BLOOD Vessel & Hemodynamics Flashcards

1
Q

Vessel walls structures

A

Know structures.

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2
Q

Arteries

A

Carry blood away from the heart

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3
Q

Atherosclerosis

A

Fats

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4
Q

Elastic arteries

A

Conducting arteries.

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5
Q

Exchange of oxygen

A

Capillaries.

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6
Q

Capillary bed blood flow

A

Contolled by metarteriole/ Precapillary sphincters.

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7
Q

Capillary bed blood flow

A

Controlled by metarteriole/ Pre-capillary sphincters.

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8
Q

Types of capillaries: Continuous

A

Occurs in most tissues

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9
Q

Types of capillaries:Fenestrated:

A

Kidneys small intestine, choroid plexus.

Cilliary bodies

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10
Q

Types of capillaries: Sinusoids

A

Found in liver, bone marrow, and spleen

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11
Q

Sinusoids

A

irregular filled blood spaces.

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12
Q

Capillary exchanged (3)

A

Simple diffusion
Transcytosis
Bulk flow.

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13
Q

Transcytosis

A

Large lipid insoluble molecules cross capillaries in vesicles via transcytosis

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14
Q

Filtration is

A

pressure driven movement of fluid and solutes from blood capillaries into interstitial fluid.

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15
Q

Filtration is promoted by

A

Blood hydrostatic pressure (BHP ) and Interstitial fluid osmotic pressure

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16
Q

Reabsorption is

A

Pressure driven movement of fluid and solutes from interstitial fluid into blood capillaries

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17
Q

Left over fluids

A

Goes over to lymph and then to SUBCLAVIAN SINUS

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18
Q

Net filtration: 2 forces

A

Hydrostatic Pressure

Colloid Osmotic pressure.

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19
Q

Increase capillary filtration

A

increase BP

Increased permeability

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20
Q

Increase capillary filtration

A

increase BP permeability
Poor venous return
Increase histamine
kidney failure

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21
Q

Decreased capillary reabsorption can be due to ________, ______, ______, ________, _____ there is low ______Pressure related to _______ ______

A

Hypoproteinemia, cirrhosis, burns, famine, kidney disease
Decrease oncotic pressure
Blood albumin

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22
Q

Veins

A

lower pressure 10mmhg
Thinner wall, less muscular and elastic tissue
Expand easily, have high capacitance

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23
Q

Venules two types:

A

Post capillary venules

Muscular venules

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24
Q

Venous sinuses; what are they?

A

Veins within walls.

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25
Q

Blood flow

A

Volume of blood flowing through the tissue in a given time

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26
Q

Perfusion

A

Rate of blood flow per given mass of tissue

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27
Q

Important for delivery of nutrients and oxygen and removal

A

metabolic wastes

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28
Q

CO determinants

A

SV and HR

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29
Q

Co also can be determine

A

MAP / R

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30
Q

MAP

A

Measurements taken at intervals

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31
Q

BP

A

Force of blood exerts against vessel wall.

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32
Q

BP is determined by

A

CO
Blood volume
Vascular resistance.

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33
Q

Factors that affect or increased BP

A

Increases SV and HR

Increase SBP

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34
Q

Regulation of BP and Flow

A

Local control
Neural
Hormonal Control –>

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35
Q

Metabolic Theory of autoregulation

A

Tissue inadequately perfused

Wastes accumulate= Vasodilation

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36
Q

Atrial nutrieretic peptide

A

Increase sodium excretion == decreased BP

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37
Q

ADH comes from

A

Posterior Pituitary
Increased water retention
Vasoconstriction
BP increased

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38
Q

Epi and norepinelphrie

A

Catecholamines released from

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39
Q

Epi and norepinephrine

A

Catecholamines released from

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40
Q

Shock and homeostatis

A

Inadequate CO that results in failure of the CV system

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41
Q

Cell membranes dysfunction: what happens to metabolism?

