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ACOLS > Microcirculation and Physiology > Flashcards

Microcirculation and Physiology Flashcards

1
Q

What is diffusion?

A

Migration of particles from higher to lower concentration
- equilibrating movement
- random movement

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2
Q

What causes diffusion to happen more quickly? (3)

A
  • as temperature increases
  • the greater the difference in concentration
  • smaller molecules diffuse faster
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3
Q

To ensure sufficient gas exchange and metabolism a ______ ________ distance is imperative.

A

short diffusion

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4
Q

What is the normal distance between cells and blood capillaries?

A

1/10 mm

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5
Q

What increases the diffusion distance by 100x?

A

Swelling of just 1cm

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6
Q

When swelling is present what happens to the immune response and why?

A

The immune system is compromised due to the increased distance defence cells have to travel. Also, there is a decrease in nutrition that reaches the cells.

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7
Q

Movement of water molecules that occurs in ONE direction across a semi-permeable membrane.

A

Osmosis

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8
Q

To move water back across the cell membrane, pressure _______ to the osmotic pressure must be applied.

A

pressure equal

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9
Q

Protein molecules are hydrophilic - the force of protein molecules attracting water is called ___-____ ______.

A

colloid-osmatic pressure

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10
Q

In 24hs what percentage of circulating protein will leave the blood capillaries into the interstitial space?

A

50%

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11
Q

The concentration of proteins in the plasma is ____ more than the interstitial fluids. Thus plasma proteins cause a _______ colloid-osmatic pressure.

A

3x - higher

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12
Q

COP pl represents and is equal to ____ mmHg.

A

Colloid Osmotic Pressure of the blood plasma proteins - 25 mmHg

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13
Q

COP ip represents and is </> COP pl.

A

Colloid Osmotic Pressure - less than

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14
Q

A sufficient return of venous blood to the heart depends on: (5)

A

1) Muscle pump
2) Valves
3) Diaphragmatic breathing
4) Suction effect of the hears
5) Pulsation of adjacent arteries

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15
Q

Distribution of blood vessels in the body.
Systemic Venous System _____%
Systemic Arterial System _____%
Pulmonary Circuit _____%

A

64%
13%
9%

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16
Q

BCB is blood capillary pressure is _____ mmHg in the arteriole capillaries vs ____mmHg in the venous capillaries.

A

29mmHg - 14mmHm

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17
Q

The blood supply to the capillary beds is based on the demand of the ______.

A

tissues

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18
Q

A band of smooth muscle located in the media of the precapillary arterioles controlling the blood flow.

A

Precapillary sphincter

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19
Q

If the precapillary sphincter contracts this means (more/less) volume and (increase/decrease) BCP.

A

less - decreased (increase in water reabsorption)

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20
Q

If the precapillary sphincter dilates this means (more/less) volume and (increase/decrease) BCP.

A

more - increased (more filtration or water into the interstitial area)

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21
Q

What internal factors control the precapillary sphincters (2) using what portion of the autonomous nervous system (ANS)?

A

1) Oxygen receptors in the tissues
2) Tissue Hormones
-Sympathetic Nervous System

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22
Q

What external factor control the precapillary sphincters? (2)

A

Temperature (heat/cold)
Massage (releases histamines which cause dilation)

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23
Q

What force tears away the water from protein molecules in the arterial capillaries?

A

Hydrostatic (filtration)

24
Q

The higher BCP arterial can overcome the force of which protein holds onto water molecules. This causes what to happen?

A

Forces water through the blood capillaries into the tissues.

