PTA - section 2 Flashcards

1
Q

SYSTEMIC CIRCUIT

A
  • vessels carry blood from the heart to the tissues and back to the heart
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2
Q

PULMONARY CIRCUIT

A
  • vessels carry blood from the heart to the lungs and back to the heart
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3
Q

OXYGEN POOR, CO2 RICH

A

-blue

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4
Q

OXYGEN RISH, CO2 POOR

A
  • red
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5
Q

THE HEART COVER

A
  • covered in a sack of pericardium, that has fluid to help with friction during contraction
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6
Q

VENTRICLES

A

-occupy the bulk of the heart

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7
Q

ARTERIES AND VEINS

A
  • are attached to the base of the heart
  • visible on the surface of the heart
  • enter heart walls to deliver oxygen & nutrients & waste
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8
Q

CORONARY SINUS

A
  • delivers deoxygenated blood to right atrium
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9
Q

VENTRICLE THICKNESS PULMONARY

A
  • low pressure, low resistance, less thickness
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10
Q

VENTRICLE THICKNESS SYSTEMIC

A
  • high pressure, high resistance, thicker wall
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11
Q

MYOCARDIC MUSCLES

A
  • fibres arranged spirally

- spiral provides ringing effect at contraction which squeezes blood upward from apex

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12
Q

DESMOSOMES

A
  • strong connection of force from one cardiac cell to another
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13
Q

GAP JUNCTIONS

A
  • channels allow ions to spread from one cell to another
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14
Q

INTERCALATED DISKS

A
  • contain desmosomes and gap junctions
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15
Q

INLET

A
  • right (AV) tricuspid, left (AV) bicuspid
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16
Q

OUTLET

A
  • pulmonary semi- lunar valve, aortic semi lunar vavle
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17
Q

1ST STEP OF BLOOD FLOW

A
  • av valves open in left ventricle, atrial pressure is great than venticle pressure
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18
Q

SEMILUNAR VALVES WHAT DO THEY DO

A
  • prevent the black flow of blood during ventricular filling
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19
Q

FLAP CONNECTED TO PAPILLARY MUSCLES

A
  • prevent flaps from being push backed into the atrium when the ventricles contract
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20
Q

2ND STEP OF BLOOD FLOW

A
  • AV valves close, ventricle pressure greater than atrial pressure, aortic semilunar vavles open
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21
Q

HEART SOUNDS

A
  • Closure of heart valves creates turbulent flow
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22
Q

1ST SOUND

A
  • inlet AV valves closing lubb
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23
Q

2ND SOUND

A
  • outlet valves closing dupp
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24
Q

CARDIAC VS SKELETAL SIMILAR

A
  • striated

- sarcomere structure

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25
Q

CARDIAC VS SKELETAL DIFFERENT

A
  • muscles fibres shorter cardiac
  • braches
  • singular nucleus
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26
Q

CARDIAC VS SMOOTH SIMILAR

A
  • electrically linked to one another
  • exhibit pacemakers
  • under sympathetic and para control as well as hormone
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27
Q

CARDIAC VS SMOOTH DIFFERENT

A
  • gap junctions in intercalated disks
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28
Q

PACEMAKER

A
  • helps maintain the heartbeat
  • used to speed up slow heart beats
  • maximize heart circulation
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29
Q

BRADYCARDIA

A
  • heart beat too slowly
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30
Q

TACHYCARDIA

A
  • fast beating heart
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31
Q

PACEMAKER STRUCTURE

A
  • battery
  • pulse generator
  • electrodes to heart
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32
Q

TEMPORARY ENDOCARDIAL (transvenous) PACE

A
  • the pulse generator is the outside heart
  • tempory abnormality
  • waiting for permanent
  • right atrium make connect with endocardium
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33
Q

EXTERNAL PACE (transcutaneous)

A
  • emergency

- generator outside

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34
Q

TEMPORARY EPICARDIAL PACE

A
  • surgery
  • can cause inflammation
  • bradycardia
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35
Q

PERMANENT (internal)

A
  • heart block - 3d & 2nd degree

- symptomatic sinus bradycardia

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36
Q

Most of the cardiac muscle of the heart is found in the:

A

Myocardium

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37
Q

The right ventricle pumps _______ blood into the _______ circulation.

