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Circulation and Respiration > Week 1: Wednesday > Flashcards

Week 1: Wednesday Flashcards

1
Q

what is the role of endothelium

anticoagulant

A

favors anticoagulant mechanisms
* has smooth surface
* negative charge

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2
Q

what does the endothelium produce

A
  • vasodilators
  • inhibitors of coagulation
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3
Q

what is the role of endothelium in procoagulant properties

A
  • vasocontriction
  • disruption of endothelial integrity (exposes collagen - activates primary hemostasis; tissue factor - activates secondary hemostasis)
  • synthesizes pro-thrombotic factors (Von Willebrand factor)
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4
Q

what is primary hemostasis

A
  • formation of the primary platelet plug
  • interaction with endothelium (exposure of collagen)
  • provide surface for coagulation factors (secondary hemostasis)
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5
Q

what are platelets

A
  • produced in bone marrow
  • lifespan - 6 days
  • pre-formed substances in platelet granules (enhance platelet function and attract more platelets to site)
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6
Q

how do plateletes work

A
  1. damage to vessel wall (exposure of collagen)
  2. adhesion
  3. activation
  4. aggregation
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7
Q

what is platelet adhesion

A
  • dependent on local blood flow
  • static or low speed flow - platelets adhere to collagen of sub-endothelium
  • high speed flow - von Willebrand factor mediated platelet adhesion
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8
Q

what is von willebrand factor (VWF)

A
  • synthesized by megakaryocytes and endothelial cells
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9
Q

what is the function of VWF

A
  • mediator of platelet adhesion in rapid blood flow conditions
  • decrease of factor VIII clearance
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10
Q

what is platelet activation

A
  • happens secondary to adhesion (collagen) or agonist mediated activation
  • thrombin (CF II) is biggest activator
  • shape change - pesudopodia
  • release of platelet granules (attract, activate more platelets)
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11
Q

what is platelet aggregation

A
  • platelets interact to provide the surface for coagulation factors
  • hemostatic plug
  • linked to each other by fibrinogen
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12
Q

what are the signs of primary hemostasis

A
  • petechiation, ecchymoses (small bruises)
  • spontaneous muscosal bleeding (GI, urogenital, oral/nasal)
  • surgical bleeding
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13
Q

what is diagnosis of primary hemostasis

A
  • platelet count
  • platelet function tests
  • VWF level (most common)
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14
Q

what is secondary hemostasis

A
  • formation of fibrin that crosslinks the primary platelet plug
  • fibrinogen (factor I) converted to fibrin by thrombin (factor II)
  • stable clot
  • coagulation factors
  • sequentially active/change other factors in a highly organized process
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15
Q

what are coagulation factors

A
  • proteins (produced in liver; factors III and VIII - endothelium)
  • enzymatic and non-enzymatic
  • some circulate in inactive form, need to be activated (by other factors; factors II, VII, IX, X - activated by VK)
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16
Q

what is the cell based model of hemostasis

A
  • overlapping phases takes place on different cell surfaces
  • initiation
  • amplification
  • propagation
  • starts with exposure of tissue factor
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17
Q

what is tissue factor (TF)

A
  • factor II
  • most important factor in initiation of secondary hemostasis
  • inactive in intravascular space, active in cytoplasm and extracellular domains
  • secondary hemostasus gets activated when TF gets exposed from endothelial damage
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18
Q

what phase in TF

A

initiation phase

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19
Q

what phases are on the activated platelet surface

A
  • amplification
  • propagation
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20
Q

what is the phospholipid bilayer of platelets

A
  • phophatidylserine (PS) and phosphatidylethanolamine (PE) localized to the inner membrane surface
  • PS and PE flip to outer surface with platelet activation
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21
Q

what enzymes flip PS and PE to the outer surface and scramble them

A
  • floppase
  • flippase
  • scramblase
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22
Q

what is the initiation phase of hemostasis

cell based model

A
  • exposure of tissue factor
  • trace thrombin
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23
Q

what is the amplification phase of hemostasis

cell based model

A
  • thrombibn travels to platelet
  • activates more factors
  • activates and attracts more platelets
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24
Q

what is the propagation phase of hemostasis

cell based model

A
  • thrombin converts fibrinogen to fibrin
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25
Q

what is secondary hemostasis cascade model

A
  • two arms of cascade (extrinsic, intrinsic, common pathway)
  • operate independently
  • redundant
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26
Q

what arm of the cascade model is prothrombin time (PT)

A

extrinsic

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27
Q

what arm of the cascade model is activated partial thromboplastin time (aPTT)

