CV system Flashcards

1
Q

CV system function

A

supply cells/tissues with oxygen/nutrients and to remove wastes (CO2, urea)

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2
Q

CV system structures

A

heart
blood vessels
*blood is a connective tissue, not part of this system

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3
Q

cardiology

A

study of the heart and the diseases associated with it

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4
Q

heart

A

location: within mediastinum
size: closed fist, 300g

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5
Q

base of heart

A

wide superior portion

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6
Q

apex of heart

A

inferior point

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7
Q

heart coverings

A

serous (visceral & parietal) pericardium

fibrous pericardium

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8
Q

visceral pericardium

A

innermost delicate epithelium

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9
Q

parietal pericardium

A

inner lining of fibrous pericardium

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10
Q

pericardial cavity

A

between visceral and parietal pericardium and is filled with serous fluid

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11
Q

fibrous pericardium

A

outermost tough, fibrous protective CT layer the prevents over-stretching of the heart

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12
Q

heart wall

A

epicardium
myocardium
endocardium

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13
Q

epicardium

A

visceral pericardium

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14
Q

myocardium

A

cardiac muscle tissue, bulk of heart

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15
Q

endocardium

A

smooth inner lining of heart chambers and valves

simple squamous epithelium called endothelium

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16
Q

heart chambers

A

atria

ventricles

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17
Q

atria

A

upper chambers
receive blood from veins (PASSIVE)
thin walled
flaps called auricles

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18
Q

interatrial septum

A

not complete during fetal development

fossa ovalis is remnant of fetal foramen ovale

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19
Q

ventricles

A

pump blood from the heart into arteries (ACTIVE)
thick walled
trabecular carneae

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20
Q

trabecular carneae

A

irregular inner surface (ridges and folds)

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21
Q

arteries

A

carry blood away from the heart

high in O2, low in CO2 EXCEPT pulmonary arteries

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22
Q

aorta

A

blood from left ventricle to body

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23
Q

pulmonary arteries

A

blood from right ventricle to lungs via pulmonary trunk

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24
Q

coronary arteries

A

cary blood to myocardium

richest blood supply

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25
Q

veins

A

carry blood toward the heart

low in 02, high in CO2 EXCEPT the pulmonary veins

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26
Q

superior vena cava

A

blood from the head and upper limbs

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27
Q

inferior vena cava

A

blood from the trunk and lower limbs

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28
Q

coronary sinus

A

blood from myocardium
drains all coronary veins
posterior side of heart

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29
Q

pulmonary veins

A

blood from lungs to left atrium

2 from each side

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30
Q

ligamentum arteriosum

A

remnant of fetal ductus arteriosus
80% of blood goes from R->L atrium
20% of blood goes to R ventricle->pulmonary trunk-> ductus arteriosus->aortic arch

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31
Q

heart valves

A

atrioventricular (AV) valves

semilunar (SL) valves

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32
Q

atrioventricular valves

A

tricuspid (R AV)

bicuspid (L AV)

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33
Q

tricuspid valve

A

lies between right atrium and right ventricle

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34
Q

bicuspid valve

A

aka mitral valve

lies between the left atrium and left ventricle

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35
Q

chordae tendineae

A

tendon-like fibrous cords that connect the cusps of AV valves to the papillary muscle
prevent cusps from swinging back into atria
hold valves shut during contraction

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36
Q

papillary muscle

A

muscular columns that are located on inner surface of the ventricles

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37
Q

semilunar valves

A
pulmonary SL (R SL)
aortic SL (L SL)
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38
Q

pulmonary SL valve

A

lies within pulmonary trunk

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39
Q

aortic SL valve

A

lies within aorta

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40
Q

pulmonary blood flow

A
right atrium (deoxygenated)
tricuspid valve
right ventricle
pulmonary SL valve
pulmonary trunk
pulmonary arteries
capillaries
pulmonary veins
left atrium
bicuspid valve
left ventricle
aortic semilunar valve
ascending aorta
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41
Q

coronary blood flow

A
ascending aorta
coronary arteries
left & right coronary arteries
capillaries in myocardium
cardiac veins
coronary sinus
right atrium
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42
Q

left coronary artery

A
circumflex branch (backside)
anterior interventricular (descending) branch (aka widow maker)
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43
Q

right coronary artery

A
right marginal branch
posterior interventricular (descending) branch
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44
Q

anastomoses

A

connections between 2 ore more branches of arteries that supply the same region with blood
provide alternate routs for blood to reach a particular region

