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Physiology > Circulation > Flashcards

Circulation Flashcards

1
Q

Name the 3 parts of the circulation

A
  • Resistance part (Arteries)
  • Exchange area (Capillaires)
  • Reservoir (Veins)
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2
Q

Location of resistance part of the circulation

A

Left ventricle → Capillary bed

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3
Q

Location of the exchange area of the circulation

A

Locations of bidirectional transport of material

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4
Q

Location of the reservoir system of the circulation

A

Venules → Right atrium

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5
Q

Under normal conditions, the largest part of blood volume is located in…

A

The reservoir system

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6
Q

Describe the structure of an artery

A
  • Muscular
  • Elastic
  • Thick walled
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7
Q

Describe the structure of an arteriole

A
  • Muscular
  • Little connective tissue
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8
Q

Describe the structure of a capillary

A
  • Endothelial layer
  • No muscle
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9
Q

Describe the structure of a venule

A
  • Thin walls
  • Some smooth muscle
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10
Q

Describe the structure of a vein

A
  • Thin-walled
  • Smooth muscle
  • Flacid
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11
Q

The resistance part is composed of…

A
  • Elastic arteries
  • Muscular arteries
  • Arterioles
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12
Q

Elastic arteries

A
  • Aorta & large arteries
  • Loaction of passive contraction (due to elastic elements)
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13
Q

Muscular arteries are the sites of…

A
  • Regulated resistance
  • Smooth muscle → active contraction
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14
Q

Arterioles

A
  • Most important part of regulated resistance
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15
Q

During diastole, the aorta…

A

Passively contracts

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16
Q

‘Windkessel’ function of the aorta

A
  • A simple pump with a closed air buffer
  • Storage of pressure in the Windkessel
  • Results in a near-constant pressure
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17
Q

What is the location of capillary exchange?

A

Area of microcirculation

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18
Q

List the types of capillary

A
  • Continuous
  • Fenestrated
  • Porous
  • Sinusoid
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19
Q

Location of continuous capillaries

A
  • Muscle
  • Skin
  • CNS
  • Lung
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20
Q

Location of the fenestrated capillaries

A
  • Intestinal mucosa
  • Endocrine glands
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21
Q

Location of the porous capillaries

A

Glomeruli of the kidney

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22
Q

Describe the structure of continuous capillaries

A
  • Endothelium (Inside layer)
  • Lamin basalis
  • Pericytes (Outside layer)
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23
Q

Sinusoid capillaries lack…

A

Pericytes

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24
Q
A

Disse-space

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25
Q

Location of sinusoid capillaries

A
  • Liver
  • Haemopoietic organs
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26
Q

What limits the enlargement of veins?

A

Collagen

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27
Q

List the types of Venule

A
  • Postcapillary venule
  • Collecting venule
  • Muscular venule
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28
Q

The function of venules is determined by…

A

The structure of the wall and valves

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29
Q

Potential energy

A

The pressure exerted onto the wall of the container (vessels)

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30
Q

Kinetic energy =

A

1/2 m x v2

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31
Q

Cause of energy loss in circulation

A

Flow friction

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32
Q

Resistance is determined by…

A

Flow rate

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33
Q

Kinetic energy =

A

Total energy - Potential energy

  • Pitot-system
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34
Q

Narrowing of blood vessels causes….

A
  • A increase of kinetic energy
  • A decrease of potential energy
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35
Q

Viscosity is higher in…

A

Larger vessels

(Fahraeus-Lindquist effect)

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36
Q

The viscosity of blood is a function of…

A

The hematocrit value

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37
Q

Factors maintaining the BP in Arteries

A
  • Work of heart
  • Total peripheral resistance (TPR)
  • Distribution of blood
  • Types of blood flow
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38
Q

Runoff (Qr)

A

Volume of blood which moves from:

Arterial part → Venous part

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39
Q

The artificial increase in work of the heart is by…

A

Pacemakers

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40
Q

The natural increase in work of the heart is by…

A

Sympathetic activation

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41
Q

Increase in TPR causes…

A

Increase of blood pressure

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42
Q

What allows arteries to distend?

A
  • Elastic elements
  • Myogenic elements
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43
Q

Critical closing pressure

A

Pressure where vessels are collapsing

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44
Q

Arterial distensibility

A
  • Volume change related to pressure change related to the original volume
  • D = dV / dP x Va
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45
Q

What is compliance?

