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AP EXAM 4 > LECTURE 29 11/11/22 (LECTURE 16 SLIDES: MICROCIRCULATION) > Flashcards

LECTURE 29 11/11/22 (LECTURE 16 SLIDES: MICROCIRCULATION) Flashcards

1
Q

What is the formula for SVR?

A

SVR = Delta P / Flow (13:23)

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2
Q

What is the normal Peripheral Resistance Unit (PRU) of the Systemic Circulation?

What is the normal PRU for the Pulmonary Vascular Resistance?

A

1 PRU (SVR)

0.14 PRU (SVR)

(17:10)

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3
Q

What is the SVR in CGS (centimeter grams seconds)

What is considered a normal range of SVR in CGS units?

A

1600 CGS units
[(100 mmHg - 0 mmHg)/ 5L/min ] x 80 = 1600

800 to 1600 CGS units

(21:00)

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4
Q

What are the units in the CGS system?

A

Dynes * Sec/Cm ^-5

(22:00)

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5
Q

What is the PVR in CGS units?

What is considered a normal range of PVR in CGS units?

A

128 CGS units
[(16 mmHg - 8 mmHg)/ 5L/min ] x 80 = 128

40 to 180 CGS units

(25:30)

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6
Q

SVR is measured from _________ to ___________.

PVR is measure from _________ to ___________.

A

SVR is from Left Ventricle (100 mmHg) to Right Atrium (0 mmHg)

PVR is from Right Ventricle (16 mmHg) to Left Atrium (2 mmHg)

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7
Q

How do you convert PRU to GCS units?

A

Multiple PRU by 1333 mmHg/ml/sec

(29:50)

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8
Q

What is the formula for conductance?

A

1/ Resistance

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9
Q

Flow is _______ to Delta P and Radius

Flow is _______ to blood viscosity and length.

A

Proportional
(Increase Delta P and Radius will increase Flow)

Inversely Proportional
(Increase in Blood Viscosity and Length will decrease Flow)

(32:40)

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10
Q

What is a normal Hematocrit level?

A

0.4

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11
Q

In laminar flow, where will blood be moving the fastest? slowest?

A

Blood will be moving fastest in the center of the vessel.

Blood will be moving slowest on the side of the vessels.

(38:00)

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12
Q

Why is chaotic or turbulent flow bad?

A
  1. Energy is wasted
  2. Turbulence can cause coagulation
  3. Blood vessels gets damaged by turbulent flow.

(39:22)

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13
Q

What is the formula for Reynold’s Number?

What does Reynold’s Number tell you?

What part of the body can we predict to have turbulent flow base on its velocity and diameter?

A

Reynold’s Number = (Velocity x Diameter x Density) / (Viscosity)

Reynold’s Number tells you the likelihood of turbulent blood flow.

Aorta d/t to large diameter and fast velocity.

(42:00)

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14
Q

What were three ways to measure blood flow and pressure discussed in lecture?

A
  1. Catheter insertion to the CV system and pressure transducer set-up
  2. Sound waves through doppler effect. (Higher flow, higher doppler effect)
  3. Generating a magnetic filed and watching Fe go by. (The faster the Fe, the more influence on the magnetic field)

(45:00)

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15
Q

What are extension of the arteriole that will control whether blood will move through the capillaries?

A

Pre-capillary sphincters

(48:25)

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16
Q

How many capillaries do we have in our systemic circulation?

How big is the surface area of the capillaries?

A

10 billion capillaries

This will give us a huge surface area for case and nutrient exchange. 500 to 700 square meters.

(48:37)

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17
Q

What are the two ways Nitric Oxide is made?

A

ACh or Bradykinin binds to a muscarinic GPCR that activates the release of Ca2+ from the ER. The Ca2+ that is released binds to Calmodulin. The Ca2+-Calmodulin complex activates eNOS which converts arginine to NO.

High shear stress can trigger the release of NO.

(Pharm and Exam 3 Recall) (49:30)

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18
Q

How does NO cause relaxation?

A

NO is diffused from the endothelium to the vascular smooth muscle and activates guanylyl cyclase.

GTP is converted to cGMP

cGMP will activate PKG.

