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CVP > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q 
Arteries have:
\_\_\_\_\_\_ pressure 
\_\_\_\_\_\_\_ velocity of blood flow
\_\_\_\_\_\_\_ walled
Lots of \_\_\_\_\_\_, \_\_\_\_\_ and \_\_\_\_\_ muscle 
Functions as a \_\_\_\_\_\_ (resistance to flow doesnt change much
A 
High pressure 
High velocity of blood flow
Thick walled 
Lots of elastin, collagen and smooth msucle 
Functions as a conduit
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2
Q

_______ control flow into capillaries and are the MOST important determinant of PERIPHERAL RESISTANCE

A

Arterioles

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3
Q

What is the most important determinant of peripheral resistance?

A

Arterioles

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4
Q

Arterioles contains much ____ muscle and can change ______

A

Smooth muscle

DIAMETER

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5
Q

_____ function to exchange fluid, nutrients, electrolytes, hormones, etc to tissue cells.

Thin walled and no muscle

A

Capillaries

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6
Q

Veins and venules have _____ pressure

Thin walls that are ________

A

Low; distensible

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7
Q

The total cords-sectional area is the sum of the individual ______ area of each ______ category

A

Cross sectional

Blood vessel

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8
Q

Even though capillaries have the ______ diameter individually, they have the _______ cross-sectional area

A

Smallest; largest combined

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9
Q

Most of the blood volume is in the _______ system

A

Venous

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10
Q

Veins and venules are considered to be the _________

A

Blood reservoir

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11
Q

As total cross-sectional area increases, blood flow velocity _______

A

Decreases

V=Q/A or V= F/A

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12
Q

What is total cross sectional area?

A

The sum of the individual cross sectional areas of each blood vessel category

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13
Q

Capillaries have the smallest ______ individually and the largest combined

A

Diameter; cross sectional area

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14
Q

Blood flow (_or _) is the same or different? For each section of the circulation

A

Q or F; is the same for each section of circulation

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15
Q

Pressure in arteries is ____
Pressure in the capillaries averages about _____ mmHg
Pressure in venous system is ____

A

High; 17; low

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16
Q

What is Ohm’s law?

A

I=V/R

**algebraic rearrangement of this equation also hold true:
Delta P= QxR
R= delta P/Q

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17
Q

Blood flow (Q)= (P1-P2)/R is what equation?

A

Basic flow equation

AKA ohm’s law

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18
Q

Blood flow (Q) means what?

A

The volume of blood that passes a given point per unit of time

Ex: Liters per min

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19
Q

Cardiac output (CO) is what? And that is the typical caridac output

A

Q for the entire systemic circulation and typically is about 5 L/min

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20
Q

Explain laminar flow

A

Flow in layers
Parabolic shape of velocities
Generally quiet

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21
Q

Explain turbulent flow

A

Layers are disrupted by some partial obstruction or excessive velocity
Noisy

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22
Q

What is a carotid bruit?

A

Atherosclerotic plaques partially occluded an artery causing turbulent flow

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23
Q

When measuring blood pressure, cuff pressure should be ________ when inflated. One slowly let air out of cuff, between 80 and 120, will revive b

A

When the cuff is inflated so that it sto[s arterial blood flow. No sound can be heard through a stethoscope placed over the brachial artery distal to the cuff

Korotkoff sounds are created by pulsatilla blood flow through the compressed artery

Blood flow is silent when the artery is no longer compressed

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24
Q

What can be used to determine turbulent flow?

A

Reynold’s number

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25
Q

When Reynolds number rises above ______, turbulence is likely

A

200- 400

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26
Q

Turbulence often occurs in the _______ due to pulse and changes in vessel diameter during ejection

A

Aorta

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27
Q

T/F: Turbulence normally occurs in smaller vessels

A

F: turbulence normally doesn’t occur in smaller vessels

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28
Q

What is used to relate radius, viscosity and length to blood flow?

A

Poiseuilles law

Q= delta P x pie x r^4 / 8 n l

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29
Q

The total resistance of vessels in series is equal to the ________

A

Sum of their individual resistances

Rtotal= R1+R2+R3

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30
Q

For blood vessels arranged in parallel, more vessels means ______________

A

More avenues for blood flow and reduces resistance

1/Rtotal= 1/R1 + 1/R2

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31
Q

What is the reciprocal of resistance?

