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From Flashcardlet > 2 A&P II Chapter 19 > Flashcards

2 A&P II Chapter 19 Flashcards

1
Q

What do arteries carry?

A

Blood away from the heart

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2
Q

What do veins carry?

A

Blood towards the heart

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3
Q

What kind of blood do systemic arteries carry?

A

Oxygenated

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4
Q

What kind of blood do systemic veins carry?

A

Deoxygenated

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5
Q

What kind of blood do pulmonary arteries carry?

A

Deoxygenated

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6
Q

What kind of blood do pulmonary veins carry?

A

Oxygenated

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7
Q

What blood vessels have contact with tissue cells?

A

Capillaries

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8
Q

Where does nutrient and gas exchange occur?

A

Through the thin walls of the capillaries

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9
Q

How many layers do blood vessels have? Which is the exception?

A

Three layers, capillaries only have one

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10
Q

What is the lumen?

A

The blood containing space

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11
Q

What is the innermost layer?

A

Tunica intima/interna

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12
Q

What comprises the tunica intima?

A

Simple squamous epithelium (endothelium) that lines the lumen

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13
Q

Why is endothelium good for the innermost layer of a blood vessel?

A

It is made up of flat cells that fit snuffly, forming a slick surface for easy gliding and no friction

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14
Q

What is found on the tunica interna in large blood vessels?

A

Internal elastic lamina

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15
Q

What kind of receptors are found on the smooth muscles of blood vessels?

A

Alpha 1 adrenergic

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16
Q

What do alpha 1 adrenergic receptors do?

A

They receive impulses from the sympathetic nervous system that cause blood vessels to constrict

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17
Q

What is the subendothelial layer?

A

Located in vessels larger than 1 mm in diameter, consists of a basement membrane and loose CT that supports the endothelium

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18
Q

What is the middle layer of a blood vessel?

A

Tunica media

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19
Q

What does the tunica media look like and consist of?

A

Circularly arranged smooth muscle cells with sheets of elastin

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20
Q

What is the smooth muscle of the tunica media controlled by?

A

Sympathetic vasomotor nerve fibers and many chemicals

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21
Q

Why is the tunica media so important?

A

It regulates the circulatory dynamics since small changes in blood vessel diameter can greatly influence blood flow and blood pressure

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22
Q

In what blood vessels is the tunica media the largest?

A

Arteries

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23
Q

What happens to arteries and veins based on the amount of tunica media?

A

Arteries maintain their circular shape, while veins are more collapsable

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24
Q

What is the outermost layer of a blood vessel?

A

Tunica externa/adventitia

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25
Q

What comprises the tunica externa?

A

Loosely woven collagen fibers

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26
Q

What are the three functions of the tunica externa?

A

Protection, reinforcement, and anchoring to surrounding structures

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27
Q

What does the tunica externa contain in larger vessels?

A

Nerve fibers, lymphatic vessels, and elastic fivers

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28
Q

What is the vasa vasorum?

A

Exists in the larger blood vessels, a system of tiny vessels that nourish the external tissues of the blood vessel’s wall

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29
Q

In what blood vessels is the tunica externa the thickest?

A

Veins

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30
Q

What are the three types of arteries?

A

Elastic, muscular, arterioles

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31
Q

What type are the largest arteries considered?

A

Elastic

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32
Q

What type are the majority of arteries?

A

Muscular

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33
Q

What is vascular tone?

A

The baseline amount of sympathetic nervous input

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34
Q

Where are elastic arteries found in general?

A

Near the heart

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35
Q

What are some examples of elastic arteries?

A
  1. Brachiocephalic
  2. Common carotid
  3. Subclavian
  4. Aorta
  5. Vertebral
  6. Pulmonary
  7. Common iliacs
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36
Q

What does a large lumen indicate, in terms of blood flow?

A

Less resistance

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37
Q

What is another term for elastic arteries?

A

Conducting arteries

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38
Q

What substance is found in all three tunics of elastic arteries?

A

Elastin, mostly in the tunica media

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39
Q

What regulatory function do elastic arteries not participate in?

A

Vasoconstriction

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40
Q

Why are elastic arteries called pressure reservoirs?

A

They expand and recoil when the heart ejects blood

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41
Q

What does it mean when we say blood flows continuously in elastic arteries.. doesn’t it flow continuously throughout the body?

A

In elastic arteries, blood flow doesn’t start and stop with the heart beat

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42
Q

What happens to the flow of blood when elastic arteries recoil? What does this mean in terms of systole and diastole then?

A

Blood is propelled forward, even in diastole

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43
Q

Where do elastic arteries flow to?

A

Muscular arteries

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44
Q

What do muscular arteries do?

A

Deliver blood to specific organs

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45
Q

What is another name for muscular arteries?

A

Distributing arteries

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46
Q

What do muscular arteries have the thickest of?

A

They have the thickest tunica media of all vessels

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47
Q

What are muscular arteries very active in?

A

Vasoconstriction

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48
Q

What are muscular arteries less capable of?

A

Stretching

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49
Q

How many layers do arterioles have?

A

Large arterioles have three tunics, but have less smooth muscle
Smaller arterioles have just a little more than one layer of smooth muscle on the endothelial lining

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50
Q

What is another name for arterioles?

A

Resistance vessels

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51
Q

What does blood flow into the capillaries from arterioles depend on?

