Module 1 - Vascular System 1.1-1.4

Question 1

Blood flow through the vascular system results from __________ created by the heart.

Answer 1

Blood flow through the vascular system results from pressure gradients created by the heart.

Question 2

The rate of blood flow can be calculated using what equation?

Answer 2

Bloodflow = change in pressure (ΔP) / resistance (R)

Question 3

The pressure gradient present across the systemic circuit arises from the difference in pressure between the _____ (leaves the left ventricle) and the ________ (entering the right atrium).

Answer 3

The pressure gradient present across the systemic circuit arises from the difference in pressure between the Aorta (leaves the left ventricle) and the Vena Cava (entering the right atrium).

Question 4

Aortic pressure is equal to the ________ which is about 90mmHg

Answer 4

Aortic pressure is equal to the Mean Arterial Pressure (MAP) which is about 90mmHg

Question 5

Pressure in the vena cava is equal to the _________ which is about 0mmHg

Answer 5

Pressure in the vena cava is equal to the Central Venous Pressure which is about 0mmHg

Question 6

How is the pressure gradient of the systemic circuit determined and what does it equal?

Answer 6

Determined by:

Mean arterial pressure - Central Venous Pressure = 90mmHg

Question 7

The pressure gradient across the pulmonary circuit arises from the difference in pressure between the ________\_

Pulmonary arterial pressure is about 15mmHg and pulmonary venous pressure is about 0mmHg. Thus the pressure gradient in the pulmonary circuit is equal to about _______

Answer 7

The pressure gradient across the pulmonary circuit arises from the difference in pressure between the pulmonary arteries and veins.

Pulmonary arterial pressure is about 15mmHg and pulmonary venous pressure is about 0mmHg. Thus the pressure gradient in the pulmonary circuit is equal to about 15mmHg

Question 8

Under normal circumstances, blood flow through the systemic circuit _______ to blood flow through the pulmonary circuit, despite differences in both pressure gradients and resistance.

Answer 8

Under normal circumstances, blood flow through the systemic circuit remains equal to blood flow through the pulmonary circuit, despite differences in both pressure gradients and resistance.

Question 9

What three factors affect resistance to blood flow?

Which is the most influential?

Answer 9

1. Vessel Radius
2. Vessel length
3. Fluid viscosity

Vessel radius is the major determinant of resistance to blood flow.

Question 10

Resistance is inversely proportional to _______

Answer 10

Resistance is inversely proportional to the fourth power of the radius

R α 1/r⁴

Question 11

A small change in the radius produces a big change in _______ and thus in _____

Answer 11

A small change in the radius produces a big change in resistance and thus in bloodflow

Question 12

Vessel radius is regulated at the level of the _____, which can be:

• _______ which decreases the radius and increases resistance

or

• _________ which increases radius and decreases resistance

Answer 12

Vessel radius is regulated at the level of the arterioles, which can be:

• Vasocontricted which decreases the radius and increases resistance

or

• Vasodilated which increases radius and decreases resistance

Question 13

Vessel length is proportional to _______

Answer 13

Vessel length is proportional to Resistance

ie: an increase in vessel length results in a proportional increase in resistance

Question 14

Fluid viscosity is related to the _____\_of the fluid; an increase in viscosity results in an ______\_ in resistance

Answer 14

Fluid viscosity is related to the thickness of the fluid; an increase in viscosity results in an increase in resistance

Question 15

The combined resistance of all blood vessels within the systemic circuit is called __________

Answer 15

Total peripheral resistance

Question 16

Within the systemic circuit, blood flow is equal to _____, the pressure gradient is equal to ________ and resistance is equal to ________

Thus we have the following two equations:

Bloodflow = change in pressure / resistance

CO = MAP / TPR

Answer 16

Within the systemic circuit, blood flow is equal to Cardiac output (CO), the pressure gradient is equal to Mean Arterial Pressure (MAP) and resistance is equal to Total Peripheral Resistance (TPR)

Thus we have the following two equations:

Bloodflow = change in pressure / resistance

CO = MAP / TPR

Question 17

What are the two major functions of Arteries?

