Certified Registered Nurse Anesthetist (CRNA) Practice Exam

Which of the following best describes pulmonary vascular resistance?

1. Pressure in the aorta

2. Flow resistance through the lungs

3. Resistant force opposing blood flow through the left atrium

4. Resistance created by the pulmonary circulatory system

The correct answer is: Resistance created by the pulmonary circulatory system

Pulmonary vascular resistance is best characterized by the resistance encountered by blood flow through the pulmonary circulation. This concept encompasses the forces that impede blood from moving through the vessels of the lungs, which includes both the pulmonary arteries and veins. The pulmonary circulatory system has its unique architecture and characteristics which contribute to this resistance. Understanding this, the emphasis lies on the specific nature of the pulmonary circulation as distinct from systemic circulation. This means that factors including the diameter of the pulmonary vessels, the right ventricular output, and the pressure gradients within the pulmonary arteries critically influence this resistance. In contrast, the other options describe aspects that either relate to systemic circulation (like the pressure in the aorta) or refer to areas that do not accurately capture the essence of the resistance specific to pulmonary blood flow, such as flow resistance in the lungs without incorporating the nuances of the pulmonary circulatory system itself. By focusing on the right context, choice D encapsulates the entirety of the resistance experienced within the pulmonary vascular system.