Respiratory strand: Lecture 8 - Matching Lung Ventilation to Lung Perfusion Flashcards

1
Q

What is ventilation and what unit is it measured in?

A
  • movement of gases in and out of the lungs
  • occurs through airways
  • measured in change in volume per unit time e.g L/min
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2
Q

What is perfusion, where does it occur and what unit is it measured in?

A
  • Blood flow through any organ e.g lungs
  • Occurs through blood vessels
  • measured as flow of blood/unit time
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3
Q

Are apical and basal alveoli the same size? If not, why?

A

No, apical alveoli are about 4 times larger than basal alveoli in the upright posture
This is due to the effect of gravity

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4
Q

Which regions of the lungs have the best ventilation?

A
  • basal regions of lungs have better ventilation than apical regions
  • basal alveoli can expand more than apical alveoli
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5
Q

What is bronchial circulation?

A

-nutrition to lung tissue
-bronchial artery from thoracic aorta
-bronchial vein to superior vena cava
-2% of cardiac output
image slide 8

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6
Q

How is pulmonary circulation different to systemic circulation?

A

lungs receive full cardiac output but at a much lower pressure compared to systemic circulation

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7
Q

What is the function of the pulmonary artery?

A

Carries deoxygenated blood from the right ventricle to the lung

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8
Q

What are extra-alveolar vessels?

A
  • pulmonary artery splits into right and left branches to supply the respective side lung
  • each branch then successfully splits into smaller branches closely following airway divisions called extra alveolar vessels
  • not part of gas exchange
  • running through lung parenchyma
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9
Q

What happens during pulmonary circulation beyond terminal bronchioles?

A

blood vessels form capillary beds (starting with smaller arterioles) where gas exchange starts

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10
Q

What is meant by a ‘sheet of blood’?

A
  • blood flowing through rich network of capillaries forms a ‘sheet’ of blood with a high surface area
  • very efficient gas exchange
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11
Q

What is emphysema?

A
  • widespread destruction and dilation of distal airway
  • regional destruction of vascular beds
  • poor gas exchange and hypoxia
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12
Q

Where in the pulmonary circulation does gas

exchange start?

A

Small arterioles

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13
Q

What is hydrostatic pressure?

A

Force exerted by weight of a fluid (blood/water) due to gravity

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14
Q

How is hydrostatic pressure related to pulmonary circulation?

A

-column of blood exerting different hydrostatic pressure in different areas of lungs in relation to the position of the right ventricle

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15
Q

What are the 3 lung zones?

A

Zone 1:

  • alveolar dead space
  • good ventilation but no perfusion
  • no gas exchange
  • apices of the lungs
  • Palv>Part>Pvein
  • poor blood flow

Zone 2:

  • recruitment zone: blood flow increases
  • lower down than zone 1
  • Arterial pressure increases due to higher hydrostatic pressure
  • more capillaries

Zone 3:

  • distension (swelling) zone: lung bases
  • hydrostatic forces raise Parterial and Pvenous above Palveolar
  • continuous blood flow
  • blood flow determined by difference between alveolar pressure and pulmonary venous pressure
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16
Q

Which ventricle is thicker and why?

A
  • Left ventricle 3x thicker
  • pushing against more force
  • pressure higher
17
Q

What would cause an alveolar vessel to get smaller?

A
  • they get squashed

- expanded alveoli encroach on alveolar vessels

18
Q

What is the Starling resistor model?

A

image slide 28

19
Q

What causes a haemorrhage?

A
  • Drop in Parterial

- no gas exchange anymore?

20
Q

If the amount of ventilation (VA) to an area of lung is equal to the amount of perfusion (Q), what would the VA/Q ratio be?

A

1 - this would be an ideal situation

Av ratio is 0.8

21
Q

What is ‘anatomic dead space’?

A

-conducting airways; no gas exchange

22
Q

What is ‘alveolar dead space’?

A

Unperfused/poorly perfused alveoli

23
Q

What is ‘physiological dead space’?

A

-volume of inspired air that does not take part in gas exchange
-Physiological dead space =
Anatomic dead space + Alveolar dead space

24
Q

Dead space is relevant in which clinical condition?

A

Pulmonary embolism

  • no blood but air is still there
  • enlarged alveolar dead space
25
Q

What is a pulmonary embolism?

A
  • medical emergency, potentially fatal
  • blood clot from deep veins of leg/ pelvis
  • large/intermediate pulmonary arteries
  • severe hypoxia
  • lack of blood supply to that part of lung
  • enlarged alveolar dead space
26
Q

Why would someone need a shunt?

A

if deoxygenated blood reaching left side of the heart either bypassing lungs or failing to get oxygenated in the lungs

27
Q

What is pneumothorax?

A
  • Lung collapses
  • no air in lung but same amount of blood is passing through
  • treatment: air must be drained out of the chest cavity so lung can re-expand