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ACOLS WRITTEN TEST > Day Two - Physiology > Flashcards

Day Two - Physiology Flashcards

1
Q

Define diffusion.

A

migration of particles from higher to lower concentration

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2
Q

There is more O2 in blood than in _________, so

02 _________ blood capillaries by process of _______.

A

tissues
leaves
diffusion

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3
Q

Define diffusion distance, as it relates to lymphedema.

A

distance between blood capillaries and cells in the tissues

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4
Q

Swelling ___________ the normal diffusion distance.

A

increases

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5
Q

Name some ways increased diffusion distance negatively impacts tissues?

A
  • local immune response is compromised
  • nutritional supply to cells suffer
  • frequent infections/increased risk for infections

SKIN CARE IS IMPORTANT TO MANAGE RISK

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6
Q

Define COP pl

A

the force of proteins to hold onto water in the blood plasma (equals 25 mm Hg)

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7
Q

In healthy individuals, COP pl is ________ COP ip.

A

greater than

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8
Q

Define COP ip

A

the force of proteins to pull water into the interstitial spaces

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9
Q

In a 24 hour period, approximately what percentage of circulating proteins will leave the blood (at the blood capillary), and move into the interstitial space?

A

50%

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10
Q

Is BP higher or lower than BCP?

A

higher

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11
Q

What is the average BP at the artery?

A

100 mm Hg

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12
Q

What is the average BP at the vein?

A

3-4 mm Hg

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13
Q

Return of blood to the heart depends on…

A
  • muscle pump
  • functioning valves
  • diaphragmatic breathing
  • suction effect of heart at diastole
  • pulsation of adjacent arteries
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14
Q

How does the precapillary sphincter impact the flow of blood to the capillaries, when in constricts?

A

contracts = less blood in capillaries - less volume = decreased BCP

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15
Q

Filtration occurs at the _______ end of the blood capillary.

A

arterial

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16
Q

Reabsorption occurs at the ______ end of the blood capillary.

A

venous

17
Q

Define reabsorption.

A

Process by which water is reabsorbed from tissues back into the venous end of the BC - water picks up waste products and returns them to venous system.

18
Q

What percentage of H2O is reabsorbed by venous system?

A

80-90%

19
Q

How does H2O remain in the interstitial spaces?

A

Proteins (hydrophilic macromolecules) exist in the interstitial spaces, and hold back 10-20% of the water. This is referred to as the lymphatic load of water, or net filtrate. Removal of LL is the responsibility of the lymphatic system.

20
Q

Describe the classic view of Starling’s Law.

A

Arterial blood capillary pressure (29 mm Hg) > colloid osmotic pressure of the plasma, causing protein to be forced out into the interstitial space, at the level of arterial capillaries. On the venous end, blood capillary pressure (14 mm Hg) < colloid osmotic pressure of the plasma, favoring return of fluid into the venous system (80-90%). Proteins are unable to cross the semi-permeable membrane back into the venous system, resulting in protein rich fluid in the interstitial space. This fluid, is managed by the lymphatic system.

21
Q

Name the components of CDT.

A
  • MLD
  • skin care
  • exercise
  • compression
22
Q

How is compression beneficial in lymphedema?

A

It increases the tissue pressure directed against the capillaries, which hinders filtration and supports reabsorption.

23
Q

Define active hyperemia.

A

anything that causes vasodilation and increased arterial flow

24
Q

How does active hyperemia influence fluid homeostasis?

A

increased arterial flow - increased volume - higher arterial BCP - increased filtration - increased net filtrate

25
Q

Name some common causes of active hyperemia.

A
  • deep tissue massage
  • inflammation/infection
  • temperature/thermal modalities
  • sunbathing
  • vigorous exercise
26
Q

Define passive hyperemia.

A

increase in BCP caused by an obstruction of venous return or deficiency of venous outflow - blood pools into capillaries

27
Q

How does the body respond to active and/or passive hyperemia?

A

activation of the lymphatic safety factor, through increase in lymphangiomotoricity and increased lymph time volume

28
Q

Define functional reserve.

A

The difference between transport capacity (LS working at max amplitude and frequency) and lymphatic load, as the LS will only work as hard as it needs to (lymph time volume), to manage current LL.

i.e. the availability for compensation

29
Q

Define dynamic insufficiency.

A
  • healthy LS is overwhelmed
  • AKA high volume insufficiency, where LL of H2O > TC
  • LTV is “maxed out”
  • results in EDEMA (which is a symptom)
30
Q

Describe mechanical insufficiency.

A
  • TC drops below normal amount of LL
  • AKA low volume insufficiency
  • due to damage to the LS
  • results in LYMPHEDEMA (which is a disease)
31
Q

Identify important characteristics of dynamic insufficiency.

A
  • healthy LS
  • TC is normal
  • LL > TC
  • protein concentration in tissue is normal
  • high volume insufficiency
  • MLD/CDT not indicated
  • max LTV = TC
  • results in edema
32
Q

Identify important characteristics about mechanical insufficiency.

A
  • unhealthy LS
  • TC is subnormal
  • LL could be normal, but > subnormal TC
  • protein concentration in tissue is > than normal
  • low volume insufficiency
  • MLD/CDT indicated
  • max LTV = subnormal TC
  • results in lymphedema
33
Q

Identified important characteristics of combined insufficiency.

A
  • unhealthy LS
  • TC is subnormal
  • LL is > normal and also than subnormal TC
  • protein concentration in tissue is elevated
  • combined insufficiency
  • Max LTV = subnormal TC
  • MLD/CDT indicated
  • results in lymphedema
34
Q

Define combined insufficiency.

A

mechanical insufficiency (that was possible under control) with insult resulting in increased LL

35
Q

What is the current gold standard diagnostic tool for lymphedema?

A

lymphoscintigraphy

36
Q

How does the precapillary sphincter impact the flow of blood to the capillaries, when in dilates?

A

dilates = more blood in capillaries - greater volume = increased BCP

ACOLS WRITTEN TEST (6 decks)

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