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Cardiopulmonary Physiology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What 2 pressures have the greatest effect on venous return?

A

Central Venous Pressure
Peripheral Venous Pressure

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2
Q

What effect does increased central venous pressure have on venous return?

A

increased central venous pressure –> decreased VR

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3
Q

What is the central venous compartment?

A

Includes Vena cava and right atrium

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4
Q

What 3 things affect the peripheral venous compartment?

A
  1. volume in peripheral veins
  2. venous vessel tone
  3. venous compliance
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5
Q

For max venous return, what pressure should the central venous compartment be at?

A

0 mmHg

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6
Q

For blood to keep flowing, what should be pressure relationship be between the peripheral venous compartment and the central venous compartment? Why?

A

peripheral venous P > central venous P
The peripheral venous compartment is anatomically before the central venous compartment. So if blood pressure is less in the peripheral venous compartment, there wouldnt be enough pressure to overcome the pressure in the central venous compartment to keep blood moving - it would just be stagnant

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7
Q

What is the immediate effect on venous return and then stroke volume if central venous compartment pressure is increased?

A

increased CVC P –> decreased VR –> decreased SV

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8
Q

What is the effect on left ventricle filling and stroke volume if central venous compartment pressure is increased?

A

increased CVC P –> increased LV filling –> increased SV

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9
Q

What input can influence venous function?

A

Sympathetic input

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10
Q

What does the venous function curve indicate?

A

indicates venous return (Y) based on central venous pressure (X)

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11
Q

What is the effect on venous return if there is an increase in blood volume?

A

–> increased peripheral venous pressure –> increased VR

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12
Q

What is the effect on venous return if venous tone is increased?

A

–> increased peripheral venous pressure –> increase VR

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13
Q

What is the effect on venous return if blood volume or venous tone is decreased?

A

–> decreased peripheral venous pressure –> decreased VR

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14
Q

What does the cardiac function curve indicate?

A

indicates cardiac output (Y) based on central venous pressure/ end diastolic volume (X)

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15
Q

What is inotropy?

A

contractility/degree of contraction (mechanical) -how strong a muscle contracts

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16
Q

What is chronotropy?

A

heart rate (electrical)

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17
Q

What is dromotropy?

A

conduction velocity (electrical)/ how fast electrical signal is propagated

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18
Q

What is lusitropy?

A

relaxation (mechanical) - how fast does a muscle relax

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19
Q

Does decreased afterload enhance or depress cardiac function?

A

enhance

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20
Q

Does increased heart rate enhance or depress cardiac function?

A

enhance

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21
Q

Does decreased inotropy enhance or depress cardiac function?

A

Depress

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22
Q

What is the role of capillaries?

A

Exchange of nutrients/waste

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23
Q

Where is most of the blood volume in the body?

A

veins/venules (Peripheral venous compartment) - 60-70%

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24
Q

What is transcapillary transport, and how does it work?

A

transport through capillaries via passive diffusion

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25
Q

How do lipophilic substances move through capillaries?

A

move through capillary endothelial cells

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26
Q

How do small, hydrophilic substances move through capillaries?

A

move through pores between the capillary endothelial cells

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27
Q

What is Fick’s Law?

A

relates to transcapillary solute diffusion; the flow through a tissue barrier over time depends on the difference in concentration across the membrane, the solute solubility, the molecular weight of the solute, the surface area for diffusion, and the diffusion distance (membrane thickness)

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28
Q

What pressure is caused by proteins, and why?

A

Oncotic pressure; proteins can’t diffuse through endothelial cells because of the negative charges on both –> repellant

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29
Q

What is the most abundant type of capillary, and what type of solute can diffuse across them?

A

continuous capillaries; lipophilic solutes

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30
Q

What is a fenestrated capillary?

A

a capillary that is 10x more water permeable than continuous capillaries; contains little “windows” in membrane for solutes to pass through (except for proteins)

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31
Q

What is a sinusoid/discontinuous capillary?

