Test 2 Flashcards by Spencer Rickers

Effect where the elastic recoil of the aorta helps to “dampen” or “smooth out” the pulsatile flow of blood out of the left ventricle of the heart

Windkessel Effect

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The there layers of arteries

Tunica intima
Tunica media
Tunica externa (or adventitia)

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Blood flow through arteries is affected by two major variables What are they?

pressure and resistance.

Q=∆P/R

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the force with which blood is pushed against the walls of blood vessels

Blood Pressure

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highest amount of pressure reached during ventricular ejection of blood

Systolic Pressure (SP)

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minimum amount of pressure just before ventricular ejection begins

Diastolic Pressure (DP)

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potential energy is then released by the RECOIL of the arterial wall, which propels the blood distally and provides the________This alteration of systolic and diastolic propulsion provides a more continuous (rather than pulsatile) flow to the peripheral tissues. This pressure-storing property of the aorta is sometimes called the ______ effect.

“diastolic runoff”

“Wind Kessel”

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Auscultatoric measurement devices determine blood pressure by monitoring…

Korotkoff sounds

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These measurements use an electronic pressure sensor with a numerical readout of blood pressure.

Oscillometric measurement device

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Mean Arterial Pressure (MAP) =

2/3 DP + 1/3 SP
or
MAP = DP + 1/3 PP

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the sum of all resistance in the vasculature

Total Peripheral Resistance (TPR) or Systemic Vascular Resistance (SVR)

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There are 3 important sources of resistance within a single vessel:

blood viscosity
vessel length
vessel diameter or radius

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The relationship between resistance, viscosity, vessel length, and vessel radius is explained with

Poiseuille’s Law.

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POLYCYTHEMIA

high hematocrit state

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Another factor that is influences viscosity is the tendency of RBCs to aggregate into stacks called…

ROULEAUX

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in blood flow Resistance=?

R = 8 V L / π r^4

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Baroreceptors are neural receptors located in the…

CAROTID SINUS and AORTIC ARCH

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Which cranial nerves carry signals from baroreceptors?

Cranial nerves IX (glossopharyngeal) and X (vagus)

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What center of the brain processes signals from baroreceptors?

MEDULLARY CARDIOVASCULAR (or CARDIOREGULATORY) CENTER of the brainstem

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Medullary Cardiovascular Center Functions

Makes decisions about what to do about hypertension or hypotension…..and then employs the services of the SNS and ParaNS to send those orders to various target tissues

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Why would baroreceptors get used to high BP?

decreased sensitivity of the baroreceptors to increases in arterial pressure or an increase in the blood pressure set point of the brainstem centers.

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A decrease in renal perfusion pressure (blood pressure) causes kidneys to secrete this enzyme

RENIN

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Renin catalyzes the conversion of

ANGIOTENSINOGEN to ANGIOTENSIN I in the plasma

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catalyzes the conversion of angiotensin I into ANGIOTENSIN II

ANGIOTENSIN CONVERTING ENZYME (ACE)

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Hypovolemia, or volume contraction ( e.g., due to hemorrhage), is also a potent stimulus for...

ADH secretion

ADH has 2 effects that tend to increase blood pressure toward normal. What are they?

It increases water reabsorption via the kidneys activates V_2 Receptors It is a potent vasoconstrictor that increases TPR by activating V_1 Receptors

The responses to an increase in blood volume include:

* increased secretion of ANP | * decreased secretion of ADH

This hormone is secreted by the atria in response to increased atrial pressure

ANP

Effects of ANP

• Causes relaxation of vascular smooth muscle, which results in vasodilation and decreased TPR • In the kidney, this vasodilation leads to increased Na+ and water excretion, thereby decreasing total body Na+ content, ECF volume and blood volume

Hypertensive cases are classified as secondary when?

Caused by a disorder or situation that increases TPR or CO, e .g.

The chronic elevation in blood pressure that occurs without any evidence of underlying disease

Primary (Essential) Hypertension

Commonly associated with hypertension and diabetes mellitus

Arteriosclerosis

Entire wall of the artery “outpouches” common in..

