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34 Cards in this Set
- Front
- Back
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What is true of the bronchial vasculature? |
-Bronchial systemic venous blood drains directly into the pulmonary veins. -Oxygen poor blood mixes with freshly oxygenated pulmonary venous blood on its way to the left ventricle. -Bronchial blood flow is only 1% to 2% of the cardiac output. |
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What is true of the pulmonary circulation? |
-It is a low resistance system compared with the systemic circulation. -Its pressures are lower even though it receives the same cardiac output as the systemic circulation. -The resistance to blood flow in the pulmonary circulation is approximately 1/10 as great as it is in the systemic circulation. |
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What is the name of the pressure that is essentially equal to the left ventricle end-diastolic pressure? |
Pulmonary pressure |
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What is the name of the pressure that is commonly used as a clinical indicator of left ventricular function? |
Wedge pressure |
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What would happen to PCWP in a patient with a stenoic mitral valve? |
It would increase |
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Why would the balloon of the PAC be left inflated when inserted in the right atrium? |
-To decrease the risk of cardiac arrhythmia. -To allow blood flow to catch the balloon and carry the catheter forward. |
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During the insertion of a pulmonary artery catheter, it is observed that the waveform increases in height and that the pressure is about 25 / 0. Where is the catheter probably located? |
RV |
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What is the explanation for the dicrotic notch on the waveform of the PAC? |
Closure of the pulmonic valve |
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What is the normal value for the PCWP? |
4 to 12MMHG |
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In drawing blood from the proximal channel of a pulmonary artery catheter the attempt is to measure which of the following pressures? |
CVP |
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What channel of the PAC should be selected to draw blood from is a mixed venous sample is required? |
Distal |
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In what conditions is the PAP increased? |
-Hypervolemia -Left ventricular failure -High pulmonary vascular resistance |
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What technique is useful in evaluating cardiac output? |
Thermodilution |
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What is the normal value for PVR? |
96 dynes•sec•cm-5 |
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What is the normal value for systemic vascular resistance (SVR)? |
1456 dynes•sec•cm-5 |
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In the presence of increased LAP due to an inadequate left ventricular pumping action, what would be the effect of PVR? |
It will be decreased |
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Increased blood volume causes what changes? |
It lowers the PVR |
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What are some endogenous substances that produce pulmonary vasodialation? |
-Bradykinin -Histamine -Serotonin |
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In what group of patients has N02 been especially beneficial in treating pulmonary hypertension? |
Infants |
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What is the most important chemical factor causing pulmonary vasoconstrition? |
Alveolar hypoxia |
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What is the Pa02 at which the maximal vasoconstrictive response occurs when the PH is 7.40? |
50 to 60 mmhg |
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In the presence of normal PaO2, how low does the PH need to get before a significant increase in PVR is present? |
Below 7.25 |
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What will inhibit HPV? |
-Alkalemia -Alkalemia-Engogenous -Engogenous nitric oxide and prostacyclin -Alpha-adrenergic blockers -Beta-adrenergic stimulants |
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In what conditions is the HPV response often diminished? |
-Smoke inhalation -ARDS -Sepsis |
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What is an alternative to inhaled N02 for lowering PVR? |
Sildenafil (Viagra) |
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Monitoring of a patient with PAC reveals an elevated PAP due to left heart failure. What therapies will be specifically directed at decreasing the PAP? |
-Diruretics -Vasodilators -Inotropes |
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What concepts apply to zone 1 under positive pressure ventilation? |
-In healthy individuals zone 1 does not exist. -It constitutes alveolar dead space ventilation. |
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What maneuvers can momentarily raise alveolar pressures, creating zone 1 conditions? |
-Coughing -Blowing a trumpet -Positive pressure mechanical ventilation |
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In the presence of exercise, the increased cardiac output and PAPs will recruit what zones? |
-1 -2 -3 |
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What is the name of the force tending to move fluid into the capillary? |
Oncotic pressure |
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What are causes of pulmonary edema? |
-Increased hydrostatic pressure -Increased capillary permeability -Decreased plasma oncotic pressure -Insufficient lymphatic drainage |
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What is a good example of a edema associated with high PCWP? |
Cardiogenic pulmonary edema |
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What conditions are associated with pulmonary edema due to increased hydrostatic pressure? |
-Left ventricular failure -Mitral valve insufficiency -Hypervolemia |
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What conditions are associated with cardiac pulmonary edema? |
Mitral stenosis |