A

Conductance

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32
Q

What is a hematocrit?

A

The amount of RBCs present

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33
Q

What is the normal levels of hematocrit for the male and female? Hematocrit is also known as packed red cell volume

A

45%

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34
Q

What occurs with ppl who have increased hematocrit?

A

Erythrocytosis (increased RBCs due to illness or repsonse to external situations)

Polycythemia Vera- bone marrow disorder

Severe dehydration

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35
Q

What occurs with decreased hematocrit?

A

Anemia
Renal disease (decreased erythropoietin)
Leukemia
Overhydration

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36
Q

How would hemorrhage affect hematocrit within minutes of bleeding? After a few hours of bleeding?

A

Within minutes of bleeding: hematocrit would be the same

After few hours of bleeding: hematocrit would be decreased bc it is easier to make the fluid than the cells

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37
Q

The higher the hematocrit/ the higher the viscosity

A

Higher

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38
Q

Describe autoregulation

A

Tissues supplied by vessels adjust their vascular resistance to maintain normal flow during changes in arterial pressure

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39
Q

What is vascular compliance?

A

The amount the volume of a vessel changes in response to pressure

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40
Q

What is distensibility?

A

Refers to the elasticity of a vessel without consideration of volume changes

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41
Q

How would one calculate compliance?

A

C= change in volume/ change in transmural pressure

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42
Q

Veins are about _____ times more compliant than arteries due to ______

A

20 times; greater elasticity

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43
Q

T/F? Vasoconstriction increases pressure at any given volume

A

True

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44
Q

Increasing volume in a vessel increases pressure but then the pressure somewhat decreases as the walls stretch to accommodate volume. What is the mechanism to which this occurs?

A

Stretch-relaxation response of smooth muscle cells

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45
Q

What two factors affect the pulse pressure?

A

Stroke volume

Compliance of the arterial tree

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46
Q

What are pulse pressure contours? 3 examples

A

Upstroke (due to systole)
Incisura (due to aortic valve closure)
Diastolic decline

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47
Q

What is damping?

A

Progressive loss of pulsation upon entering the small arteries -> arterioles -> capillaries

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48
Q

Damping is proportional to _______ and ______

A

Resistance and compliance

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49
Q

What is central venous pressure?

A

The pressure in the RA because al systemic veins flow into the RA

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50
Q

What are the 3 factors that increase venous return?

A

Increased blood volume
Increased large venous tone
Dilation of arterioles

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51
Q

What is Normal RA pressure?
Abnormally high RA pressure?
Abnormally low RA pressure?

A

Normal: 0 mmHg

Abnormally high: up to 20-30 mmHg

Abnormally low: -3 to -5 mmHg

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52
Q

In vigorously pumping heart or in severe hemorrhage, what would the RA pressure (central venous pressure) be?

A

-3 to -5 mmHg

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53
Q

Large veins have ______ resistance in general

A

Little

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54
Q

What is the effect of RA pressure on peripheral venous pressure?

A

Increase causes blood back up and an increase in peripheral venous pressure

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55
Q

Effect of gravitational pressure:
Venous pressure above the heart is ____ than 0 mmHg
Venous pressure below the heart is ____ than 0 mmHg

A

Less than; greater than

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56
Q

What ensures one-way movement of the venous system?

A

Venous valves

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57
Q

What mechanisms moves the blood in the venous system

A 
Muscle pump (extremity muscle contraction moves blood up toward th heart 
Thoracic pump (breathing action also massages blood up to heart)
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58
Q

What does venous valve incompetence cause?

A

Varicose veins in the legs

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59
Q

What are the principle blood reservoirs?

A 
Large abdominal veins
Spleen
Liver
Subcutaneous venous plexus 
Heart
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60
Q

What is the funciton of blood reservoirs?

A

Compliant nature of veins allows these vessels the ability to store blood

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61
Q

Define microcirculation

A

The microscopic circulation that occurs at the level of the tissues (capillaries)

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62
Q

What is the strucutre of a capillary bed?

