Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pathophysiology I - Exam 3 (Final) > Cardio Module 4 > Flashcards

Cardio Module 4 Flashcards

(107 cards)

Start Studying
1
Q

What are the 2 portal circulation pathways

A

1) GI/hepatic portal system - GI/spleen capillary beds sends blood to liver before blood empties into iVC
2) Renal system - has 2 capillary beds within kidney to allow reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the breakdown of blood volume in the body?

A 
70% in the systemic circulation
    - 16% in arteries (stressed volume)
    - 54% in veins (unstressed volume)
18% in pulmonary circulation
12% in coronary circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Circulation is _______ driven

A

Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pressure gradients in the systemic circulation stars at _____ mmHg and gradually decrease to _______ mmHg

A

100+

0-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the circulation pressure in the left atria

A

4-12 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the circulation pressure in the right atria

A

0-8 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the circulation pressure in the left ventricle (Systolic and end-diastolic)

A

Systolic - 90-140 mmHg

Diastolic -4-12 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the circulation pressure in the right ventricle (Systolic and end-diastolic)

A

Systolic - 15-28 mmHg

Diastolic -0-8 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the circulation pressure in the 1) aorta, 2) capillaries and 3) venous return to Vena cava

A

1) 80-140 mmHg
2) 20-40 mmHg
3) 4 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where would you find the largest functional change in arterial pressure

A

In the arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

As for pulmonary circulation, what is the circulation pressure in 1) Pulmonary trunk, 2) Pulmonary capillaries and 3) Pulmonary veins

A

1) 3-30 mmHg
2) 10 mmHg
3) 4-12 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pressure gradients in the heart chambers start out at _______ and gradually increase to.______

A

0-4 mmHg

100+ mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pressure gradients thru the systemic circulation start out at _______ and gradually increase to.______

A

100+ mmHg

0-4 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 layers of a blood vessel

A

1) Tunica intima - smooth frictionless inner layer
2) Tunica media - smooth muscle and elastic fibers
3) Tunica externa (adventitia) - Thin layer of connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the ‘elastic arteries’ and what are their function

A

Pulmonary trunk, aorta and major branches
- Elastin > smooth muscle
Function - To stretch to absorb systolic volume of blood and recoil to return to original diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the blood flow characteristics of elastic arteries

A

High pressure, High velocity, small tonal cross section area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the ‘muscular arteries’ and what are their function

A

Medium to small size arteries.
Have a thinner tunica media - transition to less elastin and more smooth muscle
Function: muscular control distributing blood flow to arterioles throughout body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the major role of arterioles?

A

They act as a controller to direct blood to the capillary bends at slow/low pressure flow. They slow the velocity, pressure and volume travelling into the capillaries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is change of pressure in the arterioles

A

The largest drop in arterial pressures happen here.
Enter arterioles - 90-100 mmHg
Leave arterioles - 25-35 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What’s the size and make up of arterioles

A

0.5 mm

Mostly smooth muscle and minimal elastin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the blood flow characteristics of the arterioles

A

1) Decrease pressure
2) Decrease velocity
3) Increase total cross section area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What controls the functions of arterioles

A

Intrinsic - Metabolic demands and conditions

Extrinsic - Autonomic nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the physical make up of capillaries

A

A Single endothelial layer with a basement membrane without tunica media and externa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the blood flow characteristics of capillaries

