Chapter 19 Blood Vessels Flashcards
Largest artery of the body
aorta
supplies the kidney
renal artery
supplies the duodenum and stomach
common hepatic artery
supplies the distal areas of the large intestine
inferior mesenteric artery
supplies pelvic structures
internal iliac artery
artery that does not anastomose
renal artery
gives rise to the right common carotid and right subclavian artery
brachiocephalic trunk
supplies the lower limbs
external iliac artery
common site to take a pulse
radial artery
major supply to the cerebral hemispheres
internal carotid artery
large unpaired branch of the abdominal aorta that supplies the liver, stomach, and spleen
celiac trunk
receives blood from all area superior to the diaphragm, except the heart wall
superior vena cava
carries oxygen-poor blood to the lungs
pulmonary trunk
drains the scalp
external jugular vein
runs through the armpit area, giving off branches to the axillae, chest wall, and shoulder girdle
axillary artery
drains an upper extremity, a deep vein
subclavian artery
artery usually auscultated to take the blood pressure
brachial artery
major artery of the thigh
femoral artery
supplies the small intestine
superior mesenteric artery
carries oxygen-rich blood from the lungs
pulmonary vein
vessel commonly used as a coronary bypass vessel
great saphenous vein
site where resistance to blow flow is greatest
arterioles
site where exchanges of food and gases are made
capillaries
site where blood pressure is lowest
large veins
site where the velocity of blood flow is the fastest
large arteries
site where the velocity of blood flow is the slowest
capillaries
site where the blood volume is the greatest
large veins
site where the blood pressure is greatest
large arteries
site that is the major determinant of peripheral resistance
arterioles
results from heart inability to sustain adequate circulation due to myocardial damage
cardiogenic shock
due to inadequate blood flow to meet tissue needs
circulatory shock
normal blood volume but poor circulation due to extreme vasodilation
vascular shock
due to large-scale blood loss
hypovolemic shock
The adjustment of blood flow to each tissue in proportion to its requirements at any point in time is termed autoregulation
true
arterial pressure in the pulmonary circulation is much higher than in the systemic circulation because of its proximity to the heart
false; much lower because the pulmonary arteries are not as muscularized
osmotic pressure is created by the presence in a fluid of small diffusible molecules that easily move through the capillary membrane
false; osmotic pressure is pressure developed by diffusion of a liquid or solvent through a membrane.
the cerebral arterial circle (circle of Willis) is an arterial anastomosis
true
the carotid sinus reflex protects the blood supply to the brain, whereas the aortic reflex is more concerned with maintaining adequate blood pressure in the systemic circuit as a whole
true
the pulmonary circulation does not directly serve the metabolic needs of body tissues
true
an obstruction in the superior vena cava would decrease the flow of blood from the head and neck to the heart
true
arteries supplying the same territory are often merged with one another, forming arterial anastomoses
true
an increase in blood viscosity will cause an increase in peripheral resistance
true
whereas diffusion is more important for solute exchange between plasma and interstitial fluid, bulk flow is more important for regulation of the relative volumes of blood and interstitial fluid
true
reduction in the concentration of albumin in blood plasma would alter capillary exchange by ____.
decreasing colloid osmotic pressure and edema will occur
If a person were to have substantial blood loss, you would expect to see all of the following physiological events to happen EXCEPT one, which one?
decreased heart rate
during a marathon which of the following hormones is least likely to be released by the runner?
ANP
Which structural layer of blood vessels is most responsible for maintaining blood pressure?
tunica media
Vessels that carry blood away from the heart and are named by the organs they supply (renal) are ______.
muscular arteries
Which of the following would NOT be expected from taking a diuretic drug?
greater stress on the heart to provide adequate perfusion
A person suddenly gaining significant amounts of adipose tissue can expect all of the following physiological changes except one. Which of the following is least likely to occur with a sudden and significant gain in adipose tissue?
lower heart rate and reduced blood flow
Which blood vessels lack elastic tissue?
capillaries and venules
In red bone marrow newly formed blood cells enter the circulation. You would expect to see many _____ type of capillaries in red bone marrow.
Sinusoid
The award or receives the full force of blood exiting the heart during ventricular systole. Which of the following statements best describes the adaptive anatomy of the aorta?
Elastic fibers are extensive in the tunica media of the aorta and dampen the pulse pressure generated by the heart.
Which of the following statement is not true of the precapillary sphincters?
They decrease the osmotic pressure in the thoroughfare channel.
Blood flow is _____ proportional to the difference in blood pressure. Blood flow is _____ proportional to the total peripheral resistance.
Directly; inversely
Arthrosclerosis causes elastic arteries to become less stretchy. How does it affect pulse pressure?
