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BMS 615 Cardiovascular > Test 3: Wk11: 10 Pulmonary Circulation and Edema - Dasgupta > Flashcards

Test 3: Wk11: 10 Pulmonary Circulation and Edema - Dasgupta Flashcards

1
Q

There are two circulatory systems associated with the lung.

A

Bronchial circulation

Pulmonary circulation

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2
Q

bronchial circulation is

part of the

A

systemic circulation.

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3
Q

bronchial circulation comprises of % of the cardiac output from the —

A

comprises of 2% of the cardiac output from the left heart

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4
Q

bronchial arteries supply the

A

tracheobronchial tree

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5
Q

About two-thirds of the bronchial capillary venous blood from Bronchial circulation drains into the

A

pulmonary veins

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6
Q

Bronchial circulation Shunt

A

two-thirds of the bronchial

capillary venous blood from this circulation drains into the pulmonary veins

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7
Q

Pulmonary circulation is driven by

A

right ventricle

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8
Q

The whole cardiac output is

delivered to the pulmonary circulation via the

A

lung

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9
Q

Vessel walls of the pulmonary vasculature are — and contain — smooth muscle than
corresponding segments in the systemic circulation.

A

much thinner

less

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10
Q

Since cardiac output of the left and right heart are essentially the same, pulmonary blood flow is equal to

A

the total

blood flow of the systemic circulation

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11
Q

blood flow measured to determine total cardiac

output

A

pulmonary blood flow

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12
Q

Pulmonary Arteries carry

A

deoxygenated blood

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13
Q

Pulmonary veins carry

A

oxygenated blood

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14
Q

Pulmonary capillaries have — walls and — vascular resistance

A

very thin

low

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15
Q

The pulmonary vessels offer — resistance to blood flow than do the systemic arterial vessels.

A

much less

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16
Q

pulmonary vessels are also much more — and — than systemic arterial vessels

A

distensible

compressible

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17
Q

Anastomoses connections between

A

between bronchial and

pulmonary capillary

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18
Q

Anastomoses function

A

They have little function in healthy adults but may open in pathological
conditions, such as when either bronchial or pulmonary blood flow to a portion of lung is occluded.

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19
Q

Pulmonary Circulation Systolic mean pulmonary Arterial pressure

Mean Diastolic

A

25 mmHg

8 mmHg

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20
Q

Pressure drop across systemic circulation

across pulmonary circulation

A

98mmHg

10mmHg

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21
Q

due to gravity both intravascular pressures and blood flow are considerably — at the apex than at the base of the lung

A

less

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22
Q

Pa top of lung

A

3cmH2O

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23
Q

Pa Middle of Lung

A

19cmH20

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24
Q

Pa bottom of lung

A

35cmH2O

25
Q

resistance to blood flow —as you go to the bottom of the lung

A

decreases

26
Q

perfusion is — in the top and — in the lowest part of the lung.

A

smallest

greatest

27
Q

Zone 1 is defined as the region that is

A

not perfused

PA>Pa>Pv

28
Q

Zone 2 is the region that is

A

perfused intermittently only at systolic pressure

Pa>PA>Pv

29
Q

Zone 3 is the region in which

A

always perfused

Pa>Pv>PA

30
Q

pt on ventilator has high amounts of

A

zone 1

31
Q

Another name for Alveolar Hypoxia is

A

Hypoxia-induced vasocontriction

32
Q

Alveolar Hypoxia

A

pulmonary vascular smooth muscle contracts in areas of low PO2

33
Q

In people with
obstructive or restrictive diseases lung disease, the alveolar PO2 is low. So if the
overall PO2 is low, it causes

A

pulmonary vasoconstriction throughout the lung.

34
Q

Vasocontraction throughout the lung can lead to

A

right heart failure

35
Q

Recruitment

A

Opening of previously closed (collapsed) arteries.

36
Q

Distension:

A

Increase in the radius of the existing blood vessels to allow blood flow. By
Poiseuille’s equation, this causes fall of PVR.

37
Q

As lung volume increases during a normal negative-pressure inspiration, the alveoli

A

increase in volume

38
Q

While the alveoli expand, the vessels found between them, mainly pulmonary capillaries are

A

are elongated

39
Q

At high lung volumes, then, the resistance to blood flow offered by the alveolar
vessels

A

increases greatly

40
Q

as lung volumes increase, the resistance to blood flow offered by the extraalveolar vessels

A

decreases

41
Q

at high lung volumes (attained by normal negative-pressure breathing), the
resistance to blood flow offered by the extra-alveolar vessels

A

decreases

42
Q

During mechanical positive-pressure ventilation, alveolar pressure (PA) and intrapleural
pressure are — during inspiration

A

positive

43
Q

both the alveolar and extra-alveolar vessels are — as lung volume increases, and the resistance to blood flow offered by both alveolar and extra-alveolar vessels
— during lung inflation.

A

compressed

increases

44
Q

PVR is elevated in both alveolar and extra-alveolar vessels

A

throughout the

respiratory cycle.

45
Q

Because intrapleural pressure is always positive, a large number of blood
vessels throughout the lung are compressed and provide a high amount of resistance. This greatly

A

increases the workload of the right ventricle to pump blood to the heart.

46
Q

High PVR and a fall in cardiac output may

A

cause right heart failure

47
Q

Starling law

A

see slide 21

48
Q

2 major types of pulmonary edema

A
  1. Hydrostatic Edema/ Cardiogenic Edema

2. Permeability Edema

49
Q

Hydrostatic Edema/ Cardiogenic Edema caused by

A

increases in capillary pressure

no change in capillary filtration or reflection coefficient

Usually with Right Heart Failure

50
Q

Hydrostatic edema is principally related to an increase

A

in capillary pressure

51
Q

This type of edema is common with left heart failure due to left
ventricular infarction or mitral stenosis

A

Hydrostatic Edema

52
Q

Permeability Edema

A

increase in permeability of vessel wall that separates blood from tissue

53
Q

Permeability Edema increased — and decreased –

A

capillary filtration kf

reflection coefficient sigma

54
Q

Permeability Edema also called

A

non-cardiogenic edema

55
Q

principal disorder in ARDS

A

Permeability Edema

56
Q

severe form of lung injury marked by persistent inflammation and increased capillary permeability

A

ARDS

57
Q

ARDS sx

A

breathlessness, rapid shallow breathing, dry cough, chest pain

58
Q

ARDS x-ray shows

A

diffuse airspaces and bilateral alveolar infiltrates

BMS 615 Cardiovascular (49 decks)

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