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CVP exam 2 > cvp exam 2 > Flashcards

cvp exam 2 Flashcards

1
Q

what has a main function of delivering adequate oxygen, nutrients to the systemic tissues and remove carbon dioxide and other waste products of the system tissues

A

systemic circulation

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2
Q

what serves as the conduit for transport of hormones, and other substances and allows these substances to potentially act at a distant site from their production

A

systemic circulation

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3
Q

what is designed to carry blood under high pressure out to the tissue beds

A

systemic arteries

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4
Q

what acts as control valves to regulate local flow

A

arterioles and pre capillary sphincters

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5
Q

what allows the exchange between tissue(cells) and blood

A

capillaries

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6
Q

how thick are capillaries

A

one cell layer

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7
Q

what collects blood from capillaries

A

venules

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8
Q

what returns blood to the heart/dynamic storage

A

systemic veins

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9
Q

what is blood flow proportional to

A

metabolic demand

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10
Q

what is cardiac output controlled by

A

local tissue flow

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11
Q

what is arterial pressure control independent of

A

local flow or cardiac output

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12
Q

what are the 4 components of vessles

A

endothelium, elastic tissue, smooth muscle, and fibrous tissue

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13
Q

one layer of what exists in all vessels

A

endothelium

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14
Q

what vessel has a high amount of elastic tissue a moderate amount of fibrous tissue and low amount of smooth muscle

A

aorta

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15
Q

what type of vessel has a high amount of smooth muscle a moderate amount of elastic tissue and a low amount of fibrous tissue

A

a typical artery

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16
Q

what type of vessel has equal parts elastic tissue, smooth muscle and fibrous tissue

A

a vein

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17
Q

what is a capillary composed of

A

only endothelium

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18
Q

what does the equation V = IR represent

A

ohm’s law

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19
Q

what is analogous to ohm’s law (V=IR)

A

⌂P = QR

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20
Q

flow(Q) is directly proportional to

A

⌂P

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21
Q

flow(Q) is inversely proportional to

A

Resistance (R)

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22
Q

what is the volume of blood that passes a certain point per unit time referred to as

A

flow (Q)

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23
Q

what is the equation used to determine flow

A

Q=⌂P/R

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24
Q

at a given Q the greater the drop in P in a segment or compartment the greater the

A

resistance to flow

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25
Q

what is the driving force of blood which is also proportional to flow

A

pressure gradient

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26
Q

what is the difference in pressure between two points

A

pressure gradient

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27
Q

independence of local flow control, minimizing total peripheral resitance, and oxygen rich blood supply to every tissue are all advantages of what

A

a parallel circuit

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28
Q

what is internal friction of a fluid associated with the intermolecular attraction

A

viscosity

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29
Q

what is the viscosity of blood

A

3

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30
Q

where does most of blood viscosity come from

A

RBC’s

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31
Q

what is the viscosity of plasma

A

1.5

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32
Q

what is the viscosity of water

A

1

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33
Q

in terms of viscosity when blood is going slow it is ____ and when it is going fast it is _____

A

thicker, thinner

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34
Q

if velocity decreases what will happen to the viscosity of blood

A

the viscosity will increase

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35
Q

when cells get stuck at constriction points momentarily what does it do to viscosity

A

increases apparent viscosity

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36
Q

where do cells line up to decrease the viscosity to offset the cells from getting stuck at constriction points

A

in small vessels with a diameter less that .3mm

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37
Q

which type of flow is streamline,silent,most efficient, and normal

A

laminar flow

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38
Q

what type of flow is cross mixing, vibrational noise, least efficient, and frequently associated with vessel disease (bruit)

A

Turbulent flow

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39
Q

the greater the R# the greater the probability for

A

turbulance

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40
Q

if R# is <2000 flow is usually what

A

laminar

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41
Q

if R# is >3000 is usually what

A

turbulant

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42
Q

when using Doppler ultrasonic flow-meter a broad band is associated with

A

turbulent flow

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43
Q

when using Doppler ultrasonic flow-meter a narrow band is associated with

A

laminar flow

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44
Q

Fick principal and indicator dilution are used to determine what

A

cardiac output

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45
Q

venous occlusion plesthymography, doppler ultrasonic flowmeter and vascular flow cuffs are used to determine what