A

a capillary that has an incomplete membrane; very permeable to water, some proteins and other solutes

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32
Q

What drives the passive diffusion of water?

A

osmolarity (solute concentration)

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33
Q

What drives movement of water between interstitial fluid and intracellular compartment?

A

osmotic pressure

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34
Q

What drives movement of water between intravascular and interstitial compartments?

A

osmotic and hydrostatic pressure

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35
Q

What is the term for the net movement of water out of the capillaries?

A

capillary filtration

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36
Q

What is the term for the net movement of water into the capillaries?

A

capillary absorption

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37
Q

What is hydrostatic pressure?

A

the pressure generated from body fluid that changes with body orientation due to gravity; affects the venous and arterial side of cardiovascular system

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38
Q

What is mean arterial pressure (MAP)?

A

the pressure/force generated by the heart to overcome hydrostatic pressure; typically 100 mmHg = normal

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39
Q

What is oncotic pressure?

A

the pressure generated by the movement of water due to the presence of proteins (more proteins present = more water wants to come in)

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40
Q

Does a difference in hydrostatic pressure inside vs outside a vessel cause filtration or absorption?

A

filtration - hydrostatic pressure drives water out

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41
Q

Does a difference in oncotic pressure inside vs outside a vessel cause filtration or aborption?

A

absorption - in normal conditions, the oncotic P will be higher inside the vessel, so water will come in

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42
Q

If there is a positive net filtration rate, is the vessel experiencing filtration or absorption?

A

filtration (movement of water out of the vessel)

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43
Q

What happens to the net filtration rate if capillary oncotic pressure decreases?

A

increase in net filtration rate

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44
Q

What is the difference in hydrostatic pressure between the arteries and veins?

A

hydrostatic pressure decreases as you move from arterial –> venous

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45
Q

What is the role of the lymphatic system?

A

picks up excess fluid from the interstitial compartment and dumps it back into the cardiovascular system (because we spend more time driving water OUT of vessels)

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46
Q

What is laminar flow?

A

Smooth/streamlined flow with little mixing of contents

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47
Q

What is turbulent flow?

A

Irregular flow with heavy mixing of contents and more friction on vessel walls/endothelial cells

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48
Q

What is shear stress?

A

interaction of fluid with vessel walls/endothelial cells

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49
Q

What are some effects of increased shear stress?

A

the endothelial cells respond –> changes in intracellular calcium; can cause changes in vessel diameter, and the ventricle has to work harder

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50
Q

Describe flow-dependent vasodilation.

A

increased shear stress caused by blood flow –> increased production of calcium in endothelial cells –> activates eNOS (endothelial nitric oxide synthase) –> increased nitric oxide in endothelial cells –> NO diffuses to vascular smooth muscle –> vasodilation/relaxation of vessel –> decreased resistance –> decreased shear stress

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51
Q

What happens if endothelial cells are damaged or dysfunctional?

A

negative effect on flow dependent vasodilation (muscle can’t relax) because cells cant properly respond to shear stress to release more NO

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52
Q

Where might turbulent flow occur

A

branch points, areas of vessel narrowing (ex during vasoconstriction, disease)

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53
Q

Under normal conditions, what is the difference in pressure during systole vs diastole?

A

systole = higher pressure, diastole = lower pressure

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54
Q

What force drives blood to peripheral organs?

A

Mean Arterial Pressure

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55
Q

What is pulse pressure? What is its relationship to SV and aortic compliance?

A

proportional to SV; inversely proportional to aortic compliance;
systolic pressure - diastolic pressure

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56
Q

What is systolic BP?

A

the highest pressure in aorta that occurs right after the left ventricle finishes contracting

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57
Q

What is diastolic BP?

A

the lowest pressure that occurs in the aorta at the end of contraction

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58
Q

What is the effect on net filtration rate when the arterioles are experiencing vasoconstriction?

