Week 3 - Lesson 1 (Part 7) Flashcards

1
Q

What does collateral flow arise from?

A

Ischemia in the presence of atheromatous disease

- re-routing due to blockages

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2
Q

Ischemia

A

No oxygen to the tissues which result in cell death

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3
Q

Collateral flow

A

Circulation to tissue or an organ can be maintained using a different pathway
- occurs over time

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4
Q

Anastomosis

A

Branches form between adjacent blood vessels

- connection between 2 veins

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5
Q

Where can collateral circulation be established? (2)

A
  1. In the venous system
    - between veins
  2. In the arterial system
    - between arteries
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6
Q

What is an example of collateral flow?

A

Blood flow to the brain is maintained through a network of collaterals that anastomose in the circle of Willis

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7
Q

What compensatory mechanisms come into play in an attempt to preserve perfusion during atherosclerosis? (3)

A
  1. Development of a collateral circulation
  2. A degree of local dilatation of the affected arterial segment
  3. An increase in the extraction efficiency of oxygen from blood
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8
Q

What is one factor used to control the flow rate to the organ?

A

The degree of constriction of distal arterial bed

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9
Q

What happens to flow rate as the resistance to flow of diseased arteries increases?

A

It is maintained within normal levels as a result of arteriolar dilatation

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10
Q

What are very high degrees of stenosis are accompanied by? (2)

A
  1. Low flow rate
  2. Low velocities
    - damped and trickle flow
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11
Q

What are 3 types of flow waves?

A
  1. Triphasic
  2. Biphasic
  3. Monophasic
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12
Q

What are 2 types of beds?

A
  1. Low resistant bed

2. High resistant bed

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13
Q

What is an example of a low bed resistance? (7)

A
  1. Brain
  2. Kidneys
  3. Liver
  4. Vertebral arteries
  5. Distal ICA
  6. Ovaries
  7. Testicles
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14
Q

What is an example of a high bed resistance? (3)

A
  1. Muscles at rest
  2. Arms and legs
    - peripheral circulation
  3. Small intestines
    - not during digestion
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15
Q

Low resistance beds

A

Structures with metabolic processes that needs continuous forward flow throughout the cardiac cycle

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16
Q

What do muscles need during exercise?

A

A high rate of oxygen exchange

17
Q

How are high resistant beds characterized? (3)

A
  1. Low
  2. Absent
  3. Reversed flow during diastole
18
Q

Where is a triphasic waveform normally found?

A

In arteries supplying a high resistance peripheral vascular bed

19
Q

What is the normal sonographic appearance of a triphasic waveform? (3)

A
  1. Highest pulsatility
  2. Highest resistance waveform
  3. 3 points in the pulse
20
Q

What is an example of a triphasic waveform? (2)

A
  1. ECA

2. Femoral artery

21
Q

What happens to flow reversal with vasoconstriction in triphasic waveforms?

A

It increases

22
Q

What does the first initial spike mean in triphasic flow?

A

Forward flow in systole

23
Q

What does the second spike mean in triphasic flow?

A

Diastolic flow reversal

24
Q

What does the third spike mean in triphasic flow?

A

Forward flow in late diastole

25
Q

What kind of wave is forward flow?

A

Reflective wave

26
Q

What kind of flow happens during systole?

A

Forward flow throughout the periphery

27
Q

What kind of flow happens during diastole?

A

Temporary flow reversal

28
Q

Why does temporary flow reversal occur during diastole?

A

Because of a negative pressure gradient caused by peripheral resistance to forward flow

29
Q

What does flow reversal decrease with? (3)

A

With increasing…

  1. Vasodilation as in exercise
  2. Body heating
  3. Stenosis
30
Q

What does flow reversal increase with?

A

Vasoconstriction

31
Q

What are the 3 components of flow?

A
  1. Forward flow in systole
  2. Diastolic flow reversal
  3. Forward flow in late diastole