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Bancroft: AP2 > Test #4: Cardiovascular System > Flashcards

Test #4: Cardiovascular System Flashcards

1
Q

How many characteristics of blood?

A

4 characteristics

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2
Q

What are the 4 characteristics of blood?

A
  1. Type of tissue; 2. Temperature; 3. Volume; and 4. Weight
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3
Q

What type of tissue is blood?

A

Blood is a type of Connective Tissue because it has ground substance and extracellular matrix (plasma).

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4
Q

What is the temperature of blood?

A

Blood is 100.4 °F

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5
Q

What is blood slightly higher than body temperature?

A

Blood is slightly higher than body temperature due to the metabolic activity of white blood cells.

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6
Q

What is the volume of blood?

A

Males have 5-6 liters and females have 4-5 liters

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7
Q

What percent of body weight does blood make up?

A

Blood makes up 8% of body weight.

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8
Q

How many functions of blood?

A

3 functions

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9
Q

What are the 3 functions of blood?

A
  1. Distribution; 2. Regulation; and 3. Protection
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10
Q

Blood: Distribution

A

Blood transports oxygen (O2), carbon dioxide (CO2), hormones, electrolytes, nutrients, waste, antibodies, vitamins, minerals, proteins, etc.

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11
Q

Blood: Regulation

A

Blood regulates temperature and pH.

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12
Q

How does blood regulate temperature?

A

Through vasoconstriction and vasodilation of blood vessels, blood can be rerouted to various regions of the body.

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13
Q

How does blood regulate pH?

A

pH of blood needs to be 7.35-7.45; buffers (CO2 + proteins) help to regulate pH.

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14
Q

Blood: Protection

A

White blood cells help to destroy foreign matter (lymphocytes) and clotting proteins help to clot blood at injury sites.

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15
Q

How many main components of blood?

A

2 main components

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16
Q

What are the 2 main components of blood?

A
  1. Plasma; and 2. Formed elements
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17
Q

Blood: Plasma

A

Plasma makes up 55% of whole blood and is a light, clear, straw-colored fluid containing nutrients, O2, CO2, waste, hormones, etc.

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18
Q

Blood: Formed Elements

A

Formed elements make up 45% of whole blood and is heavier than plasma.

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19
Q

How many formed elements in blood?

A

3 formed elements

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20
Q

What are the 3 formed elements in blood?

A
  1. Red Blood Cells; 2. White Blood Cells; and 3. Platelets
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21
Q

What are the scientific names for the 3 formed elements?

A
  1. Erythrocytes; 2. Leukocytes; and 3. Thrombocytes
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22
Q

Where are the 3 formed elements created?

A

Formed elements are born in red bone marrow.

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23
Q

What type of cells are the 3 formed elements?

A
  1. Red Blood Cells (Erythrocytes) are not true cells (they lack organelles to make space to carry hemoglobin)
  2. White Blood Cells (Leukocytes) are true cells (they have a full complement of organelles)
  3. Platelets (Thrombocytes) are not true cells (they are cell fragments)
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24
Q

How long do the 3 formed elements live?

A
  1. RBCs live for 3-4 months
  2. WBCs live for hours to a lifetime
  3. Platelets live for 5-9 days
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25
Q

What is the “graveyard” for red blood cells (erythrocytes)?

A

The spleen is the “graveyard” for RBCs (erythrocytes); they are broken down and reused by the body.

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26
Q

What is hemoglobin, what is it made up of, and what is its purpose?

A

Hemoglobin is a molecule made up of iron, red pigment and protein and oxygen binds to it.

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27
Q

What is the shape of red blood cells (erythrocytes) and platelets (thrombocytes) and why are they shaped that way?

A

RBCs are biconcave (to bend and fold as they travel through narrow passageways) and platelets have sharp edges (for initiating the blood clotting process).

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28
Q

What is the visible sign of white blood cell (leukocyte) activity?

A

Pus

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29
Q

What is unique about white blood cells (leukocytes)?

