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My respiratory physiology > Pulmonary Circulation, Pulmonary Edema, Pleural Fluid > Flashcards

Pulmonary Circulation, Pulmonary Edema, Pleural Fluid Flashcards

1
Q

Do pulmonary arteries and arterioles have larger diameters than their systemic counterparts,true or false?

A

True

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2
Q

What does the wider diameter of the pulmonary vessels along with their thin and distensible properties allow for?

A

Large compliance - 7ml/ mm Hg. Allows accommodating the stroke volume of the right ventricle.

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3
Q

why are pulmonary arteries and veins short?

A

Because only need to transport blood from heart to lung or vice versa.

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4
Q

Where do the bronchial arteries supply blood to?

A
  1. supporting tissues of the lung.
  2. septa.
  3. Large and small bronchioles.
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5
Q

What happens to the blood transported via the bronchial arteries?

A

It ends up entering the LEFT atrium rather than the right. This explains why the output in the left ventricle is 2% higher than the right one.

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6
Q

Describe the pathway of the lymphatic system in the lungs.

A

It starts in the connective tissue spaces surrounding the terminal bronchioles. Then in the hilum to end mainly in the right thoracic lymph duct.

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7
Q

How does the lymphatic system prevent pulmonary oedemas?

A

To pump tissue fluid from the interstitial space between pulmonary capillaries and the alveoli.

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8
Q

By how much, is the pressure in the left ventricle greater than the right one?

A

5 times

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9
Q

Why does the pressure in the pulmonary artery fall much SLOWER than in comparison to the right ventricle?

A

the semilunar valve shuts closes after systole, therefore, allowing the pressure in the right ventricle to decrease dramatically.

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10
Q

Values for:

  1. systolic pulmonary arterial pressure
  2. diastolic pulmonary arterial pressure
  3. Mean pulmonary arterial pressure
A
  1. 25mm Hg
  2. 8mm Hg
  3. 15mm Hg
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11
Q

Value for mean pulmonary capillary pressure?

A

7mm Hg

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12
Q

How do you estimate the left atrial pressure?

A

use the pulmonary wedge pressure. Use catheter to record pressure of small pulmonary artery which is 2-3 mm Hg greater then left atrial pressure.

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13
Q

what is the blood volume of the lungs?

A

450 ml

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14
Q

Give an example when the pulmonary circulatory system acts as a ‘blood reservoir’ for the systemic circulatory system?

A

Haemorrhage.

Heavy breathing may also cause a build-up of blood pressure in the lungs leading to some to transported to systemic system.

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15
Q

What might mitral stenosis ( narrowing of the mitral valve) do?

A

Increase the pulmonary vascular pressure.

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16
Q

What happens when the oxygen pressure falls below 70% (73 mm Hg) in the alveoli? (Hypoxia)

what’s different about this?

A

Blood vessel vaso-constrict in the pulmonary system.

ii. It is different from the systemic system as blood vessels vaso-dilate during hypoxia.

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17
Q

What is a possible reason for vaso-constriction during hypoxia?

A

Maybe due to the fact that vasodilator substances are inhibited in the lungs such as nitric oxide.

Others believe hypoxia may directly induce vasoconstriction by inhibition of oxygen-sensitive potassium ion channels in pulmonary vascular smooth muscle cell membranes. With low partial pressures of oxygen, these channels are blocked, leading to depolarization of the cell membrane and activation of calcium channels, causing influx of calcium ions. The rise of calcium concentration then causes constriction of small arteries and arterioles.

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18
Q

What are the benefits of pulmonary vessels constricting during hypoxia?

A

This dramatically increases vascular resistance. Therefore it diverts blood to alveoli which are aerated.

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19
Q

What is the pulmonary arterial pressure difference from the uppermost part of the lung to the lowermost part?

A

23 mm Hg

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20
Q

what are the two important factors acting on pulmonary capillaries?

A
  1. blood pressure causes them to distend.

2. alveolar air pressure causes them to contract.

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21
Q

Describe what would happen in zone 1 pulmonary blood flow?

why is this?

A
  1. No blood flow throughout all stages of the cardiac cycle.

2. Alveolar air pressure is greater than the blood pressure in the capillaries.

22
Q

Describe what would happen in zone 2 pulmonary blood flow?

why is this?

A
  1. intermittent blood flow. It only occurs during systole.

2. Systolic blood pressure is greater than alveolar air pressure. However, diastolic blood pressure is lower.

23
Q

Describe what would happen in zone 3 pulmonary blood flow ?

why is this?

A
  1. continuos blood flow.

2. Alveolar capillary pressure is able to maintain being higher than alveolar air pressure.

24
Q

Where would you find zone 2 pulmonary blood flow normally?