Pulse pressure is chronically increased
In general, it is expected that ______.
Hydrostatic pressure will drop as blood moves away from the arteriole end of the capillary bed
In general it is expected that _____.
Osmotic pressure will remain relatively consistent throughout the capillary bed
Which of the following is most likely to occur in the arteriovenous shuts present in the blood vessels of the finger tips and toes?
Colder temperatures will result in vasoconstriction in the arteriovenous shuts.
Which of the following does not contribute to venous blood pressure?
Venus anastomoses
The velocity of blood is slowest in the capillaries and pressure of blood is lowest in the veins. Which of the following is not an accurate description of the benefits of slow, low pressure blood in the capillary beds?
Lower pressure in the capillary bed helps to increase pressure in the venous circulation
The release of which hormone is most likely to cause a reduction in blood volume and pressure?
Atrial natriuretic peptide
Which will not occur if blood pressure drops below homeostatic levels?
baroreceptors in the carotid sinuses and aortic arch will be stimulated.
Which statement best describes arteries?
All carry blood away from the heart
Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary function of ______.
Capillaries
Which of the following statements regarding the hepatic portal system is false?
It branches off of the inferior vena cava
Which of the following contain oxygenated blood?
Pulmonary veins
Each of the following describes the action of aldosterone except one. Which of the following does not describe the activity of aldosterone hormone?
It will result in higher sodium levels in the urine
The pulse pressure is _______.
Systolic pressure minus diastolic pressure
Which of the following signs of hypovolemic shock is a relatively late sign?
Rapidly falling blood pressure
Which of the following is likely during a vigorous exercise?
Capillaries of the active muscles will be engorged with blood
Which of the choices below explains why the arterioles are known as resistance vessels?
The contraction and dilation of the smooth muscle in their walls can change the diameter
Which of the following processes provide a long-term response to changes in blood pressure?
Renal regulation
Peripheral resistance ______.
Increases as blood viscosity increases
Bring blood flow autoregulation _____.
Is abolished when abnormally high CO2 levels persist
Blood flow to the skin ______.
Increases when body temperature drops so that the skin does not freeze
Which of the choices below reflects the balance or imbalance between the direction and amount of fluid that flows across the capillary walls?
Hydro static and osmotic pressure
Which of the following is a type of circulatory shock?
Vascular, due to extreme vasodilation as a result of loss of vasomotor tone.
The abdominal aorta splits into which vessels?
Right and left common iliac arteries
The influence of blood vessel diameter on peripheral resistance is ______.
Significant because resistant is inversely proportional to the fourth power of the vessel radius
The form of circulatory shock known as hypovolemic shock is _____.
Shock that results from a large scale loss of blood volume, or after severe vomiting or diarrhea
Which of the following is the most significant source of blood flow resistance?
Blood vessel diameter
The term ductus venosus refers to _____.
A special fetal vessel that allows umbilical blood to bypass the liver
The beginning of a true capillary is surrounded by a precapillary sphincter. The opening and closing of precapillary shrinkers is controlled by _______.
Local chemical conditions
The pulse rate depends on all of the following except one. Select the one answer that does not affect a pulse rate reading.
The vessel selected to palpate
Which of the following is least involved in pulmonary circulation?
Pulmonary arteries and veins
Histologically, the ______ is squamous epithelium supported by a sparse connective tissue later.
Tunica intima
Due to the branching of arteries the type of arteries that would be most numerous would be _______.
Arterioles
Which of the following is not true regarding fenestrated capillaries?
Fenestrated capillaries form the blood brain barrier
These capillaries may be aligned with phagocytes that can extend their process into the plasma to catch prey.
Sinusoids
Factors that aid venous return include all except ______.
Urinary output
Which of the following blood pressure readings would be indicative of hypertension?
170/96
Select the correct statement about factors that influence blood pressure.
Excess red cell production would cause a blood pressure increase
Mechanisms that do not help regulate blood pressure include ______.
The dural sinus reflex
The velocity of blood flow is ______.
Slowest in the capillaries because the total cross-sectional area is the greatest
Select the correct statement about blood flow.
Blood flow through the entire vascular system is proportional to cardiac output
A thrombus 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
Cerebral blood flow is regulated by _______.
Intrinsic auto regulatory mechanisms
A patient with essential hypertension might have pressures of 200/120 mmHg. This hypertensive state could result in all of the following changes except what?
Decrease the size of the heart muscle
The short term controls of blood pressure mediated by the nervous system and blood-borne chemicals primarily operate via all but which of the following?
Altering blood volume
Secondary hypertension can be caused by ________.