A

Leukocytes (WBCs) can leave the circulatory system and eat up foreign matter via phagocytosis.

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30
Q

What percentage of each make up formed elements?

A
  1. RBCs 99%

2. WBCs <1%

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31
Q

What is hemostasis?

A

The process of stopping blood loss at the site of a blood vessel tear.

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32
Q

How many steps in hemostasis?

A

3 steps

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33
Q

What are the 3 steps in hemostasis?

A
  1. Vascular spasm; 2. Platelet plug formation; and 3. Coagulation/blood clotting
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34
Q

Hemostasis: Vascular Spasm

A

Blood vessel spasms and constricts to slow the flow of blood through the area.

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35
Q

Hemostasis: Platelet Plug Formation

A

Platelets get caught on the exposed collagen fibers at the injury site forming a “plug” to slow blood loss.

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36
Q

Hemostasis: Coagulation/Blood Clotting

A

RBCs and clotting proteins get caught on the platelet plug forming a mesh or clot over the injury.

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37
Q

What is the heart?

A

A hollow, muscular organ that brings blood to every cell in the body.

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38
Q

Heart: Size

A

About the size of a fist, weighing less than a pound.

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39
Q

Heart: Location

A

a. Sits within the mediastinum (medial cavity of thorax between the lungs).
b. Extends from level of 2nd rib to 5th intercostal space where it rests on the superior surface of the diaphragm.
c. 2/3 of its mass lies to the left side of mid-sternal line.

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40
Q

Heart: Pericardium

A

The serous membrane which surrounds, protects and anchors the heart.

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41
Q

Pericardium: Fibrous Pericardium

A

Outer layer of fibrous connective tissue. It anchors and protects the heart.

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42
Q

Pericardium: Serous Pericardium

A

Deep to the fibrous pericardium, the serous pericardium is a double layer with a space in between called the Pericardial Fluid Space which contains a clear, viscous fluid called serous fluid. The outer layer is the Parietal Layer and the inner layer is the Visceral Layer.

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43
Q

Heart Wall: Epicardium

A

Outer layer of the heart wall, made up of connective tissue. Deep to the pericardium, the epicardium is the same as the visceral layer of the serous pericardium.

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44
Q

Heart Wall: Myocardium

A

Middle layer of the heart wall, made up of cardiac muscle. Deep to the epicardium, the myocardium is the thickest layer.

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45
Q

Heart Wall: Endocardium

A

Innermost layer of the heart wall, made up of epithelial tissue that is smooth and friction free. Deep to the myocardium, the endocardium lines the chambers, covers valves and is continuous with the inner lining of blood vessels.

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46
Q

How many chambers of the heart?

A

4 chambers

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47
Q

What are the 4 chambers?

A

1-2. Right and Left Artria; and 3-4. Right and Left Ventricles

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48
Q

Chambers: Atria

A

Receives blood.

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49
Q

Chambers: Ventricles

A

Expels blood.

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50
Q

Chambers: Right Atrium

A

Receives deoxygenated blood from the body.

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51
Q

Chambers: Right Ventricle

A

Receives deoxygenated blood from the right atrium and expels it to the lungs.

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52
Q

Chambers: Left Atrium

A

Receives oxygenated blood from the lungs.

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53
Q

Chambers: Left Ventricle

A

Receives oxygenated blood from the left atrium and expels it to the body.

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54
Q

How many sets of valves of the heart?

A

4 sets of valves

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55
Q

What are the 4 sets of valves of the heart?

A

1-2. Atrioventricular Valves (Tricuspid and Bicuspid [Mitral])
3-4. Semilunar Valves (Pulmonary and Aortic)

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56
Q

Valves

A

Prevents back-flow of blood.

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57
Q

Atrioventricular Valves: Tricuspid

A

Lies between the right atrium and ventricle.

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58
Q

Atrioventricular Valves: Bicuspid (Mitral)

A

Lies between the left atrium and ventricle.