Answer 17

1. Rapidly transport blood away from the heart towards the arterioles and capillaries
2. Serve as a pressure reservoir

Question 18

Surrounding the endothelial cell layer of the arteries is a thick wall composed of ______ and ______

Answer 18

Surrounding the endothelial cell layer of the arteries is a thick wall composed of Smooth Muscle and Connective Tissue

Question 19

The connective tissue layer of arteries contains:

1. ________
2. ________

Which provide elasticity and strength

Answer 19

The connective tissue layer of arteries contains:

1. elastin - elasticity
2. collagen fibres - strength

Question 20

Having elastin and collagen in the CT layer of arteries allow for the arterial walls to _____ to accommodate increased volumes during cardiac _____ and to slowly relax during cardiac _____

Answer 20

Having elastin and collagen in the CT layer of arteries allow for the arterial walls to expand to accommodate increased volumes during cardiac systole and to slowly relax during cardiac diastole

Question 21

The elastic recoil provided by elastin in the CT of arteries provides __________

Answer 21

The elastic recoil provided by elastin in the CT of arteries provides continuous blood flow through the systemic circuit throughout the cardiac cycle

Question 22

Arteries are “low compliance” vessels and thus are considered __________

• compliance*- measure of how pressure changes with changes in volume
• low-compliance*- small change in volume = large change in pressure

Answer 22

Arteries are “low compliance” vessels and thus are considered pressure reservoirs

Question 23

Arteries serve as pressure reservoirs: (Top) What happens as blood flows into arteries during systole? Why?

(Bottom) What happens as blood flows out of the arteries during diastole? How is blood moved through the vasculature during diastole?

Answer 23

Arteries serve as pressure reservoirs: (Top) As blood flows into the arteries during systole, the arterial walls are stretched outward and volume increases. This occurs because the pressure on the blood in the left ventricle is greater than that in the arteries. (Bottom) As blood flows out of the arteries during diastole, the arterial walls recoil inward and volume decreases. During diastole, blood is moved through the vasculature due to the elastic recoil of the arteries as the aortic valve is closed.

Question 24

Arterial blood pressure is _________\_

• How does it vary with the cardiac cycle?

Answer 24

Arterial blood pressure is the pressure of the blood in the aorta

• Systolic blood pressure is the maximum pressure in the aorta during cardiac systole
• Diastolic blood pressure is the minimum blood pressure in the aorta during cardiac diastole. DOES NOT EQUAL 0mmHg

Question 25

Arterial blood pressure is used as a measure of _______ and is indirectly measured using a sphygmomanometer:

Answer 25

Arterial blood pressure is used as a measure of _Cardiovascular Function_

Question 26

What is happening at each of the numbers on the graph of sphygmomanometry: 1. Cuff pressure is greater than 120mmHg and exceeds BP throughout the cardiac cycle = *\_\_\_\_\_\_\_\_\_\_* _=\_\_\_\_\_\_\_\_\_\_\__ 2. When Cuff pressure is between 120 and 80mmHg: * _*\_\_\_\_\_\_\_\_\_\_\_\_*_ * _**\_\_\_\_\_\_\_\_\_\_\_\_**_ 3. Intermittent sounds are heard because of _\_\_\_\_\_\_\_\_\_\_\_\_\_\__ 4. **The last sound is heard at _\_\_\_\_\_\_\_\_\_\_\__** 5. When cuff pressure is less than 80mmHg and is below bp throughout the cardiac cycle: * _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\__ * _**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**_

Answer 26

What is happening at each of the numbers on the graph of sphygmomanometry: 1. Cuff pressure is greater than 120mmHg and exceeds BP throughout the cardiac cycle = *_no blood flows through the vessel_* _= **no sound is heard because of no flow**_ 2. When Cuff pressure is between 120 and 80mmHg: * *_blood flow through vessel is turbulent whenever bp exceeds cuff pressure_* * **_The first sound is heard at peak systolic pressure_** 3. Intermittent sounds are heard because of _turbulent spurts of flow as blood pressure cyclically exceeds cuff pressure_ 4. **The last sound is heard at _minimum diastolic pressure_** 5. When cuff pressure is less than 80mmHg and is below bp throughout the cardiac cycle: * _blood flows through the vessel in smooth laminar fashion_ * **_No sound is heard because of uninterrupted, smooth laminar flow_**

Question 27

How is pulse pressure calculated?

