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Respiratory > Pulmonary vascular physiology > Flashcards

Pulmonary vascular physiology Flashcards

1
Q

describe pulmonary blood supply

A

unique dual blood supply

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2
Q

describe pulmonary circulation

A

from RV

100% CO, involved in gas circulation, huge SA for gas exchange

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3
Q

describe bronchial circulation

A

2% of LV output

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4
Q

what are the differences between pulmonary and systemic blood vessels

A 
pulmonary v systemic;
thin v thick vessel wall
minor v significant muscularisation
no need v need for redistribution
high v low pressure
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5
Q

what is the purpose of systemic blood vessel

A

deliver O2 to hypoxic tissue

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6
Q

what is the purpose of pulmonary blood vessels

A

pick up o2 from oxygenated lungs

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7
Q

what are vasodilators in systemic blood vessels

A

hypoxia
acidosis
CO2

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8
Q

what are vasoconstrictors in systemic blood vessels

A

oxygen

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9
Q

what are vasodilators in pulmonary blood vessels

A

oxygen

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10
Q

what are vasoconstrictors in pulmonary blood vessels

A

hypoxia

acidosis

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11
Q

what does oxygen do in pulmonary vessels

A

vasodilates

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12
Q

what does oxygen do in systemic blood vessels

A

vasoconstricts

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13
Q

what is the equation for pressure across a circuit

A

CO x resistance

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14
Q

what is an equation for pressure across pulmonary circulation

A

= mPAP - LA pressure x PVR

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15
Q

what is alveolar recruitment

A

pulmonary capillary response to increased pulmonary artery pressure
occurs as a consequence of exercise
- compressed pathways open

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16
Q

what do recruitment and distension do

A

reduce resistance

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17
Q

what is the difference between recruitment and distension

A

recruitment opens compressed arteries/ cpilaries, distention stretches arteries/ capillaries that are already open

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18
Q

describe type 1 respiratory failure

A

pO2 < 8kPa
pCO2 < 6kPa
- can’t get O2 in

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19
Q

describe type II respiratory failure

A

pO2 < 8kPa
pCO2 > 6kPa
- can’t get O2 in or CO2 out = ventilation problem

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20
Q

what is hypoxia

A

deficiency of O2 at tissue level - low pO2

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21
Q

what is hypoxemia

A

arterial pO2 reduced

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22
Q

what is hypercapnia

A

too much CO2 at tissue level; high pCO2

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23
Q

what detects hypercapnia and what is the consequence

A

chemoreceptors
alters HR and BR
can cause respiratory acidosis

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24
Q

types of hypoxia

A

hypoxaemia/ hypoxic hypoxia
anaemia/ CO hypoxia
ischemia/ stagnant hypoxia
histotoxic hypoxia

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25
Q

how to remember types of hypoxia

A

HASH

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26
Q

what is the definition of hypoxic hypoxia

A

decreased oxygen tension

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27
Q

what is the definition of anaemic hypoxia

A

decreased carrying capacity

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28
Q

what is the definition of stagnant hypoxia

A

decreased perfusion

29
Q

what is the definition of histotoxic hypoxia

A

cellular hypoxia

30
Q

causes of hypoxia

A

hypoventilation
diffusion impairment
shunting
V/q mismatch

31
Q

what is the effect of hypoxia in the lungs

A

vasoconstriction

32
Q

what can hypoventilation cause

A

type II respiratory failure due to increased arterial pCO2

33
Q

what can cause hypoventilation

A

muscular weakness, obesity, loss of respiratory drive

34
Q

what is diffusion impairment in regards to hypoxia

A

failure of blood pO2 and alveolar pO2 to equilibrate

35
Q

what is a cause of gaseous diffusion impairment

A

pulmonary oedema

36
Q

what is a cause of membrane diffusion impairment

A

interstitial fibrosis

37
Q

what is a cause of blood diffusion impairment

A

anaemia

38
Q

what are the 3 types of diffusion impairment

A

gaseous, membrane, blood

39
Q

define shunting

A

blood goes through a completely non-ventilated area

40
Q

causes of shunting (lungs)

A

intrapulmonary deficit; e.g. asthma, pneumonia, pulmonary oedema, PAVM, complete lobar collapse

41
Q

what is an intrapulmonary deficit

A

mixed venous blood perfuses unventilated area

42
Q

what is PAVM

A

pulmonary arteriovenous malformation (R to L shunt between PA and vein)

43
Q

what can shunting lead to

A

V/Q mismatch

44
Q

can you have V/Q mismatch without shunting

A

yes; if cause is arterial e.g. emboli

45
Q

what is the most common cause of V/Q mismatch

A

discrepancies in amount of air reaching alveoli v amount of blood arriving in capillaries

46
Q

describe V/Q mismatch

A

total ventilation and perfusion is normal but well ventilated regions can’t compensate for poorly ventilated regions

47
Q

causes of V/Q mismatch

A

physiological, pulmonary emboli, asthma, pneumonia, pulmonary oedema

48
Q

what is the effect of V/Q mismatch

A

pO2 decreases in systemic arterial blood

49
Q

what happens if O2 in alveoli decreases

A

hypoxic vasoconstriction, perfusion decreases so blood diverted away from poorly ventilated areas towards well-ventilated areas

50
Q

what does a decrease in CO2 do to bronchioles

A

constriction so ventilation decreases

51
Q

what does an increase in co2 do to bronchioles

A

dilation so ventilation increases

52
Q

what does hypoxia do in the lungs

A

vasoconstriction

53
Q

hypoxaemia causes

A 
hypoventilation
diffusion impairment
shunting 
V/ Q mismatch
(same as hypoxia)
54
Q

what is the difference between hypoxia and hypoxaemia

A

deficiency of oxygen at tissue level (hypoxia) v arterial level (hypoxaemia)

55
Q

what are the 2 forms Hb can exist in

A 
Hb = deoxyhaemoglobin
HbO2 = oxyhaemoglobin
56
Q

describe the shape of an OD curve

A

non-linear, sigmoid

57
Q

what is an equation for the combination of Hb with oxygen

A

O2 + Hb ⇆ HbO2

58
Q

explain the shape of an OD curve

A

O2 binds to each subunit sequentially

59
Q

where is O2 given up from Hb

A

areas of low pO2 i.e. metabolically active tissue

60
Q

what is the effect of increased pH on OD curve

A

shifts to left - more affinity for O2

61
Q

what is the effect of decreased pH on OD curve

A

shifts to right - less affinity for O2 -gives up more

62
Q

what is the effect of increased temperature on OD curve

A

shifts to right - less affinity for O2 - gives up more

63
Q

what is the effect of decreased temperature on OD curve

A

shifts to left - more affinity for O2

64
Q

what is the effect of increased CO2 in OD curve

A

shifts to right - less affinity for O2 - gives up more

65
Q

what is the effect of decreased CO2 on OD curve

A

shift to left - more affinity for O2

66
Q

what is the affinity of CO v O2 for Hb and what is the effect

A

200 times greater affinity
CO irreversibly binds so reduces amount of O2 that can combine with Hb
Alters Hb molecule so has more affinity for O2 so OD shifts right so decreased unloading in tissue

67
Q

what is 2-3 diphosphoglycerate

A

created in erythrocytes during glycolysis

68
Q

what is the effect of high levels of 2-3 diphosphoglycerate on OD curves

A

shifts them to the right

69
Q

what is the name of the molecule made by erythrocytes during glycolysis that shifts OD curve to right in high levels

A

2-3 diphosphoglycerate

Respiratory (11 decks)

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