A

Volume change per unit pressure change

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46
Q

When is distensibility used for blood pressure?

A

If different circulations are compared

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47
Q

When is compliance used for blood pressure?

A

When absolute change is of interest

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48
Q

Compliance decreases with…

A

Age

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49
Q

Law of Laplace related to blood vessels

A
  • In order to maintain BP
  • There should be an increase in wall tension
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50
Q

An increase in arterial volume causes…

A

An increase of blood pressure

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51
Q

Parallel attachment of organs is beneficial because…

A

Changes in perfusion of one organ don’t suddenly change the work of the heart

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52
Q

Examples of serially coupled elements of the circulation

A
  • Arteries
  • Capillaries
  • Veins
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53
Q

Perfusion

A
  • Flow of volume
  • Determined by Ohm’s law
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54
Q

Reynolds number =

A
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55
Q

Laminar blood flow

A

Re<2320

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56
Q

Turbulent flow

A

Re>2320

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57
Q

The physiological relevance of laminar flow

A
  • Low resistance, less work of the heart
  • Blood cells arranged in the axis of the flow
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58
Q

Capillary blood pressure is maintained by…

A

Microcirculation

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59
Q

Factors maintaining venous blood pressure

A
  • Gravitation
  • ‘Vis a tergo’ (work of the heart)
  • Valves
  • Skeletal muscle pump
  • Central venous pressure (CVP)
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60
Q

Skeletal muscle pump

A
  • Muscle tension pumps blood
  • Valves cause centripetal flow
  • Weak muscle tension → Blood accumulation → Increased pressure → Oedema
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61
Q

Pressure changes in chest and abdomen

A
  • Inspiration → Intrathoracic pressure decreases (RA fills)
  • Abdominal pressure → Transmural pressure of veins in abdomen
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62
Q

Peripheral blood pressure is maintained by…

A

Cardiovascular regulatory mechanism

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63
Q

Static pressure

A
  • Blood pressure measured post mortem
  • Approx 7mmHg​
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64
Q

Blood pressure above and below the heart

A
  • Higher below the heart
  • Lower above the heart
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65
Q

Pulse pressure

A

Systolic pressure - Diastolic pressure

  • e.g 120 - 80 = 40 mmHg
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66
Q

Mean arterial pressure

A
  • Weighted average of the systolic and diastolic pressure
  • Diastole 2 times longer than systole, therefore:
  • (Psyst + (2xP diast)) /3
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67
Q

Relationship of blood pressure and body size

A
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68
Q

Types of blood pressure measurement

A
  • Direct method
  • Indirect method
    • Palpation
    • Auscultation
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69
Q

Direct blood pressure measurement

A
  • Glass catheter inserted into carotis
  • Height of fluid volume measured
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70
Q

Palpation blood pressure measurement

A
  • Closing a BP cuff
  • Opening and recording Systolic BP when a pulse is felt

Cannot measure diastolic pressure

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71
Q

Auscultation blood pressure measurement

A
  • Closing cuff around an arm
  • Opening cuff and listening for first pulse (Systolic pressure)
  • Continue opening, listening for the sound to stop (Diastolic pressure)
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72
Q

What is the diagram?

What is indicated?

A

Pressure pulse

  • Anacrotic limb
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73
Q
A

Steepness

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74
Q
A

Pulse pressure

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75
Q
A

Dicrotic notch

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76
Q
A

Catacrotic limb

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77
Q

Speed of a palpable pulse

78
Q

Dicrotic notch of pressure pulse

A
  • Effect of the reflected pressure wave
  • Increases with distance from the aorta
79
Q

Flow rate in the aorta

80
Q

Flow rate in capillaries

81
Q

Pulse diagnosis is carried out with…

A

A sphygmograph

82
Q

The sphygmograph shows which components?

A
  • Frequency
  • Rhythm
  • Amplitude
  • Steepness
  • Tension
83
Q

Which two kinds of substance exchange occur during microcirculation?

A
  • Diffusion
  • Filtration/resorption
84
Q

What % of capillaries are open during rest?