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59
Q

Semilunar Valves: Pulmonary

A

Lies between the right ventricle and pulmonary trunk.

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60
Q

Semilunar Valves: Aortic

A

Lies between the left ventricle and aorta.

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61
Q

How many major vessels of the heart?

A

6 major vessels

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62
Q

What are the 6 major vessels?

A

1-2. Superior and Inferior Vena Cava; 3. Pulmonary Trunk; 4. Pulmonary Arteries; 5. Pulmonary Veins; and 6. Aorta

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63
Q

Major Vessels: Superior and Inferior Vena Cava

A

Receives deoxygenated blood from the body (SVC from all areas above the diaphragm; IVC from all areas below the diaphragm) and drain into the right atrium.

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64
Q

Major Vessels: Pulmonary Trunk

A

Receives deoxygenated blood from the right ventricle and splits into the right and left pulmonary arteries.

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65
Q

Major Vessels: Pulmonary Arteries

A

Receives deoxygenated blood from the pulmonary trunk and sends it to the lungs.

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66
Q

Major Vessels: Pulmonary Veins

A

Receives oxygenated blood from the lungs and sends it to the left atrium.

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67
Q

Major Vessels: Aorta

A

The major vessel leaving the heart. It is the largest artery in the body. Receives oxygenated blood from the left ventricle and sends it to the body.

68
Q

Heart: Interventricular Septum

A

The wall between the left and right ventricles. It is a thick region of myocardium and is the pathway for electrical energy (Action Potential) traveling down to the ventricles.

69
Q

How many circulatory pathways?

A

3 circulatory pathways

70
Q

What are the 3 circulatory pathways?

A
  1. Coronary; 2. Pulmonary; and 3. Systemic
71
Q

Circulatory Pathway: Coronary

A

Blood circulatory pathway to the heart itself. It is the shortest of 3 pathways. From the base of the aorta to the heart, then back to the same place the superior and inferior vena cava deposit blood.

72
Q

Circulatory Pathway: Pulmonary

A

Circulatory pathway from the heart to the lungs, then back to the heart.

73
Q

Circulatory Pathway: Systemic

A

Circulatory pathway that brings oxygenated blood to all cells of the body, then returns deoxygenated blood to the heart.

74
Q

How many steps of the flow of blood through the heart?

75
Q

What are the 10 steps of the flow of blood through the heart (long)?

A
  1. Deoxygenated blood returns (via the superior vena cava and inferior vena cava) from the body and enters the right atrium.
  2. It then passes through the tricuspid valve and enters the right ventricle.
  3. Passing through the pulmonary semilunar valve, it enters the pulmonary trunk to the pulmonary arteries.
  4. It travels through the pulmonary arteries to the lungs.
  5. In the lungs, the blood gives up carbon dioxide and picks up oxygen.
  6. The pulmonary veins carry oxygenated blood back to the left atrium.
  7. Passing through the bicuspid valve to the left ventricle.
  8. Leaving the left ventricle through the aortic semilunar valve.
  9. Oxygenated blood enters the aorta where it is sent back out to the body.
  10. Elastic arteries > muscular arteries > capillaries (gaseous exchange occurs) > venules > veins > superior vena cava and inferior vena cava.
76
Q

What are the 10 steps of the flow of blood through the heart (short)?

A
  1. De-O2 blood (via S.V.C. and I.V.C.) from body > RT atrium.
  2. Through tricuspid valve > RT ventricle.
  3. Through pulm. semilunar valve > pulm. trunk > pulm. arteries.
  4. Through pulm. arteries > lungs.
  5. In the lungs, blood gives up CO2 & picks up O2.
  6. Pulm. veins carry O2 blood > LT atrium.
  7. Through the bicuspid valve > LT ventricle.
  8. LT ventricle through aortic semilunar valve.
  9. O2 blood enters aorta to body.
  10. Elastic arteries > muscular arteries > capillaries (gaseous exchange occurs) > venules > veins > S.V.C. and I.V.C.
77
Q

Pathology: Myocardial Infarction

A

“Heart attack” occurs when arteries are blocked 75% or more shutting off blood supply to the heart.

