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Cardiopulmonary 18
Pulmonary and Fetal Circulation
21
Medical
Graduate
12/13/2012

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Cards

Term
what is the difference in pressures between the systemic and pulmonary systems and what contributes to this difference?
Definition
the pulmonary system is a low pressure (25/10)
whereas the systemic system is high pressure (120/80)
the pulmonary has short and large diameter vessels as opposed to the systemic system which has long and narrow vessels
Term
true or false, the lungs can serve as a reservoir for blood holding about 0.5L of blood? how is this determined?
Definition
true, the pulmonary artery can be occluded and the aortic pressure is not affected for several beats
Term
what pattern does the pulmonary artery pressure resemble?
Definition
the aortic pressure (but much lower pressure)
Term
define alveolar and extra-alveolar vessels.
Definition
alveolar vessels surround the alveoli
and extra-alveolar vessels run through the stroma of the lung
Term
what forces affect pulmonary circulation?
Definition
gravity, alveolar pressure, perfusion pressure, and lung volume
Term
what affect does alveolar pressure have on pulmonary circulation?
Definition
as the alveolar pressure increases the alveolar vessel can become impinged reducing flow through that alveoli
Term
what affect does lung volume have on pulmonary circulation?
Definition
lung volume controls how many extra-alveolar vessels are open and therefore affects flow
Term
what are the functions of the lung?
Definition
gas exchange, blood reservoir, blood filtration, metabolism, and defense
Term
what are the three parts of gas exchange?
Definition
ventilation, diffusion, perfusion
Term
how does the lung serve as a blood filter?
Definition
it can trap tiny particles from entering the coronary and cerebral circulations, and due to the large degree of collateralization it is hardly affected
Term
what is the metabolic function of the lung?
Definition
the pulmonary endothelial cells produce ACE which is important in the breakdown of bradykinin
Term
what immune functions do the lungs perform?
Definition
the lungs produce Ig's, store WBC's, and sequester platelets
Term
what affect does pulmonary artery pressure have on pulmonary circulation, how does it occur, and how is it different from the systemic circulation?
Definition
as pressure increases the vascular resistance decreases in order to increase flow, this is achieved through the recruitment and distention of vessels.

in the systemic circulation increased pressure results in vasoconstriction and a decrease in flow
Term
what are the critical opening / closing pressures?
Definition
the pressure required to open new vessels in the pulmonary circulation, and below that pressure would cause closing of the vessels
Term
compare the vascular resistance of a deflated vs inflated lung?
Definition
resistance in a deflated lung is higher than in the inflated lung because you must inflate alveolar and extra-alveolar vessels in order to perfuse the lung, past a certain amount of inflation however the alveolar pressure impinges on the vessels and increases resistance
Term
describe the role of gravity on pulmonary circulation.
Definition
the pulmonary arteries enter the lungs at the sternal angle, below this flow is increased because of hydrostatic forces caused by gravity, but above this flow is reduced due to negative hydrostatic forces as well as potential collapse of the lung tissue
Term
describe the regional differences in pulmonary blood flow.
Definition
at the bottom of the lung you have high vascular pressure and distended vessels so alveolar pressure is not an issue, whereas at the top of the lung you have low vascular pressure and less distention in which alveolar pressure can be an issue. The middle is somewhere in between.
Term
describe the chemical control of pulmonary circulation.
Definition
alveolar O2 pressure controls blood flow, a decrease in O2 levels causes vasoconstriction to limit flow to areas that have higher O2 content
Term
what affect does high altitude have on pulmonary circulation?
Definition
due to low O2 content you get global vasoconstriction throughout the lung, this raises pulmonary arterial pressure in order to utilize more of the lung tissue
Term
what are the six structures found in fetal circulation that are not found in the adult and where are they located?
Definition
2 umbilical arteries - branching off descending aorta to placenta
umbilical vein - branches off IVC to placenta
ductus venosus - runs from umbilical vein to IVC
foramen ovale - hole between atria
ductus arteriosus - runs from aorta to pulmonary trunk
Term
what causes the closure of the foramen ovale, ductus arteriosus, and ductus venosus?
Definition
a change in blood pressure from the venous to arterial circulation, the RA to LA, and from the pulmonary artery to the aorta
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