Blood Vessels, Ch18 Flashcards

1
Q

The distribution circuit of the vasculature. Those in the pulmonary circuit carry deoxygenated blood, while those in the systemic carry oxygenated. As they travel away from the heart, they branch into vessels that become progressively smaller.

A

Arteries

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2
Q

The exchange system of the vasculature. Very-small-diameter vessels that form branching networks called what?

A

Capillaries. Capillary beds.

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3
Q

The collection system of the vasculature, draining blood from capillary beds and returning it to the heart. Small ones merge with others to become progressively larger as they progress toward the heart. In the pulmonary circuit, they carry oxygenated blood, and deoxygenated in the systemic.

A

Veins

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4
Q

This is the innermost tunic of blood vessels. What is it composed of?

A

Tunica intima, composed of endothelium which consists of a sheet of squamous epithelium and its basal lamina. Deep to the endothelium is a layer of subendothelial connective tissue and a layer of elastic fibers called internal elastic lamina, which provide the vessel with distensibility and elasticity.

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5
Q

What is the middle tunic of blood vessels? What is it composed of?

A

Tunica media, composed of a layer of smooth muscle cells arranged circularly around the lumen, and a layer of elastic fibers called the external elastic lamina. The smooth muscle cells control diameter and thus blood flow.

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6
Q

These nerves stimulate the smooth muscle cells of the tunica media in what two ways?

A

Vasomotor nerves. When they stimulate contraction and narrowing of the vessel, it’s known as vasoconstriction. When sympathetic stimulation of the cells decreases, they relax and the vessel’s diameter increases, which is vasodilation.

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7
Q

What is the outermost tunic of blood vessels? What is it composed of?

A

Tunica externa/adventitia. It’s composed of dense irregular collagens connective tissue that supports the blood vessel to prevent overstretching.

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8
Q

This is the ability to stretch when subjected to increased pressure. This is the ability to recoil back to original size when the stretching force is removed.

A

Distensibility. Elasticity.

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9
Q

“Vessels to the vessels.” What do they do?

A

Vasa vasora. They supply oxygen and nutrients to the tunica media and externa, whose cells are too far away from the lumen to receive oxygen and nutrients by diffusion alone.

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10
Q

How do arteries differ from veins in structure?

A

Most arteries have much thicker tunicae mediae than do veins, which reflects their role in controlling blood pressure and flow to the organs. The internal and external elastic laminae are much more extensive in arteries than in veins, reflecting the fact that the arteries are under much higher pressure than are veins.

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11
Q

This type of artery has the largest diameter. They are nearest to the heart and therefore under the highest pressure of any vessels in the cardiovascular system.

A

Elastic/conducting arteries. The tunica media contains 40-70 sheets of elastic fibers arranged between thin layers of smooth muscle cells. The relatively small amount of smooth muscle tissue mean that their diameter does not change much with each stimulation from vasomotor nerves.

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12
Q

This type of artery is generally intermediate in diameter. They contain a well-developed tunica media composed primarily of smooth muscle cells. Most likely to become blocked.

A

Muscular/distributing arteries. Due to all the smooth muscle cells, their diameter does change a lot with vasoconstriction and dilation. This allows the nervous and endocrine systems to adjust local blood flow to different organs by changing the vessel diameter. Also controls blood pressure.

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13
Q

The smallest kind of artery, ranging from 0.3mm to 70-120um. Tunica media contains only 1-3 layers of smooth muscle cells. Diameter is affected by both vasomotor nerves and hormones the blood.

A

Arterioles. The smallest arterioles, called metarterioles, directly feed capillary beds in most tissues. The smooth muscle cells of met arterioles are confined mostly to a circular precapillary sphincter that encircles the metarteriole-capillary junction.

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14
Q

These pressure receptor arteries are found in the aorta, as well as in the common carotid artery in the neck. What is their overall purpose? Also in the aorta and carotid are these that detect blood oxygen, carbon dioxide, and hydrogen ion concentrations.

A

Baroreceptors, whose purpose is to protect the body from sudden increases or decreases in BP from moment to moment. Chemoreceptors.

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15
Q

How do veins differ from arteries?

