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Physiology > Respiratory II Pulmonary Circulation > Flashcards

Respiratory II Pulmonary Circulation Flashcards

1
Q

what is the relationship of the pressure, resistance, compliance and volume in the pulmonary circulation compared to the systemic circulation

A

everything is lower in pulmonary system

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2
Q

is diameter of arteries and arterioles large in pulmonary circulation or systemic

A

pulmonary

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3
Q

are any pulmonary capillaries closed at rest

A

yes

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4
Q

how many pulmonary capillaries supply how many alveoli

A

280 billion capillaries supply 300 million alveoli

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5
Q

what is the potential surface area for gas exchange

A

50-100 m^2

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6
Q

what does bronchial circulation do

A

supplies oxygen and nutrients to the tracheobronchial tree down to the terminal bronchioles and pulmonary blood vessels, visceral pleura, nerves and hilar lymph nodes

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7
Q

what percentage of cardiac output does bronchial flow make up

A

2%

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8
Q

why does blood in the LA have a slightly lower O2 concentration than the blood in the pulmonary capillaries

A

because of bronchial circulation because some of the deoxygenated blood from the bronchial veins mixes with oxygenated blood in the pulmonary veins

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9
Q

how do structures in the respiratory zone receive oxygen and nutrients

A

receive oxygen directly by diffusion from the alveolar air and nutrients from the mixed venous blood in pulmonary circulation

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10
Q

what is MAP of pulmonary circulation

A

14 mmHg

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11
Q

what is pulmonary capillary pressure

A

7mmHg

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12
Q

what is pulmonary venous/left atrial pressure

A

2 mmHg

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13
Q

what percentage of pulmonary blood volume accounts for total blood volume

A

9% or 450 mL

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14
Q

how does pulmonary blood volume change during inspiration

A

it increases

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15
Q

how does pulmonary blood volume change when lying down

A

increases

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16
Q

what happens to pulmonary artery pressure as a result of increased cardiac output

A

only a small increase in pulmonary pressure

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17
Q

which circulation is more prone to hypertension

A

systemic

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18
Q

how does an increase in CO to lungs decrease pulmonary resistance

A

recruitment of pulmonary capillaries
distension of pulmonary capillaries

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19
Q

at what PAO2 do adjacent blood vessels constrict

A

below 70% of normal

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20
Q

when do adjacent vessels dilate

A

when PAO2 is high

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21
Q

what happens when O2 is low in the pulmonary system? circulatory system?

A

-pulmonary: blood vessels constrict
-systemic: blood vessels dilate

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22
Q

what would perfusion of a hypoventilated alveolus result in

A

blood with decreased PaO2

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23
Q

what does hypoxic pulmonary vasoconstriction cause

A

blood to be sent to a better ventilated alveoli to maximized gas exchange

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24
Q

what are vasodilators in pulmonary arterioles

A

-high O2 in alveoli
- dopamine
-bradykinin
-prostacyclin
-NO
-histamine
-AcH

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25
Q

what are the vasoconstrictors for the pulmonary arterioles

A

-low O2 in alveoli
-high CO2 in alveoli
-NE
-ANG II
-endothelin
-ADH
- TXA2

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26
Q

What does high O2 do in systemic circulation

A

vasoconstrict

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27
Q

what does low O2 do in systemic circulation

A

vasodilate

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28
Q

what are the alveolar vessels

A

pulmonary capillaries, smallest arterioles and venules

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29
Q

what are the extra alveolar vessels

A

all other vessels such as larger vessels feeding in

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30
Q

what is the PVR (pulmonary vascular resistance)

A

total of alveolar vessels + extra alveolar vessel resistance

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31
Q

what happens to the alveolar vessels and the extra alveolar vessels during inspiration

A

-alveolar vessels are compressed/elongated and their resistance increases
- extra alveolar vessels have decreased resistance

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32
Q

when is resistance in the pulmonary circulation lowest

A

when lung volume is equal to FRC

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33
Q

at low lung volumes extraalveolar vessel resistance increases which does what to total PVR

A

increases it

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34
Q

at high lung volumes alveolar vessel resistance increases which does what to total PVR

A

increases it

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35
Q

what is FRC

A

-functional residual capacity
-the volume of air in the lungs after a normal expiration

36
Q

what is the difference in pulmonary arterial pressure from the apex to the base when in an upright position

A

23mmHg

37
Q

which zone is the most inferior zone in the lungs

A

zone 3

38
Q

which zone has the highest hydrostatic pressure

A

zone 3

39
Q

which zone has highest blood flow per alveolus

A

zone 3

40
Q

exercise increases blood flow to which zones of the lung

A

all zones but bottom still receives the most

41
Q

what forces do the pulmonary capillaries in the zones of the lungs experience

A

-hydrostatic pressure of the blood inside of the capillaries (Pa) favoring filtration
-the tissue pressure outside of the capillary which opposes filtration and favors vessel collapse

