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Physiology I Test I > part 8 > Flashcards

part 8 Flashcards

1
Q

Cardiac output =?

A

Venous return.

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2
Q

What determines vascular resistance of the body?

A

The size of peripheral vascular tubes which is a collective r^4.

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3
Q

So if delta-P (pressure difference) is set by cardiac output and cardiac output is set by venous return then what collective behavior will determine cardiac output?

A

Behavior of vascular tubes. Or the collective r^4.

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4
Q

What will determine the r^4 for the entire system?

A

Local factors from metabolizing tissues.

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5
Q

So after all of that what will determine the cardiac output?

A

Metabolizing tissues.

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6
Q

The heart is a permissive pump that responds to what?

A

Body tissue.

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7
Q

How will increasing metabolism increase cardiac output?

A

it will increase local metabolites which increase vasodilation and increase flow into the venous system which increases venous return which increase cardiac output.

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8
Q

What are the 2 outputs in the cardiovascular system?

A
  1. cardiac output. 2. tissue output (coupled with venous pump)
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9
Q

What are the 2 pumps for the systemic circulation of blood?

A
  1. Left ventricle. 2. Collective skeletal muscles.
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10
Q

If r^4 for a given area increases what happens to Q?

A

It should increase.

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11
Q

What keeps blood pressure from dropping off all the way when r^4 increases and so flow increases?

A

Delta-P must be maintained.

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12
Q

Blood pressure in the short-term is regulated how?

A

Regulated by the redistribution of blood.

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13
Q

How is mean systemic filling pressure made?

A

average of all arterieal and venous pressures.

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14
Q

What is the mean systemic filling pressure usually at?

A

10 mm Hg.

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15
Q

Why is the mean systemic filling pressure so low?

A

Because most blood is in the venous system and this is very low pressure.

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16
Q

What system can control the potential chaos that could result from excessive demands of tissues all crying out I want blood?

A

The sympathetic nervous system can modify the cardiac output and peripheral tissues.

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17
Q

Why do we need to warm down after exercising?

A

it is needed to prevent sudden post-exercise pooling of blood through venous pumping.

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18
Q

what is VO2?

A

the volume of o2 consumed per minute.

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19
Q

What is a typical VO2 at rest?

A

250 ml/min.

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20
Q

What is maxvo2?

A

Maximum aerobic limit.

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21
Q

What is A-V O2?

A

Arteriovenous oxygen difference. It is a measure of tissue metabolism.

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22
Q

With exercise Q or flow of blood is sent where?

A

To brain as a constant and sent to skin for sweating, also muscles and heart.

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23
Q

With exercise Q or Flow of blood is decreaes where?

A

gut, kidneys.

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24
Q

Mean arterial pressure divided by Resistance equals what?

A

Cardiac output.

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25
Q

What is the source of flow for pulmonary circulation?

A

Right ventricle.

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26
Q

What shape will the right ventricle be?

A

Crescentic or “c” shaped.

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27
Q

How much blood will the right ventricle pump compared to the left ventricle?

A

The same amount per unit time. Just not as far.

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28
Q

What is the normal or average pulmonary circulation blood pressure?

A

22/8

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29
Q

What is the pulse pressure for the pulmonary circulation?

A

14 mm Hg.

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30
Q

What is the mean blood pressure for pulmonary system?

A

13 mm Hg.

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31
Q

What will the blood pressure be in the capillaries of the pulmonary system?

A

around 7 mm Hg.

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32
Q

Why can pulmonary blood pressure be so low?

A

It doesn?t need to be high since it only travels short distances from the heart, and the lungs have a negative interpleural pressure.

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33
Q

What will low blood pressure do for the alveoli?

A

Allows them to ramain relatively dry.

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34
Q

How is blood distributed in lungs normally?

A

The lower 1/3 will have the most blood due to gravity and this area will be over-perfused, The upper 1/3 will not have much blood and it will be under-perfused, and the middle 1/3 of the lungs will be just right.

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35
Q

Pulmonary vasculature is compliant, but what is the size of the container here?

A

It is small.

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36
Q

Pulmonary blood vessels are like what?

A

veins.

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37
Q

How much blood can be in the pulmonary circuit at any time?

A

around 450 ml.

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38
Q

How much blood can be in the pulmonary capillaries at any given time?

A

only around 75 ml.

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39
Q

What is pulmonary edema?

A

A condition where the lungs accumulate too much blood.

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40
Q

What happens when there is too much blood in the lungs?

A

It ends up in plasma filtrate and goes into alveoli.

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41
Q

What happens to alveoli when they get blood on them?

A

This will greatly compromise the ventilation and gas exchange.

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42
Q

Is it possible to shift blood volume between the pulmonary and systemic systems?

