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Physiology > Respiratory Physiology II: Pulmonary Circulation (Exam IV) > Flashcards

Respiratory Physiology II: Pulmonary Circulation (Exam IV) Flashcards

1
Q

It takes a red blood cell about _______ to travel through pulmonary circulation at resting cardiac output; about _______ of this time is spent in pulmonary capillaries; when in reality gas exchange takes only about _______

A

4-5 seconds; 0.75 seconds; 0.25 seconds

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2
Q

List the order of blood flow from start to finish through the circulation:

A
  1. Vena cava
  2. Right atrium
  3. Tricuspid valve
  4. Right ventricle
  5. Pulmonary valve
  6. Pulmonary artery
  7. Pulmonary capillaries
  8. Pulmonary vein
  9. Left atrium
  10. Bicuspid valve
  11. Left ventricle
  12. Aortic valve
  13. Aorta
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3
Q

Compared to systemic circulation, pulmonary circulation has: (4)

A
  1. Lower pressure
  2. Lower resistance
  3. Higher compliance
  4. Lower volume
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4
Q

Pulmonary arteries & arteriole diameters are _____ than systemic arteries & arterioles

A

larger

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5
Q

Pulmonary arteries & arteriole walls are _____ & _____ resulting in ______

A

Thin; distensible; large compliance

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6
Q

Compared to systemic circulation in which only the veins have a high compliance, in pulmonary circulation what has the high compliance?

A

Arteries, capillaries & veins all have high compliance

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7
Q

What is unique about the pulmonary capillaries in pulmonary circulation?

A

There is a population of capillaries in the lungs that are closed at rest that can be recruited

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8
Q

Bronchial circulation is part of _____ circulation:

A

Systemic

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9
Q

Supplies oxygen & nutrients to the tracheobronchial tree down to the terminal bronchioles & also pulmonary blood vessels, visceral pleura, nerves & hilar lymph nodes:

A

Bronchial circulation

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10
Q

Pulmonary capillaries in the Zones of the lung experience force from the fluids inside _______ & outside the vessel _______

A

Inside vessel: Pa (hydrostatic pressure)

Outside vessel: PALV (alveolar air pressure)

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11
Q

The hydrostatic pressure of blood inside the capillaries:

(how do we abbreviate this)

A

Pa

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12
Q

The hydrostatic pressure of blood in the capillaries favors _____ and functions to ______

A

Filtration; keep the vessel open

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13
Q

Pa is greater in zone ______ of the lungs compared to zone ______ due to _____

A

Zone 3; Zone 1; gravity

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14
Q

The tissue pressure of the lungs is largely based on:

A

Alveolar air pressure (PALV)

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15
Q

The tissue pressure (largely based on alveolar air pressure- PALV) outside the capillary opposes _____ & favors _____

A

FIltration
Vessel collapse

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16
Q

Only the capillaries & smallest of the arterioles & venules (alveolar vessels) are altered by:

A

P-Alveolar

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17
Q

A pressure that can compress & close the vessel:

A

PALV

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18
Q

A pressure that can hold the vessel open because it is the pressure inside the vessel:

A

Pa (sometimes referred to as Pc)

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19
Q

Capillaries at the base of the lungs have a higher _____ meaning it will hold the vessel open more efficiently

A

Hydrostatic pressure

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20
Q

The pulmonary capillaries near the alveolar can become _______ during ______

A

Compressed; inspiration

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21
Q

What happens to the resistance of the vessel in the alveolus when there is more air in the alveolus and why?

A

The resistance in the alveolus goes up if the alveolus has more air in it, because there is more external pressure from the outside compressing that vessel

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22
Q

In zone 1: P-arterial (Pa) is ______ than P-Alveolar (PA)

This means that the capillaries are _____

A

Lower; compressed

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23
Q

If P-arterial (Pa) drops (hemorrhage) or P-Alveolar (PA) increases (positive pressure breathing), a greater portion of the lung is converted to:

Why?