Answer 27

By subtracting the diastolic pressure from the systolic pressure eg: 120/80 pulse pressure = 120-80 = 40

Question 28

What value can be estimated using the values for diastolic pressure and pulse pressure? What is the equation?

Answer 28

Mean Arterial Pressure (MAP) MAP=diastolic pressure + 1/3pulse pressure eg: individual with arterial bp of 120/80mmHg, pulse pressure would be 40mmHg and MAP would be 93mmHg

Question 29

Arteries branch into _____ when they reach the organ they are supplying

Answer 29

Arterioles

Question 30

The largest decrease in pressure occurs in which blood vessels?

Answer 30

Arterioles

Question 31

Among the various blood vessels, which supply the greatest resistance? By how much?

Answer 31

Arterioles \>60% total peripheral resistance

Question 32

Changes to the radius of the arterioles are regulated to achieve two purposes: 1. to distribute to individual \_\_\_\_\_\_\_\_\__,_ and 2. to _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\__.

Answer 32

Changes to the radius of the arterioles are regulated to achieve two purposes: 1. to distribute _cardiac outpu_t to individual _capillary beds,_ and 2. to _regulate mean arterial pressure (MAP)_.

Question 33

Arteriolar radius is dependent upon the state of contraction of the _\_\_\_\_\_\_\_\_\__ in the arteriole wall.

Answer 33

Arteriolar radius is dependent upon the state of contraction of the _smooth muscle_ in the arteriole wall.

Question 34

What does **Arteriolar tone** refer to?

Answer 34

Refers to the state of partial constriction under basal conditions (i.e in the absence of other influences) which establishes the base-line arteriolar resistance

Question 35

What two factors are responsible for arteriolar tone?

Answer 35

1. myogenic activity of arteriolar smooth muscle ie self-induced contractile activity 2. Continuous release of norepinephrine by sympathetic fibres

Question 36

What is Vasoconstriction?

Answer 36

Increased contraction that serves to decrease arteriolar radius

Question 37

What is vasodilation?

Answer 37

Decreased contraction (relaxation) of circular smooth muscle which increases arteriolar radius and leads to decreased resistance and increased flow through the vessel

Question 38

Changes in arteriolar radius are regulated by both _____ and _____ mechanisms.

Answer 38

Changes in arteriolar radius are regulated by both _intrinsic_ and _extrinsic_ mechanisms.

Question 39

Factors that influence level of contractile activity of arteriolar smooth muscle fall into two categories: 1. Intrinsic (local) controls - important in determining _________ depending of the metabolic needs of individual capillary beds 2. Extrinsic controls - important in regulation of \_\_\_\_\_\_\_

Answer 39

1. Intrinsic (local) controls - important in determining _the distribution of Cardiac output_ *by altering blood flow patterns* 2. Extrinsic controls - important in regulation of _blood pressure_

Question 40

Provide an example of how intrinsic controls alter the distribution of cardiac output: (Consider exercise)

Answer 40

During exercise, blood flow to the heart, skeletal muscles, and skin is increased, whereas blood flow to the digestive tract, liver, kidneys, and bone is decreased

Question 41

Intrinsic mechanisms are regulated by _\_\_\_\_\_\_\_\_\__, many of which result from _\_\_\_\_\_\_\_\__

Answer 41

Intrinsic mechanisms are regulated by _local chemical factors_, many of which result from _local metabolic changes_

Question 42

Define **Active Hyperaemia**

Answer 42

Active hyperaemia refers to an **increase in blood flow** in response to an **increase in metabolic demand**, such as during exercise.

Question 43

What does **Reactive Hyperaemia** refer to?