A

increased arterial pressure –> decreased downstream volume in caps and veins –> decreased pressure in caps and veins –> decreased hydrostatic pressure –> decreased net filtration rate (less water out) –> increased absorption (more water in)

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59
Q

What is vessel compliance? What determines compliance?

A

-the ease of stretch that a vessel experiences to accommodate fluid
-elastin : smooth muscle & collagen ratio
- more elastin = easier to stretch

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60
Q

What type of reservoir is the arterial compartment? Why?

A

-“pressure reservoir”
-arteries have a low elastin:SM/collagen ratio, meaning they arent very compliant, so adding more volume will increase the pressure more drastically because the arteries dont expand very well

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61
Q

What type of reservoir is the venous compartment? Why?

A

-“volume reservoir”
-Veins have a high elastin:SM/collagen ratio, meaning they are more compliant, so adding more volume wont drastically increase the pressure/veins can hold a lot of volume

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62
Q

What is the difference between compliance and elasticity? How does this apply to arteries and veins?

A

-compliance = ease of stretch
-elasticity = amount of recoil when stretched
-arteries are less compliant, but more elastic than veins

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63
Q

What 2 inputs/factors can increase tone in veins?

A

skeletal smooth muscle or sympathetic input

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64
Q

What happens in the venous compartments when you add/increase sympathetic input?

A

–> venoconstriction via SM contraction –> increased peripheral venous pressure –> increased VR –> increased central venous pressure

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65
Q

Which is greater, systemic or pulmonary pressure?

A

systemic pressure > pulmonary pressure

66
Q

How is the distribution of blood flow regulated?

A

changes in vascular smooth muscle (contraction/relaxation)

67
Q

What are the 3 immediate mechanisms to regulates distribution of blood flow/vascular resistance of an organ?

A

1) Neural influence (sympathetic input)
2) Local influence (autoregulation)
3) Endothelium-mediated (shear stress)

68
Q

What is the long-term mechanism for regulating the distribution of blood flow/vascular resistance of an organ?

A

Hormones

69
Q

What are the 2 types of local/autoregulatory mechanisms of blood flow?

A

1) myogenic
2) metabolic

70
Q

What vessel types have no smooth muscle?

A

Venules and capillaries

71
Q

In what vessel types would you find vascular smooth muscle?

A

arterioles, arteries, veins

72
Q

What is vascular tone?

A

the degree of vascular smooth muscle contraction or vessel constriction

73
Q

What is basal tone?

A

the “resting” state of a vessel

74
Q

What is the basal tone of an arteriole?

A

partial constriction

75
Q

What is the basal tone of a vein?

A

dilated

76
Q

Why is it beneficial that veins are mostly influenced by sympathetic input?

A

-parasympathetic input –> dilation/relaxation
-veins’ basal tone is in a state of dilation
-so if they were more influenced by parasympathetic input, then they would dilate even more, which would decrease VR

77
Q

Is vascular smooth muscle most affected by the sympathetic or parasympathetic system?

A

Sympathetic

78
Q

What are the 2 types of neural influences on vascular smooth muscle?

A

1) autonomic nervous system (SANS & PANS input)
2) neural reflexes (baroreceptors and chemoreceptors)

79
Q

What are variscosities?

A

a “swollen” area on a nerve fiber where norepinephrine (NE) is stored and released

80
Q

What is the difference between multi-unit and single unit smooth muscle?

A

-multi-unit = each individual muscle fiber has to be stimulated individually because there are very few gap junctions
-single unit = one is stimulated and all respond because there are lots of gap junctions; mostly hormone activated, very little innervation

81
Q

Which baroreceptor is the most prominent adrenergic (SANS) receptor on vascular smooth muscle?

A

alpha 1

82
Q

What neurotransmitter is associated with parasympathetic activation/cholinergic nerve fibers?

A

acetylcholine (Ach)

83
Q

What neurotransmitter is associated with sympathetic activation/adrenergic nerve fibers?