A

Veins typically outnumber arteries and their lumens have a larger average diameter. 70% of the total blood in the body is located in the veins at any given moment, which allows them to function as blood reservoirs. Have much thinner walls, fewer elastic fibers, less smooth muscle.

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16
Q

These are the smallest veins, which drain blood from the capillary beds. The tiny ones consist of little more than endothelium and some surrounding connective structure, which enables them to exchange material with the surrounding interstitial fluid.

A

Venules. Postcapillary venules. Small ones have only a tunica intima, larger ones have all three tunics. The three tunics become more distinct as the venules merge to become larger venules and then veins.

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17
Q

Most veins contain these, which are extensions of the tunica intimate that overlap and prevent blood from flowing backward in the venous circuit.

A

Venous valves. Especially numerous in the veins of the legs, where blood flow to the heart is strongly opposed by gravity.

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18
Q

Locations where vessels connect via pathways called collateral vessels. What is the most common type?

A

Anastomoses. Venous anastomosis is the most common, in which neighboring veins are connected by small collaterals.

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19
Q

This type of anastomoses exists in many organs such as the heart and brain, as well as around joints. Tissues deprived of oxygen secrete chemicals that trigger a process called what, or the formation of new blood vessels?

A

Arterial anastomosis. Angiogenesis.

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20
Q

This type of anastomosis is when an artery empties directly into a vein without passing through a capillary bed.

A

Arteriovenous anastomosis. Found in the skin and fetal circulation.

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21
Q

This is the leading cause of death in the developed world, an arterial disease that affects large and medium size muscular arteries. Characterized by the formation of plaques, which are buildups of lipids, cholesterol, calcium salts, and cellular debris within the tunica intima. How does it occur?

A

Atherosclerosis. Plaques are generated in response to injury to the endothelium, which causes the vessel wall to become inflamed, which attracts phagocytes. The damaged area turns into a plaque, causing changes in the tunica media.

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22
Q

This is the outward force that the blood exerts on the walls of the blood vessels. It is highest in the large systemic arteries and lowest in the large systemic veins. How is it measured?

A

Blood pressure. Expressed in units millimeters of mercury, or mm Hg. This is the force exerted by a column of mercury one millimeter in height.

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23
Q

The volume of blood that flows per minute, which generally matches CO, averaging about 5-6 L/min. Its velocity is largely determined by the cross-sectional area of blood vessel. What is it affected by?

A

Blood flow. It’s directly proportional to the pressure gradient, meaning blood flow increases when the pressure gradient does and vice versa. Resistance also determines it, which is any impedance to blood flow. Resistance is inversely proportional to blood flow.

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24
Q

Most of the resistance in vessels is encountered away from the heart, which gives rise to what term? How is it related to blood pressure?

A

Peripheral resistance. They are directly related. As peripheral resistance increases, blood pressure increases.

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25
Q

What are the three main variables that determine peripheral resistance? Which is the fastest to change and which is the slowest?

A

Blood vessel radius, blood viscosity, and blood vessel length. Vessel radius is the quickest, whereas vessel length is the slowest.

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26
Q

How is resistance related to blood vessel radius?

A

Resistance varies inversely with the vessel’s radius. As a radius increases, and the vessel dilates, the resistance to blood flow decreases and vice versa.

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27
Q

What is the inherent resistance that all liquids have to flow? How can it change in blood? How is it related to resistance?

A

Viscosity. Generally blood viscosity remains constant but it can be altered by states that change either the number of cells or proteins in the blood, or the amount of water in it. Resistance is increased by conditions that increase viscosity and vice versa.

28
Q

How does blood vessel length affect resistance?

A

The longer the blood vessel, the greater the resistance. This is one reason why resistance in the pulmonary is lower than in the systemic, the vessels in the pulmonary are shorter.

29
Q

What is a fourth factor in determining peripheral resistance? What is ideal blood flow like?

A

Presence of obstructions within the blood vessels. Ideally, blood flow should be laminar (“layered”) in which the layer of blood nearest the vessel wall adheres to it due to friction but the blood in the center flows more freely. Flow becomes turbulent when there are obstructions, requiring more force to move the blood and therefore more resistance. Bruits is the sound heard when turbulent.

