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SA Cardiovascular system > S1) Haemodynamics > Flashcards

S1) Haemodynamics Flashcards

1
Q

What is haemodynamics?

A

Haemodynamics is the study of how pressure affects blood flow in blood vessels

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2
Q

Define infarction

A

Infarction is tissue death due to inadequate blood supply

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3
Q

Distinguish between the blood flow to different tissues of the body:

  • Brain
  • Kidneys
  • Heart
  • Skeletal muscle
  • Gut
A
  • 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
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4
Q

What is perfusion rate?

A

Perfusion rate is the rate of blood flow (l.min-1)

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5
Q

Increases in metabolism are met by increases in blood flow.

Compare and contrast the perfusion rate at rest and during exercise

A
  • At rest - total blood flow is about 5 l.min-1
  • During exercise - total blood flow can rise to 25 l.min-1
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6
Q

State the factors that affect the rate of diffusion

A
  • Area available for exchange
  • Diffusion resistance
  • Concentration gradient
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7
Q

Describe what determines the area available for exchange in diffusion

A
  • 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
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8
Q

Identify the 3 factors which affect diffusion resistance

A
  • Nature of the molecule
  • The barrier
  • Distance
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9
Q

Describe what determines the concentration gradient in diffusion

A

The perfusion rate determines the concentration gradient driving O2 diffusion into the cells

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10
Q

What is pericardial effusion?

A

Pericardial effusion is when excess fluid accumulates in the pericardial cavity, compressing the heart due to the inextensible fibrous pericardial layer

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11
Q

What is the danger associated with pericardial effusion?

A

Compression of the heart can lead to cardiac tamponade as the heart cannot fill during diastole

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12
Q

How can excess fluid be removed from the pericardial cavity?

A

Through a procedure called pericardiocentesis, excess fluid is removed for testing / to relieve compression

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13
Q

What is coronary circulation?

A

Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocardium)

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14
Q

What are coronary arteries?

A

Coronary arteries are the vessels which deliver oxygen-rich blood to the myocardium

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15
Q

What are cardiac veins?

A

Cardiac veins are the vessels that remove the deoxygenated blood from the myocardium

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16
Q

Describe the general origins and location of the left and right coronary arteries and their branches

A
  • Origins: base of the aorta from openings (coronary ostia) located behind the aortic valve leaflets
  • Location: lie on the surface of the heart
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17
Q

State the specific origins of the left and right coronary arteries

A
  • Right coronary artery rises in the right aortic sinus
  • Left coronary artery rises in the left aortic sinus
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18
Q

What is the problem associated with coronary arteries?

A

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

  1. atheroma plaques
  2. plaques rupture
  3. thrombus
  4. embolism
  5. MI/Stroke
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19
Q

Which artery is commonly blocked in an AMI and which regions does it supply?

A
  • The anterior interventricular artery (LAD)
  • Supplies the apex of the heart, the septum and the left ventricle and a bit of right ventricle
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20
Q

Discuss the relationship between pathology in the aortic and mitral valves

A
  • The aortic and mitral valves are closely associated
  • Hence, if a disease affects one it will likely affect the other
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21
Q

What is serum?

A

Serum is plasma minus the clotting factors

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22
Q

What is the main clotting factor in the body?

A

The main clotting factor is fibrinogen

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23
Q

What are the contents of buffy coat?

