Cardiovascular Vessels Flashcards
1
Q
what is the goal of the cardiovascular system?
A
to maintain adequate blood flow to peripheral tissue and organs
2
Q
angiography
A
- Cerebral
- Cardiac
- Abdominal
- Peripheral
- Catheterization via arteries: Femoral, Radial or Brachial
3
Q
what is the blood vessel structure?
A
a blood vessel has 3 layers or tunics
1. tunica interna or intima
2. tunica media
3. tunica externa
4
Q
what is the tunica internal or intima?
A
innermost layer (endothelium) that is in contact with blood
5
Q
what is tunica media?
A
middle layer containing smooth muscle and elastic tissue
6
Q
what is tunica externa?
A
outermost layer (anchors vessel)
contains vasa vasorum
7
Q
types of blood vessels?
A
- Arteries
- Arterioles
- Capillaries
- Venules
- Veins
8
Q
what are the two types of arteries?
A
- elastic (conducting)
- muscular (distributing)
9
Q
Slide 8
A
layers of blood vessel
10
Q
elastic arteries
A
- Largest arteries in the body
- Contain more elastic fibers in the thick tunica media
- Function is to propel blood onward when ventricles are relaxing
- Walls stretch when ventricles contract > stores mechanical energy (pressure reservoir) > elastic fibers recoil converting stored energy to kinetic
11
Q
what arteries are elastic?
A
Aorta, Pulmonary Trunk, Brachiocephalic, Subclavian, Common Carotid, Common Iliac
12
Q
What does it mean that elastic arteries have high compliance?
A
ability to stretch without tearing in response to increased pressure
13
Q
muscular arteries
A
- Medium sized
- Contain more smooth muscle compared to elastic fibers
- Muscular layer provides an ability to contract
= VASCULAR TONE (maintains pressure and efficient flow) - Vasoconstriction vs. vasodilation controls the flow or distribution of blood to organs or structures
14
Q
what arteries are muscular
A
femoral, axillary, brachial, radial, intercostal, splenic, mesenteric, popliteal and tibial
15
Q
anastomoses
A
- Union of 2 or more branches of arteries supplying the same tissue or region
- Protects the tissues or organs
- Collateral circulation is the term for this alternate route
- May also occur between veins or between arterioles and venules
- End arteries do not anastomose - Blockage of these lead to necrosis and cell death
16
Q
arterioles
A
- “small” arteries
- Metarteriole
- Resistance vessels (resistance occurs as a result of friction between the blood and inner walls of vessel)
- Precapillary sphincter
17
Q
what is a metarteriole?
A
- Terminal end of arterioles
- Joins to the capillary beds
18
Q
what are resistance vessels?
A
- Vessel constricts…greater friction…more resistance…less blood flow
- Change in diameter also affects blood pressure
- Vasoconstriction increases blood pressure
19
Q
Precapillary sphincter
A
- Located at the Metarteriole-Capillary junction
- Controls blood flow into the capillary
20
Q
Capillaries
A
- exchange vessels
- 20 billion in number
- capillary bed
- structure varies with function
21
Q
exchange of capillaries
A
- between blood and interstitial fluid
- Lack both a tunica media and externa
- Single layer of endothelial cells and basement membrane
22
Q
where are there higher numbers of capillaries
A
- More extensive in number when metabolic activity is high (kidney, liver, brain, muscle)
23
Q
where are capillaries absent?
A
- Absent in cartilage, cornea and lens of the eye, epithelial tissues
24
Q
what is the capillary bed?
A
- Network of 10-100 capillaries that arise from a single metarteriole
- Increase surface area so cells can rapidly receive oxygen and nutrients and remove waste products back into the blood
25
where are continuous (least exchange) capillaries located?
CNS, muscles, skin and lungs
26
where are fenestrated (small pores) capillaries located?
Kidneys, small intestine villi and choroid plexus
27
where are sinusoids (most exchange) capillaries located?
Liver, spleen and red bone marrow
28
diagrams 17-19
demonstrated different kinds of capillaries
29
what are venules?
- Drain the capillaries
- Thin-walled vessels that may lose their shape
- Postcapillary Venules
- Muscular venules
- Both types of venules are very distensible - excellent reservoir of blood
30
what do post capillary venues exchange?
exchange of nutrients and wastes
31
what do muscular venues exchange?
no exchange occurs
32
compared to arteries, veins have?