A

cell metabolism is abnormal

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42
Q

Homeostatic responses to SHOCK

A

Activation of RAAS
Secretion of ADH
Activation fo SNS

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43
Q

Signs and Symptoms of shock

A

Homeostatic mechanisms bring about recovery

Decreased BP tri

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44
Q

What is an an anastomose? Function?

Arteries that do not form an anastomosis are called__________

A

Union of the branches of 2 or more arteries supplying the same region of the body
This provides an alternate route for blood flow
“end arteries”

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45
Q

Elastic arteries (“conducting” arteries)

A

Large diameter
More elastic fibers, less smooth muscle
Function as pressure reservoirs

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46
Q

Muscular arteries (“distributing” arteries)

A

Medium diameter
More smooth muscle, fewer elastic fibers
Distribute blood to various parts of the body

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47
Q

Elastic expansion and recoil of the aorta & its main branches Functions?

A

Maintaines steady flow of blood during diastole;
Decrease stress on small arteries
Smoothes out pressure fluctuations

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48
Q

Elastic aorta and arteries STRETCH During

A

Ventricular contraction

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49
Q

Elastic aorta and arteries RECOIL During

A

Ventricular Relaxation

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50
Q

In general a blood vessel has 3 layers:

A
Tunica interna (a.k.a. tunica intima)
Innermost layer, adjacent to lumen(AL) 
Tunica media (SMEF)
Middle layer, smooth muscle and elastic fibers
Tunica externa (around tissue)
Outermost layer, adjacent to surrounding tissue
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51
Q

Parts of the capillary? (outer to inner) BEL

A

Basement membrane
Endothelium
Lumen

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52
Q

Parts of the Veins (outer to inner) TSBLE

A
Tunica externa
Smooth Muscle (TUNICA MEDIA) 
Basement membrane
Lumen 
Endothelium
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53
Q

Parts of the ARTERIES (outer to inner)

TETIBE

A
Tunica EXTERNA
External Elastic Lamina
Tunica Media (smooth muscle) 
Internal elastic Lamina
Basement membrane
Endothelium (Tunica INTERNA)
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54
Q

The walls of the arteries are _______ which allows them to do what?
smooth muscle in the tunica media regulate________

A

elastic; which allows them to absorb the pressure created by ventricles of the heart (creating a pressure resevoir)
- diameter

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55
Q

What layer in the arteries regulate diameter

A

ELASTIC SMOOTH MUSCLE IN THE TUNICA MEDIA

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56
Q

BP ____ with age: arteries become _________

A

rises ; less distensible

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57
Q

Name 3 arterial sense organs

A

Carotid Bodies
Carotid Sinuses
Aortic Bodies

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58
Q

Carotid Sinuses : What do they cause?

Sensitive to ?

A

Dilation in wall of internal carotid arteries. (sensitive to pressure change)
Monitor BP - signaling brainstem
HR decrease and vessels dilate.

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59
Q

FUNCTION: Carotid bodies : oval bodies near carotids (cluster of _______) monitor ________
adjust _______ to stabilize _________

A

oval bodies near carotids (cluster of chemoreceptors)
blood chemistry
respiratory rate to stabilize pH, CO2, and O2

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60
Q

Aortic bodies found were

Function ?

A

walls of aorta

same as carotid bodies

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61
Q

Arterial sense organ innervation 2 nerves

A

Vagus

GLOSSOPHARYNGEAL

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62
Q

Aortic bodies innervated by (think VA)

A

Vagus nerve

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63
Q

Carotid bodies innervated by (think GC)

A

Glossopharyngeal nerve

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64
Q

Capillaries are

A

microscopic vessels that connect arterioles and venules

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65
Q

Capillaries Walls composed of_________

Thin walls permit _______ _________

A

single layer of cells and basement membrane

he exchange of nutrients & wastes between blood and tissue

66
Q

Capillary Bed BLOOD flow is controlled by what?

A

Metarteriole

PreCapillary Sphincters

67
Q

PreCapillary sphinters Relaxed, what happen?