30
Q

How is the pressure gradient determined? What increases and decreases CO?

A

DeltaP (change in pressure gradient)=CO x PR. When CO increases, blood pressure increases and vice versa. SNS simulation and caffeine increase CO. PNS simulation and drugs blocking the sympathetic response decrease CO.

31
Q

How are blood volume and pressure related? Small increases in blood volume are offset by the ability of the vessels to stretchy a property known as what? How does this occur in veins and arteries?

A

As blood volume increases, pressure increases. Compliance. Veins are the most compliant, stretching with a tiny rise in pressure. When they cannot stretch any further, the extra blood shifts to arteries, which are less compliant, meaning that overall pressure rises. When compliance decreases, even small increases in volume can raise pressure.

32
Q

What are pressures like in the right and left ventricles?

A

The CO of the right and left ventricles are equal under normal conditions, but the resistance is far greater in the systemic than in the pulmonary. Therefore, pressures average about 15 mm Hg in the pulmonary and 95 mm Hg in the systemic.

33
Q

This is the average pressure in the systemic arteries during an entire cardiac cycle. How is it calculated?

A

Mean arterial pressure, or MAP. MAP=diastolic + 1/3(systolic-diastolic). MAP is about equal to the diastolic pressure plus one-third of the pulse pressure. Average is 120/80 which comes to 93, close to the average of 95 mm Hg.

34
Q

The pressure gradient in the heart pulsates, rising during ventricular systole and declining during diastole. This leads to what two separate pressures? What is the difference between them?

A

Systolic pressure, which averages about 120 mm Hg. Diastolic pressure, which averages about 80 mm Hg when at rest. The difference is known as the pulse pressure, about 40 mm Hg.

35
Q

How is arterial blood pressure measured with a sphygmomanometer and stethoscope?

A

The cuff is inflated to a pressure higher than the systolic. This cuts off blood flow to the brachial artery. As the blood returns when the cuff reaches systolic, it becomes turbulent. This produces sounds of Korotkoff that are listened to. The pressure at which the downs are first heard is the systolic, and the muffled/disappearing are the diastolic.

36
Q

What is pressure like at the arteriolar end of the systemic capillary beds vs the venous?

A

Pressure at the arteriolar end of the capillary bed is about the same as at the small arterioles, about 35 mm Hg. At the venous end it decreases to 15 mm Hg. This is largely due to reduction in blood volume that takes place in the capillaries.

37
Q

What is pressure like in the systemic venules and veins?

A

4 mm Hg in the vena cava and as low as 0 mm Hg in the right atrium. Largely due to high compliance of veins and the declining resistance as these vessels become larger.

38
Q

Veins have a higher cross-sectional area than arteries, which makes the flow of venous blood slower than arterial. What mechanisms assist venous return?

A

Skeletal muscle pumping works in the upper and lower limbs when the muscles squeeze the blood in the veins and propel it upward toward the heart as they contract and relax. For the thoracic and abdominopelvic cavities, the respiratory pump is driven by changes in pressure that occur with ventilation. During inspiration high pressure on ab cavity pushes blood from abdominal veins upward and low pressure in thoracic allows the thoracic veins to expand. And vice versa during expiration.

39
Q

How does the SNS affect cardiac and smooth muscle cells in the blood vessels? Through what neurotransmitters?

A

The axons release norepinephrine and epinephrine, increasing heart rate and contractility, which increases the CO. Vasoconstriction of all types of vessels, but especially arterioles, which increases peripheral resistance. Both changes increase blood pressure.

40
Q

How does the PNS slow the heart rate, decreasing CO and blood pressure?

A

The axons, via the vagus nerve, release acetylcholine primarily onto pacemaker cells (esp SA and AV nodes) and atrial cardiac muscle cells. An increase in parasympathetic activity does allow vasodilation and a decrease in peripheral resistance, because it crease firing of the PNS neurons inhibits the SNS.

41
Q

How does the baroreceptor reflex work to monitor blood pressure?