78
Q

Pathology: Angina Pectoralis

A

“Choked chest” is pain that is felt in the chest due to a decrease of blood flow to the coronary circulatory system.

79
Q

Pathology: Incompetent Valve

A

A valve that allows back-flow of blood due to improper function; causes a “heart murmur”

80
Q

What is the Intrinsic Conduction System?

A

The heart’s ability to beat on its own.

81
Q

How many unique elements of cardiac muscle cells?

A

2 unique elements

82
Q

What are the 2 unique elements of cardiac muscle cells?

A
  1. Auto-rhythmic cells; and 2. Gap junctions
83
Q

Cardiac Muscle Cells: Auto-rhythmic Cells

A

“Excitable cells”

Some cardiac muscle cells are able to depolarize without the need of an action potential/nerve stimulus.

84
Q

Cardiac Muscle Cells: Gap junctions

A

Open doorways for action potential to travel to adjacent cardiac muscle cells so they can all contract together.

85
Q

How many parts to the Intrinsic Conduction System?

86
Q

What are the 5 parts to the Intrinsic Conduction System (ICS)?

A
  1. Sinoatrial (SA) node; 2. Atrioventricular (AV) node; 3. Atrioventricular (AV) bundle; 4. Bundle branches; and 5. Purkinje fibers
87
Q

ICS: Sinoatrial (SA) node

A

“Pacemaker”

It’s a collection of auto-rhythmic cells located in the upper, right atrium. Generates an action potential at 100 beats per minute (bpm). Slowed to 75 bpm by the parasympathetic nervous system. Controlled by the vagus nerve (cranial nerve #10).

88
Q

ICS: Atrioventricular (AV) node

A

Another collection of auto-rhythmic cells located in the lower, right atrium. Generates an AP at 50 bpm.

  • Causes a 1/10th second delay of the action potential.
89
Q

ICS: Atrioventricular (AV) bundle

A

Auto-rhythmic cells located in the interventricular septum carry the AP down to the ventricles.

Known as “bundle of His”

90
Q

ICS: Bundle branches

A

Right and left bundle branches. Auto-rhythmic cells which carry the AP to the ventricles.

91
Q

ICS: Purkinje fibers

A

Carry the AP deep into the myocardium of the ventricles.

92
Q

Vocabulary: Tachycardia

A

Abnormally fast heart rate @ >100 bpm

93
Q

Vocabulary: Bradycardia

A

Abnormally slow heart rate @ <60 bpm

94
Q

Cardiac Cycle: Systole

A

Contraction phase of a heart beat

95
Q

Cardiac Cycle: Diastole

A

Relaxation phase of a heart beat

96
Q

How many events associated with one complete heart beat?

97
Q

Cardiac Cycle: What 3 events are associated with one complete heart beat, and how long?

A
  1. Atrial systole = .1 seconds
  2. Ventricular systole = .3 seconds
  3. Total diastole = .4 seconds

One complete heart beat = .8 seconds

98
Q

What is auscultation?

A

The diagnostic listening to the sounds of internal organs.

In the case of the heart we listen for the sound of valve closure.

99
Q

How many characteristic sounds of the heart?

100
Q

What are the 3 characteristic sounds of the heart?

A
  1. Lubb; 2. Dupp; and 3. Pause
101
Q

Heart Sounds: Lubb

A

Atrioventricular (AV) valves closing

102
Q

Heart Sounds: Dupp

A

Semilunar valves closing

103
Q

Heart Sounds: Pause

A

Diastole

“at rest”

104
Q

What is the formula for cardiac output?

A

stroke volume * beats per minute

The amount of blood expelled by the ventricles per minute.

105
Q

Cardiac Volume: Stroke volume

A

The amount of blood expelled by the ventricles per contraction.

