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Med 310B > vascular > Flashcards

vascular Flashcards

1
Q

the right side of the heart delivers _____ of its blood to the _____

A

100%
lungs

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2
Q

the left side of the heart delivers oxygenated blood to other tissues in the body through systemic circulation. list the body parts in order of which recieves most to least;

A

digestive - 21%
kidneys - 20%
skeletal muscle - 15%
brain - 13%
skin - 9%
other - 8%
liver - 6%
bone - 5%
heart muscle - 3%

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3
Q

what is pressure a measure of?

A

force/area

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4
Q

what are modern units for pressure?

A

PSi (pounds per square inch), kPa (kilopascal), mmHg (milimeters of mercury)

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5
Q

what unit of pressure is used for measuring pressures in the cardiovascular system?

A

mmHG

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6
Q

what does mmHg represent?

A

the pressure exerted by a X mm column of liquid mercury

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7
Q

why drives the flow of blood through the vascular system?

A

pressure gradient established from the aorta to the right atrium

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8
Q

why does pressure decrease along the vascular tree?

A

due to conversion of energy into heat from friction

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9
Q

the rate of blood flow is ____ proportional to the pressure gradient and _____ proportional to vascular resistance

A

directly proportional
inversly proportional

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10
Q

how do you calculate rate of blood flow?

A

F = pressure gradient/resistance

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11
Q

what is pressure gradient?

A

the difference in pressure between the beginning and end of a vessel or organ

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12
Q

what is the direction of blood flow in terms of pressure?

A

blood flows from an area of high pressure to an area of lower pressure

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13
Q

______ provides the motive force to drive blood flow within conduit vessels and organs

A

blood pressure

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14
Q

what determines how much blood each organ will recieve?

A

vascular resistance

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15
Q

what is resistance?

A

the measure of the hindrance or opposition of blood flow through a vessel

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16
Q

how is resistance produced in the cardiac system?

A

by friction between the moving fluid and stationary walls

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17
Q

what are the 3 factors that resistance is dependent on?

A
  • blood viscosity (n)
  • vessel length (L)
  • vessel radius (r)
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18
Q

a slight change in vessel radius produces a _____ change in blood flow

A

significant

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19
Q

what is the equation to which resistance is proportional to?

A

1/r^4

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20
Q

what are the assumptions for Poiseuille’s law?

A
  • newtonian fluid - viscosity of blood remains constant
  • laminar flow - blood travels smoothly without turbulence
  • no slip condition - the speed of the blood that is in contact with the vessel wall is 0
  • steady flow
  • cylindrical vessels
  • rigid vessel walls
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21
Q

flow is equivalent to what mathamatical equation?

A

r^4

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22
Q

flow is equivalent to what?

A

pressure gradient

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23
Q

what are arteries?

A

rapid transit ways that carry blood away from heart to tissues

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24
Q

what are arterioles?

A

smaller branches of arteries that control distribution of blood

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25
Q

what are capillaries?

A

smaller branches of arterioles optimized for excahnge with surrounding cells

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26
Q

what are venules?

A

after nutrient excahnge, blood goes into the venules for return back to heart

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27
Q

what are venules?

A

form when venules merge, return blood to heart

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28
Q

what is the structural features of arteries?

A

thick, highly elastic walls with a large radi

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29
Q

what are the structural features of arterioles?

A

highly muscular, well innervated walls with small radi

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30
Q

what are the structural features of capillaries?

A

very thin walled

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31
Q

what are the structural features of veins?

A

thin walled compared to arteries, highly distensible, with large radi

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32
Q

an artery has the following structure; (inner-outer)

A

endothelium
basement membrane
elastic fibers
smooth muscle
elastic fibers
connective tissue coat

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33
Q

an arteriole has the following structure; (inner-outer)

A

endothelium
basement membrane
smooth muscle
connective tissue coat

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34
Q

a capillary has the following structure; (inner-outer)

A

endothelium
basement membrane

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35
Q

a large vein has the following structure; (inner-outer)

A

venous valve + endothelium
basement membrane
smooth muscle
conncetive tissue

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36
Q

what are conduits?

A

rapid-transport passageways for blood from heart to organs. due to their large radius, these large arteries offer little resistance to blood flow

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37
Q

what is pressure reservoir?

A

provides driving force for blood when heart is relaxing and refilling

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38
Q

compliance of arteries is related to _________

A

connective tissue components including;
collagen fibers - tensile strength
elastin fibers - elasticity to arterial fibers

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39
Q

blood pressure on its own usually refers to the blood pressure within _________

A

large central arteries of the systemic circulation

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40
Q

why does mean BP fall across the systemic vasculature?