A

Buffy coat contains white blood cells and a few platelets

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24
Q

Differentiate between the different types of fluid collected from blood

A
  • The fluid collected from unclotted blood = plasma
  • The fluid collected from clotted blood = serum
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25
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
26
What is the effect of increases in whole blood viscosity?
Increased whole blood viscosity leads to **sludging in the peripheries**
27
Identify the commonest cause for increases in plasma viscosity leading to increased whole blood viscosity
Multiple myeloma where cancerous plasma cells accumulate in the bone marrow and crowd out healthy cells
28
In terms of plasma viscosity, how can one attempt to measure inflammation?
- Results from raised levels of **acute phase plasma proteins** *e.g. fibrinogen, complement factors and CRP* which increase in response to **inflammation** - Hence, minor changes in plasma viscosity can be used to ‘measure’ the inflammatory response
29
Explain the difference between flow, velocity and pressure of blood
- **Velocity** is the distance blood has moved per unit of time (cm/sec) (rate) - **Flow** is the volume of blood that is moving per unit of time (l/min) - **pressure** is the force per unit area (pascal)
30
Explain the difference between laminar and turbulent flow
- **Laminar flow:** blood usually flows in streamlines with each layer of blood remaining the same distance from the wall, silent and most common flow - **Turbulent flow:** blood flows in all directions in the vessel and continually mixing within the vessel, disorganised and noisy
31
Identify 5 situations wherein turbulent blood flow could happen
- When the **perfusion rate** becomes too great - When the blood passes by an **obstruction** in a vessel - When the blood makes a **sharp turn** - When the blood passes over a **rough surface** - Where there's **increased resistance** to blood flow
32
What is peripheral resistance?
**Peripheral resistance** is the totality of the resistance being posed to the blood pumped from the heart
33
What is the impact of low peripheral resistance?
**Low peripheral resistance** lowers diastolic pressure and therefore increases pulse pressure due to the vasolidation of arterioles *e.g. hot bath, exercise, pregnancy*
34
What is the impact of high peripheral resistance?
**High peripheral resistance** raises diastolic (pressure in artery) pressure and therefore decreases pulse pressure due to the vasoconstriction of arterioles *e.g. cold, thirsty*
35
What is a pulse?
A **pulse** is a rhythmical throbbing of the arteries as blood is propelled through them, typically as felt in the wrists or neck
36
Differentiate between the terminology for weak and strong pulses
- A weak pulse is often described as “**thready**” - A strong pulse is often described as “**bounding**”
37
Which 2 factors determine the strength (volume) of a pulse?
- The **force** with which the left ventricle is able to eject blood into the arterial system and thus develop a normal shock wave - The **pulse pressure**
38
Identify conditions which lead to a stronger/weaker pulse
- **Weaker pulses** can result from left ventricular failure, aortic valve stenosis, hypovolaemia (severe dehydration, bleeding) - **Stronger pulses** can result from bradycardia seen in conditions such as heart block// vasodialation
39
Explain what Phase I and Phase 5 are when measuring blood pressure
- **Phase 1** – the point at which the first sound appears - **Phase 5** – the point at which the sounds disappear
40
What is pulse pressure?
Volume of blood ejected and the compliance of the arterial system govern pulse pressure **Pulse pressure** is peak systolic pressure – end diastolic pressure 120mm Hg – 80 mm Hg = **40mm Hg**
41
Describe the impact of pulse pressure on the volume of the pulse
The greater the pulse pressure the stronger the pulse
42
Define mean arterial pressure
**- Mean arterial pressure** is estimated as diastolic pressure + 1/3 of the pulse pressure - Therefore, most commonly, mean arterial pressure is 80 mmHg + 13 mmHg = 93 mm Hg or find area under the curve
43
how does blood travel
down a pressure gradient from high to low
44
what is serum
plasma without clotting factors
45
Flow equation
=K(change in pressure) k= conductant (measure of ease of flow) **Darcys Law** Flow = Change in pressure/resistance flow and resistance are reciprocally related as one goes up the other goes down or **Flow** = velocity x cross section **flow** proportional to velocity x radius(squared)
46
relationship between resistance and change in pressure
as resistance increases the pressure increases and the flow decreases
47
turbulent flow diagram
48
3 factors that affect flow
diameter, length and viscosity
49
what does a drop in pressure indicate
change in resistance
50
why is a lower velocity useful in capillaries
so you can have more diffusion also high velocity would break the walls
51
total peripheral resistance (TPR) equation
change in pressure -------------------------- cardiac output or mean arterial pressure ----------- cardiac output
52
2 factors that affect pulse pressure
haemorrage age
53
relationshio between velocity and radius
velocity is inversely proportional to radius^2
54
thrill (measuring blood pressure)
can be felt
55
bruit (measuring blood pressure)
Can be heard
56
korotkoff sounds
sounds you hear when measuring blood pressure and involved in turblwnt flow
57
when do you hear korotkoff sounds
in between systolic and dystolic
58
effect of gravity on blood pressure
pressure below heart \> pressure above heart - gravity maintains a pressure gradient
59
how to calculate blood pressure from systolic and diastolic pressure
top number (systolic) - bottom number (diastolic)
60
what affect the venous and arterial pressure
1. resistance 2. blood viscosity 3. blood vessel diameter
61
what can cause pericardial effusion
* infection * blood leakage
62
what happens to the sounds of the heart when you have pericarditis
* sound of the heart beats get quiet
63
why does a low BP result in tachycardia
heart beats faster to try and maintain pressure of the blood and to transport blood around the body
64
distended veins
they are swollen because the pressure in them is raised due to increased volume of blood in them
65
what are the common symptoms of an MI
heart pain spreading to the jaw, neck and arms

SA Cardiovascular system (16 decks)

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