A

vessel flow

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46
Q

what is a small cuff that fits around a vessel. and is an electromagnetic measuring device

A

Vascular flow cuff

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47
Q

what is represented by the following equations Flow = amount of substance per min / AV difference

A

fick principal

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48
Q

what is the ability of a vessel to stretch known as

A

distensibility

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49
Q

what is the ability of a vessel to stretch and hold volume known as

A

compliance

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50
Q

which vessel is thick has low distensibility, low compliance and contains ~15% of blood volume

A

Artery

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51
Q

which vessel is thin has high distensibility, high compliance, and holds ~65% of blood volume

A

Vein

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52
Q

what does the following equation represent ⌂ vol / ⌂ pressure X initial volume

A

Distensibilty

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53
Q

what does the following equation represent ⌂ Vol /⌂ pressure

A

compliance

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54
Q

what does distensibility X initial vol. determine

A

compliance

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55
Q

where is a small change in volume associated witha large change in pressure

A

systemic arteries

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56
Q

where is a large change in volume associated with a small change in pressure

A

systemic veins

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57
Q

viens are about __ times more distensible and __ times more compliant than systemic arteries

A

8X, 24X

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58
Q

local blood flow is regulated in proportion to

A

metabolic demand

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59
Q

what type of control involves vasodilation and vasoconstriction of precapillary resistance vessels

A

short term control of blood flow

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60
Q

what type of control involves changes in tissue vascularity

A

long term control of blood flow

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61
Q

the formation or dissolution of vessels as well as vascular endothelial growth factor and angiogenin are associated with what

A

long term control of blood flow

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62
Q

in regards to blood flow: what acts as an integrator of multiple inputs, are richly innervated by SNS vasoconstrictor fibers and have alpha receptors, and may be effected by local factors

A

arterioles

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63
Q

Adenosine, CArbon Dioxide, adenosine phosphate compounds, histamine, potassium ions, hydrogen ions, PGE & PGI series prostoglandins, NO, CO are all what

A

local vasodilators

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64
Q

what is the ability to keep blood flow constant in the face of a changing arterial blood pressure known as

A

autoregulation

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65
Q

in the kidney both renal flow and the glomerular filtration rate are what

A

autoregulated

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66
Q

what is the production of new microvessels referred to as

A

angiogenesis

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67
Q

the shear stress caused by enhanced blood flow velocity associated with partial occlusion is referred to as

A

arteriogenesis

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68
Q

small peptides that stimulate growth of new vessels such as VEGF are referred to as

A

angiogenic factors

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69
Q

what is it called when mesenchymal cells differentiate into endothelial cells

A

vasculogenesis

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70
Q

what is the formation of new blood vessels by sprouting from pre existing small vessels ( usually lacking developed tunica media) called

A

angiogenesis

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71
Q

what is the rapid proliferation of pre-existing collateral vessels with fully developed tunica media

A

arteriogenesis

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72
Q

what are the mechanical tirggers of angiogenesis

A

hemodynamic and shear stress

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73
Q

what is the broad term from producing new vessels (vasculogenesis, angiogenesis, arteriogenesis)

A

Neovascularization

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74
Q

what are the chemical triggers of angiogenesis

A

hypoxia and NO

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75
Q

decreased glucose, increased VEGF, inflammation, and angiogenic growth factors are all example of what kind of angiogenic triggers

A

molecular

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76
Q

fibroblast growth factor, VEGF, placenta growth factor, and angiopoietin are all what type of growth factor

A

angiogenic growth factors

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77
Q

protein therapy, Gene therapy, and cellular therapy are all example of what type of angiogenesis

A

therapeutic angiogenesis

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78
Q

what method of therapeutic angiogenesis utilizes growth factor proteins

A

protein therapy

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79
Q

what method of therapeutic angiogenesis utilizes manipulation of gene expression for angiogenic peptides

A

Gene therapy

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80
Q

what method of therapeutic angiogenesis utilizes cells that produce angiogenic factors are introduced into ischemic tissue