A

deoxygenated; pulmonary

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38
Q

The _______ supply oxygenated blood to the heart muscle itself

A

coronary arteries

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39
Q

The wall of the left ventricle is thicker than the wall of the right ventricle because the:

A

Left ventricle must pump the same amount of blood into the high-resistance, high-pressure systemic system as does the right ventricle into the low-resistance, low-pressure pulmonary system

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40
Q

How is blood drained by the tissues of the heart?

A

Mainly into the coronary sinus, which empties into the right atrium

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41
Q

Which chamber of the heart has the thickest musculature?

A

Left ventricle

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42
Q

The function of the pericardial fluid is to:

A

reduce friction between the heart and the pericardium

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43
Q

Chordae tendinae are strands of connective tissue extending from________ to ________?

A

AV valves : papillary muscle

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44
Q

Which of the following is NOT a component of the pulmonary circuit?

A

Vena cava

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45
Q

The source of blood carried to capillaries in the myocardium would be_______

A

coronary arteries

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46
Q

EC COUPLING CARDIAC 1

A
  • action potential enters from adjacent cells
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47
Q

EC COUPLING CARDIAC 2

A
  • voltage gated ca2 channels open, ca2 enters cells
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48
Q

EC COUPLING CARDIAC 3

A
  • ca2 induces ca2 release through RYR channels
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49
Q

EC COUPLING CARDIAC 4

A

local release ca2 sparks

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50
Q

EC COUPLING CARDIAC 5

A
  • summed ca2 sparks create a ca2 signal
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51
Q

EC COUPLING CARDIAC 6

A
  • ca2 ions bind to tropinin to initate contraction
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52
Q

EC COUPLING CARDIAC 7

A
  • relaxation occurs when ca2 unbinds from troponin
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53
Q

EC COUPLING CARDIAC 8

A
  • ca2 is pumped back into sacroplasmic reticulum for storage
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54
Q

EC COUPLING CARDIAC 9

A
  • ca2 is exchanged with a by NCX antiporter
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55
Q

EC COUPLING CARDIAC 10

A
  • na gradient is maintained by Na k atpase
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56
Q

EC COUPLING CARDIAC VS SKELETAL

A
  • initiation of actional potential
  • source and role of ca2 in muscle contraction
  • muscle relaxation - handling of unbound ca2
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57
Q

FRANK STARLING MECHANISM 1

A
  • crowding do to actin overlap

- no force

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58
Q

FRANK STARLING MECHANISM 2

A
  • actin overlap due to polarity

- force same

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59
Q

FRANK STARLING MECHANISM 3

A
  • no problems / no overlapping

- lots of force

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60
Q

FRANK STARLING MECHANISM 4

A
  • really stretched
  • actin is out of reach
  • no force
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61
Q

FRANK STARLING LAW

A

The law states that the stroke volume of the heart increases in response to an increase in the volume of blood in the ventricles, before contraction (the end diastolic volume), when all other factors remain constant.

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62
Q

In excitation-contraction coupling in myocardial contractile cells, Ca2+ induces Ca2+ release from the sarcoplasmic reticulum through:

A

Ryanodine receptor channels (Ryr)

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63
Q

When a cardiac contractile cell is stimulated:

A

Voltage-gated Ca2+ channels open. Ca2+ enters the cell

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64
Q

From the point of Ca2+ diffusing through the cytosol to the contractile elements, what step below is unique to cardiac contractile muscle cells compared with skeletal muscle cells?

A

Ca2+ is removed from the cell via a Na+- Ca2+ exchanger

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65
Q

In excitation-contraction coupling in myocardial contractile cells, the Ca2+ that causes contraction comes from:

A

The opening of Ca2+ -sensitive channels in the sarcoplasmic reticulum that have picked up calcium from the extracellular fluid

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66
Q

AUTHORHYTHMIC CELL ACTION POTENTIAL

A
  • sa node =pacemaker
  • funny channel open, then close at -40 ca open
  • ca close at threshold, k open, close at -60
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67
Q

CONTRACTILE CELL ACTION POTENTIAL

A
- na open
na close
ca opn, fast k close
ca close, slow k open 
resting
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68
Q

REFRACTORY PERIOD OF CARDIAC CELL

A
  • force of contraction can be graded = to how much ca enters
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69
Q

If channels are permeable to:

A

Na+ and K+

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70
Q

Myocardial cells can generate action potentials spontaneously because they have

A

unstable ion channels

71
Q

A typical action potential of a myocardial contractile cell lasts ________ millisecond(s).