A

Blood flow through the capillaries

68
Q

PreCapillary sphinters CONTRACTED,What happens?

A

Blood flow through thorough fare channels.

69
Q

Capillaries most common route ?

A

Heart –> Arteries–> Arterioles

Capillaries –> Venules –> Veins

70
Q

Portal system has

A

2 capillary beds.

71
Q

Explain the PORTAL SYSTEM

A

Blood flows through two consecutive capillary networks before returning to heart
Hypothalamus/pituitary
Kidneys
Hepatic Portal System between intestines - liver

72
Q

Arteriovenous shunt

A

artery flows directly into vein

73
Q

Venous anastomosis

A

most common, blockage less serious

alternate drainage of organsVenous anastomosis

74
Q

Which is the most common blockage?

A

Venous anastomosis.

75
Q

Arterial anastomosis

A

collateral circulation (coronary)

76
Q

**Continuous - occurs in most _____and Functions

A

occur in most tissues

endothelial cells have tight junctions with intercellular clefts (allow passage of solutes)

77
Q

** Fenestrated - KSCC
Function?
Filtration pores do what?

A

located in kidneys, small intestine, choroid plexus (CSF), ciliary bodies (aqueous humor)
1.organs that require rapid absorption or filtration
2.filtration pores – allows passage of small molecules
KSCC

78
Q

**Sinusoids (LBS) – found in liver, bone marrow, spleen

FUNCTIONS:

A

irregular blood-filled spaces; some have extra large fenestrations, allow proteins and blood cells to enter

79
Q

Substances cross capillary walls by:

DTB

A

Diffusion
Transcytosis
Bulk flow.

80
Q

Capillaries exchange via DIFFUSION Include which substances?
COGAH

A

Substances such as oxygen, carbon dioxide, glucose, amino acids, and some hormones cross capillary walls via simple diffusion

81
Q

Capillaries exchange via TRANSCYTOSIS INCLUDE (1) characteristics

A

Large, lipid-insoluble molecules (like insulin) cross capillary walls in vesicles via

82
Q

Bulk flow is a passive process in which l

A

which large numbers of ions, molecules, or particles in a fluid move together in the same direction
Bulk flow is more important for regulation of the relative volumes of blood and interstitial fluid

83
Q

Bulk flow occurs from an area of ______ _______ to an area of _______ ____, and it continues as long as a pressure difference exists

A

higher pressure ; lower pressure

84
Q

Bulk flow is more important for ________

A

regulation of the relative volumes of blood and interstitial fluid

85
Q

Define Filtration is

A

pressure-driven movement of fluid and solutes from blood capillaries into interstitial fluid

86
Q

2 pressure promoting filtration

A

Blood Hydrostatic Pressure (BHP)

Interstitial fluid osmotic pressure (IFOP)

87
Q

Net filtration of arterial end at capillaries is _____L

A

20

88
Q

Net REABSORPTION of Venous end at capillareis

A

17 L

89
Q

Reabsorption is ___________

Interstitial fluid hydrostatic pressure (IFHP) and blood colloid osmotic pressure (BCOP) promote reabsorption

A

pressure-driven movement of fluid and solutes from interstitial fluid into blood capillaries

90
Q

2 pressure promoting REABSORPTION

A

Interstitial Fluid hydrostatic Pressure (IFHP)

Blood Colloid Osmotic pressure (BCOP)

91
Q

2 causes of Edema

A
Increased Capillary Filtration (increased BP or permeability ) 
Decreased Reabsorption ( Decreased oncotic pressure
92
Q

Increased Capillary Filtration from

PPICKI

A

poor venous return
congestive heart failure - pulmonary edema
insufficient muscular activity
kidney failure (water retention, hypertension)
Increased histamine = increased capillary permeability

93
Q

Decreased Capillary Reabsorption from

CFBK

A
hypoproteinemia (decreased oncotic pressure related to blood albumin) 
cirrhosis
famine
burns
kidney disease
94
Q

4 consequences of Edema

A

Tissue Necrosis: O2 delivery and waste removal impaired
Pulmonary Edema: suffocation
Cerebral Edema: Headaches, Nausea seizures coma
Circulatory Shock : xcessive fluid in tissue spaces cause low BP and blood voluem

95
Q

What is Circulatory Shock?