85
Q

Filtration is blocked by…

A

The precapillary sphincter

86
Q

Components of microcirculation

A
  • Arterioles
  • Metarterioles
  • Precapillary sphincters
  • Capillaries
  • Venules
87
Q

The two types of capillary exchange

A
  • Flow limited
  • Diffusion-limited
88
Q

What is exchanged by capillaries?

A
  • Gas
  • Ions
  • Small substances
89
Q

Transport of small molecules during diffusion is dependent on…

A

Blood flow

Flow limited needed

90
Q

Transport of large molecules during diffusion required

A

Diffusion limited exchange

91
Q

What are the determining factors of diffusion?

A
  • Conc. gradient
  • Permeability
  • Surface area
92
Q

The extent of gas diffusion is dependent on…

A

Partial pressure

93
Q

The higher the O2 consumption, the faster the drop of…

A

pO2

(Partial pressure of oxygen)

94
Q

The drop of pO2 leads to…

How is it mitigated?

A
  • Hypoxia
  • More capillaries open → Local autoregulation
95
Q

Partial pressure of a gas

A

Measure of how much gas is present

96
Q

Major/Starling forces of substance exchange

A
  • Hydrostatic pressure difference (Ph)
  • Permeability
  • Oncotic pressure (Ponc)
  • Pressure of tissue (Pinterst)
97
Q

The direction of substance movement is determined by…

A

Effective filtration pressure

98
Q

Peff =

A

Phydrostatic - Poncotic - Ptissue

99
Q

Net filtration

A

Phydrostatic > Poncotic

100
Q

Net reabsorption

A

Phydrostatic < Poncotic

101
Q

Phydrostatic at the arteriolar end of the capillary

102
Q

Phydrostatic at the venule end of the capillary

103
Q

Pressure profile of the capillary is…

104
Q

Phydrostatic of ISF

105
Q

Colloid Oncotic pressure

A
  • Sucking force
  • Absorbing H2O from the ISF to the plasma
  • Proportional with [protein]
106
Q

Oncotic pressure of plasma

107
Q

Oncotic pressure of ISF

108
Q

Net oncotic pressure value

109
Q

The balance of effective partial pressure can be altered by

A
  • Changes in capillary pressure near arterioles or venules
  • Alterations in oncotic pressure
110
Q

Vasodilation

A

Increased BP at the capullaries

111
Q

Characteristics of the venous system

A
  • Capacitance system
  • Redistribution
  • Large distensibility
112
Q

What % of blood is found in the veins?

113
Q

What sets the limit of distensibility of veins?

A

Collagen networks of vessels

114
Q

Pressure goes…from veins to venules

115
Q

Local/intrinsic regulation of circulation

A

Dependent on oxygen and nutrient demand of organs

116
Q

Central/Extrinsic regulation of circulation

A

Maintaining the optimal working condition of organs

117
Q

List all forms of the regulatory systems

A
  • Intrinsic short term
  • Intrinsic long term
  • Extrinsic short term
  • Extrinsic long term
118
Q

Intrinsic short term regulation

A
  • Fast adjustment of perfusion rate
    • Autoregulation & myogenic regulation
      • Constant perfusion rate
    • Endothel derived regulation
    • Metabolites related regulation
119
Q

Autoregulation by myogenic tone

A
  • Microcirculation not influenced by BP (Myogenic adaptation)
  • Bayliss effect
120
Q

Bayliss effect

A
  • Pressure changes → Metarteriole sphincter contraction/relaxation
  • Stable pressure maintained
121
Q

Autoregulation of perfusion exists within which pressure range

A

40-140mmHg

122
Q

Endothel-related humoral factors

A
  • Endothelium-derived relaxing factor (EDRF)
  • Endothelium-derived contracting factor (EDCF)
123
Q

Describe detection during endothel-related regulation

A
  1. BP expressed on endothelium
  2. Deformation + plasma factors
  3. Humoral signals generated
  4. Contraction of smooth muscle
124
Q

Causes of EDRF regulation

A
  • Nitrogen monoxide
  • Prostacyclin (PGI2 hormone)
  • Endothelial-factor
125
Q

