cvp exam 2 Flashcards
(228 cards)
1
Q
what has a main function of delivering adequate oxygen, nutrients to the systemic tissues and remove carbon dioxide and other waste products of the system tissues
A
systemic circulation
2
Q
what serves as the conduit for transport of hormones, and other substances and allows these substances to potentially act at a distant site from their production
A
systemic circulation
3
Q
what is designed to carry blood under high pressure out to the tissue beds
A
systemic arteries
4
Q
what acts as control valves to regulate local flow
A
arterioles and pre capillary sphincters
5
Q
what allows the exchange between tissue(cells) and blood
A
capillaries
6
Q
how thick are capillaries
A
one cell layer
7
Q
what collects blood from capillaries
A
venules
8
Q
what returns blood to the heart/dynamic storage
A
systemic veins
9
Q
what is blood flow proportional to
A
metabolic demand
10
Q
what is cardiac output controlled by
A
local tissue flow
11
Q
what is arterial pressure control independent of
A
local flow or cardiac output
12
Q
what are the 4 components of vessles
A
endothelium, elastic tissue, smooth muscle, and fibrous tissue
13
Q
one layer of what exists in all vessels
A
endothelium
14
Q
what vessel has a high amount of elastic tissue a moderate amount of fibrous tissue and low amount of smooth muscle
A
aorta
15
Q
what type of vessel has a high amount of smooth muscle a moderate amount of elastic tissue and a low amount of fibrous tissue
A
a typical artery
16
Q
what type of vessel has equal parts elastic tissue, smooth muscle and fibrous tissue
A
a vein
17
Q
what is a capillary composed of
A
only endothelium
18
Q
what does the equation V = IR represent
A
ohm’s law
19
Q
what is analogous to ohm’s law (V=IR)
A
⌂P = QR
20
Q
flow(Q) is directly proportional to
A
⌂P
21
Q
flow(Q) is inversely proportional to
A
Resistance (R)
22
Q
what is the volume of blood that passes a certain point per unit time referred to as
A
flow (Q)
23
Q
what is the equation used to determine flow
A
Q=⌂P/R
24
Q
at a given Q the greater the drop in P in a segment or compartment the greater the
A
resistance to flow
25
what is the driving force of blood which is also proportional to flow
pressure gradient
26
what is the difference in pressure between two points
pressure gradient
27
independence of local flow control, minimizing total peripheral resitance, and oxygen rich blood supply to every tissue are all advantages of what
a parallel circuit
28
what is internal friction of a fluid associated with the intermolecular attraction
viscosity
29
what is the viscosity of blood
3
30
where does most of blood viscosity come from
RBC's
31
what is the viscosity of plasma
1.5
32
what is the viscosity of water
1
33
in terms of viscosity when blood is going slow it is ____ and when it is going fast it is _____
thicker, thinner
34
if velocity decreases what will happen to the viscosity of blood
the viscosity will increase
35
when cells get stuck at constriction points momentarily what does it do to viscosity
increases apparent viscosity
36
where do cells line up to decrease the viscosity to offset the cells from getting stuck at constriction points
in small vessels with a diameter less that .3mm
37
which type of flow is streamline,silent,most efficient, and normal
laminar flow
38
what type of flow is cross mixing, vibrational noise, least efficient, and frequently associated with vessel disease (bruit)
Turbulent flow
39
the greater the R# the greater the probability for
turbulance
40
if R# is <2000 flow is usually what
laminar
41
if R# is >3000 is usually what
turbulant
42
when using Doppler ultrasonic flow-meter a broad band is associated with
turbulent flow
43
when using Doppler ultrasonic flow-meter a narrow band is associated with
laminar flow
44
Fick principal and indicator dilution are used to determine what
cardiac output
45
venous occlusion plesthymography, doppler ultrasonic flowmeter and vascular flow cuffs are used to determine what
vessel flow
46
what is a small cuff that fits around a vessel. and is an electromagnetic measuring device
Vascular flow cuff
47
what is represented by the following equations Flow = amount of substance per min / AV difference
fick principal
48
what is the ability of a vessel to stretch known as
distensibility
49
what is the ability of a vessel to stretch and hold volume known as
compliance
50
which vessel is thick has low distensibility, low compliance and contains ~15% of blood volume
Artery
51
which vessel is thin has high distensibility, high compliance, and holds ~65% of blood volume
Vein
52
what does the following equation represent ⌂ vol / ⌂ pressure X initial volume
Distensibilty
53
what does the following equation represent ⌂ Vol /⌂ pressure
compliance
54
what does distensibility X initial vol. determine
compliance
55