- thinner tunica interna and media
- relatively no smooth muscle or elastic tissue
- larger lumens (lower blood pressure – may collapse)
- VALVES; Cusps point toward the heart; Aid in venous return by preventing backflow
33
veins
- Formed from the union of several venules
- Thin walls compared to their diameter
- Diameters range from 0.5 mm to 3 cm
34
what does the post capillary venule lead into?
the post capillary venule drains into the muscular venule
35
where is most of our blood at any given time?
in the venous system
36
what would cause pre capillary sphincters to contract and bypass capillary beds?
- requirement for blood is greater somewhere else
- limited supply of blood, goes to essential only in this instance
37
largest artery in our body?
aorta
38
largest vein in our body?
IVC
39
slides 23-28
varicose veins and comparison between artery and veins
40
what are vericose veins?
- veins that are leaky, blood is allowed to back flow because valves aren't completely closing
- veins gain a bulgy appearance
41
why is the venous system such a good resevoir for blood?
larger lumens
42
what are starlings forces (fluid exchange)?
as blood flows to the tissues of the body, hydrostatic and osmotic forces at the capillaries determine how much fluid leaves the atrial end of the capillary and how much is then reabsorbed at the venous end
43
filtration - starlings forces
movement of fluid through the walls of the capillary into the interstitial fluid
- pressure-driven movement of fluid and solutes from blood capillaries into interstitial fluid
- Blood hydrostatic pressure (BHP) and interstitial fluid osmotic pressure (IFOP) promote filtration
44
reabsorption - starlings forces
movement of fluid from the interstitial fluid back into the capillary
- pressure-driven movement of fluid and solutes from interstitial fluid into blood capillaries
- interstitial fluid hydrostatic pressure (IFHP) and blood colloid osmotic pressure (BCOP) promote reabsorption
45
what is blood hydrostatic pressure (BHP)?
pushes fluid out of capillaries into interstitial fluid
** atrial end = 35 mmHg
** venous end = 16 mmHG
46
What is interstitial fluid osmotic pressure (IFOP)?
pulls fluid out of capillaries to interstitial fluid
- 1 mmHg
47
What is blood colloid osmotic pressure (BCOP)?
- caused by large proteins in blood
- pulls fluid from interstitial spaces into capillaries
- 26 mmHg
48
What is interstitial fluid hydrostatic pressure (IFHP)?
- pushes fluid from interstitial spaces back into capillaries
- 0 mmHg
49
how do you calculate net filtration pressure?
NFP = Filtration - reabsorption
NFP = (BFP + IFOP) - (BCOP + IFHP)
50
what is the net filtration pressure at the atrial end?
NFP = (35 + 1) - (26 + 0)
NFP = 10
51
What is the net filtration pressure at the venous end?
NFP = (16 + 1) - (26 + 0)
NFP = -9
52
what is starling's law of the capillaries?
- normally there is nearly as much fluid reabsorbed as there is filtered
- on average, about 85% of fluid filtered is reabsorbed
- the other 15% of fluid is used by the lymphatic system
53
starlings law at the atrial end of capillaries?
net pressure is outward at 10 mmHg and fluid leaves the capillary (filtration).
54
starlings law at the venous end of capillaries?
net pressure is inward at –9 mmHg (reabsorption)
55
what is cardiac output formula?
CO = SV * HR
CO = approx. 5L/min from each ventricle
56
what is how the cardiac output gets distributed to circulatory routes dependant on?
pressure and resistance
flow = P/R
57
resistance depends on which factors of the blood?
1. Diameter of lumen - Smaller = greater resistance
2. Viscosity of blood - Thicker blood = greater resistance
3. Length of vessel - Longer = greater resistance
58
what is blood pressure?
- fluid pushing against the wall (hydrostatic)
- Travel from areas of high pressure to low - Highest in Aorta and large systemic arteries
- Dependent on total blood volume - hemorrhage
BP = Flow * Resistance
59
What is systolic blood pressure?
SBP
- highest pressure in arteries
* ventricle systole
60
What is diastolic blood pressure?
DBP
- lowest pressure in arteries at the end of ventricle diastole
61
what is mean arterial pressure?
- average blood pressure in arteries
MAP = DBP + 1/3 (SBP-DBP)
62
what is pulse pressure?
difference between systolic and diastolic
63
what is the normal ratio of systolic:diastolic:pulse?