Kidney disease
Where in the body would you find low oxygen levels causing vasoconstriction and high levels causing vasodilation?
Lungs
Normal average blood pressure for a newborn baby is what?
90/55.
If a person has lost a significant amount of blood but still remains a normal blood pressure it does not necessarily mean that the person is maintaining adequate perfusion. Which of the following best explains why this is so?
Blood vessels are constricting causing greater peripheral resistance
what do ductus arteriosus and the foramen ovale become at birth?
ligamentum arteriosum; fossa ovalis
Which of the following would not result in the dilation of the feeder arterioles And opening of the precapillary sphincters in systemic capillary beds?
A local increase in pH
Arteriolar blood pressure increases in response to all but which of the following?
Falling blood volume
The baroreceptors in the carotid sinus and aortic arch are sensitive to which of the following?
Changes in arterial pressure
A family of peptides _____ Are released by the endothelium and are among the most potent vasoconstrictors known.
endothelins
Arterial ______ Provide alternate pathways for blood to get to an organ
anastomes
The _____ In the carotid sinuses and aortic arch detect increases in blood pressure
baroreceptors
The internal carotid arteries supply the ____ with blood.
brain
List the major factors that are linked to essential hypertension and know which ones are controllable by the patient
Heredity, diet, obesity, age, diabetes mellitus, stress, smoking. All our controllable except for heredity and age.
What are the sounds of Korotkoff?
thumping sounds heard as blood spurting through constricted artery when blood pressure cuff is deflated
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.
Describe the forces that determine fluid movement across capillary walls.
Capillary hydrostatic pressure tends to force fluid out of capillaries into interstitial spaces. Osmotic pressure tends to draw water into the capillaries
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 lumen due to smooth muscle relaxation. Both are regulated by vasomotor nerve fibers of the sympathetic division of the autonomic nervous system and by local metabolic substances
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 2 mm would carry less fluid because the resistance in the smaller vessels is much greater and the volume of the 4 mm vessel is greater than that of the 2 mm.
The abdominal aorta divides into three arteries at its terminus; what are they?
Left and right common iliac arteries and the median sacral artery
The mesenteric artery’s branch of the abdominal aorta, but the mesenteric veins do not connect directly to the vena cava. Why?
The mesenteric vein’s merge into the hepatic portal vein before entering the liver, which dumps into the vena cava
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.
Arthrosclerosis 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 and tissue types and molecules.
The disease process involves several stages and usually affects of the aorta and coronary arteries. The initial event involves damage to the tunica intima caused by blood-borne chemicals or physical factors such as a mechanical stress from hypertension 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. From cells become a fatty streaks, which, along with collagen and elastin and fibers secreted by smooth muscle cells, form arthrosclerosis plaques. These protrude into the lumen and narrow the blood vessels.
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 can result if proper healing does not occur. The danger in thrombophlebitis is the possibility that a clot could detach and form an embolus.
For each of the following situations, describe the anticipated affect on blood pressure in the physiological basis of the response. 1) a high salt diet 2) a blow on the head that damages the vasomotor center 3) an attack by a mugger 4) a hypothalmic 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 toll and a drop in blood pressure because the vasomotor center is the integrating center for blood pressure control. 3) During the mug or attack, blood pressure would increase due to sympathetic nervous system stimulation triggered by the hypothalamus 4) Excess a DH production would cause an increase in blood pressure through increased water retention and therefore increased blood volume. ADH also stimulates vasoconstriction.
Mrs. Gray, a 50-year-old mother of seven children, is complaining of dull, aching pain 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 patient’s 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 patient’s case is her pregnancies, because the enlarged uterus exert downward pressure on groin vessels, restricting return blood flow.
Mr. Wilson is a 45-year-old stockbroker with essential hypertension. He is African-American, obese, and he smokes 2 to 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 be made? 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 blocker’s, and angiotensin converting enzyme inhibitor’s. Complications could include arthrosclerosis, heart failure, renal failure, and stroke.
A pregnant patient comes into a clinic and ask about a small painless dark compressible 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 in larges these veins and put additional strain on other peripheral vein valves down the line.
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 he was wounded. Which blood vessel was most likely to have been injured? Why is a tourniquet usually in effective in stopping the bleeding from this wound?
The wound severed his femoral artery, the largest artery serving the lower limb. A tourniquet may be in effective 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.
A patient 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 the 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 Reno reabsorption of sodium with water following Causing water retention and stimulates the posterior pituitary to release ADH, Which promotes more water reabsorption. As sodium moves into the bloodstream, water follows; sauce, both blood volume and blood pressure rise. Stimulate the thirst center to consume more fluids.
A patient 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.