42
Q

what vessels are altered by the hydrostatic pressure of blood inside the capillaries

A

only the capillaries and smallest of the arterioles and venules

43
Q

which is greater in zone 1: Pa or PA

A

PA> Pa

44
Q

describe the capillaries in zone 1

A

compressed

45
Q

when is a greater portion of the lung converted to zone 1

A

if Pa drops (hemorrhage) or PA increases (positive pressure breathing)

46
Q

which is greater in zone 2: PA or Pa

A

Pa is higher than PA during systole. during diastole Pa will drop lower than PA

47
Q

describe blood flow in zone 2

A

intermittent

48
Q

which is higher in zone 3: PA or Pa

A

highest Pa. Pa remains higher than PA during systole and diastole

49
Q

describe blood flow in zone 3

A

continuous

50
Q

what zones are used during exercise

A

zone 2 is converted into zone 3

51
Q

what zone predominates in supine position

A

zone 2

52
Q

what is the ventilation (V)/Perfusion (Q) match

A

index of the match between air flow (alveolar ventilation-V) and pulmonary blood flow (perfusion-Q)

53
Q

what is normal whole lung V/Q

A

0.8

54
Q

what does a normal whole lung V/Q of 0.8 mean

A

there is more blood than air flow

55
Q

where in the lung is the V/Q higher

A

at the apex as there is slower increase in ventilation than blood flow as you go from zone 1 to zone 3

56
Q

why does fast shallow breaths in upright position cause V/Q mismatch

A

air flows to upper lobes and blood to lower lobes

57
Q

what is the V/Q at the apex of the lung

A

greater than 1

58
Q

where do pulmonary capillaries receive more blood flow

A

at the base of the lung

59
Q

where do alveoli receive more ventilation

A

at the base of the lung

60
Q

what is the average Pip

A

-5 mmHg

61
Q

describe ventilation at the apex and Pip

A

-intrapleural pressure more negative
-greater transmural pressure gradient
- alveoli larger, less compliant
-less ventilation
-Pip = -10 mmHg

62
Q

describe perfusion at the apex

A

-lower intravascular pressure
-less recruitment, distension
-higher resistance
-less blood flow

63
Q

describe ventilation at the base and the Pip

A

-intrapleural pressure less negative (-2.5mmHg)
-smaller transmural pressure gradient
-alveoli smaller, more compliant
-more ventilation

64
Q

describe perfusion at the base of the lung

A
  • greater vascular pressures
  • more recruitment, distension
    -lower resistance
    -greater blood flow
65
Q

what is the V/Q ratio at the base of the lung

A

less than 1

66
Q

if ventilation is limited what is the V/Q, O2, CO2, and where does smooth muscle constrict

A

-V/Q is low
- O2 is low
-CO2 is high
-smooth muscles in the blood vessels constrict

67
Q

is perfusion is limited what is the V/Q, O2, CO2, and where does smooth muscle constrict

A

-V/Q is high
-O2 is high
-CO2 is low
- smooth muscles in the bronchioles constrict

68
Q

how long does blood traverse through the pulmonary capillaries

A

0.3-0.8 seconds

69
Q

what is fluid filtration determined by

A

hydrostatic fluid forces and capillary and interstitial colloid

70
Q

what are the hydrostatic pressures

A

-capillary pressure (Pc)
- interstitial fluid pressure (Pif)

71
Q

what are the osmotic pressures

A

-plasma colloid osmotic pressure (Pi c)
-interstitial fluid colloid osmotic pressure (pi if)

72
Q

what does it mean it Pif is negative

A

filtration pressure

73
Q

what is the total filtration pressure

A

29 mmHg

74
Q

what is capillary pressure (Pc) (number)

A

7 mmHg

75
Q

what is the interstitial fluid pressure (Pif)

A

-8mmHg

76
Q

what does the negative in interstitial fluid pressure tell you

A

filtration pressure

77
Q

what is the interstitial colloid osmotic pressure (pi if) (number)

A

14mmHg

78
Q

why is interstitial colloid osmotic pressure in the pulmonary capillary half of systemic capillaries

A

because pulmonary capillaries are leaky to protein

79
Q

what is the total absorption pressure

A

28 mmHg

80
Q

what is the plasma colloid osmotic pressure (pi p)

A

28 mmHg

81
Q

what does it mean that the filtration pressures are greater than the absorptive pressures

A

continual flow of fluid from the pulmonary capillaries into the interstitial spaces

82
Q

what happens to the extra fluid that enters the alveoli

A

it gets sucked into the interstitial space due to the slight negative pressure and then picked up by lymphatic capillaries

83
Q

what causes pulmonary edema

A

disrupted balance of the pulmonary capillary and interstitial hydrostatic and colloid pressures

84
Q

what is pulmonary edema

A

large increases in net capillary filtration

85
Q

what can pulmonary edema result from pathologically

A

left sided heart failure, mitral valve stenosis, damage to pulmonary capillary membranes

Physiology (41 decks)

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