A

It starts 10 cm above the midline of the heart and extends to the apexes of lungs.

25
Q

where would fine zone 3 pulmonary blood flow normally?

A

It starts 10cm above the level of the heart all the way to the bottom of the lungs.

Also when a person is lying down as the lungs are only a few centimeters above the heart, the entire pulmonary system as zone 3 blood flow.

26
Q

What may cause zone 1 blood flow?

A
  1. upright patient breathes against positive air pressure. This would lead to zone 1 in the apexes.
  2. systemic blood loss would decrease the systolic blood pressure.
27
Q

How does exercise help blood flow?

A

Increases pulmonary vascular pressure in the lung apexes causing zone 2 blood flow to change to zone 3.

28
Q

What three ways does the pulmonary system accommodate for extra blood flow during exercise?

A
  1. Increase number of opened capillaries
  2. Distend all capillaries
  3. Increase pulmonary arterial pressure.

First two greatly lower pulmonary vascular resistance greatly meaning PAP wasn’t needed to increase that much.

29
Q

What are the benefits of not greatly increasing the pulmonary arterial pressure?

A
  1. Saves energy for right side of heart.

2. Stops rise in pulmonary capillary pressure reducing risk of pulmonary oedemas forming.

30
Q

What is the normal maximum value of the left atrial pressure?

A

+6 mm Hg

31
Q

What happens when the Left atrial pressure rises to 7-8 mm Hg

2.What happens at 30 mm Hg?

A
  1. Causes huge rise in Pulmonary arterial pressure.

2. Causes huge rise in pulmonary capillary pressure- oedema.

32
Q

What is meant by ‘sheet of flow’?

A

Describes the arrangement of capillaries in the alveolar walls being parallel to each other in the pulmonary system.

33
Q

What is the normal Pulmonary capillary pressure?

  1. how can it be measured?
A

7 mm Hg

  1. ‘isogravimetrically’
34
Q

What is the Peripheral capillary pressure?

A

17 mm Hg

35
Q

Tissue fluid in the lungs as a more negative pressure value then peripheral subcutaneous tissue fluid.

true or false?

A

True

36
Q

Oncotic pressure of tissue fluid in the pulmonary system is greater than in comparison to peripheral tissue fluid.

True or false?

A

True?

37
Q

The alveolar’s thin,weak walls allow for what if there is a pressure gradient greater in the interstitial spaces?

A

It allows large amount of tissue fluid to enter them. (BAD)

38
Q

What is the role of the lymphatic system with tissue fluid.

A

It drains it from the interstitial space.

39
Q

Describe what happens to extra fluid in alveoli under normal conditions?

A
  1. Drained from alveoli via pressure gradient into interstitial spaces via gaps in alveoli epithelial cells
  2. Enters lymphatic system.
  3. some fluid remains on lining of epithelium to keep te surface moist.
40
Q

Two most common causes of pulmonary oedema?

A
  1. Mitral valve disease.
  2. Damage to pulmonary capillaries via infection e.g. Pneumonia- breathes in sulfur dioxide or chlorine gas. This causes leakiness in capillaries- plasma proteins and fluid enter interstitial space and then alveoli.
41
Q

What is the relationship of left atrial pressure and the pulmonary capillary pressure?

A

Remember that every time the left atrial pressure rises to high values, the pulmonary capillary pressure rises to a level 1 to 2 mm Hg greater than the left atrial pressure.

42
Q

How do the lungs combat chronic high pulmonary capillary pressure?

A

Lymphatic channels increase the amount of tissue fluid it removes from interstitial space by tenfold.

43
Q

What is the pulmonary capillary pressure at which an acute pulmonary oedema would form?

A

21 mm Hg.

44
Q

What is the role of mucoid fluid in the pleural cavity?

A

Allow for lungs to slide back and forth during inspiration and expiration.

45
Q

What are the characteristics of the visceral pleura which allows for tissue fluid to pass through it?

A
  1. Porous
  2. Mesenchymal
  3. Serous
46
Q

What is the pleural space also known as?

A

Potential space. As it is so narrow to be defined as physical space.

47
Q

What is pleural effusion.

A

Collection of Large Amounts of Free Fluid in the Pleural Space.

48
Q

What are the four main causes of pleural effusion?

A
  1. Blockage of lymphatic draining system in the pleural cavity.
  2. Cardiac failure which causes increase in pulmonary capillary and arterial pressure. Therefore allowing for excess fluid to enter cavity.
  3. Low oncotic pressure
  4. Infection- causes inflammation and therefore increase permeability of capillaries.
49
Q

What is oncotic pressure also refered to as?

A

colloid osmotic pressure.

50
Q

will theo fart?

A

yes

My respiratory physiology (3 decks)

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