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Respiratory Pathophysiology > Pulmonary Vascular Disease > Flashcards

Pulmonary Vascular Disease Flashcards

1
Q

why is pulmonary circulation low pressure?

A

right ventricle generates less pressure than the left
vessels are thin-walled and distensible

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2
Q

the adult pulmonary circulation is _____ flow, _____ pressure, and _____ resistance

A

high
low
low

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3
Q

where does the bronchial artery come from?

A

systemic aorta

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4
Q

what is venous drainage from the bronchial circulation?

A

bronchial veins to right atrium and partly pulmonary veins to left atrium

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5
Q

what does nitric oxide produced by pulmonary endothelial cells mediate?

A

vascular relaxation

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6
Q

arachidonic acid metabolites thromboxane A2 and LTC4 and D4 are ________________________________________________

A

potent vasoconstrictors and increase pulmonary vascular resistance

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7
Q

what is the primary determinant of pulmonary vascular resistance?

A

PAO2

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8
Q

what are some vasoactive agents that are metabolized by pulmonary endothelial cells before they are delivered to general circulation?

A

polypeptides
biogenic amines
arachidonic acid metabolites

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9
Q

what leads to cardiogenic pulmonary edema?

A

inadequate left ventricular function
capillary hydrostatic pressure increases

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10
Q

what does altered permeability due to epithelial or endothelial cell injury and loss of barrier integrity lead to?

A

non-cardiogenic pulmonary edema
ALI/ARDS

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11
Q

what are some chronic changes that can lead from reversible vasoconstriction to persistent pulmonary hypertension?

A

hyperbaric oxygen
chronic endotoxemia
monocrotaline

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12
Q

cattle pastured at high altitude develop:

A

pulmonary arterial hypertension
congestive heart failure
edema involving thorax, abdomen, and subcutaneous tissue of brisket forelimbs and abdomen

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13
Q

what is equine exercise-induced pulmonary hemorrhage (EIPH) characterized by?

A

pulmonary hypertension
alveolar edema
pulmonary capillary rupture
intra-alveolar hemorrhage

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14
Q

what do repeated bouts of EIPH result in?

A

fibrosis and sustained pulmonary inflammation

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15
Q

where does bleeding occur in exercise-induced pulmonary hemorrhage?

A

caudo-dorsal lungs

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16
Q

what is pulmonary thromboembolism (PTE)?

A

obstruction of pulmonary vessel by a thrombus that may have formed locally or translocation of a thrombus from elsewhere

17
Q

why is a large thrombus obstructing obstructing in a major pulmonary artery a bad thing?

A

increases dead space and disrupts V/Q ratio
increased flow to non-obstructed areas alters V/Q and results in hypoxemia, which induces vasoconstriction
concurrent bronchoconstriction can lead to airway collapse and alveolar collapse

18
Q

what organism is most commonly involved in bovine septic thromboembolism (caudal vena cava thrombosis)?

A

Fusobacterium necrophorum
gram negative pleomorphic rod and normal inhabitant of GI tract

19
Q

what leads to right ventricular dilation and hypertrophy (cor pulmonale)?

A

chronic pulmonary hypertension

20
Q

what is the normal systolic pressure of the pulmonary circulation?

A

25mmHg

21
Q

when does resistance in the pulmonary circulation increase?

A

when lungs are inflated to very high volumes

22
Q

what does the bronchial circulation provide blood for?

A

cells in walls of trachea and airways
vascular bundles
nerves
lymph nodes
visceral pleura

23
Q

what do PGI2 and PAF do with vascular supply?

A

vasodilate

24
Q

what mediates hypoxic vasoconstriction?

A

sensor at level of smooth muscle cells mitochondria and Ca influx
LTC4 and D4
oxygen radicals or peroxide may also act as mediators through control of transmembrane Ca flux

25
Q

what are some growth factors that pulmonary endothelial cells synthesize and release when perturbed?

A

platelet-derived growth factor
epidermal growth factor
heparin-like growth inhibitory factor

26
Q

why does altered permeability of endothelial barriers occur?

A

epithelial or endothelial cell injury and loss of barrier integrity
ALI/ARDS or non-cardiogenic pulmonary edema

27
Q

what pathologic changes occur when reversible vasoconstriction leads to persistent pulmonary hypertension?

A

thickening of medial smooth muscle
extension of smooth muscle distally to normally non-muscular arteries
narrowing and occlusion of distal arteries

28
Q

what does bovine brisket disease develop as a sequelae to?

A

hypoxic pulmonary vasoconstriction
chronic pulmonary hypertension with vascular remodeling

29
Q

how is equine exercise-induced pulmonary hemorrhage (EIPH) diagnosed?

A

observation of epistaxis
endoscopy followed by transtracheal aspiration
bronchoalveolar lavage to obtain a cytology sample to detect hemosiderophages

30
Q

where does equine exercise-induced pulmonary hemorrhage occur?

A

caudo-dorsal lungs

31
Q

what is the treatment and prevention for equine exercise-induced pulmonary hemorrhage?

A

diuretics
nasal dilator strips
inhaled nitric oxide leads to more severe bleeding (but reduces pulmonary artery pressure)

32
Q

what signs are associated with pulmonary thromboembolism?

A

hypoxemia
hyperventilation
dyspnea

33
Q

what develops after septic emboli from hepatic abscesses metabolize to the lungs?

A

pulmonary arteritis and aneurysms develop
aneurysms may rupture: fatal pulmonary hemorrhage

34
Q

what stage of Dirofilariasis larvae cause lesions?

A

5th

35
Q

what are the two types of lesions that develop during canine Dirofilariasis?

A

intimal proliferation due to effects of live parasites
thrombosis due to dead parasites

36
Q

why does pulmonary hypertension occur with canine Dirofilariasis?

A

intravascular proliferative lesions
inflammatory-mediated vasoconstriction
decreased endothelial nitric oxide production

Respiratory Pathophysiology (22 decks)

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