A

at least 200

72
Q

Epinephrine and norepinephrine increase ion flow through ________ channels.

A

If and Ca2+

73
Q

The action potentials of myocardial autorhythmic cells are due to a combination of increasing Na2+ ________ and decreasing K+ ________.

A

influx, efflux

74
Q

The flattening of the action potentials of myocardial contractile cells, called the plateau phase, is due to a combination of ________ K+ permeability and ________ Ca2+ permeability.

A

decreasing, increasing

75
Q

During the plateau phase of the action potentials of myocardial contractile cells, which ion(s) is/are crossing the membrane?

A

both Ca2+ and K+

76
Q

The rapid depolarization phase of the action potentials of myocardial contractile cells is due to which ion(s)?

A

Na+ only

77
Q

The action potential in a cardiac contractile cell causes:

A

opening of L-type calcium channels

78
Q

In cardiomyocytes, voltage-gated Na+ channels are found in the _______ cells and contribute to the _______ phase of the action potential

A

contractile; depolarization

79
Q

CONDUCTING HEART SYSTEM

A

sa node –> intermodial pathways –> av node –> av bundle –> bundle branches –> purkinjie fibers

  • sa node depolarizes
  • electrical activity goes rapidly to av node via intermodial pathways
  • depolar spreads more slowly across atria conductions slows through av node
  • depolar moves rapidly through ventricular cconducting system to apex of heart
  • depolar wave spreads upward from apex
80
Q

ECG

A
  • the summuened electrical activity of the heart
81
Q

P WAVE

A
  • atrial depolarization
82
Q

P-R SEGEMENT

A
  • conduction through AV node and av bundle
83
Q

Q -T WAVE

A
  • ventricular contraction
84
Q

T WAVE

A
  • ventricular repolarisation
85
Q

HEART EXCITATION NOTE

A
  • QRS = to ventricular depolarisation

- t = repolarisationn

86
Q

AUTONOMIC CONTROL OF HEART RATE - PARA

A
  • decreases heart rate

- stimulation of hyperpolarizations

87
Q

AUTONOMIC CONTROL OF HEART RATE - SYM

A
  • increases heart rate

- stimulation of epinephrine

88
Q

AVERAGE RESTING HR

A
  • 72 beats
89
Q

STROKE VOLUME

A
  • amount of blood pumped by one ventricle during a contraction
90
Q

CARDIAC OUTPUT

A
  • measurement of effectiveness of heart as a pump

co=hr x sv

91
Q

CARDIAC PERFORMANCE HEART RATE

A
  • postive sympathetic

- negative para

92
Q

CARDIAC PERFORMANCE STROKE VOLUME

A
  • end of disastolic volume venous return/ preload (P)
  • contractile strength of heart muscle (P)
  • load on the ventricle as it contracts afterload (N)
93
Q

AUTOHYTHIMIC CELLS PARA HORMONES AND NERVES

A
  • acetylcholine vagus nerves
  • slow heart beat
  • muscarinic receptors
94
Q

AUTOHYTHIMIC CELLS SYM HORMONES AND NERVES

A
  • thoracic spinal nerves/norepinephrine
  • fast heartbeat
  • b1 - adrenergic receptors
95
Q

STROKE VOLUME

A
  • 70 ml
96
Q

LONG TENSION RELATIONSHIP SKELETAL

A
  • resting muscle = optimal length for developing maximal tension
  • is longer or shorter = contraction is weaker
97
Q

LONG RELATIONSHIP CARDIAC

A
  • resting muscle fibre length is less than optimal length
98
Q

LONG TENSION RELATIONSHIP FILL MORE BLOOD

A
  • increase stroke volume
99
Q

EDV IS DETERMINED BY VENOUS RETURN

A
  • EDV is an indicator of ventricular preload
100
Q

LONG TENSION RELATIONSHIP RELEASE CATECHOLAMINES TO INCREASE VENTRICULAR CONTRACT

A
  • increase stroke volume
101
Q

AFTERLOAD WITH CONTRACTION OCCURS

A
  • reflects the preload and the effort required to push blood out into the circulation = increase in cardiac workload
102
Q

