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Physiology I Test I > part 2 > Flashcards

part 2 Flashcards

1
Q

The intrinsic pathway used to activate prothrombin requires what factors?

A

IX, and VIIIa.

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2
Q

Which pathway is faster at activating prothrombin intrinsic or extrinsic?

A

Extrinsic pathway is the quickest.

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3
Q

Which pathway is most effective at activating prothrombin?

A

Intrinsic pathway because it is amplified.

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4
Q

which factors are required to use the extrinsic pathway?

A

VII, III

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5
Q

The bl0od clotting system is an example of what type of feedback?

A

Positive.

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6
Q

How is the endothelial lining of vessels engineered to act as a anti-clotting mechanism?

A

They are smooth simple squamous cells that are coated with glycocalyx which tends to repel clotting factors.

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7
Q

A formed clot will minimize blood flow to the area and how will this be an anti-clotting factor?

A

This will minimize the amount of clotting factors that can come into the area.

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8
Q

How will thrombin help with anti-clotting?

A

It will activate an alpha a globulin (plasma protein) called antithrombin III which will bind to thrombin and inactivate it in a delayed way that takes longer than clotting.

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9
Q

What will help antithrombin III destroy or inhibit thrombin? Where will it come from?

A

Heparin that comes from mast cells.

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10
Q

What is fibrinolysis?

A

Plasminogen is an inactive protease (a group of enzymes that degradates proteins) that will destroy fibrin when activated and this happens as fibrin is forming.

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11
Q

What is the active form of plasminogen and how is it activated?

A

Plasmin and it is activated by tpa

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12
Q

What is tpa? And where will it come from?

A

Tissue plasminogen activator. It is released from injured tissues a day or so later.

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13
Q

tPA has been commercially sold as a drug that is used for?

A

Acute heart attacks and strokes, but must be infused very soon after injury to be helpful.

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14
Q

What vitamin is required for synthesis of several clotting factors?

A

Vintamin K

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15
Q

How is Vitamin K made?

A

By bacterial flora in the Intestine

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16
Q

What does coumarin do?

A

It is a competitive inhibitor for vitamin K sites in Hepatocytes. It is wrongly called a blood thinner it wont thin blood but it will minimize dangerous clotting in patients.

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17
Q

What results from a lack of factor VIII?

A

Hemophilia A and lots of uncontrolled bleeding.

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18
Q

What are 2 thromboembolitic conditions.

A
  1. Thrombus 2. Embolism.
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19
Q

An abnormal clot that forms in vessels is called what?

A

A thrombus.

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20
Q

What is an embolism?

A

A thrombus that breaks away and freely float in vessel.

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21
Q

Generally how will thromboembolic conditions arise?

A

From roughened endothelia or in area where blood moves slowly.

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22
Q

why is the platelet count down in Idiopathic thrombocytopenia pruprua?

A

They are destroyed and removed from the blood in the spleen.

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23
Q

What does idiopathic mean and why is idiopathic thrombocytopenia purpura idiopathic?

A

Unknown and the root cause of this disease is still unknown.

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24
Q

Why will people with idiopathic thrombocytopenia purpura have increased bleeding times?

A

Because they need platelets to participate in clotting pathways.

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25
Q

Why will people with Idiopathic thrombocytopenia Purpura bruse easy?

A

With low platelets they cant fix routine micro holes in the vessels and this leads to bleeding from membranes and dermal microvasculature.

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26
Q

What form of Idiopathic thrombocytopenia Purpura is more serious the childhood or adult form? And why?

A

Adult. Because of autoimmunity.

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27
Q

What are some treatment for idiopathic thrombocytopenia purpura?

A

Some receive a splenectomy. Some receive platlets. Some get corticosteroids.

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28
Q

How many children will show a functional murmur at some point in time?

A

80%

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29
Q

How can you tell someone has a functional murmur?

A

Listen for a sound that can be heard during the ejection of blood from a normal heart. A noise between the lub and dub of the heart.

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30
Q

What specifically will the sound of a functional murmur sound like?

A

short and twangy low-pitched sound.

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31
Q

A functional murmur will often be seen with what other conditions?

