PULMONARY

CIRCULATION
By idan-mitable
 OUTLINE
• PULMONARY BLOOD VESSELS
• CHARACTERISTIC FEATURES OF PULMONARY BLOOD
VESSELS
• PULMONARY BLOOD FLOW
• PULMONARY BLOOD PRESSURE
• MEASUREMENT OF PULMONARY BLOOD FLOW
• REGULATION OF PULMONARY BLOOD FLOW
 PULMONARY BLOOD VESSELS

• Pulmonary blood vessels include pulmonary artery, which carries

deoxygenated blood to alveoli of lungs and bronchial artery, which supply
oxygenated blood to other structures of lungs.
• PULMONARY ARTERY : Pulmonary artery supplies deoxygenated blood
pumped from right ventricle to alveoli of lungs (pulmonary circulation). After
leaving the right ventricle, this artery divides into right and left branches. Each
branch enters the corresponding lung along with primary bronchus. After
entering the lung, branch of the pulmonary artery divides into small vessels
and finally forms the capillary plexus that is in intimate relationship to alveoli.
Capillary plexus is solely concerned with alveolar gas exchange. Oxygenated
blood from the alveoli is carried to left atrium by one pulmonary vein from
each side.
PULMONARY CIRCULATION
 PULMONARY BLOOD VESSELS

• BRONCHIAL ARTERY : Bronchial artery arises from descending

thoracic aorta. It supplies arterial blood to bronchi, connective tissue
and other structures of lung stroma, visceral pleura and pulmonary
lymph nodes. Venous blood from these structures is drained by two
bronchial veins from each side. Bronchial veins from right side drain
into azygos vein and the left bronchial veins drain into superior
hemiazygos or left superior intercostal veins. However, the blood from
distal portion of bronchial circulation is drained directly into the
tributaries of pulmonary veins.
• PHYSIOLOGICAL SHUNT : Physiological shunt is defined as a
diversion through which the venous blood is mixed with arterial blood.
• Physiological shunt has two components:
1. Flow of deoxygenated blood from bronchial circulation into pulmonary
veins without being oxygenated makes up part of normal physiological
shunt
2. Flow of deoxygenated blood from thebesian veins into cardiac chambers
directly.
Thebesian veins are also called venae cordis minimae ( smallest cardiac veins )
are a small group of valveless myocardial coronary veins within the walls of
each of the four cardiac chambers that drain venous blood directly into each of
the respective chambers. The thebesian veins of the left side of the heart drain
deoxygenated blood into the newly oxygenated blood of the left atrium and
ventricle. They are name after the German anatomist Adam Christianus
thebesius.
 PHYSIOLOGICAL SHUNT VS.
PHYSIOLOGICAL DEAD SPACE
• Physiological shunt is analogous to physiological dead space.
• Physiological shunt includes wasted blood and physiological dead space
includes wasted air. Both wasted blood and wasted air exist on either
side of alveolar membrane and both affect the ventilation-perfusion
ratio.
 CHARACTERISTIC FEATURES OF
PULMONARY BLOOD VESSELS
• Following are the characteristic features of pulmonary blood vessels:
1. Pulmonary artery has a thin wall. Its thickness is only about one third of thickness
of the systemic aortic wall. Wall of other pulmonary blood vessels is also thin.
2. Pulmonary blood vessels are highly elastic and more distensible
3. Smooth muscle coat is not well developed in the pulmonary blood vessels
4. True arterioles have less smooth muscle fibers
5. Pulmonary capillaries are larger than systemic capillaries. Pulmonary capillaries
are also dense and have multiple anastomosis, so, each alveolus occupies a
capillary basket.
6. Vascular resistance in pulmonary circulation is very less; it is only one tenth of
systemic circulation
7. Pulmonary vascular system is a low pressure system. Pulmonary arterial pressure
and pulmonary capillary pressure are very low
 CHARACTERISTIC FEATURES OF
PULMONARY BLOOD VESSELS
8. Pulmonary artery carries deoxygenated blood from heart to lungs and
pulmonary veins carry oxygenated blood from lungs to heart
9. Physiological shunt is present.
 PULMONARY BLOOD FLOW
• Lungs receive the whole amount of blood that is pumped out from right
ventricle. Output of blood per minute is same in both right and left
ventricle. It is about 5 liter. Thus, the lungs accommodate amount of
blood, which is equal to amount of blood accommodated by all other
parts of the body.
 PULMONARY BLOOD PRESSURE
• Pulmonary blood vessels are more distensible than systemic blood
vessels. So the blood pressure is less in pulmonary blood vessels. Thus,
the entire pulmonary vascular system is a low pressure bed.
• Pulmonary Arterial Pressure ;
Systolic pressure : 25 mm Hg
Diastolic pressure : 10 mm Hg
Mean arterial pressure : 15 mm Hg.
Pulmonary Capillary Pressure ;
Pulmonary capillary pressure is about 7 mm Hg. This pressure is
sufficient for exchange of gases between alveoli and blood.
MEASUREMENT OF PULMONARY BLOOD
FLOW
• Pulmonary blood flow is measured by applying Fick principle.
• The Fick principle is a formula that calculates the uptake or release of a
substance by an organ. It is based on the product of the blood flow to
the organ and the difference in the concentration of the substance
between the arterial and venous blood. The Fick principle can be used
to measure cardiac output, which is the amount of blood pumped by
the heart per minute.
 REGULATION OF PULMONARY BLOOD
FLOW
• Pulmonary blood flow is regulated by the following factors:
1. Cardiac output
2. Vascular resistance
3. Nervous factors
4. Chemical factors
5. Gravity and hydrostatic pressure.
 CARDIAC OUTPUT