106
Q

How much blood does the average healthy adult heart contain?

A

70 ml (~ 2 oz)

107
Q

What is the cardiac output for the average healthy adult?

A

Cardiac Output = stroke volume * beats per minute

C.O. = 75 ml blood * 75 bpm = 5,250 ml (5.25 l) blood/min

108
Q

What 2 things can help regulate stroke volume?

A

Exercise and massage

109
Q

Starling’s law of the heart

A

States that cardiac output and veinous return are directly proportional.

If venous return increases, then cardiac output increases.
If venous return decreases, then cardiac output decreases.

110
Q

How many things can regulate heart rate?

111
Q

What 3 things can regulate heart rate?

A
  1. Autonomic Nervous System; 2. Chemicals; and 3. Physical factors
112
Q

Heart Rate: Autonomic Nervous System

A

“Fight or flight”: Sympathetic nervous system increases heart rate

“Rest and digest” or “Feed and breed”: Parasympathetic nervous system decreases heart rate

113
Q

Heart Rate: Chemical

A

The hormones epinephrine (adrenaline) and thyroxine increases heart rate.

114
Q

How many physical factors can affect heart rate?

115
Q

What are the 3 physical factors that can affect heart rate?

A
  1. Age; 2. Gender; and 3. Exercise
116
Q

Heart Rate: Physical factors

A
  1. Age: Fetal heart rate = 140-160 bpm; declines as we get older.
  2. Gender: Male heart rate = 64-72 bpm; female 72-80 bpm
  3. Exercise: increases heart rate
117
Q

How many structures of blood vessel walls?

A

5 structures

118
Q

What are the 5 structures of blood vessel walls?

A
  1. Tunica intima; 2. Tunica media; 3. Tunica extrema; 4. Lumen; and 5. Valves
119
Q

Blood Vessels: Tunica intima

A

Innermost lining of a blood vessel made up of epithelial tissue.

120
Q

Blood Vessels: Tunica media

A

Smooth muscle layer responsible for vasoconstriction and vasodilation.

121
Q

Blood Vessels: Tunica externa

A

The outermost layer of connective tissue which anchors blood vessels. It also provides a pathway for blood vessels, nerves and lymphatics.

122
Q

Blood Vessels: Lumen

A

The central space where blood flows.

123
Q

Blood Vessels: Valves

A

Some vessels (veins) have valves which prevent back-flow of blood.

124
Q

How many main types of blood vessels?

A

3 main types

125
Q

What are the 3 main types of blood vessels?

A
  1. Arteries; 2. Veins; and 3. Capillaries
126
Q

Which direction do the blood vessels travel?

A
  1. Arteries travel away from the heart

2. Veins travel toward the heart

127
Q

What type of blood is carried in the blood vessels?

A
  1. Arteries carry oxygenated blood.
  2. Veins carry deoxygenated blood.
  • Except pulmonary arteries and veins.
128
Q

What is the blood pressure in the blood vessels?

A
  1. Arteries have higher blood pressure.

2. Veins have lower blood pressure.

129
Q

How does the shape of the blood vessels affect blood pressure?

A
  1. Arteries narrow as they travel away from the heart, maintaining blood pressure
  2. Veins act as blood reservoirs; 65% of blood is in the venous system.
130
Q

Blood Vessel differences: Tunica externa connective tissue

A
  1. Thinner for arteries

2. Thicker for veins

131
Q

Blood Vessel differences: Tunica media (smooth muscle tissue)

A
  1. Thicker for arteries

2. Thinner for veins

132
Q

Blood Vessel differences: Lumen

A
  1. Gets smaller for arteries

2. Bigger for veins

133
Q

Where are blood vessels located?

A
  1. Arteries are deep with some local surfacing

2. Veins are superficial and deep

134
Q

Do blood vessels have valves?

A
  1. Arteries do not

2. Some veins do

135
Q

How many subtypes of arteries?