PKG will inhibit Ca2+ channels and activate myosin light chain phosphatase. Leading to relaxation.

(Pharm and Exam 3 Recall) (49:30)

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19
Q

What moves out in the arterial end of the capillary?

What moves in in the venous end of the capillary?

A

O2 and Nutrients are secreted out.

Waste products are absorbed.

(50:00)

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20
Q

Water will sneak through the ____________ in endothelial cells.

A

Intercellular Clefts (50:30)

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21
Q

What describes a protein with a sugar attached to it in the interstitial fluid?

A

Proteoglycan Filament (51:30)

22
Q

Label A, B, C, D.

A

A. Collagen Fiber Bundles
B. Proteoglycan Filaments
C. Free Fluid Vesicles
D. Rivulets of Free Fluid

23
Q

What substance is found in skin lotion and anti-aging cream to prevent wrinkles?

A

Hyaluronic Acid (52:00)

24
Q

What is the consistency of the interstitial fluid?

A

Gel-like consistency.

The Gel will help interfere any excessive water movement from the capillaries and prevents water build up in the interstitium. (52:30)

25
Q

What are areas devoid of gel-like quality in the interstitial fluid called?

A

Rivulets of Free Fluid, just made up of water.

(53:45).

26
Q

What is a way to move immense amount of water into the interstitial space?

A

Infection can affect the capillary permeability where proteins are filtered out and bring quite a bit of fluid along with them.

If enough fluid enters the rivulets of free fluid and expand the size of them. The rivulets can bud up right next to the capillary and make a pathway for water movement resulting in pitting edema.

(55:00).

27
Q

What separates the plasma compartment and interstitial compartment in the Extracellular fluid?

A

Capillary Membrane

28
Q

Plasma makes ups 3 L of our total blood volume. Where does the other 2 L come from?

What percentage of our blood volume makes up plasma?

A

2 Liters come from intracellular fluid, this would get us a total blood volume of 5 Liters. (70:30)

60%

29
Q

What are 4 factors of Capillary Starling Forces and how they influence water movement?

A
  1. Internal Blood Pressure of the Capillary (PCAP)
    (30 mmHg)
  2. Interstitial Fluid Pressure (PISF)
    (-3 mmHg)
  3. Interstitial Fluid Colloid Osmotic Pressure (πISF)
    (8 mmHg)
  4. Capillary Colloid Osmotic Pressure (πCAP)
    (28 mmHg)
30
Q

What is hydrostatic pressure?

What is the hydrostatic pressure at the arteriole end of a capillary?

What is fluid movement out of the capillary called?

A

Another term for PCAP. This is the physical fluid pressure generated by the pump.

30 mmHg

FILTRATION. 30 mmHg of hydrostatic pressure would be pushing fluid out of the capillary.

(72:30)

31
Q

What is the value of the interstitial fluid pressure?

What does this force favor in regards to the capillaries?

What 2 factors stated per lecture contribute to our negative interstitial fluid pressure?

A

-3 mmHg

Filtration, negative pressure will pull fluid out of the capillaries.

  1. Lymphatic System
  2. Skin Tightness

(74:30)

32
Q

Proteins outside the capillary generate how much osmotic pressure?

A

8 mmHg ( πISF, this would favor filtration and pull fluid out of the capillaries.

(77:50)

33
Q

What are the forces that favor filtration out of the capillary?

What is the total filtration pressure?

A

PCAP ,PISF, πISF

41 mmHg

(78:50)

34
Q

What factor favors reabsorption into the capillaries?

What is another name for this?

What is the value of this pressure?

A

Capillary Protein/Colloid Osmotic Pressure (πCAP)

Oncotic Pressure

28 mmHg

(79:00)

35
Q

What are the four factors that contribute to Capillary Oncotic Pressure.

A
  1. Albumin - protein
  2. Globulins - protein
  3. Fibrinogens - protein
  4. Donnan Effect - pressure contributed by charged ions that keeps fluids from moving out of the capillary.

(80:15)

36
Q

What is the pressure contribution of the Donnan Effect?

What is the pressure contribution of the other 3 proteins that contribute to capillary oncotic pressure?

