A&p2 Unit 3/1

Front 1

2 different circulatory systems providing blood to lungs

Back 1

bronchial/systemic
pulmonary

Front 2

bronchial arteries originate from?

Back 2

directly off of thoracic aorta or
branches off of first 2 intercostal arteries

Front 3

bronchial circulation supplies blood to what portion of the lungs?

Back 3

stroma

Front 4

exact areas that will receive blood from bronchial arteries?

Back 4

lower part of trachea adn remainder of conducting airways
(bronchi:1,2,3
conducting bronchioles to terminal bronchiole)
visceral pleura

Front 5

what structures sends their venous drainage into the bronchial veins?

Back 5

lower part of trachea, all bronchi, visceral pleura

Front 6

where does venous drainage from the conducting bronchioles drain?

Back 6

into pulmonary veins, causing normal R to L shunt (1-2%)

Front 7

2 fxns of bronchial circulation

Back 7

-supply nutrients to and remove waste products from the conducting airways
-in abnormal circum, it can provide collateral circulation to the gaseous exchange airways if necessary

Front 8

why does collateral circulation form if there is a blockage in the pulmonary arteriole?

Back 8

to supply nutrients and remove waste products from the alveoli, even though no gas exchange is taking place, it helps it remain viable in case the pulmonary arteriole becomes unblocked later

Front 9

what do we know about the regulation of the bronchial circulation?

Back 9

poorly understood, SNS can cause vasoconstriction of bronchial aa's and vv's, but importance is questioned

Front 10

why does the pulm circulation exist?

Back 10

GAS EXCHANGE! Primary fxn

Front 11

5 secondary fxns of pulm circulation

Back 11

-blood reservoir
-filter
-questionable role in blood clotting
-facilitate absorption of exogenous fluid from alveoli
-supply nutrients to and remove products from parenchyma of lungs

Front 12

total blood volume of lungs at rest

Back 12

500cc

Front 13

amt of blood in pulmonary capillaries actually involved in gas exchange

Back 13

100cc

Front 14

how much blood comprises the blood reservoir in the lungs?

Back 14

400ccs: equally divided b/t arterial and pulm venous side

Front 15

during severe hemorrhage, how do the lungs participate as a reservoir?

Back 15

the blood vv's vasoconstrict and decrease their capacitance, "transfuse" blood to left side of heart, which eventually goes into systemic circulation

Front 16

what could prevent a clot in the lungs from enlarging?

Back 16

maybe the heparin produced by the pulm mast cells

Front 17

does the pulmonary circulation absorb the endogenous fluid lining the alveoli?

Back 17

no, just exogenous fluid that are ingested into lungs, keeping the alveoli dry

Front 18

nutrients for the gas exchange airways are?

Back 18

glucose
vitamins
amino acids

Front 19

how do cells of the alveoli get their oxygen?

Back 19

diffusion directly from alveolar air, they don't need to get it from pulm cap beds

Front 20

4 components of pulmonary circulatory system:

Back 20

pump:
distributing system
exchange system
collecting system

Front 21

RV serves as?

Back 21

a low pressure pump for pulmonary circulation

Front 22

distributing system of pulm circ?

Back 22

pulm aa's and arterioles

Front 23

exchange system of pulm circ?

Back 23

pulm capillaries involved in gas exchange across alveolar memb

Front 24

collecting system of pulm circ?

Back 24

pulm venules and veins

Front 25

# of pulm veins?

Back 25

few as 3, up to 5

Front 26

how many valves are present in the pulm vv's?

Back 26

none

Front 27

3 special characteristics of pulmonary circulatory system

Back 27

-low resistance
-high distensibility
-low pressure

Front 28

is resistance of pulm vv's greater than that of systemic?

Back 28

no, they have 1/10 the resistance

Front 29

pulmonary circ resistance is divided equally b/t:

Back 29

-pulm arteries
-pulm capillaries
-pulm veins
(all have 1/3 of the resistance)

Front 30

what is the systemic resistance on the arterial side of circulation?

Back 30

70%

Front 31

where do you see greatest resistance?

Back 31

high lung volumes

Front 32

least resistance is at?

Back 32

FRC

Front 33

as lung volume increases: resistance of alveolar/small vessels _______ ?