A

norepinephrine (NE)

84
Q

What is the effect of NE binding to alpha 1 receptors on vascular smooth muscle?

A

vasoconstriction

85
Q

What is the effect of NE binding to alpha 2 receptors on vascular smooth muscle?

A

vasoconstriction

86
Q

What is the effect of NE binding to alpha 2 receptors on endothelial cells?

A

relaxation/dilation (via production of NO which diffuses to the smooth muscle, because endothelial cells dont have any contractile properties)

87
Q

Where are beta 1 receptors primarily located?

A

cardiac myocytes

88
Q

What is the effect of NE binding to a beta 1 receptor in cardiac myocytes?

A

increased contractility & increased HR

89
Q

Where are beta 2 receptors primarily located?

A

vascular smooth muscle

90
Q

What do beta 2 receptors respond to/what binds to them?

A

-circulating epinephrine
-beta 2 receptors are NOT innervated

91
Q

Though it may vary based on the number of receptors present, what is the general effect of epinephrine binding to beta 2 receptors on vascular smooth muscle?

A

-relaxation/dilation

92
Q

What happens to upstream & downstream pressures if you decrease sympathetic input to arterioles?

A

decreased SANS input –> arteriolar vasodilation/relaxation –>
-decreased upstream pressure in arteries (bc blood can more freely flow from arteries to arterioles)
-increased downstream pressure in capillaries and veins (bc larger volume is moving faster out of the arterioles into capillaries, which are smaller vessels)

93
Q

What effect will increased SANS input on arterioles have on capillary filtration?

A

increased SANS input –> arteriolar vasoconstriction –>
-increased upstream pressure in arteries
-decreased downstream pressure in caps and veins (bc lower volume of blood moving through at a slower rate)–> decreased capillary filtration (because less volume and less pressure on caps)

94
Q

What effect does changing arteriolar tone have on the venous function curve? Why does it rotate instead of shift?

A

-rotates the venous function curve
-increasing arteriolar tone/constriction –> decreased venous return, but you still have the same central venous pressure because there was no change to CO

95
Q

Does changing arteriolar tone affect systolic or diastolic BP?

A

diastolic

96
Q

Does changing venous tone affect systolic or diastolic BP?

A

systolic
-venoconstriction –> increased VR –> increased end diastolic volume –> increased SV –> increased CO

97
Q

What is autoregulation?

A

-an immediate response to regulate the distribution of blood flow locally, despite perfusion pressure
-an automatic adjustment to blood flow in tissue that’s proportional to its current metabolic needs

98
Q

What is myogenic autoregulation?

A

smooth muscle in arterioles respond to the physical stretching of vessel (increased stretch –> vasoconstriction via stretch activated Ca channels)

99
Q

What is the most important influence on local blood flow?

A

Metabolic autoregulation

100
Q

What is metabolic autoregulation?

A

smooth muscle in arterioles respond to changes in interstitial fluid

101
Q

What are the 2 types of metabolic autoregulation?

A

1) active hyperemia
2) reactive hyperemia

102
Q

What is hyperemia?

A

increased blood flow

103
Q

What is active hyperemia?

A

increased blood flow as a result of increased metabolic rate of the tissue/organ

104
Q

What is reactive hyperemia?

A

increased blood flow above normal (temporarily) as a result of restricted flow

105
Q

What type of metabolic autoregulation do you experience while exercising?

A

active hyperemia

106
Q

-Which type of autoregulation would be most dominant if blood flow increases without a change in metabolic activity?
-What would be the result, vasoconstriction or vasodilation?

A

-myogenic autoregulation
-vasoconstriction (increased flow –> increased stretch –> increased intracellular Ca via stretch activated channels –> contraction)

107
Q

-Which type of autoregulation would be most dominant if blood flow increases and there is an increase in metabolic activity in systemic circulation?
-What would be the result, vasoconstriction or vasodilation?