where is a small change in volume associated witha large change in pressure
systemic arteries
56
where is a large change in volume associated with a small change in pressure
systemic veins
57
viens are about __ times more distensible and __ times more compliant than systemic arteries
8X, 24X
58
local blood flow is regulated in proportion to
metabolic demand
59
what type of control involves vasodilation and vasoconstriction of precapillary resistance vessels
short term control of blood flow
60
what type of control involves changes in tissue vascularity
long term control of blood flow
61
the formation or dissolution of vessels as well as vascular endothelial growth factor and angiogenin are associated with what
long term control of blood flow
62
in regards to blood flow: what acts as an integrator of multiple inputs, are richly innervated by SNS vasoconstrictor fibers and have alpha receptors, and may be effected by local factors
arterioles
63
Adenosine, CArbon Dioxide, adenosine phosphate compounds, histamine, potassium ions, hydrogen ions, PGE & PGI series prostoglandins, NO, CO are all what
local vasodilators
64
what is the ability to keep blood flow constant in the face of a changing arterial blood pressure known as
autoregulation
65
in the kidney both renal flow and the glomerular filtration rate are what
autoregulated
66
what is the production of new microvessels referred to as
angiogenesis
67
the shear stress caused by enhanced blood flow velocity associated with partial occlusion is referred to as
arteriogenesis
68
small peptides that stimulate growth of new vessels such as VEGF are referred to as
angiogenic factors
69
what is it called when mesenchymal cells differentiate into endothelial cells
vasculogenesis
70
what is the formation of new blood vessels by sprouting from pre existing small vessels ( usually lacking developed tunica media) called
angiogenesis
71
what is the rapid proliferation of pre-existing collateral vessels with fully developed tunica media
arteriogenesis
72
what are the mechanical tirggers of angiogenesis
hemodynamic and shear stress
73
what is the broad term from producing new vessels (vasculogenesis, angiogenesis, arteriogenesis)
Neovascularization
74
what are the chemical triggers of angiogenesis
hypoxia and NO
75
decreased glucose, increased VEGF, inflammation, and angiogenic growth factors are all example of what kind of angiogenic triggers
molecular
76
fibroblast growth factor, VEGF, placenta growth factor, and angiopoietin are all what type of growth factor
angiogenic growth factors
77
protein therapy, Gene therapy, and cellular therapy are all example of what type of angiogenesis
therapeutic angiogenesis
78
what method of therapeutic angiogenesis utilizes growth factor proteins
protein therapy
79
what method of therapeutic angiogenesis utilizes manipulation of gene expression for angiogenic peptides
Gene therapy
80
what method of therapeutic angiogenesis utilizes cells that produce angiogenic factors are introduced into ischemic tissue
cellular therapy
81
inhibition of platelet aggregation, and relaxation of vascular smooth muscle (dilating) is a result of the release of what
prostacyclin (PGI2)
82
Release of NO in healthy endothelium results in
vasodilation
83
release of endothelin to damaged endothelium causes what to happen to vascular smooth muscle
constricts vascular smooth muscle
84
what is the functional unit of circulation
capillary
85
where does the bulk of exchange take place
capillary
86
diffusion,ultrafiltration, and vesicular transport are all example of what
mechanisms of exchange
87
if flow doubles and we don't uptake any more oxygen what happens
non-functional flow increase
88
if flow doubles and we have and increase in uptake of oxygen what will happen
metabolic demand increase
89
what are non nutritive flow increases associated with
shunting of blood
90
what is the average capillary hydrostatic pressure gradient
17mmHg
91
what is the average interstitial hydrostatic Pressure gradient
-3 mmHg
92
what does high hydrostatic pressure favor
filtration
93
what does low colloid osmotic pressure favor
reabsorption
94
what is the average colloid osmotic pressure of a capillary
28mmHg
95
what is the average interstitial colloid osmotic pressure
9mmHg
96
what proteins can exert osmotic pressure
only those that cannot cros the capillary wall
97
what may have walls that can range from tight junctions(blood brain barrier) to discontinuous(liver)
capillaries
98
what capillaries have filtration slits (fenestrations)
glomerular capillaries in the kidneys
99
if all colloid proteins freely cross the capillary wall none are reflected(no colloid effect) what is the reflection coefficeint and what tissue may this be in
RC=0 in the liver
100
if all colloid protiens are reflected and none cross the capillary wall (full colloid effect) what is the reflection coefficient and what tissue may this be found in