A

intrinsic

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28
Q

what does the cascade model test for

A

time (sec) for blood to go from fluid to clot

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29
Q

what are clinical signs of bleeding in secondary hemostasis

A
  • body cavities (thoracic and abdominal)
  • joints
  • brain
  • muscle
  • subcutaneous tissue
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30
Q

what are tests of secondary hemostasis

A
  • PT
  • aPTT
  • activated clotting time (ACT)
  • individual factor levels
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31
Q

what is the termination phase

A
  • endogenous antithrombotic elements
  • regulation of hemostasis
  • contains hemostasis to a localize area
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32
Q

what is used to deactivate a clot

A
  • tissue factor pathway inhibitor
  • antithrombin
  • thrombomodulin
  • protein C
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33
Q

what is fibrnolysis

A

uses plasmin to turn fibrin to fibrin degradation products

34
Q

what does the circulatory system do

A
  • mediates movements of all body fluids
  • regulates body temp and distribution of hormones and leukocytes
35
Q

what do arteries do

A

transport oxygen and nutrients to tissues

36
Q

what do veins do

A

transport of CO2 and metabolic waste from tissues

37
Q

what are the two functional components of the circulatory system

A
  • blood vascular system
  • lymph vascular system
38
Q

what is the blood vascular system organized into

A
  • heart
  • arteries
  • arterioles
  • capillaries
  • venules
  • veins
39
Q

this circuit of ___ ___ sustains the blood flow maintained by the heart

A

blood vessels

40
Q

what does the arterial system provide

A

a distribution network for capillaries

interchange of gases and metabolites between tissues and blood

41
Q

what does the venus system do

A

returns blood from the capillaries to the heart

42
Q

what is endothelium

A

flat epithelium in blood vessels

43
Q

what is the tunica intima

A

inner lining made of single layer of endothelium supported by basement membrane and collagenous tissue

44
Q

what is the tunica media

A

intermediate muscular layer

45
Q

what is the tunica externa/adventitia

A

outer supporting tissue layer

46
Q

what are companion vessels

A

artery traveling with vein because they supply the same body region and lie next to each other

47
Q

what structural component is not in the vein

A

internal elastic layer in tunica intima

48
Q

what do arteries look like

A

thick and have contractile muscular walls

49
Q

____ permit change in vessel size in response to ____ ____ change and allow artery to absorb the pressure

A

elastic; blood pressure

50
Q

what gives an artery the ability to change in size actively

A

contractility

51
Q

what induces vasoconstriction

A

arterial smooth muscle contract and contrists artery

52
Q

what is vasodilation

A

when smooth muscle relax to increase artery diameter

53
Q

what does the venous system look like

A
  • larger in diamter than arteries
  • thinner walls than arteries because blood pressure is lower
54
Q

what is less prominent in the venous system

A

elastic and muscular components

55
Q

what is reveral in blood flow prevented by

A

valves in medium sized veins

56
Q

where is a major part of the total blood volume contained

A

within the venous system

57
Q

what is microcirculation

A

regulates exchange of gases, fluids, nutrients and metabolic waste

58
Q

where does exhange occur

A

in capillaries that have extremely thin wall which lack a tunica media and form interconnected networks

59
Q

blood flow is slow so there is sufficient time for ____ or ____ ____

A

diffusion or active transport

60
Q

what are the 3 types of capillary endothelium

A
  1. continuous - uninterrupted lining
  2. fenstrated - contains pores/fenstrations
  3. discontinous-
61
Q

what are endothelial cells

A

flat polygonal cells interconnected by junctional complexes

62
Q

what do endothelial cells act as

A

permeability barrier

63
Q

what do endothelial cells synthesize

A
  • extracellular matrix components for basement membrane maintenance
  • products regulating blood coagulation, thrombosis and the balance between vascoconstriction/vasodilation
64
Q

what do endothelial cells regulate

A

acute and chronic inflammatory responses through the expression of cell adhesion molecules and immune mediators

65
Q

endothelial cell function is _______-dependent

A

compartment

66
Q

what is the function of the nervous tissue

A

to recieve external and internal stimuli which are then analyzed and integrated to produce appropriate and coordinated responses

67
Q

what is the nervous tissue composed of

A

network of neurons which constitute most sensory receptors, the conducting pathways, and sites of integration and analysis

68
Q

what is the function of the neuron supported by

A

glial cells

69
Q

the functions of the nervous system depend on the ____ of neurons

A

excitability

70
Q

what does excitability involve

A

a change in membrane permeability in reponse to appropriate stimuli and the plasma membrane becomes depolarized inducing action potential which then spread along the plasma membrane

71
Q

where are action potentials conducted

A

along the axon to influence other neurons/target organs

72
Q

what are axons commonly reffered to as

A

nerve fibers

73
Q

axons in the CNS are surrounded by ____ while in the PNS they are enclosed by _____ ___

A

oligodendrocytes; Schwann cells

74
Q

small diameter axons are enveloped by the cytoplasm of

A

Schwann cells (non-myelinated nerves)

75
Q

large diameter fibers are wrapped by cocentric layers of

A

schwann cell plasma membrane forming a myelin sheath (myelinated nerves)

76
Q

what are myelinated nerves comprised of

A

fascicles

77
Q

what are fasicles

A

bundles of funiculus that are group of axons

78
Q

what are bundles of fascicles bounded by

A

epineurium

79
Q

what is the CT called that surrounds each myelinated nerve fiber

A

endoneurium

80
Q

what are fascicles bound by

A

perineurium

81
Q

what is the neurovascular bundle

A
  • consists of the binding of blood vessels and nerves with CT
  • risk during surgery

Circulation and Respiration (7 decks)

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