respiration (pulmonary circulation
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Amna inayat medical college UHS uploaded by class representative,TRANSCRIPT
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RespirationRespiration
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Blood supply to lungsBlood supply to lungs
• Pulmonary arteries
• Pulmonary capillaries
• Pulmonary veins
• Bronchial vessels
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Pulmonary Pulmonary CirculationCirculation
• Pulmonary arteries highly distensible with compliance of 7ml/mmHg = compliance of total systemic arterial tree
• Pulm. Arteries so accommodate whole stroke volume
• 1 – 2 % venous drainage through bronchial blood vessels into oxygenated blood, so volume of blood coming to left atrium ↑ by 1 – 2 %
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• Also PO2 ↓ by 1 – 2 % (shunted blood)
• Pulmonary blood flow of low pressure – 25/8 mmHg
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• Compliance of pulmonary vasculature is due to
• Shorter length of pulmonary arteries and arterioles
• Increase diameter
• Thin vascular walls
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• Left atrial pressure = 2mmHg
• Rises in cases of CCF
• Pulmonary capillary wedge pressure
• BLOOD VOLUME OF LUNGS
• 450 ml, 70 ml in pulmonary capillaries
• Lungs act as reservoirs of blood
• e.g. in cases of shock- shift of blood from pulmonary to systemic circulation
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• Automatic control of pulmonary blood flow distribution
• Secretion of unknown vasoconstrictor agent by hypoxic alveoli
• So the supply of blood flow to the areas that are better aerated
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• Effect of CO2 - ↑ CO2 → Vasoconstriction
↓ CO2 → Vasodilatation
• Effect of O2 - ↓ O2 → Vasoconstriction
↑ O2 → Vasodilatation
• During exercise – Opening of pulm. Capillaries by three folds– Distension of already open capillaries by two
folds– ↑ pulmonary arterial pressure
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• No pressure on Rt. Heart
• Normal Lt. Atrium pressure – 1 – 5 mmHg
• Any rise in this pressure compensated in pulm. Capillaries by compliance & distention of pulm. capillaries
• In case of Lt. heart failure – – Retrograde pressure in pulm. Vessels– If ↑ in pressure more than 7mmHg → Also ↑in
pulmonary arterial pressure– So concomitant increased load on Rt. Heart– If ↑ in Lt arterial pressure more than 30mmHg
→ pulmonary edema
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• Zones of blood flow in lungs
• Height difference of uppermost and lowermost point of lungs= 30cm
• 23mmHg pressure difference
• Level of heart= tricuspid valve
• In standing person
• Pap in upper part of lung=15mmHg lesser
• Pap in lower part =8mmHg greater
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• Pressure differences affecting blood flow
• Little flow on top and 5 times more flow at bases of lungs
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• Capillary exchange of fluid in the lungs and pulmonary interstitial fluid dynamics
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• Pulmonary edema• Causes• Lt sided ht failure• Damage to pulmonary
capillary membrane• TYPES• Acute• Chronic
• SAFETY FACTOR• Acute: pulmonary
capillary pressure of 21mmHg
• Chronic: expansion of lymph vessels
• Increase in draining capacity by 10 folds