A

cellular therapy

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81
Q

inhibition of platelet aggregation, and relaxation of vascular smooth muscle (dilating) is a result of the release of what

A

prostacyclin (PGI2)

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82
Q

Release of NO in healthy endothelium results in

A

vasodilation

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83
Q

release of endothelin to damaged endothelium causes what to happen to vascular smooth muscle

A

constricts vascular smooth muscle

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84
Q

what is the functional unit of circulation

A

capillary

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85
Q

where does the bulk of exchange take place

A

capillary

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86
Q

diffusion,ultrafiltration, and vesicular transport are all example of what

A

mechanisms of exchange

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87
Q

if flow doubles and we don’t uptake any more oxygen what happens

A

non-functional flow increase

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88
Q

if flow doubles and we have and increase in uptake of oxygen what will happen

A

metabolic demand increase

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89
Q

what are non nutritive flow increases associated with

A

shunting of blood

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90
Q

what is the average capillary hydrostatic pressure gradient

A

17mmHg

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91
Q

what is the average interstitial hydrostatic Pressure gradient

A

-3 mmHg

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92
Q

what does high hydrostatic pressure favor

A

filtration

93
Q

what does low colloid osmotic pressure favor

A

reabsorption

94
Q

what is the average colloid osmotic pressure of a capillary

A

28mmHg

95
Q

what is the average interstitial colloid osmotic pressure

A

9mmHg

96
Q

what proteins can exert osmotic pressure

A

only those that cannot cros the capillary wall

97
Q

what may have walls that can range from tight junctions(blood brain barrier) to discontinuous(liver)

A

capillaries

98
Q

what capillaries have filtration slits (fenestrations)

A

glomerular capillaries in the kidneys

99
Q

if all colloid proteins freely cross the capillary wall none are reflected(no colloid effect) what is the reflection coefficeint and what tissue may this be in

A

RC=0 in the liver

100
Q

if all colloid protiens are reflected and none cross the capillary wall (full colloid effect) what is the reflection coefficient and what tissue may this be found in

A

RC=1 in the blood brain barrier

101
Q

superficial portions of the skin, the CNS, endomysium of muscle and bones all lack what type of vessels

A

lymphatic vessels

102
Q

____ duct drains the lower body and left side of head,left arm, and part of the chest

A

thoracic duct

103
Q

_____ duct drains the right side of the head, neck and right arm and part of the chest

A

right lymph duct

104
Q

what acts as the lymphatic system in the CNS

A

perivascular spaces

105
Q

what spaces contain CSF and communicate with subarachnoid space functioning as the “lymphatic system” of the CNS

A

perivascular spaces

106
Q

any factor that increases filtration and/or decreases reabsorption will do what to lymph formation

A

increase

107
Q

how much lymph flows through the thoracic duct

A

100ml/hr

108
Q

how much lymph flows through the right lymph duct

A

20ml/hr

109
Q

what is the total lymph flow

A

120ml/hr or 2.9L /day

110
Q

return of lost protein to the vascular system, draining of excess plasma filtrate from the ISF space, carrying absorbed substances/nutrients from the GI tract are all function of what system

A

lymphatics system

111
Q

a meshwork of sinuses lined with tissue macrophages is a description of what

A

a lymph node

112
Q

the volume of blood interacting with the wall is refered to as

A

arterial blood pressure

113
Q

when the left ventricular output is greater than peripheral runoff the heart is in

A

systole

114
Q

during what phase does total blood volume rise causing arterial blood pressure to increase to a peak

A

systole

115
Q

during systole the arteries are _____

A

distended

116
Q

during what phase of the heart is the the left ventircle is filling, the arteries are recoiling, serving to maintain perfusion to the tissue beds

A

diastole

117
Q

when total blood volume in the arterial tree is decreasing causing arterial blood pressure to fall to a munium value what is this phase of the heart called

A

diastole

118
Q

what represents the maximum pressure in the systemic arteries

A

systolic blood pressure

119
Q

pressure peaks as blood is ejected from the left bentricle into the aorta during what phase