Answer 43

Reactive hyperemia refers to an **increase in blood flow** in response to a **previous reduction in blood flow**, such as following a blood vessel occlusion

Question 44

Local metabolic changes that would result in Active hyperaemia (increases in blood flow through arteriolar vasodilation) include the following: * decreased concentrations of \_\_\_\_\_ * increased _\_\_\_\_\_\__ * increased concentrations of _\_\_\_\_\_\_\__ * increased concentrations of _\_\_\_\_\_\_\_\__ * increased concentrations of _\_\_\_\_\_\_\_\__ * increased concentrations of _\_\_\_\_\_\_\_\__ * increased concentrations of _\_\_\_\_\_\_\_\__

Answer 44

* decreased concentrations of _oxygen (O2)_ * increased _osmolarity_ * increased concentrations of _carbon dioxide (CO2)_ * increased concentrations of _hydrogen ions (H+)_ * increased concentrations of _potassium (K+)_ * increased concentrations of _adenosine_ * increased concentrations of _prostaglandins_

Question 45

What are two well-known vasoactive (*acting on vessels*) mediators?

Answer 45

1. nitric oxide (NO), which causes vasodilation, and 2. endothelin, which causes vasoconstriction.

Question 46

During an allergic reaction or injury, the local chemical factor _______ is secreted from CT cells and leukocytes and acts directly on arteriolar smooth muscle to cause vasodilation

Answer 46

During an allergic reaction or injury, the local chemical factor _histamine_ is secreted from CT cells and leukocytes and acts directly on arteriolar smooth muscle to cause vasodilation

Question 47

Intrinsic mechanisms are regulated by \_\_\_\_\_\_\_\_, including temperature changes, shear stress, and the myogenic response.

Answer 47

Intrinsic mechanisms are regulated by _local physical factors_, including temperature changes, shear stress, and the myogenic response.

Question 48

An example of intrinsic control on arteriolar resistance is temperature. What are the results of temperature changes: An increase in temperature results in arteriolar \_\_\_\_\_\_\_\_, whereas a decrease in temperature results in arteriolar \_\_\_\_\_\_\_\_\_

Answer 48

An example of intrinsic control on arteriolar resistance is temperature. What are the results of temperature changes: An increase in temperature results in arteriolar _vasodilation_, whereas a decrease in temperature results in arteriolar _vasoconstriction_

Question 49

What is Shear stress? What is the consequence of an increase in shear stress?

Answer 49

Shear stress is the force on the endothelial cells in response to blood flow. An increase in shear stress results in the release of NO from endothelial cells, which results in **arteriolar vasodilation.**

Question 50

Explain the myogenic response as an intrinsic control mechanism of arteriolar resistance. What is the myogenic response to an increase in blood pressure?

Answer 50

The myogenic response is: the response of arteriolar smooth muscle to stretching. An increase in blood pressure causes stretching of the arteriolar wall, which subsequently results in **vasoconstriction** to increase the resistance and decrease the blood flow.

Question 51

Extrinsic mechanisms regulate ___________ through which two systems? Extrinsic mechanisms function to regulate mean arterial pressure (MAP) and involve both the nervous and endocrine systems.

Answer 51

Extrinsic mechanisms function to regulate _mean arterial pressure (MAP)_ and involve both the _nervous_ and _endocrine systems._

Question 52

All arterioles are under which branch of the nervous system (with the exception of the erectile organs in the reproductive system)

Answer 52

With the exception of the erectile organs in the reproductive system, which are innervated by the parasympathetic nervous system, all other arterioles are under the control of the _sympathetic nervous system._

Question 53

The sympathetic nervous system releases the neurotransmitter norephinephrine, which binds to _\_\_\_\_\_\_\__ receptors present in the smooth muscle cells of most arterioles to cause _\_\_\_\_\_\_\_\_._ **_Note:_** There are NO a-1 receptors in the smooth muscle cells of the brain

Answer 53

The sympathetic nervous system releases the neurotransmitter norephinephrine, which binds to _alpha-1 (α-1) adrenergic_ receptors present in the smooth muscle cells of most arterioles to cause _vasoconstriction._

Question 54

The _\_\_\_\_\_\_\__ nervous system innervates the adrenal medulla and causes release of two neurohormones: _\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_._ Both of these neurohormones bind to a-1 receptors to cause vasoconstriction