A

LOW pressure
SLOW velocity (1.5 sec for RBC to pass thru capilaries0
HUGE total cross section area (1000 x larger than aorta)
Individual cross section very narrow (one cell at a time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the cross section of capillaries
Individual cross section very narrow | Total cross section huge
26
What is the functional role of capillaries?
Its the site of respiration (gas exchange) as well as nutrient and H2O exchange
27
How much of the circulating blood is generally found in the capillaries?
About 5%
28
At any given moment, most capillaries are _____
closed
29
What are some differences between arteries and veins
1) Veins have thinner and more fibrous walls 2) Veins have less elastin than arteries 3) Veins have larger diameter 4) Greater compliance of venous system allows for larger blood volume fluctuations w/o dramatic BP variations
30
When it comes to blood vessels which are more related to 'elastance"
Arteries - More force is required to stretch and accommodate volume increase
31
When it comes to blood vessels which are more related to 'compliance"
Veins - They expand easily to accommodate volume increase
32
What assists veins to direct blood flow back to the heart
One way valves (formed by in-folds of tunica intima)
33
By the time that blood reaches the heart from the veins it has increased in velocity (for its original velocity by)
60%
34
Since the veins have lower pressure. What are two pumps that assist in bringing blood back to the heart?
Respiratory pump - Thru inspiration | Muscular pump - Lower extremity muscles contract pushing blood to the heart as valves behind it close
35
After surgery or during a long flight one should be instructed to do ________, This will help avoid_____?
Ankle pumps | DVT - Deep vein thrombosis
36
What are some factors that affect blood flow?
1) Velocity 2) Pressure of fluid 3) Laminar vs. Turbulent flow 4) Resistance
37
How does resistance affect blood flow?
Resistance is inversely related to blood flow (increase resistance = decrease flow and volume per unit of time)
38
Describe Laminar flow
Perfect blood flow no resistance, RBC can 'shoot' thru system.
39
Describe turbulent flow
"Funny flow" something is getting in the way of the RBC making its way as fast as it can thru the system
40
Most resistance in blood flow is due to...(what else can?)
Length and diameter of blood vessels ( due to buildup or vasoconstriction and dilation) Viscosity of blood - More 'sludgy' tougher time getting thru vessels
41
What is the most important determinant of blood viscosity
Hematocrit
42
What is the relation between hematocrit and blood viscosity.
As hematocrit increases, there is a DISPROPORTIONATE increase in viscosity. Hematocrit increases from 40% to 60% viscosity doubles Hematocrit = 40%, Relative viscosity = 4 Hematocrit = 60%, Relative viscosity = 8
43
What is Total Peripheral Resistance
Aka Systemic vascular resistance its the resistance to all systemic vasculature excluding pulmonary vasculature
44
What is the vessels play a major role in regulating TPR (total peripheral resistance)
Arterioles - The narrowed channel of arterioles provide the most resistance
45
What is the relationship between TPR (total peripheral resistance) and blood flow
Inverse: If you decrease resistance you are allowing for a larger diameter for blood to flow easier... It allows more arterial blood to reach the tissues and an increased blood flow to the venous system
46
What are things contribute to the Neural control of TPR?
1) Autonomic nervous system - Sympathetic and Parasympathetic 2) Baroreceptors 3) Chemoreceptors
47
What are the sympathetic NS's influence on TPR
1) Alpha and Beta receptors on BV 2) Epinephrine and norepinephrine 3) Nodal tissue and myocradium on the atria 4) Myocardium on ventricles
48
What are receptors on blood vessels that allow sympathetic influence on TPR
``` Alpha receptors (a1 and a2) - they CONSTRICT smooth muscles of BV - a1 - major constrictor - a2 - more inhibit relaxation (weaker constrictor) Beta receptors (B2) - they DIALATE (or inhibit contraction) of smooth muscle of BV ```
49
How does norepinephrine provide a sympathetic influence on TPR
NE has a strong affinity for alpha (both 1 and 2 but mostly a1) receptors that give a vasoconstriction response and they weakly bind to beta (B2) receptors which can help for vasodilation but it's generally 'overpowered' by alpha receptor vasoconstriction
50
How does epinephrine provide a sympathetic influence on TPR
Epi has a strong affinity for beta (B2) receptors = vasodilation response in some organs Epi's response is 'concentration dependent' - High epi concentration will bind to alpha receptors and overpower beta and will vasoconstrict
51
What is the sympathetic NS role in the actual heart for TPR
In Atria - It acts on nodal tissue to increase HR and on the myocardium to increase the contractility of the atria In Ventricles - It acts on the myocardium to increase contractility (strength) of the ventricles
52
What is the sympathetic NS role in the kidneys for TPR
It forces the kidneys to retain more fluid and up Blood volume
53
What is the parasympathetic NS influence on TPR
PS muscarinic (M3) receptors 'indirectly' promote vasodilation via a coupling reaction in BV wall. Acetylcholine binds to M3 recptors in BV that signals Nitric Oxide production. NO stimiulates vasodilation (counteracts a contraction that would have happened w/o NO.
54
How do conditions like HTN and Reynaud's affect parasympathetic NS influence on TPR
They block NO and when Ach binds to M3 receptors they vasoconstrict and increase blood flow resistance
55
What is the parasympathetic NS role in the actual heart for TPR
Parasymp fibers innervate ATRIA ONLY. Atria - Influence nodal tissue and decrease HR Ventricles - NO INFLUENCE
56
Where are baroreceptors (stretch receptors) localted?
Located in the aorta and carotid sinus
57
How do baroreceptors (stretch receptors) affect HR
Pressure changes in the carotid flow will signal CV centers in the medulla to increase/decrease BV resistance and CO If increase stretch (Simulated) (BP up) - Parasymp output up, Symp output down... CO/HR an contractility down. Systemic BV dilation up If decrease stretch (BP down) - Parasymp output down and symp output up.