A

It is determined by arteriole diameter

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52
Q

What is arteriole diameter influenced by?

A

Neural, hormonal and chemical factors

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53
Q

How do arterioles effect blood pressure?

A

They regulate systemic blood pressure because they generate SVR !!!!

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54
Q

What is another name for capillaries?

A

Exchange vessels

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55
Q

What are capillaries composed of?

A

Simple squamous epithelium sitting on a basement membrane

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56
Q

What layer do capillaries have?

A

Tunica intima

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57
Q

What are pericytes?

A

Smooth muscle like cells that stabilize the capillary wall and help control capillary permeability, spider shaped, located on the outer surface of a capillary

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58
Q

Why do capillaries branch extensively?

A

It increases the surface area for exchange

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59
Q

What is the diameter of a capillary?

A

8-10 um - just big enough for RBCs to slip through single file

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60
Q

What parts of the body are poorly vascularized?

A

Tendons and ligaments

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61
Q

What parts of the body are completely avascular?

A

Cornea and lens - receive nutrients from aqueous humor

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62
Q

What parts of the body don’t have vascularization from capillaries?

A

Cartilage and epithelia - receive nutrients from blood vessels nearby in CT

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63
Q

What is microcirculation?

A

The area of arterioles and capillaries and venules

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64
Q

What are the three types of capillaries?

A

Continuous, fenestrated, and sinusoid

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65
Q

What do continuous capillaries look like?

A

A plasma membrane of endothelial cells forms a continuous tube

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66
Q

What does the basement membrane of continuous capillaries look like?

A

Intact

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67
Q

Where are continuous capillaries abundant?

A
  1. Skeletal muscle
  2. Smooth muscle
  3. CT
  4. Lungs
  5. Skin
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68
Q

What makes continuous capillaries continuous?

A

Because the endothelial cells are joined by tight junctions

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69
Q

What are intercellular clefts?

A

Tight junctions are incomplete in the endothelium, leaving gaps of unjoined membrane

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70
Q

What do the intercellular clefts of continuous capillaries look like?

A

Small, just large enough to allow limited pass of fluids and small solutes

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71
Q

What kind of vesicles are present in continuous capillaries and what do they do?

A

Pinocytotic vesicles that ferry liquids across the capillary wall

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72
Q

How are the capillaries in the brain unique? What does this create?

A

They have tight junctions extending around the entire perimeter, creating the blood brain barrier

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73
Q

What do fenestrated capillaries look like?

A

Similar to continuous capillaries except they have oval pores called fenestrations

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74
Q

What is the permeability like of fenestrated capillaries?

A

Much more permeable to liquids and small solutes

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75
Q

Where are fenestrated capillaries found?

A

Where active capillary absorption or filtrate formation occurs

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76
Q

Where are there perpetually open pores in fenestrated capillaries in the body?

A

The kidney’s glomerulus, where rapid filtration of blood plasma is essential

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77
Q

Where are fenestrated capillaries located elsewhere?

A
  1. Kidney
  2. Villi in small intestine
  3. Choroid plexus of the ventricle of the brain
  4. Ciliary body in the eye
  5. Endocrine glands
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78
Q

What does the basement membrane of fenestrated capillaries look like?

A

Intact

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79
Q

What do the intercellular clefts of fenestrated capillaries look like?

A

Small

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80
Q

What do sinusoid capillaries look like?

A

Highly modified, leaky capillaries

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81
Q

Where are sinusoid capillaries found?

A
  1. Spleen
  2. Liver
  3. Bone marrow
  4. Adrenal medulla
  5. Pituitary and parathyroid glands
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82
Q

What does the lumen of sinusoid capillaries look like?

A

Large, irregularly shaped

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83
Q

Are sinusoid capillaries fenestrated?

A

Yes

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84
Q

What do the intercellular clefts of sinusoid capillaries look like?

A

Largeeeee

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85
Q

What does the basement membrane of sinusoid capillaries look like?

A

Not intact

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86
Q

What do the intercellular clefts allow in sinusoid capillaries?

A

Allow large molecules and even blood cells to pass between the blood and surroudning tissues

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87
Q

How does blood flow through the spleen?

A

Sluggishly, to allow time for it to be modified

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88
Q

What happens in the intercellular clefts in the spleen?

A

Phagocytes just outside the sinusoid capillary stick cytoplasmic extensions through the intercellular clefts into the sinusoid lumen

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89
Q

What are stellate macrophages?

A

Large cells in the liver that remove and destroy bacteria

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90
Q

What system influences vasoconstriction of the blood vessels?

A

Sympathetic

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91
Q

What system influence vasodilation of the blood vessels?

A

Decreased sympathetic input!

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92
Q

What four substances also influence vasodilation of the blood vessels?

A
  1. Nitric oxide
  2. Potassium
  3. Hydrogen ion
  4. Lactic acid
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93
Q

What kind of receptors receive input from the sympathetic nervous system in blood vessels?

A

Beta 1 adrenergic

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94
Q

What is microcirculation?

A

Blood flow from arteriole to venule, or blood flow through the capillary bed

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95
Q

What are the two regions of the capillary bed?

A
  1. Vascular shunt

2. True capillaries

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96
Q

What is the vascular shunt?

A

Short vessel that directly connects the arteriole and venule at opposite ends of the bed

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97
Q

What are true capillaries?

A

The actual exchange vessels

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98
Q

What makes up the vascular shunt?

