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CP2.07_Pulmonary Circulation > Pulmonary Circulation > Flashcards

Pulmonary Circulation Flashcards

1
Q

Lung receives blood flow from:

A
  1. bronchial circulation (oxygenated)
  2. pulmonary circulation (deoxygenated)
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2
Q

Bronchial blood flow constitutes what percentage of left ventricular output:

A

2%

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3
Q

The entire output of the right ventricle goes to:

A
  • pulmonary circulation
  • supplies the lung with mixed venous blood draining all tissues of the body.
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4
Q

Pressure in pulmonary circulatory system:

A
  • low pressure
  • allows for pulmonary capillaires to be very thin walled (for gas exchange).
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5
Q

Alveoli are connected to:

A
  • interstitium, which is connected to a pulmonary capillary bed.
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6
Q

Pressure in pulmonary circulation is what percentage of systemic blood pressure?

A

1/8th to 1/10th

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7
Q

Why can the pulmonary artery and its branches be much thinner walled than corresponding parts of systemic circulation?

A

pulmonary circulation is a low pressure system.

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8
Q

Pulmonary vessels have little vascular smooth muscle. What does this allow for?

A
  • less resistance and more distension than the systemic arterial tree.
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9
Q

Why are pulmonary vessels much more compressible than systemic arteries?

A
  • much lower intravascular pressures
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10
Q

Reasons for left ventricular maintaining high arterial pressure:

A
  • overcome hydrostatic forces.
  • pump blood “uphill” to brain.
  • redistribution of left ventricular output to control blood flow to different tissues.
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11
Q

Why is high pressure output from the right ventricle unnecessary?

A
  • apices of lung short distance from right ventricle.
  • redistribution of right ventricular output not necessary.
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12
Q

Why is redistribution of right ventricular output not necessary?

A
  • all alveolar-capillary units are performing the same function.
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13
Q

Right ventricle has thinner walls than the left ventricle because:

A
  • RV pumps blood into a low pressure/resistance system.
  • No redistribution of flow.
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14
Q

Higher pulmonary pressures will put the right ventricle under stress, which will cause:

A
  • right ventricle to dilation.
  • leads to a flattened interventricular septum.
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15
Q

A dilated right ventricle on echocardiogram/ultrasound is indicative of:

A

increased pulmonary pressure/resistance.

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16
Q

What type of catheter is used for measuring pulmonary artery pressures?

A
  • balloon tipped Swan Ganz catheter
    • measures:
      • RA pressure
      • pulmonary artery pressure
      • pulmonary capillary wedge pressure
17
Q

Pulmonary capillary wedge pressure is:

A
  • the pressure measured by wedging a pulmonary catheter with an inflated balloon into a small pulmonary arterial branch.
  • Gives pulmonary pressure and an indirect measurement of left atrium pressure.
18
Q

Gravity effect on the lungs:

A
  • pressures greater in lower lobes.
  • resistance to blood flow is lower in lower lobes.
19
Q

Why is resistance to blood flow lower in the lower lobes of the lung?

A
  • gravity causes higher pressure, which leads to greater blood flow and more recruitment and distention of vessels.
20
Q

When does perfusion seize in the lung?

A
  • alveolar pressure = pulmonary arterial pressure.
  • alveolar pressure > pulmonary arterial pressure.
21
Q

Characteristics/pressures of Zone 1 of the lung:

A
  • PA > Pa > Pv
  • ventilated, not perfused:alveolar dead space.
22
Q

Characteristics/pressures of Zone 2 of the lung:

A
  • Pa > PA > Pv
  • arterial pressure drives perfusion; perfusion in pulses.
23
Q

Characteristics/pressures of Zone 3 of the lung:

A
  • Pa > Pv > PA
  • ventilated and perfused.
24
Q

High alveolar pressure can compress the capillaries and reduce blood flow in Zone 1 of the lungs. What can cause this?

A
  • gravity when standing.
  • hemorrhage (decreases arterial pressure; Pa).
  • PPV (increases alveolar pressure).
25
Q

Effect of exercise on the zones of the lung:

A
  • cardiac output and pulmonary artery pressure increase.
  • Existing Zone 1s become Zone 3s.
26
Q

When a person is supine, do the zones of the lung exist?

A

No; zones are dependent on gravity.

27
Q

Process of hypoxic pulmonary vasoconstriction:

A
  1. alveolar hypoxia causes pulmonary vasoconstriction of the pulmonary vessels supplying the hypoxic region.
  2. pulmonary venous blood flow diverted away from poorly ventilated areas of the lung to well-ventilated areas by locally increasing vascular resistance.
28
Q

What occurs if you have hypoxia in an alveoli/region of alveoli?

A

hypoxic pulmonary vasoconstriction

  • regional vasoconstriction to divert pulmonary circulation to oxygenated alveoli to avoid a decrease in blood oxygen saturation.
29
Q

Pulmonary edema is:

A
  • extravascular accumulation of fluid in lung.
  • first in the interstitium and then later in alveoli.
30
Q

End result of pulmonary edema:

A
  • impaired gas transfer.
  • decreased oxygen diffusion.
31
Q

What occurs when fluid accumulates in the interstitium during pulmonary edema?

A
  • type 1 and type 2 pneumocytes junction injured.
  • increased distance of diffusion.
  • decreased diffusion.
32
Q

Conditions that may led to pulmonary edema (6):

A
  1. Increased capillary endothelium permeability.
  2. Increased capillary hydrostatic pressure.
  3. Decreased interstitial hydrostatic pressure.
  4. Decrease in plasma colloid (oncotic) pressure.
  5. Increased intersitial colloid (oncotic) pressure.
  6. Lymphatic insufficiency.
33
Q

Lymphatic removal is greatest where in the lungs?

A

at the bases of the lungs.

34
Q

At what values of increased extravascular fluid does the lymph system/removal become overwhelmed?

A
  • Lymph system can remove 10X what is normally in interstitial fluid.
  • Once 10X normal value of interstitial fluid is exceeded, pulmonary edema will result.
35
Q

Fluid exits a capillary when:

A
  • capillary hydrostatic pressure > capillary blood oncotic pressure.
  • Causes pulmonary edema.
36
Q

Fluid will not exit a capillary when:

A
  • capillary hydrostatic pressure = capillary blood oncotic pressure.
37
Q

Fluid reenters capillary when:

A
  • capillary hydrostatic pressure < capillary blood oncotic pressure.

CP2.07_Pulmonary Circulation (1 decks)

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