3:2:1
64
blood pressure in vessels
120 mmHg in Aorta during systole
80 mmHg in Aorta during diastole
35 mmHg in arterioles as they pass into the capillaries
16 mmHg at the venous end of capillaries
0 mmHg as blood enters the right ventricle
65
what 2 mechanisms help to return blood to the heart?
skeletal muscle pump and respiratory pump
66
** skeletal muscle pump
- contraction of leg muscles compresses the veins pushing the blood back through the veins/valves back towards the heart
67
** respiratory pump
- During inspiration, diaphragm moves down causing a decrease in pressure in thoracic cavity and an increase in pressure in the abdominal cavity
- Veins in abdomen compress and force blood into lower pressure veins in thorax
- On expiration, the increased pressure in the thoracic cavity forces the blood from the thoracic veins back to the heart
68
neural control of blood pressure?
- baroreceptors
- chemoreceptors
69
hormonal control of blood pressure?
Increase blood pressure
- Renin-Angiotensin-Aldosterone system
- Epinephrine and Norepinephrine
- ADH
Decrease blood pressure
- ANP
70
baroreceptors
- sense changes in pressure
- located in aorta arch and internal carotid artery (carotid sinus)
71
what happens if a clot gets back to the heart?
will get stuck in the pulmonary arteries causing a pulomonary embolism
72
chemoreceptors
- sense changes in chemical composition of blood
- located close to baroreceptors
73
how long does it take for a drop of blood to go from the right atrium through th body and back?
1 minute
74
how far does your blood travel in 1 day?
12,000 miles
75
how many times does your heart beat per year?
35 million times
76
how many barrels of blood does our heart pump during the average lifetime?
1 million barrels
77
What are the 4 parts of the aorta?
1. ascending
2. aortic arch
3. thoracic
4. abdominal
78
where is the ascending aorta located?
arotic arch to sternal angle
79
aortic arch location?
T4/5
80
thoracic aorta location?
T4/5 to T12 (aortic hiatus)
81
abdominal aorta location?
**aortic hiatus or L1 to L4
82
ascending aorta?
- posterior to pulmonary trunk**
- travels superior and anterior
- goes into coronary arteries
83
aortic arch?
- star and ends at T4/5
- directed superiorly and posteriorly
- 45 RPO/LAO position makes the arch parallel to IR
84
3 artery branches of the aortic arch?
1. brachiocephalic trunk or A
2. Left common carotid A
3. Left subclavian A
85
How would you position the patient so that the aortic arch was parallel to the image receptor?
**45 RPO/LAO**
86
slide 6 or 7 diagram
the arteries of the arch
87
What is the brachiocephalic trunk?
1st branch off the arch
posterior to the right SC joint
- right common carotid A
- right subclavian A
88
what are the 4 main arteries that supply the brain?
1. right common carotid A
2. left common carotid A
3. right vertebral A
4. left vertebral A
89
common carotid arteries
**branch into internal and external carotid arteries at C4**
90
internal carotid A
- carotid sinus forms the first part
- enters skull through the carotid canal of the temporal bone
- branches into anterior and middle cerebral arteries
91
where does the internal carotid artery branch into the anterior and middle cerebral arteries?
the pituitary gland
92
anterior middle A
frontal lobe of cerebrum
93
middle cerebral A
temporal and parietal lobes
94
External carotid A
branches at the TM joints into superficial temporal and facial arteries
95
vertebral arteries
- arise from subclavian arteries
- ascend through the transverse foramina of the c-spine
- enters skull through the foramen magnum
96
what do the right and left vertebral arteries unite to become?
basilar A
97
where does the basilar A travel?
basilar A travels anterior to the brain stem and splits into right and left posterior cerebral A
- supplies posterior portion of cerebrum and cerebellum
98
what is the circle of willis?
elaborate anastomoses of the entire circulation to the brain
- anterior and posterior circulations are connected
- right and left circulations are connected
surrounds the pituitary gland
99
Anterior communicating artery?
- connects both anterior cerebral A
- provides both a right to left shunt (or left to right)
100
what would contrast in the left vertebral artery demonstrate?
the entire posterior circulation of the brain
101
slide 18 and slide 19, 20 labelling
know exact names with spellings
102
posterior communicating artery?
- connects the posterior cerebral A with the internal carotid A
- provides and anterior to posterior shunt to vice versa
103
What does the subclavian artery supply?
supplies blood to the upper extremity, head and thorax
104
**what does the subclavian artery become at the lateral edge of the 1st rib**
the axillary artery
105
*what are the major branches of the subclavian artery?