RC=1 in the blood brain barrier
101
superficial portions of the skin, the CNS, endomysium of muscle and bones all lack what type of vessels
lymphatic vessels
102
____ duct drains the lower body and left side of head,left arm, and part of the chest
thoracic duct
103
_____ duct drains the right side of the head, neck and right arm and part of the chest
right lymph duct
104
what acts as the lymphatic system in the CNS
perivascular spaces
105
what spaces contain CSF and communicate with subarachnoid space functioning as the "lymphatic system" of the CNS
perivascular spaces
106
any factor that increases filtration and/or decreases reabsorption will do what to lymph formation
increase
107
how much lymph flows through the thoracic duct
100ml/hr
108
how much lymph flows through the right lymph duct
20ml/hr
109
what is the total lymph flow
120ml/hr or 2.9L /day
110
return of lost protein to the vascular system, draining of excess plasma filtrate from the ISF space, carrying absorbed substances/nutrients from the GI tract are all function of what system
lymphatics system
111
a meshwork of sinuses lined with tissue macrophages is a description of what
a lymph node
112
the volume of blood interacting with the wall is refered to as
arterial blood pressure
113
when the left ventricular output is greater than peripheral runoff the heart is in
systole
114
during what phase does total blood volume rise causing arterial blood pressure to increase to a peak
systole
115
during systole the arteries are _____
distended
116
during what phase of the heart is the the left ventircle is filling, the arteries are recoiling, serving to maintain perfusion to the tissue beds
diastole
117
when total blood volume in the arterial tree is decreasing causing arterial blood pressure to fall to a munium value what is this phase of the heart called
diastole
118
what represents the maximum pressure in the systemic arteries
systolic blood pressure
119
pressure peaks as blood is ejected from the left bentricle into the aorta during what phase
systole
120
the minimum pressure in the systemic arteries
diastolic blood pressure
121
increased cycle length will do what to diastolic blood pressure
decrease
122
increased total peripheral resistance (TPR) will do what to diastolic blood pressure
increase
123
what two factors does how low the diastolic blood pressure will fall depend on
cycle length (CL) and total peripheral resistance (TPR)
124
when may diastolic blood pressure not change much due to decrease in cycle length being offset by decreased total peripheral resistance
during excersise
125
1/3 pulse pressure + diastolic blood pressure roughly yields what
Mean Arterial Blood Pressure (MAP)
126
critical luminal pressure is required to keep arterioles from doing what
closing completly
127
vascular tone is proportional to what
critical closing pressure
128
as arterial pressure falls, ther is a critical pressure below which, flow ceases due to ...
closure of arterioles
129
if cardiac output is stopped, arterial pressure will fall and venous pressure will do what
rise
130
the equilibration pressure where arterial blood pressure is equal to venous blood pressure is know as
mean circulatory filling pressure (MCFP)
131
equilibration pressure may be prevented by what
the closure of arterioles (critical closing pressure)
132
what is responsible for pressure gradient driving peripheral venous return
Mean Circulatory filling pressure
133
at a given mean circulatory filling pressure as central venous pressure increases venous return will do what
decrease
134
if MCPF = CVP venous return will equal what
0
135
as central venous pressure increases, cardiac output increases due to what effects
intrinsic and extrinsic
136
the pressure in the central veins at the entry into the fight atrium are referred to as the
central venous pressure
137
central venous pressure is equal to
right atrial pressure
138
the pressor center, depressor center, sensory area, and cardioinhibitory area are the four major regions of what
Vasomotor center
139
the pressor center of the vasomotor center functions to
increase blood pressure
140
the depressor center of the vasomotor center functions to
decrease blood pressure
141
the sensory area of the vasomotor center functions to
mediate baroreceptor reflex
142
the cardioinhibitory area of the vasomotor center functions to
stimulate CN X
143
what center of the vasomotor center causes vasoconstiction, stimulates cardiac activity, and is tonically active exiting SNS outflow and is located in the anterolateral portion of the upper medulla
the pressor center of the vasomotor center
144
what center of the vasomotor center has fibers that project into and inhibit the pressor center, causes decreased cardiac activity, and vasodilation, and is located in the anterolateral lower part of the M.O.
