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Developmental Concepts > Lec 4 > Flashcards

Lec 4 Flashcards

1
Q

Blood pathway

A
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2
Q

Vascular Development (begins when)

A

3-4 weeks after conception

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3
Q

What cells differentiate into vessels

A

mesodermal

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4
Q

Vasculogenesis vs Angiogenesis

A

vasculo - formation of arteries and veins
ONLY DURING EMBROYONIC DEVELOPMENT

angiogenesis; formation of vascular branches from existing blood vessels OCCURS DURING EMBRYONIC AND THROUGHOUT LIFE

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5
Q

3 layers of blood vessels

A

tunica externa (adventitia) - outer connective tissue

tunica media - middle smooth muscle

tunica intima - inner endothelial layer

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6
Q

large elastic arteries

A

Aorta, left common carotid artery artery

tunica media

elastic fibers to allow expansion and recoil

constant flow of blood during diastole

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7
Q

Medium muscular arteries

A

femoral artery, axillary artery

tunica media

smooth muscle fibers to allow for regulation of diameter and control blood flow to different parts of the body

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8
Q

Small arteries and arterioles

A

controls the filling of capillaries

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9
Q

Distinguishing features of veins

A

larger and more compliant than arteries

thin walls (especially tunica media)

large lumens - larger blood reservoir

*one way valves

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10
Q

One way valves :

A

typically located in veins inferior to the heart

facilitate blood flow toward the heart

affected by autonomic nervous system and skeletal muscle pump

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11
Q

What does the autonomic nervous system regulate

A

BP and peripheral resistance

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12
Q

What are the sympathetic and parasympathetic roles in circulation?

A

sympathetic - increases HR and causes vasoconstriction

parasympathetic - decrease HR and cause vasodilation

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13
Q

Embryo: when does the heart develop

A

3 weeks after conception

recognizable structure after 20 days - heart tube that begins to elongate

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14
Q

When does circulation begin?

A

4 weeks gestation - rhythmic pulsations of primitive heart tube

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15
Q

Gestation
3 weeks
4 weeks
7 weeks

A

week 3; heart and vessels develop

week 4: heart begins to beat and pump blood

week 7: heart forms into 4 chamber structure

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16
Q

Shunting systems (prenatal)

A

small passages for blood to travel through in order to bypass body parts that are not yet developed

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17
Q

shunting systems; foramen ovale
Ductus arteriosus
Ductus venosus

A

foramen ovale; R atrium to L atrium

ductus arteriosus; R pulmonary artery to aorta

ductus venosus; inferior vena cava to umbilical vein

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18
Q

What happens to shunting systems?

A

close and form new structures

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19
Q

foramen ovale

A

fossa ovalis

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20
Q

ductus arteriosus

A

ligamentum arteriosum

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21
Q

umbilical venosus

A

ligamentum teres

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22
Q

ductus venosus

A

ligamentum venosum

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23
Q

umbilical arteries

A

lateral umbilical ligaments

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24
Q

_ % of live births have congenital heart disease

A

1

leading non-infectious death in 1st year

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25
Q

CV development; infancy and childhood

A

left side of heart becomes predominant

left ventricle wall becomes twice as thick by adulthood

heart changes from horizontal to vertical orientation with lung expansion

heart size increases with body weight

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26
Q

Heart volume (infancy and childhood)

A

40 mL at birth
80 mL 6 months
160 mL at age 2

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27
Q

Ratio of heart voume to body weight

A

remains constant = 10 mL/kg of body weight

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28
Q

Cardiac muscle changes in infancy and childhood

A

Myocytes; increase in cross sectional area and number of myofibrils in cross-section

increased contraction of myocyte

myofibrils mature and change from a random orientation to being oriented in the same direction

stroke volume = increased efficiency

NO INCREASE IN THE NUMBER OF MYOCYTES

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29
Q

Vascular changes infancy and childhood

A

increased heart vascularization

at birth - 1 vessel for every 6 muscle fibers

adulthood 1:1 ratio

Fetal blood has more Hb and less O2 saturation

As infants lungs begin to function, blood has less Hb and more O2 saturation

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30
Q

Newborn, 3-6 month and adult Hb levels

A

newborn: 20g/100mL

3-6 month: 10g/100mL

Adult: 14-16g/mL

31
Q

What happens to blood volume through development

A

300-400 mL at birth to 5 L in adults

32
Q

What happens to stroke volume through development

A

increases, directionally proportional to heart size

4mL at birth
40mL in children
60 mL in adults

33
Q

What happens to HR through development

A

decreases

in newborns HR is faster to compensate for lower stroke volume (110)

At one years old, HR decreases to 105 bmp

34
Q

What happens to blood volume during development

A

influenced by development of autonomic nervous system and peripheral vascular resistance

increase is strongly related to increase in height and weight

35
Q

CV development adolescence

A
  • heart size and weight keeps growing
  • increased left ventricle and stroke volume
  • *As body weight increases, blood pressure increases
  • boys > girls
36
Q

CV development adulthood

A
  • heart size may increase due to fatty deposition

most evident in women; increase seen between 30-60s

37
Q

CV changes with aging

A

Vessels become thicker and stiffer and less flexible = increased peripheral resistance = increased BP = heart works harder = muscular walls become thicker