A

9 mmHg

19 mmHg

(83:00)

37
Q

What is the net filtration pressure of the arteriole end of the systemic capillary? What does this favor?

What is the net filtration pressure of the venular end of the systemic capillary? What does this favor?

A

13 mmHg / Favors Filtration
41 mmHg- 28 mmHg = 13 mmHg

-7 mmHg / Favors Reabsorption
21 mmHg - 28 mmHg = -7 mmHg
**Hydrostatic pressure in the venous end of the capillary is 10 mmHg instead of 30 mmHg.

38
Q

What two components balance out the pressure in the arteriolar and venular ends of the capillaries?

A
  1. Some capillaries have larger surface areas on the venular end than the arteriolar end.
  2. Branching of the capillaries will have favor venular end than arteriolar end of the capillary.
    (90:00)
39
Q

What is the average capillary blood pressure?

What is the excessive average net filtration pressure of the total systemic capillary?

What collects excessive filtration?

A

17.3 mmHg

0.3 mmHg
Explanation too long to type out, refer to time stamp.
(92:30)

Lymphatic systemic

40
Q

What is the average flow rate of the lymphatic system in a healthy individual and not bed bound?

A

120 ml/hr (works out to 2-3L/day)

(95:00)

41
Q

Give two reason why protein leaking out of the capillary into the interstitium can be bad?

Will the lymphatic system resolve the excess of proteins?

A
  1. Since protein is no longer in the CV system, they will not be able to keep fluid in.
  2. Long term problem: proteins that originally leaked out will not be able to go back into the capillary. This will instead contribute to the πISF pressure.

Eventually, the lymphatic system reabsorbs proteins VERY slowing. This will take forever. (98:00)

42
Q

What quality does the lymphatic system have that does not allow fluid to move backwards?

How can you get fluid to move through the lymphatic system?

A

one-way valves (98:49)

Through contractions and relaxations of muscles, body movement. Same idea as the muscle pump for blood return to the heart.

43
Q

How much can the lymphatic flow increase from baseline in a healthy individual?

A

20 fold increase

120 mL/hr can increase to 2400 mL/hr.
(102:00)

44
Q

What is the point of entry back into the CV system from the lymphatics?

A

Subclavian Veins/ Top of the Thorax ( 102:30)

45
Q

What can increase capillary pressure in the arteriole end?

What can increase capillary pressure in the venous end?

A

Hypertension increase pressure on the arteriolar side of the capillaries will increase filtration.

Heart Failure, increases CVP which will increase capillary pressure on the venular side from 10 mmHg to 20-25 mmHg. The venular side of the capillaries will now favor filtration instead of reabsorption. (106:15)

46
Q

_________ will decrease plasma colloid production by decreasing production of clotting factors and fibrinogen productions.

How will this affect oncotic pressure?

How will burns affect oncotic pressure?

A

Liver Failure

Decrease oncotic pressure

Decrease oncotic pressure

(107:00)

47
Q

What is an easy way to increase someone’s Interstitial Fluid Pressure?

A

Massaging an area will increase PISF.

(109:00)

48
Q

The Filtration coefficient (Kf) is related to what 3 factors?

What is the Kf given in lecture?

A
  1. Capillary permeability
  2. Number of capillaries
  3. Surface area of capillaries

Kf= 6.67 ml/min/mmHg

49
Q

What is the formula for overall filtration?

What is the calculated filtration of the systemic capillaries in mL/min?

What does this correlate with?

A

Filtration = Kf x Net Filtration Pressure

2 mL/min
6.67 mL/min/mmHg x 0.3 mmHg = 2 mL/min

Lymphatic Flow Rate of 120 mL/hr

(111:00)

50
Q

Per lecture, the Kf is important to which organ?

A

Kidney (112:00)

The kidney has two capillary beds, one for filtration and one for reabsorption. Kf plays an important role in this organ.

51
Q

What is Inulin used to measure?

A

Kidney Function (114:30)

52
Q

Why are Hemoglobin and Albumin useful as colloids?

A

They have very low permeability through the capillaries and will help increase oncotic pressure. (114:45)

AP EXAM 4 (8 decks)

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