A

Metarteriole and the thoroughfare channel

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99
Q

What is the terminal arteriole?

A

The arteriole that feeds the bed

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100
Q

What is the metarteriole?

A

The vessel intermediate between the terminal arteriole and the capillaries

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101
Q

What is the thoroughfare channel?

A

Vessel intermediate between the capillaries and the venule

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102
Q

What is the postcapillary venule?

A

The venule that drains the capillary bed

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103
Q

What is the gatekeeper to regulate blood flow into the capillaries so that high pressure doesn’t rupture the capillaries?

A

Metarteriole

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104
Q

How many true capillaries are present in a capillary bed?

A

10-100

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105
Q

Where do the true capillaries branch to and from?

A

From the metarteriole to the thoroughfare channel (sometimes capillaries might bypass the bed and branch from the terminal arteriole to the postcapillary venule)

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106
Q

What is vasomotion?

A

The change in blood flow in the capillary bed due to contraction or relaxation of the metarteriole and precapillary sphincters

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107
Q

What do venous valves look similar to?

A

Semilunar valves

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108
Q

What is the precapillary sphincter?

A

A cuff of smooth muscle fibers surrounding the root of each true capillary at the metarteriole

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109
Q

What does the precapillary sphincter do?

A

Acts as a valve to regulate blood flow into the capillary

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110
Q

What happens when the precapillary sphincter is open?

A

Blood flows through the capillaries and takes part in exchanges with tissue cells

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111
Q

What happens when the precapillary sphincter is closed?

A

Blood flows through shunts and bypasses tissue cells

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112
Q

What two factors regulate the amount of blood in the capillary bed?

A

Chemical conditions and arteriolar vasomotor nerve fibers

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113
Q

Why does the amount of blood in the capillary bed need to be regulated?

A

The bed can be flooded or bypassed based on the body’s condition

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114
Q

Where do veins carry blood to and from?

A

From the capillary bed to the heart

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115
Q

What is the diameter range of a venule?

A

8-100 um

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116
Q

What are the smallest kind of venule?

A

Post capillary venule

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117
Q

What does a post capillary venule look like?

A

Entirely endothelium around which pericytes congregate, extremely porous

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118
Q

What substances move easily through the post capillary venule?

A

Fluid and WBCs

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119
Q

What layers do larger venules have?

A

1-2 layers of smooth muscle cells - tunica media and tunica interna

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120
Q

How many layers do veins have?

A

Three distinct layers

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121
Q

What are two determining characteristics of veins?

A

Thinner walls and larger, collapsible lumens

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122
Q

What does a vein’s lumen look like?

A

Slit like

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123
Q

What tunic is the largest in a vein?

A

Tunica externa

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124
Q

What kind of fibers are found in the tunica externa of veins?

A

Collagen fibers and elastic networks

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125
Q

Why are veins called blood reservoirs?

A

Because they hold 65% of the body’s blood supply at one time

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126
Q

Why are veins able to have very thin walls?

A

Because venous circulation pressure is low

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127
Q

Why do veins have a large diameter?

A

To ensure that blood returns to the heart at the same rate that it was pumped out

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128
Q

What do venous valves do?

A

Prevent backflow of blood

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129
Q

What layer creates the venous valves?

A

Folds of tunica interna

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130
Q

Where are venous valves abundant?

A

In veins in the limbs where gravity opposes upward blood flow

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131
Q

Where are venous valves absent?

A

Thoracic and abdominal cavities

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132
Q

What are varicose veins?

A

Tortuous and dilated veins due to incompetent or leaky valves

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133
Q

Where are varicose veins usually found?

A

The lower limbs and esophagus

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134
Q

What causes varicose veins?

A
  1. Hereditary
  2. Elevated venous pressure
  3. Obesity
  4. Pregnancy
  5. Extended standing
  6. Conditions that hinder venous return
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135
Q

What do veins look like when they are varicose?

A

Blood pools in the lower limbs and valves weaken and the walls of the veins become stretched and floppy

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136
Q

Are varicose veins a serious condition?

A

No

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137
Q

What are venous sinuses?

A

Specialized, flattened, extremely thin walled with only endothelium

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138
Q

Do venous sinuses have tunics? How are they supported?

A

No tunics, they are supported by surrounding tissues

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139
Q

What are two examples of venous sinuses?

A

Coronary sinus

Dural venous sinuses in brain

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140
Q

What is venous return?

A

The volume of blood returning to the heart from the systemic veins

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141
Q

What makes blood move upstream from the systemic veins to the right ventricle?

A

A small but sufficient pressure gradient

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142
Q

What are the values of the pressure gradient from the systemic veins to the right ventricle?

A

16 mm Hg in the systemic veins to 0 mm Hg in the right ventricle

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143
Q

What are some ways that the venous blood can be returned back to the heart?

A

Skeletal muscle pump
Respiratory pump
Valves

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144
Q

What is the skeletal muscle pump?

A

Skeletal muscle contraction causes a milking action of blood in the direction of return to the heart

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145
Q

What is the respiratory pump?

A

Inhalation causes abdominal pressure to increase, squeezing the local veins and forcing blood towards the heart
(pressure in chest also decreases, allowing thoracic veins to expand and return blood to the heart)

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146
Q

What are anastomoses?

A

Special junctions

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147
Q

Why do arteries create anastomoses?

A

To provide alternate pathways for blood to reach a body region in case a branch becomes blocked

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148
Q

What are these alternate pathways termed?

A

Collateral channels

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149
Q

Where are anastomoses common in joints?

A

Around joints because active movement can hinder blood flow

Also brain, abdominal, and heart

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150
Q

Are arterial or venous anastomoses more common?

A

Venous

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151
Q

Where are anastomoses absent?

A

Retina, kidney, and spleen - if blood flow stops, cells die

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152
Q

How does a greater pressure difference effect blood flow?

A

The greater the difference, the greater the blood flow

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153
Q

What is blood flow?

A

The volume of blood flowing through a vessel, or an organ, or the entire circulation, at a given period

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154
Q

What is blood flow equivalent to?

A

Cardiac output

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155
Q

When does blood flow vary?

A

Due to individual needs of an organ

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156
Q

What is blood pressure?

A

The force per unit area exerted on a vessel wall by the contained blood, due to ventricular contraction

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157
Q

What is the driving force in the body that keeps blood moving?

A

Pressure gradient

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158
Q

What is resistance?

A

Opposition to blood flow, measurement of amount of friction blood encounters as it passes through the vessels

159
Q

Where is most of the blood flow’s resistance encountered?

A

The systemic circuit

160
Q

What term do we use to describe resistance in blood flow?

A

Total peripheral resistance, or systemic vascular resistance

161
Q

Who are the biggest contributors to resistance?

A
  1. Arterioles**
  2. Capillaries
  3. Venules
162
Q

What are three sources of resistance?

A
  1. Viscosity
  2. Vessel length
  3. Vessel diameter
163
Q

What is viscosity?

A

Internal resistance to flow that exists in all fluids

164
Q

What is viscosity related to?

A

The thickness or stickiness of fluid

165
Q

What happens to the movement of molecules when viscosity increases?

A

Movement of molecules decreases

166
Q

What is polycythemia?

A

Increased viscosity of blood

167
Q

What is anemia?

A

Decreased viscosity of blood

168
Q

What could polycythemia be caused by?

A

Dehydration

169
Q

What could anemia be caused by?

A

Hemorrhage

170
Q

How can viscosity be described in terms of the number of RBCs?

A

The proportion of RBCs to the amount of plasma

171
Q

How does blood vessel length influence resistance?

A

Increased length, increased resistance

172
Q

What happens to the resistance of flow as children grow?

A

Their blood vessels grow longer, therefore resistance increases (and blood pressure increases)

173
Q

How does obesity effect resistance?

A

Increases resistance - for every 2.2 pound of weight, add 400 miles of blood vessels

174
Q

How does blood vessel diameter influence resistance?

A

Increased diameter, decrease resistance

Decreased diameter, increased resistance

175
Q

How often does resistance change due to blood vessel diameter changes?

A

Diameter changes are frequent, so it frequently alters resistance

176
Q

Does blood flow faster or slower close to the blood vessel wall?

A

Fluid close to the wall flow slower

177
Q

Does blood flow faster or slower in the center the blood vessel?

A

Faster

178
Q

What is laminar flow/streaming?

A

The speed and position of fluid in different regions of the tube remain constant

179
Q

Why does a smaller tube have increased resistance?

A

Because more fluid is touching the tube’s wall

180
Q

What does resistance vary with (what values)?

A

Resistance varies inversely with the 4th power of the radius

181
Q

What vessels do not contribute to resistance?

A

Large vessels near the heart ( because their diameter does not change drastically)

182
Q

What vessels are the largest contributors to resistance?

A

Arterioles, because they constrict and dilate often

183
Q

What happens to blood flow when it encounters an abrupt change in diameter?

A

Turns to turbulent flow

184
Q

What is turbulent flow?

A

Irregular fluid motion where blood from different laminae mixes

185
Q

What is the equation representing the relationship of blood flow?

A

F = delta P/R

186
Q

What is the largest factor influencing blood flow, and why?

A

Resistance, because diameter of vessels can easily be changed

187
Q

What happens to a fluid’s pressure when it is closer to the pump?

A

Increased pressure on the fluid

188
Q

Where is the blood pressure the highest in the body?

A

Aorta

189
Q

Where is the blood pressure the lowest in the body?

A

Right atrium

190
Q

Where is the steepest drop in blood pressure?

A

Occurs in arterioles where more resistance is met

191
Q

What does arterial blood pressure reflect?

A
  1. How much the elastic arteries close to the heart can stretch (compliance/distensibility)
  2. Volume of blood forced into the elastic arteries at any time
192
Q

What does it mean that blood pressure is pulsatile?

A

It rises and falls in regular fashion

193
Q

What is the systolic pressure?

A

Left ventricle contracts, expels blood into aorta, stretches aorta as aortic pressure reaches its peak

194
Q

What is the average value for systolic pressure?

A

120 mm Hg

195
Q

What is the diastolic pressure?

A

Aortic valve closes, prevents blood from backflowing into the heart. Walls of aorta recoil, maintaining sufficient pressure to keep blood flowing forward into the small blood vessels. When aortic pressure drops to its lowest

196
Q

What is the average value for diastolic pressure?

A

70-80 mm Hg

197
Q

What is the pulse pressure?

A

Difference between systolic and diastolic pressures

198
Q

When is pulse pressure increased temporarily?

