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259 - physiology > lecture 8: guyton chapter 16/17 > Flashcards

lecture 8: guyton chapter 16/17 Flashcards

1
Q

what are the 4 forces that contribute to starling equilibrum

A 
capillary hydrostatic pressure
interstitial fluid hydrostatic pressure
osmotic force (plasma proten conc)
osmotic force (iterstitial protein)
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2
Q

what is the capillary hydrostatic pressure due to

A

due to the BP within the capillary (increase pressure, more force/filtratioin into the instersticium)

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3
Q

which pressure value is llways negatice

A

interstiial fluid hydrostatic pressuer

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4
Q

interstial fluid hydrostatic pressure pushes fluid up or out

A

pushes flud=ud back to the cpaillary

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5
Q

what 2 forces increase filtration

A

cap hydrostatic pressure

osmotic force due to interstital fluid plprotein concentration

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6
Q

what 2 forces increase reabsorbition

A

intertitial fluid hydrostatic pressure

osmotic foce force due to plasma protein concentraion

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7
Q

what is lymph and where is it found

A

is a fluid (like blood) found in lymph vessels (similar to veins) that conntrians some proteins that have escaped through capillary walls

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8
Q

what does the lymphatic system move

A

moves interstial fluid with proteins

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9
Q

true or falseL tthe lymphatic system is interconnected with capillary system

A

true

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10
Q

what size are the proteins that escape the cpaillary walls and why

A

they are usually small because others have a hard time passing through the fenestarions of capilaries

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11
Q

lymphatic sytse=m is an open or closed ended entwork

A

close ended (just appears)

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12
Q

lymph capillaries are highly permeable or not highly

A

they are highy permeable

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13
Q

lymphatics lack what in compoarionn to capillaries

A

lack tight junctions

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14
Q

why is lymphatics not havinng tight junctions a good thing

A

therefore larger ptoteins can easily get in

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15
Q

how are lymphatnics attached to connective tissue

A

finne filament anchors to connective tissue

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16
Q

where does lymph drain

A

at the level of the vena cava (mixes with blood)

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17
Q

what is the general flow of fluid

A 
capillary
inntersitum 
lymphatic system (flow)
to lymphnodes (for filtration)
vena cava (with clean fluid)
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18
Q

the lympathic makes an accessory route by what

A

by which fluid protein can flow from intnerstium to the blood

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19
Q

the lympathic system is important in prventeing what

A

edema

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20
Q

what is a majo rorute for the absroption of nutriends from the GI tract

A

lymphatic systtem

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21
Q

why is the lymphatic system imporant route for absoption of nutrients from the GI tract

A

since large proteinns cannot pass trhough capillaries but it is easier to pass thrgouh lymph (nno tight junctions)

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22
Q

true or false and why: the lymphatic system provides a important rule in ummune system

A

true
when the fluid passes though the lymphnodes (which gets fitlrated) and the unwanted things like bacteria, eccess lipids, proteins get caught inn lymph
=cleans fluid

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23
Q

what is the negative pressure in the innterstital fluid socae caused by

A

pumping by lympatic sysm

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24
Q

plasma filtrate is returned to the circulation by what (4 ways)

A

tissue pressure
intermitted skeltal muscle actvitiy
lymphatic vessel contraction
system of one what valve

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25
Q

whatt are some elements that get returned back into the circulation due to the lymphatnics

A

prottein (albmin)
bacteria
fat
excess fluid

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26
Q

what does the degree of activtiy of lymphathic pump depend on
(determinants of lymph flow)

A

smooth muscle filmanets in the lyph vessels cause them to contract

external compression also contributes

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27
Q

true or false: lymph vessels do not have smooth muscle filaments

A

false

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28
Q

what makes the valves of the lympaticic sytem

A

elongated endothelial in lympnodes

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29
Q

what arte the 2 phases of movement of lymph

A

expansion phase

compressio phase

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30
Q

explain the expansion phase of movement of lymph

A

Fluid travels from intersttitisum into the lymph (no tight junctions so itd easier)

hydrostatic pressure in the intersitcium exceeds sthat inside lymphastic causing microvalves to open and fluid to enter

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31
Q

explain the compression phase of the movement of lymph

A

the hydrostatic pressure inside the lymph rises, closing the microvalves ans causing lymph to flow downstream (froward) so valves can open again

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32
Q

what is the highest driving force of moving lymph/main determinant

A

interstitial fluid hydrostatic pressure

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33
Q

if there is an icncrease in interstitual fluid hydrostatic pressure, there is an increase or decrease in lymph flow

A

increase

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34
Q

the more fluid is travelling into the intersitum (filtration) what happens to the flow

A

more lymph flow

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35
Q

what are the factos affeccting the formation of interstiaial fluid

A

capillary hydrostatic pressue (more filtration)

colloid osmotid pressure (putting more fluid in the interstitum)

lymph return

capiliary permiability

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36
Q

what are the factors that increase hydrosttic pressure

A 
Impaired venous return
Congestive heart failure  
Constrictive pericarditis  
Ascites (liver cirrhosis)  
Venous obstruction or compression
Thrombosis    
External pressure (e.g., mass)
Lower extremity inactivity with prolonged dependency
Arteriolar dilation
Heat  
Neurohumoral dysregulation
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37
Q

explain how an increased hydrostatic pressue can lead to an impaired venous return (vice versa)