A

in proportion to the resistance it encounters

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41
Q

inadequate BP can lead to___

A

inadequate tissue blood flow

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42
Q

excessive BP can cause _______

A

immediate problems such as overload on the heart or excessive tissue blood flow

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43
Q

even modest increases in BP can increase the risk of _______

A

cardiovascular disease

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44
Q

pulse pressure can be determined by what mathamatical equation?

A

Psystolic - Pdiastolic

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45
Q

BP refers to the pressure generated as a consequence of _______

A

ventricular ejection

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46
Q

how do you determine mean arterial pressure?

A

MAP = diastolic pressure + 1/3 pulse pressure

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47
Q

pressure ahead of resistance is also known as?

A

arterial pressure

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48
Q

pressure after resistance is also known as?

A

venous pressure

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49
Q

ohms law determines;

A

Parterial - Pvenous = CO x TPR (total peripheral vascular resistance)

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50
Q

which pressure is normally very small and can be considered neglible in ohms law?

A

Pvenous

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51
Q

a decrease in CO will have what effect of BP?

A

decrease

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52
Q

an increase in TPR will have what effect on BP?

A

increase

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53
Q

an increase in CO and decrease in TPR will have what effect on BP?

A

stabilized

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54
Q

can the normal distribution of blood from the left side of the heart at rest be changed?

A

yes. it is changed according to metabolic demands of the tissues

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55
Q

veins carry deoxygenated blood, arteries carry oxygenated blood… but there is 1 exception to this rule, what is it?

A

the pulmonary arteries that carry deoxygenated blood from the heart to the lungs

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56
Q

what is the tunica adventitia or externa?

A

the external layer of blood vessel tissues

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57
Q

what is the tunica media?

A

the middle layer of blood vessel tissues

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58
Q

what is the tunica intima?

A

the inner layer of blood vessel tissues

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59
Q

all types of blood vessels have a single layer of _______ cells that makw up most of the tunica intima

A

endothelial cells

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60
Q

where is the highest proportion of collagen fibers found?

A

in large veins

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61
Q

what is the windkessel effect?

A

when the heart contracts it ejects blood into the aorta which will stretch the arteries aas it rapidly flows. this energy will be stored as elastic energy and when the heart finishes contracting there will be elastic recoil.

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62
Q

what type of pressure is covered under hydrodynamics?

A

blood pressure produced by the contraction of the ventricular muscle which drives blood flow through circulation

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63
Q

what is hydrostatic pressure?

A
  • pressures of fluid that are somehow confined and not able to move and for which ohms law does not apply
  • the pressure resulting from the height of the fluid column
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64
Q

what is the equation that is representative of hydrostatic pressure?

A

P = height of fluid coolumn x fluid density

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65
Q

mercury is ________ times denser than water

A

13.6

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66
Q

what type of system was used to make the ffirstt measurement of BP?

A

a vertical glass column of water

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67
Q

why would a coulmn of water have to be taller than a column of mercury to accurately depict the same BP?

A

beacuse of the difference in density

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68
Q

can gravity affect BP?

A

yes because blood is a clumn of fluid

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69
Q

would regions above the heart have increased or decreased arterial pressure?

A

decreased

70
Q

would regions below the heart have increased or decreased arterial pressure?

A

increased

71
Q

blood is ______ times denser than water

A

1.06

72
Q

each meter of elevation of a verticle column of blood corresponds to __________ mmHg

A

78

73
Q

to minimize the effect of gravity on BP, what is used as a referance point?

A

the heart (brachial artery)

74
Q

can BP measurements be taken from places other than the brachial artery

A

yes they would just have to corrected to the pressure expected at the heart level

75
Q

when standing, what effect does gravity have on blood?

A

promote the pooling of blood in the veins of the lower limbs and impede venous return to the heart

76
Q

what does a sphygmomanometer combine?

A

a cuff to occlude an artery
something to generate cuff pressure
something to measure cuff pressure
hg column

77
Q

how does a blood pressure cuff work?

A
  • the BP cuff is inflated well above systolic pressure and then slowly deflated
  • when it is above systolic pressure the artery is collapsed and no arterial blood flow will occur and a korotkoff sound will not be heard
  • when it is below systolic pressure but above diastoli cpressure thge artery is partially collapsed so some aarterial flow will occur and a korotkoff sound will be heard
  • when cuff pressure is less that diastolic the aretery will be open and blood flow can occur quietly so korotkoff sounds wont be heard
78
Q

what is the method for noninvasive BP measurement?

