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Chapter 20 Flashcards

1
Q

Most common circulatory route?

A

Heart -> arteries -> arterioles -> capillaries -> venules -> veins

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2
Q

What are portal systems?

A

When blood flows through 2 consecutive capillary networks, interconnected by a vein, before returning to the heart

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3
Q

Notable portal systems?

A

Between the hypothalamus and anterior pituitary, in the kidneys, and between the intestines to the liver

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4
Q

What is anastomosis?

A

A point of convergence between 2 blood vessels other than capillaries. Provides alternate routes of travel for blood so clots don’t cause issues

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5
Q

What are arteries?

A

Thick, pressure-withstanding blood vessels that carry blood away from the heart

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6
Q

What are veins?

A

Blood vessels with a large circumference which carry blood to the heart

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7
Q

What are capillaries?

A

The site of gas exchange, connecting small arteries or arterioles to small veins or venules

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8
Q

Why do artery walls have elastic membranes?

A

To allow recoil for continuous blood flow

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9
Q

Why do veins have valves?

A

They are under very low pressure which may make it hard for blood to flow in the proper direction, so valves help with this and push it in one direction

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10
Q

How do veins act as a blood reservoir?

A

At any given time, the majority of the body’s blood is sitting in veins, waiting to constrict and send blood to the heart in the case of low BP

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11
Q

Types of arteries?

A

Conducting arteries, distributing arteries, and arteriole arteries

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12
Q

What are conducting arteries?

A

AKA elastic or large arteries, they are the largest arteries and have a thick media and layer of elastic tissue for recoil

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13
Q

What are distributing arteries?

A

AKA muscular or medium arteries, they distribute blood to specific organs or tissues

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14
Q

What are arteriole arteries?

A

AKA small arteries, they control the amount of blood distributed to various organs

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15
Q

What factors affect systemic vascular resistance (SVR)?

A

Blood viscosity, vessel length, flow characteristics, and vessel radius

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16
Q

Blood pressure formula?

A

BP = cardiac output x systemic vascular resistance

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17
Q

What layers make up the artery walls?

A

Tunica interna, tunica media, and tunica externa

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18
Q

What is the tunica interna?

A

Innermost of the arteries’ walls, it has an endothelium that acts as a selectively permeable barrier, and also usually repels blood cells and platelets to prevent unnecessary clotting

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19
Q

What is the tunica media?

A

Middle layer of the arteries’ walls, it consists of smooth muscle, collagen, and elastic tissue, and serves vasomotion - vasoconstriction and vasodilation - to increase or decrease SVR

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20
Q

What is the tunica externa?

A

The outermost layers of the arteries’ walls, it contains vasa vasorum - small vessels that supply blood to outer half of larger vessels. While blood from lumen nourishes inner half via diffusion

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21
Q

What is a pulse?

A

A wave of pressure caused by the expansion and recoil of arteries

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22
Q

What arteries are used for palpating pulses?

A

Superficial temporal, facial, common carotid, radial, brachial, femoral, popliteal, dorsal, posterior tibial, and dorsal pedal

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23
Q

What are carotid and aortic sinuses?

A

Baroreceptors that adjust blood pressure via baroreflex

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24
Q

What are carotid and aortic bodies?

A

Chemoreceptors that adjust the body’s O2 and CO2 levels and repair blood pH

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25
Q

How do the carotid and aortic bodies influence blood pH?

A

When oxygen levels drop / CO2 levels increase, vagus and glossopharyngeal nerves activate, sending signal to brainstem, activating phrenic nerve, activating diaphragm, increasing respiration

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26
Q

How do the carotid and aortic sinuses influence blood pressure?

A

When blood pressure increases, arteries stretch, activate baroreceptors, stimulate cardioinhibitory neurons, parasympathetic nerve releases acetylcholine, reducing pacemaker cells’ action potentials, decreasing heart rate, lowering blood pressure. And vice versa when BP is low

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27
Q

How does blood viscosity impact SVR?

A

RBC count and albumin concentration affect the thickness of the blood. High viscosity from polycythemia increases SVR, low viscosity from anemia decreases SVR

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28
Q

How does vessel length impact SVR?

A

Pressure and flow decline with distance traveled due to friction

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29
Q

How does vessel radius impact SVR?

A

It is in fact the most significant and powerful influence over SVR - vasoconstriction and vasodilation increase and decrease blood pressure

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30
Q

How do flow characteristics influence SVR?

A

Fast flow - more resistance - turbulent flow
Slow flow - less resistance - laminar flow

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31
Q

What is flow?

A

The amount of blood flowing through an organ, tissue, or blood vessel in a given time

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32
Q

What is flow in a resting individual?