A

there will be a smaller pressure gradient therefore the heart needs to but more pressure to contract

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38
Q

explain ho w congestive heart failure and constrictive pericarditis

A

heart is not pumping blood properly, the blood startts to back up in veous size

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39
Q

explain how heat can cause an increased hydrosttic pressure

A

vasodiliation, icnrease flow/rate, increase filtrattion

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40
Q

herreohprage is a long term or short term solution

A

short term

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41
Q

when you are hemmoraging what is happen to the pressure

A

there is a low fluid pressure (low cap hydro) but a normal osmotic prssure (blood is lost but the concentration of proteins has not changed)

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42
Q

explai nthe hemmorage mechanism

A

1) bllod is lost so the force tthat drives fluid from the capillaries is diminued (less filtration) but the force that moves the fluid back into the capilaries is not altered (force differential)

this movement provides a homeostatic adjustment which restores fluid volume

(to rebuild the plasma volume there will be an increased reabsoption of fluid from interstium to capilary
=eventually the plasma colloid will decreae pbecause it is diluted with fluid

43
Q

when you are starving, what is hapening in terms of presure

A

normal fluid pressure but low osmotic pressure (arent getting enough food, body will use plaasma proteins for energy)

44
Q

plasma proteins are always used for energy

A

false, a last resortt for energy

45
Q

when you use plasma proteins what happens to the pressur

A

decreases capiliarry absorption (lower osmotic pressire)

46
Q

explain pressure and starvation

A

When you are stariving you have a normal fluid pressure but low osmotic pressure (not enough proteins in the blood)
to increase the concentration in the capillary, more water will enter the tissue than pulled back (swelling.edema)

47
Q

exp[lain why swelling/edema happens when starving

A

because low concentration in blood so more water will move to tthe tissues causing swelling

48
Q

in starvation that is more or less filtration than reabsorb

A

more filtratiton

49
Q

what happens if your lymphnodes are blocked

A

there is no draining causing a build up of fluid

50
Q

explain elphantitus

A

a parasite blocks flow of lymph and feeds of lipids and proteins and is growing which causes swelling

51
Q

regulation of perepheral blood flow is a uni or dual control

A

dual (intrinsic and extrinsic)

52
Q

what are the 2 ways we control how bllod gets to perphery

A

extrinsinc and intrisinc

53
Q

what system is responsible for extrisinc control of peripheral blood blow

A

primarily by nervous system (also by hormones)

54
Q

intrisic control of peripheral blood bflow occurs where

A

locally in the tissues

55
Q

what is intrinsic control of perepheral blood flow controlled by

A

controlled by the conditions in the immediate viscinity of the blood vessels

56
Q

what are the 4 tissue needs

A

delivery of oxygen

2) delivery of nutrients such as glucose, amino acids, etc.
3) removal of carbon dioxide, hydrogen and other metabolites from the tissues
4) transport various hormones and other substances to different tissues

57
Q

flow is closed related to what

A

metabolic rate of tissues

58
Q

what is the reason for control of blood flow

A

REASON: Body needs various amounts of nutrient delivery and metabolic removal for different levels of activity

59
Q

ig a tissue has a high activity is needs w BLANK blood flow

A

high

60
Q

whatt is the principle behind control of blood flow

A

Blood flow is regulated to minimal level to just meet needs – body will not ‘waste’ blood
(metabolic need determines how much blood the tissue recevies)

61
Q

explain tissue blood flow at restt

A

at rest, tthings like skeletal muscles dont need to be perfused /filled iwth oxygen so the sphnicts will constrict tbecause metabolic need is determining flow

at rest, organs will be taking up more of the flow

62
Q

what is the main factor in acute control of local blood flow

A

tissue metabolic acitivity

63
Q

what is one of the most fundemental principles of circulartory function

A

the ability of each tissue to control its own local blood flow in proportion to its metabolic needs

64
Q

if there is an change that results in an inadequate oxygen (nutrient) supply for the metabolic requirements of the tissues results in what

A

the formation of vasodilator substances which increase blood flow to the tissues

65
Q

what are the 2 major thereories for local blood flow (acutte control)

A

The vasodilator theory - Increases in tissue metabolism lead to increases in blood flow

2)  Oxygen demand theory - Decreases in oxygen availability to tissues increase tissue blood flow
66
Q

what are the vasodilators in the vasodilator therory

A

Adenosine, CO2, Lactic acid, ADP compounds, Histamine, K ions, H ions

67
Q

explain the vasodilator theory for blood flow conttrol

A

increase tissue metabolism (increase tissue needs, increase conbustion)

=incrrease release of vasodilators
=decrease arteriole resistance
=increase blood flow