the depressor center of the vasomotor center
145
what area of the vasomotor center receives input primarily from CN IX and X, has outputs to both pressor and depressor centers, mediates baroreceptor reflex and is located in the posterolateral portions of the pons and medulla in the nucleus tractus solitarius
Sensory Area
146
what area of the vasomotor center transmits impulses into DMNV inhibiting heart activity and is located medially next to dorsal motor nucleus of vagas
cardioinhibitory area
147
what maintains normal arterial blood pressure and is due to pressor center input
sympathetic vasoconstrictor tone
148
rapid short term control of blood pressure involves the nervous system effect on what
vascular smooth muscle
149
long term control of blood pressure is dominated by what organ
kidneys
150
control of blood pressure is accomplished by affecting what two things
vascular tone or blood volume
151
where are baroreceptors especially abundant in
carotid sinus and the arch of the aorta
152
baroreceptors are stimulated when stretched and inhibit was vasomotor center
pressor center
153
what receptors are located in atrial walls and pulmonary arteries and minimize arterial pressure changes in response to blood volume changes
low pressure baroreceptors
154
which reflex senses low pressure
baroreceptor reflex
155
which reflex senses increased heart rate
Bainbridge reflex
156
increased total peripheral resistance will not create a long term elevation of blood pressure if what does not change
fluid intake and renal function
157
what is the normal glomerular filtration rate
~100ml/min
158
what is normal renal blood flow
~1.25L/min
159
in the kidney constriction of afferent arterioles will have what effect on renal flow and GFR
decrease both
160
in the kidney constriction of efferent arterioles will have what effect on renal flow and GFR
decrease renal flow but increase GFR (by creating back pressure)
161
with rising arterial blood pressure constriction of what arterioles alone can autoregulate flow and GFR
afferent arterioles
162
what happens to arterial pressure when extracellular fluid levels rise
they rise as well
163
SNS stimulation, the renin-angiotensin system, aldosterone and ADH all have what effect on chronic blood pressure
raise it
164
what effect does ANP have one chronic blood pressure
decrease it
165
is the heart an endocrine organ
yes
166
norepinephrine, epinephrine and angiotesin II have what effect on renal blood flow
decrease
167
what hormone increases renal blood flow
Prostaglandins (E and I)
168
what monitors the Nacl in the macula densa of the distal tubule
tubuloglomerular feedback
169
where does tubuloglomerular feedback take place
between the afferent and efferent arteriole
170
renin is released from the juxtaglomerular cells causeing an increase in angiotensin II levels, causing and increase in efferent arteriole resistance in turn causing an overall increase in total blood pressure. what causes this cascade of events
a decrease in NaCl in the Macula densa
171
decrease in NaCl in the macula densa causes dilation of what arteriole
afferent
172
where is the synthesis, storage, and release of renin from
smooth muscle cells in afferent arterioles
173
decreased perfusion pressure, SNS stimmulation, decreased NaCl delivery to the macula densa as well as thyroid and growth hormone all stimulate the release of what enzyme from smooth muscle cells in afferent arterioles
Renin
174
what enzyme catalyses the formation of angiotensin 1 from angiotensinogen,
Renin
175
angiotensin I changes into angiotensin II via angiotensin converting enzyme in what tissue
primarily the pulmonary endothelium of the lungs
176
what hormone stimulates the adrenal cortex to secrete aldosterone, stimulates the release of ADH/vasopressin, and stimulates the kidneys
angiotensin II
177
the decrease of Na and H2O excretion from angiotensin II has what effect on blood pressure
increases blood pressure
178
increasing what will reduce the number of free radicals allowing nitric oxide (a dilator) to have a longer lasting effect in lowering blood pressure
antioxidants
179
what inactivates nitric oxide
superoxide
180
glutathione, melatonin, superoxide dismutase, beta-carotene, lutein, lycopene, selenium, Vit A, Vit C, Vit E, are all examples of what
antioxidants
181
what humoral substance may act at the CNS to inhibit relex SNS activation
Serotonin
182
what humoral substance may act centrally to inhibit sympathetic nerve activity
Nitric Oxide
183
what humoral substances my promote bradycardia and hypotension
Serotonin, Nitric Oxide
184
the umbilical arteries are branches off the anterior lilac arteries supplies blood to what
the placenta
185
blood returns to the fetus from the placenta via what vessel