A 
Arteriole 
Meta arterioles and precapillary sphincters
True capillaries 
Preferential channels (bypass)
Venules
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63
Q

True capillaries DO NOT have smooth muscle. T or F?

A

True

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64
Q

What is vasomotion?

A

Contraction and dilation of metaarterioles and precapillary sphincters

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65
Q

What is autoregulation?

A

Regualtion of vasomotion by local tissue conditions (mainly O2)

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66
Q

What are the three types of capillary walls?

A

Continuous
Fenestrated
Sinusoidal/discontinuous

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67
Q

_______ capillaries are located in muscle, nervous tissue, heart, lung and skin

A

Continuous

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68
Q

________ capillaries are highly permeable and located in intestinal villi, choriod plexus, glomeruli and endocrine.

A

Fenestrated

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69
Q

_______ capillaries have a large diameter and are located in liver, bone marrow and spleen

A

Discontinuous

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70
Q

What are the three ways movement can occur through capillary walls?

A

Intercellular clefts (slit-pores)
Transcytosis
Fenestrae

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71
Q

Name the organ that has continuous capillaries with tight junctions that only allow small molecules to pass (water, oxygen and CO2)

A

Brain

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72
Q

What organ has discontinuous capillaries with wide intercellular clefts that allow all dissolved substances including plasma proteins to pass through

A

Liver

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73
Q

Name the organ that has fenestrae that allow absorption through capillary wall

A

GI tract

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74
Q

What has numerous fenestrae to allow large amount of filtration?

A

Glomerulus

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75
Q

_______ soluble substances can diffuse directly through membrane

_______ soluble substances rely on clefts/fenestrae etc

A

Lipid

Water

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76
Q

capillary pores are about ______ nm in diameter which is too small for most plasma proteins or blood cells to pass through

A

6-7

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77
Q

How much of the body consists of spaces between cells?

A

1/6th

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78
Q

What are the 3 components of the interstitium?

A

Collagen fiber bundles
Proteoglycan filaments
Interstitial fluid

** together these components form a gel

79
Q

Interstitial fluid is derived by _______ and _______ from the capillaries

A

Filtration and diffusion

80
Q

What are the 4 force that determine movement of fluid between the capillary and the interstitium?

A

Capillary pressure (Pc)
Interstitial fluid pressure (Pif)
Plasma colloid osmotic pressure
Interstitial colloid osmotic pressure

81
Q

What causes fluid movement across the capillary wall in a particular direction?

A

Each of the starling forces

82
Q

In capillary dynamics,
Arterial end there is net _________
Venous end there is net _____

A

Filtration

Reabsorption

83
Q

At the ARTERIAL end of the capillary, what are the outward forces that result in net filtration?

A

Capillary pressure
Negative interstitial free fluid pressure
Interstitial colloid osmotic pressure

84
Q

At the ARTERIAL end of capillaries, what are the inward forces that result in net filtration?

A

Plasma colloid osmotic pressure

85
Q

At the VENOUS end of the capillary, what are the outward forces that result in net reabsorption?

A

Capillary pressure
Negative interstitial free fluid pressure
Interstitial colloid osmotic pressure

86
Q

What is the inward force at the Venous end of the capillary that result in net reabsorption back into the capillaries?

A

Plasma colloid osmotic pressure

87
Q

________ is an accessory route for the return of fluid and protein from the interstitial space to the blood

A

Lymphatic system

88
Q

How much of the fluid that leaves the blood capillaries enters the lymph capillaries?

A

1/10th

89
Q

________ are blind ended, lined with endothelial cells that overlap to form simple valve-like structures, lymphatics channels and valves.

A

Lymph capillaries

90
Q

increases in the ________ pressure increase lymph flow

A

Interstitial pressure

91
Q

What sterling forces increase interstitial pressure?

A

Elevated capillary pressure
Decreased plasma colloid osmotic pressure
Increased interstitial fluid colloid osmotic pressure
Increased permeability of capillaries

92
Q

What are the functions of the lymphatic system?

A

Overflow system for capillaries
Controls the concentraiton of protein in the interstitial fluid
Controls the volume of interstitial fluid
Controls interstitial pressure (keeps it negative in most tissues)
Role in immune function

93
Q

What are the mechanisms of blood flow control?

