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Hemology > Cardiovascular Hemodynamics 1C2 > Flashcards

Cardiovascular Hemodynamics 1C2 Flashcards

1
Q

what do arteries do

A

blood from heart to organs

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2
Q

what are arterioles

A

smaller arteries of the organs receiving blood supply

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3
Q

what are capillaries and what exchanges happen

A

smaller vessels where exchange between blood and organs occur

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4
Q

where do venules carry blood from

A

carry blood from the organs

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5
Q

what are veins

A

veins are convergence of venues to return blood to the heart

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6
Q

what are big differences between artery and veins

A

veins and arteries have about the same amount of endothelium and fibrous tissues

arteries have a more elastic tissue and smooth muscle then veins

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7
Q

arteries carry blood ____ from the heart

A

away

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8
Q

pulmonary arteries carry what

A

carry deoxygenated blood from right ventricle to the pulmonary circulation

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9
Q

what does the aorta do

A

pumps oxygenated blood from the left ventricle to the systemic circulation

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10
Q

veins carry blood to the

A

heart

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11
Q

what drains into the right atrium

A

SVC, IVC, coronary sinus drains deoxygenated blood from the systemic circulation

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12
Q

what drains into the left atrium

A

right and left pulmonary veins drains oxygenated blood from pulmonary circulation

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13
Q

blood flow of the heart is

A

unidirectional

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14
Q

one way valves will not open in ______ direction

A

opposite direction

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15
Q

greater pressure behind the valve causes the valve to

A

open

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16
Q

greater pressure in from the valve causes the valve to

A

close

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17
Q

what are the valves

A

mitral
tricuspid
aortic
pulmonary

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18
Q

what is the windkessel effect

A

large arteries expand, absorb pressure wave then release it with elastic recoil
-helps push the blood down the legs/ to the rest of the body

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19
Q

what help to push blood along during diastole

A

elastic arteries

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20
Q

what can the aorta and elastic arteries change

A

can vasoconstrictor or vasodilator

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21
Q

with aging, what do we have less of when it comes to elastic arteries

A

less expansion and recoil

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22
Q

Elastic recoil of ____ propels blood along

A

artery

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23
Q

what enables the arteries to expand

A

great amount of elastin

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24
Q

in terms of elastic recoil, what happens when the heart relaxes

A

the recoil propels blood onward

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25
Q

what do the contraction of skeletal muscles in the leg assists with

A

assists with venous return from the legs

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26
Q

how does the blood vessels in the leg move blood forward (and against gravity) back toward the heart

A
  • veins in the legs are guarded by valves to prevent back flow of the blood
  • contraction provides an extravascular compression on these blood vessels which moves the blood forward
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27
Q

what aids in keeping the airways of the lungs open

A

the slight negative pressure that is in the thoracic cavity

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28
Q

what helps assists with venous return to the right side of the heart

A

the contraction of the diaphragm and intercostal muscles in the thoracic cavity

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29
Q

what causes the contraction in the thoracic cavity to help with the venous return to the heart

A
  • each time a person inhales, there is a slight drop in internal thoracic pressure
  • this creates a pressure gradient which assists in the flow of venous blood moving forward (against gravity) and back toward the heart
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30
Q

what are the principles of Boyle’s law

A

pressure and volume have an inverse relationship

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31
Q

equation for Boyle’s Law

A

P1 x V1 = P2 x V2

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32
Q

during quiet inspiration, the lung volume ____ and the pressure in the lungs ______

A

the lung volume increases and the pressure in the lungs decrease

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33
Q

Hemodynamics definition

A

physical factors that govern blood flow

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34
Q

Ohm’s Law

A

current (I) equals the voltage difference (delta V) divided by resistance (r)

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35
Q

Ohm’s Law to fluid flow

A

F = delta P / R

  • the voltage difference is the pressure difference
  • the resistance is the resistance to flow (R) offered by the blood vessel and its interactions with the flowing blood
  • the current is the blood flow (F)
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36
Q

regarding Ohm’s law to fluid flow and for the flow of blood in a blood vessel the delta P is what

A

the pressure difference between any two points along a given length of the vessel

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37
Q

what is the formula for the flow of blood in a blood vessel

A

F = delta P / R = (Pa - Pv) / R

  • Pa is arterial pressure
  • Pv is venous pressure
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38
Q

when talking about blood flow across a heart valve, what is the equation>

A

F = (Piv - Pao) / R

  • Piv is the intraventricular pressure
  • Pao is the aortic pressure
  • R is resistance
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39
Q

what is the pressure that drives flow across the aortic valve during ventricular ejection

A

intraventricular pressure

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40
Q

what is the resistance to flow related to

A

related in large part to the size of the valve opening

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41
Q

what is blood flow

A

mass of substance that passes a certain point in one minute

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42
Q

in perfusion, what is blood flow measured in?