A

Zone 1

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24
Q

Compared to zone 1, zone 2 has a higher ______ due to ____

A

P-arteriole (Pa)
Gravity

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25
Q

Because zone 2 has a higher P-arteriole (Pa) due to gravity, this means that P-arteriole is _____ than P-Alveolar (PA) during ______

A

Higher; systole

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26
Q

In zone 2 during diastole, what occurs with the P-arteriole (Pa) and P-Alveolar (PA)

A

During diastole, P-arteriole (Pa) will drop lower than P-alveolar (PA)

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27
Q

In zone 2, because of the pressure differences during systole & diastole, we call this the region of:

A

Intermittent blood flow

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28
Q

In zone 2, during systole (heart contraction) the vessels are _____ & during diastole (heart relaxation) the vessels are _____

A

Systole- open
Diastole- closed

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29
Q

Zone 3 has the highest ______ due to ______

A

P-arteriole (Pa); gravity

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30
Q

Zone 3 is considered the region of:

A

Continuous blood flow

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31
Q

Why is zone 3 considered the region of continuous blood flow?

A

Because P-arteriole is higher than P-Alveolar (PA) during both systole & diastole

32
Q

When does gas exchange occur in zone 1?

When does gas exchange occur in zone 2?

When does gas exchange occur in zone 3?

A

Zone 1- never
Zone 2- during systole (Pa > PA- opposite in diastole)
Zone 3- all of the time (Pa> PA- during systole & diastole)

33
Q

The majority of healthy lungs have _____ & _____ blood flow

A

Zone 2 & Zone 3

34
Q

Excercise conver

A
35
Q

Exercise converts _____ into _____ blood flow

A

Zone 2; Zone 3

36
Q

When in the supine position, the lungs have mostly _____ blood flow because _____

A

Zone 2; because gravity is reduced

37
Q

How might someone with diseased lungs be positioned when they sleep or when they are in your dental chair?

A

More upright if possible

38
Q

Index of the match between airflow (alveolar ventilation) & pulmonary blood flow (perfusion)

A

V/Q match

39
Q

Normal whole lung V/Q:

A

0.8

40
Q

Because the normal whole lung V/Q is 0.8 this means there is more _____ than ______

A

Bloodflow than airflow

41
Q

In a normal individual, the _____ of the lung has a higher V/Q than the rest of the lung

A

Apex

42
Q

As one moves from zone 1 to zone 3, there is a ______ in ventilation than blood flow

A

Slower increase

43
Q

Fast, shallow breaths =

A

A lower tidal volume

44
Q

Fast, shallow breaths in an upright position cause V/Q mistmatch because:

A

Air flows to upper lobes & blood flows to lower lobes

45
Q

The V/Q ratio at the apex of lung is ______ meaning:

A

Greater than 1; Overall the apex receives more ventilation than blood flow

46
Q

Ventilation in zone 1:

  1. intrapleural pressure is _____
  2. Transmural pressure gradient is ______
  3. Alveoli are _____ & _____
  4. Overall _____ ventilation

Perfusion in zone 1:

  1. ______ intravascular pressures
  2. _____ recruitment
  3. _____ resistance
  4. Overall ______ blood flow
A
  1. more negative
  2. greater
  3. larger, less compliant
  4. less
  5. Lower
  6. Less
  7. Higher
  8. Less
47
Q

Ventilation in zone 1 compared to zone 3:

Ventilation in zone 1 compared to perfusion in zone 1:

A

Less
More (we know this bc V/Q ratio > 1)

48
Q

Ventilation in zone 3:

  1. Intrapleural pressure is ______
    2._____ transmural pressure gradient
  2. Alveoli are _____ & _____
  3. Overall ___ ventilation

Perfusion in zone 3:

  1. ____ vascular pressures
  2. ____ recruitment
  3. _____ resistance
  4. Overall _____ blood flow
A
  1. less negative
  2. smaller
  3. smaller, more compliant
  4. More
  5. Greater
  6. More
  7. Lower
  8. More
49
Q

Ventilation in zone 3 compared to ventilation in zone 1:

Ventilation in zone 3 compared to perfusion in zone 3:

A

Greater
Greater perfusion in zone 3 compared to ventilation in zone 3 (we know this because V/Q ratio <1)

50
Q

Alveoli at the _____ of the lungs receive more ventilation than those at the _____

A

Base; Apex

51
Q

The pulmonary capillaries at the _____ of the lungs receive more blood flow than those at the _____

A

Base; Apex

52
Q

Describe the intrapleural pressure (PIP) at the apex of the lungs compared to the base of the lungs:

A

PIP at apex is more negative and at base is less negative, these average out to around -5 mmHg

53
Q

Responses to V/Q mismatch are:

A

Negative feedback responses

54
Q

The respiratory & circulatory systems are working to deliver air & blood to the ______ portions of the respiratory membrane

A

Same

55
Q

If ventilation is limited:

  1. V/Q is _____
  2. This O2 is ____ & CO2 is ____
  3. Smooth muscles in the ____ constrict
A
  1. Low
  2. Low; high
  3. blood vessel
56
Q

In times of an airway obstruction, we are not getting proper air into that alveolus, therefor what do we want to occur?

