Lectures on respiratory physiology

Pulmonary Blood Flow

Pulmonary and systemic circulations

Alveoli with capillaries

Compression of capillaries

Pulmonary capillary has a very thin wall

Small pulmonary vein

Alveolar and extra-alveolar vessels

Comparison of vascular and electrical resistance

Pin
Pout

FLOW

VASCULAR RESISTANCE =

ELECTRICAL RESISTANCE =

INPUT PRESSURE OUTPUT PRESSURE

FLOW
INPUT VOLTAGE OUTPUT VOLTAGE
CURRENT

Effects of increased pressures on vascular resistance

Recruitment and distension of capillaries

Pulmonary capillary has a very thin wall

Demonstration of recruitment

Demonstration of distension

Effect of lung volume on resistance

Measurement of total pulmonary blood

.
flow
Vo
2

FICK PRINCIPLE

C vo

Ca o

.
.
- )
Vo2 = Q ( Ca o - C vo
2
2
.
.
Vo2
Q =
Ca o - C vo
2

Uneven distribution of blood flow

Effects of change of posture and exercise

Normal distribution in isolated lung

Effect of reducing pulmonary artery pressure

Effect of raising pulmonary venous pressure

Three zone model of distribution of blood flow

Compression of capillaries

Three zone model of distribution of blood flow

Model of a Starling resistor

Three zone model of distribution of blood flow

Non-gravitational causes of uneven blood

flow
Random variations in the resistance of blood
vessels
Some evidence that proximal regions of an
acinus receive more blood flow than distal
regions
In some animals some regions of the lung have
an intrinsically higher vascular resistance

Effect of breathing 10% oxygen

Effect of reducing the alveolar PO2

Alveolar gas is very close to the wall of the artery

Low alveolar PO2 causes vasoconstriction

Evolutionary pressure for hypoxic

pulmonary vasoconstriction
Pulmonary blood flow in the fetus is only about 15% of the
cardiac output
Most of the output of the right ventricle bypasses the lung
through the ductus arteriosus
The pulmonary vascular resistance is high because of hypoxic
vasoconstriction in the very muscular pulmonary arteries
Immediately after birth, and pulmonary blood flow must
increase dramatically
The great fall in pulmonary vascular resistance is due mainly
to the release of hypoxic vasoconstriction
In addition the ductus arteriosus gradually closes

Substances metabolized by the lung

Biological activation: Angiotensin I is converted to the
vasoconstrictor, angiotensin II via ACE
Biological inactivation:. Examples include bradykinin,
serotonin, prostaglandins E1, E2, and F2 alpha.
Norepinephrine is also partially inactivated
Not affected: Examples include epinephrine, prostaglandins
A1 and A2, angiotensin II and vasopressin.
Metabolized and released: Examples include the arachidonic
acid metabolites - the leukotrienes, and prostaglandins.
Secreted: Immunoglobulins, particularly IgA, in bronchial
mucus.