• Pulmonary blood flow is directly proportional to cardiac output. So, any

factor that alters the cardiac output, also affects pulmonary blood flow.
• Cardiac output is in turn regulated by four factors:
i. Venous return
ii. Force of contraction
iii. Rate of contraction
iv. Peripheral resistance
 VASCULAR RESISTANCE

• Pulmonary blood flow is inversely proportional to the pulmonary vascular

resistance. Pulmonary vascular resistance is low compared to systemic
vascular resistance. Pulmonary vascular resistance is altered in different
phases of respiration. During inspiration, pulmonary blood vessels are
distended because of decreased intrathoracic pressure. This causes decrease
in vascular resistance resulting in increased pulmonary blood flow.
• During expiration, the pulmonary vascular resistance increases resulting in
decreased blood flow.
• During the conditions like exercise, the vascular resistance decreases and
blood flow increases. It is influenced by the exercise-induced hypoxia and
hypercapnea.
 NERVOUS FACTORS

• Stimulation of sympathetic nerves under experimental conditions

increases the pulmonary vascular resistance by vasoconstriction and the
stimulation of parasympathetic, i.e. vagus nerve decreases the vascular
resistance by vasodilatation.
• However, under physiological conditions, it is doubtful whether
autonomic nerves play any role in regulating the blood flow to lungs
 CHEMICAL FACTORS

• Excess of carbon dioxide or lack of oxygen causes vasoconstriction. The

cause for pulmonary vasoconstriction by hypoxia is not known. But it
has some significance. If some part of lungs is affected by hypoxia, there
is constriction of capillaries in that area. Thus, blood is directed to the
alveoli of neighboring area where gaseous exchange occurs.
GRAVITY AND HYDROSTATIC PRESSURE.

• Normally in standing position, blood pressure in lower extremity of the body is very
high and in upper parts above the level of heart, the pressure is low. This is because
of the effect of gravitational force. A similar condition is observed to some extent in
lungs also. Pulmonary vascular pressure varies in different parts of the lungs:
1. Apical Portion – Zone 1
• Normally, in the apical portion of lungs, pulmonary capillary pressure is almost
same as alveolar pressure. So, the pulmonary arterial pressure is just sufficient for
flow of blood into alveolar capillaries. However, if pulmonary arterial pressure
decreases or if alveolar pressure increases, the capillaries are collapsed. This
prevents flow of blood to alveoli. So, this zone of lung is called area of zero blood
flow. Under these conditions, there is no gaseous exchange in this zone of lungs.
So, it is considered as the part of physiological dead space, which is ventilated but
not perfused. And, the ventilation-perfusion ratio increases. It may lead to growth of
bacteria, particularly tubercle bacilli making this part of lungs susceptible for
tuberculosis.
GRAVITY AND HYDROSTATIC PRESSURE.

2. Midportion – Zone 2
• In the midportion of lungs, the pressure in alveoli is less than
pulmonary systolic pressure and more than the pulmonary diastolic
pressure. Because of this, the blood flow to the alveoli increases during
systole and decreases during diastole. So, this zone of the lung is called
area of intermittent flow. Ventilation-perfusion ratio is normal.
GRAVITY AND HYDROSTATIC PRESSURE.

3. Lower Portion – Zone 3

• In the lower portion of lungs, the pulmonary arterial pressure is high
and it is more than alveolar pressure both during systole and diastole.
So the blood flows continuously. Hence, this part of lungs is called area
of continuous blood flow. Ventilation-perfusion ratio decreases because
of increased blood flow.
ZONES OF THE LUNGS