A

Short term (acute metabolic) control / autoregulation

Long term control (slow changes over days, weeks, or months by changing the number of capillaries in tissue

94
Q

What are the two mechanisms of short term control of local blood flow?

A

Vasodilator theory

Oxygen lack theory

95
Q

Describe the vasodilator theory

A

The greater the metabolic rate of a tissue, or lack of oxygen, the more vasodilator substances are secreted

96
Q

What 3 things do vasodilators affect?

A

Pre-capillary sphincters
Met arterioles
Arterioles

97
Q

Describe oxygen lack theory in short term control of local blood flow

A

Since oxygen is necessary for smooth muscle contraction, its lack will cause smooth muscle to relax

98
Q

What are 5 important LOCAL vasodilators?

A 
ADENOSINE***
CO2
Histamine
K+ ions
H+ ions (from lactic acid)

*** repeated this in the review a lot

99
Q

_______ is an increase in the quantity of blood flow to a tissue or body part

A

Hyperemia

100
Q

___________ is normal autoregulation to increase blood flow due to metabolic need

A

Active hyperemia

101
Q

_____________ is response to temporary interruption of blood flow to pay back oxygen debt

A

Reactive hyperemia

102
Q

________ is response of smooth muscle to contract with excessive pressure; is generally over-ridden by metabolic control of blood flow

A

Myogenic response

103
Q

_________ occurs in kidneys. Is the composition of fluid in the distal tubule is sensed by the macula densa, which then regulates the afferent arteriole

A

Tubuloglomerular feedback

104
Q

In the brain, the concentraiton of ____ and ____ are as important as O2 to normal brain function. ________ are important in regulating cerebral blood flow

A

CO2 and H+

Astrocytes

105
Q

In the skin, blood flow control is closely linked to ________ regulation and is controlled largely via _______ innervation

A

Temperature

Sympathetic

106
Q

_______ is an endothelial derived relaxing factor

A

NO (nitric oxide)

107
Q

When is NO released by endothelial cells?

A

In small arteries in responses to shear stress, when there is rapid blood flow into the capillary bed

108
Q

NO causes vasodilation in __________ which reduces wall stress and improves flow in downstream capillary

A

Small arteries

109
Q

Long term control of blood flow is due to changes in ________

A

Vascularity

110
Q

What is the main determining factor in long term control of blood flow?

A

Oxygen

111
Q

What are the main vascular growth (angiogenesis) factors?

A

Vascular endothelial growth factor
Fibroblast growth factor
Angiogenin

112
Q

What are examples of vasoconstrictors?

A

Norepinephrine and epinephrine
Angiotensin II
Vasopressin
Endothelin

113
Q

______ is formed by a cascade initiated by renin release from the ______

A

Angiotensin II

Kidneys

114
Q

What does angiotensin II cause?

A

Arteriole constriction to increase total peripheral resistance and increase blood pressure

115
Q

Where are norepinephrine and epinephrine from?

A

Sympathetic NS and adrenal medulla

116
Q

What vessels respond to NE and epinephrine by vasodilation?

*** normally NE and epinephrine result in vasoconstriction

A

Coronary arteries

117
Q

What is another name for vasopressin?

A

ADH

118
Q

Where is vasopressin (ADH) released from?

A

The posterior pituitary

119
Q

What is the function of vasopressin (ADH)?

A

Increases water resorption by the kidneys

In increased amounts causes arteriolar vasoconstriction

Increases peripheral resistance and blood pressure

120
Q

What triggers the release of endothelin?

A

Endothelial damage

121
Q

What is the function of endothelin?

A

Prevents excessive bleeding

122
Q

What are examples of vasodilators?

A

Bradykinin
Histamine
NO

123
Q

How is bradykinin formed?

A

By cascade initiated by tissue inflammaiton

124
Q

_________ causes dilation and increased capillary permeability

A

Bradykinin

125
Q

________ is derived primarily from mast cells and basophils

A

Histamine

126
Q

_______ causes vasodilation of arterioles in inflammatory reactions

A

Histamine

127
Q

What is an important mediator in allergic reactions?

A

Histamine

128
Q

What is the vascular effect of Ca?

A

Causes vasoconstriction (stimulates smooth muscle)

129
Q

What is the vascaulr effect of increased K+ and Mg2+?