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45
Q

cardiac veins

A

great cardiac vein (alongside widow maker)

middle cardiac vein (alongside posterior IV branch)

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46
Q

common causes of heart problems

A

blood clots
fatty atherosclerotic plaques
smooth muscle spasms w/in coronary vessels

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47
Q

ischemia

A

reduction of blood flow in the presence of normal oxygen

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48
Q

hypoxemia

A

reduction of oxygen with normal blood flow

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49
Q

hypoxia

A

reduction of oxygen and blood flow

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50
Q

angina pectoris

A

severe pain accompanied by myocardial ischemia
crushing pain radiating down left arm
labored breathing, weakness, dizziness, perspiration
during exertion, fades with rest
relieved by vasodilators (nitroglycerin)

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51
Q

stable angina

A

pain on exertion relieved with rest

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52
Q

unstable angina

A

pain on exertion, no relief with rest

usually due to atherosclerosis

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53
Q

Prinzmetal angina

A

associated with vasospasm

idiopathic

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54
Q

myocardial infarction

A

pathological term
ischemic necrosis due to lack of oxygen
caused by thrombus or embolus in coronary artery
may result in sudden death if conduction system interrupted and ventricular fibrillation occurs

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55
Q

heart attack

A

clinical term

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56
Q

MI tests

A

ECG (EKG): wider QRS, arrhythmias
troponin levels elevated w/in 30 minutes, normal within 5-7 days
CKMB - creatinine kinase, cardiac; elevated 1-2h after, normal w/in 2-3 days
neutrophilic response within 4-7 days; could result in cardiac tampanade

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57
Q

MI treatments

A

clot dissolving agents (TPA, streptokinase)
heparin
angioplasty

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58
Q

reperfusion damage

A

when oxygen deprived tissue’s blood supply is reestablished
formation of free radicals
damage to enzymes, neurotransmitters, nucleic acids, phospholipids

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59
Q

reperfusion damage implications

A
heart disease
parkinson's 
alzheimer's
cataracts
rheumatoid arthritis
aging
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60
Q

antioxidants

A

defend body against free radicals

include enzyme catalase, vitamin A, C, E

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61
Q

cardiac conduction system

A

sinoatrial (SA) node
atrioventricular (AV) node
atrioventricular (AV) bundle (right and left branches)
purkinje fibers

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62
Q

SA node

A

located in right uppermost atrial wall
aka pacemaker; initiates cardiac impulses (60-100bpm)
travels through atrial fibers via gap junctions in intercalated discs to AV node

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63
Q

AV node

A

located in interatrial septum
delay signal that allows for ventricular filling
impulse travels to AV bundles

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64
Q

AV bundles

A

aka bundle of His
only electrical connection between atria and ventricles
located in superior interventricular septum
enters both right & left branches downward toward apex and purkinje fibers

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65
Q

perkinje fibers

A

aka conduction myofibers
large diameter
located within papillary muscles of ventricles
conduct impulse into mass of ventricular muscle tissue
cause ventricles to contract

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66
Q

electrocardiogram (ECG/EKG)

A

recording of the electrical changes that occur in the myocardium during the cardiac cycle

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67
Q

EKG uses

A

evaluate conduction pathways
heart enlargement
heart regions damaged

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68
Q

rules to remember (EKG)

A

depolarization precedes contraction

repolarization precedes relaxation

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69
Q

heartbeat waves

A

P wave
QRS complex
T wave

70
Q

P wave

A

small upward wave
represents atrial depolarization (movement of electrical impulse through atria)
0.1s after P wave begins, atria contract

71
Q

QRS complex

A

begins as downward deflection, continues as large, upright, triangular wave, ends as downward wave
represents onset of ventricular depolarization
shortly after QRS begins, ventricles start to contract

72
Q

T wave

A

dome-shaped, upward deflection
represents ventricular repolarization
just before ventricles relax
shape indicates slow process