Mechanism of nitrogen monoxide in endothelial related regulation

A
  • NO → Smooth muscle
  • cGMP increases
  • Smooth muscle relaxes
126
Q

Mechanism of Prostacyclin (PGI2 hormone) in endothelial related regulation

A

Increases production of NO

127
Q

Mechanism of endothelial-factor in endothelial related regulation

A
  • Hyperpolarisation by activating ATP dependent K-channels
  • K is an indirect vasodilator
128
Q

Causes of EDCF regulation

A
  • Endothelins
  • Cyclooxygenase dependent factors
  • Angiotensins
129
Q

Mechanism of Cyclooxygenase dependent factors in the Endothelial related regulation

A
  • TXA2
  • Stimulates NO degradation

Also a direct effect resulting in contraction

130
Q

Mechanism of Endothelins in Endothelial related regulation

A
  • Strong constrictors
  • ET-1-3 (in tissues)
  • ET-4 (In lung)
131
Q

Mechanism of Angiotensin-II in Endothelial related regulation

A

Direct vasoconstrictor

  • Stimulates endothelin production
  • Increases sympathetic vasoconstriction
132
Q

ET-1

A
  • Binds to ET receptor
    • Vasoconstriction of airways and lung
    • Formation of new blood vessels
    • Survival of specific cell types
133
Q

Role of acetylcholine in endothelial related regulation

A
  • Through nerve endings
    • Direct stimulation
    • Vasoconstriction
  • From lumen of the blood vessel
    • Increase NO production
    • Vasodilation
134
Q

During endothelial related regulation through metabolites, increased metabolic activity results in…

A
  • Increased O2 consumption
  • Increased [adenosine]
  • Increased [H+]
  • Increased [CO2]
  • Increased [K<span>+</span>]

All stimulate EDRF stimulation

135
Q

What is the response to EDRF stimulation through increased metabolic activity?

A
  • NO production increases
  • PGI2 released
  • Hyperpolarising factors released
136
Q

Lack of oxygen at a tissue level (hypoxia) causes…

A
  • Automatic increase of perfusion
  • Better O2 supply
137
Q

Intrinsic long-term regulation

A
  • Morphologic changes
  • Stimulation of revascularisation
138
Q

Hyperemia

A

Increased local perfusion

139
Q

Give the types of hyperemia

A
  • Active (functional) hyperemia
  • Reactive hyperemia
140
Q

Active hyperemia

A

Caused by increased metabolic activity of the tissue

141
Q

Reactive hyperemia

A

A secondary increase of perfusion

Compression of artery → hyperemia

142
Q

Causes of extrinsic short-term regulation of circulation

A
  • Sympathetic effects
  • Parasympathetic effects
  • Humoral effects
  • Vessel-related reflexes
143
Q

Extrinsic regulation of circulation

A
  • Compensation of organ perfusion differences
    • via redistribution
  • Balance of:
    • Sympathetic-vasoconstrictor tone
    • Sympathetic-vasodilator tone
  • Results in permanent vasoconstriction
144
Q

Location of the cardio-vasomotor centres

A

Medulla oblongata

(formatio reticularis)

145
Q

List the cardio-vasomotor centres

A
  • Pressor area
  • Depressor area
  • Cardioaccelerator area
146
Q

Pressor area responsibilities

A
  • Spontaneous activity of the heart
  • General sympathetic vasoconstriction
  • Increasing blood pressure
147
Q

Depressor area responsibilities

A
  • Blood pressure decrease
  • Vasodilation
  • Decrease chronotropic and dromotropic effects
  • Direct inhibition of pressor centre
148
Q

Effect of the depressor centre on heart rate

A

Inhibits cardiac activity via vagal stimulation

  • n. vagus determines the work of the heart
149
Q

Sympathetic effect on the circulation

A
  • The depressed activity of the pressor area
    • The decrease of sympathetic vasoconstrictor tone
    • Vasodilation
150
Q

Parasympathetic effects on the circulation

A

Decrease of sympathetic vasoconstrictor tone

(No parasympathetic effect is actually expressed)

151
Q

Indirect parasympathetic vasodilation

A

Bradykinin release → Vasodilation

152
Q

During exercise, redistribution of blood is mainly to the…

A

Skeletal muscles

153
Q

Redistribution in regulation of circulation

A
  • Resistance vessels
  • (under influence of sympathetic postganglionic fibres)
154
Q

