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103 theme 3 > Introduction to circulation > Flashcards

Introduction to circulation Flashcards

1
Q

what is the function of circulation

A

supply oxygen and nutrients to tissues and remove waste (co2 and heat)
homeostasis of extracellular fluid (via kidneys)
distribute hormones
regulate temperature
infection defence

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2
Q

how do circulatory pathologies arise

A

diminished oxygen and diminished perfusion (compelling symptoms derived from waste)

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3
Q

what is the function go the cardiovascular system

A

perfusion (flow) which requires a pressure difference (pressure and resistance are closely linked)

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4
Q

why must correct blood pressure be maintained

A

blood pressure too low then there’s insufficient delivery of blood and oxygen

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5
Q

what does hypertension cause

A

vessel damage, heart damage and other pathologies

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6
Q

what does hypotension cause

A

syncope (shock) via insufficient perfusion (common death in the critically ill)

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7
Q

what are the two sides of the heart

A

right - pulmonary

left - systemic

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8
Q

what are the principles of blood pressure and flow

A

determined by heart, blood volume and vessels

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9
Q

how can BP be calculated

A

BP = cardiac output x peripheral resistance

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10
Q

how can BP be measured

A

korotkoff sounds
via a blood pressure cuff
artery closed/ open = no sounds but at right pressure it opens and closes (systole then diastole) = sounds

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11
Q

what is the function of the aorta and arterioles

A

aorta - stretch and recoil, store energy

arteries - distribute and adjust volume

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12
Q

what is the function of the venules and veins

A

venules - collect blood, some exchange

veins - reservoir (2/3 blood in veins), muscle pump

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13
Q

what is the structure of blood vessels

A

intima (endothelium, basement membrane and lamina propria)
internal elastic membrane
media (smooth muscle and some elastic fibres)
adventitia
vasa vasorum (VAN)

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14
Q

how do arteries and arterioles compare

A

arteries - muscular and thick elastic walls

arterioles - muscular and little connective tissue

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15
Q

how do veins and venules compare

A

veins - thin walls, smooth muscle, flacid

venules - thin walls with some smooth muscles

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16
Q

how do systemic and pulmonary circulation compare

A

pulmonary - right ventricle, thin walled, crescent x section (lungs only, low pressure, high flow, low resistance)
Systemic - left ventricle, thick walled, circular x section (multiple organs, high pressure, variable flow, variable resistance)

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17
Q

what is the apex beat

A

at systole, the apex of the heart moves forward to strike the chest wall

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18
Q

what prevents valve prolapse

A

chordae tendinae attached to papillary muscles (2 mitral and 3 tricuspid)

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19
Q

what is the function of the mitral and tricuspid (AV) valves

A

papillary fibres close in systole (S1 1st heart sound, Lub)

20
Q

What is the function of the aortic and pulmonary (semilunar) valves

A

close during diastole (longer than systole) (S2 2nd heart sound, dub)

21
Q

how does the heart muscle (cardiomyocytes) contract

A

by a conducting system
myocyte is electrically activated (Action potential, extra cell (negative) to intracell (positive) as free intracellular calcium increases
muscle contracts
calcium removed and muscle relaxes

22
Q

how is blood volume set

A

by the kidneys (water and sodium central to this as depends on water intake)

23
Q

do formed elements have any effect on blood pressure

A

not unless blocking entire vessels

24
Q

how is BP determined

A

balance between circulating blood volume and circulating capacity

25
Q

what do the kidneys control

A

blood volume and the concentration of salts, ions, electrolytes

26
Q

how is blood filtered in the kidney

A

small molecules (H20, glucose, ions) go through nephron (contains glomerulus)
blood cells and protein can’t pass
desirable small molecules reabsorbed
excess fluid and undesirables left in bladder and excreted

27
Q

what controls filtration in the kidney

A

endocrine system and autonomic nervous system

28
Q

how can the rate of filtration be changed

A

constrict afferent arteriole (decrease)

dilate afferent and constrict efferent arteriole (increase)

29
Q

what is the renal portal system (filtration, reabsorption, secretion, excretion)

A 
afferent arteriole 
glomerulus
bowman's capsule
urinary excretion
or continue to efferent arteriole to peritubular capillaries to the renal vein
30
Q

how many glomeruli are there

A

1 million in a kidney

one input via the afferent arteriole and two exits via bowman’s capsule or via efferent arterioles

31
Q

what is the glomerular filtration rate

A

fluid entering all bowman’s capsules in ml/min
increasing GFR = fluid loss to urine
increasing renal blood flow = increases GFR

32
Q

what is hypoxia/ anoxia/ hypoxaemia

A

insufficient O2 supply to region/ entire body

anoxia (complete deprivation)

33
Q

what causes insufficient O2 in tissues

A 
low haemoglobin (anaemia)
tissue consumption to much for flow
lung - failure of gas exchange/ breathing
34
Q

what is ischaemia

A

insufficient blood flow to a region

35
Q

what causes ischaemia

A

vessels clogged, constricted or closed
insufficient blood volume (eg haemorrhage)
heart generates insufficient pressure

36
Q

What is angina pectoris

A

a symptom
chest pain (overexertion of (damaged) heart tissue)
with/without physical exertion

37
Q

how can angina pectoris be treated

A

nitrates for immediate relief

long term as per CHD

38
Q

what causes angina pectoris

A

ischaemia of the heart tissue due to obstruction/ spasm of coronary artery
ultimately may be caused by coronary artery disease/ embolism

39
Q

what is myocardial infarction

A

death of one region of the heart

40
Q

what are signs of MI

A

sudden crushing chest pain from occlusion of coronary artery

41
Q

how can MI be treated

A

immediate reperfusion (morphine, nitrates, aspirin, oxygen)

42
Q

what is heart failure

A

pumps out insufficient blood resulting from previous MIs

43
Q

what are symptoms of heart failure

A

fatigue, dysponea, oedema

44
Q

what is shock

A

critically low perfusion eg haemorrhagic shock

affects cerebral and renal function

45
Q

what is syncope

A

loss of consciousness due to insufficient blood flow to the brain due to heart failure (shock, arrhythmia)

103 theme 3 (20 decks)

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