CYTOKINES

A
  • Determine pathway
  • regulate blood production
  • stem cell factor
103
Q

PLURIPOTENT HEMATOPOIETIC STEM CELL

A
  • ability to become different cells
104
Q

ERYTHROPOIESIS

A
  • erythrocyte production (red blood cells)
  • occurs in bone marrow
  • don’t have nuclei = cant repair
105
Q

KIDNEYS CELLS (negative feed back loop)

A
  • detect decrease delivery (hypoxia)
  • kidney secretion erythropoietin increase
  • increase red blood cell production in bone marrow
  • increase circulating red blood cells
  • increase in oxygen delivery in tissues
106
Q

RED BLOOD CELLS NUTRITIONAL REQUIREMENT

A
  • iron for heme groups
  • cells division
  • folate (dna production)
  • vitamin B12
107
Q

DISORDERS OF BLOOD CELLS

A
  • deficiencies in cytokines

- anticancer treatments

108
Q

SYNTHETIC EPO

A
  • clinical uses (cancer, anemia)

- potential abuses ( performance enhancing drug)

109
Q

LEUKEMIA

A
  • cancer from abnormal growth and development of leukocytes
110
Q

DESTRUCTION OF RED BLOOD CELLS

A
  • become fragile with age
  • cannot repair
  • components recycled
111
Q

AGGLUTINATION

A
  • when antibody and same antigen bind together

- clumping of blood

112
Q

GROUP O

A

-universal donor

113
Q

GROUP AB

A
  • universal receiver
114
Q

RHESUS FACTOR - NEGATIVE

A
  • no rhesus antigens

- no antibodies

115
Q

RHESUS FACTOR - POSITIVE

A
  • rhesus d antigen

- no rhesus antibodies

116
Q

RHESUS NEGATIVE EXPOSED

A
  • no rhesus anitgens

- anti rhesus antibodies

117
Q

RH FACTOR PROBLEM

A
  • if the mother is negative and baby is positive
  • it can kill baby
  • injected with antibodies to stop this
118
Q

HEMOSTASIS

A
  • prevention of blood loss
119
Q

HEMOSTASIS PRODUCTION

A
  • vasoconstriction
  • platelet plug
  • coggulation
120
Q

VASOCONSTRICTION

A
  • immediate
  • smooth muscle contraction
  • reduces blood flow
121
Q

PLATELET PLUG

A
  • mechanical blockage of hole
  • exposed collagen causing binding of platelets
  • platelet factors (ADP, TXA)
122
Q

CLOT FORMATION

A
  • formation of fibrin protein mesh that stabilizes platelet
123
Q

CLOT PATHWAY

A
  • extrinsic activated first
  • thrombin formed
  • 3 pathways in intrinsic
124
Q

THROMBIN

A
  • positive feedback model to promote more clotting
125
Q

LIVER

A
  • impaired blood clotting
126
Q

FIBRINOLYTIC SYSTEM

A
  • dissolved clotting
127
Q

INHIBITION OF PLATELET ADHESION

A
  • limitation of the clot to the damaged area (NO, prostacyclin)
128
Q

INHIBITION OF COAGULATION CASCADE

A
  • anticoagulants block reactions in clotting
  • heparin and antithrombin
  • protein c
129
Q

Which of the following are the two anticoagulants produced by the body?

A

Antithrombin III and Heparin

130
Q

Which of the following regarding platelets is CORRECT?

A

They are fragments of large cells.

131
Q

The fibrinolytic system:

A

refers to the physiological removal of the clot.

132
Q

Which of the following does NOT play a role in blood clot formation?

A

Plasmin

133
Q

The platelet plug does not continuously expand along the entire length of the blood vessel due, in part, to the action of:

A

prostacyclin.