A

excess fluid in tissue spaces causes low blood volume and low BP

96
Q

Veins _____ blood pressure: _____mmHg with little fluctuation
______walls, ______ muscular and elastic tissue. expand ____,have_____capacitance valves aid _____ ______ ___ ________

A

lower; 10mmHg thinner ; less
easily, have high
skeletal muscles in upward blood flow

97
Q

Venules postcapillary venules ____ _____than capillaries muscular venules have tunica _______

A

more porous ; tunica media

98
Q

Venous sinuses

A

veins with thin walls, large lumens, no smooth muscle

99
Q

Veins are formed from ____ ___

A

the union of several venules

100
Q

Compared to arteries, veins have a ______tunica interna and media and a _______ tunica externa

A

thinner tunica interna and media and a thicker tunica externa

101
Q

Veins have______elastic tissue and _____smooth muscle than arteries

A

less ; less

102
Q

Veins have ____ ____ ____ that prevent backflow

A

one-way valves that

103
Q

Venous return is the

A

the volume of blood flowing back to the heart through the systemic veins, occurs due to the pressure generated by contractions of the heart’s left ventricle

104
Q

*****VENOURS RETURN (VEINS) ARE ASSISTED BY (CROGS)

A
Cardiac suction of expanding atrial space
Respiratory Pump
One way Valves
Gravity (for head and neck)
Skeletal muscle pump.
105
Q

At rest the largest portion of the blood is where?
how much is in systemic arteries and arterioles
Heart
pulmonary

A

SYSTEMIC VEINS AND VENULES (BLOOD RESERVOIR (64%)
13%
7%
9%

106
Q

**Perfusion definition

Important for ____

A

rate of blood flow per given mass of tissue (ml/min/100g)

delivery of nutrients and oxygen, and removal of metabolic wastes

107
Q

*****Hemodynamics: Flow is based on ____and _____

A

Flow based on pressure and resistance

108
Q

Total blood flow:

A

cardiac output (CO), the volume of blood that circulates through systemic (or pulmonary) circuits each minute

109
Q

2 formulas for CO

A
CO= HR x SV
CO= MAP/ Resistance.
110
Q

measurements taken at intervals of cardiac cycle, best estimate: diastolic pressure + (1/3 of pulse pressure)

A

diastolic pressure + (1/3 of pulse pressure)

111
Q

Which varies with Gravity

A

MAP

112
Q

Which varies with Gravity (hemodynamics)

A

MAP

113
Q

– force blood exerts against vessel wall

A

Blood pressure.

114
Q

AS the distance from the left ventricle increases, pressure

A

Decreases.

115
Q

Contraction of the _______ generates BP

The higher the BP, the greater the blood flow

A

ventricles
CO, blood volume, and vascular resistance

greater

116
Q

3 BP determinants (CBV)

A

CO
Blood Volume
Vascular Resistance

117
Q

R is the opposition to blood flow due to f

The higher the R, the ______the blood flow

A

friction between blood and the walls of blood vessels

smaller

118
Q

Vascular Resistance depends on which 3 things (TBS)

A

Size of the blood vessel lumen
Blood viscosity
Total blood vessel length

119
Q

3 ways of Regulation of BP and Flow

A

Autoregulation
Neural Regulation
Hormonal regulation.

120
Q

Autoregulation of BP via

A

Physical and chemical stimuli

121
Q

Autoregulation of BP via: Metabolic theory of autoregulation?