A

Exercise

199
Q

When is pulse pressure increased permanently?

A

Atherosclerosis

200
Q

What is the mean arterial pressure?

A

The pressure that propels blood back to the tissues

201
Q

What is the equation for mean arterial pressure?

A

MAP = diastolic + Pulse pressure/3

202
Q

What is the average MAP?

A

93 = 80 + (120-80)/3

203
Q

Where do the MAP and pulse pressure decrease?

A

Further away from the heart

204
Q

What is the pressure at the beginning of the capillary bed?

A

35 mm Hg

205
Q

What is the pressure at the end of the capillary bed?

A

15 mm Hg

206
Q

Why is low pressure desirable in the capillary bed?

A
  1. Capillaries are fragile and high pressure would rupture them
  2. Capillaries are extremely permeable so even low pressure can force solute containing fluids out of the blood and into the interstitium
207
Q

What is the main characteristic of venous blood pressure?

A

Steady, little change during cardiac cycle

208
Q

What is the pressure gradient from the vena cava to the venules?

A

15 mm Hg

209
Q

How does blood flow from a vein when you get a cut?

A

It oozes slowly, nonpulsatile

210
Q

How does blood flow from an artery when you get a cut?

A

It spurts, in a pulsatile fashion

211
Q

What are the functional adaptations that the venous system uses to promote adequate venous return?

A
  1. Skeletal muscle pump
  2. Respiratory pump
  3. Sympathetic venoconstriction
212
Q

What is the equation for BP?

A

BP = CO x SVR

213
Q

What three factors does blood pressure vary directly with?

A
  1. Cardiac output
  2. Resistance
  3. Blood volume
214
Q

What factors influence the short term regulation of BP?

A

Nervous system and hormones

215
Q

How do the nervous system and hormones alter BP?

A

By changing resistance and cardiac output

216
Q

What factor influences the long term regulation of BP?

A

Blood volume alterations via the kidney

217
Q

How do neural controls alter CO and R?

A
  1. Maintain adequate MAP by altering BV diameter moment to moment
  2. Alter blood distribution to respond to specific demand of organs
218
Q

Where does the sympathetic nervous system shunt blood to in response to exercise or fear?

A

Vital organs

219
Q

What four reflex arcs do neural controls operate via?

A
  1. Baroreceptors
  2. Vasomotor center of medulla
  3. Vasomotor nerve fibers
  4. Vascular smooth muscle
220
Q

What is the cardiovascular center?

A

Cluster of neurons in the medulla which regulate blood vessel diameter and cardiac output

221
Q

What are the two components of the cardiovascular center?

A

Acceleratory and inhibitory

222
Q

What center control the diameter of the blood vessels?

A

Vasomotor center

223
Q

Where in the spinal cord do the vasomotor fibers exit?

A

T1 - L2

224
Q

What is vasomotor tone?

A

The constant rate of firing of sympathetic nerves to the smooth muscle of arterioles

225
Q

What organs have more frequent input from the vasomotor center?

A

Skin and GI

226
Q

What three things modify the cardiovascular center activity?

A
  1. Baroreceptors
  2. Chemoreceptors
  3. Higher brain centers
227
Q

What system causes vasoconstriction of blood vessels?

A

Increased sympathetic input

228
Q

What system causes vasodilation of blood vessels?

A

Decreased sympathetic input

229
Q

Where do epinephrine and norepinephrine bind to in order to cause vasodilation/constriction of blood vessels?

A

Alpha 1 adrenergic receptors

230
Q

What is a baroreceptor?

A

Pressure sensitive mechanoreceptor that respond to changes in arterial pressure and stretch

231
Q

When are baroreceptors activated?

A

When arterial blood pressure rises

232
Q

Where are baroreceptors located?

A
  1. Carotid sinuses
  2. Aortic arch
  3. Walls of large arteries in the neck and thorax
233
Q

What happens when baroreceptors are stretched?

A

They send rapid streams of impulses to the cardiovascular center

234
Q

What do the impulses that baroreceptors send inhibit and accelerate?

A

Inhibit vasomotor and cardioacceleratory centers

Stimulate cardioinhibitory center

235
Q

Overall, what response to baroreceptors initiate?

A

Decreased BP and vasodilation

236
Q

Where is the cardiovascular center located?

A

Medulla

237
Q

What cranial nerves do the baroreceptor’s impulses travel to the medulla on?

A

CN IX (glossopharyngeal) and CN X (vagus)

238
Q

What happens to cardiac output when baroreceptors are initiated?

A

Decreased cardiac output

239
Q

What do baroreceptors protect from?

A

Acute, short term changes in BP

240
Q

What are baroreceptors ineffective at protecting the body from?

A

Sustained, long term changes in BP

241
Q

What is an example of when baroreceptors will kick in?

A

If you stand up too fast

242
Q

Who experiences orthostatic hypotension?

A

Elderly, dehydrated, people on certain medications

243
Q

Where are the chemoreceptors?

A

Aortic arch and carotid

244
Q

What three factors influence chemoreceptors?

A
  1. Increased CO2
  2. Decreased pH
  3. Decreased O2
245
Q

Where are impulses sent to by chemoreceptors?

A

Cardioacceleratory center and vasomotor center

246
Q

What happens when chemoreceptors send an impulse to the cardioacceleratory center?

A

Increased cardiac output

247
Q

What happens when chemoreceptors send an impulse to the vasomotor center?

