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Human Body > Physiology (Cardio 2) > Flashcards

Physiology (Cardio 2) Flashcards

1
Q

Overall takeawayes

A
  1. Circulatory system exhanges substances between the blood and the tissue
    • Blood gives things to tissie and tossie puts waste into blood
  2. Arterioles control regulate blood flow
  3. Capilaries regulate exchange
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2
Q

What is the blood composed of

A

Overall - Plasma + Hemocrit
1. Proteins (Albumin, Globulin, Fibrogin)
- Albumin = most abdinent (comes from the liver)
- Globulin = comes from the immune system
2. Water (Water + ions + nutrients)
3. Hemocrit - cells (RBCs, WBCs, Platlets)
- RBCs = most abduent
- When spin down blood the cells go to the bottom)

Plasma = proteins + water

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3
Q

Garden hose analogy

A

The pressure the hose delivers to force wtaer out is based on:
1. How much flow
2. How narrow the tuve is

IF squeeze the hole = water goes faster = goes faster as you increase the resistance???

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4
Q

Hemodynamics (Pressure equation)

A

Pressue of blood vessel = Flow X Resistence
- Flow = pump = heart –> when heart squeezes you get cardiac output
- Resistence = Blood vessels dialating

dP = Flow (q) X resistence (R)

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5
Q

Cardiac output

A

Cardiac output = flow –> Cardiac output = stroke volume X herat rate

CO – heart squeezes and relaxes
- Squeezes once per second ; squeeze 100 mL –> squeeze 10 times = squeeze 1 mL

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6
Q

Normal cardiac output

A

Cardiac output is usuallly 4 Liters/minutae

Normal flow = 4 liters/minute

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7
Q

Pumps and circuts in the body

A

There are two pumps and two circuts in the body

  1. Heart
  2. Pulomary

BOTH = dP = flow (flow = Cardiac output) X resistence –> dBP = CO X systemic vascular resistice
- Pressure in lungs = flow X resistnce

AND dbP = Flow X Pulimary vascular resistence –> dBP = Cardiac output X Pulimary vascular resistnce

Cardiac output and systemic vascular resistnce –> lead to blood pressure

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8
Q

Stroke volume

A

How much volume per stroke

CO = How much volume per stroke X how many strokes
- Heart beats fast = higher Cardiac output
- Heart is good at squeezing = higher cardiac output ; Bad at squeezing = lower cardiac output

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9
Q

BP equation

A

BP = Cardiac output X resistnce –> dBP = Cardiac output X Systemic vacular resstnce

Cardiac output = deterined by heart squeezing per minute

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10
Q

ALL together stroke vlume, CO, Resistnce, Blood pressure

A

Stroke volume and Heart rate –> gives cardiac Output

Cardiac output and systemic vascular resistice –> gives Blood pressure

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11
Q

Anatmy of the cardiovascular system (overall)

A
  1. Heart
  2. Pulminary circulation
  3. Systemic circulation
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12
Q

Heart Pumps

A

Heart = has two pumps (one on the left and one on the right)
- right = pumps blood to the lungs
- Left = pumps blood to the body

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13
Q

Heart division

A

Heart = 2 Sides
- Blue = dosxyganted blood going to the lungs
- red = oxygenicated blood going to the body

Image: Right side = red blood –> going to the body –> blood turns to blue because th body uses teh oxygen –> deoxygnated blood goes to the heart –> blood go to the lung to get reoxugented

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14
Q

Pulminary circulation

A

Pulminary circulation:
- Has blood flow
- has gas exchnage (Exchanges CO2 and O2)
- Uses hemoglobin

See in image in the left side - blood with CO2 goes to the lungs - the CO2 is exchnaged for O2 in the lungs - O2 rich blood goes back to the heart –> blood goes to the body

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15
Q

Systemic Circulation

A

Oxygeated blood going from the heart to the tissues (red blood goes to the body) –> tissues use the oxygen –> deioxygenated (blue) blood goes back to the heart

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16
Q

What carries oxygen in the blood

A

Hemoglobin (carrier of has that will be exchnaged)

O2 dissolves in water at low levels –> BUT binds to hemoglobin at higher levels = hemoglobin carries O2

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17
Q

Pulminary Circulation (image 2)