A

korotkoff sounds with a stethoscope

79
Q

inflating the BP cuff causes;

A

when it is above systolic pressure the artery is collapsed and no arterial blood flow will occur and a korotkoff sound will not be heard

80
Q

as the cuff begins to deflate what happens?

A

when it is below systolic pressure but above diastoli cpressure thge artery is partially collapsed so some aarterial flow will occur and a korotkoff sound will be heard

81
Q

when the cuff is almost fully deflated what happens?

A

when cuff pressure is less that diastolic the aretery will be open and blood flow can occur quietly so korotkoff sounds wont be heard

82
Q

when are korotkoff sounds heard?

A

when the BP cuff is less than systolic pressure but higher than diastolic pressure

83
Q

using the korotkoff method, how do you determin systolic and diastolic BP?

A

systolic - when korotkoff sound first appears
diastolic - when the last korotkoff sound is heard

84
Q

what are considered as major resistance vessels?

A

arterioles

85
Q

how does adjusting the radius of arteriooles beneficial?

A
  • help distribute cardiac output ammong systemic organs depending on bod’s momentary needs
  • help regulate arterial blood pressure
86
Q

what are the methods involvedd in adjusting arteriole resistance?

A

vasoconstriction and vasodialation

87
Q

what is vasoconstriction?

A
  • descrbes the process of narrowing a vessel
  • results from contraction of smooth muscle layer
  • leads to increased resistance and decreased flow through that vessel
88
Q

what is vasodialation?

A
  • the enlargement in internal circumference and internal radius if vessel
  • results from relaxation of smooth muscle layer
  • leads to decreased resistance and increased flow through that vessel
89
Q

vascular smooth muscle cells sustain a level of partial contraction which is referred to as __________

A

vascular tone

90
Q

what are the 2 factors responsible for vascular tone?

A

myogenic activity of smooth muscle
sympathetic fibers continually release norepi

91
Q

vasoconstriction can be caused by;

A
  • increased myogenic activity
  • increased oxygen
  • decreased carbon dioxide
  • increased endothelian
  • increassed sympathetic stimulation
  • vasopression
  • angiotensin 2
  • cold
92
Q

vasodialation can be caused by;

A
  • decreased myogenic activity
  • decreased oxygen
  • increased carbon dioxide
  • increased nitic oxide
  • decreased sympathetic stimulation
  • histamine release
  • cold
93
Q

if an arteriole changes radius within a certain organ, does that affect other vessels in another\?

A

yes

94
Q

what are chemical influences on arteriolar radius?

A

local metabolic change
histamine release

95
Q

what are physical influences on arteriolar radius?

A

local application of heat or cold
chemical response to shear stress
myogenic response to stretch

96
Q

during exercise, cardiac output changes, what organ/body part would have the highest percent change in flow?

A

skeletal muscle

97
Q

what are vasoactive mediators?

A
  • decreased oxygen - hypoxia and initiate vasodialation
  • increase carbon dioxide - hypercapnia and initiated vasodialation
  • increased acid - acidosis and iinitiate vasodialation
  • increased potassium - hyperkalemia and initiate vasodialation
  • increased osmolarity - initiate vasoconstriction
  • adenosine release - initiate vasodialation
  • prostaglandi release - different protsglandins will initiate different responses
98
Q

venous pressures are low at the heart level.
true or false

A

true - approximately 10 mmHg

99
Q

which has higher venous pressure, the foot or the vena cava?

A

the foot

100
Q

does the cross section of blood vessels maintain its form even in an absence of pressure? why?

A

yes because the coat of collagen on the outside limits the maximum diameter changes

101
Q

at rest, skeletal muscle recieves about 15% of cardiac out put but goes to _____- during exercise

A

64%

102
Q

why does the blood supply to the heart and skin increase during exercise?

A

for increasing the cardiac output and for radiating the heat generated during exercise

103
Q

why does blood supply to the digestive system and kidneys decrease suring exercise?

A

to send more blood to skeletal muscle

104
Q

what is a decrease in oxygen content referred to as?

A

hypoxia

105
Q

what is an increase in carbon dioxide content referred to as?

A

hypercapnia

106
Q

what is an increase in acid referred to as?

A

acidosis

107
Q

what is an increase in potassium concentration referred to as?

A

hyperkalemia

108
Q

endothelial cells play an essential role in regulating ________

A

arteriolar diameter

109
Q

how do endothelial cells regulater arterolar diameter?

A
  • release chemical mediators
  • release locally activating chemical messengers in response to chemical changes in the environment
  • Endothelian-1 type A causes vasoconstriction in
  • endothelian-1 type B causes no release
110
Q

NO is one of the most studied ___-

A

local vasoactive mediators

111
Q

what are the functions of endothelial cells?