A

Increased vasoconstriction

248
Q

What are chemoreceptors located near?

A

Baroreceptors

249
Q

What do chemoreceptors play a larger role in?

A

Respiratory rate

250
Q

What is the chemical formula Dr. Tucker loves?

A

H2O + CO2 –>H2CO3 –> H+ + HCO3-

251
Q

What is hypercapnea?

A

Increased CO2

252
Q

What is acidosis?

A

Decreased pH, Increased presence of H+

253
Q

Do chemoreceptors increase/decrease para/sympathetic output?

A

Increase sympathetic output

254
Q

What are examples of the higher brain centers that effect blood pressure?

A
  1. Hypothalamus
  2. Cerebral cortex
  3. Limbic system
255
Q

What higher brain center control the fight or flight symptoms?

A

Hypothalamus

256
Q

What does the hypothalamus do?

A

Mediates the redistribution of blood flow during exercise and changes in body temperature

257
Q

How do hormonal controls regulate BP in the short term?

A

Change resistance

258
Q

How do hormonal controls regulate BP in the long term?

A

Change in blood volume

259
Q

What does the adrenal medulla release?

A

Epi and NE

260
Q

What do epi and NE do?

A

Increase cardiac output, and cause vasoconstriction

261
Q

Where do epi and NE bind to in the heart?

A

Beta 1 adrenergic receptors

262
Q

Where do epi and NE bind to in the smooth muscle of blood vessels?

A

Alpha 1 adrenergic receptors

263
Q

What is renin?

A

Enzyme that catalyzes the creation of angiotensin II

264
Q

What organ secretes renin?

A

Juxtaglomerular cells in the kidney

265
Q

When does the kidney secrete renin?

A

When blood pressure or volume decreases

266
Q

What does angiotensin II do?

A

Causes vasoconstriction

Stimulates the release of aldosterone and ADH

267
Q

What do aldosterone and ADH influence?

A

Long term effects on blood volume

268
Q

Where is ADH made? Where is it secreted?

A

Hypothalamus, secreted by posterior pituitary

269
Q

What does ADH stand for, and what is another name for it?

A

Antidiuretic hormone, vasopressin

270
Q

What does ADH do?

A

Stimulates the kidneys to preserve water, causing blood pressure to rise

271
Q

What is the one hormone that causes a decrease in blood pressure?

A

Atrial natriuretic peptide (ANP)

272
Q

Where is ANP produced?

A

Atria of the heart

273
Q

What does ANP do?

A

Causes reduction of blood volume and therefore, BP

274
Q

How does ANP cause reduction of blood volume?

A

Stimulates the kidneys to excrete sodium and water

275
Q

What condition might prompt a doctor to prescribe ANP?

A

CHF

276
Q

What are the two types of renal mechanisms?

A

Direct and indirect

277
Q

What is a direct renal mechanism?

A

One that alters volume independent of hormones

278
Q

What happens to filtered fluid with direct renal mechanisms?

A

The rate at which fluid filters from the bloodstream into the kidney tubules increases

279
Q

How does a direct renal mechanism increase BP?

A

Since the fluid filtration speeds up, the kidney can’t reabsorb the fluid fast enough, so more filtrate leaves the body as urine and blood volume and therefore BP drops

280
Q

What happens to fluid if BP or blood volume is low?

A

Water is conserved and goes to the bloodstream, increasing volume and BP

281
Q

What is the name of the indirect renal mechanism?

A

Renin-angiotensin-aldosterone mechanism

282
Q

Where is aldosterone made?

A

Adrenal cortex

283
Q

When is renin secreted?

A

When BP drops

284
Q

What does renin cleave and create?

A

Angiotensinogen to create angiotensin I

285
Q

Where is angiotensinogen made?

A

Liver

286
Q

What enzyme converts angiotensin I to II?

A

Angiotensin converting enzyme (ACE)

287
Q

What four ways does angiotensin II stabilize BP and volume?

A
  1. Stimulating the adrenal cortex to secrete aldosterone
  2. Prods posterior pituitary to make ADH
  3. Triggers thirst sensation
  4. Vasoconstriction
288
Q

What does aldosterone do?

A

Stimulates renal absorption of sodium, so water follows the sodium into the blood and increases volume and pressure

289
Q

What does ADH do?

A

Promotes water reabsorption by the kidneys, increasing blood volume and pressure

290
Q

Where is the thirst sensation triggered?

A

The hypothalamic thirst center

291
Q

What does systolic blood pressure represent?

A

The highest pressure exerted on the BVs during systole

292
Q

What is systolic BP usually valued?

A

110-140 mm Hg

293
Q

What does diastolic blood pressure represent?

A

The lowest pressure exerted on the BVs during diastole

294
Q

What is diastolic BP usually valued?

A

70-80 mm Hg

295
Q

What two things assess the proficiency of circulation?

A

Pulse and blood pressure

296
Q

What is pulse?

A

Altering expansion and recoil of arteries during each cardiac cycle creates a pressure wave

297
Q

What is a pressure point?

A

Compress these points to stop blood flow into distal tissues during hemorrhage

298
Q

What artery do we usually use to assess BP?

A

Brachial

299
Q

What are the sounds heard in the stethoscope when you auscultate BP?

A

Korotkoff sounds

300
Q

What does the first sound you hear when taking BP represent?

