the pulmonary and systemic circulation?

A

3.5-5 L/min

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9
Q

What is the PaO2 in the pulmonary circulation?

A

40

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10
Q

What is the PaO2 for the systemic circulation?

A

100

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11
Q

What is the PaCO2 in the pulmonary circulation?

A

45

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12
Q

What is the PaCO2 in the systemic circulation?

A

40

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13
Q

What response does the pulmonary circulation have to hypoxia?

A

Vasoconstriction

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14
Q

What response does the systemic circulation have to hypoxia?

A

Vasodilation —> deliver more blood/O2

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15
Q

What is hypoxic vasoconstriction?

A

Regional vasoconstriction in response to hypoxia through myogenic mechanism (no innervation required)

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16
Q

What is the purpose of hypoxic vasoconstriction?

A

Direct blood to areas of lung with better oxygenation

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17
Q

Describe the alveolar capillaries

A

Receive blood from the RV
Low O2 and high CO2
Involved in the exchange of O2 and CO2 between the blood and air

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18
Q

Describe the extra-alveolar (aka bronchial) capillaries

A

Receive blood from the LV
High O2 and low CO2
Deliver O2 and CO2 to the tissue of the lungs

19
Q

What are the two pathways of blood flow returning to the heart from the extra alveolar capillaries?

A

Flow into azygos vein and other nearby returning to RV
In the pulmonary veins -> leads to venous admixture which reduces the PaO2 of the arterial blood and increases the PaCO2 to a small degree

20
Q

How does blood return to the heart from alveolar capillaries?

A

Pulmonary vein

21
Q

What are the levels of blood gases in the veins in alveolar and extra alveolar vessels?

A

High O2 and low CO2

22
Q

How is pulmonary blood pressure calculated?

A

CO x PVR

23
Q

How does PVR compare with the rest of the body?

A

PVR is much lower than the rest of the body (about 1/10 of TPR)

24
Q

What is PVR determined by?

A

High number of capillaries
How many are open at any given moment in time
Much less sympathetic tone/vasoconstricting forces

25
Q

What happens to PVR during exercise?

A

Drops as more pulmonary capillaries open to accommodate the increased CO

26
Q

PVR also depends on what?

A

Lung volume
At low or very high lung volumes the resistance increases a little bc the stretch of the tissue compresses the capillaries (diameter of capillaries decreases a little)

27
Q

What is BP in PVR compared to systemic resistance?

A

25/15

Systemic 120/80

28
Q

Describe blood flow in the apex of the lungs

A

Blood pressure is reduced bc it is slightly above the heart
However the alveoli are expanded
The blood flow is less

29
Q

Describe blood flow in the middle of the lung

A

BP is a little higher bc we are at the level of the heart
Alveoli are an average size
Blood flow is “normal”

30
Q

Describe blood flow at the base of the lung

A

BP is high because we are below the level of the heart
Alveoli are smaller
Blood flow is greater than in other regions of the lung

31
Q

Regional blood flow is determined by what?

A

How gravity is acting on the blood and how much air is in that region of the lung

32
Q

What are chemical modulators of pulmonary blood flow?

A

NO, endothelin 1 and thromboxane A2

33
Q

What is the role of NO on pulmonary blood flow?

A

Made by endothelium (EDRF)
Causes SM relaxation and vasodilation
Significant role in normal pulmonary blood flow

34
Q

What role does endothelin 1 play on pulmonary blood flow?

A

Also made in the lungs
Vasoconstrictor
Seems to be a player under pathologic conditions (not normal conditions)

35
Q

What role does thromboxane A2 have on pulmonary blood flow?

A

Similar to endothelin 1

Can be found in the pulmonary vasculature under the right (pathologic) conditions

36
Q

What controls how much fluid moves from the capillary to the lung?

A

The starling forces (hydrostatic and oncotic pressures)

37
Q

Which forces move water from the capillary to the alveolus?

A

Capillary hydrostatic pressure
Tissue hydrostatic pressure
Oncotic pressure of the tissues

38
Q

Which forces move water from the alveolus to the capillary?

A

Capillary oncotic pressure

39
Q

Which pressure is the greatest in the lung?

A

Hydrostatic pressure in the capillaries

40
Q

What is the net result of starling forces in the lung?

A

Favor net filtration (movement) of fluid into the alveoli

But this is bad for gas exchange - solution = lymphatic system

41
Q

The lymphatics are crucial in doing what?

A

Removing the filtered fluid from the alveolus

42
Q

ACE not only converts angiotensin I into angiotensin II but it also does what?

A

Inactivates bradykinin

This is why people on ACE inhibitors can develop a cough

43
Q

How do the lungs participate in the metabolism of arachidonic acid metabolites?

A

Both leukotrienes and prostaglandins/thromboxane A2 are produced by immune system activation in the lungs
Prostaglandins E2 and F2-alpha are also almost completely removed from the circulation in the lungs as are the leukotrienes

CPR Exam 2 (18 decks)

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