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Human Organs and Tissues > Vascular Anatomy and Physiology > Flashcards

Vascular Anatomy and Physiology Flashcards

1
Q

What is the general cellular and ECM composition for the vasculature of the CV system?

A

Cellular Composition:

  • Endothelial Cells
  • Smooth Muscle Cells

Extracellular Matrix

  • Collagen
  • Elastin
  • Glycosaminoglycans
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2
Q

What are the 3 general layers of vessels?

A

Tunica Intima
Tunica Media
Tunica Adventitia

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3
Q

Whats the composition of the tunica intima?

A

Single layer of epithelial cells with minimal connective tissue set on the Internal Elastic Lamina (IEL)

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4
Q

What do the junction between epithelial cells of the tunica intima mediate?

A

provide a permeability barrier to macromolecules and vascular cells

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5
Q

What anticoagulant; antithrombotic; and Fibrinolytic molecules molecules are produced and secreted by ECs in the tunica intima?

A
  • Prostacyclins
  • Thrombomodulin
  • Heparins
  • Plasminogen activator
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6
Q

what 3 pro-thrombotic factors are produced and secreted by ECs of the tunica intima?

A

Von Willebrands Factor
Tissue Factor
Plasminogen Activator Inhibitor

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7
Q

What does Plasminogen activator inhibitor do?

A

Prevents the breakdown of clots

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8
Q

What two matrix molecules do ECs of the tunica intima make?

A

Collagen

Proteoglycans

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9
Q

Which two factors do ECs of the tunica intima to vasodialate?

A
  1. Nitric Oxide via e NOS (results in acetylcholine being released)
  2. prostacyclin
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10
Q

Which two factors do ECs of the tunica intima to vasocontrict?

A
  1. Endothelin

2. Angiotensin Converting Enzyme

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11
Q

What 3 stimulators of cell growth are released by ECs of the tunica intima ?

A
  1. PDGF : platelet derived growth factor
  2. FGF: fibroblast growth factor
  3. VEGF: vascular endothelial growth factor
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12
Q

What 2 inhibitors of cell growth are released by ECs of the tunica intima ?

A
  1. Heparin

2. TGF ß

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13
Q

How can ECs of the tunica media influence inflammation and immunity

A

By expressing certain cell adhesion molecules and releasing cytokines

For example: Interleukins 1 and 6; Chemokines; Adhesion Molecules (VCAM (vascular cell adhesion molecule)-1, ICAM-1, E Selectin, P-Selectin, Histocompatability Antigens

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14
Q

What are 7 factors that can have activating effects on ECs of the tunica intima?

A

Cytokines; Bacterial Products; Lipid (LDL); Glyosylation end products (DM); Viruses; Complement; Hypoxia

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15
Q

What is the primary cellular element of the vascular media?

A

vascular smooth muscle cells

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16
Q

What are vascular smooth muscle cells responsible for?

A

Vasocontriction/vasodilation

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17
Q

What do vascular smooth muscle cells synthesize and secrete? what things do they just synthesize

A

secrete: growth factors and cytokines

Produce: proteoglycans, collagen, elastin.

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18
Q

What do smooth muscle cells do in response to injury of the vasculature? what factors promote this?

A

Migrate to intima and proliferate

Promoted by PDGF; Endothelin; FGF; IFN gamma

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19
Q

What is characteristic of the anatomy of large elastic arteries?

A

vessels are thick, with cells and connective tissue organized in lamella (up to 50 layers in proximal aorta)

Too thick for diffusion of oxygen, thus have the vaso vasorum

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20
Q

Which arteries are part of the large elastic arteries group?

A

Aorta; Brachiocephalic; Carotid; Subclavian; Iliac

Basically the first arteries out of the heart/aorta

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21
Q

What are the dominant component of the intima, media, and aventitia of the large elastic arteries?

A

Intima: EC and minimal matrix
Media: Elastin, VSMC are dominant cell in media
Aventitia: Collagen

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22
Q

What is the significance of elastin being present in the media of large elastic arteries?