Vasomotor effect of regulation of circulation

A
  • Decreased sympathetic predominance → vasodilation
  • Epinephrine release → Dilates vessels of skeletal muscle
    • Increased perfusion to the skeletal muscle
      • Increased Cardiac output
155
Q

Humoral regulation of circulation effects

A
  • Epinephrine
  • Nor-epinephrine
  • Other hormones
156
Q

Small epinephrine dose causes…

A
  • Skeletal muscle vasodilation
    • Through ß-adrenergic receptors
  • Skin/splanchnic muscle vasoconstriction
    • Through α-adrenergic Receptors
157
Q

High dose of epinephrine causes…

A

General α-adrenergic constriction

158
Q

Effect of norepinephrine dose

A

Has only α-adrenergic vasoconstrictive effect

159
Q

Humoral regulation of circulation effect

A
  • Transport via blood (endocrine)
  • Epinephrine + norepinephrine
160
Q

List the blood vessel related reflex mechanisms

A
  • Baroreceptors
  • Volume receptors
  • Bainbridge-reflex
  • Effect of pO2 and pCO2
161
Q

Location of baroreceptors

A
  • Arcus aortae
    • Baroreceptors & Chemoreceptors​​​
  • Sinus caroticus
    • Baroreceptors & Chemoreceptors
162
Q

Function of baroreceptors

A

Fast resetting of blood pressure

163
Q

Describe Heimans’ crossed-dog experiment

A
  1. Dog B blood → Dog A (via carotis)
  2. Dog A BP changes reciprocally to dog B
164
Q

What is the effective range of baroreceptors?

A

50-170mmHg

165
Q

Volume receptors functions

A
  • Atrial stretching → ADH release
  • ANF (atrial natriuretic factor) release during hypervolaemia
166
Q

Volume receptors

A

Regulate cardiovascular and renal volume

167
Q

What does this figure show

A

The Starling mechanism/Bainbridge effect on heart rate

168
Q
A

Intravenous infusion

169
Q
A

Atrial pressure increases

170
Q
A

CNS pressor response

171
Q
A

HR increase

172
Q
A

Transient increase in cardiac output

173
Q
A
  • Baroreceptor reflex
  • (Overrides the Bainbridge reflex)
  • CNS depressor response
174
Q
A

HR decrease

175
Q

Location of peripheral receptors of pO2 and pCO2

A
  • Glomus caroticum
  • Glomus aorticum
176
Q

What stimulates peripheral differentiation?

A

Decrease of pO2

177
Q

What stimulates central afferentation?

A

Increase of pCO2

178
Q

What stimulates efferentation?

A

Sympathetic activation

179
Q

Extrinsic long-term regulation

A
  • CV system adapts to the needs of the organism
  • Adaptation in climatic changes
  • Long-term changes in oxygen supply
180
Q

Organs with specialised circulations

A
  • Heart
  • Brain
  • Skin
  • Liver
  • Fetus
181
Q

Coronary circulation during systole

A
  • Fast ejection:
    • High pressure ensures coronary flow
  • Slow ejection:
    • Aortic pressure drops → slow coronary perfusion
182
Q

Coronary circulation during diastole

A

Maximal coronary flow (More than when in systole)

183
Q

What occurs in the coronary circulation during the beginning of systole?

A
  • Blood pressed out from coronary vessels
  • Reversed flow of blood
184
Q

What occurs in the coronary circulation during the end of systole?

A
  • Fast ejection
  • Slow ejection
185
Q

Describe the blood flow entering and leaving the brain

A

Both are of equal value

186
Q

Blood pressure in the brain

A

Between 60-160 mmHg

  • Blood flow doesn’t change when in this range
187
Q

Splanchnic circulation

A
  • Double, serially-attached capillary system
  • Main regulator → Alpha-receptor (Sympathetic tone)
188
Q

Blood entering the fetal circulation

A
  • Via umbilical vein
  • 85% spO2
  • 35 mmHg pO2
  • Travels to the liver and heart
189
Q

Describe circulation at birth

A
  1. After delivery → Increase of pulmonary circulation
  2. The onset of breathing → Surfactant factors appear
  3. Pulmonary resistance decreases dramatically
  4. More blood passes through the lung
190
Q

Which process closes the ductus arteriosus?

A

Prostaglandin liberation

191
Q
192
Q

Physiology (18 decks)

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