A

yes.

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43
Q

What medical condition is associated with blood volume leaving the systemic system and entering the pulmonary system?

A

Congestive heart failure.

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44
Q

What controls the flow of blood through the pulmonary system?

A

The venous return. This can be metabolizing tissues in the systemic system.

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45
Q

Why will local factors not regulate blood flow through the pulmonary system?

A

decreased O2 in the pulmonary system will cause vasoconstriction.

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46
Q

Why will decreased O2 in the pulmonary system cause vasoconstriction?

A

So the blood can flow to better oxygenated areas.

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47
Q

Will nervous innervation go to the pulmonary system and will it help control flow of blood?

A

Yes it is innervated, but it will not help regulate flow.

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48
Q

What is circulatory shock?

A

inadequate blood flow to the extent the tissues become damaged.

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49
Q

What are the 3 basic types of circulatory shock?

A
  1. Hypovolemic shock. 2. low-resistance shock. 3. Cardiogenic shock.
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50
Q

What causes hypovolemic shock?

A

A hemorrhage (internal or external) that decreased blood volume. Or burns that remove lots of fluids.

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51
Q

Hypovolemic shock is aka?

A

Cold shock.

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52
Q

What causes low-resistance shock?

A

Due to loss of vasomotor tone.

53
Q

Low-resistance shock is aka?

A

Warm shock.

54
Q

What is anaophylaxis?

A

Widespread mast cell degranulation.

55
Q

What type of shock is created from anaophylaxis?

A

Low-resistance shock.

56
Q

What causes a cardiogenic shock?

A

Loss of pumping capacity.

57
Q

Cardiogenic shock happens in what percentage of MI patients?

A

10% and is very deadly.

58
Q

The warm or cold aspects relate to what?

A

The presence or lack of compensatory mechanisms at work.

59
Q

What type of shock will blood pressure increase?

A

Hypovolemic shock.

60
Q

What type of shock will blood pressure decrease?

A

low-resistance shock.

61
Q

Why would you lay a patient down with head below trunk to treat shock?

A

to increase venous return.

62
Q

What type of disorder is lymphedema?

A

A tissue swelling disorder.

63
Q

Ultimately the only blood flow that matters is where?

A

In the tissues.

64
Q

What is interstitium?

A

aka Extra cellular matrix or ECM.

65
Q

Fluid/molecular movement is a function of what 5 basic factors?

A
  1. Solubility 2. Size 3. capillary permeability 4. concentration 5. pressure.
66
Q

What are the different types of capillaries?

A

type I, Type II, Type III.

67
Q

Of the different types of capillaries which one is most common?

A

Type I.

68
Q

Of the 5 basic factors of fluid/molecular movement which one is a huge determinate of the net flux across an endothelium?

A

Permeability.

69
Q

If a molecule can move across a capillary what will primarily drive the permeation ?

A

pressure dynamics between blood and interstitium.

70
Q

What are the 4 forces that determine net fluid exchange between the blood and the interstitium?

A
  1. Capillary pressure 2. interstitial free fluid pressure 3. plasma colloidal osmotic pressure 4. interstitial fluid colloidal osmotic pressure.
71
Q

What is capillary pressure?

A

An outward pushing force= Pc

72
Q

What is interstitial free fluid pressure?

A

an inward pushing force= Pt

73
Q

What is plasma colloidal osmotic pressure?

A

an inward pulling force= pi c

74
Q

What is interstitial fluid colloidal osmotic pressure?

A

an outward pulling force= pi t

75
Q

What do these 4 forces (that determine net fluid exchange between the blood and the interstitium) collectively produce?

A

A net driving force.

76
Q

What are the actual forces of capillary pressure?

A

10-20 mmHg

77
Q

What is the interstitial free fluid pressure?

A

around -6 mmHg

78
Q

What is a negative pressure?

A

It is just below atmospheric pressure.

79
Q

What is the plasma colloidal osmotic pressure?

A

around 28 mmHg

80
Q

What is the interstitial fluid colloidal osmotic pressure?

A

Around 5 mm Hg

81
Q

How can we determine the net driving force?

A

Add up all the pressures.

82
Q

Of the 4 forces which is the only one that has an inward pressure?

A

Plasma colloidal osmotic pressure.

83
Q

What will increased venous pressure do to capillary pressure?

A

Increase it.

84
Q

What will increased capillary pressure do to arteriolar resistance?

A

Decrease it.

85
Q

What will decreased arteriolar resistance do to capillary pressure?

A

Increase it.

86
Q

Of the different forces on blood in the capillaries which one is variable?

A

Pc aka capillary pressure.

87
Q

What will the net driving force be at for different parts of the capillary?