A

Allows for expansion during systole

Recoil acts as a second pump

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23
Q

Why is collagen dominant in the aventitia of large elastic arteries?

A

because it provides strength

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24
Q

What arises from the root of the ascending aorta?

A

the right and left coronary arteries

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25
Q

What are the 3 arteries that branch from the arch of the aorta (in order)

A
  1. Braciocephalic
  2. Left common carotid
  3. Left subclavian
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26
Q

What does the brachiocephalic artery then branch into

A

The right common carotid and the right subclavian

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27
Q

where do the carotid and subclavian arteries go to?

A

carotids to the head and subclavians to the arms

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28
Q

what are 3 changes in the aorta that are indicative of atherosclerosis?

A
  1. Intima thickens and develops plaque
  2. Media degenerates owing to reduced blood supply
  3. `Fragmentation of collagen and elastin
    * *Results in aortic aneurysm or dissection
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29
Q

What is aortic dissection?

A

Partial tear through intima and propagating along media.

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30
Q

When the aorta descends through diaphragm to give rise to visceral vessels and lower extremity vessels, what does it split into?

A
  1. Superior and inferior mesenteric arteries which supply blood to the viscera
  2. Iliac arteries that supply legs and pelvic region
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31
Q

What is different in the elastin/collagen levels between the large elastic arteries and the muscular arteries?

A

less elastin and more collagen in the muscular arteries

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32
Q

how do the layers of vasculature compare between the large elastic arteries and the muscular arteries?

A

In muscular arteries…

  1. Intima is thinner
  2. Internal and External Elastic Laminas well defined
  3. Media has sewer and finer elastin fibres, lamella defined but occasionally discontinuous. VSMC major component (75% of the mass)
  4. Aventitial strength and thickness is variable
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33
Q

What are 4 examples of muscular arteries?

A
  1. Coronaries
  2. Renal Arteries
  3. Femorals and distributive arteries of the lower extremities
  4. Axillaries and distributive arteries of upper extremity
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34
Q

What 6 things does the celiac trunk supply?

A

Supplies:

  1. hepatic arteries
  2. left gastric
  3. branches to foregut (duodenum)
  4. splenic artery
  5. distal esophagus
  6. pancreas.
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35
Q

What 4 things does the superior mesenteric artery supply?

A
  1. Inferior pacreaticoduodenal artery (distal duodenum; pancreas)
  2. Intestinal branches (jejunem; ileum)
  3. ileocolic and right colic (caecum; ascending colon)
  4. middle colic artery (transverse colon);
36
Q

What 3 things does the inferior mesenteric artery supply?

A
  1. Left Colic (Descending (left) Colon)
  2. Sigmoid Branches (Sigmoid Colon)
  3. Superior Rectal Artery (upper rectum)
37
Q

What is the function of the marginal artery?

A

to anastomose the superior and inferior mesenteric arteries

38
Q

What are the main muscular arteries of the upper extremities (starting after the subclavian artery) ?

A
  1. Axillary artery
  2. Brachial
  3. Radial
  4. Ulnar
39
Q

Where does the axillary artery begin/end?

A

Begins at lateral border of first rib to teres major

40
Q

What does the axillary artery supply?

A

Multiple branches to shoulder and chest wall (pec, deltoid,intercostal)

41
Q

Where does the brachial artery begin/end?

A

Teres major to antecubital fossa

42
Q

What does the brachial artery supply? what does it branch into ?

A

Branches to elbow and adjacent forearm musculature

Turns into the radial and ulnar arteries

43
Q

What do the radial and ulnar arteries supply?

A

the forearms

44
Q

What supplies blood to the hands/digits?

A

Deep and Superficial Palmar arches

45
Q

What is the common iliac artery ? where does it begin?

A

Paired arteries arise at the terminus of the abdominal aorta

- Fourth lumbar vertebra

46
Q

What do the common iliac arteries bifurcate into?

A

external and internal iliac arteries

47
Q

Where does the External iliac artery arise? where does it travel?