A

mL/min or L/min

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43
Q

blood flow is dependent on _____ and _____

A

pressure gradient and resistance

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44
Q

definition of pressure gradient

A

difference in pressure b/w the beginning and end of the vessel

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45
Q

Blood flow from and area of ___ to an area of ____

A

high pressure to an area of low pressure

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46
Q

when does the heart create high pressure

A

when it contracts

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47
Q

why does pressure drop along the length of a blood vessel

A

due to frictional losses between the fluid and blood vessel walls

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48
Q

where is the high pressure in the vessels of the cardiovascular system?

A

aorta

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49
Q

where is the lowest pressure in the vessels of the cardiovascular system?

A

right atrium

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50
Q

flow and resistance are _____ related

A

reciprocally

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51
Q

an increase in resistance _____ flow at any given ___

A

an increase in resistance decreases flow at any given delta P

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52
Q

at any given flow along a blood vessel or across a heart valve, an ___ in resistance ____ the delta P

A

an increase in resistance increases the delta P

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53
Q

During ____ flow conditions, there is a ___ and _____ relationship between flow and perfusion pressure

A

During laminar flow conditions, there is a linear and proportionate relationship between flow and perfusion pressure

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54
Q

what does turbulence cause

A

decrease the flow at any given perfusion pressure

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55
Q

what causes an increase in resistance to flow and thus a decrease flow

A

pulsatility in blood pressure

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56
Q

an increase in delta P does what to the flow

A

increase in flow

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57
Q

what does flow require

A

a pressure gradient

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58
Q

the higher the pressure gradient = ______ = _____

A

the higher the pressure gradient = the greater pressure gradient = the higher the flow

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59
Q

flow always follows the path of

A

least resistance

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60
Q

as blood vessels get small….

A

the flow is decreased

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61
Q

small amounts of ___ ____ can have dramatic effects

A

small amounts of arterial occlusion can have dramatic effects

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62
Q

small vessels are the dominant contributors to ___ _____

A

flow resistance

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63
Q

__ _____ is accomplished by vasodilation and vasconstriction in the arterioles

A

flow regulation is accomplished by vasodilation and vasoconstriction in the arterioles

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64
Q

what does Poiseuille’s law describe

A

smooth flow conditions

if you change one, it’ll have an effect on the others

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65
Q

a 19% increase in radius will do what to the volume flow rate

A

will double the volume flow rate

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66
Q

In terms of Poiseuille’s law, what will have the biggest effect on flow rate

A

increasing the radius

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67
Q

Suppose the original flow rate is 100 cm3/sec. the effect of doubling the length changes the flow rate to

A

50 cm3/sec

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68
Q

Suppose the original flow rate is 100 cm3/sec. the effect of doubling the viscosity changes the flow rate to

A

50 cm3/sec

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69
Q

Suppose the original flow rate is 100 cm3/sec. the effect of doubling the pressure changes the flow rate to

A

200 cm3/sec

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70
Q

Suppose the original flow rate is 100 cm3/sec. the effect of doubling the radius changes the flow rate to

A

1600 cm3/sec

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71
Q

Suppose you have an emergency requirement for a five-fold increase in blood volume rate (like being chased by a big dog), does your body supply it?

A
  • arterioles in their position just prior to the capillaries provide major control on volume flow rate
  • small vessels can constrict flow to one part of the body while enhancing flow to another to meet changing demands of oxygen and nutrients
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72
Q

How occluded does arteries have to be before bypass surgery can happen?

A

70%

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73
Q

definition of resistance

A

opposition to blood flow due to friction between the fluid and vessel walls

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74
Q

what are 4 factors that determine resistance

A
  • vessel radius
  • vessel length
  • viscocity
  • turbulent flow
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75
Q

increased radius =

A

decrease resistance

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76
Q

increased length =

A

increased resistance

77
Q

increased viscocity (n) =

A

greater resistance

78
Q

vasoconstriction causes ____ in radius and ____ in resistance

A

decrease in the radius and increases in resistance

79
Q

vasodilation causes ____ in radius and ____ in resistance

A

increase in the radius and decreases in resistance

80
Q

what is the most important factor of resistance

A

changes in vessel radius

-alters resistance to the fourth power of the change in radius

81
Q

if the radius of a blood vessel doubles (by vasodilation) then the Flo will

A

increase 16 fold

82
Q

if the radius of a vessel is reduced in half (by vasoconstriction) then the blood will

A

be reduced 16 fold

83
Q

what does small diameter arterioles cause

A

major determinant of peripheral vascular resistance (PVR)

84
Q

what does fatty plaques from atherosclerosis cause

A

cause turbulent flow and dramatically increase resistance due to turbulence

85
Q

delta P = 100 mmHg
normal CO is 5 l/min
total PVR is 20 mmHg*min/L

assuming constant pressure differences, which resistance value will raise the blood flow to 25 L/min?

A

r = 4

86
Q

high arteriolar resistance causes a mark drop in

A

MAP

87
Q

what are considered major resistance vessels

A

arterioles

88
Q

what makes the arterioles a major resistance vessels

A

the radius is small enough and can be adjust to variable distribute cardiac output among the tissue organs

89
Q

resistance converts the pulsatile nature of systolic-diastolic pressure to

A

non-pulsatile pressure within the capillaries

90
Q

smooth muscle of the small arterioles is contracted by

A

sympathetic nerves

91
Q

the _______ respond to local factors

A

precapillary sphincters

92
Q

does exchange happen in metarterioles?

A

no

93
Q

what do metarterioles serve as

A
  • serve as thoroughfare channels, which bypass the capillary bed
  • or conduits to supply the capillary bed
94
Q

what is the neurogenic stimulator for vasoconstrictor

A

enothelin-1

95
Q

what is the neurogenic stimulus for vasodilater

A

nitric oxide

96
Q

vascular tone is normally in a state of slight ____

A

constriction

97
Q

what does vascular tone establish and enable?

A
  • establishes baseline arteriolar resistance

- enables vasoconstriction and dilation

98
Q

what is myogenic activity of smooth muscle and what is it responsive to

A
  • self induced contractile activity

- responsive to neural and hormonal mediators

99
Q

___ is released continuously by sympathetic fibers of ANS

A

NE

100
Q

what reduces blood flow through an arteriole and redirects the flow through all arterioles with a lower resistance?

A

arteriolar constriction

101
Q

total blood flow through all the arterioles of the body always equals what.?

A

cardiac output

102
Q

local control of arteriolar diameter is by _____, secreted by the _____ or by _____ which the arterioles are supply blood

A

diameter is by paracrines, secreted by the vascular endothelium or by tissues to which the arterioles are supplying blood

103
Q

in terms of local control, low O2 and high CO2 ____ arterioles which ____ blood flow into the tissues

A

dilate arterioles which increase

104
Q

systemic control of arteriolar diameter is by

A

sympathetic innervation

-release of NE, which then binds on vascular smooth muscle

105
Q

if sympathetic release of NE decreases, what happens to the arterioles

A

they dilate

106
Q

if the release of norepinephrine increases, what happens to arterioles

A

constrict

107
Q

what is the major role of arterioles

A

to constrict or dilate to control the resistance of blood flow in the body as a whole

108
Q

what is the center in the brainstem that regulates SVR or total peripheral resistance?

A

vasomotor center

109
Q

what are the neuroreceptors that cause constriction or dilation in the arterioles

A

constriction = a1

dilation = b2

110
Q

laminar flow is what kind of direction

A

uniform direction

blood moving in a parallel downtown he length of blood vessel

111
Q

turbulent flow iswwhat kind of direction

A

chaotic flow

112
Q

where does turbulent flow usually happen

A

usually occur across a valve

113
Q

what two things does turbulent flow increase?

A
  • increases energy required to drive blood flow b/c increases friction
  • increases perfusion pressure required to drive a given flow
114
Q

what kind of flow is in capillaries and why?

A

always laminar flow

b/c of smaller radius and lowest velocity

115
Q

what does Reynolds number predict

A

when turbulence will occur, under ideal conditions

116
Q

Reynolds number equation

A

Re = (v * D * p) / n

v = mean velocity 
D = vessel diameter 
p = blood density 
n = blood viscosity
117
Q

Laminar flow = numbers up to _____

A

2000

118
Q

turbulent flow = numbers greater than ____

A

4000

119
Q

what are the numbers for transition b/w laminar and turbulent flow

A

b/w 2000-4000

120
Q

flow equation

A

flow = pressure / resistance

121
Q

CO =

when applied to circulatory system

A

CO = (MAP - RAP) / TPR

122
Q

what is CO measured in

A

L/min

123
Q

what is MAP and what does it measure

A

mean arterial pressure (mmHg)

the average pressure of blood as it leaves the heart

124
Q

what is RAP and what does it measure

A

right atrial pressure (mmHg)

average pressure of blood as it returns to the heart

125
Q

what is total TPR

A

total peripheral resistance (in mmHg*min/L)

126
Q

capacitance of blood vessels means what

A

the ability of a vessel to distend and increase volume with increasing transmural pressure

127
Q

equation for capacitance

A

C = delta V / delta P

change in volume divided by change in pressure

128
Q

compliance _____ at higher pressure and volumes

A

decreases at high pressures and volumes

129
Q

at lower pressure, the compliance of a vein is about ___ to ___ times greater than an artery

A

10 to 20

130
Q

____ can accommodate a LARGE change in blood volume with only a small change in pressure

A

veins

131
Q

which has high compliance, veins or arteries

A

veins

132
Q

equation for MAP

A

diastolic pressure + (1/3) x pulse pressure

133
Q

when do pulse pressure and MAP decline

A

increasing distance from the heart

134
Q

what kind of relationship do velocity of blood flow and total cross-sectional are of blood vessels have?

A

incerse

135
Q

the greater the cross sectional area, the ____ the blood flow

A

slower

136
Q

blood flow velocity is _____ in the middle of the vessel and _____ at the vessel wall

A

is fastest in the middle of the vessel and slowest at the vessel wall

137
Q

equation for CI

A

Sv/BSA x HR

138
Q

how many modulators are involved in maintaining adequate supply of oxygen to all tissues under all metabolic conditions

A

4

139
Q

what are the four hemodynamic modulators

A
  1. intravascular volume
  2. inotropy
  3. vasoactivity
  4. chronotropy
140
Q

what are some volume reducing drugs (diuretics)

A

volume expanders
blood plasma
albumin

141
Q

vasodilators

A

hydralazine
nitric oxide
sodium nitroprusside

142
Q

vasoconstrictors

A

phenylephrine
methoxamine
vasopressin
ADH

143
Q

what do baroreceptor reflexes change

A

peripheral resistance, heart rate, and stroke volume in response to changes in bp

144
Q

what are chemoreceptor reflexes sensitive to

A

lack of oxygen, CO2 excess, low pH levels of blood

145
Q

central nervous system ischemic response is a result from

A

severe decrease blood flow to the brain

146
Q

where are baroreceptors found

A
  • carotid sinuses by glossopharyngeal nerve

- aortic arch by vagus nerve

147
Q

the heart is controlled by what cardiac centers

A

medulla oblongata and innervated by the autonomic nervous system

148
Q

where does the parasympathetic neuron come from and where does it synapse

A

from cardioinhibitory center and synapses in the dorsal Motor nucleus of the medulla

149
Q

what sends parasympathetic impulse to theSA and AV node

A

vagus

150
Q

when the CIC activity increases by stimulating the vagus nerve, this causes

A

decrease HR

decrease SV

151
Q

where does the sympathetic neuron come from and where does it synapse

A

from cardioacceletory center and synapses at thoracic spinal cord

152
Q

what sends sympathetic impulse to theSA and AV node

A

postgangloionic fibers

153
Q

when the CAC activity decreases and inhibits sympathetic nerves, this causes

A

decreases in CO

154
Q

short term regulation of falling blood pressure

A
  • baroreceptors inhibited
  • decreased impulse to the brain
  • decreased parasympathetic activity and increased sym activity
  • cause an increase in HR, contractility, and vasoconstriction
  • then cause an increase in bp
155
Q

short term regulation of rising bp

A
  • rising blood pressure
  • stretching of arterial walls
  • stimulation of baroreceptors in carotid sinus, aortic arch, and other large arteries of neck and thorax
  • increased impulses to the brain
156
Q

where are the peripheral chemoreceptors and what do they detect

A
  • located in the carotid body and aortic body

- detect large changes in pO2

157
Q

if an abnormal low pO2 is detected, what happens to increase it again?

A
  • impulse travel to respiratory centers
  • increasing respiratory rate
  • direct blood flow towards kidneys and brain
  • increase CO in order to maintain blood flow
158
Q

where are the central chemoreceptors and what are they sensitive to

A
  • located in the medulla oblongata of the brainstem

- more sensitive and detect smaller changes in arterial pCO2 and changes in pH of CSF

159
Q

the pH of the CSF is approx ____ proportional to the arterial pCO2

A

inversely proportional

160
Q

a small drop in pCO2 leads to what

A

an increase in pH of CSF

  • stilmulates decrease in ventilation
  • this results in more CO2 being retained in lungs
161
Q

if pCO2 levels stay abnormal for 3 or more days, what happens

A
  • choroid plexus cells allow HCO2 ions to enter the CSF

- this can reset to a different pCO2 by manipulating the pH

162
Q

when there’s a loss of blood

A

BP and blood volume decrease

163
Q

long term regulation of BP is done by

A

the kidneys

164
Q

principle hormone involved in long term regulation of BP by kidneys

A

ADH
aldosterone
renin-angiotensin system
ANP

165
Q

what are the capillary types

A

continuous
fenestrated
sinusoidal

166
Q

continuous capillary type

A

most common

endothelial cels are joined by leaky junctions

167
Q

where are continuous capillary found

A

skeletal muscle
blood brain barrier
skin

168
Q

sinusoidal capillary type

A

open pore capillary

aka discontinuous capillary

169
Q

where is sinusoidal capillaries found

A

spleen and liver

170
Q

fenestrated capillary type

A

endothelial cells have large pores that allow high volume to pass quickly b/w the plasma and interstitial fluid

171
Q

where are fenestrated capillaries found

A

endocrine glands, intestines, pancreas, and the kidney

172
Q

what is bulk flow

A

solutes can move by diffusion as a result of hydrostatic and/or osmotic pressure gradients across capillary wall

173
Q

filtration

A

bulk of flow is out of the capillary

174
Q

reabsorption

A

bulk flow is into the capillary

175
Q

transcellular exchange

A

non polar gasses and solutes can move by diffusion through the cell membrane of endothelial cells
-large polar solutes can move by vesicular transport

176
Q

pinocytosis

A

method by which a cell absorbs small particles outside the cell and brings them inside

177
Q

when and where does pinocytosis

A
  • usually used for taking in extracellular fluid (ECF)

- happens in the tissues

178
Q

what side of the capillary has a high capillary hydrostatic pressure and lower capillary osmotic pressure?

A

arterial side

179
Q

what is the pressure like in the venous side of the capillary?

A

lower hydrostatic pressure

higher capillary osmotic pressure

180
Q

filtration happens at the ____ end and absorption happens at the _____ end

A

filtration happens at the arterial end and absorption happens at the venous end

181
Q

diffusion depends on ____ and bulk flow depends on ______

A

diffusion depends on concentration gradient and bulk flow depends on pressure

182
Q

is it true that nearly as much fluid is reabsorbed as was filtered

A

yes

183
Q

___ of the fluid that was filtered id then reabsorbed

A

85%

184
Q

why does not 100% fluid return

A

bc a few plasma proteins leave vessels into interstitial space

185
Q

remainder of fluid and proteins enter ___ ____ and is eventually returned to blood

A

enter lymphatic capillaries and is eventually returned to blood

186
Q

the change in set driving pressure is caused by

A

a decrease in the capillary hydrostatic pressure along the length of the capillary

187
Q

what two things cause swelling

A
  1. excess filtration out of capillaries

2. decreased reabsorption of fluid and solutes from extracellular fluid

188
Q

what 4 things cause edema

A
  1. increase filtration out of vessel
  2. decreased absorption back into vessel;s
  3. increased membrane permeability: leaky
  4. increased interstitial colloid pressure pulls fluid out of vessels

Hemology (2 decks)

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