A

systole

120
Q

the minimum pressure in the systemic arteries

A

diastolic blood pressure

121
Q

increased cycle length will do what to diastolic blood pressure

A

decrease

122
Q

increased total peripheral resistance (TPR) will do what to diastolic blood pressure

A

increase

123
Q

what two factors does how low the diastolic blood pressure will fall depend on

A

cycle length (CL) and total peripheral resistance (TPR)

124
Q

when may diastolic blood pressure not change much due to decrease in cycle length being offset by decreased total peripheral resistance

A

during excersise

125
Q

1/3 pulse pressure + diastolic blood pressure roughly yields what

A

Mean Arterial Blood Pressure (MAP)

126
Q

critical luminal pressure is required to keep arterioles from doing what

A

closing completly

127
Q

vascular tone is proportional to what

A

critical closing pressure

128
Q

as arterial pressure falls, ther is a critical pressure below which, flow ceases due to …

A

closure of arterioles

129
Q

if cardiac output is stopped, arterial pressure will fall and venous pressure will do what

A

rise

130
Q

the equilibration pressure where arterial blood pressure is equal to venous blood pressure is know as

A

mean circulatory filling pressure (MCFP)

131
Q

equilibration pressure may be prevented by what

A

the closure of arterioles (critical closing pressure)

132
Q

what is responsible for pressure gradient driving peripheral venous return

A

Mean Circulatory filling pressure

133
Q

at a given mean circulatory filling pressure as central venous pressure increases venous return will do what

A

decrease

134
Q

if MCPF = CVP venous return will equal what

A

0

135
Q

as central venous pressure increases, cardiac output increases due to what effects

A

intrinsic and extrinsic

136
Q

the pressure in the central veins at the entry into the fight atrium are referred to as the

A

central venous pressure

137
Q

central venous pressure is equal to

A

right atrial pressure

138
Q

the pressor center, depressor center, sensory area, and cardioinhibitory area are the four major regions of what

A

Vasomotor center

139
Q

the pressor center of the vasomotor center functions to

A

increase blood pressure

140
Q

the depressor center of the vasomotor center functions to

A

decrease blood pressure

141
Q

the sensory area of the vasomotor center functions to

A

mediate baroreceptor reflex

142
Q

the cardioinhibitory area of the vasomotor center functions to

A

stimulate CN X

143
Q

what center of the vasomotor center causes vasoconstiction, stimulates cardiac activity, and is tonically active exiting SNS outflow and is located in the anterolateral portion of the upper medulla

A

the pressor center of the vasomotor center

144
Q

what center of the vasomotor center has fibers that project into and inhibit the pressor center, causes decreased cardiac activity, and vasodilation, and is located in the anterolateral lower part of the M.O.

A

the depressor center of the vasomotor center

145
Q

what area of the vasomotor center receives input primarily from CN IX and X, has outputs to both pressor and depressor centers, mediates baroreceptor reflex and is located in the posterolateral portions of the pons and medulla in the nucleus tractus solitarius

A

Sensory Area

146
Q

what area of the vasomotor center transmits impulses into DMNV inhibiting heart activity and is located medially next to dorsal motor nucleus of vagas

A

cardioinhibitory area

147
Q

what maintains normal arterial blood pressure and is due to pressor center input

A

sympathetic vasoconstrictor tone

148
Q

rapid short term control of blood pressure involves the nervous system effect on what

A

vascular smooth muscle

149
Q

long term control of blood pressure is dominated by what organ

A

kidneys

150
Q

control of blood pressure is accomplished by affecting what two things

A

vascular tone or blood volume

151
Q

where are baroreceptors especially abundant in

A

carotid sinus and the arch of the aorta

152
Q

baroreceptors are stimulated when stretched and inhibit was vasomotor center

A

pressor center

153
Q

what receptors are located in atrial walls and pulmonary arteries and minimize arterial pressure changes in response to blood volume changes

A

low pressure baroreceptors

154
Q

which reflex senses low pressure

A

baroreceptor reflex

155
Q

which reflex senses increased heart rate

A

Bainbridge reflex

156
Q

increased total peripheral resistance will not create a long term elevation of blood pressure if what does not change