73
Q

enlarged P wave

A

enlargement of atrium possibly due to mitral stenosis

74
Q

enlarged Q wave

A

MI

75
Q

enlarged R wave

A

ventricular hypertrophy

76
Q

cardiac cycle

A

atria and ventricles contract alternately
blood flows from areas of high pressure to low pressure
complete cycle includes systole and diastole of atria and ventricles

77
Q

systole

A

phase of contraction

78
Q

diastole

A

phase of relaxation

79
Q

blood pressure

A

systolic/diastolic

80
Q

pulse pressure

A

systolic - diastolic

81
Q

cardiac muscle contraction

A
  1. rapid depolarization due to opening of Na+ channels
  2. plateau due to opening of Ca++ channels
  3. repolarization due to opening K+ channels
  4. refractory period; longer than contraction
82
Q

relaxation (quiescent) period

A

early ventricular diastole (0.4s)

  1. follows t-wave
  2. ventricular pressure drops
  3. SL valves close
  4. brief isovolumetric relaxation
  5. when ventricular pressure drops below atrial, AV valves open
83
Q

ventricular filling

A

mid-late ventricular diastole (0.1s)

  1. rapid ventricular filling after AV valves open
  2. SA node fires (P wave), atria contract filling ventricles
  3. atria relax, ventricles depolarize (QRS)
84
Q

ventricular systole

A
  1. impulse passes through AV node to ventricles
  2. ventricles contract
  3. ventricular pressure increases rapidly
  4. AV valves close (lubb)
  5. lasts 0.3s
85
Q

isovolumetric contraction phase

A

start of contraction to SL valve opening = 0.05s

86
Q

ventricular ejection phase

A

opening of SL valves to closing SL valves

87
Q

phase: ventricular contraction (systole)

A

blood flow: ventricles into arteries

valves: SL open, AV closed
pressure: V high

88
Q

phase: atrial relaxation (diastole)

A

blood flow: atria fill

valves: SL open, AV closed
pressure: A low, but rises

89
Q

phase: ventricular relaxation (diastole)

A

blood flow: ventricles fill

valves: AV open, SL closed
pressure: V low, but rises

90
Q

phase:

A

blood flow: atria to ventricles

valves: AV open, SL closed
pressure: A high

91
Q

lubb

A

S1: closing of AV valves (ventricular systole); loud and long
mitral stenosis: diastolic

92
Q

dupp

A

S2: closing of SL valves (ventricular diastole); short and sharp
aortic stenosis: systolic

93
Q

murmur

A

incomplete closing of valve cusps

94
Q

cardiac output (CO)

A

volume of blood pumped by each ventricle in one minute; average is 5L; HR x SV

95
Q

stroke volume (SV)

A

volume of blood pumped out by a ventricle with each beat (EDV - ESV); average is 50-70mL

96
Q

end diastolic volume (EDV)

A

average is 120-150mL

97
Q

end systolic volume (ESV)

A

average is 50-60mL

98
Q

blood pressure (BP)

A

the pressure exerted by blood on the wall of arterioles
mean (systemic) arterial blood pressure (MABP)
Maximum during systole, minimum during diastole
normal range is 120/80
CO x TPR

99
Q

total pressure resistance (TPR)

A

pressure within arterioles

100
Q

CV regulation: autonomic nervous system

A

located in medulla of brainstem
parasympathetic (normal) decreases (CN X, vagus)
sympathetic (stress) increases (white rami communicates)

101
Q

CV regulation: chemicals

A

hormones (epinephrine increases rate and force)
ions (calcium increases, potassium, sodium decreases)
atrial natriuretic peptide (ANP)

102
Q

CV regulation

A
decreases with age
females higher, males lower
temperature (heat increases)
emotion
disease
103
Q

chronotropic

A

rate of contraction

104
Q

inotropic

A

force of contraction

105
Q

baroreceptors

A

aortic/carotid sinuses
increase in BP, vasodilation, decrease heart rate
decrease in BP, vasoconstriction, increase heart rate

