Ch 19 - Blood Vessels Flashcards
1
Q
Largest artery of the body
A
Aorta
2
Q
Supplies the kidney
A
Renal artery
3
Q
Supplies the duodenum and
stomach
A
Common hepatic artery
4
Q
Supplies the distal areas of
the large intestine
A
Inferior mesenteric artery
5
Q
Supplies pelvic structures
A
Internal iliac artery
6
Q
Artery that does not
anastomose
A
Renal artery
7
Q
Gives rise to the right
common carotid and right
subclavian artery
A
Brachiocephalic trunk
8
Q
Supplies the lower limbs
A
External iliac artery
9
Q
Common site to take the
pulse
A
Radial artery
10
Q
Major supply to the cerebral
hemispheres
A
Internal carotid artery
11
Q
Large unpaired branch of the
abdominal aorta
A
Celiac trunk
12
Q
Abdominal aorta splits to
form two
A
Common iliac artery
13
Q
Receives blood from all areas
superior to the diaphragm, except the heart wall
A
Superior vena cava
14
Q
Carries oxygen-poor blood to
the lungs
A
Pulmonary trunk
15
Q
Drains the scalp
A
External jugular vein
16
Q
Runs through the armpit area
A
Axillary artery
17
Q
Drains the upper extremities,
deep vein
A
Subclavian vein
18
Q
Artery usually palpated to
take the blood pressure
A
Brachial artery
19
Q
Major artery of the thigh
A
Femoral artery
20
Q
Supplies the small intestine
A
Superior mesenteric artery
21
Q
Carries oxygen-rich blood
from the lungs
A
Pulmonary vein
22
Q
Longest vein in the body,
superficial
A
Great saphenous vein
23
Q
Site where resistance to blood
flow is greatest
A
Arterioles
24
Q
Site where exchanges of food
and gases are made
A
Capillaries
25
Site where blood pressure is
| lowest
Large veins
26
Site where the velocity of
| blood flow is fastest
Large arteries
27
Site where the velocity of
| blood flow is slowest
Capillaries
28
Site where the blood volume is greatest
Large veins
29
Site where the blood pressure is greatest
Large arteries
30
Site that is the major
determinant of peripheral
resistance
Arterioles
31
True or False? The adjustment of blood flow to each tissue in proportion to its requirements at any point in time is termed autoregulation.
True
32
True or False? Arterial pressure in the pulmonary circulation is much higher than in the systemic circulation because of its proximity to the heart.
False
33
True or False? Osmotic pressure is created by the presence in a fluid of small diffusible molecules that easily move through the capillary membrane.
False
34
True or False? The cerebral arterial circle (circle of Willis) is an arterial anastomosis.
True
35
True or False? The outermost layer of a blood vessel is the tunica intima.
False
36
True or False? The thick-walled arteries close to the heart are called muscular arteries.
False
37
True or False? Hypotension is generally considered systolic blood pressure that is below 100 mm Hg.
True
38
True or False? A precapillary sphincter is a cuff of smooth muscle that regulates the flow of blood into the
capillaries.
True
39
True or False? Thoroughfare channels connect a metarteriole to a venule.
False
40
True or False? Vasodilation is a widening of the lumen due to smooth muscle contraction.
False
41
True or False? The pulmonary circulation does not directly serve the metabolic needs of body tissues.
True
42
True or False? In infants and young people, congenital vascular problems are less common than congenital
heart disease.
True
43
True or False? The most common form of shock is hypovolemic shock.
True
44
True or False? Every minute, about 1.5 ml of fluid leaks out of the capillaries.
True
45
True or False? The pancreas is an example of an organ with arteries that do not anastomose.
False
46
True or False? An obstruction in the superior vena cava would decrease the flow of blood from the head and
neck to the heart.
True
47
True or False? Arteries supplying the same territory are often merged with one another, forming arterial anastomoses.
True
48
True or False? An increase in blood viscosity will cause an increase in peripheral resistance.
True
49
True or False? The first major branch of the femoral artery is the dorsalis pedis artery.
False
50
True or False? The azygos vein originates in the abdomen.
True
51
```
Which of the following is not one of the three main factors influencing blood pressure?
