S1) Haemodynamics Flashcards
What is haemodynamics?
Haemodynamics is the study of how pressure affects blood flow in blood vessels
Define infarction
Infarction is tissue death due to inadequate blood supply
Distinguish between the blood flow to different tissues of the body:
- Brain
- Kidneys
- Heart
- Skeletal muscle
- Gut
- Brain needs high, constant flow
- Kidneys need high, constant flow
- Heart muscle needs high flow which can vary
- Blood flow to skeletal muscle increases during exercise
- Blood flow to gut increases after a meal
What is perfusion rate?
Perfusion rate is the rate of blood flow (l.min-1)
Increases in metabolism are met by increases in blood flow.
Compare and contrast the perfusion rate at rest and during exercise
- At rest - total blood flow is about 5 l.min-1
- During exercise - total blood flow can rise to 25 l.min-1
State the factors that affect the rate of diffusion
- Area available for exchange
- Diffusion resistance
- Concentration gradient
Describe what determines the area available for exchange in diffusion
- Area available for exchange between capillaries and tissues depends on capillary density
- A tissue which is more metabolically active will have more capillaries & a higher capillary density
Identify the 3 factors which affect diffusion resistance
- Nature of the molecule
- The barrier
- Distance
Describe what determines the concentration gradient in diffusion
The perfusion rate determines the concentration gradient driving O2 diffusion into the cells
What is pericardial effusion?
Pericardial effusion is when excess fluid accumulates in the pericardial cavity, compressing the heart due to the inextensible fibrous pericardial layer
What is the danger associated with pericardial effusion?
Compression of the heart can lead to cardiac tamponade as the heart cannot fill during diastole
How can excess fluid be removed from the pericardial cavity?
Through a procedure called pericardiocentesis, excess fluid is removed for testing / to relieve compression
What is coronary circulation?
Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocardium)
What are coronary arteries?
Coronary arteries are the vessels which deliver oxygen-rich blood to the myocardium
What are cardiac veins?
Cardiac veins are the vessels that remove the deoxygenated blood from the myocardium
Describe the general origins and location of the left and right coronary arteries and their branches
- Origins: base of the aorta from openings (coronary ostia) located behind the aortic valve leaflets
- Location: lie on the surface of the heart
State the specific origins of the left and right coronary arteries
- Right coronary artery rises in the right aortic sinus
- Left coronary artery rises in the left aortic sinus
What is the problem associated with coronary arteries?
Coronary arteries are vital to supply well oxygenated blood to the myocardium however, they are prone to atheroma wherein a thrombus forms and can block the artery
- atheroma plaques
- plaques rupture
- thrombus
- embolism
- MI/Stroke
Which artery is commonly blocked in an AMI and which regions does it supply?
- The anterior interventricular artery (LAD)
- Supplies the apex of the heart, the septum and the left ventricle and a bit of right ventricle
Discuss the relationship between pathology in the aortic and mitral valves
- The aortic and mitral valves are closely associated
- Hence, if a disease affects one it will likely affect the other
What is serum?
Serum is plasma minus the clotting factors
What is the main clotting factor in the body?
The main clotting factor is fibrinogen
What are the contents of buffy coat?
Buffy coat contains white blood cells and a few platelets
Differentiate between the different types of fluid collected from blood
- The fluid collected from unclotted blood = plasma
- The fluid collected from clotted blood = serum
Identify 4 factors which increase whole blood viscosity
- Increase in plasma viscosity
- Polycythaemia: increase in red blood cells
- Leukaemia: increase in white blood cells
- Thrombocythaemia: increase in platelets
What is the effect of increases in whole blood viscosity?
Increased whole blood viscosity leads to sludging in the peripheries