Back 33

increase

Front 34

what causes increased resistance of the alveolar vessels and lung volume increases?

Back 34

as they are stretched in inspiration, the alveolar capillaries become elongated, which decreases radius and increases resistance

Front 35

extraalveolar/large bld vv's have their greatest resistance at ?

Back 35

low lung volumes

Front 36

the effect on the resistance of the extraalveolar blood vessels is determined by what?

Back 36

IPP/Interstitial pressure
(low lung volumes--less neg IPP, squeezes on bv's, decr radius, increase resist...and vice versa)

Front 37

total PVR consists of:

Back 37

resistance of both the alveolar and extraalveolar blood vessels

Front 38

how does mean pulmonary BP affect PVR?

Back 38

increase in PAP, decrease in PVR

Front 39

Reasons for a decreased PVR when you increase your PAP?

Back 39

-recruitment
-distention

Front 40

why are pulmonary vessels highly distensible?

Back 40

thin walled compared to systemic vv's, d/t less smooth mm in the walls.
-this makes it easier for pressure inside vessel to push walls outward and increase radius...which decreases resistance

Front 41

What is required to increase pulm blood flow?

Back 41

a relatively small increase in pulm BP d/t the pulm vv's being highly distensible

Front 42

To increase BF in systemic circulation, you must ___?

Back 42

have a large increase in BP

Front 43

during strenuous activity, CO is increased how much?

Back 43

3 fold, 15 L

Front 44

when you increase systemic circulation, what else must you do?

Back 44

you must increase pulm circulation just as much

Front 45

as compared to systemic circ, it takes less pressure to increase the pulm circ to the same degree.
why is this beneficial?

Back 45

b/c if the pulmonary BP gets to high, you will have pulm edema

Front 46

what is the principle explaining why increase PAP too great will cause pulm edema?

Back 46

starling's capillary exchange

Front 47

2 reasons pulm circulation is a low pressure system?

Back 47

-low resistance of blood flow
-high distenibility of pulm bv's

Front 48

RA pressure

Back 48

0 mmHg

Front 49

RV pressure

Back 49

25/0

Front 50

PA pressure

Back 50

25/8

Front 51

mean PAP

Back 51

15mmHg

Front 52

pressure at pulm cap arteriolar end

Back 52

12

Front 53

pressure at pulm cap venule end

Back 53

7

Front 54

LAP

Back 54

5

Front 55

lung height of physiological man

Back 55

30cm

Front 56

column of blood 15cm in height, has a pressure of what at the bottom?

Back 56

11 torr

Front 57

where does the pulm artery enter?

Back 57

hilum(midpoint) and delivers blood to apex and base

Front 58

height from hilum to apex

Back 58

15cm

Front 59

height from hilum to base

Back 59

15cm

Front 60

pressure of blood coming to the lungs?

Back 60

25/8

Front 61

when does blood flow to the apex?

Back 61

systole, it is intermittent

Front 62

where is BP higher? apex or base

Back 62

base

Front 63

ramifications of higher BP in base compared to apex

Back 63

-continual bloodflow during systole and diastole
-if BP is >25/8 in upright position, the base will be first to experience pulm edema

Front 64

factors increasing pulmonary blood volume:

Back 64

-inspiration
-recumbency
-left heart failure
-excessive IVF"s
-exercise

Front 65

factors decreasing pulm blood volume

Back 65

-expiration
-positive press ventilation
-diuretics

Front 66

major cause of non-uniform distribution of blood flow

Back 66

gravity

Front 67

which areas are always better perfused?

Back 67

dependent/down lung if in lateral decub/posterior aspects if supine

Front 68

as you go from the apex to the base, what happens to blood flow and ventilation?

Back 68

both increase

Front 69

in exercise, what happens to blood flow in the lung as CO increases?

Back 69

it becomes MORE uniform, not uniform, only more uniform than at rest

Front 70

abnormalities causing non-uniform distribution of blood flow

Back 70

blood clot
tumor/cyst that compresses vessels

Front 71

Zone 1 represents an area of:

Back 71

no blood flow and no gas exchange

Front 72

does Zone 1 normally exist?