A) cardiac output
B) peripheral resistance
C) emotional state
D) blood volume
```
C) emotional state
52
```
Which of the following chemicals does not help regulate blood pressure?
A) ADH
B) atrial natriuretic peptide
C) angeiotensin II
D) nitric acid
```
D) nitric acid
53
Which statement best describes arteries?
A) All carry oxygenated blood to the heart.
B) All carry blood away from the heart.
C) All contain valves to prevent the backflow of blood.
D) Only large arteries are lined with endothelium.
B) All carry blood away from the heart.
54
```
Which tunic of an artery contains endothelium?
A) tunica intima
B) tunica media
C) tunica externa
D) basement membrane
```
A) tunica intima
55
Permitting the exchange of nutrients and gases between the blood and tissue cells is the
primary function of ________
Capillaries
56
The circulatory route that runs from the digestive tract to the liver is called ________
Hepatic portal circulation
57
The arteries that are also called distributing arteries are the _________
Muscular arteries
58
Aldosterone will promote an increase in ________
Blood pressure
59
The pulse pressure is ________
Systolic pressure minus diastolic pressure
60
```
Which of the following signs of hypovolemic shock is a relatively late sign?
A) cold, clammy skin
B) increased heart rate
C) rapid, thready pulse
D) rapidly falling blood pressure
```
D) rapidly falling blood pressure
61
Which of the following is likely during vigorous exercise?
A) Blood will be diverted to the digestive organs.
B) The skin will be cold and clammy.
C) Capillaries of the active muscles will be engorged with blood.
D) Blood flow to the kidneys increases.
C) Capillaries of the active muscles will be engorged with blood.
62
Continuous capillaries are abundant in the _______
Skin and skeletal muscles
63
Which of the following is true about veins?
A) Venous valves are formed from the tunica media.
B) Up to 35% of total body blood is in venous circulation at any given time.
C) Veins have a small lumen in relation to the thickness of the vessel wall.
D) Veins are called capacitance vessels or blood reservoirs.
D) Veins are called capacitance vessels or blood reservoirs.
64
Venous anastomoses form __________ than arterial anastomoses
More freely
65
Peripheral resistance increases as ________
Blood viscosity increases
66
Brain blood flow autoregulation is _______ when abnormally high CO2 levels persist
Abolished
67
Blood flow to the skin increases when ___________ rises
Environmental temperature
68
Select the correct statement about the movement of materials at the capillary level.
A) Oxygen diffuses up its concentration gradient.
B) Chemical waste products follow the same general path as oxygen.
C) Carbon dioxide moves from its production site into the interstitial fluid.
D) If the osmotic pressure in the blood vessels is relatively higher than that in the tissues,
tissue edema will result.
C) Carbon dioxide moves from its production site into the interstitial fluid.
69
Which of the following is a type of circulatory shock?
A) hypovolemic, caused by increased blood volume
B) cardiogenic, which results from any defect in blood vessels
C) vascular, due to extreme vasodilation as a result of loss of vasomotor tone
D) circulatory, where blood volume is normal and constant
C) vascular, due to extreme vasodilation as a result of loss of vasomotor tone
70
Which tunic of an artery is most responsible for maintaining blood pressure and continuous
blood circulation?
Tunica media
71
The influence of blood vessel diameter on peripheral resistance is significant because _______________
Resistance is inversely proportional to the fourth power of the vessel radius
72
The form of circulatory shock known as hypovolemic shock is ________
Shock that results from large-scale loss of blood volume, or after severe vomiting or
diarrhea
73
In the dynamics of blood flow through capillaries, hydrostatic pressure is the same as _______
Capillary blood pressure
74
The hepatic portal vein carries _____________ to the liver
Nutrient-rich blood
75
The term ductus venosus refers to ________ that allows blood to bypass the liver
A special fetal vessel
76
The term blood islands refers to __________ of mesodermal cells that give rise to the endothelial lining of blood vessels
Embryonic masses
77
```
Which of the following has anastomosing vessels?
A) retina
B) kidney
C) heart
D) spleen
```
C) heart
78
```
Which of the following do NOT influence arterial pulse rate?
A) activity
B) postural changes
C) emotions
D) the vessel selected to palpate
```
D) the vessel selected to palpate
79
Which of the following are involved directly in pulmonary circulation?
