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MS1 - Cardiovascular, Pulmonary, and Renal > Pulmonary Circulation > Flashcards

Pulmonary Circulation Flashcards

1
Q

The bronchial circulation supplies the __________.

A

supplies the conducting airways

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2
Q

The bronchial arteries arise from the _________.

A

aorta and intercostal arteries

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3
Q

Typical pulmonary pressure is _______. Mean pulmonary arterial pressure is ______.

A

25/8; 14

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4
Q

The lungs can be thought of as a circuit. Give Ohm’s law for the lungs.

A 
PAP - LAP = CO x PVR
PAP: pulmonary arterial pressure
LAP: left atrial pressure
CO: cardiac output
PVR: pulmonary vascular resistance
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5
Q

The large elastic arteries absorb __________.

A

pulsatile flow

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6
Q

The muscular pulmonary arterioles __________.

A

regulate blood pressure

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7
Q

The pulmonary veins and lymphatics run in the ____________.

A

interlobular septa

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8
Q

The pulmonary circulation has _______ compliance.

A

greater

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9
Q

What is unique about Swan-Ganz catheters?

A

They are flow-directed; an inflated balloon on the end of the catheter bends it.

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10
Q

On a pressure diagram (gathered from a Swan-Ganz catheter), the RV and PA should be __________.

A

the same

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11
Q

Pulmonary pressure does not increase as much as would be predicted by increased cardiac output. Why?

A

The vessels are more distensible and unperfused capillaries can be recruited.

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12
Q

Blood only flows when ___________.

A

pulmonary arterial pressure is greater than alveolar air pressure

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13
Q

There are three lung zones: ___________.

A

1: P(A) > P(a) > P(v)
2: P(a) > P(A) > P(v)
3: P(a) > P(v) > P(A)

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14
Q

How does mechanical ventilation affect the lungs?

A

It increases pulmonary vascular resistance and increases zone 1 area.

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15
Q

Normally in the pulmonary capillares, the hydrostatic pressure is _________ than the oncotic pressure. As such, ______________.

A

much greater; lymphatics must pull fluid back from the alveoli

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16
Q

Pulmonary edema is most often caused by ____________.

A

increased hydrostatic pressure

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17
Q

Because the capillaries and veins reside in the __________, these often enlarge in pulmonary edema.

A

interlobular septa (seen on x-ray as Kerley B lines)

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18
Q

Non-cardiogenic pulmonary edema is due to ____________.

A

increased permeability of the blood vessels

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19
Q

What are the criteria for ARDS?

A

1) Bilateral alveolar infiltrates

2) P(a[O2])/FiO2 less than 300 when given 100% O2; less than 200 for ALI

20
Q

People can develop acute respiratory failure in response to sudden release of ____________.

A

inflammatory cytokines (which leads to increased permeability)

21
Q

Pulmonary hypertension is defined as ___________.

A

mean pulmonary arterial pressure greater than 25 mmHg

22
Q

The equation for pulmonary arterial pressure is ____________.

A 
PAP = CO x PVR + LAP
PAP: pulmonary arterial pressure
CO: cardiac output
PVR: pulmonary vascular resistance
LAP: left atrial pressure
23
Q

Pulmonary hypertension is said to arise from a pre-capillary source if the __________.

A

post-capillary wedge pressure is less than 15 mmHg

24
Q

Pulmonary hypertension is said to arise from a post-capillary source if the ____________.

A

post-capillary wedge pressure is greater than 15 mmHg

25
Q

What are three causes of pre-capillary pulmonary hypertension?

A

Hypoxia, pneumonia, and pulmonary embolism

26
Q

Define paresis.

A

(n.) a condition of muscular weakness caused by nerve damage or disease; partial paralysis

27
Q

The most common ECG sign of pulmonary embolism is __________; less common signs include ___________.

A

sinus tachycardia; SI, QIII, and TIII

28
Q

What are the WHO’s five pulmonary hypertension groups?

A

1) Pulmonary arterial hypertension
2) PH secondary to left heart disease
3) PH secondary to lung diseases and hypoxia
4) Thromboembolic
5) Multifactorial

29
Q

PH is defined as mean PAP > 25 mmHg. PAH is defined as ____________.

A

mean PAP > 25 mmHG; PCWP less than 15 mmHg, PAP greater than 25 mmHg, and greater than 3 Wood units

30
Q

Demographically, idiopathic pulmonary arterial hypertension preferentially affects _________.

A

women in their 3rd and 4th decades of life

31
Q

Median survival of those with idiopathic pulmonary hypertension without treatment is _______; with treatment it is ________.

A

2.8 years; 7 years

32
Q

PAH by itself will not produce _______ on physical exam.

A

abnormal lung sounds

33
Q

Before treating a patient for suspected PAH, you need to obtain a ____________.

A

right-heart catheterization to determine what kind

34
Q

Why should you not use PAH treatments in those with PVH?

A

Because you will increase volume flowing to a high-resistance area, leading to more overload

35
Q

Much of the bronchial circulation drains directly into ___________.

A

the left atrium

36
Q

The pulmonary circuit has ______ elastance and _______ compliance.

A

less; more

37
Q

What is hypercapnia?

A

High arterial CO2

38
Q

Non-cardiogenic pulmonary edema is characterized by a PWCP less than ___.

A

18

39
Q

What is the mmHg PCWP level that separates pre-capillary from post-capillary pulmonary hypertension?

A

15 mmHg

40
Q

__________ are the gold standard in detecting pulmonary emboli, but they are rarely performed.

A

Angiograms

41
Q

Histologically, PAH is characterized by early __________.

A

intimal thickening

42
Q

Lung auscultation will be ______ in those with PAH.

A

normal

43
Q

The ideal treatment for chronic pulmonary emboli is __________.

A

endarterectomy

44
Q

Pulmonary venous hypertension treatment is similar to treatment for ___________.

A

heart failure

45
Q

Why are the bronchial arteries the most common source of hemoptysis?

A

Because they increase the most in inflammatory states

MS1 - Cardiovascular, Pulmonary, and Renal (154 decks)

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