Decreased blood volume and RBC

WBC remain same

(But lymphocytes decrease)

38
Q

Adult heart disease***

A

leading cause of death
1 million heart attacks per year
5 million adults with heart failure

39
Q

conducting zone

A

passageway for air to travel, nose pharanyx, laranyx, trachea, bronchi and bronchioles

40
Q

Respiratory zone

A

located deep in the lungs

respiratory bronchioles, alveolar ducts, alveoli

41
Q

Where is the respiratory center

A

brain stem - medulla oblongata and pons

42
Q

what controls ventilation

A

autonomic nervous system

sympathetic nervous - bronchial dilation

parasympathetic - bronchial constriction

43
Q

Muscles of inspiration

A
  • main: external intercostals, diaphragm

accessory:
- SCM
- Scalenes group
- pec minor

44
Q

exhalation muscles

A

quiet breathing: recoil of lungs, rib cage and diagphram

active breathing: internal intercostals, abdominals, QL

45
Q

Tidal volume;

A

amount of air inhaled or exhaled at rest with each breath

46
Q

residual volume

A

amount of air remaining in the lungs following expiration

47
Q

minute ventilation

A

total volume of air inspired and expired in one minute

48
Q

when is prenatal pulmonary development

A

4-8 weeks

differentiation of trachea, long buds form, bronchi begin to form

49
Q

6 weeks neonatal pulmonary

A

primitive alveoli form

50
Q

8 weeks neonatal pulmonary

A

conducting zone developed

51
Q

24 weeks neonatal pulmonary

A

surfactant is reduced

52
Q

26-28 weeks neonatal pulmonary

A

viable respiratory zone (vascularized terminal sacs and surfactant)

53
Q

Pulmonary at birth

A

rib cage is horizontal and muscles not fully developed

53
Q

What happens after achievement of sitting

A
  • ribs become angled
  • diaphragm forms dome-shaped
  • muscles strogner
  • increased effciency
54
Q

Pulmonary in childhood and infancy

A
  • increased alveoli until 8 years
  • airways are smaller in children
  • decreased smooth muscle in bronchiole walls (until 3-4 years)
  • decreased alveolar elasticity until puberty and collateral ventilation mechanism
  • decreased compliance and elasticity = increased workload for breathing
    *Implications:
  • increased risk of respiratory infections until 6-8
55
Q

Pulmonary adolescence

A
  • increased size proximal airways and vasculature
  • increase in alveolar size, elastic fibers and capillaries to alveoli
    = INCREASED GAS EXCHANGEE

19 YEARS - SMOOTH MUSCLE IN ARTERIAL WALLS OF ALVEOLI ARE FULLY DEVELOPED

56
Q

19 Year pulmonary

A

SMOOTH MUSCLE IN ARTERIAL WALLS OF ALVEOLI ARE FULLY DEVELOPED

efficient control of blood flow through vasoconstriction and vasodilation

57
Q

When do functional impairments of pulmonary present

A

7th decade (60s)

58
Q

Thoracic wall and muscular changes in pulmonary aging (and their result)

A

stiffer bony thorax, decreased joint mobility

decreased expansion of chest wall during breathing

decreased strength and endurance of inspiratory muscles (accessory muscles have to work harder)

altered length-tension relationship of muscles

= INCREASED WORK OF BREATHING

59
Q

Pulmonary adulthood/aging LUNG changes;

A

decreased compliance and elasticity

decrease vital compacity

*body responds to these changes with an increase in breathing rate in order to increase minute ventilation

60
Q

Alveolar changes in adult/aging

A

decreased elasticity - risk for collapse

increased size of lungs and alveoli due to increased residual volume = MORE TIME REQUIRED FOR INSPIRED AIR TO REACH ALVEOLI

61
Q

Vascular changes (pulmonary) in adult/aging:

A

smaller capillary bed around alveoli

decreased blood flow/volume in capillary bed

62
Q

Big picture adulthood/aging

A

PULMONARY SYSTEM IS WORKING HARDER AND LESS OXYGEN IS IS DELIVERED TO THE BODY

63
Q

Newborn

A

HR: 120-125
BP: 73/75
RR: 30-40

64
Q

2 years

A

HR: 110
BP: 91/56
RR: 25-32

65
Q

10 years

A

HR: 90
BP: 102/62
RR: 20-26

66
Q

16 years

A

HR: 75-80
BP: 117/67
RR: 16-20

67
Q

Adult < 45 and
45-65

A

HR: 74-76
BP; 120/80 (140/85)
RR: 10-20

68
Q

Older adult

A

HR” 74-76
BP; 150/85

69
Q

CV Adaptations to long term exercise

A

increased: max cardiac output and SV, plasam volume, hemoglobin, HDL

Decreased; resting HR, BP, LDL

70
Q

Pulmonary Adaptations to long term exercise

A

increased; minute ventilation, vital capacity, tidal volume

decreased: inspiratory/expiratory reserve, respiratory rate at submax exercise

71
Q

What reflect the efficiency of the cardiopulmonary system

A

cardiac output, minute ventilation, maximal aerobic capacity

72
Q

minute ventilation

A

tidal volume x respiratory rate = minute ventilation

73
Q

maximal aerobic capacity

A

determined by level of CV and pulmonary fitness

Developmental Concepts (4 decks)

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