A

Blue = goes to the lungs –> gets O2 –> now have red blood with O2

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18
Q

Oxygen exchange in the lungs

A

Overall - O2 exchnage happens in the capilary

O2 enters the aveoli (because have O2 in air???) –> O2 diffuses across averoli and goe sto cells –> Cells go to the body

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19
Q

Systemic Circulation

A

Uses:
1. Blood flow
2. Oxygenation
3. Hemoglobin

Oxygenated (red) blood goes to the body –> blood goes to the tissues –> tissue puts waste into the blood + O2 is unloaded from the hemaglobin in blood –> blood goes back to the heart

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20
Q

O2 movment overall

A

O2 is in the air –> O2 goe sinto the lungs –> O2 goes inot the blood –> Blood gives O2 to the peripheral tissue

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21
Q

Blood vessel histology

A

Blood vessels all have 3 layers:
1. Intima - Single layer of endothelial cells
- Has internal elastic lamina
2. Media - Smooth muscle cells
- Middle layer of vessel wall
- External elastic lamina
- Arteries = have a big media layer ; veins are weeker = have a smaller media layer
3. Adentitia - Smooth muscle cells + connective tissue + ECM

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22
Q

Atery cross histology cross-section

A

Intima - single layer of endothelial cells on inside
Media - large layer of smoooth muscle
Adventia - on the outside

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23
Q

Circulatory Vasculator

A

Arteries + capilares + veins –> bring blood to the heart and blood from the heart to the lungs

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24
Q

Arteries function

A

Arteries send blood to the periphery

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25
Q

Pressure change in different vessels

A

Biggest drop in systemic pressure is across arterioles
- Blood pressure drops for smaller vessels
- As you go form Aorta –> Arteries –> arterioles = getting smaller vesells BUT capilaries to venuals to veins the vessels get bigger

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26
Q

Capilaries

A

Capilaries - Thin walled vessels with pores
- Pores = allow for diffusion

Arteries regulate blood flow into the capilaries

Have diffision across capilary (Capilary = where exchange occurs)
- Difusion of water + ions + nutrients (Ex. glucose) + gasses (CO2 and O2) + Small proteins

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27
Q

Capilary structure

A

Capilaries = connect arteries and veins –> can have an exchnage of substances across capilaries
- Example - put O2 from artery (oxygenated) blood to deoxygenated vein blood

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28
Q

Forces in the Capilaries

A
  1. Hydrostatic pressire - pushes fluid out of the capilary (Put water out of the capilary)
  2. Oncatic pressure - Water going into the capilary
    • Water goes up the concetration gradient (Going towards area of high solutes)

As the water leaves the capilary due to hydrostatic pressire - you have an increase in concetration of the protein in the capailary (because les diliuted form the water) –> water goes in towards the region of high portein concetratio (goes into the capilary)

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29
Q

Different forces in different areas of the capilary

A

Start of the capilary = have hydrostatic pressure = water goes out of the capilary –> end of the capilary have oncatic pressure (water goes in)

Starlings law - fluid movement = k[Pc+Pii] - (Pi + PiC)

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30
Q

Hydristatic vs. Oncotic pressure

A

Hydrostatic = Tissue Pi and capilary Pc
- Start of the capilary = lost of pressure to get the fluid out

Oncotic = Tissie Pii and Capipary PiC
- End of the capilary = high oncotic pressire –> fluid goes into the capilary

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31
Q

Capilary Functions (Overall)

A
  1. Gas Exchnage (Oxygen, CO2, NO)
  2. Nutrient Exchange (Glucose + Amino Acids)
  3. Fluid Exchange (Water)
32
Q

Capilary Functions mechanism Gas exchnage

A

Gas Exchange:
1. O2 goes into the tossie because it flows down the concetration gradient (High O2 coming from the heart to low O2 going to a vein)
2. Have a lot of CO2 in the tisue (where the dexegnated blood is) = CO2 flows down gradient into the blood
- Get CO2 from blood vessels

33
Q

Peripheral Arterial disease

A

Disease where the blood vessels get narrow

Narrow blood vessels = less blood is delivered to the tossie = less )2 and nutrinets go to the tissue + have a build up of waste in the tissue

34
Q

Venous system

A

Function - Transports blood from the periphery back to the heart

Starts as venules (Smallest) –> goes to be bigger veins –> veins converge to create the vena cava (biggest)

Most blood = in the venous system - 64% (2/3) of blood is slowly being moved in the veins to the heart