Back 72

no

Front 73

instances when zone 1 can exist

Back 73

-decreased pulmonary BP: hemorrhage
-increased intra-pulmonic pressure by + pressure ventilation or blowing a wind instrument

Front 74

what happens to your alveolar pressure in Zone 1 as compared to your pulm BP?

Back 74

it is greater, so there is no blood flow through pulm cap
PA>Pa>Pv

Front 75

describe Zone 2

Back 75

-area of intermittent blood flow
-blood flows during systole when pressure is enough to keep pulm cap open
-area from apex to 10cm above heart
-vv's collapes during diastole
-Pa>PA>Pv

Front 76

describe zone 3

Back 76

-continuous blood flow
-from 10cm above heart to base
-pulm caps are open all the time b/c pressures in sys & dia are > alveolar pressure
Pa>Pv>PA

Front 77

when does the entire lung become zone 3?

Back 77

lying down and during exercise

Front 78

describe zone 4

Back 78

lowermost base of lung, representing an area where the blood flow is decreasing from the peak high BF seen in zone 3

Front 79

what causes decreased blood flow of zone 4

Back 79

extra-alveolar bv's that lie outside of gas exchange airways are being compressed by blood weight, radius decreases, increased resistance, and decreased BF

Front 80

apex or base has greater intravascular pressures

Back 80

base

Front 81

where do you see more recruitment and distention? why?

Back 81

in the bases d/t increase in BP

Front 82

where is there lower resistance, apex or base? why?/

Back 82

base, d/t increased BP pushing against walls and increasing radius

Front 83

where do you see greater blood flow, apex or base?

Back 83

base, d/t gravity and decreased resistance to BF

Front 84

during inspiration, why do you have an increase in total thoracic blood volume?

Back 84

-increased Right CO and decreased Left CO
-RV is pumping more blood to lungs, dilation of bv's d/t decreased IPP causes lungs to hold onto more blood

Front 85

During inspiration, what happens to your LV filling and SV? why?

Back 85

-lungs expand->extraalveolar vessels dilate->lungs hold onto more blood
-intraventricular septum is pushed to left side by increased filling of right side of heart
**all lead to decreased LV filling and decreased SV

Front 86

During expiration, decreased total thoracic BV is d/t ?

Back 86

-lungs recoil inward, squeeze more blood to left side of heart
**leads to decrease in Right CO and increased in Left CO secondary to more blood leaving the lungs

Front 87

increased venous return does what to cardiac output?

Back 87

increased

Front 88

overall, what happens to venous return in inspiration and expiration?

Back 88

increase; decrease

Front 89

decrease in sys BP of more than 10mmHg during inspiration

Back 89

pulsus paradoxus

Front 90

why do you normally see a decrease in systolic BP during inspiration?

Back 90

b/c of decreased venous return to the left side of the heart...which decreases your SV

Front 91

major determinant of systolic BP

Back 91

SV

Front 92

common causes of pulsus paradoxus

Back 92

obstructive pulm dx
cardiac tamponade
constrictive pericarditis
cardiomyophathies
RV infarction

Front 93

IPPB: Inspiration
what happens to intrathoracic pressure?

Back 93

increases

Front 94

IPPB/inspiration:
what happens to RV filling and SV?

Back 94

decreases

Front 95

IPPB/inspiration:
what happens to RV CO?

Back 95

decreases

Front 96

IPPB/inspiration:
what happens to total thoracic BV?

Back 96

decreases

Front 97

IPPB/inspiration:
what happens to LV filling and SV?

Back 97

increases

Front 98

IPPB/insp:
what happens to LV CO?

Back 98

increases

Front 99

Normal/insp:
what happens to intrathoracic pressure?

Back 99

decreases

Front 100

normal/insp:
what happens to RV filling and SV?

Back 100

increases

Front 101

normal/insp:
what happens to RV CO?

Back 101

increases

Front 102

normal/insp:
what happens to total thoracic BV?

Back 102

increase

Front 103

normal/insp:
what happens to LV filling and SV?

Back 103

decrease

Front 104

normal/insp:
what happens to LV CO?

Back 104

decreases

Front 105

during IPPB, when will you see the largest increase in LV CO?

Back 105

during inspiration