A

Vasodilation (inhibits smooth muscle)

130
Q

What is i the vascular effect of H+?

A

Increases dilation (lowers pH)

131
Q

Control of blood flow in tissues is mainly the funciton of local control mechanisms (ex: ___________)

A

Autoregulation

132
Q

The sympathetics innverate all vessels except _______, ______ and _____

A

Capillaries, pre-capillaries and metarterioles

133
Q

_______ innverates the heart ( increases HR)

A

Sympathetic

134
Q

Vasoconstrictor fibers highly innervates what structures?

A

Kidneys, gut, spleen, and skin

135
Q

Vasoconstrictor sympathetic fibers lightly innervates

A

Skeletal muscle and brain

136
Q

Norepinephrine release binds to ______ receptors

**vasoconstrictor fibers

A

Alpha receptors

137
Q

_______ fibers innervates the heart principally, some in skeletal muscle

A

Vasodilator fibers

138
Q

With vasodilator fibers, norepinephrine release binds to ______ receptors

A

Beta

139
Q

_______ releases epinephrine and norepinephrine as hormones

A

Adrenal medulla

140
Q

Which of the adrenal medulla hormones (epinephrine or norepinephrine is a more potent stimulator of beta receptors?

A

Epinephrine

Vasodilation

141
Q

Which of the adrenal medulla hormones are more potent stimulator of alpha receptors?

A

Norepinephrine

Vasoconstriction

142
Q

______ innervates the heart but not the peripheral circulation

A

Parasympathetic

143
Q

What parasympathetic neurotransmitter causes decrease in heart rate and a decrease in force of contraction

A

Ach

144
Q

Where is the vasomotion center located?

A

Reticular substance in medulla and pons

145
Q

What are the vasomotor center areas? (3)

A

Vasoconstrictor area
Vasodilator area
Sensory area

146
Q

The vasoconstrictor area of the vasomotor center excites the ______ neurons of the sympathetic NS

A

Vasoconstrictor

147
Q

What inhibits the vasoconstrictor area in in vasomotor center?

A

Vasodilator area

148
Q

________ recieves sensory input from baroreceptors (blood pressure receptors)

A

Sensory area

149
Q

The vasomotor center is involved in what two actions?

A

Control of blood vessels

Regulating vasomotor tone

150
Q

The aortic baroreceptors transmit signals via the _______ nerve

A

Vagus

151
Q

The carotid sinus transmits signals via the ________ nerve

A

Glossopharyngeal nerve

152
Q

Vasomotor center control of heart is in the _____ area and _____ area

A

Lateral area and medial area

153
Q

The lateral area of the vasomotor center controls ______ activity to the heart

A

Sympathetic

154
Q

The medial area of the vasomotor center controls _______ activity to the heart via the ______ nerve

A

Parasympathetic activity via the vagus nerve

155
Q

What occurs to increase arterial pressure?

A

Almost all arterioles are constricted (increase peripheral resistance)
Veins are constricted (increase venous return)
Heart is stimulated to (increase rate and contractility)

156
Q

What plays a central role in the control of blood pressure on a long term basis by controlling fluid and salt balance?

A

Kidneys

157
Q

Renal function curve shows that as arterial pressure increases, urinary output _______

A

Increases

158
Q

Water balance is determined by what 2 factors?

A

Renal output of water and salt

Dietary intake of water and salt

159
Q

What is the infinite gain principle?

A

When blood pressure increases or decreases, kidney output changes to restore equillibrium

160
Q

What is equillibrium point?

A

Water and salt intake matches water and salt output and blood pressure is normal

161
Q

Changes in the equillibrium point change the level of water and salt intake which shifts the pressure level for the renal output curve to the ______

A

Left due to alteration of kidney function or pathology

162
Q

Will an increase in peripheral resistance cause an increase in long term blood pressure?