A

-Metabolic autoregulation
-vasodilation

108
Q

What are the 2 major circulating catecholamines, and were are they secreted from?

A

-epinephrine and norepinephrine
-secretes from adrenal medulla

109
Q

What would be the effect of high concentrations of circulating epinephrine on vascular smooth muscle?

A

-epi can bind to beta 2 and alpha 1 receptors
-there are typically more alpha 1 receptors on vascular SM than beta 2
-so once the beta 2 receptors are full, then the epi will start binding alpha 1, which will cause vasoconstriction

110
Q

What would be the effect of low concentrations of circulating epinephrine on vascular smooth muscle?

A

vasodilation

111
Q

What is the effect of vasopressin?

A

vasoconstriction

112
Q

What is the effect of angiotensin 2?

A

very potent vasoconstriction

113
Q

What is the effect of atrial natriuretic peptide (ANP)?

A

vasodilation

114
Q

What is the short-term regulator or arterial blood?

A

Baroreceptors

115
Q

Does the system prioritize fixing/monitoring low BP or high BP? Why?

A

prioritizes low BP because damage/lack of flow to brain would be a more immediate problem

116
Q

How do you calculate mean arterial pressure (MAP)?

A

= CO x TPR (total peripheral resistance)
or
= [(Psystolic - Pdiastolic) / 3] + Pdiastolic

117
Q

How do you calculate cardiac output (CO)?

A

= HR x SV

118
Q

What is the most important short term (immediate) mechanism for regulating mean arterial pressure?

A

Arterial baroreceptor reflex

119
Q

What are the 2 locations where baroreceptors are found?

A

1) Carotid artery
2) Aorta

120
Q

What type of feedback is the arterial baroreceptor reflex?

A

negative feedback

121
Q

Why is the location of baroreceptors important/what do they respond to?

A

-the baroreceptor in the aorta detects pressure changes going out to the body - allows them to start compensating for the pressure change before the blood ever gets to the rest of the body
-the baroreceptor in the carotid artery detects pressure changes going to the brain

122
Q

Which is the most important baroreceptor?

A

-the carotid baroreceptor
-bc it responds to the tiniest pressure changes bc protecting the brain = most important

123
Q

What is the effect of increased blood pressure on cardiac output, MAP, and firing rate of baroreceptors?

A

increased BP –> increased CO –> increased MAP –> increased volume of blood ejecting from ventricle into aorta (ejection fraction) –> increased stretch on mechanoreceptors –> increased firing rate of receptors

124
Q

What is the effect of longer-term/chronic high blood pressure on baroreceptors?

A

-the baroreceptors will adapt to the new normal by increasing their “set-point” (basal firing rate) at that higher BP
-when the BP initially increased, baroreceptor firing rate increased, but over time the brain will tell them the high BP is now the new normal, so they will decrease their firing rate at that pressure to their basal tone –> now the body will no longer try to fix the increased BP

125
Q

Why are the baroreceptors not adequate for long term mean arterial pressure regulation?

A

because they tend to adjust their basal firing rate/set point after pressures are too high or too low for a longer period of time

126
Q

What is directly affected by changing arteriolar tone?

A

TPR (Total peripheral resistance)

127
Q

What is directly affected by changing venous tone?

A

VR (Venous return)

128
Q

What is total peripheral resistance?

A

Overall resistance to flow through the entire systemic circulation (based on flow through organs + flow between pulmonary and cardiovascular circulation)

129
Q

What is the effect on baroreceptor discharge/firing rate if MAP is increased?

A

increased baroreceptor discharge

130
Q

What is the effect on sympathetic activity if baroreceptor discharge is increased?

A

increased baroreceptor firing rate –> decreases sympathetic activity

131
Q

What is the effect on arteriolar tone if sympathetic activity is decreased?

A

decreased arteriolar tone

132
Q

What is the effect on central venous pressure if peripheral venous pressure decreases?