What is this referred to as?

A

We want the blood vessel that is serving this alveolus to constrict

Hypoxic pulmonary constriction

57
Q

If perfusion is limited:

  1. V/Q is ____
  2. This O2 is ___ & CO2 is ____
  3. Smooth muscles in the _____ constrict
A
  1. High
  2. High; Low
  3. Bronchioles
58
Q

In times of low perfusion, why would we want smooth muscles in the bronchioles to constrict?

A

We would rather send that air to an alveoli that is perfused with blood

59
Q

What is an example of a condition that may cause low perfusion?

A

Pulmonary embolus

60
Q

Pulmonary capillary exchange:

Blood traverses pulmonary capillaries _____ & ___ must occur during this time frame

A

0.3-0.8; gas exchange

61
Q

Pulmonary capillary exchange:

In addition to gas exchange _____ also occurs & is dictated by _____

A

Fluid exchange; Starling’s forces

62
Q

Pulmonary capillary exchange:
Fluid filtration (F) is determined by ______ & _____

A

Hydrostatic fluid forces & Capillary & Interstitial colloid

63
Q

What are the hydrostatic pressures?

A

Capillary pressure (Pc) & Interstitial fluid pressure (Pif)

64
Q

What are the osmotic pressures?

A

Plasma colloid osmotic pressure (Pi-p) & Interstitial fluid colloid osmotic pressure (Pi-if)

65
Q

Movement of things OUT of the capillary bed:

A

Filtration

66
Q

Movement of things INto the capillary bed:

A

Absorption

67
Q

Determine whether the following pressures results in filtration or absorption:

  1. Capillary pressure (Pc)
  2. Plasma colloid osmotic pressure (Pi-P)
  3. Interstital fluid pressure (Pif = negative)
  4. Interstitial fluid pressure (Pif = positive)
  5. Interstital fluid colloid osmotic pressure (Pi-if)
A
  1. Filtration
  2. Absorption
  3. Filtration
  4. Absorption
  5. Filtration
68
Q

Filtration pressures = a total of:

A

29 mmHg

69
Q

Describe what makes the total filtration pressure of 29 mmHG:

A

Capillary pressure (Pc) = 7 mmHg

Interstitial fluid pressure (Pif) = -8 mmHg (here we use absolute value)

Interstitial colloid osmotic pressure (Pi-if) = 14 mmHg

70
Q

The value of interstitial fluid pressure (Pif)= -8. What does the (-) tell us?

A

That this is a filtration pressure

71
Q

The absorptive pressure = a total of:

A

28 mmHg

72
Q

What makes up the total absorptive pressure of 28 mmHg?

A

Plasma colloid osmotic pressure (Pi-P)

73
Q

Because normal filtration pressures are greater than absorptive forces by +1 mmHg (29-29), there is a slight continual flow of fluid from the:

A

Pulmonary capillaries into the interstitial spaces

74
Q

Fluids that leaves the capillaries is absorbed by ______ and returned to ____

A

lymphatic circulation; circulation

75
Q

Extra fluid that enters the alveoli will be sucked into the interstitial space, due to the _____ and then picked up by lymphatic capillaries to keep the alveoli dry

Why do we want to keep the alveoli dry?

A

Slight negative pressure

Because type 1 alveolar cells are delicate & can be damaged easily

76
Q

The balance of pulmonary capillary & interstitial hydrostatic & colloid pressures can be disrupted resulting in _____

Describe this phenomenon:

A

Pulmonary edema

Large increase in net capillary filtration

77
Q

Pulmonary edema can occur with: (3)

A
  1. Left-sided heart failure
  2. Mitral valve stenosis
  3. Damage to pulmonary capillary membranes

Physiology (11 decks)

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