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Pulmonary vascular physiology Flashcards

(69 cards)

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1
Q

describe pulmonary blood supply

A

unique dual blood supply

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2
Q

describe pulmonary circulation

A

from RV

100% CO, involved in gas circulation, huge SA for gas exchange

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3
Q

describe bronchial circulation

A

2% of LV output

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4
Q

what are the differences between pulmonary and systemic blood vessels

A 
pulmonary v systemic;
thin v thick vessel wall
minor v significant muscularisation
no need v need for redistribution
high v low pressure
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5
Q

what is the purpose of systemic blood vessel

A

deliver O2 to hypoxic tissue

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6
Q

what is the purpose of pulmonary blood vessels

A

pick up o2 from oxygenated lungs

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7
Q

what are vasodilators in systemic blood vessels

A

hypoxia
acidosis
CO2

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8
Q

what are vasoconstrictors in systemic blood vessels

A

oxygen

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9
Q

what are vasodilators in pulmonary blood vessels

A

oxygen

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10
Q

what are vasoconstrictors in pulmonary blood vessels

A

hypoxia

acidosis

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11
Q

what does oxygen do in pulmonary vessels

A

vasodilates

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12
Q

what does oxygen do in systemic blood vessels

A

vasoconstricts

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13
Q

what is the equation for pressure across a circuit

A

CO x resistance

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14
Q

what is an equation for pressure across pulmonary circulation

A

= mPAP - LA pressure x PVR

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15
Q

what is alveolar recruitment

A

pulmonary capillary response to increased pulmonary artery pressure
occurs as a consequence of exercise
- compressed pathways open

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16
Q

what do recruitment and distension do

A

reduce resistance

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17
Q

what is the difference between recruitment and distension

A

recruitment opens compressed arteries/ cpilaries, distention stretches arteries/ capillaries that are already open

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18
Q

describe type 1 respiratory failure

A

pO2 < 8kPa
pCO2 < 6kPa
- can’t get O2 in

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19
Q

describe type II respiratory failure

A

pO2 < 8kPa
pCO2 > 6kPa
- can’t get O2 in or CO2 out = ventilation problem

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20
Q

what is hypoxia

A

deficiency of O2 at tissue level - low pO2

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21
Q

what is hypoxemia

A

arterial pO2 reduced

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22
Q

what is hypercapnia

A

too much CO2 at tissue level; high pCO2

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23
Q

what detects hypercapnia and what is the consequence

A

chemoreceptors
alters HR and BR
can cause respiratory acidosis

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24
Q

types of hypoxia

A

hypoxaemia/ hypoxic hypoxia
anaemia/ CO hypoxia
ischemia/ stagnant hypoxia
histotoxic hypoxia

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25
how to remember types of hypoxia
HASH
26
what is the definition of hypoxic hypoxia
decreased oxygen tension
27
what is the definition of anaemic hypoxia
decreased carrying capacity
28
what is the definition of stagnant hypoxia
decreased perfusion
29
what is the definition of histotoxic hypoxia
cellular hypoxia
30
causes of hypoxia
hypoventilation diffusion impairment shunting V/q mismatch
31
what is the effect of hypoxia in the lungs
vasoconstriction
32
what can hypoventilation cause
type II respiratory failure due to increased arterial pCO2
33
what can cause hypoventilation
muscular weakness, obesity, loss of respiratory drive
34
what is diffusion impairment in regards to hypoxia
failure of blood pO2 and alveolar pO2 to equilibrate
35
what is a cause of gaseous diffusion impairment
pulmonary oedema
36
what is a cause of membrane diffusion impairment
interstitial fibrosis
37
what is a cause of blood diffusion impairment
anaemia
38
what are the 3 types of diffusion impairment
gaseous, membrane, blood
39
define shunting
blood goes through a completely non-ventilated area
40
causes of shunting (lungs)
intrapulmonary deficit; e.g. asthma, pneumonia, pulmonary oedema, PAVM, complete lobar collapse
41
what is an intrapulmonary deficit
mixed venous blood perfuses unventilated area
42
what is PAVM
pulmonary arteriovenous malformation (R to L shunt between PA and vein)
43
what can shunting lead to
V/Q mismatch
44
can you have V/Q mismatch without shunting
yes; if cause is arterial e.g. emboli
45
what is the most common cause of V/Q mismatch
discrepancies in amount of air reaching alveoli v amount of blood arriving in capillaries
46
describe V/Q mismatch
total ventilation and perfusion is normal but well ventilated regions can't compensate for poorly ventilated regions
47
causes of V/Q mismatch
physiological, pulmonary emboli, asthma, pneumonia, pulmonary oedema
48
what is the effect of V/Q mismatch
pO2 decreases in systemic arterial blood
49
what happens if O2 in alveoli decreases
hypoxic vasoconstriction, perfusion decreases so blood diverted away from poorly ventilated areas towards well-ventilated areas
50
what does a decrease in CO2 do to bronchioles
constriction so ventilation decreases
51
what does an increase in co2 do to bronchioles
dilation so ventilation increases
52
what does hypoxia do in the lungs
vasoconstriction
53
hypoxaemia causes
``` hypoventilation diffusion impairment shunting V/ Q mismatch (same as hypoxia) ```
54
what is the difference between hypoxia and hypoxaemia
deficiency of oxygen at tissue level (hypoxia) v arterial level (hypoxaemia)
55
what are the 2 forms Hb can exist in
``` Hb = deoxyhaemoglobin HbO2 = oxyhaemoglobin ```
56
describe the shape of an OD curve
non-linear, sigmoid
57
what is an equation for the combination of Hb with oxygen
O2 + Hb ⇆ HbO2
58
explain the shape of an OD curve
O2 binds to each subunit sequentially
59
where is O2 given up from Hb
areas of low pO2 i.e. metabolically active tissue
60
what is the effect of increased pH on OD curve
shifts to left - more affinity for O2
61
what is the effect of decreased pH on OD curve
shifts to right - less affinity for O2 -gives up more
62
what is the effect of increased temperature on OD curve
shifts to right - less affinity for O2 - gives up more
63
what is the effect of decreased temperature on OD curve
shifts to left - more affinity for O2
64
what is the effect of increased CO2 in OD curve
shifts to right - less affinity for O2 - gives up more
65
what is the effect of decreased CO2 on OD curve
shift to left - more affinity for O2
66
what is the affinity of CO v O2 for Hb and what is the effect
200 times greater affinity CO irreversibly binds so reduces amount of O2 that can combine with Hb Alters Hb molecule so has more affinity for O2 so OD shifts right so decreased unloading in tissue
67
what is 2-3 diphosphoglycerate
created in erythrocytes during glycolysis
68
what is the effect of high levels of 2-3 diphosphoglycerate on OD curves
shifts them to the right
69
what is the name of the molecule made by erythrocytes during glycolysis that shifts OD curve to right in high levels
2-3 diphosphoglycerate

Respiratory (11 decks)

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