A

Branches from the common iliac artery at the sacroiliac joint

courses along psoas muscle anterior and inferior to the inguinal ligament (lateral to pubic tubercle)

48
Q

What does the external iliac artery give rise to? what does this anastomose with?

A

Inferior Epigastric a. Courses superficially along the rectus sheath superficially and superiorly to anastomose with Superior Epigastri (br. of Internal thoracic)

Pelvic Branches

49
Q

Where is the internal iliac located in relation to the external one and what does it give rise to?

A

Courses postero-inferior to external iliac giving rise to branches that supply the pelvic viscera (e.g. rectum) and medial thigh

50
Q

What are 6 arterial branches of the internal iliac arteries?

A
  1. Iliolumbar artery: psoas muscle; quadratus lumborum
  2. Superior Gluteal a. : Gluteal Muscle
  3. Obturator a. : bone and muscle of iliac fossa
  4. Rectal aa. : to middle and inferior rectum
  5. Umbilical a. Carried oxygenated blood to the placenta; post natal supplies bladder and in males vas deferens
  6. Uterine and Vaginal aa. (females): major supply of blood to uterus
51
Q

Where does the femoral artery arise?

A

Arises when the external iliac artery crosses the inguinal ligament

52
Q

What does the femoral artery give rise to? (3 things)

A
  1. Branches (circumflex aa; pudendal aa) that supply thigh; scrotum/labia
  2. Profunda Femoris Artery: Supplies muscles of upper extremity and provides collaterals down to knee (geniculate br.
  3. Superficial femoral artery: Courses down anteromedial thigh deep to muscles to lower ext.
53
Q

what does the superficial femoral artery give rise to as it descends into the knee?

A

the popliteal artery

54
Q

How/where does the popliteal artery travel?

A

Gives five geniculate branches to the knee

Travels in interchondylar fossa

55
Q

What does the popliteal artery branch into? where?

A

Divides at popliteal muscle into anterior and posterior tibial aa.

56
Q

what does the anterior tibial artery divide into? what does it supply?

A

Gives Posterior Tibial a.
Dorsalis Pedis in foot
Supplies tibia and adjacent muscles

57
Q

What does the posterior tibial artery give? what does it supply?

A

courses down behind the tibia in the posterolateral leg

Gives Peroneal a.

Supplies tibia and adjacent muscles

58
Q

Where does the peroneal/fibular artery travel? what does it supply?

A

Descends along medial border of fibula

Supplies fibula and adjacent muscles

59
Q

At which point do the right and left common carotid arteries branch into the internal and external carotids?

A

at the carotid sinus

60
Q

What is the carotid sinus rich in? what else is present?

A
  1. Baroreceptors that regulate blood pressure

2. Carotid body: organ that senses O2 levels to control breathing

61
Q

What does the external carotid supply?

A

head and neck external to cranium

62
Q

What does the internal carotid supply?

A

Brain; Eyes; Forehead

63
Q

how does the internal carotid enter the cranium?

A

via the cranial canal in the temporal bone

64
Q

what other artery supplies the brain? where does it originate from?

A

Vertebral artery: Branches of the subclavian artery ascend through posterior neck and enter cranium through foramen magnum, also supplying brain

65
Q

All the resistance to blood flow in the CV system is at the level of the ___. Why?

A

arterioles
- they provide blood flow regulation via medial smooth muscle contraction

Huge decrease in diameter (down to about 2mm)
- by Poiseuille’s (Hagen) law, if you lose half your diameter you lose 15/16 of your flow

66
Q

What is the histology of very small arteries/arterioles?

A
  1. Intima very thin
  2. Media: 1 to 6 layers of VSMC
  3. Adventitia comparable in thickness to media, merges with adjacent tissue connective tissue
67
Q

what is the approximate diameter of capillaries?

A

8 µm to 30 µm

68
Q

What is the histology of capillaries ? What provides structural support?

A

Endothelial cell lining but no media, no elastin

Myosin containing pericytes provide structural support

69
Q

The thin lining and large cross-sectional area of the capillaries allows for…?

A

rapid exchange of oxygen and nutrients via diffusion

70
Q

What are the 3 types of EC lining in capillaries? What is different between the types ?