A
  1. Tissue inadequately perfused

2. wastes accumulated resulting in VASODILATION

122
Q

Autoregulation of BP via vasoactive chemicals:

A

substances that stimulate vasomotion; histamine, bradykinin

123
Q

Autoregulation of BP via vasoactive :

Reactive hyperemia

A

blood supply cut off then restored

124
Q

Autoregulation of BP via vasoactive: Angiogenesis

A

growth of new vessels
regrowth of uterine lining, around obstructions, exercise, malignant tumors
controlled by growth factors and inhibitors

125
Q

Neural CONTROL of BP and Blood flow

A

Medulla OBLONGATA VASOMOTOR CENTER

sympathetic control stimulates most vessels to constrict, but dilates vessels in skeletal and cardiac muscle

126
Q

In neural control of BP and BLOOD flow, SYMPATHETIC control stimulates most vessels to ______ but _____vessels in _____And cardiac muscle

A

Constrict; dilate ; skeletal

127
Q

*****Medulla OBLONGATA VASOMOTOR CENTER integrates (BMC)

A

integrates 3 autonomic reflexes
Baroreflexes
Chemoreflexes
Medullary ischemic reflex

128
Q

****BARORECEPTORS : Explain

A
Detect changes in BP detected by stretch receptors (baroreceptors), located in large arteries above heart aortic arch
aortic sinuses (behind aortic valve cusps)
carotid sinus (base of each internal carotid artery)
129
Q

**Where are BARORECEPTORS LOCATED?

ACA

A

large arteries above heart
aortic arch
aortic sinuses (behind aortic valve cusps)
carotid sinus (base of each internal carotid artery)

130
Q

Signals sent to Medulla Oblongata:

A
  1. Increase BP causes rate of signals to rise, inhibits vasomotor center, Decreases sympathetic tone, vasodilation causes BP decreased.
  2. Decreasd BP causes rate of signals to drop, excites vasomotor center, increased sympathetic tone, vasoconstriction and BP increases
131
Q

Chemoreceptors in aortic bodies and carotid bodies

A

located in aortic arch, external carotids, subclavian arteries

Autonomic response to changes in blood chemistry
pH, O2, CO2
primary role: adjust respiration
secondary role: vasomotor
hypoxemia, hypercapnia and acidosis stimulate chemoreceptors, stim. vasomotor center to cause vasoconstriction, inc. BP, inc. lung perfusion and gas exchange

132
Q

Medullary Ischemic Reflex

Inadequate perfusion of brainstem lead do

A
  1. cardiac / vasomotor centers send sympathetic signals to heart & blood vessels
  2. Increased C.O. and causes widespread vasoconstriction
    increased BP

Other brain centers
stress, anger, arousal can also incr. BP

133
Q

Input to CV centers comes from (nerve impulses)

A

higher Brain centers: cerebral cortex, limbic, hypothalamus
Proprioceptors: monitor joint movements
Baroreceptors: Monitor BP
Chemoreceptors: monitor Blood acidity, ph, CO2, H+

134
Q

OUTPUT FROM CV to EFFECTOR organs

A

increased frequency of nerve impulses
Heart: decreased HR (parasympathetic vagus nerve)
heart: increased rate of contractility (through cardiac accelerator from sympathetic nerve)
Blood vessels: Vasoconstriction (through vasomotor nerves of sympathetic system

135
Q

Hormonal control of BP

A

Renin –> Angiotensinogen –>Angiotensin I –> ACE –> Angiotensin II–> Vasoconstriction = increased BP
–>Aldosterone : stims. Kidney to reabsorb Na+, water follows salt = increased BP

136
Q

BP rises with age because

A

Arteries become less distensible.

137
Q

Walls of capillaries composed of

A

single layer of cells

Basement membrane,

138
Q

Simplest pathway

A

1 Capillary bed

139
Q

Portal pathway

A

2 capillary beds.

140
Q

Histamine makes capillaries more

A

permeable.

141
Q

During inhalation
What happens to increased blood flow to what? Intrathoracic pressure, blood flow into thoracic veins, Diaphragm , intraabdomial pressure

A
Blood flow into thoracic veins.
Decreased
Increased
contracts
Increased.
142
Q

During exhalation
What happens to increased blood flow to what? Intrathoracic pressure, blood flow into thoracic veins, Diaphragm , intraabdomial pressure

A

Increases blood flow to heart and abdominal veins
Increased thoracic pressure
Diaphragm relaxes
Decreased intra-abdominal pressure
Release of compression of abdominal veins.

143
Q

Chemoreflex

A

Chemoreceptors in aortic bodies and carotid bodies. \

Located in aortic arch, external carotids, subclavian arteries.

144
Q

2 roles of chemoreflex

A

Autonomic response to change in blood chemistry
ph, O2, Co2
Primary role: Adjust respiration
Secondary role: Vasomotor

145
Q

3 things that chemoreflex response to

A

hypoxemia
Hypercapnia
acidosis
stimulate vasomotor center to cause vasoconstriction by Increasing BP and lung perfusion and gas exchange.

146
Q

Hormonal Control of BP –> 4 ways

A

ANP : increase sodium excretion = decrease BP
ADH: Increased water retention, vasocontriction = increase BP
Epinephrine and Norepinephrine: catecholamines released from adrenal medulla increase CO and BP
General somatic blood vessels: Binds to alpha adrenergic receptors , vasoconstriction = BP increased

147
Q

Pulse points are

A
Superficial temporal artery
Facial artery
Common carotid artery
Brachial artery
Femoral artery
Popliteal 
Radial
Dorsal artery of foot
148
Q

Homeostatic Responses to Shock?

A

Activation of the Renin-angiotensin aldosterone system
Secretion of ADH
Activation of the sympathetic division
Release of local vasodilators.

149
Q

Responses to hypovolemic shock

A

Increase Renin, ADH, Epi

150
Q

Signs of SHOCK

A

Tachycardia
Clammy cool, pale skin
weak, rapid pulse

151
Q

Shock is and

A

inadequate CO that results in failure of the CV systm to meet metabolic demands of body cells
Cell membranes dysfunction, cell metabolism is abnormal and cell death occurs

152
Q

Types of SHOCK

A

Hypovolemic
Neurogenic (from decreased vasomotor tone)
Cardiogenic (acute MI)
Vascular (normal volume w/ vasodilation septic, anyphylactic)
Obstructive (PE, cardiac tamponade)

153
Q

Compensated shock

A

Homeostatic mechanisms bring about recovery
Decreased BP triggers baroreflex and production of angiotensin II< both stimulate vasonconstriction.
If faint: Gravity restores blood flow to brain

154
Q

Decompensated Shock

A

Life threatening positive feedback loops occur
Decreased CO–> Myocardial ischemia
slow circulation –> DIC –> slow circulation
Ischemia and acidosis _-> Decreased vasomotor tone, vasodilation, decreased CO, ischemia and acidosis of brainstem.

155
Q

TIA

A

Lasts from a moment to a few hours

WARNING OF IMPENDING STROKE

156
Q

CVA

A

Brain infarction caused by ischemia
due to atherosclerois, thrombosis, ruptured aneurysm
recovery depends on surrounding neurons, collateral circulation

157
Q

Ascending Aorta

A

Right and left coronary arteries supply heart

158
Q

Aortic arch

A

Brachiocephalic
Right common carotid supplying right side of head
Right subclavian supplying R shoulder and upper limb

Left common carotid supplying left side of head
Left subclavian supplying shoulder and upper limb

159
Q

Descending aorta include

A

Thoracic aorta above diaphragm

Abdominal aorta below diaphragm.

160
Q

Organs that require rapid absorption or filtration use what kind of capillaries

A

Fenestrated

161
Q

Filtration pores does what?

A

Allow passage of small molecules.

162
Q

characteristic of the sinusoids basement membrane

A

Sinusoids have an incomplete basement membrane