A

When the small amount of blood spurts through a constricted artery

301
Q

What does the last sound you heart when taking BP represent?

A

Blood will now flow freely in an open artery

302
Q

What are changes in BP adaptations to?

A
  1. Posture
  2. Physical exertion
  3. Emotional upset
  4. Fever
303
Q

What are some characteristics of a person that could effect BP?

A
  1. Age
  2. Weight
  3. Race
  4. Sex
304
Q

What is hypertension?

A

Chronically elevated BP

305
Q

What values constitute hypertension?

A

Systolic above 140, diastolic above 90

306
Q

What is pre-hypertension?

A

When BP is high but not in the range, signifies high risk and patient should make lifestyle changes

307
Q

What is the nickname for hypertension?

A

The silent killer

308
Q

Why is hypertension the silent killer?

A

It slowly strains the heart and damages the arteries over time

309
Q

What does prolonged hypertension result in?

A
  1. Heart failure
  2. Stroke
  3. Vascular disease
  4. Renal failure
310
Q

What happens to the myocardium with prolonged hypertension, and why?

A

Myocardium enlarges due to increased workload - accelerates atherosclerosis and walls become weak, thin, and flabby

311
Q

What is primary/essential hypertension?

A

There is no underlying cause identified - a mix of hereditary and several environmental factors

312
Q

What kind of diet results in hypertension?

A

High salt, saturated fat, cholesterol, and deficiency in metal ions

313
Q

How does obesity relate to hypertension?

A

Adipocytes release hormones that increase the sympathetic tone and interfere with the endothelial ability to vasodilate

314
Q

At what age do people become at high risk for hypertension?

A

40

315
Q

Why does smoking increase hypertension?

A

Nicotine causes vasoconstriction by prompting epi and NE. Also chemicals in smoke damage the tunica intima so it can’t regulate arteriolar diameter

316
Q

What kinds of drugs are used to control hypertension?

A

Diurectics, beta blocers, Ca channel blockers, ACE inhibitors, and angiotension receptor blockers

317
Q

What is secondary hypertension

A

Hypertension due to an identifiable cause

318
Q

What are some examples of identifiable causes of hypertension?

A

Obstructed renal arteries
Kidney disease
Endocrine disorders

319
Q

What is hypotension?

A

Low blood pressure

320
Q

What values depict hypotension?

A

90/60

321
Q

When is hypotension a concern?

A

When it effects perfusion to the tissues

322
Q

What is acute hypotension a sign of?

A

Shock

323
Q

What is orthostatic hypotension?

A

Temporary drop in BP when the patient stands suddenly

324
Q

What is tissue perfusion?

A

Blood flow through the body tissues

325
Q

What are four examples of tissue perfusion?

A
  1. Delivering O2 and nutrients to tissue cells and removing wastes
  2. Exchanging gas into the lungs
  3. Absorbing nutrients from digestive tract
  4. Forming urine in kidneys
326
Q

What are the percentages of blood flow to the main organs of the body?

A 
Brain 13%
Heart 4%
Kidneys 20%
Abdominal 24%
Skeletal muscle 20 %
327
Q

Where is blood flow the fastest?

A

Aorta

328
Q

Where is blood flow the slowest?

A

Capillaries

329
Q

Blood flows faster when the cross sectional area is smallest/largest

A

Smallest

330
Q

What is velocity of blood proportional to?

A

Velocity is inversely proportional to the cross sectional area

331
Q

If an artery branches into two arterioles, is the velocity slower or faster?

A

Slower, because the overall cross sectional area is bigger

332
Q

What is autoregulation?

A

Automatic adjustment of blood flow to each tissue in proportion to the tissue’s requirement at any instant

333
Q

What stimulates autoregulation, leading to increased blood flow?

A

When flow is inadequate to meet tissue needs, oxygen decreases and metabolic products accumulate

334
Q

What are five metabolic factors that increase blood flow?

A
  1. Decreased oxygen
  2. Increased H+
  3. K+
  4. Adenosine
  5. Prostaglandins
335
Q

What effect does nitric oxide have?

A

Vasodilation

336
Q

What system does nitric oxide work in?

A

Cyclic GMP second messenger system

337
Q

What can nitric oxide override when tissues need increased blood flow?

A

Sympathetic vasoconstriction

338
Q

What are endothelins?

A

Peptides released by endothelium that cause vasoconstriction

339
Q

What counteracts and balances endothelins?

A

Nitric oxide

340
Q

What is the result of metabolically controlled autoregulation?

A

Immediate vasodilation of arterioles serving capillaries of needy tissues

341
Q

What do inflammatory chemicals that are released during injury, allergic reaction, or infection do to blood vessels?

A

Vasodilation

342
Q

What are some examples of inflammatory chemicals?

A

Histamine, Kinins, Prostaglandins

343
Q

Why do inflammatory chemicals vasodilate?

A

To help clear microorganisms and toxins

344
Q

What do myogenic controls of vascular smooth muscle do?

A

Vascular smooth muscle responds directly to passive stretch caused by increased pressure, resisting stretch and vasoconstricting

345
Q

What is reactive hyperemia?

A

Dramatically increased blood flow into a tissue that occurs after the blood supply to the area has been temporarily blocked

346
Q

What is long term autoregulation?

A

If a tissue needs more nutrients than short term autoregulation can supply, developing over weeks or months to enrich blood flow

347
Q

What are some examples of long term autoregulation?