A

3 subtypes

136
Q

What are the 3 subtypes of arteries?

A
  1. Elastic; 2. Muscular; and 3. Arterioles
137
Q

Arteries: Elastic

A

Major arteries off of heart which need to expand and recoil.

138
Q

Arteries: Muscular

A

Serve major regions and organs

139
Q

Arteries: Arterioles

A

Smallest form leads into capillaries. Re-routes blood as needed.

140
Q

How many subtypes of veins?

141
Q

What is the 1 subtype of vein?

142
Q

Veins: Venules

A

Smallest form leads into veins from merging capillaries.

143
Q

How many ways aid venous return?

144
Q

What are the 3 ways that aid venous return?

A
  1. Skeletal muscle pump; 2. Respiratory pump; and 3. Swedish massage
145
Q

Venous Return: Skeletal muscle pump

A

Skeletal muscle squeezes veins which helps return blood to the heart (e.g. soleus)

146
Q

Venous Return: Respiratory pump

A

Contraction of the diaphragm increases abdominal pressure which forces blood in veins back toward the heart.

147
Q

Venous Return: Swedish massage

A

Theoretically, the centripetal stroke of effleurage aids in blood flow toward the heart.

148
Q

Vocab: Thrombus

A

A blood clot lodged in a blood vessel wall.

e.g. Deep Vein Thrombosis aka DVT

149
Q

Vocab: Embolus

A

A traveling blood clot.

150
Q

Vocab: Varicosity

A

A dilated vein due to incompetent valves.

151
Q

What is the most common vein to suffer from vericosity?

A

Greater Saphenous Vein

Runs up the medial leg (anterior to the medial malleolus) and thigh.

152
Q

Arterial Pulse

A

The physical palpation of the expansion/recoil of superficial arteries corresponding to systole/diastole of the ventricles.

153
Q

What is the most common area to palpate the arterial pulse in Western medicine?

A

The radial pulse on the anterior wrist.

154
Q

Blood Pressure

A

The measurement of the amount of force blood exerts on the insides of the arteries in response to systole/diastole of the ventricles.

155
Q

What is the formula for blood pressure?

A

Blood Pressure = systolic pressure/diastolic pressure

e.g. BP = 120/80 mmHg (millimeters of mercury)

156
Q

How many factors can affect blood pressure?

157
Q

What are the 6 factors that can affect blood pressure?

A
  1. Condition of blood vessels; 2. Autonomic Nervous System; 3. Renal factors; 4. Temperature; 5. Hormones; and 6. Diet
158
Q

Blood Pressure: Condition of blood vessels

A

Plaques/build up inside arteries will increase the pressure due to less expansion/recoil)

159
Q

Blood Pressure: ANS

A

Sympathetic nervous system increases heart rate which increases blood pressure

Parasympathetic nervous system decreases both

160
Q

Blood Pressure: Renal factors

A

If blood pressure is too high, then kidneys make more urine to remove water from blood plasma.

If blood pressure is too low, then kidneys retain water/make less urine.

161
Q

Blood Pressure: Temperature

A

Heat causes vasodilation which decreases blood pressure.

Cold causes vasoconstriction which increases blood pressure.

162
Q

Blood Pressure: Hormones

A

Epinephrine (adrenaline) and thyroxine both increase heart rate and blood pressure.

163
Q

Blood Pressure: Diet

A

Eat a healthy diet low in saturated fat, cholesterol, and salt to maintain a healthy blood pressure.

164
Q

Effects of Swedish Massage

A

Theoretically increases venous return.

165
Q

Local effects of deep tissue massage

A

Research shows that it stimulates mast cells (type of epithelial cell) which produces histamine. It’s a vasodilator that causes capillaries in the area to become more porous and leak. This increases blood flow (hyperemia).

166
Q

Precautions and Contraindications

A

If client indicates a cardiovascular issue and is not being medically treated, massage should be avoided until cleared by a physician.

Bancroft: AP2 (6 decks)

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