A) superior vena cava, right atrium, and left ventricle
B) right ventricle, pulmonary artery, and left atrium
C) left ventricle, aorta, and inferior vena cava
D) right atrium, aorta, and left ventricle
B) right ventricle, pulmonary artery, and left atrium
80
Histologically, the ________ is squamous epithelium supported by a sparse connective tissue
layer.
Tunica intima
81
The arteries that directly feed into the capillary beds are called _____
Arterioles
82
Fenestrated capillaries are NOT found in the _______________
Brain
83
Modified capillaries that are lined with phagocytes are called __________
Sinusoids
84
Factors that aid venous return include all except ________.
Urinary output
85
Which of the following blood pressure readings would be indicative of hypertension?
170/96 in a 50-year-old man
86
Select the correct statement about factors that influence blood pressure.
A) An increase in cardiac output corresponds to a decrease in blood pressure, due to the
increased delivery.
B) Systemic vasodilation would increase blood pressure, due to diversion of blood to
essential areas.
C) Excess protein production would decrease blood pressure.
D) Excess red cell production would cause a blood pressure increase
D) Excess red cell production would cause a blood pressure increase
87
Mechanisms that do NOT help regulate blood pressure include _______
The dural sinus reflex
88
The velocity of blood flow is ________ since the total cross-sectional area is the greatest
Slowest in the capillaries
89
Select the correct statement about blood flow.
A) It is relatively constant through all body organs.
B) It is measured in mm Hg.
C) It is greatest where resistance is highest.
D) Blood flow through the entire vascular system is equivalent to cardiac output.
D) Blood flow through the entire vascular system is equivalent to cardiac output.
90
A thrombus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to the ________
Right side of the head and neck and right upper arm
91
Cerebral blood flow is regulated by ________
Intrinsic autoregulatory mechanisms
92
A patient with essential hypertension might have pressures of 200/120 mm Hg. This hypertensive state could result in all of the following changes except ________
Decreased size of the heart muscle
93
The short-term controls of blood pressure, mediated by the nervous system and bloodborne chemicals, do not primarily operate via _________
Altering blood volume
94
Secondary hypertension can be caused by ________
Arteriosclerosis
95
Where in the body would you find low oxygen levels causing vasoconstriction and high levels
causing vasodilation?
Lungs
96
Normal blood pressure for a newborn baby is ________
90/55
97
The first major branch of the aortic arch is the ________ branch
Brachiocephalic trunk
98
The embryonic mesodermal cells that will eventually form the endothelial lining of blood
vessels are called ________
Blood islands
99
The most common form of shock is ________
Hypovolemic
100
Released by the endothelium, a family of peptides called ________ are among the most potent vasoconstrictors known.
Endothelins
101
A ________ capillary has many oval holes in it
Fenestrated
102
Arterial ________ provide alternate pathways for blood to get to an organ
Anastomoses
103
The ________ in the carotid sinuses and aortic arch detect increases in blood pressure.
Baroreceptors
104
The ________ artery is a blood vessel on the arm used as a pressure point.
Brachial
105
________ shock is due to abnormal expansion of blood vessels and a rapid drop in blood
pressure.
Vascular
106
The third major branch of the aortic arch is the ________ artery
Left subclavian
107
The ________ supply the brain with blood
Internal carotid arteries
108
________ pressure is the difference between systolic and diastolic pressure
Pulse
109
Blood flow equals the difference in blood pressure divided by ________
Peripheral resistance
110
The lowest venous blood pressure is found in the ________
Venae cavae
111
As a cuff is deflated on the arm, sounds of ________ can be heard
Korotkoff
112
Which type of blood vessels contain valves and what is their function?
Veins contain valves to prevent blood from flowing backward. This is necessary because
the venous vessels are a low-pressure system and the blood must sometimes flow
against gravity, particularly in the limbs.
113
Describe the forces that determine fluid movements across capillary walls.
(1) Capillary hydrostatic pressure (equal to capillary blood pressure) tends to force fluid
out of capillaries into the interstitial spaces. (2) Osmotic pressure, created by large
nondiffusible particles in the blood, tends to draw water into the capillaries. At the
arterial end of the capillary bed, hydrostatic forces dominate and fluid moves out, while
at the venous end, osmotic forces dominate and the net fluid movement is into the
capillaries.