Overall - Oxygenated blood is used in the system –> goes back deoxygenated in the veins

35
Q

Venous Disease

A

Veins don’t work –> blodd builds up in leg –> don’t get gas or nutrient xchnage –> tissue breaks down

36
Q

Lymphatic system

A

Overall - vascular system in the body that is seperate from blood
- Takes away waste
- vessles that drain interstaial space
- Empty out into venous circulation at the thoracic duct
- Thin-walled vessels
- Sewer system that collects water
Fluid flows out of the blood (flows out of the capilaries) –> fluid goes to the lymphatic system –> vessels come out of thoracic duct go to drain the fluid

37
Q

What does the lymphatic system collects

A

Lymphatc = collectx water and waste from the tissue + collects virsues/bacteria/antigens (monitors issues)

Extra fluid in tisue = taken up by the lympathic tissue

38
Q

Split of lymphatic system

A

Comes off the venous system –> goe sto large lympathtic vessles –> goes to lymph node

39
Q

Filariasis

A

Worm (Wucheria bancrofti) infects people through masquitoes –> worm enters the lympahtic system – blocks the lympatic system

Infects the leg lymphatic system = lymph return is blocked = leg sweels

40
Q

What determines systemic vascular resistence

A

Vasculature is constantly regulated by opposing forces of vasoconstriction and vasodilation
- Blood vessles always relac and dilate at the same time (two forces oppse each other)
- If you stop contracting the vessel = the vessl will dilate (because if no contraction then it would be able to dilate)

41
Q

Regulation of blood flow

A

3 Systems regulation dilation and contraction:
1. Nueronal - brain contrls blood flow through nuerons
2. Hormonal - Kidney controls blood flow through hromones
3. Local - Arterial control blood flow

ALL three systems are active at the same time

42
Q

Regulation of blood flow (Sensors)

A

There are receptors all throughout the body –> repctors sense the blood pressure and prodvide feedback to all of the systems to reponde (Dilate or constrict the area)

Sensors in the body detect BP –> Sensors tel the brain, kidney, and local factors –> nerves, hormons, local factors respond and regulate the heart and blood vessles

43
Q

Things that regulate blood flow

A
  1. Receptors
  2. Afferent nerves
  3. Brainstem
  4. Efferent nerves
  5. Vascular response
44
Q

Regulation of blood flow (brain)

A

Regulation is completed through nuerons –> done through the autonomic nervous system
- Autonomic = involtary (hard to control conciously)
- Driven by nerves going to the body

Uses Sympthetic + Parasympathetic

45
Q

Regulation of Blood flow Sympathtic vs. parasympathetic

A

Sympathetc (fight or flight) –> constricts Blood vessels
- Uses Pond/medula + spinal cord + arteries + norepinephrine
- Have Vasomotor center in the brain stem –> sends nuerons to blood vessels and heart

Parasympathetic –> relaxes
- Uses brain + Spinal cord + heart/other ogans + Acetylcholine
- PNS does not innervate vessels

46
Q

Regulation of blood flow (Barororeceptor)

A

Brain gets reponse about blood pressure form the sensors in the body –> brain response to sense and controls blood flow

Barrarorecptors = sense BP in body –> Sends signal to the brain
- If Barorector sense high BP –> Brain sends signal to nerve to stop constricting = decrease the BP

Goes form sensors in aortic arch _ coratic + atria + ventricles –> Autonimic nervous system –> signals go to vessels and heart

IMAGE - shows the path of system

47
Q

Hypertension of Fast Heart rate in ER

A

If someone has hypertention of Fast heart rate i the ER –> doctors can massage the coroted –> receptors think that the BP is high –> Bararorecpotors will tell the brain to send signals to the nervous system to respond

48
Q

Chemorecptor regulation of blood flow

A

Chemorecptors - sense the Oxgen level in blood –> sends message to the brain –> brain sends message to the autonmic system
- Example - if the blood needs more O2 then the brain will signal to breath faster
- Affect = decreases O2 or increases CO2
- Aorta + cortid + medulla (where receptors are?)
- Uses autonimic
- Can cause vasoconstriction = increases the Heart rate + increases reporation = gets more O2

49
Q

Homonal regulation of blood flow (overall)