106
Q

chemoreceptors

A

aortic/carotid bodies

detects changes in pH, temperature, ions, and hormones

107
Q

artery

A
  1. strong, thick-walled
  2. carry blood under great pressure
  3. carry blood that is high in oxygen, low in CO2 (except pulmonary)
  4. branch into arterioles
  5. may unite with branches of other arteries supplying the same region forming anastomosis
108
Q

hemodynamics

A

study of the forces in blood movement

109
Q

arteriole

A
  1. small artery
  2. carry blood to capillaries
  3. regulates blood pressure
110
Q

vasoconstriction

A

decreased blood flow, increased blood pressure

111
Q

vasodilation

A

increased blood flow; decreased blood pressure

112
Q

capillary

A
  1. smallest, thinnest blood vessels
  2. permit exchange of gases, nutrients, and wastes between blood and tissues
  3. endothelium, basement membrane, no tunica media
113
Q

types of capillaries

A

continuous
fenestrated
sinusoids

114
Q

continuous capillary

A

plasma membranes form continuous ring around lumen

found in skeletal/smooth muscle, CTs, lungs

115
Q

fenestrated capillary

A

endothelial plasma membrane contain pores

found in glomeruli of kidneys, villi of small intestine

116
Q

sinusoids

A

contain spaces between the endothelial cells with basement membranes being incomplete or absent
found in liver, spleen

117
Q

capillary exchange

A

simple passive diffusion
vesicular transport
bulk flow

118
Q

simple passive diffusion

A
  1. most common
  2. substances include oxygen, CO2, glucose, hormones
  3. lipid soluble pass directly through endothelial cell membrane
  4. water soluble pass through fenestrations between endothelial cells
119
Q

vesicular transport

A

formation of a vesicle to move in/out of cell, fuses with cell membrane

120
Q

bulk flow

A

filtration, absorption

121
Q

vein

A
  1. carry blood toward heart
  2. thin walled
  3. carry blood under low pressure
  4. contain valves to preven regurgitation
  5. carry blood high in CO2 (except pulmonary)
122
Q

venule

A

carry blood from veins to capillaries

123
Q

blood distribution

A
60-70% in veins/venules
10-12% in arteries/arterioles
10-12% in pulmonary vessels
8-10% in heart
4-5% in capillaries
124
Q

BP factors

A
  1. cardiac output
  2. blood volume
  3. peripheral resistance
125
Q

peripheral resistance

A

opposition to blood flow primarily due to friction

  1. blood viscosity
  2. vessel length
  3. vessel radius
126
Q

neuro regulation of CV system

A
  1. medulla
  2. three centers: higher brain centers, baroreceptors, chemoreceptors
  3. from CV center to SA node; vasomotor center to smooth muscle of peripheral vessels
127
Q

negative feedback high BP

A
  1. BP increase detected by baroreceptors in carotid or aorta
  2. Impulse sent to CV & vasomotor centers
  3. CV center sends impulse to SA node to decrease HR, lowering CO/BP
  4. vasomotor center sends an impulse the arterioles causing vasodilation, lowering BP
128
Q

hormones that increase BP

A

1, epinephrine, norepinephrine (increases CO, vasoconstriction)

  1. antidiuretic hormone (increases reabsorption of H2O by collecting ducts in kidneys, vasoconstriction)
  2. angiotensin II (vasoconstriction, secretion of aldosterone)
  3. aldosterone (increases Na+, water reabsorption in DCT
129
Q

hormones that decrease BP

A
  1. atrial natriuretic peptide (vasodilation, loss of salt/water in urine)
  2. histamine (vasodilation)
130
Q

pulse

A
  1. pressure wave that travels through arteries following ventricular systole
  2. strongest in arteries closest to heart
  3. commonly measured in radial artery
  4. normal is 70-80bpm
131
Q

tachycardia

A

pulse > 100bpm

132
Q

bradycardia

A

pulse < 60bpm

133
Q

sphygmomanometer

A

instrument used to measure BP; typically use brachial artery

134
Q

pulmonary circuit

A

vessels that carry blood the right ventricle to the lungs, and vessels that return the blood to the left atrium

  1. pulmonary trunk
  2. R&L pulmonary arteries
  3. capillaries in lungs
  4. R&L pulmonary veins
135
Q

top CV diseases

A
  1. ischemic heart disease
  2. hypertension
  3. congenital septal defects
136
Q

ischemic heart disease

A

primary cause is atherosclerosis within vessels restricting blood flow; coronary artery disease