114
Define vasoconstriction and vasodilation. What is the mechanism of regulation?
Vasoconstriction is a reduction in the lumen diameter of a blood vessel due to smooth
muscle contraction. Vasodilation is a widening of the lumen due to smooth muscle
relaxation. Both are regulated by vasomotor nerve fibers of the sympathetic division of
the autonomic nervous system.
115
Consider the diameter of one 4-mm blood vessel and two 2-mm blood vessels. Would the two
2-mm vessels carry more, less, or the same amount of fluid, given that pressure is a constant?
Why?
The two 2-mm vessels would deliver considerably less fluid for two reasons: (1) the
resistance in the smaller vessels is much greater and (2) the volume of the 4-mm vessel is greater than that of two 2-mm vessels. Draw a 4-inch circle; then put two 2-inch circles in it and notice the volume difference.
116
Based on what we have learned about the regulation of blood flow to various organs, do you
think it is wiser to rest or exercise after a heavy meal? Explain your answer.
At rest, the abdominal organs receive approximately 24% of the total blood flow. With
exercise, blood flow is shifted away from abdominal organs to skeletal muscles. It
would therefore be wiser to rest after a heavy meal to allow optimum function of the organs of digestion and absorption of nutrients.
117
The average thickness of an arteriole is six times that of the average venule, why?
The arteriole wall still contains some smooth muscle and some elastic fibers which tend
to be quite thick at times. This is needed due to the higher pressure in arterioles. The
venule, on the other hand, is more like a giant capillary with only occasional smooth
muscle fibers wrapped around it.
118
Why do the blood vessel colors appear backwards on the models of the heart and the lungs?
They are backwards! The pulmonary vessels appear backwards from the rest of the body because the heart is pumping deoxygenated blood to the lungs and oxygenated
blood toward the heart.
119
The abdominal aorta divides into three arteries at its terminus, what are they?
Left and right common iliac arteries and the median sacral artery.
120
The mesenteric arteries branch off the abdominal aorta, but the mesenteric veins do not
connect directly to the vena cava, why?
The mesenteric veins merge into the hepatic portal vein before entering the liver. The
liver dumps into the vena cava.
121
Describe the effect of hypovolemic shock on the blood vessels and the heart.
Hypovolemic shock causes blood vessels to constrict to increase venous return and
maintain pressure. Heart rate increases to compensate for loss of blood pressure and to
maintain cardiac output. If volume loss continues, pressure eventually drops sharply and the shock becomes irreversible, leading to death.
122
Atherosclerosis is a progressive disease of blood vessels that is responsible for millions of
deaths each year. Describe the disease process, noting the involvement of specific cell/tissue
types and molecules.
The disease process involves several stages and usually affects the aorta and coronary
arteries. The initial event involves damage to the tunica intima caused by bloodborne chemicals or physical factors such as a blow or infection. Injured endothelial cells
release chemicals that increase the uptake by the endothelium of fats, LDLs, and cholesterol. This eventually attracts macrophages that ingest the oxidized fats and,
along with smooth muscle cells from the tunica media, transform into foam cells. Foam
cells become fatty streaks, which, along with collagen and elastin fibers secreted by
smooth muscle cells, form atherosclerotic plaques. These protrude into the lumen and narrow the blood vessels.
123
A woman in her early 50s appeared at a walk-in clinic, complaining of aching pain in her right
leg following a fall. Visual examination revealed that the medial aspect of that leg was red and
swollen. A diagnosis of phlebitis was made. What is phlebitis, and what more serious
condition may result if proper healing does not occur?
Phlebitis is an inflammation of a vein accompanied by painful throbbing and redness of
the skin over the inflamed vessel. Thrombophlebitis (clot formation) can result if proper
healing does not occur. The danger in thrombophlebitis is the possibility that a clot
could detach and form an embolus.
124
For each of the following situations, describe the anticipated effect on blood pressure and the
physiological basis of the response: (1) a high-salt diet, (2) a blow on the head that damages
(disables) the vasomotor center, (3) an attack by a mugger, and (4) a hypothalamic tumor
resulting in excess ADH production.