A

Have vasoconstrictors and vasodilators - hormones can increase or decrease BP

Uses teh Kidneys –> Kidneys sense BP

Vasoconctrictors:
1. Adrenal gland (make Epinepheran + cortisol)
2. Kidneys (make renin)
3. Pituitaruy (makde Vassopresing - ADH)

Vasodilators:
1. Tisues (local regulators) - Produce Hypoxia + CO2 + Adenosine + Bradykinin + Histamine + Seratonin

50
Q

Kidneys sensing Low BP

A

Major hormones that control BP from kidney = angiotensinoin and aldosterone

Example - if the kidneys sense decrease in BP –> kidney sends hormon Renin –> renin acts on teh angiotensionin(from the liver) –> get angiotensinoin 1 –> ACE acts on angiotensinoin 1 –> get angiotensinoin 2 –> angiotensinoin 1 is a vasoconstrictor = vascoconstrocts
- End = get angiotensinoin 2 = acts on Blood vessles
- rapid responce

Kidney = also induces aldostereone –> aldosterone will induce to kep salt and wtaer + pee less
- Long term effect (slower repsonde)

51
Q

Affect of brain + kidney

A

Burrorecptors = doted lines –> go to brain stem –> integrates signals –> sends signals to the heart + blood vessels

Kidney = sense BP = makes renin + andiogenstsin

52
Q

Local Mediators (Overview)

A

Every tissue regulates blood flow locally –> produces things to constrict or dilate arteries
- example - if have too much nuertnets –> have atretial vasoconstriction
- if need O2 or Amino acids = have vasodilation (done locally + through brain + through kidney)

Have vasodialtors and vasoconstrictors

Vasodilators - Nitric Oxide
Vasoconstroctors:
1. Peptides - Endothelins + Angiotensin
2. Arachadonic Acid - EDHP + Thromboxane

53
Q

What leads to vasodlation

A

Have metabolic demands (Decreased O2 or Increased Co2 or Adenosine) –> leads to vasodilation

54
Q

NO mechanism

A

Endotheliam cell = contrls dilation at local level through NO product
- Endothelial cell has eNOS

NO diffuses to the smoothe muscle (diffsuses across the cell layer) –> activated mediater to cause dilation (mediator = cGMP ; smooth muscle has cGMP) –> Get H+ or CO2 or K+ to tissue cell –> get

55
Q

NO structure

A

NO is a free radical = very reactive + has a short half life

NO diffuses across cell memebranes

NO reacts with superxides + metals + thiols

NO = gas –> has no protein rceptor

56
Q

NO synthesis

A

Synthesized by NO synthetase

Agrinine (Amino acid) + O2 –> Cirtiline (Amino Acod) + NO

Enzyme = Nitric Oxide sythetase - Uses NADPH + FAD + FMN + H4 biopterin

Overall - Rip electron off of NAPHD to create NO

57
Q

Affect of NO on Vasculator

A

NO = vasodialtaor (causes the arterial to dialte)
- Endthelial cell disfunction (I THINK if have issue with enodthelial cells = have isue with NO = issue with dialation)

If have a disease in NO = have issue with dialation

NO:
1. Vasodilator
2. Has Antithormotoc activity (affects platlets)
3. Has anti inflamatory activity (affects lymphocytes)

58
Q

How does NO cause vasodilation

A

Endothelial cells have NOS = make NO –> NO diffuses to smooth muscle cells –> NO turns on signaling cascade (NO activates gunylate cyclase –> Gunaylate cyclase make cGMP –> get kinase –> have a relaxation of the smooth muscle cell

59
Q

NO Overall

A

NO is produces by blood vessels + some drugs

NO Dilates the blood vessels + protects blood vessels from disease
- Loss of NO predisposes to artheroscelrosis

60
Q

What causes local vasoconstriction

A

Have metabolic demands –> get Enodthelin + Angiotensi 2 + superoxide + EdHF + Thromboxan –> Get vassoconstriction

Many things that constrict affect vessel dilation –> moleculaes diffuse from the tissue –> hits the vessel –> consticts the vessel

61
Q

Vascular disease

A
  1. Hemerage
  2. Shock
  3. Hypertension
  4. Artherosclrosis
62
Q

Hemorrage

A

Overall: Loss of blood
- Heart rate goes up
- Blood pressure goes down
- Have vasoconstriction (causes people to become pale)

IF you lose 10-20% of blood –> body can compensate
- Body senses that you have a decrease in BP and tries to incerase BP