A 
Increased number of RBCs
Vessels enlarging (angiogenesis)
348
Q

When is long term autoregulation common?

A

When the coronary vessels are partially occluded

349
Q

What are the vital organs, where blood is shunted during exercise?

A

Brain, heart, lungs, skeletal muscle, skin

350
Q

What speed does blood flow through the capillaries?

A

Slowly

351
Q

What is vasomotion?

A

The on and off opening and closing of precapillary sphincters in response to local autoregulatory controls

352
Q

What substances pass bewteen the blood and interstitial fluid by diffusion?

A

Oxygen
Carbon dioxide
Nutrients
Wastes

353
Q

What is diffusion?

A

Net movement always occurring along concentration gradients from high to low

354
Q

What are the four routes of diffusion across a capillary wall for different molecules?

A
  1. Lipid soluble molecules pass through lipid bilayer
  2. Movement through intercellular clefts
  3. Movement through fenestrations
  4. Active transport in pinocytotic vesicles or caveolae
355
Q

What kinds of molecules pass the capillary wall through the lipid bilayer?

A

Respiratory gases like O2 and CO2

356
Q

What kinds of molecules pass the capillary wall through intercellular clefts?

A

Small water soluble solutes like amino acids and sugars

357
Q

What kinds of molecules pass the capillary wall through fenestrations?

A

Small water soluble solutes like amino acids and sugars

358
Q

What kinds of molecules pass the capillary wall through active transport?

A

Large molecules like proteins

359
Q

What are two examples of how capillary permeability differs between different regions of the body?

A

Capillaries in the liver let through almost anything, while in the brain, capillaries let through almost nothing

360
Q

What are two examples of when a patient will have edema?

A
  1. Liver disease - no albumin being made, so fluid is being pushed out but none is being sucked in
  2. Venous occlusion - backflow into arterioles resulting in higher hydrostatic pressure and arterioles pushing out too much fluid
361
Q

What is bulk flow?

A

A passive process in which a large number of ions, molecules, or particles in a fluid move together in the same direction

362
Q

Where is fluid forced out of?

A

Arteriole end

363
Q

Where is fluid sucked back in?

A

Venous end

364
Q

What does albumin control?

A

Osmotic pressure

365
Q

Where is albumin created?

A

Liver

366
Q

What does the direction and amount of blood flow across capillary walls reflect the balance between?

A

Hydrostatic pressure and colloid osmotic pressure

367
Q

What is hydrostatic pressure?

A

The force exerted by a fluid pressing against a wall

368
Q

What is capillary blood pressure?

A

Same as hydrostatic pressure, the force exerted by blood on capillary walls

369
Q

What is capillary hydrostatic pressure?

A

Forces fluids through capillary walls, leaving behind cells and most proteins

370
Q

What is filtration?

A

Pressure driven movement of fluid and solutes from the blood into the interstitium and thus the cells

371
Q

What is reabsorption?

A

Pressure driven movement of fluid and solutes from the interstitium, and thus cells, back into the blood

372
Q

What is the hydrostatic pressure on the arterial end?

A

35

373
Q

What is the hydrostatic pressure on the venous end?

A

17

374
Q

What is the hydrostatic pressure of the interstitium?

A

0

375
Q

What is colloid osmotic pressure?

A

Opposes hydrostatic pressure, created by large nondiffusible molecules that are unable to cross the capillary wall,
which draw water towards themselves

376
Q

What is the colloid osmotic pressure of the arteriole end?

A

26

377
Q

What is the colloid osmotic pressure of the venous end?

A

26

378
Q

What is the colloid osmotic pressure of the interstitium?

A

1

379
Q

Does osmotic pressure differ from arteriole to venous ends?

A

No

380
Q

HP — OP —-

A

HP pushes, OP sucks

381
Q

What is the net HP and OP on the arteriole end?

A

Net HP = (35-0) = 35

Net OP = (26-1) = 25

382
Q

What is the net filtration pressure on the arteriole end?

A

Net HP - Net OP = 35 - 25 = 10

383
Q

What is the net HP and OP on the venous end?

A

Net HP = (17-0) = 17

Net OP = (26-1) = 25

384
Q

What is the net filtration pressure on the venous end?

A

Net HP - Net OP = 17 - 25 = -8

385
Q

What does in mean in terms of fluid movement when the NFP is positive?

A

Fluid moves out

386
Q

What does in mean in terms of fluid movement when the NFP is negative?

A

Fluid moves in

387
Q

What is net filtration pressure?

A

The consideration of all forces acting on the capillary bed

388
Q

What is starling’s law of capillaries?

A

Overall the volume of fluid and solutes reabsorbed normally is almost as large as the volume filtered

389
Q

What happens to the portion of fluid that is not reabsorbed back into the capillary?

A

Removed by lymphatic vessels

390
Q

At what percentage is edema usually first noticeable?

A

Not usually detected until interstitial volume exceeds 30%

391
Q

What two instances does filtration exceed reabsorption?

A

Excess filtration

Inadequate reabsorption

392
Q

What happens when there is excess filtration?

A

Increased capillary BP and increased permeability in capillaries (inflammation)

393
Q

What happens when there is inadequate reabsorption?

A

Decrease plasma proteins (liver disease, burns, malnutrition, kidney disease)

From Flashcardlet (133 decks)

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