A
  • line the blood vessels and heart chambers like a physical barrier between blood and vessel wall
  • secrete vasoactive substances for relaxation or contraction
  • secrete substances to stimulate new vessel growth and proliferation of smooth muscle cells
  • participate in material exchange between blood and surrounding tissue
  • influence formation of platelet plus, clotting, and clot dissolution
  • participate in the determination of capillary permeability by contracting to vary the size of the pores between adjacent endothelial cells
112
Q

ACh stimulation of ________ cells causes an influx of _______- into fluo-4 loaded ______- cells which result in flourescence.

the decrease in _________ in the surrounding smooth muscle causes _________

A

endothelial
Ca2+
endothelial
CA2+
vasodialation

113
Q

what are the functions of NO?

A
  • causes relaxation of arteriolar smooth musclr - control of blood flow through tissues and maintaining mean arterial BP
  • dilates the arterioles of the penis and clitoris
  • acts as chemical warfare against bacteria and cancer cells via release from macrophages, large phagocyte cells of the immune system
  • interferes with platelet function and clotting at vessel damage sites
  • serves as a neurotransmitter
  • plays a role in the changes underlying memory
  • helps regulate peristalsis by promoting relaxation of digestive tract smooth muscle
  • helps keep airways open to facilitate movement of air in and out of lungs by relaxing thr smooth muscle cells
  • modulates the filtering process involved in urine formation
  • directs blood flow to oxygen-starved tissues
  • relaxation of skeletal muscle
114
Q

heat leads to ____

A

vasodialation
it is used in the skin to shed heat from the body core
flushing/reddening

115
Q

cold leads to ____

A

vasoconstriction
preserves core heat
frost bite

116
Q

people with raynaud’s syndrome experience more sensitivity to the cold which in turn leads to greater degrees of ____

A

vasoconstriction

117
Q

what does shear stress refer to?

A

the forces exerted on the endothelial cells as blood passes over it

118
Q

increasing sheer stress causes _______

A

vasodialation - partially through NO

119
Q

in a blood vessel wall, sudden increase in aarterial pressure ___________ the cells and as a result, cell contractions will reduce the radius of the vessels

A

stretches

120
Q

what is reactive hyperanemia?

A

an increase in blood flow that occurs after the occlusion of a blood vessel.

the degree of vasodialation is proportionate to the oxygen debt created during the stopped flow

121
Q

what is pressure autoregulation?

A
  • intrinsic mechanisms that maintain a constant level of blood flow over a specific range of pressures
  • blood flow is kept constant by mechanisms that adjust the radius in order to alter resistance in response to a change in pressure
122
Q

what is autoregulation critical for?

A

functions of the kidneys, brain and heart

123
Q

what are the influences of norepi on smooth muscle?

A
  • brain arterioles do not constrict with norepi
  • smally coronary vessels do not constrict with norepi
  • no parasympathetic innervation to arterioles
124
Q

norepi and epi can influence the ____________- control center in the medulla

A

cardiovascular

125
Q

sympathetic stimulation of the adrenal medulla influences…

A

vasopressin and angotensin 2 to maintain body’s fluid balance

126
Q

what do vasopressin and angiotensin 2 do?

A

maintain body’s fluid balance

127
Q

vasopressin and angiotensin 2 are potent ___________

A

vasoconstrictiors

128
Q

receptor alpha1 is located __________ and recieves _________ from sympathetic fibers and adrenal medula and results in the ___________ response

A

in all arteriolar smooth muscle except the brain
norepi
vasoconstriction

129
Q

receptor beta2 is located ______ and recieves _______ from the adrenal medulla and results in the __________ response

A

arteriolar smooth muscle in the heart and skeletal muscles
epi
vasodialation

130
Q

capillaries maximize what factor to be the site of exchange between blood and surrounding tissue cells?

A

surface area

131
Q

there are ________ in capillary walls to passs water soluble substances

A

pore

132
Q

plasma proteins ___ cross the capillary wall

A

cannot

133
Q

lipid soluble substances pass through the capillary wall via ____

A

endothelial cells

134
Q

how are exchangeable proteins moved across the capillary wall?

A

vesicualr transport

135
Q

to support increased metabolic demands capillaries are _____ to support RBC flux

A

recruited

136
Q

endothelial cells produce NO using an enzyme called __________

A

NO synthase

137
Q

there are 3 types of NO synthases, what are they?

A

endothelial NO synthase (eNOS)
neuronal NO synthase (nNOS)
inducible NO synthase (iNOS)

138
Q

eNOS oxidises what amino acid into NO?