A

Usually 5.25 L/min

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33
Q

What is perfusion?

A

The flow per given volume or mass of tissue

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34
Q

What is hemodynamics?

A

Physical properties of blood flow

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35
Q

How do resistance and pressure affect flow?

A

High pressure = greater flow
High resistance = lower flow

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36
Q

What is blood pressure?

A

The force that blood exerts against a vessel wall

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37
Q

What is systolic pressure?

A

Peak arterial pressure during ventricular contraction

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38
Q

What is diastolic pressure?

A

Minimum arterial pressure during ventricular contraction

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39
Q

What is pulse pressure?

A

The difference between systolic and diastolic pressure

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40
Q

What is mean arterial pressure (MAP)?

A

The mean pressure you would obtain from taking measurements at several intervals throughout the cardiac cycle

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41
Q

What does MAP influence the risk of getting?

A

Syncope (fainting), atherosclerosis, kidney failure, edema, and aneurysm

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42
Q

How does blood flow differ from arteries, capillaries, and veins?

A

In arteries it is pulsatile, in capillaries and veins it is steady

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43
Q

What is arteriosclerosis?

A

Hardening of arteries due to cumulative damage by free radicals

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44
Q

What is atherosclerosis?

A

Growth of lipid deposits in arterial walls - they can become calcified and make arteries hard and crunchy

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45
Q

What is hypertension?

A

Chronic high blood pressure

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46
Q

What blood pressure indicated hypertension?

A

A resting blood pressure higher than 140/90

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47
Q

What is hypotension?

A

Chronic low blood pressure. Happens near end of life a lot

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48
Q

What is peripheral resistance?

A

Opposition to flow that the blood encounters in vessels away from the heart

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49
Q

What is peripheral resistance dependent on?

A

Blood viscosity, vessel length, and vessel radius

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50
Q

What is laminar flow?

A

When blood flows in layers - faster in the middle of the vessels, slower near the walls

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51
Q

Most significant point of control over peripheral resistance?

A

Arterioles, because they are positioned well, outnumber other arteries, and are very muscular in proportion to their diameters

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52
Q

What is autoregulation?

A

The ability of tissues to regulate their own blood supply

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53
Q

What are vasoactive chemicals?

A

Chemicals released under trauma, inflammation, exercise, etc. which stimulate vasodilation

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54
Q

What is angiogenesis?

A

Growth of new blood vessels

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55
Q

When does angiogenesis occur?

A

Regrowth of uterine lining after menstrual period, development of higher density of blood capillaries in muscles of athletes, and growth of arterial bypasses around obstructions in coronary circulation

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56
Q

What is the vasomotor center an integrating center for?

A

Baroreflexes, chemoreflexes, and medullary ischemic reflexes

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57
Q

What are medullary ischemic reflexes?

A

Raise blood pressure to restore normal cerebral perfusion

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58
Q

What hormones can influence blood pressure?

A

Angiotensin II, aldosterone, natriuretic peptides, antidiuretic hormone, epinephrine and norepinephrine

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59
Q

What does vasomotion do?

A

Generalized raising and lowering of blood pressure, and selectively modifying perfusion of a particular organ and rerouting blood from one region of the body to another

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60
Q

What does the aortic arch split off into?

A

Brachiocephalic artery, left common carotid artery, and left subclavian artery

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61
Q

What does the brachiocephalic artery split into?

A

Right subclavian, which transitions into brachial artery, which divides into radial and ulnar arteries

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62
Q

What does the brachiocephalic artery supply?

A

Head, neck, upper extremities

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63
Q

What does the left common carotid artery supply?

A

Head and neck

64
Q

What does the left subclavian artery supply?

A

Head, neck, arms

65
Q

What does the brachial artery supply?

A

Arm

66
Q

What do the radial and ulnar arteries supply?

A

Forearm

67
Q

What does the axillary artery supply?

A

Pecs and deltoid

68
Q

What does the celiac trunk split off into?

A

Splenic arteries, hepatic artery, and gastric artery

69
Q

What does the superior mesenteric artery supply?

A

Large intestine

70
Q

What do the renal arteries supply?

A

Kidneys

71
Q

What do the gonadal arteries supply?

A

Testes and ovary

72
Q

What does the inferior mesenteric artery supply?

A

Small intestine

73
Q

What does the popliteal artery supply?

A

Back of knee

74
Q

What does the posterior tibial artery supply?

A

Back of leg

75
Q

What does the anterior tibial artery supply?

A

Front of leg

76
Q

What does the dorsal artery supply?

A

The top of the foot

77
Q

What artery can you palpate to judge the body’s circulation?

