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

Question 1

There are two circulatory systems associated with the lung.

Answer 1

Bronchial circulation

Pulmonary circulation

Question 2

bronchial circulation is

part of the

Answer 2

systemic circulation.

Question 3

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

Answer 3

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

Question 4

bronchial arteries supply the

Answer 4

tracheobronchial tree

Question 5

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

Answer 5

pulmonary veins

Question 6

Bronchial circulation Shunt

Answer 6

two-thirds of the bronchial

capillary venous blood from this circulation drains into the pulmonary veins

Question 7

Pulmonary circulation is driven by

Answer 7

right ventricle

Question 8

The whole cardiac output is

delivered to the pulmonary circulation via the

Answer 8

lung

Question 9

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

Answer 9

much thinner

less

Question 10

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

Answer 10

the total

blood flow of the systemic circulation

Question 11

blood flow measured to determine total cardiac

output

Answer 11

pulmonary blood flow

Question 12

Pulmonary Arteries carry

Answer 12

deoxygenated blood

Question 13

Pulmonary veins carry

Answer 13

oxygenated blood

Question 14

Pulmonary capillaries have — walls and — vascular resistance

Answer 14

very thin

low

Question 15

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

Answer 15

much less

Question 16

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

Answer 16

distensible

compressible

Question 17

Anastomoses connections between

Answer 17

between bronchial and

pulmonary capillary

Question 18

Anastomoses function

Answer 18

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.

Question 19

Pulmonary Circulation Systolic mean pulmonary Arterial pressure

Mean Diastolic

Answer 19

25 mmHg

8 mmHg

Question 20

Pressure drop across systemic circulation

across pulmonary circulation

Answer 20

98mmHg

10mmHg

Question 21

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

Answer 21

less

Question 22

Pa top of lung

Answer 22

3cmH2O

Question 23

Pa Middle of Lung

Answer 23

19cmH20

Question 24

Pa bottom of lung

Answer 24

35cmH2O

Question 25

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

Answer 25

decreases

Question 26

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

Answer 26

smallest greatest

Question 27

Zone 1 is defined as the region that is

Answer 27

not perfused PA>Pa>Pv

Question 28

Zone 2 is the region that is

Answer 28

perfused intermittently only at systolic pressure Pa>PA>Pv

Question 29

Zone 3 is the region in which

Answer 29

always perfused Pa>Pv>PA

Question 30

pt on ventilator has high amounts of

Answer 30

zone 1

Question 31

Another name for Alveolar Hypoxia is

Answer 31

Hypoxia-induced vasocontriction

Question 32

Alveolar Hypoxia

Answer 32

pulmonary vascular smooth muscle contracts in areas of low PO2

Question 33

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

Answer 33

pulmonary vasoconstriction throughout the lung.

Question 34

Vasocontraction throughout the lung can lead to

Answer 34

right heart failure

Question 35

Recruitment

Answer 35

Opening of previously closed (collapsed) arteries.

Question 36

Distension:

Answer 36

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

Question 37

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

Answer 37

increase in volume

Question 38

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

Answer 38

are elongated

Question 39

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

Answer 39

increases greatly

Question 40

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

Answer 40

decreases

Question 41

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

Answer 41

decreases

Question 42

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

Answer 42

positive

Question 43

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.

Answer 43

compressed increases

Question 44

PVR is elevated in both alveolar and extra-alveolar vessels

Answer 44

throughout the | respiratory cycle.

Question 45

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

Answer 45

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

Question 46

High PVR and a fall in cardiac output may

Answer 46

cause right heart failure

Question 47

Starling law

Answer 47

see slide 21

Question 48

2 major types of pulmonary edema

Answer 48

1. Hydrostatic Edema/ Cardiogenic Edema | 2. Permeability Edema

Question 49

Hydrostatic Edema/ Cardiogenic Edema caused by

Answer 49

increases in capillary pressure no change in capillary filtration or reflection coefficient Usually with Right Heart Failure

Question 50

Hydrostatic edema is principally related to an increase

Answer 50

in capillary pressure

Question 51

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

Answer 51

Hydrostatic Edema

Question 52

Permeability Edema

Answer 52

increase in permeability of vessel wall that separates blood from tissue

Question 53

Permeability Edema increased --- and decreased --

Answer 53

capillary filtration kf reflection coefficient sigma

Question 54

Permeability Edema also called

Answer 54

non-cardiogenic edema

Question 55

principal disorder in ARDS

Answer 55

Permeability Edema

Question 56

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

Answer 56

ARDS

Question 57

ARDS sx

Answer 57

breathlessness, rapid shallow breathing, dry cough, chest pain

Question 58

ARDS x-ray shows

Answer 58

diffuse airspaces and bilateral alveolar infiltrates