Skin and heart circulation Flashcards

Properties of special circulations

1
Q

Where do the coronary arties originate from? [1 mark]

A

The root of the aorta

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2
Q

Where do coronary veins carry deoxygenated blood from? [2 marks]

A
  • From the myocardium to the right atrium

- To the coronary sinus

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3
Q

Does coronary circulation need a high basal supply of O2? [1 mark]

A

YES

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4
Q

What are the special structural features of cardiac muscle? [4 marks]

A
  • High capillary density (to reduce diffusion distance)
  • Large surface area for O2 transfer
  • High blood flow
  • Sparse sympathetic innervation
  • High levels of nitric oxide (leading to vasodilation)
  • High O2 extraction
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5
Q

What happens to coronary circulation during increased demand? [3 marks]

A
  • Blood flow increases
  • Vasodilators outcompete low sympathetic vasoconstriction
  • Circulating adrenaline dilates coronary arties (due to lots of beta 2 adrenoceptors)
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6
Q

What causes more oxygen to be extracted in the myocardium? [2 marks]

A
  • Bohr shift

- Vasodilation

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7
Q

Why are coronary arteries functional end-arteries? [2 marks]

A
  • There are lots of capillaries in the heart

- So there is less arterio-arterial anastomoses

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8
Q

What is the result of a thrombus in the left anterior descending coronary artery? [6 marks]

A
  • Ischaemia and cell death
  • Acidosis
  • Pain due to C-fibres being stimulated
  • Impaired contractility
  • Sympathetic activation
  • Arrhythmia
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9
Q

What happens to arteries and arterioles to meet increased demand of oxygen in healthy coronary vessels? [2 marks]

A
  • Resistance in large coronary artery is low but resistance in arteriole is high
  • Resistance in arteriole is reduced
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10
Q

Why can’t vessels with atheromas meet increased demands of oxygen? [3 marks]

A
  • Resistance in large coronary artery is high due to the atheroma
  • The arteriole dilates to try and reduce resistance but total resistance is still too high
  • Angina develops
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11
Q

Does blood pass through coronary vessels in systole? [2 marks]

A

NO

Only in diastole are vessels able to pass blood, in systole they are compressed.

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12
Q

What does the left ventricle and aorta do in systole? [4 marks]

A
  • Left ventricle contracts and empties its blood into the aorta
  • Aorta expands a little due to compliance
  • Aortic valve closes and blood enters systemic circulation
  • Aorta still has high pressure and it contracts
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13
Q

How does a myocardial infarction affect ventricles? [2 marks]

A
  • Stiffening of ventricles means that they can’t fully relax

- Ventricular pressure remains high, even in diastole

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14
Q

What happens to the aorta in hypotension? [2 marks]

A
  • If the aortic valves are damaged, there is aortic regurgitation
  • Less blood enters systemic circulation
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15
Q

What are the special properties of the skin? [3 marks]

A
  • Defence against the environment
  • Lewis triple response to trauma
  • Temperature regulation
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16
Q

What does the Lewis triple response to trauma involve? [3 marks]

A
  • Redness
  • Swelling
  • Flare
17
Q

What is involved in temperature regulation of the heart? [4 marks]

A
  • Blood flows from core to the skin surface
  • Radiation is proportional to skin temperatures
  • Conduction to skin and convection from skin
  • Sweating (latent heat of evaporation)
18
Q

What does poikilothermic mean? [1 mark]

A

Large variation in temperature (a property the skin, without damage)

19
Q

What does skin temperature depend on? [2 marks]

A
  • Skin blood flow

- Ambient temperatures

20
Q

What is cold induced vasoconstriction? [4 marks]

A
  • Helps to conserve heat
  • Sympathetic nerves release noradrenaline that binds to alpha 2 receptors
  • alpha 2 receptors bind to noradrenaline at lower temperatures that alpha 1 receptors.
  • Anastomoses open and capillaries close to maintain heat
21
Q

What is paradoxical cold vasodilation? [3 marks]

A
  • Caused by paralysis of sympathetic transmission (that cause vasoconstriction)
  • To protect the skin from damage
  • Long term exposure causes oscillations of contraction and relaxation as temperatures fluctuate.
22
Q

What do sympathetic vasoconstrictor fibres do? [2 marks]

A
  • Help arterio-venous anastomoses constrict

- Release noradrenaline and acts on alpha 1 adrenoceptors

23
Q

What do sudomotor vasodilator fibres do? [2 marks]

A
  • Release acetylcholine and act to increase nitric oxide production
  • Driven by temperature regulation nerves in the hypothalamus
24
Q

What is sweating caused by? [1 mark]

A

Increased sympathetic activity to sweat glands

25
Q

What do the baroreflex, RAAS system and ADH do? [2 marks]

A
  • Constrict arteries to skin

- Divert blood to central organs after drop in BP (caused by sepsis, haemorrhage, acute cardiac failure)

26
Q

What is baroreflex/RAAS/ADH-mediated vasoconstriction caused by? [4 marks]

A
  • Vasoconstrictor fibres
  • Adrenaline
  • Vasopressin
  • Angiotensin II
27
Q

Why is it dangerous to warm up a body too quickly during a haemorrhage? [1 mark]

A

It can reduce cutaneous vasoconstriction and less blood is able to reach the central organs

28
Q

What causes blushing? [1 mark]

A

Sympathetic sudomotor nerves