134
Q

An agent that promotes the coagulation of blood; also called a clotting factor

A

procoagulant

135
Q

Plasma protein that forms polymer fibres that stabilize platelet plugs; inactive form is fibrinogen

A

fibrin

136
Q

Enzyme that breaks down fibrin

A

plasmin

137
Q

Plasma protein that converts fibrinogen into fibrin

A

thrombin

138
Q

A genetic blood defect that is characterized by delayed clotting of the blood and consequent difficulty in controlling haemorrhage even after minor injuries

A

haemophilia

139
Q

A protein-phospholipid mixture released by damaged blood vessel walls

A

tissue factor

140
Q

Any chemical that inhibits blood coagulation

A

anticoagulant

141
Q

A blood clot that adheres to the wall of a blood vessel

A

thrombus

142
Q

A detached blood clot that travels through the bloodstream and lodges so as to obstruct or block a blood vessel

A

emblous

143
Q

A molecule that promotes dissolution of blood clots

A

tPA

144
Q

Substance in membrane of intact endothelial cells that precents platelets from adhering

A

prostacyclin

145
Q

An anticoagulant molecule

A

heparin

146
Q

BLOOD VESSELS

A
  • network of hollow tubes that carry blood throughout the entire body
147
Q

STRUCTURE AND FUNCTION OF BLOOD VESSELS

A
  • blood flow = cardiac output
  • pressure in left ventricle is stored in elastic wall
  • 60% of blood is in veins to cap
148
Q

STRUCTURE OF VESSEL WALLS ARTERY

A
  • thicker walls = closer to heart

- smaller lumen help w blood pressure flow

149
Q

STRUCTURE OF VESSEL WALLS VEINS

A
  • nervi vasom used for exchange (dilation and restriction)
  • less resistant
  • closer to lumen
150
Q

DIFFERENT ARTERIES

A
  • condult vessels ( elastic artery, muscular)
  • resistance vessel ( arterioles)
  • decrease in diameter elasticity
151
Q

STRUCTURES CAPILLARIES

A
  • continuous = water and small molecules
  • fenestrated = walls leaky kidneys
  • sinusoid = large molecules more gaps
152
Q

METARTERIOLES AND PRE CAP SPHINCTERS

A
  • ## pre sphincter = regulate blood flow, open when oxygen is needed
153
Q

HEMODYNAMICS

A
  • describes the physical factors that govern blood flow
  • moves from high pressure (heart) to regions of low pressure (tissue)
  • fluid is impeded by resistance
154
Q

THE FLOW EQUATION RELATIONSHIP

A
  • garden hose (flow constant) - p/ increase r
  • water supply to home (constant pressure)
  • flushing toliet during a shower ( constant resistance)
155
Q

RESISTANCE TO BLOOD FLOW

A
  • physical characteristics ( viscosity)
  • size of vessels
  • organization of network
156
Q

LAMINAR FLOW

A
  • layers flow without mixing
  • streamline
  • flow is 0 at wall and maximal at centre
157
Q

TURBULENT FLOW

A
  • layers mix
  • non streamline
  • high speeds
158
Q

POISEUILLES LAW

A
  • the resistance to laminar flow of an incompressible fluid having viscosity through a horizontal tube of uniform radius and length
159
Q

SERIES VS PARALLEL ARRANGEMENT

A
  • arteries = series

- cap = parrallel

160
Q

SERIES ARRANGEMENT

A
  • total resistance = to sum of the individual
161
Q

PARALLEL ARRANGEMENT

A
  • total resistance is less than individual
162
Q

VISCOSITY OF BLOOD FLOW

A
  • is not related to the proximity of heart but depends on the diameter and the cross section of areas of vessels
163
Q

FLOW RATE

A
  • blood flow rate - pressure resistance
164
Q

AUTOREGULATION

A
  • occurs automatically
  • heart, brain, kidney = increase regulation
  • skeletal muscle = moderate
  • skin = no regulation
165
Q

BELOW 60 mmHg

A
  • no regulation vessels are dilated
166
Q

HIGHER 170 mmHg

A
  • can not constrict any greater
167
Q

MYOGENIC THEORY

A
  • stretchy of smooth muscle vessels q
168
Q

VARIABLE RESISTANCE

A
  • the main factor of mean arterial pressure
169
Q

LOCAL INTRINSIC CONTROL

A
  • regulate coronary, cerebral, skeletal, pulmonary and renal circulation
170
Q

SYSTEMIC EXTRINSIC CONTROL

A
  • regulate and maintain skin circulation
171
Q

HYPEREMIA

A
  • local mediated increase in blood flow
172
Q

ACTIVE HYPEREMIA

A
  • matches blood flow to increase metabolism
173
Q

REACTIVE HYPEREMIA

A
  • follows a period of decreased blood flow
174
Q

HORMONAL CONTROL

A
  • relaxation