A

fluid intake and renal function

157
Q

what is the normal glomerular filtration rate

A

~100ml/min

158
Q

what is normal renal blood flow

A

~1.25L/min

159
Q

in the kidney constriction of afferent arterioles will have what effect on renal flow and GFR

A

decrease both

160
Q

in the kidney constriction of efferent arterioles will have what effect on renal flow and GFR

A

decrease renal flow but increase GFR (by creating back pressure)

161
Q

with rising arterial blood pressure constriction of what arterioles alone can autoregulate flow and GFR

A

afferent arterioles

162
Q

what happens to arterial pressure when extracellular fluid levels rise

A

they rise as well

163
Q

SNS stimulation, the renin-angiotensin system, aldosterone and ADH all have what effect on chronic blood pressure

A

raise it

164
Q

what effect does ANP have one chronic blood pressure

A

decrease it

165
Q

is the heart an endocrine organ

A

yes

166
Q

norepinephrine, epinephrine and angiotesin II have what effect on renal blood flow

A

decrease

167
Q

what hormone increases renal blood flow

A

Prostaglandins (E and I)

168
Q

what monitors the Nacl in the macula densa of the distal tubule

A

tubuloglomerular feedback

169
Q

where does tubuloglomerular feedback take place

A

between the afferent and efferent arteriole

170
Q

renin is released from the juxtaglomerular cells causeing an increase in angiotensin II levels, causing and increase in efferent arteriole resistance in turn causing an overall increase in total blood pressure. what causes this cascade of events

A

a decrease in NaCl in the Macula densa

171
Q

decrease in NaCl in the macula densa causes dilation of what arteriole

A

afferent

172
Q

where is the synthesis, storage, and release of renin from

A

smooth muscle cells in afferent arterioles

173
Q

decreased perfusion pressure, SNS stimmulation, decreased NaCl delivery to the macula densa as well as thyroid and growth hormone all stimulate the release of what enzyme from smooth muscle cells in afferent arterioles

A

Renin

174
Q

what enzyme catalyses the formation of angiotensin 1 from angiotensinogen,

A

Renin

175
Q

angiotensin I changes into angiotensin II via angiotensin converting enzyme in what tissue

A

primarily the pulmonary endothelium of the lungs

176
Q

what hormone stimulates the adrenal cortex to secrete aldosterone, stimulates the release of ADH/vasopressin, and stimulates the kidneys

A

angiotensin II

177
Q

the decrease of Na and H2O excretion from angiotensin II has what effect on blood pressure

A

increases blood pressure

178
Q

increasing what will reduce the number of free radicals allowing nitric oxide (a dilator) to have a longer lasting effect in lowering blood pressure

A

antioxidants

179
Q

what inactivates nitric oxide

A

superoxide

180
Q

glutathione, melatonin, superoxide dismutase, beta-carotene, lutein, lycopene, selenium, Vit A, Vit C, Vit E, are all examples of what

A

antioxidants

181
Q

what humoral substance may act at the CNS to inhibit relex SNS activation

A

Serotonin

182
Q

what humoral substance may act centrally to inhibit sympathetic nerve activity

A

Nitric Oxide

183
Q

what humoral substances my promote bradycardia and hypotension

A

Serotonin, Nitric Oxide

184
Q

the umbilical arteries are branches off the anterior lilac arteries supplies blood to what

A

the placenta

185
Q

blood returns to the fetus from the placenta via what vessel

A

umbilical vein

186
Q

what fetal shunt fits the following path SVC –> RA –>RV –> pulmonary trunk –> ______–>aorta

A

Ductus arteriosis (DA)

187
Q

what fetal shunt fits the following path IVC –> RA–>______ –>LA –> LV –> aorta

A

foramen ovale (FO)

188
Q

what fetal shunt fits the following path umbilical vein –>_____–>IVC

A

Ductus Venosus (DV)

189
Q

what fetal shunt fits the following path portal vein –____–>IVC

A

Ductus Venosus (DV)

190
Q

what fetal shunts allow blood to bypass the lungs

A

ductus arteriosus and foramen ovale

191
Q

what fetal shunt allows the umbilical and portal blood to bypass the liver

A

ductus venosus

192
Q

how does oxygen saturation in the fetal blood compare to that of an adult

A

it is lower compared to an adult

193
Q

upon birth pulmonary vascular resistance decreases causing an increase of blood flow through which organs

