Pulmonary Vasculature – Respiratory Medicine | Medical Education Videos



the pulmonary vasculature there are two arterial circulation to the lungs there's the pulmonary arteries or veins which arise from the right ventricle and then draining to the left atrium those are involved in gas exchange and is a low pressure system the normal pressure of pulmonary artery is about 20-25 minutes of mercury maximum whereas for most people the systemic circulation is 100 110 millimeters of mercury then there's the bronchial artery circulation that's a systemic circulation arises from the normal left-sided cardiac circulation and provides oxygenated blood to the lung tissue and because it goes to the left left ventricle circulation it's a high pressure system so describe the pulmonary arteries in a bit more detail the low pressure system that rises from the right ventricle the pulmonary trunk comes out from the right ventricle that divides into a right and into a left pulmonary artery and let those enter into the lung at the hilar those arteries then divide and basically they follow the bronchi so every time the bronchus divides the primary artery divides so you get an accompanying bronchial artery with each bronchus during the further subdivisions out further into the lungs and that supplies blood eventually to the primary computer red capillary bed around the alveoli so this is an invasive pulmonary angiogram somebody's injected contrast into the right ventricle and that contrast has been pumped out from the right ventral down the primary arch and you can see the branching nature of the pulmonary arteries are delineated by this contrast and how the arteries divide and get thinner and smaller as they could move out into the distal part of the lung at the alveoli the primary arterioles form the primary pulmonary capillaries which we've already described former plexus around the outside of the alveoli covering about 70% of the alveolar surface and this is a diagram just showing that in a diagrammatic form those pulmonary capillaries then drain into promoted venules which then drain into pulmonary veins and essentially the venous Pommery venous circulation does verse of the pulmonary circulation becoming the branches forming together forming bigger and bigger blood vessels in exactly the same pattern as the pulmonary arteries but in Reverse eventually ending up though in two veins leaving each lung the right and left inferior and superior pulmonary veins and these drain directly into the into the left atrium so two veins coming from right two veins coming from the left the clinical relevance of the drainage into the left atrium has become more recently because there's increasing number of patients with atrial dysrhythmias who are undergoing a Trull procedures where they cause ablation and to try and prevent the atrial dysrhythmia and those ablations are often around the origins of where the veins are coming into the left atrium and that can cause mechanical problems with drainage of the blood back into the left atrium from the lungs the bronchial artery is completely different it's an important source of blood for the lungs and it's important clinically because it's often the source of blood form a gym opposites being under hydro pressure it's much more likely to cause a significant hemoptysis than the low pressures pulmonary artery circulation they supply the pom Riyad bronchial artery supply blood down to the terminal bronchioles and also supply blood to the visceral pleura the intrapreneur blood vessel the walls of those vessels and lymphatics they arise from the systemic circulation and this are where they come from does vary quite a lot between people even in normal circumstances so the left bronchial tree generally speaking comes from the aorta but may not the right bronchial artery arises in the third or fourth intercostal artery but there are often very abnormal Arrangements where the bronchi arises directly from subclavian arteries example for example the pulmonary sorry the bronchial veins drain back into the systemic circulation venous circulation to the zygous and the hemizygous veins occasioned and there is actually a small amount of blood that goes back in for the pulmonary capillaries to the left atrium as well and that's a essentially an anatomical physiological shunt where a deoxygenated blood reaches into the pulmonary venous circulation and reaches left ventricle the left ventricle but is actually physiologically and not particularly relevant in most circumstances you just completed your first video of the world's best medical exam preparation lectio brings the knowledge of worldwide leading medical experts and Teaching Award winners to your PC tablet or smartphone prepare yourself and check your progress with thousands of quiz questions customized to USMLE standards and the very best you can get in touch with our medical experts personally visit Latorre Oh calm now and continue with the most inspiring medical education around the globe anytime anywhere you

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