A

The dorsal artery on the foot

78
Q

What are precapillary sphincters?

A

Little muscles that regulate blood flow to certain organs, and allows you to regulate blood pressure by redirecting blood back to the veins

79
Q

What is the only site of nutrient, waste, and hormone exchange?

A

Capillaries

80
Q

3 capillary types?

A

Continuous capillaries, fenestrated capillaries, sinusoids

81
Q

What are continuous capillaries?

A

The least permeable, they allow diffusion of glucose and regulate blood flow (using pericytes)

82
Q

What are fenestrated capillaries?

A

Medium permeable, they’re in organs that require rapid absorption or filtration and allow passage of glucose

83
Q

How do lipid-soluble substances diffuse?

A

Directly through the plasma membrane. Can be done by steroid hormones, O2, and CO2, for example

84
Q

How do substances that are not lipid-soluble diffuse?

A

They go through filtration pores or intercellular clefts. Can be done by glucose and electrolytes, while larger molecules like protein are held back

85
Q

What is transcytosis?

A

The name for when endothelial cells pick up material on one side by pinocytosis, transport the vesicles across the cell, and discharge material on the other side by exocytosis. For fatty acids, albumin (protein) and some hormones like insulin

86
Q

How do water-soluble substances diffuse?

A

They pass through filtration pores and intercellular clefts. Stuff like glucose and electrolytes

87
Q

What is blood hydrostatic pressure?

A

Drives water-soluble fluid out of the capillary

88
Q

What is colloid osmotic pressure?

A

Draws water-soluble fluid into the capillary. Results from plasma proteins like albumin

89
Q

What is interstitial hydrostatic pressure?

A

Negative pressure from the lymphatic system that moves fluids into the tissue

90
Q

What is tissue osmotic pressure?

A

Proteins present in tissue pulls fluid into the capillaries

91
Q

What is edema?

A

Accumulation of excess fluid in a tissue

92
Q

Risks of pulmonary edema?

A

Suffocation

93
Q

Risks of cerebral edema?

A

Headaches, nausea, seizures, and coma

94
Q

What causes edema?

A

An increase in hydrostatic pressure due to heart failure or inflammation

95
Q

3 primary causes of edema?

A

Increased capillary filtration, reduces capillary reabsorption, and obstructed lymphatic drainage

96
Q

What is the purpose of valves?

A

Ensuring one-way flow of blood toward the heart

97
Q

What is venous return?

A

The flow of blood back to the heart

98
Q

How is venous return achieved?

A

Pressure gradient, gravity, skeletal muscle pump, thoracic pump, and cardiac suction

99
Q

What is central venous pressure?

A

Pressure at the point where venae cavae enter the heart

100
Q

What is venous pooling?

A

Blood accumulating in the limbs when a person is still for a while since venous pressure isn’t high enough to override gravity

101
Q

What is circulatory shock?

A

Any state in which cardiac output is insufficient to meet the body’s metabolic needs

102
Q

Forms of circulatory shock?

A

Cardiogenic shock and low venous return

103
Q

What is cardiogenic shock?

A

Inadequate pumping by the heart

104
Q

What is low venous return?

A

Cardiac output is low because too little blood is returning to the heart

105
Q

Forms of low venous return shock?

A

Hypovolemic shock, obstructed venous return shock, and venous pooling shock

106
Q

What is hypovolemic shock?

A

Low of blood volume due to hemorrhage, trauma, bleeding ulcers, burns, or dehydration

107
Q

What is obstructed venous return shock?

A

When any object, like a tumor or an aneurysm, compresses a vein and impedes its’ blood flow

108
Q

What is venous pooling shock?

A

When the body has a normal blood volume, but too much of it accumulates in the lower body

109
Q

What is neurogenic shock?

A

A form of venous pooling shock that results from a sudden loss of vasomotor tone, allowing blood vessels to dilate

110
Q

What is septic shock?

A

Bacterial toxins trigger vasodilation and increased capillary permeability

111
Q

What is anaphylactic shock?

A

Exposure to an antigen to which a person is allergic, causing release of histamine which causes generalized vasodilation and increased capillary permeability

112
Q

Smallest veins?

A

Postcapillary venules

113
Q

What are medium veins?

A

Up to 10mm in diameter, they have a thin tunica media and a thick tunica externa

114
Q

What forms venous valves?

A

Tunica interna

115
Q

What are large veins?

A

Over 10mm in diameter, they include venae cavae, pulmonary veins, internal jugular veins, and renal veins

116
Q

What are capacitance vessels?

A

Veins are considered this, since they contain like 50% of the systemic blood volume at any given time

117
Q

What happens in veins when blood pressure drops?