68
Q

what is the oxygen demand theory for blood flow control

A

increase tissue metalosim or decrease oxugen delivery to tissue

=decrase tissue oxygen concentrration

=decrease arteriole resistnce

=increase blood flow

69
Q

what structures controls local blood flow by sensing changes

A

precapilary shincters

70
Q

explain acute local feedback control of blood flow (sphincs)

A

if there is a change (lack of oxygen, formation of vasodilatesr ettc), the precapilary sphincters will relax (relation of smooth muscle) to increase blood flow

71
Q

what is an example of metabolic control of local blood flow

A

active hyperemia

increased blood flow to meed increase metabolic needs

72
Q

true or false: there will be a maximal flow for increasing metabolic activties

A

true

73
Q

will your body stay in active hyperemeia after increased metabolism for a pronglued period

A

no, eventually itt will adapt

74
Q

ehat is an example of oxygen demand contrtol of local blood flow

A

reactive hyperemia

75
Q

explain reactive hyperemia

A

If there is an occlusion/block, there wil lbe a lack of oxygen to the cells and will cause the sphincts to fully dilatet and allow an icreased flow

76
Q

what is the realtionship between peak blood flow and duration of hyperemia

A

they proportional to tthe duraction of the occlusion

77
Q

what does autoregulation mean

A

intrinsic ability of a tissue to maintain blood flow relatively constant over a wide range of arterial pressures.

78
Q

what is a possible explanation for autoreg.

A

q/f= pa-pv/r

79
Q

be able to explain the autoregulation slides

A
80
Q

metabolic theory suggests taht as arterial pressure is decreased, oxygen/nutrient deliver is BLANK

A

is decreased resulting in release of a vasodilators

81
Q

if there is a decrease of oxygen or nutrients, what will be released

A

vasodilator

82
Q

myogenic theory proposes that as arteiral pressure falls, what happens to the arterioles

A

have an intrinsic property to dialte in response to decrases in wall tension

83
Q

what is the mechanism for blood flow control in the kidneyts

A

they have a feedback system between the tubules and arterioles

84
Q

what is the mechanism for the brain blood flow

A

controlled by carbon dioxde and hyderogen ion concentration

85
Q

what is the theory to explain metablic mecahnism

A

When the pressure in a vessel to a tissue increases, the flow increases, and excess oxygen and nutrients are provided to the tissues. These excess nutrients cause the blood vessels to constrict and the flow to return nearly to normal despite the increased pressure.

86
Q

what is the theory to explain myogenic mechanisms

A

When the lumen of a blood vessel is suddenly expanded, the smooth muscles respond by contracting in order to restore the vessel diameter and resistance. The converse is also true.

Proposed mechanism is stretch of vascular smooth muscle causes activation of membrane calcium channels.

Consequently, vascular smooth muscle cells depolarize when stretched.

87
Q

know the slide about theroy to ecxplain myogenic mechanism

A

.

88
Q

true or false; Vessels are “built to withstand the wall tensions they normally “see”

A

true

89
Q

if intravascular pressure increases, what happens to the vessel wall tension

A

it will increase

90
Q

if intravascular pressure increases and the vessel wall tension alsp increases, what happens to the muscles of the vessels

A

the vascular smooth muscle contracts and the ttension returns to normal

91
Q

what is the law of LaPlace

A

radius defines tension (increase radius, increase tension)

92
Q

For given BP, increasing the radius of the vessel leads to BLANK

A

a increase in tension.

93
Q

why do arteries needtthicker walls than veins

A

because they carry much higher BP (more tension)

94
Q

true or false: because capillaries also carry significant BP they have thick walls

A

false, because of thei small size, there is reduced tension to the thick walls is not needed

95
Q

does the endothelium play an active role in what

A

in regulationg the microcirculation

96
Q

explain why the endothelium is important in regulation microcirculation

A

Endothelium is a source of substances that elicit contraction or relaxation of the vascular smooth muscle

sends substances to tunica media to allow for vasodilation and contriction

97
Q

what are some vasoactie substances realased from endothelium

A 
Nitric Oxide (NO) (Endothelium-derived relaxing factor)
Prostacyclin 
Endothelin
Endothelial-derived hyperpolarizing 
	factor (EDHF)
98
Q

long term or acute regulatory mechanisms that control blood flow are more effective

A

long ter,

99
Q

how does long term local blood flow regulation occur

A

by by changing the degree of vascularity of tissues (size and number of vessels).

100
Q

what is an important stimulus for regulating tissue vascularity

A

oxygen

101
Q

what is angiogenesis

A

growth of new blood vessels

102
Q

Angiogenesis occurs in response to angiogenic factors released from where

A

ischemic tissue

	2) rapidly growing tissue
	3) tissue with high metabolic rates
103
Q

what are most angiogeneic factors

A

small peptides such as vascular endothelial cell growth factors (VEGF) and fibroblast growth factor (FGF).

104
Q

why is long term regulation of blood flow more effective than short term

A

it can withstand even larger pressure changes

259 - physiology (21 decks)

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