25
What occurs at the venous end of the capillary due to BCPven < COPpl?
REABSORPTION - Water is reabsorbed back into the blood capillaries.
26
Water leaving the blood (capillaries) via _________ washes over the tissue cells carrying nutrients and solutes with it.
filtration
27
Water returning to the capillary system via _______ deposits waste products from the cells back into the venous system.
reabsorption
28
What percentage of water remains in the tissues and what is this called?
10-20% - Net Filtrate or Lymphatic Load of H2O
29
BCPart and COPip are ________ forces.
Outward (pulling water out)
30
COPpl and Tissue pressure are _____forces.
Inward (pulling water in)
31
Subtracting inward forces from outward forces on the capillary will determine _________ _________.
effective filtration
32
Active Hyperemia is
anything that causes vasodilation.
33
If the lymphatic load of H2O increases so does the lymph time volume due to activation of the Lymphatic _____ ______
Safety Factor
34
Active Hyperemia is caused by (5)
1) Massage 2) Inflammation/Infection 3) Temperature/thermal modality 4) Sunbathing 5) Vigorous Exercise
35
Passive Hyperemia is caused by (8)
1) Increased Blood capillary pressure caused by obstruction 2) Cardiac Insufficiencies 3) Pregnancy 4) Obesity 5) Chronic Venous Insufficiency 6) DVT 7) Sedentary 8) Immobility
36
What happens in passive hyperemia?
Blood pools in the capillaries causing an increase in BCP net filtrate.
37
What is Hypoproteinemia?
Abnormally low levels of protein in the blood.
38
What Causes Hypoproteinemia? (4)
1) Decreased protein intake -malnutrition 2) Decreased protein synthesis - chronic liver disease (cirrhosis) 3) Increased protein loss - malabsorption (intestine) - protein-losing gastropathy (stomach) 4) Protein-losing nephropathy- kindey (nephrotic syndrome >3.5g/24hr protein loss)
39
How many grams of protein does the body attempt to maintain in the blood?
75gm
40
With hypoproteinemia what happens to COPpl thus filtration and reabsorption?
COPpl - decrease Filtration - increase Reabsorption - decreased
41
What causes a Dehydration Reaction?
This is the body's response to an increase in net filtration - a decrease in circulating fluid, a drop in BP.
42
What occurs during a Dehydration Reaction?
1) Renal blood flow decreased - low urine output 2) Feeling of thirst 3) Minimal sweating 4) Blood diverted to heart/brain
43
What is the maximum amount of lymph fluid a healthy system is able to transport in a given length of time called?
Transport Capacity - 10x higher than the normal Lymphatic Load
44
The body's ability to react to an increase in lymphatic load by increasing contraction frequency is called?
Functional Reserve
45
What term represents the amount of lymph fluid the lymphatic system is able to transport?
Lymph Time Volume
46
The functional reserve (FR) enables the lymphatic system to respond to an increase in lymph fluid volume with an increase in
Lymph Time Volume
47
What is Lymphatic Dynamic Insufficiencies?
The Lymphatic system is overwhelmed. Lymph Time Volume (LTV) and thus the Total Capacity have maxed out.
48
Why does Manual Lymphatic Drainage not work with Dynamic insufficiencies?
Since MLD increases LTV and with Dynamic Insuficiencies LVT is already at its maximum capacity it is not effective.
49
What causes Dynamic Insufficiency?
Insufficient Venous Return - CHF, pregnancy, venous insufficiency.
50
The therapeutic Approach for Dynamic Insufficiency includes what? (4)
Ambulation, elevation, exercises and if indicated - compression garments.
51
Why does long-term dynamic insufficiency cause secondary damage to the Lymphatic System?
Increased intra-lymphatic pressure (max TC) results in damage to the collector walls and valve system.
52
Mechanical or "Low-volume insufficiency causes what to happen to the transport capacity?
Drops below normal amounts
53
What causes Mechanical Insufficiencies?
Surgery Radiation Infections Trauma Chronic Venous Insufficiency Congenital Malformation
54
In mechanical insufficiency what is damaged and unable to cope with even a normal lymphatic load?
Transport Capacity
55
When protein, water and waste products are not removed from the interstitium what happens?
Causes tissue damage and increases diffusion distance for immune cells to respond leading to an increased incidence of cellulitis.
56
What is the term for lymphedema caused by not only mechanical insufficiency but also an increased lymphatic load?
Combined Insufficiency
57
How quickly can swelling occur in Combined Insufficiency?
1 day

ACOLS (7 decks)

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