A

Vasoconstriction occurs, moving blood toward the heart, working to fix blood pressure

118
Q

How does the muscular pump work?

A

Contracting your muscles pushes against the walls of the veins, displacing blood toward the heart

119
Q

How does the respiratory pump work?

A

When you inhale, thoracic volume increases, causing drop in intrapleural pressure, negative pressure acts like a vacuum, suctioning blood into the heart

120
Q

How does exercise increase venous return?

A

Heart beats faster and harder, vessels of skeletal muscles and lungs and heart dilate, respiratory rate increases, skeletal muscle pump increases

121
Q

Control over vasomotion?

A

Local control, neural control, and hormonal control

122
Q

What is local control over vasomotion?

A

Tissue releases vasodilators

123
Q

What is neural control over vasomotion?

A

Sympathetic nervous system causes vasoconstriction

124
Q

What is hormonal control over vasomotion?

A

Epinephrine and angiotensin II cause vasoconstriction

125
Q

What type of blood vessel holds the greatest volume of blood?

A

Veins

126
Q

Blood normally flows into a capillary bed from?

A

A metarteriole

127
Q

Substance that is likely to cause a rapid drop in blood pressure?

A

Histamine

128
Q

Why is blood flow faster in venules than capillaries?

A

Larger diameter

129
Q

How is pulse pressure calculated?

A

Subtracting diastolic pressure from systolic pressure

130
Q

Longest blood vessel in the body?

A

Saphenous vein

131
Q

What are varicose veins?

A

A permanently distend vein, common in lower legs, due to weakened valves

132
Q

What are hemorrhoids?

A

Distend veins found in the anus due to weakened valves

133
Q

What is orthostatic hypertension?

A

Temporary low BP and dizziness when suddenly standing

134
Q

What is the organ where blood flow fluctuates the least?

A

To the brain

135
Q

What happens if the brain loses oxygen?

A

For a couple seconds, loss of consciousness. For 4-5 minutes, irreversible damage

136
Q

How does blood flow change in response to different functions?

A

It is redirected to different parts of the brain

137
Q

How does the brain regulate its blood flow?

A

In response to changes in blood pressure and chemistry

138
Q

Main chemical stimulus for cerebral autoregulation?

A

pH

139
Q

What happens when there is too much CO2 or O2 in the brain?

A

Low CO2 - local vasodilation
Low O2 - local vasoconstriction

140
Q

What is hyperventilation?

A

Exhaling CO2 faster than the body can produce it, leading to hypocapnia

141
Q

Effects of hyperventilation?

A

Cerebral vasoconstriction, ischemia, dizziness, and sometimes syncope

142
Q

What are transient ischemic attacks?

A

Dizziness, loss of vision, weakness, paralysis, headache, or aphasia resulting from brief episodes of cerebral ischemia

143
Q

What is a stroke?

A

AKA cerebrovascular accident, sudden death of brain tissue caused by ischemia

144
Q

Effects of a stroke?

A

Blindness, paralysis, loss of sensation, and loss of speech

145
Q

What happens to blood flow during strenuous exercise?

A

Blood is diverted from the digestive tract and kidneys to meet the needs of working muscles

146
Q

How does muscular contraction affect blood flow?

A

It compresses blood vessels, impeding flow. Sustained isometric contraction fatigues more quickly than intermittent isotonic contraction

147
Q

Blood vessels carry what blood in the systemic and pulmonary circuits?

A

Pulmonary: arteries are oxygen-poor, veins are oxygen-rich
Systemic: arteries are oxygen-rich, veins are oxygen-poor

148
Q

Why do capillaries in the pulmonary circuit have a lower pressure than those in the systemic circuit?

A

To help blood flow more slowly, allowing more time for gas exchange, and preventing fluid accumulation for the same reason

149
Q

What do systemic arteries do in response to hypoxia?

A

Dilate and improve tissue perfusion

150
Q

What do pulmonary arteries do in response to hypoxia?

A

Contract, redirecting blood flow to another, better ventilated region

151
Q

What does the pulmonary trunk branch into?

A

Right and left pulmonary arteries

152
Q

What does the right pulmonary artery branch into?

A

Upper branch and lower branch

153
Q

Where do arteries in the lungs lead?

A

To capillary beds surrounding pulmonary alveoli

154
Q

Where does pulmonary blood go after leaving alveolar capillaries?

A

It flows into venules and veins, ultimately leading to the main pulmonary veins

155
Q

Primary purpose of pulmonary circuit?

A

Exchanging CO2 for O2

156
Q

How do lungs get systemic blood supply?

A

From bronchial arteries

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