A

L-arginine

139
Q

the ________ artery has the lowest innervation of sympathetic fibers

A

gracilis feed artery

140
Q

there are 3 different types of capillaries, what are they?

A

continuous
fenestrated
sinusoidal

141
Q

what is a continuous capillary?

A

has very little gaps between adjacent endothelial cells which leads to limited exchange through the pores

142
Q

what is a fenestrated capillary?

A

the endothelial cells have large pores which facilitae the movement of large molecuels from the vasculature to the extracellular spce

143
Q

what is a sinusoidal capillary?

A

endothelial cells feature large gaps between cells which requires the movement of even bigger molecules out of the vasculature
- usually liver and lymph node tissue

144
Q

froms most to least, how is the volume of blood is the circulatory system distributed?

A
  • systemic veins
  • systemic arteries
  • pulmonary vessels
  • heart
  • systemic capillaries
  • systemic arterioles
145
Q

what factors effect venous return?

A
  • driving pressure from cardiac return
  • sympathetically induced venous vasoconstriction
  • skeletal muscle activity
  • effect of venous valves
  • respiratory activity
  • effect of cardiac suction
146
Q

what are the most common sites of varicose veins?

A

lower limbs
esophagus
anal canal

147
Q

what happens to varicose veins? (symptom)

A

affected vein and surrounding tissue become inflamed and painful

148
Q

what causes varicose veins?

A

leaky venous valves

149
Q

describe inhalation;

A
  • increased abdominal pressure pushes on the inferior vena cava
  • the venous valves ensure unidirectional flow towards thorax
  • reduced pressure in the thorax creates suction
150
Q

describe exhalation;

A
  • reduced pressure in the abdomin, it is easier for blood to go up the vena cava
  • increased pressure in the thorax compresses thoracic vena cava to push blood to the right atrium
151
Q

ISF resembles __________ in composition

A

plasma

152
Q

80% of ECF is _________
20% of ECF is _________

A

ISF
plasma

153
Q

the walls of capillaries are ________

A

highly permeable

154
Q

capillary BP is denoated by?

A

Pc

155
Q

what does capillary bP refer to?

A

fluid or hydrostatic pressure exerted on the inside of the capillary walls by blood
- 37 mmHg arteriolar end
- 17 mmHg venular end

156
Q

how is Plasma-colloid osmotic pressure denoted?

A

(pi)p

157
Q

what is plasma-colloid osmotic pressure?

A

forces caused by the colloid dispersion of the plasma proteins. protein concentration tends to be higher in the plasma so this force directs fluid into the capillaries
- 25 mmHg

158
Q

how is interstitial fluid hydrostatic pressure denoted?

A

PiF

159
Q

what is interstitial hydrostatic pressure?

A

the pressure exerted on the outside of the capillary wall by ISF. tends to push fluid into the capillaries

160
Q

what is interstitial fluid-colloid osmotic pressure deonted by?

A

(pi)iF

161
Q

what is interstitial fluid-colloid osmotic pressure?

A

colloid dispersion of plasma proteins inn the ISF, tends to pull fluid out of the capillaries

162
Q

bulk flow of ISF occurs any time there is _________

A

a net + or - exchange pressure

163
Q

bulk flow is critical is ___________

A

regulating the distribution of extracellular fluids between plasma and interstitum
- maintains normal balance of plasma and ISF

164
Q

following a hemorrhage, a fall in Pc promotes ________

A

reabsorption of ISF

165
Q

bulk flow can lead it excess ISF volume in _________

A

edema

166
Q

what is the lymphatic system?

A

the network of vessels that start with blind-ends and end with a single connecction to the venous circulation
an accessory route for returning fluid from interstitial to blood

167
Q

what is lymph

A

interstitial fluid that has entered the lymphatic system

168
Q

how does lymph enter the vessel?

A

fluid pressure on the outside of the vessel pushes the endothelial cells free edge inward permitting its entrance

169
Q

why cant lymp escape?

A

fluid pressure on the inside of the vessel forces the overlapping edges together

170
Q

what is edema?

A

swelling of tissues that occurs when there is too much ISF

171
Q

what are the possible causes of edema?

A
  • reduced concentration of plasma proteins (loss of proteins from urine in kidney disease, reduced synthesis from liver disease, diet, large burn)
  • increased capillary wall permeability (histamine release from injury or allergy)
  • increased venous pressure (congestive heart failure, pregnancy)
  • blockage of lymph vessels (lymph node removal)
172
Q
A

Med 310B (6 decks)

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