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Pulmonary Circulation

DR. CHHAYA SARAF

LEARNING ISSUES
Why are pulmonary vascular pressures lower than
systemic pressures?
What are the functions & peculiarities of pulmonary
circulation
Discuss regional blood flow distribution and the lung
zones that exist in the upright, human lung.
Describe how the pulmonary capillaries maintain fluid
balance. (Starlings Hypothesis as it applies to the Lungs).

PULMONARY
CAPILLARY
NETWORK

PULMONARY CIRCULATION

Pulmonary vessels: Short,

thin, large diameter, distensible so more compliance


(7ml/mmHg)-accepts SV

Less

smooth muscles

Multiple

anastomoses in capillaries

Bronchial vessels:-Bronchial artery carries oxygenated blood,


supplies supporting tissue, empties into pulmonary Veins LV
flow>RV flow & Hb saturation % also decreases.

Lymphatics:-Present in whole lung, removes particulate matter &


prevents the pulmonary edema by removing plasma proteins.

Functions of Pulmonary Circulation


Exchange

of oxygen & carbon dioxide


Removal of emboli
Immunological function
Synthesis of converting enzymes
Reservoir function

PULMONARY CIRCULATION PRESSURES


Right Ventricle: SBP=25mmHg & DBP=0 mmHg
Pulmonary Artery:-

PP=17mmHg
Pulmonary Capillary:- 7 mmHg
Pulmonary Vein & Lt. atrium:-

mmHg

SBP=25mmHg & DBP=8 mmHg


Mean pressure=15

2 mmHg
Pulmonary Blood volume: 450 ml (9% of CO)
Acts as a reservoir
70 ml is in capillaries
Rest is equally divided in arteries & veins

PECULIARITIES OF PULMONARY CIRCULATION

Arteries deoxygenated blood

Veins oxygenated blood

Low pressure circulation (25/8mmHg)

Arteries are distensible so less in pressure during


exercise

Offers less resistance

Capillary pressure is 7 mmHg & COT is 25 mmHg so in


drawing force is 17 to 18 mmHg. This keeps the alveoli dry

Pulsatile flow in capillaries

Sympathetic Stimulation causes VC

Hypoxia causes VC

EXIAFFECT OF HYPO

pO2 < 73mmHg

Hypoxia causes VC-Redistribution of blood to better aerated areas of lung

Role of hydrostatic pressure in regional blood flow


15 mmHg
23 mmHg
pressure difference

8 mmHg

Distance
30cm

REGIONAL PULMONARY BLOOD FLOW


Vascular

pressures are greater in the


base of the lung due to hydrostatic
pressure gradient
This distends the vessels and reduces
their resistance to flow
The base of the lung receives more blood
flow than the apex

BLOOD FLOW IN DIFFERENT ZONES

Palv > Ppc

Systole:-Ppc > Palv


Diastole:-Ppc < Palv

Ppc > Palv

EFFECT OF EXERCISE
Blood

flow in all parts of the lung increases


4-7 times
Causes:

no. of open capillaries - Resistance


Distending all the capillaries rate of blood
Flow - Resistance
pulmonary arterial pressure

resistance due to 1st 2 causes prevents too


much increase in pulmonary AP

AP REMAINS SAME SO PREVENTS PULMONARY


EDEMA & CONSERVES ENERGY

Forces moving fluid outside capillary= (7+14+8)=29mmHg


Forces causing absorption = 28mmHg
Net outward force = (29-28)=+1 mm Hg
Negative interstitial pressure keeps the alveoli dry

PULMONARY EDEMA FORMATION

Any in LAP > 7to8mmHg pulmonary capillary


pressure >30mmHg will cause the pulmonary
edema

Causes
Left

sided heart failure

Mitral

valve diseases

Damage

to pulmonary capillary membrane

Hypoxia

at high altitude

Study material
Guyton 11th edition, Chap. 38

Thanks