* Internal thoracic (mammary) A
* vertebral A
106
why is the internal thoracic (mammary) artery important?
used for heart replacements
107
Why is vertebral artery important?
send blood up to the brain
108
What does the axillary artery supply?
supplies scapula, humerus, shoulder and thoracic muscles
109
when does the axillary artery become the brachial artery?
when it leaves the axilla or passes the tires major muscle
110
what is the brachial artery used for?
often used to obtain blood pressures
111
what does the brachial artery branch into and where?
branches into Radial A and ulnar A at the antecubital fossa
112
what is the radial artery?
- lateral side, smaller (supplies the posterior forearm)
- measure pulse at the distal end (superficial)
113
What is the ulnar artery?
- medial side, larger (supplies anterior forearm
114
where is the thoracic (descending) aorta located?
T4/5 to T12 (Aortic hiatus)
115
Slide 32 and slide 34
all three hiatus and there vertebral levels
- at different vertebral levels because the diaphragm slopes posteriorly, so it depends where they are located
116
what branches arise from the thoracic aorta?
visceral (visceral organs) and parietal (body wall)
117
abdominal aorta contains what branches and in what order?
contains both visceral and parietal branches
1. inferior phrenic arteries (parietal)
2. Celiac Trunk
3. Superior Mesenteric Artery (SMA)
4. Renal arteries
5. Gonadal Arteries
6. Inferior Mesenteric Artery
7. Lumbar Arteries
118
Which arteries come off anterior to abdominal aorta?
Celiac trunk, SMA and Inferior mesenteric
119
which renal artery is longer?
right
120
Which arteries come off the side of the abdominal aorta?
renal arteries, gonadal arteries and lumbar arteries
121
where does the celiac trunk come off of?
comes off the anterior part of the aorta
122
**What arteries come off the celiac trunk?
1. Left gastric A
2. Splenic A
3. Common Hepatic A
123
What does the left gastric artery supply?
Lesser curvature of stomach, lesser omentum
124
what does the splenic artery supply?
pancreas
125
What does the common hepatic artery supply?
Liver and superior part of duodenum
126
what does the splenic artery further divide into?
- pancreatic arteries
127
what does the common hepatic artery further divide into?
- hepatic artery proper
- gastroduodenal artery
128
Slide 43
be able to label
129
what does the superior mesenteric artery (SMA) divide into?
1. Inferior pancreaticoduodenal artery (distal part of duodenum)
2. Jejunal and ileal arteries
3. ileocolic artery
4. Right colic artery
5. Middle colic artery
130
What supplies the small intestine?
the SMA supplies all of the small intestine except for the common hepatic artery which supplies the superior part of the duodenum
131
what does the ileocolic artery supply?
Terminal ileum, cecum, appendix
132
What does the right colic artery supply?
Ascending colon and first part of transverse
133
What does the middle colic artery supply?
Most of transverse colon
134
What does the inferior mesenteric artery split into?
1. left colic artery
2. sigmoid arteries
3. superior rectal artery
135
supplied by descending mesenteric artery
descending, sigmoid and colon
136
where does the abdominal aorta bifurcate? to become what?
L4
Left an right common iliac arteries
137
what does the external iliac artery become?
femoral > popliteal > anterior tibial > posterior tibial > fibular artery
138
what are systemic veins?
- return blood to the heart
has deep and superficial veins
139
what are deep veins?
travel alongside the artery and have the same name
140
What are superficial veins?
- located just beneath the skin
- clinically important for withdrawing blood or giving injections
141
Slide 50 digram
be able to label
142
in what veins does deoxygenated blood return to the right atrium?
1. coronary sinus
2. SVC
3. IVC
143
where does the SVC receive blood from?
receives blood from all veins above the diaphragm (except pulmonary because they carry oxygenated blood)
144
What is the IVC and where does it receive blood from?
Largest vein
- receive blood from all Viens below the diaphragm
145
What are the veins of the head and neck?
1. internal jugular vein
2. external jugular vein
3. vertebral vein
146
what do the internal jugular veins supply, and where do they exit the skull?
- dural sinuses, deep veins within the brain
- exits the skull via the jugular foramen
147
What do the external jugular veins supply?
scalp and skin of head, face and neck, oral cavity
148
Do the internal and jugular veins unite?
no
149
What do the vertebral veins pass through and what do they supply?
