Pulmonary Circulation Flashcards

1
Q

What is the resting pressure of the pulmonary artery?

A

14 mmHg (25/8)

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2
Q

How does the pulm vasculature respond to an increase in pressure?

A

it does NOT auto regulate = it distends when intravascular pressure increases

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3
Q

Blood flow (inc or dec) from the apex to the base of the lungs. Why and how is this significant?

A

increases because the vascular resistance is lower at the base and pressure is higher at the base

Q = P/R

This means perfusion increases as you move from the apex to the base

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4
Q

Where does edema form in the lungs (in PAH)?

A

at the base (bc the pressure is highest there)

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5
Q

What keeps the lungs dry?

A

low pulmonary arterial pressure (low hydrostatic pressure in capillaries)

oncotic pressure in capillaries > OP in interstitial space

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6
Q

What effect does hypoxia have on lung arteries and arterioles?

A

causes them to constrict

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7
Q

What effect does hypercapnia have on lung arteries and arterioles?

A

causes them to constric

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8
Q

What effect does acidosis have on lung arteries and arterioles?

A

causes them to constrict

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9
Q

Blood flow to poorly perfused alveoli (inc or dec)?

A

decreases due to hypoxic pulmonary vasoconstriction

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10
Q

The greater the alveolar ventilation : Q ratio, the (higher or lower) the O2 and CO2 content.

A

higher O2 and lower O2

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11
Q

Will supplemental O2 correct a VA/Q mismatch?

A

yes

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12
Q

Will supplemental O2 correct a shunt?

A

no

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13
Q

Where is alveolar ventilation the greatest? Why?

A

lung base

Gravity and the lung’s weight ↑ the pleural pressure at the lung base → makes pleural pressure less negative ∴ ↓ alveolar volume → smaller alveoli are more compliant ∴ capable of more efficient ventilation.

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14
Q

Where is Q the greatest? Why?

A

lung base

Because of gravity, when a patient is upright pulmonary blood flow is highest at the base and lowest at the apex.

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15
Q

What does the VA/Q (alveolar ventilation/blood flow) represent?

A

describes how efficiently gas is exchanged

V/Q is highest in the apex and lowest in the base:
↑ V/Q (e.g., at the lung apex) → ↑ PO2, ↓ alveolar PCO2
↓ V/Q (e.g., at the lung base) → ↓ PO2, ↑ alveolar PCO2

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16
Q

What effect does VA/Q mismatch have on PaCO2?

A

No effect. PaCO2 is determined by the production of CO2 (VCO2) and the VA

VA/Q mismatch will decrease PaO2

17
Q

How can PaCO2 be corrected?

A

increasing ventilation

18
Q

How does a shunt effect PaCO2?

A

no effect. PaCO2 is determined by the production of CO2 (VCO2) and the VA

VA/Q mismatch will decrease PaO2

19
Q

If VA/Q = 0 what is going?

A

VA = 0 which indicates airway obstruction

20
Q

If VA/Q = infinit

A

Q = 0 which indicates hypotension or pulmonary embolism

21
Q

When will the PO2 and PCO2 of alveolar capillary blood will approach that of mixed venous blood?

A

when there is no gas exchange

↑ pCO2 because it can’t be exhaled and ↓ pO2 – it can’t be inhaled