A

A net Out of around 7 at the arteriole end and a net in around -7 at the venule end.

88
Q

What is the net filtration when the net driving force is greater than 0, and when it is less than 0?

A

Greater than 0 = out, less than 0= in

89
Q

What is it called when the net fluid loss and net fluid resorption is 0?

A

Starling equilibrium.

90
Q

Where is the starling equilibrum found at?

A

Roughly the midpoint of the capillary.

91
Q

What is the net filtration pressure in the typical systemic capillary?

A

There is a slight net outward filtration pressure.

92
Q

Will blood that leaves one capillary return only to the same capillary?

A

no it can go to other capillaries.

93
Q

What is the slight net capillary out and what will it cause?

A

around 0.3 mmHg and it causes a flux from plasma to interstitium.

94
Q

Since our capillaries lose more plasma than they resorbe how much plasma is lost from the capillary system per minute?

A

2-3 ml/min.

95
Q

What is flux?

A

A net fluid movement.

96
Q

A net flux can be more percisely determined by including what 2 factors?

A
  1. Kf= filtration coefficient 2. A= surface area.
97
Q

What will pick up the lost plasma from the capillary system?

A

The lymphatic system.

98
Q

Where are lymphatic capillaries found at?

A

Nearly everywhere in the body.

99
Q

What is the pressure like in lymphatic vessels?

A

Very low.

100
Q

Since lymphatic pressure is so low how will it flow?

A

It uses valves and action of skeletal muscle to move blood.

101
Q

What is the use of valves and skeletal muscle to move lymph called?

A

The lymphatic pump.

102
Q

What can increase the lymphatic fluid pressure?

A

If the interstitial free fluid pressure is increased.

103
Q

What is the usual cause of increased interstitial free fluid pressure?

A

Increased capillary pressure.

104
Q

Increased capillary pressure will do what to arteriolar resistance and venous resistance?

A

Arteriolar resistance will decrease, and venous resistance will increase

105
Q

Of the 4 forces that determine net fluid exchange between the blood and the interstitium which one will go down if the interstitial free fluid pressure increases?

A

Plasma colloidal osmotic pressure.

106
Q

What is interstitial free fluid pressure normally like?

A

It is stable due to natural turgor of tissues that tend to resist internal stretching.

107
Q

How compliant are tissues generally?

A

Not very compliant.

108
Q

What happens to most fluid that leaves the capillaries?

A

It is conducted into the lymphatic system.

109
Q

What is the average amount of total body interstitium?

A

12 liters in average adult.

110
Q

What is the normal pressure of the lymphatic system?

A

around -6 mmHg

111
Q

At what lymphatic pressure will fluid go into the lymphatic system?

A

anywhere below zero.

112
Q

What is the safety factor?

A

The large range for lymphatic pressure where fluid will still be taken in. Lymphatics take fluid in for a decent range on either side of -6 mm Hg.

113
Q

What is the safety factor analogous to?

A

Blowing up a balloon it is hard to do until you reach a point and then it is easy to do.

114
Q

What happens when the safety factor is exceeded?

A

Fluids pour into tissues.

115
Q

What is edema?

A

fluid accumulation in tissues.

116
Q

How is increased capillary permeability caused?

A

burns, histamine from mast cells, injury. This allows for increased seepage by way of vessel wall changes.

117
Q

What can cause a high capillary pressure?

A

Venous obstruction, acute arteriolar dilation, cardiac failure

118
Q

What happens with high capillary pressure?

A

it allows for increased Net driving force and the starling equilibrium shifts to the right.

119
Q

What can cause a decrease in plasma protiens?

A

nephrosis (kidney disease), starvation, burns.

120
Q

What will decreased plasma proteins cause?

A

It allows for increased seepage due to decreased colloidal osmotic pressure.

121
Q

What causes lymphatic obstruction?

A

parasites, or surgery

122
Q

What will a lymphatic obstruction cause?

A

Lymphedema because it blocks the drainage from the lymphatic system and increases the interstitial free fluid.

123
Q

What is lymphedem due to?

A

accumulation of lymphatic fluid in interstitium.

124
Q

What will lymphedema cause?

A

Swelling in tissues.

125
Q

What is the pressure called that drives fluid out of the capillaries?

A

Capillary pressure.

126
Q

What is the fluid that pushes fluid out of the interstitial space called?

A

Interstitial free fluid pressure.

127
Q

What is the pressure that pulls fluid in from the interstitial area into the capillaries?

A

Plasma colloidal osmotic pressure.

128
Q

What is the pressure that pulls fluid out of the capillaries into the interstitial area?

A

Interstitial fluid colloidal osmotic pressure.

Physiology I Test I (8 decks)

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