Compensatory mchanism =
1. Barororecotors - sense BP is lowered –> tells the brain –> tells the vessles to constrict (fast resposne)
2. Chemorecotors - Makes angiostenin + holds onto salt and water over time
3. Vasoconstriction
4. Renal mechanisms

63
Q

Mechanim of loss of Blood Pressure in Hemerage

A

Less blood in the system = Cardiac outpuc decreases = Blood pressure decreases
- Based on equation BP = Cardiac output X systemic vascular reisstence (CO decreased = BP decreases)

IF have a really low BP (lose >20% of blood) = body can’t compensate = get hypotension = tissues don’t get blood = brain can’t think + muscles can’t constrict

64
Q

Shock

A

Hypotension (I THINK can cause shock - list below causes hypotnesion = causes shock)
- Heart attcked = decrease BP
- Issue in brain (autonmic not working) = Decrease BP
- Sepsis = barriocetprois in body don’t work = local system doesn’t work

Inability to profuse tissues

Organ dysfunction (urine + mental)

Differential diagnosis –> Hypovlemia + cardiogenic + nueroggenic + septic

65
Q

Clincal role of NO

A

NO = acts as immune effector
- NO kills viruses + bacteria + aytpical bacteria + fungi + Parasites

If have lots of bacteria –> body makes a lot of NO to kill bacteria = get vasodilataion –> if have too much NO then get too much dialation

66
Q

Sepsis and NO

A

Sepsis = caused by overproduction of NO –> can lead to hypotension ad death
- get hypotension because NO dilates the blood vessles to much

Have infecation/bateria –> get NO –> dilated vessles too much –> get hypotension

67
Q

What happens if arteries dilate

A

Arteries dilate = resistnce decreased = BP decreased

Based on dP equation (dBP = CO X systemic vascular resistence)

68
Q

Hypertension

A

When blood pressure is >130/85
- When healthy - brain and kidney keep BP at 120/80 (normal) but sometimes the kdiney increases teh BP to 130/85
- Clasifications = unknown + renal + endocrine

Often due to kidney not working + kidney does not extrecet slay and water at normal blood pressures

69
Q

BP throughout the day

A

BP varies throughout the dau (highest 1-5 AM) + varies if excersizing

70
Q

Normal kidney response vs. hypertension

A

Noormally when you eat salty food + water –> kidneys see BP and makes les angiostnin + aldronin BUT somtimes the kidneys decide to want a higher BP = release hormones and hold onto more sat and water = keeps high BP

71
Q

Hypertension mechanism

A

Normal = hypervolemia –> increase BP –> kidneys sense BP –> Kidneys extretes salt + water == Volume decreases –> BP decrease

During Hypertension –> Kidneys want the avergae BP to be higher –> kidneys sense 120 as low –> kidneys work to incerase the BP by releasing antiostensin + holding onto water = BP rising over the course of years
- Kidney regulates body fluid and blood pressure
- Renin-angiotensi-aldosterone hormeon system is activated = kidney retains excess salt and water
- Have increase CO + release of angiotensin = increase resistence

IF BP is 130/80 = need lifestyle chnage (need t treat because overtime high BP can caus eissues)

72
Q

Atheroscelorsis

A

Disease of the arteries - hardening of the arteries

Risk factors - smoking + diabetes + cholestrol + family history
- High cholestrol for a long period of time –> get atheroscelrosis –> get heart attack

When have damage to endothelial lning = cuases issues
- Pathogensis = endothelial damage + inflamation

Inducers - Nicotone + oxidized LDL

73
Q

Atheroscelorsis + damage to endothelium

A

High choletral = endothelium will be enflamed –> white blood cells will become adherant to the endothelum –> inflamatories enter the vessel wall to scuh the cholestral out –> have fatty secretion –> have wall off and scarr invades the vessels –> vessels become filled with lipids + smoothers + smooth muscle –> blocks the vessle –> get heart attck or stroke
- have stroke if occurs in brain

Overall - have smooth muscle migration + form cell formation + T-cell activarion + adherance and agregasion of platelets + adgerane and entry of luekocyes = block the vessel
- Can also have macrophage accumilation + formation of necrotic core + fibrous cap formation

74
Q

Ruptured cap in Atherosckerosis

A

Have plaque ruptire + thinnning of fiberous cap + hemoerrahe from plaque microvessels

75
Q
A

Human Body (31 decks)

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