Circumferential or Fusiform Aneurysms Common in the abdominal aorta (AAA = abdominal aortic aneurysm)

Only one portion of the arterial wall “outpouches”

Saccular or Berry Aneurysms

Most often observed in the small arteries of the brain, especially in the Circle of Willis

Saccular or Berry Aneurysms

Tunics of the arterial wall separate; blood collects in-between the tunics and are common in...

Dissecting Aneurysms | Common in the aortic arch

Fluid movement across clefts and fenestrations is driven by...

Starling forces | Pc ∏c etc...

collects lymph from most of the body regions

The thoracic duct

receives lymph from the right side of the head, neck, and trunk and from the right upper extremity. It empties into the right subclavian vein

The right lymphatic duct

Edema occurs when the volume of interstitial fluid exceeds the capacity of the lymphatics to return it to the circulation. It can be caused by:

* excess filtration (typically reflected by ↑P * decreased absorption (typically reflected by ↓π * increased capillary permeability * blocked lymphatics

When the external | intercostals contract, they do two things:

``` • elevate the ribs superolaterally (“bucket handle”) • move the sternum anteriorly (“pump handle”) ```

Upper Respiratory Structures

* nose * pharynx * larynx

Lower Respiratory Structures

* trachea * bronchi * bronchioles * alveolar ducts & sacs * alveoli

Causes bronchodilation

sympathetic nervous system via β2 receptors

causes bronchoconstriction

parasympathetic nervous system via muscarinic receptors

gas exchange occurs within the

alveoli

Right lung has ___ lobes, while the left lung has__ lobes.

3 | 2

These cells are thin and flat (simple squamous); constitute 90% of alveolar surface area

Type I alveolar cell (Type I pneumocyte)

These cells synthesize pulmonary surfactant

Type II alveloar cell (Type II pneumocyte)

clean off particles such as dust or microorganisms; frequently contain granules of exogenous material such as particulate carbon that they have picked up from respiratory surfaces (particularly in smokers)

Alveolar macrophage (dust cell)

protects tissues from neutrophil elastase

ALPHA-1-ANTITRYPSIN

The absence of alpha-1- antitrypsin results in

respiratory complications ( i.e., emphysema, COPD) and cirrhosis

Is a tool for the measurement of the breathing capacity of the lungs

Diagnostic spirometry

is a method of encouraging voluntary deep breathing by providing visual feedback about inspiratory volume.

Incentive spirometry

Incentive spirometry reduces the risk of

atelectasis (collapsed lung) and pulmonary consolidation.

Define Tidal Volume (TV)

amount of air that moves into and out of the (TV) airways with each inspiration and expiration during normal quiet breathing -- usually around 500 ml

Define Minute Ventilation

Total volume of air taken in by the body during 1 minute

Minuet Ventilation=

TV x RR

Define Anatomical Dead Space

The portion of the tidal volume that remains in the nose, pharynx, larynx, trachea, bronchi, and terminal bronchioles -- i.e. the air that does not participate in gas exchange

Define Alveolar Ventilation

Total volume of air that reaches the sites of gas exchange during 1 minute

Alveolar Ventilation+

AVe = (TV-ADS) x RR

Define Inspiratory Reserve Volume (IRV)

The amount of air you can inspire above your normal tidal volume

Define Expiratory Reserve Volume (ERV)

The amount of air you can expire above your normal tidal volume

Define Residual Volume (RV)

The amount of air that remains in the respiratory system after a forced expiration

Define Functional Residual Capacity (FRC)

The sum of the residual volume and expiratory reserve volume

Define Inspiratory Capacity (IC)

The sum of the tidal volume and IRV

Define Vital Capacity

The sum of tidal volume, IRV and ERV

Temporary increase in blood pressure when standing up

Orthostatic Hypertension

RAA system steps

Rennin, Angiotensinogen, Angiotensin 1, angiotensin 2>> (Brain ADH and Kidney Aldosterone)

What is whiteout syndrome

BP increases when a doctor or someone tries to take your blood pressure.

What is Atherosclerosis?

Plaque buildup in arteries

What is Arteriosclerosis?

Hardening of the arteries. Via hypertrophy of muscular layer.

The most common cause of type 2 hypertension

renal failure

What is intermediate Clodication?

When light activity causes chest pain, muscle pain, and fatigue.

What is the circle of willis?

arteries in the base of the brain that get aneurysms some times.