(1) A high-salt diet causes increased sodium in the blood, which increases total
extracellular fluid volume. This leads to increased blood volume and blood pressure. (2) Damage to the vasomotor center will cause a loss of vasomotor tone and a drop in blood pressure because the vasomotor center is the integrating center for blood pressure control. (3) During the mugger attack, blood pressure would increase due to sympathetic nervous system stimulation (the fight-or-flight response) triggered by the
hypothalamus. (4) Excess ADH production would cause an increase in blood pressure through increased water retention and therefore increased blood volume. ADH also stimulates vasoconstriction.
125
Mrs. Gray, a 50-year-old mother of seven children, is complaining of dull, aching pains in her
legs. She reports that they have been getting progressively worse since the birth of her last
child. During her physical examination, numerous varicosities are seen in both legs. How are
varicosities recognized? What veins are most likely involved? What pathologic changes have
occurred in these veins, and what is the most likely cause in this patientʹs case?
Varicosities are recognized by the enlargement of the veins. Superficial veins are most
likely involved because they have little support from surrounding tissues. The veins
have become tortuous and dilated because of incompetent valves that allow the blood to
pool, stretching the vein walls. The likely cause in this patientʹs case is her pregnancies,
because the enlarged uterus exerts downward pressure on groin vessels, restricting
return blood flow to the heart.
126
Mr. Wilson is a 45-year-old stockbroker with essential hypertension. He is African American, obese, and he smokes 2-3 packs of cigarettes daily. What risk factors for hypertension are typified by Mr. Wilson? What steps should be taken to treat Mr. Wilson, and what lifestyle changes should he make? What complications are likely if corrective steps are not taken?
The risk factors are obesity, race, a high-stress job, and smoking.
Mr. Wilson should lose
weight, reduce salt intake, quit smoking, and try to reduce his stress level, perhaps by
relaxation training. Medical intervention could include treatment with diuretics, beta
blockers, calcium channel blockers, and angiotensin-converting enzyme inhibitors.
Complications could include atherosclerosis, heart failure, renal failure, and stroke.
127
A pregnant patient comes into a clinic and asks about a small dark bulge that is becoming
more apparent on her leg. What is it and what caused it?
The patient is getting a varicose vein. Due to the growing fetus putting downward
pressure on the vessels of the groin and restricting the return of blood to the heart, the
valves in the peripheral veins begin to fail. This causes blood pooling, which enlarges
these veins and puts additional strain on other peripheral vein valves down the line.
128
At the battle of Shiloh in the American Civil War, Confederate General A. S. Johnston was killed when he was shot in the thigh. Witnesses reported that he bled to death almost before he
realized that he was wounded. Which blood vessel was most likely to have been injured? Why
is a tourniquet usually ineffective in stopping the bleeding from this wound?
The wound severed his femoral artery, the largest artery serving the lower limb. A tourniquet may be ineffective because it is a high-pressure, deep artery with a large diameter. It is therefore difficult to exert enough pressure through the thigh muscles to
stop the bleeding.
129
A client lost a lot of blood during surgery and his blood pressure dropped from 120/80 to
90/50. Describe how the kidneys respond to this change in blood pressure.
When arterial blood pressure declines, special cells in the kidneys release the enzyme
renin into the blood. Renin triggers a series of enzymatic reactions that produce angiotensin II, which is a potent vasoconstrictor. Angiotensin causes an increase in systemic blood pressure, and increases the rate of blood delivery to the kidneys and
renal perfusion. It also stimulates the adrenal cortex to secrete aldosterone, a hormone
that enhances renal reabsorption of sodium, and prods the posterior pituitary to release
ADH, which promotes more water reabsorption. As sodium moves into the bloodstream, water follows; thus both blood volume and blood pressure rise.
130
A client has an 80% blockage of his left anterior descending coronary artery. Describe what occurs in terms of myocardial oxygen supply and demand if his sympathetic nervous system is stimulated.
When the sympathetic nervous system is stimulated there is increased myocardial
contractility, which increases cardiac output and blood flow to active muscles. This increases the demand for oxygen to the cells. The coronary artery is a major blood vessel of the heart. When the demand for myocardial oxygen exceeds the ability of the coronary arteries to supply it, death of myocardial tissue can occur.