A

lungs and liver

194
Q

how does the loss of blood flow through th placenta effect the systemic vascular reistance

A

it doubles the systemic vascular resistance

195
Q

the reversal of pressure gradient between the RA and LA causes what to close

A

foramen ovale

196
Q

reversal of flow from the aorta to the pulmonary artery, and increased oxygen levels causes constriction of smooth muscles causing the closure of what

A

ductus arteriosis

197
Q

the closure of what allows portal blood to perfuse liver sinuses

A

Ductus venosus

198
Q

patent ductus arteriosus,ventricular septal defect, transposition of great vessels and tetrology of follot are all examples of what

A

congenital deftects

199
Q

what congenital defect is associated with right ventricular hypertophy, large ventricular septal defect, right ventricular outflow obstruction and overrides the aorta

A

tetrology of fallot

200
Q

what are symptoms of tetrology of fallot

A

cyanosis, dyspnea

201
Q

increased heart rate and decreased blood flow to organs are associated with what activity

A

excersise

202
Q

during exercise cardiac output is increased how much

A

5-6 fold

203
Q

vasoconstriction of arterioles to decrease flow to non active tissues, and vasoconstriction of veins to increase MCFP which increases venous return are both SNS effects activated by what

A

excersise

204
Q

during excersise an increased O2 uptake will decrease VO2 causing what to happen to AVO2 difference

A

increase in AVO2 difference

205
Q

increased heart rate and stroke volume induces what at the heart

A

local metabolic vasodilation

206
Q

during exercise: reflex signals from active joint prorioceptors and muscle spindles, as well as local chemoreceptor signals originating in the active muscle stimulate what

A

SNS

207
Q

SNS stimulation of pre-capillary resistance vessels during excersise (organs and inactive skeletal muscle) has what effect on blood flow

A

decreases blood flow

208
Q

SNS stimulation of veins during excersise causes constriction which mobilizes blood out of veins doing what to venous return

A

increases by the redistribution of blood volume

209
Q

SNS stimulation of vascular smooth muscle in walls of arteries helps maintain slightly ______ blood pressure during excersise

A

increased

210
Q

will skeletal muscle activation trump SNS stimulation during excersise

A

yes

211
Q

does metabolism trump constrictor effects during excersise

A

yes

212
Q

increase in systolic blood pressure during exercise is due to what

A

increase in cardiac output

213
Q

increased blood flow to the active muscles during exercise is not mediated by SNS but by the local release of _____________

A

tissue metabolites

214
Q

tissue metabolites are released in response to the increase in what

A

metabolism local vasodilators

215
Q

adenosine,CO2,K+ histamine and lactic acids are examples of

A

local vasodilatiors

216
Q

coronary, and active muscle blood flow both _______ with excersise

A

increase

217
Q

what % of blood flow is redirected to active muscle during excersise

A

90%

218
Q

what is the cardiovascular endpoint that decreases with excersise

A

total peripheral resistance will decrease, and stroke volume will increase then decrease

219
Q

the maximum volume of oxygen that one can take up from the lungs and deliver to the tissues/minute is known as

A

VO2 Max

220
Q

what is the VO2 max in a cadiac patient

A

1.5L/min

221
Q

what is the VO2 max in a sedentary man

A

3.0L/min

222
Q

what is the VO2 max in a endurance athlete

A

6.0L/min

223
Q

the VO2 max is proportional to what as training occurs

A

stroke volume

224
Q

the function of cardiac output and AVO2 difference is

A

VO2 max

225
Q

if energy demands of excercise cannot be met by oxidative phosphorylation what occurs

A

O2 debt

226
Q

how does O2 debt get repayed

A

by respiration remaining elevated after excercise

227
Q

restoring metabolite levels and metabolizing lactate generated by glycolysis is resolved by

A

extra O2

228
Q

energy consumed during exercise - the energy supplied by oxidative metabolism yields what

A

O2 debt

CVP exam 2 (1 decks)

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