A

BP increases above normal range, stretching the arteries. Baroreceptors in the carotid and aortic sinus detect it, causing action potentials to fire at a faster rate. The impulses travel to the medulla via the PNS afferent neurons for integration. PNS in the medulla inhibits sympathetic activity, inducing vasodilation and decreasing heart rate, lowering CO. BP decreases as CO and peripheral resistance decreases, decreasing the rate of firing of baroreceptors. Opposite of all this happens for less stretch.

42
Q

In this test, the subject bears down and tries to expire against a closed glottis, as occurs during coughing, sneezing, defecation, and heavy lifting. What does this test do to the body?

A

Valsalva maneuver. It raises the BP in the thoracic cavity reducing the flow of venous blood to the heart, causing a drop in BP. This should trigger the baroreceptor reflex and generate an increase in heart rate.

43
Q

What do peripheral chemoreceptors, located near baroreceptors in the aortic arch and carotid artery, do?

A

Primarily play a role in breathing but they also affect BP. They respond mostly to the level of oxygen in the blood, in that a big decrease in oxygen concentration triggers a series of feedback loops that indirectly stimulate an increase in HR and cause vasoconstriction.

44
Q

Where are central chemoreceptors and what do they do?

A

They are located in the medulla of the brainstem, responding to the pH of the interstitial fluid of the brain. When the pH of this fluid decreases, another feedback loop is stimulated that indirectly increases the activity of the SNS which results in vasoconstriction and a rise in BP.

45
Q

What are hormones that increase CO, and how do they work?

A

Epinephrine and norepinephrine increase HR and contractility. The thyroid hormone causes the cardiac muscle cells to produce more receptors for epinephrine and norepinephrine, which allows these chemicals to have a greater effect on CO.

46
Q

Hormones affect peripheral resistance mainly through their control of blood vessel diameter. What hormones do this and how?

A

Epinephrine and norepinephrine cause vasoconstriction and increase peripheral resistance, elevating BP. Angiotensin-II is a vasoconstrictor that sharply increases PR and BP. ANP causes vasodilation, especially of the vessels supplying the kidney, in response to increased blood volume, decreasing PR and BP.

47
Q

How does the endocrine system regulate blood volume when BP increases?

A

Atrial cells secrete ANP, which causes the kidneys to excrete more water and Na to decrease blood volume, and so BP.

48
Q

How does the endocrine system regulate things when BP decreases?

A

ADH secretion increases, triggering thirst and increasing water retention. Also the enzyme renin gets secreted from the kidneys, which begins the process activating angiotensin-II. This induces thirst, causes Na ion retention, which increases blood volume. Angiotensin-II also triggers secretion of aldosterone which causes retention of Na and water.

49
Q

An estimated 20% of the world’s population has this, which is associated with what? What does drug therapy treat?

A

Hypertension. Coronary artery disease, stroke, heart failure, certain types of dementia, kidney disease, and vascular disease. Essential (more than 95%) and secondary hypertension. Drugs are aimed at modifying RASS, tubules in the kidneys, Ca ions in the vascular smooth muscle, and SNS receptors on the heart. Cardiac output, BV, peripheral resistance.

50
Q

Any abnormally low blood pressure, defined by a systolic lower than 90 mm Hg and/or diastolic lower than 60 mm Hg. Generally diagnosed only if the patient shows symptoms. What is the severe version? Potential causes?

A

Hypotension. Circulatory shock is when it’s more severe, resulting in more dramatic symptoms like loss of consciousness and organ failure. Causes include reduced blood volume, hypovolemia. Decreased CO. Vasodilation. Mild cases can be managed by increasing fluid intake and changing medication.

51
Q

The blood flow to a tissue through a capillary bed.

A

Tissue perfusion

52
Q

Describe the physical characteristics of capillaries. Around some capillaries are cells called what, that have contractile filaments and appear to control blood flow through capillary?

A

Extremely thin with walls only about 0.2 um thick. 8-10 um in diameter. Consists of an endothelium rolled into a tube and small amount of basil lamina secreted by the cells. Pericytes.

53
Q

What is the primary function of capillaries? What is this known as? How does it occur?

A

Nutrients, gases, ions, and wastes must be able to cross the wall and travel between the blood in the capillary and the tissue cells. Capillary exchange. Diffusion and osmosis through gaps and fenestrastions. Diffusion through the membranes of endothelial cells. Transcytosis.

54
Q

Small pores within some endothelial cells of capillaries, through which water is able to freely move when a gradient exists, as well as substances such as monosaccharides and amino acids that are dissolved in the water.

A

Fenestrastions.

55
Q

The majority of capillaries in the body are of this type. Located in the muscles, skin, and most nervous and connective tissues. Least leaky because of the tight junctions. Substances move through by diffusion or transcytosis.

A

Continuous capillaries. Capillaries in the brain are a modified type of continuous capillary.

56
Q

These capillaries are much leaker than continuous ones because of what? This allows diffusion to take place more quickly so they’re located in places where substances must rapidly enter or exit the blood, like endocrine glands, the small intestine, and the kidneys.

A

Fenestrasted capillaries, because of fenestrations.

57
Q

These are the leakiest kind of capillaries. They have a discontinuous sheet of epithelium, irregular basal lamina, and very large pores in the endothelial cells. Size, shape, and sluggish blood flow allow them to transfer large substances such as blood cells and large proteins. Liver, lymphoid organs, bone marrow, spleen.

A

Sinusoids. Typically 3-4 times larger than other capillaries, often with an irregular shape because their boundaries are determined by the organs in which they reside.

58
Q

The flow of blood that takes place within the body’s capillary bed is collectively called? It occurs in what two types of vessels? Explain?

A

Microcirculation. True capillaries, where materials are exchanged. A small, central vessel. True capillaries are fed by the proximal end of the central vessel, which is formed by either a terminal arteriole or metarteriole. True capillaries are drained at the distal end of the capillary bed by a portion of the central vessel called a thoroughfare channel, which lacks pre capillary sphincters.

59
Q

This ensures that the correct amount of blood is delivered to match a tissue’s level of activity. What are the two main types?

A

Autoregulation. Myogenic mechanism and metabolic controls.

60
Q

This type of autoregulation relies occurs when increases in arteriolar pressure open stretch-sensitive channels in the arteriolar smooth muscle cells. Explain further?

A

Myogenic mechanism. The increased pressure initiates a depolarization in the membranes of these that allows them to contract without nervous stimulation. Thus, increases in arteriolar pressure lead to arteriolar vasoconstriction and vice versa. The mechanism slows blood flow by increasing resistance when pressure rises, and speeds it up by decreasing resistance when pressure lowers.

61
Q

Autoregulatory mechanism mediated by chemicals present in the interstitial fluid surrounding capillaries. These chemicals are the result of cellular metabolic activities. Explain?

A

Metabolic controls. Cells consume oxygen to generate ATP, making carbon dioxide as a waste product, which diffuses into interstitial fluid. Metabolizing cells contain low O and high CO2/H. This causes the smooth muscle cells of local aterioles to relax and dilate, increasing perfusion and ensuring adequate O and nutrient delivery to the actively metabolizing cells. And vice versa.

62
Q

The force that a fluid exerts on the wall of its container. Generally drives water out of the capillary. Equal to blood pressure. Explain?

A

Hydrostatic pressure. Fluid flows through the holes from the area of higher HP to the area of lower HP until the gradient is extinguished. This flow is a passive process known as filtration.

63
Q

Involves movement of water from a solution with a lower solute concentration to one with a higher solute concentration. Solute particles in a solution exert a force, or pull, on the water molecules, drawing them into the capillary. What is it created by?

A

Osmotic pressure. Determined almost exclusively by the number of particles, not their size. Created by large proteins in the blood, especially albumin.

64
Q

Proteins are too large to leave the capillary, so the OP remains the same throughout the capillary’s length. The OP of the interstitial fluid is low. This difference in osmotic pressure creates what OP gradient?

A

Colloid osmotic pressure, COP.

Capillary OP - interstitial OP = COP

65
Q

Characterized by an excessive amount of water in the interstitial fluid. Common causes include an increase in the HP gradient and a decrease in COP.

A

Edema. Hypertension causes greater capillary HP at both the arteriolar and venular ends of capillaries, raising the overall net filtration pressure, which causes more water to be lost from the blood. When COP decreases, the cause could be the liver not making proteins anymore.