A

Unless there is a decrease in blood flow to the kidney, blood pressure will return to normal within hours or days

If the vasculature of the kidney is ALSO affected, this will shift the renal function curve to the RIGHT and cause hypertension

163
Q

Increased blood volume ______ cardiac output and blood pressure

A

Increases

164
Q

Increased cardiac output causes ________ (via autoregulation), increased ________ and ________

A

Vasoconstriction
Increased total peripheral resistance
Arterial blood pressure

165
Q

Increased blood pressure _______ urine output via pressure _______ and ______

A

Diuresis and natiuresis

166
Q

Increased salt intake increases ___________ which stimulates the thirst center of the brain (hypothalamus

A

Blood osmolarity

167
Q

Increased osmolarity also stimulates ______ secretion from the posterior pituitary gland which increases water resorption in the kidneys

A

ADH

168
Q

______ is cleared more slowly than water from the body

A

Salt

169
Q

What is renin secreted from?

A

Juxtaglomerular cells of the kidneys

170
Q

Renin is secreted by the ________ cells of the kidney in response to __________

A 
Juxtaglomerular cells (JG)
Low blood pressure
171
Q

Renin catalyzes what reaction?

A

Angiotensinogen -> angiotensin I

172
Q

Angiotensin converting enzyme is located in the ____ and catalyzes what reaction?

A

Angiotensin I-> Angiotensin II

173
Q

What are the effects of angiotensin II

A

Vasoconstriction-> increased peripheral resistance and BP

Increased Na retention by kidneys-> fluid retention

Stimulates release of aldosterone -> increase Na retention and K excretion by kidneys

174
Q

Where is aldosterone released from?

A

Adrenal cortex

175
Q

What is mean arterial pressure?

A

MAP= 1/3 pulse pressure + diastolic pressure

Pulse pressure = systolic pressure minus diastolic pressure

176
Q

________ is a common problem that can damage the heart kidneys, brain and other organs

A

Hypertension

177
Q

What are hypertensive patients at higher risk for?

A 
Congestive heart failure 
Coronary artery disease 
Renal damage 
Strokes 
Aneurysms
178
Q

What is normal systolic and diastolic blood pressure?

A

Systolic: less than 120
Diastolic: less than 80

179
Q

Elevated BP is _______ systolic and _______ diastolic

A

120-129 and

Less than 80

180
Q

stage 1 hypertension of blood pressure: ______ systolic and ______ diastolic

A

130-139 systolic or

Diastolic 80-89

181
Q

stage 2 HT: systolic _____ or diastolic _______

A

Greater than 140

Greater than 90

182
Q

What are 2 other names for primary hypertension?

A

Essential hypertension, idiopathic hypertension

183
Q

What are the treatments of primary hypertension?

A

Life style

Antihypertensive drugs

184
Q

T/F: there is no known cause of primary hypertension

A

True

185
Q

Secondary hypertension is due to a known cause; most lead to HT because of what?

A

An increased ECF volume

186
Q

What are 4 examples of disorders that have HT as a symptom?

A

Primary hyperaldosteronism
Renal failure
Phenochromocytoma (adrenal medulla tumor)

187
Q

What are non-pharmacological interventions for HT?

A 
Weight loss
Healthy diet 
Avoid excess sodium 
Get enough K+ 
Physical activity 
Moderation of alcohol 
Chiropractic

** used to treat elevated BP or for stage 1 HT with patients with low cardiac risk

188
Q

What are the antihypertensive drug classes? (5)

A 
Diuretics 
ACE inhibitors 
Vasodilator drugs 
Beta blockers 
Ca2+ channel blockers
189
Q

What are common substances that can elevate BP? (6)

A 
Alcohol 
Amphetamines 
Some kinds of antidepressants 
Caffeine 
Some kinds of decongestants 
NSAIDS
Cocaine
190
Q

Which of the following contains endothelium, elastic tissues smooth muscle and fibrous tissue? (2)

Artery
Arteriole
Capillary
Venule
Vein
A

Artery

Vein

191
Q

Which of the following contains endothelium and smooth muscle only?

Artery
Arteriole 
Capillary 
Venule 
Vein
A

Arteriole

192
Q

Which of the following is made up of only endothelium?

Artery
Arteriole
Capillary
Venule 
Vein
A

Capillary

193
Q

Which of the following is made up of endothelium and fibrous tissue only?

Artery
Arteriole
Capillary 
Venule 
Vein
A

Venule

194
Q

Renal disease is associated with what risk?

A

Risk of high blood pressure

CVP (3 decks)

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