137
Q

congenital septal defects

A

acyanotic: ventricular/atrial septal defect
cyanotic: tetralogy of Fallow; transposition of great vessels

138
Q

tetralogy of Fallow

A

dextraposed aorta -> pulmonary stenosis -> right ventricular hypertrophy -> blood leaks R->L ventricle

139
Q

transposition of great vessels

A

pulmonary trunk & aorta switched; often accompanied by septal defects

140
Q

circle of willis

A

sits around sella turcica; blood-brain barrier
left and right internal carotid (also from middle cerebral)
left and right anterior cerebral
anterior communicating
left and right posterior cerebral (from basilar

141
Q

pulse deficit

A

difference between cardiac contractions vs. pulse; normal is below 10.

142
Q

branches of the aorta

A

ascending aorta
aortic arch
descending aorta

143
Q

branches of the ascending aorta

A
right coronary (myocardium)
left coronary (myocardium)
144
Q

branches of the aortic arch

A

brachiocephalic (right arm/head)
left subclavian (left arm)
left common carotid (left head)

145
Q

branches of the common carotid arteries

A

internal common carotid (brain)

external common carotid (scalp)

146
Q

branches of the subclavian arteries

A

axillary (armpit)

vertebral (cervical vertebrae/skull)

147
Q

vertebral arteries

A

anastomose into basilar artery

148
Q

branches of axillary arteries

A

becomes brachial distally (upper arm)
radial (lateral forearm)
ulnar (medial forearm)

149
Q

descending aorta

A

becomes thoracic within thoracic cavity

becomes abdominal within abdominal cavity

150
Q

branches of abdominal aorta

A

celiac trunk (liver, stomach, spleen)
superior mesenteric (sm intestine, cecum, ascending/transverse colon, pancreas)
inferior mesenteric (descending/sigmoid colon, rectum)
suprarenal & renal
gonadal
common iliac

151
Q

common iliac arteries

A

becomes external iliac within pelvis (lower extremities)
becomes femoral in leg (thigh)
becomes popliteal in knee

152
Q

branches of popliteal arteries

A
posterior tibial (lower leg)
anterior tibial (foot/toes)
153
Q

superior vena cava

A

right & left brachiocephalic

154
Q

branches of brachiocephalic veins

A

jugular (branches into internal and external)

subclavian

155
Q

branches of subclavian veins

A

cephalic

axillary

156
Q

branches of axillary veins

A

basilic

brachial

157
Q

median cubital vein

A

anastomose with basilic & cephalic veins

common venipuncture site

158
Q

coronary sinus

A

drains directly into right atrium

159
Q

inferior vena cava

A

hepatic
renal & suprarenal
gonadal
common iliac

160
Q

hepatic vein

A

becomes hepatic portal vein

branches: gastric, mesenteric, splenic

161
Q

common iliac vein

A

internal

external

162
Q

external iliac vein

A
femoral
great saphenous (longest vein, begins median ankle)
163
Q

atrial natriuretic peptide

A
  1. increased blood pressure/volume
  2. stretched atrial walls
  3. ANP released
  4. stimulates water/Na+ release, inhibits aldosterone, surpasses thirst, dilates blood vessels
  5. increased fluid loss, reduced fluid gain, reduced blood pressure
164
Q

hydrostatic pressure (HP)

A

force generated by pressure on capillary wall

165
Q

oncotic (colloid osmotic) pressure (OP)

A

force exerted by proteins (albumin) present in blood or interstitial fluid on capillary walls

166
Q

HP > OP

A

fluid forced out of capillary (24L/day)

167
Q

HP < OP

A

fluid reabsorbed into capillary (20.4L/day)

168
Q

lymphatic capillaries

A

absorb remaining fluids (3.6L/day)

169
Q

net filtration pressure

A

difference between hydrostatic and oncotic pressure

170
Q

total capillary net filtration pressure

A
CH - capillary hydrostatic pressure
CO - capillary oncotic pressure
IH - interstitial hydrostatic pressure
IO - interstitial oncotic pressure
(CH + IO) - (CO + IH)