umbilical vein
186
what fetal shunt fits the following path SVC --> RA -->RV --> pulmonary trunk --> ______-->aorta
Ductus arteriosis (DA)
187
what fetal shunt fits the following path IVC --> RA-->______ -->LA --> LV --> aorta
foramen ovale (FO)
188
what fetal shunt fits the following path umbilical vein -->_____-->IVC
Ductus Venosus (DV)
189
what fetal shunt fits the following path portal vein --____-->IVC
Ductus Venosus (DV)
190
what fetal shunts allow blood to bypass the lungs
ductus arteriosus and foramen ovale
191
what fetal shunt allows the umbilical and portal blood to bypass the liver
ductus venosus
192
how does oxygen saturation in the fetal blood compare to that of an adult
it is lower compared to an adult
193
upon birth pulmonary vascular resistance decreases causing an increase of blood flow through which organs
lungs and liver
194
how does the loss of blood flow through th placenta effect the systemic vascular reistance
it doubles the systemic vascular resistance
195
the reversal of pressure gradient between the RA and LA causes what to close
foramen ovale
196
reversal of flow from the aorta to the pulmonary artery, and increased oxygen levels causes constriction of smooth muscles causing the closure of what
ductus arteriosis
197
the closure of what allows portal blood to perfuse liver sinuses
Ductus venosus
198
patent ductus arteriosus,ventricular septal defect, transposition of great vessels and tetrology of follot are all examples of what
congenital deftects
199
what congenital defect is associated with right ventricular hypertophy, large ventricular septal defect, right ventricular outflow obstruction and overrides the aorta
tetrology of fallot
200
what are symptoms of tetrology of fallot
cyanosis, dyspnea
201
increased heart rate and decreased blood flow to organs are associated with what activity
excersise
202
during exercise cardiac output is increased how much
5-6 fold
203
vasoconstriction of arterioles to decrease flow to non active tissues, and vasoconstriction of veins to increase MCFP which increases venous return are both SNS effects activated by what
excersise
204
during excersise an increased O2 uptake will decrease VO2 causing what to happen to AVO2 difference
increase in AVO2 difference
205
increased heart rate and stroke volume induces what at the heart
local metabolic vasodilation
206
during exercise: reflex signals from active joint prorioceptors and muscle spindles, as well as local chemoreceptor signals originating in the active muscle stimulate what
SNS
207
SNS stimulation of pre-capillary resistance vessels during excersise (organs and inactive skeletal muscle) has what effect on blood flow
decreases blood flow
208
SNS stimulation of veins during excersise causes constriction which mobilizes blood out of veins doing what to venous return
increases by the redistribution of blood volume
209
SNS stimulation of vascular smooth muscle in walls of arteries helps maintain slightly ______ blood pressure during excersise
increased
210
will skeletal muscle activation trump SNS stimulation during excersise
yes
211
does metabolism trump constrictor effects during excersise
yes
212
increase in systolic blood pressure during exercise is due to what
increase in cardiac output
213
increased blood flow to the active muscles during exercise is not mediated by SNS but by the local release of _____________
tissue metabolites
214
tissue metabolites are released in response to the increase in what
metabolism local vasodilators
215
adenosine,CO2,K+ histamine and lactic acids are examples of
local vasodilatiors
216
coronary, and active muscle blood flow both _______ with excersise
increase
217
what % of blood flow is redirected to active muscle during excersise
90%
218
what is the cardiovascular endpoint that decreases with excersise
total peripheral resistance will decrease, and stroke volume will increase then decrease
219
the maximum volume of oxygen that one can take up from the lungs and deliver to the tissues/minute is known as
VO2 Max
220
what is the VO2 max in a cadiac patient
1.5L/min
221
what is the VO2 max in a sedentary man
3.0L/min
222
what is the VO2 max in a endurance athlete
6.0L/min
223
the VO2 max is proportional to what as training occurs
stroke volume
224
the function of cardiac output and AVO2 difference is
VO2 max
225
if energy demands of excercise cannot be met by oxidative phosphorylation what occurs
O2 debt
226
how does O2 debt get repayed
by respiration remaining elevated after excercise
227
restoring metabolite levels and metabolizing lactate generated by glycolysis is resolved by
extra O2
228
energy consumed during exercise - the energy supplied by oxidative metabolism yields what
O2 debt