- pass through cervical transverse foramina
- supplies C-spine, spinal cord and deep muscles of the neck
150
what are all the venous sinuses?
- Superior Sagittal
- Inferior Sagittal
- Straight
- Transverse
- Sigmoid - Internal Jugular vein
151
Slide 57 - 59
be able to label
152
Where are the Superior and inferior sagittal sinus and straight sinus located?
in the falx cerebri
153
what do the vertebral and external jugular veins drain into?
subclavian vein
154
what forms the brachiocephalic vein?
subclavian and internal jugular veins
155
What forms the superior vena cava?
right and left brachiocephalic veins
156
slide 61* - 63
be able to label
157
what are characteristics of the veins of the upper limb?
- Superficial veins anastomose frequently with one another and with deep veins
- Superficial veins are larger and return most of the blood from the arms
- Both superficial and deep veins have valves…but deep veins have more
158
deep veins of the upper limb?
- Radial (lateral side) and Ulnar (medial side) veins join just distal to the elbow joint > Brachial Vein > *Brachial vein joins with the basilic vein > Axillary Vein (armpit) > At the lateral border of the 1st rib it becomes the Subclavian Vein
159
Diagram slide 66 and 67
label veins of the upper limb
160
what are the superficial veins of the upper limb?
- cephalic
- basilic
- median antebrachial
161
what is the cephalic vein?
lateral side
- joint to axillary
162
what is the basilic vein?
Bs like to be together, Basilic and brachial veins join, basilica vein is close to the boob
medial side
- joins to the brachial vein
163
what is the median antebrachial vein?
drains the palm
- joins either basilic or median cubital or both
164
what is the media cubital vein or antecubital vein?
- anastomoses between cephalic and basilic vein
- preferred site for puncture or injection
165
diagram slide 71
all the veins of the arm
166
what are the veins of the thorax?
brachiocephalic veins
the azygos system
166
what forms the azygos system?
azygos vein
hemiazygos vein
accessory hemiazygos vein
167
where does the azygos vein drain? What does it join and at what vertebral level?
- right side of thorax (intercostal veins)
- joins SVC at T4
168
where does the hemiazygos vein drain? Where does it join the azygos vein?
- left lower part of thorax
- joins azygos around T9
169
where does the accessory hemiazygos vein drain? Where does it join the azygos vein?
- left upper thorax
- joins azygos around T8
170
what forms the right brachiocephalic vein?
right subclavian and right internal jugular vein
171
what veins of the abdomen drain into the IVC?
- inferior phrenic
- hepatic veins (2 or 3)
- lumbar veins
- renal veins (left is longer)
- gonadal veins
- common iliac veins (left and right)
172
How would you describe the position of the IVC compared to the abdominal aorta?
IVC is to the right of the midline and more anterior than the Abdominal aorta which is slightly to the left of the midline and is more posterior
173
do the GI Tract, spleen, pancreas and gallbladder drain into the IVC?
no, the blood goes to the liver first to drain to the IVC through the hepatic veins
174
diagram on slide 76
understand order
- IVC joins directly to right atrium
175
hepatic portal circulation made up of?
- superior mesenteric vein and splenic vein make up the hepatic portal vein
- the hepatic portal vein brings 70% of blood to the liver
- blood from the hepatic portal vein then go through the liver sinusoids (capillaries of the liver) to the hepatic veins where it joins the IVC
176
what vessel carries the majority of the oxygenated blood to the liver?
hepatic artery proper
177
hemoptysis
coughing up blood from the lungs
178
hematemesis
vomiting up blood
179
deep veins of the lower limbs from inferior to superior?
anterior and posterior tibial veins > popliteal vein > femoral vein (more medial) > external iliac vein (internal iliac veins joins here) > common iliac vein
180
superficial veins of the lower limbs are more prone to varicosities, why?
- no skeletal muscle pump
- long vessels
181
great saphenous vein?
superficial vein of the lower limb
- used for coronary artery bypass grafting
- medial
- empty into femoral vein
182
Small saphenous veins
superficial vein of the lower limb
- empties into popliteal veins
183
skeletal muscle pumps of venous blood flow?
- Action of muscles along with venous valves aids in movement of venous blood from legs
- Saphenous veins most likely to become varicosed due to lack of surrounding muscular support
184
slide 82 diagram
deep and superficial veins of the lower limbs
