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Cardiorespiratory Biology > Pulmonary Circulation > Flashcards

Pulmonary Circulation Flashcards

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1
Q

2 blood supplies to the lungs

A

the bronchial and the pulmonary circulations

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2
Q

bronchial circulation is part of what circulation and where does it arise from?

A

The bronchial circulation is part of the systemic circulation
– arises from the aorta

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3
Q

where does the bronchial vascular bed supply oxygen to?

A

The bronchial vascular bed supplies oxygen and nutrients to the
smooth muscle and interstitial tissues of the lung

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4
Q

where does blood supplied in the smooth muscle and interstitial tissue of the lungs go to afterwards

A

It drains into pulmonary veins and returns back to the left ventricle

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5
Q

because it drains into pulmonary veins and returns back to the left ventricle what does that mean for venous return and gas exchange

A

– so pulmonary venous return is slightly greater than cardiac output
– it is also why gas exchange will never be perfect

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6
Q

what does pulmonary circulation distribute and where

A

The pulmonary circulation transports deoxygenated blood from right ventricle to the alveolar capillaries
– and returns oxygenated blood to the left atrium

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7
Q

pulmonary circulation receives what cardiac output and why

A

• Pulmonary circulation receives the whole of cardiac output as right
ventricular output must equal left

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8
Q

the pressure in the pulmonary circulation

A

low pressure system

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9
Q

right ventricular pressure

A

25/0 mmHg

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10
Q

Pulmonary artery pressure

A

25/10 mmHg

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11
Q

Pulmonary Pulse pressure

A

15 mmHg

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12
Q

Mean Pulmonary pressure

A

15 mmHg

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13
Q

• Pulmonary capillary pressure

A

~6 mmHg

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14
Q

Left atrial pressure (LAP)

A

~ 2 mmHg

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15
Q

how is systemic pressure measured

A

plethysmography

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16
Q

where is pulmonary capillary pressure measured

A

capillary wedge pressure
– is slightly higher than left atrial pressure
– used to estimate left atrial pressure

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17
Q

HOW is pulmonary capillary pressure measured

A

• Catheter put through right side into branch of pulmonary artery
– it wedges at the pulmonary capillaries and stops flow

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18
Q

what is resistance and pressure like during inhalation and why?

A

• As lung expands during inspiration, the extra-alveolar vessels are
pulled open
resistance is low, pressure is low

19
Q

what is resistance and pressure like during expiration and why

A

lungs constrict during expiration, alveolar vessels smaller,
greater resistance and pressure

20
Q

how are the shapes of the alveolar capillaries changed by blood pressure and air pressure and wht

A

distended by blood pressure
compressed by air pressure
due to its thin walls

21
Q

why is there a difference between base and apex of lung

A

Given the height of the lung there is a difference in pressure between
the base and the apex
– it is ~30 cm in height, so this is ~22 mmHg of difference
– apex is -14 mmHg; base is +8 mmHg relative to cardiac leve

22
Q

3 different zones of pulmonary blood flow

A

zone 1 - no flow
zone 2 - intermittent flow
zone 3 - continuous flow

23
Q

zone 1 of pulmonary blood flow

A

capillary systolic pressure is less than alveolar leads to capillary collapse
– but only under abnormal conditions,
• e.g. very low pulmonary systolic pressure is there no flow at apex
PA > Pa > Pv

24
Q

zone 2 of pulmonary blood flow

A

– capillary diastolic pressure less than alveolar
– in exercise, increased pulmonary arterial pressure means continuous flow in lung
Pa > PA > Pv

25
Q

zone 3 of pulmonary blood flow

A

capillary diastolic pressure more than alveolar (most of lung).
Pa > Pv > PA

26
Q

pulmonary resistance

A

low pressure - low resistance
darcy’s law
can take larger cardiac output w/o increasing resistance or pressure

27
Q

pulmonary blood volume

A

500 ml

28
Q

breathlessness - in heart failure

A 
pulmonary congestion
heart failure, 
ventricle pressure rises,
pulmonary pressure rises
reduced flow
29
Q

how come pulmonary volume can increase w/o change in pressure or resistance

A

due to capillary recruitment and distension

30
Q

how is pulmonary resistance controled

A

low neural/hormonal influence (SNS, PNS innervation)
little myogenic/metabolic effect like in other beds
oxygen - important factor

31
Q

in pulmonary circulation hypoxia leads to …

A

constriction

32
Q

pulmonary arteries constrict because of..

A

hypoxia

33
Q

what does pulmonary arteries constriction in response to hypoxia control

A

capillary perfusion
shunting blood away from poorly ventilated areas
matching ventilation and perfusion

34
Q

important factors of hypoxic disease

A

– COPD/high altitude cause hypoxic pulmonary vasoconstriction
– ultimately leads pulmonary hypertension and oedema
– may eventually lead to right heart failure

35
Q

systemic circulation relates to …

A

starling forces
values in lungs are different
different pressure (hydrostatic pressure, mean interstitial pressure, colloid osmotic pressure) - bigger change in impact

36
Q

what does low hydrostatic pressure mean

A

low capillary pressure - 6mm Hg

37
Q

low lymphatic pumping mean

A

interstitial pressure lower: -8 mmHg

38
Q

colloid osmotic pressure means

A

– leaky capillaries allow more colloid in interstitium: 15 mmHg
– plasma colloid the same: 26 mmHg

39
Q

by what mechanisms do fluid in the alveoli leave?

A

active pumping of Na+ creating an osmotic gradient or

negative interstitial pressure sucks it out

40
Q

cause of peripheral oedema

A

an imbalance in Starling forces or failure

to clear fluid leads to oedema

41
Q

impact of interstitial oedema

A

increases the diffusion distance for O2 and
decreases lung compliance.
– if it reaches positive interstitial fluid pressure, fluid crosses alveolar
membranes giving alveolar oedema
– potentially fatal due to suffocation

42
Q

major causes of pulmonary oedema

A

Rises in pulmonary capillary pressure

Increases in pulmonary capillary permeability

43
Q

how does rise in pulmonary capillary pressure cause pulmonary oedema

A

left heart failure leads to failure of the circulation and pulmonary congestion
increasing capillary pressure
– high altitude causes hypoxic pulmonary vasoconstriction leading to HAPE
– in chronic conditions lymphatics can expand to compensate

44
Q

increases in pulmonary capillary permeability

A

– damage to the capillary in conditions like pneumonia
– damage leads to leakiness and a decrease in the colloid osmotic pressure holding
fluid in the capillary

Cardiorespiratory Biology (25 decks)

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