Answer 54

The _sympathetic_ nervous system innervates the adrenal medulla and causes release of two neurohormones: _norephinephrine and epinephrine_

Question 55

Both norepinephrine and epinephrine bind to _\_\_\_\_\_\__to cause vasoconstriction. However, epinephrine also binds to _\_\_\_\_\_\_\__ receptors located in the smooth muscle cells of the arterioles supplying \_\_\_\_\_and _\_\_\_\_\_\__ muscle, resulting in vasodilation

Answer 55

Both norepinephrine and epinephrine bind to _α-1 receptors_ to cause vasoconstriction. However, epinephrine also binds to _beta-2 (β-2)_ receptors located in the smooth muscle cells of the arterioles supplying _skeletal_ and _cardiac_ muscle, resulting in vasodilation

Question 56

Two other hormones released from the endocrine system are involved in the regulation of arteriolar radius: 1. _______ and 2. \_\_\_\_\_\_\_

Answer 56

Two other hormones released from the endocrine system are involved in the regulation of arteriolar radius: 1. vasopressin and 2. angiotensin II

Question 57

* Vasopressin is secreted from the _\_\_\_\_\_\_\_\_\__ and is involved in the maintenance of _\_\_\_\_\_\_\_\_\_._ * Angiotensin II is part of the _\_\_\_\_\_\_\_\__system (RAAS) and is involved in the maintenance of _\_\_\_\_\_\_\_\__. * Both vasopressin and angiotensin II are secreted following decreases in blood volume and cause _\_\_\_\_\_\_\_\_\_\_._

Answer 57

* Vasopressin is secreted from the _posterior pituitary_ and is involved in the maintenance of _water balance._ * Angiotensin II is part of the _renin-angiotensin-aldosterone_ system (RAAS) and is involved in the maintenance of _salt balance_. * Both vasopressin and angiotensin II are secreted following decreases in blood volume and cause _vasoconstriction._

Question 58

The following flow chart summarizes the intrinsic and extrinsic mechanisms that influence arteriolar radius and, thus, vascular resistance. * Total peripheral resistance depends on ______ and \_\_\_\_\_\_\_\_ * Blood viscosity is primarily dependent on the number of \_\_\_\_\_ * Arteriolar Radius depends on both _____ and _____ control * Local (intrinsic) control (local changes acting on the ________ in the vicinity) mechanisms include: * Response to \_\_\_\_\_\_\_ * ________ responses to stress - plays minor role in active and reactive hyperaemia * Application of \_\_\_\_\_/\_\_\_\_\_ - therapeutic * _______ release (injury/allergic response) * Extrinsic control mechanisms are important in regulation of ______ and include: * Four hormones: \_\_\_\_\_\_(fluid balance - vasoconstrictor), \_\_\_\_\_\_\_(fluid balance, vasoconstrictro), and _______ and \_\_\_\_\_\_\_\_(reinforce sympathetic nervous system) * \_\_\_\_\_\_activity (exerts generalized vasoconstrictor effect)

Answer 58

The following flow chart summarizes the intrinsic and extrinsic mechanisms that influence arteriolar radius and, thus, vascular resistance. * Total peripheral resistance depends on _arteriolar radius_ and _blood viscosity_ * Blood viscosity is primarily dependent on the number of _red blood cells_ * Arteriolar Radius depends on both _local (intrinsic)_ and _extrinsic_ control * Local (intrinsic) control (local changes acting on the _arteriolar smooth muscle_ in the vicinity) mechanisms include: * Response to _shear stress_ * _myogenic_ responses to stress - plays minor role in active and reactive hyperaemia * Application of _heat_/_cold_ - therapeutic * _histamine_ release (injury/allergic response) * Extrinsic control mechanisms are important in regulation of _blood pressure_ and include: * Four hormones: _vasopressin_ (fluid balance - vasoconstrictor), _Angiotensin II_ (fluid balance, vasoconstrictor), and _Epinephrine_ and _Norepinephrine_ (reinforce sympathetic nervous system) * _Sympathetic_ activity (exerts generalized vasoconstrictor effect)