A

central venous pressure decreases

133
Q

What happens to peripheral venous pressure if venous tone is decreased?

A

decreases peripheral venous pressure

134
Q

What happens to capillary pressure if there is decreased vasoconstriction (arteries are relaxing)? Does this result in net capillary absorption or filtration?

A

-increases capillary pressure
-capillary filtration (fluid out)

135
Q

What 3 things are primarily affected by decreasing sympathetic input?

A

-decreased arteriolar tone
-decreased venous tone
-decreased cardiac contractility

136
Q

What happens to blood volume when there is decreased vasoconstriction?

A

decreased vasoconstriction = relaxation of arteries/arterioles –> increased capillary pressure –> decreased blood volume

137
Q

Why is mean arterial pressure important?

A

MAP drives blood through systemic organs

138
Q

How is arterial pressure regulated in long-term?

A

By regulating blood volume (kidney)

139
Q

What is glomerular filtration rate (GFR)?

A

the rate of movement of water (and thus Na+ bc sodium follows water) from capillaries to renal tubules

140
Q

What is the type of capillary found in the kidney that allows water and sodium to leave the capillaries so easily?

A

fenestrated capillary
-10x more permeable than continuous
-has little “windows” for stuff to get through

141
Q

What 2 pressure influence glomerular filtration rate?

A

1) net hydrostatic pressure
2) oncotic pressure

142
Q

What 2 things determine urine volume?

A

1) amnt of water filtered from cardiovascular system
2) amnt of water reabsorbed from kidney

143
Q

What volume influences blood volume?

A

urine volume

144
Q

What is pressure diuresis?

A

an increased renal output of water

145
Q

What is pressure natriuresis?

A

an increased output of sodium, which increases water loss

146
Q

If arterial pressure increases, what is the effect on urinary output rate, blood volume, and cardiac output?

A

increased arterial P –> increased urinary output –> decreased blood volume –> decreased cardiac output

147
Q

What is one of the most important mechanisms for regulating kidney reabsorption?

A

Renin-Angiotensin-Aldosterone System (RAAS)

148
Q

What is the effect on renin if glomerular filtration rate is decreased? (movement of water/sodium from capillaries to renal tubules is decreased)

A

decreased GFR (decreased MAP) –> increased renin secretion

149
Q

What is the role of aldosterone in long-term arterial pressure regulation?

A

-regulates renal sodium reabsorption
-increases sodium reabsorption –> increased reabsorption of water
-Net effect: increased blood volume, which increases arterial pressure

150
Q

What hormone regulates aldosterone?

A

Angiotensin II

151
Q

What hormone regulates angiotensin II?

A

Renin

152
Q

What is the role of Angiotensin II on long term regulation of arterial pressure?

A

-in vessels: serves as a vasoconstrictor
-in kidney: increases sodium and water absorption
-stimulates secretion of vasopressin which increases the increase in blood volume and thus arterial pressure even more

153
Q

What is the role of Atrial Natriuretic Peptide (ANP) on long term regulation of arterial pressure?

A

-releases from atria in response to the increased stretch resulting from increased blood volume
-effect: decreases renin, which decreases aldosterone, which decreases sodium and water absorption, which increases the amount excreted in urine (natriuresis and diuresis)
-Net effect: decreases blood volume and decreases arterial pressure

154
Q

Which direction is +Gz?

A

head to toe (blood moving toward feet)

155
Q

Which direction is +Gx?

A

Chest to back

156
Q

Which direction is +Gy?

A

side to side

157
Q

What 3 factors influence physiological effects/severity of gravity?

A

The forces
1) Magnitude
2) Duration
3) Direction

158
Q

What is linear acceleration?

A

Change in speed with no change in direction

159
Q

What is radial acceleration?

A

Change in direction with no change in speed

160
Q

What is angular acceleration

A

Change in speed AND direction

Cardiopulmonary Physiology (2 decks)

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