A

Anxiety, stress, fever, anemia, hyperthyroidism, or pregnancy.

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32
Q

What is the physics formula for flow?

A

Q=delta P/R Q= flow Delta P = pressure differential R= vascular resistance.

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33
Q

What happens to Q (flow) if R (vascular resistance) is increased?

A

IT goes down.

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34
Q

How can we solve for R (vasculature resistance)?

A

R= 8nL/pi r^4 n= viscosity L= length r= radius

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35
Q

viscosity of blood is just a function of what?

A

Hematocrit (a measure of what percentage of blood is RBC).

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36
Q

What is more viscous plasma or water and why?

A

Plasma because of proteins.

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37
Q

What is the formula for blood flow after we take out all the factors that can’t be changed?

A

Q = r^4

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38
Q

What is the single greatest determinant of blood flow through a vessel?

A

The diameter (or Radius).

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39
Q

Doubleing the diameter of a blood vessel will increase its flow by how much and why?

A

16 fold because the formula Q=r^4 and the radius is raised to the fourth power.

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40
Q

The normal result of blood flow moving through vessels takes what kind of profile?

A

a Parabolic velocity profile.

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41
Q

If a barrier was removed from a blood vessel what blood will travel the fastest and why?

A

The blood in the middle because there is not drag from the walls.

42
Q

What is the name of the flow when blood moves faster in the middle and slower as we move towards the walls?

A

Laminar flow.

43
Q

What are the qualities of laminar flowing fluids?

A

Very efficient, smooth, and quiet.

44
Q

What happens when the streamlines of flowing blood are disturbed?

A

We get turbulent flow.

45
Q

What are the qualities of turbulent flow?

A

Inefficient, rough, and noisy.

46
Q

Noise from turbulent flow in vessels and in valves is known as what?

A

Vessels = bruit valves = murmur

47
Q

Turbulent flow typically happens when?

A

With obstructions and high velocity.

48
Q

Obstructions will disturb laminar streamlines into what?

A

Eddy currents.

49
Q

What is stenosis and what will it cause?

A

A narrowing and it causes the velocity to increase and the total flow to decrease.

50
Q

When we increase the diameter of a blood vessel what happens to flow and what happens to pressure of the blood upstream?

A

The flow will increase, but the pressure upstream will decrease as more blood is flowing through.

51
Q

What other agents will help convert or activate plasminogen besides tPA?

A

Tissue lysosomes.

52
Q

What is Reynolds number?

A

The point when turbulence happens.

53
Q

What is the destabilizing factor in reynolds number?

A

Velocity.

54
Q

How will shear force effect blood flow?

A

Normaly it is minimal, but with turbulence (exceeding reynolds number) it causes clotting and additional injury.

55
Q

What is carotid artery stenosis? what will it cause? how common is it?

A

The carotid artery becomes occluded by fatty plaque. It can cause a ischemic stroke common in aging process

56
Q

During carotid artery stenosis what is reynolds number like?

A

It is exceeded and turbulence happens.

57
Q

What are korotkoff sounds?

A

Normal arterial noises heard during routine assessment of blood pressure using the ausculatory method and using a sphygmomanometer and a stethoscope.

58
Q

What is auscultation?

A

Listening to beats with the stethoscope.

59
Q

What is compliance when talking about blood vessels?

A

Intravascular pressure that stretches blood vessels in proportion to their ability to absorb more blood.

60
Q

How is compliance numerically defined?

A

a change in volume per a change in pressure: Compliance= delta V/delta p

61
Q

What is more compliant an artery or a vein?

A

Arteries are not very compliant Veins are very compliant.

62
Q

What type of stimulation can modify the performance of vessel systems?

A

Sympathetic stimulation

63
Q

What percentage of our blood is found in Veins/venules, and arteries/arterioles?

A

Veins/venules= 64% or about 2/3 artery/arterioles= 15%

64
Q

What is the aorta used for?

A

Pulse dampening and distribution.

65
Q

What are large arteries used for?

A

Pulse dampening and distribution.

66
Q

What are small arteries used for?

A

Distribution and resistance.

67
Q

What are arterioles used for?

A

Distribution and resistance.

68
Q

What are capillaries used for?

A

Nutrient and waste exchange.

69
Q

What are venules used for?

A

limited exchange and collection. Also some capacitance (blood storage).

70
Q

What are Veins used for?

A

Capacitance

71
Q

What is the Vena cava used for?

A

collection of blood sent into the heart.

72
Q

What does it mean for a vascular compartment to be variably compliant?

A

Due to the capacity of the vascular system’s smooth muscle cells to relax if exposed to sustained stretching forces the vessel can be enlarged if chronically overloaded with blood and this is a DELAYED COMPLIANCE.

73
Q

Can delayed compliance also constrict vessels to increase pressure?

A

Yes.

74
Q

What is the major determinant of flow?

A

Q=R^4

75
Q

What causes the noise heard in a functional murmur?

A

due to the powerful ejections of blood from the left ventricle this can cause the blood to exceede reynolds number and become turbulent in the aortic arch.

76
Q

Why is a functional murmur termed functional?

A

because it is of physciological and not anatomical origin.

77
Q

What phase of heart contraction is the functional murmur heard?

A

Systole phase.

78
Q

What causes contact dermatitis? What will contact dermatitis cause?

A

Contact with an external agent. It causes a localized inflammation response in the integument.

79
Q

What are the 2 types of contact dermatitis? Which one is more common?

A
  1. Irritant (80%) 2. Allergic (20%)
80
Q

What are the clinical features of contact dermatitis?

A

within minutes of exposure the skin becomes itchy, red and may blister.

81
Q

How long will contact dermatitis last?

A

it disappears within a few days to weeks and blisters dry up.

82
Q

What type of cells are the capillary beds made of?

A

Metabolizing cells.

83
Q

Most blood vessles have _____ muscle around them in the form of a ______ _______.

A

Smooth, Tunica media.

84
Q

What are the regulators of microvasculature (controlling the entry into capillaries)?

A

Arterioles

85
Q

How is vascular smooth muscle innervated?

A

sympathetic branch of the autonomic nervous system.

86
Q

Decreasing the radius of a blood vessel will do what to blood? This is aka?

A

decrease flow aka vasoconstriction

87
Q

Increasing the radius of the blood vessels will do what to blood flow and it is aka?

A

It will increae flow and it is aka vasodilation.

88
Q

What type of contractions will smooth muscle have?

A

slow sustained tonic contractions.

89
Q

What is vascular smooth muscle like?

A

It is composed of small spindle shaped cells that lack the regulatory protein troponin. The actin and myosin are poorly organized. they can maintain a good slow level contracted state.

90
Q

Is calcium needed for vascular smooth muscle to contract?

A

Yes. also needs atp.

91
Q

What 3 ways can vascular smooth muscle tone be modified?

A
  1. Mechanical stimulation 2. Electrical stimulation 3. Chemical stimulation
92
Q

How is mechanical stimulation of vascular smooth muscle tone accomplished?

A

Rapid expansion of a vessel causes depolarization of the vascular smooth muscle (passive stretching lead to a contraction).

93
Q

Why is the mechanical stimulation of vascular smooth muscle often described as autoregulation?

A

Because it stabilizes the flow.

94
Q

Is the mechanical stimulation of vascular smooth muscle a slow or fast reaction?

A

Fast.

95
Q

If flow is increased in a vascular blood vessel what will mechanical stimulation do to it?

A

It will cause vasoconstriction and decrease the flow.

96
Q

What happens to a vascular blood vessel with mechanical stimulation if the blood flow is decreased?

A

It causes vasodilation and increases flow.

97
Q

How will mechanical stimulation of vascular blood vessels be effected by sustained force?

A

It may do the oppostie due to the slow delayed compliance.

98
Q

What do endothelial cells of blood vessels do with increased shear stress?

A

They secrete nitric oxide.

99
Q

What will nitric oxide do to vascular smooth muscle?

A

Causes Vasodilation.

100
Q

How will electrical stimulation of vascular smooth muscle work?

A

It will open voltage-dependent ca2+ channels and start an action potential in a neighboring smooth muscle cell.

Physiology I Test I (8 decks)

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