A
  1. Continuous: Complete EC lining
  2. Fenestrated: EC gaps allowing macromolecular passage (glomerulus)
  3. Discontinuous: Larger gaps in EC layer (liver)
    - Larger diameter called sinusoids (liver; spleen; marrow)
71
Q

What is the histology of veins like?

A

Intima: narrow and IEL difficult to identify
- Sparse elastin with only incomplete elastic lamina
Media: VSMC dominate in media but fewer and less organized, much thinner than arteries
Adventitia: Only largest veins have appreciable connective tissue

72
Q

what sized veins have valves?

A

small and medium sized ones

73
Q

What are valves in veins? what do they accomplish?

A

two bands of lumenal tissue

Allow skeletal muscles to assist in blood return against gravity

74
Q

Compare and contrast the histology of large veins with that of medium veins

A

LARGE VEINS

  • Intima: EC with some connective tissue
  • Media: Multiple layers of VSMC but still much thinner than adjacent artery
  • Adventitia: Richer in connective tissue than medium sized veins; blend with adjacent connective tissue
  • No valves

MEDIUM VEINS

  • Very thin intima, EC complete
  • Media: few (2-5) layers SMC
  • Adventitia identifiable and blends into adjacent connective tissue
  • Vein valves
75
Q

What is the histology of post capillary venules?

A

very thin walled

Intima: very thin, no elastin, EC
Media: one or two layers of VSMC

76
Q

What is the Frank-Starling law?

A

With more venous return to the heart, the heart pumps more

  • Operates at the level of the sarcomere (actin/myosin)
  • no change in arterial pressure or heart rate
  • due to increased muscular contraction and stretch
77
Q

What receptors mediate sympathetic control of heart rate?

A

Beta Adreno receptors

78
Q

What are 3 forms of sympathetic control over heart rate?

A
  1. Increase Heart Rate (chronotropic)
    - Range 50-250
  2. Increase Strength of Contraction (Inotropic)
  3. Basal firing of sympathetic fibres (i.e. normal condition is baseline sympathetic drive)
79
Q

What are 3 forms of parasympathetic control over heart rate?

A
  1. Bradycardia (major effect) (to 20-40 bpm)

2. Decreased Force of Contraction (minor effect) “Vagal Episode”

80
Q

With the exception of the kidney, how can metabolic rate control blood flow?

A

States of low tissue oxygen result in release of vasodilator substance(s) that affect arteriolar tone
- metabolic rate is proportional to blood flow

81
Q

How is blood flow controlled by the endothelium? What is released? what does this control?

A

Vasodilators: Nitric Oxide; Prostaglandin

Vascoconstrictors: Endothelin; Thromboxane

Affects diameters of pre-arteriolar vessels (even to muscular arteries).

82
Q

What 2 factors are involved in humoral regulation of blood flow?

A

norepinepherine and epinepherine

83
Q

What does activation of “fight or flight” have as an effect on blood flow?

A

Results in humoral release (adrenals) and increased sympathetic tone

Humoral release has same effect as local sympathetic innervation

  • Constricts vascular smooth muscle
  • Increase heart rate and force of contraction
84
Q

What 3 things are increased during exercise?

A
  1. Increased return of blood (Frank/Starling)
  2. Local vasodilatation of skeletal muscle
    - - Arteriolar and EC regulated
  3. Increased CNS activity (Reticular Activating System) results in vasoconstrictor center activation (humoral and sympathetic drive via epi/nor-epi)
85
Q

What are baroreceptors? where are they located? what do they activate?

A 
Stretch receptors widely distributed in vascular system
Especially carotid sinus; aortic arch
Stimulate CNS (Medulla)
86
Q

What happens when baroreceptors stimulate the medulla?

A

Increased pressure (from lying down) results in inhibition of vasoconstrictor centre and Excitation of vagal centre (With standing, the opposite effect)

Results in:

  • Vasodilation of veins and arterioles
  • Decreased heart rate and contractility

Human Organs and Tissues (16 decks)

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