58
Where are Arterial chemoreceptors located
In aorta and carotid arteries. Central receptors located in the brainstem (medulla)
59
What is the major role of Arterial chemoreceptors
Respiratory rate but also has a smaller influence on resistance by vasodilating and constricting BV
60
What is compliance?
The ability for a BV to stretch per given increase in BP (veins more than arteries)
61
What is Elastance?
Ability for BV to return (Recoil) to original diameter. (arteries more than veins
62
Arteries will not accommodate______?
A large blood volume change (unless accompanied by a large pressure increase)
63
What is systolic pressure?
The highest atrial pressure during the cardiac cycle - It's measured after the ventricular ejection
64
What is diastolic pressure?
The Lowest atrial pressure during the cardiac cycle. It's measured during ventricular (passive) filling
65
What is pulse pressure
The difference btwen systolic and diastolic pressures (systolic - diastolic = PP).
66
Pulse pressure is determined by....
Stroke volume
67
What are pathological effects of pulse pressure
Any pathology that reduces contraction or filling of ventricle will reduce PP.
68
What is Mean arteriole pressure (MAP) (how is it determined)
The average pressure of the arterial system. Measured by Diastolic pressure + 1/3 Pulse pressure
69
What are normal MAP values
70-110 mmHg
70
What are the Minimal and Maximal MAP values
Minimal - 50-60 mmHg (threshold to sustain visceral organ health Maximal - > 160 mmHg (may elevate CSF and intracranial pressure.
71
All changes in MAP are due to
A change in CO or TPR
72
Why does a higher HR make MAP come closer to actual average btwn systolic and diastolic pressure (rather than diastolic + 1/3 PR
Because you're eliminating or reducing the rest time in between heart beats when HR increases
73
What is CVP
Central venous pressure - the assessment of the right ventricular function and systematic fluid status
74
How is CVP measured
by a CVP catheter on the right side of the heart (on the SVC, IVC side to the right atria)
75
What are normal CVP values?
Btwn 2-6 mmHg (values of the blood returning to right atria)
76
What are factors that increase CVP?
1) Over hydration 2) CHF 3) Pulmonary trunk stenosis 4) Positive pressure breathing (like a ventilator or bag mask) or physiological straining
77
What are factors that decrease CVP?
1) Under hydration 2) Transient orthostatic (stand up) 3) Negative pressure breathing (Iron lung)
78
The mean CVP is determined by...
The High points and low points of the A wave
79
What is the A wave of an EKG
It represents atrial contraction (high point = right ventricular-end diastolic pressure). Atria is contracted and tricuspid valve is open so atrial and ventricle pressures are equal
80
What is the c wave of an EKG
Occurs at the closure of the tricuspid valve. Its peak occurs from the tricuspid valve bulging back into the atrium
81
What is the x decent of an EKG
Represents atrial relaxation
82
What is the V wave of an EKG
Represents the rise in atrial pressure before the tricuspid valve opens
83
What is the y decent of an EKG
Represents atrial emptying as blood fills the ventricle
84
What may tricuspid regurgitation show on an EKG
An enlarged V wave
85
What is the z-point in an EKG
It occurs just before the tricuspid valve closes (mid to end QRS)
86
What is Pulmonary Capillary wedge pressure (PCWP)?
Opposite of CVP it measures the back pressure of the left side of the heart
87
What is PCWP measured
A balloon tipped catheter (Swan-Ganz catheter) is passed into a peripheral vein and goes thru the right atrium, ventricle and into the pulmonary artery (and branch). When balloon is inflated it indirectly measures the pressures within the pulmonary veins and left atrium
88
What are the normal values of PCWP (or LAP Left Atrial PRessure)
8-10 mmHg
89
What will an abnormal elevation in PCWP cause
Congestion (back up) into the pulmonary system
90
What is the PCWP or LAP threshold (what happens then)
> 20mmHg, pulmonary edema may occur
91
Why is PCWP measured?
1) Evaluate severity of any pathology causing elevated LAP. 2) Left ventricular failure 3) Mitral or Aortic valve stenosis or regurgitation 4) Evaluated pulmonary HTN 5) Monitor blood volume during hypotensive shock 6) Monitor and titrate diuretic meds
92
What are some influences on MAP
1) CO 2) TPR 3) Hormonal control (endocrine system) 4) Venous compliance
93
What are the hormonal influences on MAP
1) ADH 2) Renin-angiotensin system 3) Natriuretic peptides (ANP) 4) Adenomedullin 5) Insulin
94
What is ADH's influence on MAP
It stimulates the retention of water
95
What is the Renin-angiotensin's influence on MAP
It stimulates the retention of sodium and constricts BV
96
What is Natriuretic peptides (ANP)'s influence on MAP
It stimulated excretion of sodium and water
97
What is Adenomedullin's influence on MAP
From the endothelium and smooth muscle of BV. They have a vasodilation effect on BV and thus decreasing MAP
98
What is Insulin's influence on MAP
Stimulates NO from endothelium to dilate BV
99
What is the net result of the renin-angiotensin-aldosterone system
1) Blood pressure down 2) Fluid volume down 3) B2 sympathetics up
100
What's another role for Angiotensin II
It can be a direct vasoconstrictor
101
What is Natriuretic peptides (ANP)'s influence on MAP
It stimulated excretion of sodium and water. Opposite effect of Renin angiotensin and ADH.
102
What is Adenomedullin's influence on MAP
From the endothelium and smooth muscle of BV. They have a vasodilation effect on BV and thus decreasing MAP
103
What is Insulin's influence on MAP
Stimulates NO from endothelium to dilate BV
104
What is the net result of the renin-angiotensin-aldosterone system
1) Blood pressure down 2) Fluid volume down 3) B2 sympathetics up
105
What's another role for Angiotensin II
It can be a direct vasoconstrictor
106
What is the venous return influence on MAP
Increase venous return increases preload SV/CO and indirectly increases afterload
107
How much blood volume can the venous system accommodate?
Up to 60% and still maintain a 10 mmHg pressure

Pathophysiology I - Exam 3 (Final) (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions