Lec 4 Flashcards

(74 cards)

1
Q

Blood pathway

A
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2
Q

Vascular Development (begins when)

A

3-4 weeks after conception

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3
Q

What cells differentiate into vessels

A

mesodermal

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4
Q

Vasculogenesis vs Angiogenesis

A

vasculo - formation of arteries and veins
ONLY DURING EMBROYONIC DEVELOPMENT

angiogenesis; formation of vascular branches from existing blood vessels OCCURS DURING EMBRYONIC AND THROUGHOUT LIFE

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5
Q

3 layers of blood vessels

A

tunica externa (adventitia) - outer connective tissue

tunica media - middle smooth muscle

tunica intima - inner endothelial layer

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6
Q

large elastic arteries

A

Aorta, left common carotid artery artery

tunica media

elastic fibers to allow expansion and recoil

constant flow of blood during diastole

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7
Q

Medium muscular arteries

A

femoral artery, axillary artery

tunica media

smooth muscle fibers to allow for regulation of diameter and control blood flow to different parts of the body

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8
Q

Small arteries and arterioles

A

controls the filling of capillaries

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9
Q

Distinguishing features of veins

A

larger and more compliant than arteries

thin walls (especially tunica media)

large lumens - larger blood reservoir

*one way valves

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10
Q

One way valves :

A

typically located in veins inferior to the heart

facilitate blood flow toward the heart

affected by autonomic nervous system and skeletal muscle pump

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11
Q

What does the autonomic nervous system regulate

A

BP and peripheral resistance

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12
Q

What are the sympathetic and parasympathetic roles in circulation?

A

sympathetic - increases HR and causes vasoconstriction

parasympathetic - decrease HR and cause vasodilation

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13
Q

Embryo: when does the heart develop

A

3 weeks after conception

recognizable structure after 20 days - heart tube that begins to elongate

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14
Q

When does circulation begin?

A

4 weeks gestation - rhythmic pulsations of primitive heart tube

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15
Q

Gestation
3 weeks
4 weeks
7 weeks

A

week 3; heart and vessels develop

week 4: heart begins to beat and pump blood

week 7: heart forms into 4 chamber structure

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16
Q

Shunting systems (prenatal)

A

small passages for blood to travel through in order to bypass body parts that are not yet developed

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17
Q

shunting systems; foramen ovale
Ductus arteriosus
Ductus venosus

A

foramen ovale; R atrium to L atrium

ductus arteriosus; R pulmonary artery to aorta

ductus venosus; inferior vena cava to umbilical vein

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18
Q

What happens to shunting systems?

A

close and form new structures

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19
Q

foramen ovale

A

fossa ovalis

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20
Q

ductus arteriosus

A

ligamentum arteriosum

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21
Q

umbilical venosus

A

ligamentum teres

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22
Q

ductus venosus

A

ligamentum venosum

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23
Q

umbilical arteries

A

lateral umbilical ligaments

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24
Q

_ % of live births have congenital heart disease

A

1

leading non-infectious death in 1st year

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25
CV development; infancy and childhood
left side of heart becomes predominant left ventricle wall becomes twice as thick by adulthood heart changes from horizontal to vertical orientation with lung expansion heart size increases with body weight
26
Heart volume (infancy and childhood)
40 mL at birth 80 mL 6 months 160 mL at age 2
27
Ratio of heart voume to body weight
remains constant = 10 mL/kg of body weight
28
Cardiac muscle changes in infancy and childhood
Myocytes; increase in cross sectional area and number of myofibrils in cross-section increased contraction of myocyte myofibrils mature and change from a random orientation to being oriented in the same direction stroke volume = increased efficiency NO INCREASE IN THE NUMBER OF MYOCYTES
29
Vascular changes infancy and childhood
increased heart vascularization at birth - 1 vessel for every 6 muscle fibers adulthood 1:1 ratio Fetal blood has more Hb and less O2 saturation As infants lungs begin to function, blood has less Hb and more O2 saturation
30
Newborn, 3-6 month and adult Hb levels
newborn: 20g/100mL 3-6 month: 10g/100mL Adult: 14-16g/mL
31
What happens to blood volume through development
300-400 mL at birth to 5 L in adults
32
What happens to stroke volume through development
increases, directionally proportional to heart size 4mL at birth 40mL in children 60 mL in adults
33
What happens to HR through development
decreases in newborns HR is faster to compensate for lower stroke volume (110) At one years old, HR decreases to 105 bmp
34
What happens to blood volume during development
influenced by development of autonomic nervous system and peripheral vascular resistance increase is strongly related to increase in height and weight
35
CV development adolescence
- heart size and weight keeps growing - increased left ventricle and stroke volume - *As body weight increases, blood pressure increases - boys > girls
36
CV development adulthood
- heart size may increase due to fatty deposition most evident in women; increase seen between 30-60s
37
CV changes with aging
Vessels become thicker and stiffer and less flexible = increased peripheral resistance = increased BP = heart works harder = muscular walls become thicker Decreased blood volume and RBC WBC remain same (But lymphocytes decrease)
38
Adult heart disease***
leading cause of death 1 million heart attacks per year 5 million adults with heart failure
39
conducting zone
passageway for air to travel, nose pharanyx, laranyx, trachea, bronchi and bronchioles
40
Respiratory zone
located deep in the lungs respiratory bronchioles, alveolar ducts, alveoli
41
Where is the respiratory center
brain stem - medulla oblongata and pons
42
what controls ventilation
autonomic nervous system sympathetic nervous - bronchial dilation parasympathetic - bronchial constriction
43
Muscles of inspiration
- main: external intercostals, diaphragm accessory: - SCM - Scalenes group - pec minor
44
exhalation muscles
quiet breathing: recoil of lungs, rib cage and diagphram active breathing: internal intercostals, abdominals, QL
45
Tidal volume;
amount of air inhaled or exhaled at rest with each breath
46
residual volume
amount of air remaining in the lungs following expiration
47
minute ventilation
total volume of air inspired and expired in one minute
48
when is prenatal pulmonary development
4-8 weeks differentiation of trachea, long buds form, bronchi begin to form
49
6 weeks neonatal pulmonary
primitive alveoli form
50
8 weeks neonatal pulmonary
conducting zone developed
51
24 weeks neonatal pulmonary
surfactant is reduced
52
26-28 weeks neonatal pulmonary
viable respiratory zone (vascularized terminal sacs and surfactant)
53
Pulmonary at birth
rib cage is horizontal and muscles not fully developed
53
What happens after achievement of sitting
- ribs become angled - diaphragm forms dome-shaped - muscles strogner - increased effciency
54
Pulmonary in childhood and infancy
- increased alveoli until 8 years - airways are smaller in children - decreased smooth muscle in bronchiole walls (until 3-4 years) - decreased alveolar elasticity until puberty and collateral ventilation mechanism - decreased compliance and elasticity = increased workload for breathing *Implications: - increased risk of respiratory infections until 6-8
55
Pulmonary adolescence
- increased size proximal airways and vasculature - increase in alveolar size, elastic fibers and capillaries to alveoli = INCREASED GAS EXCHANGEE 19 YEARS - SMOOTH MUSCLE IN ARTERIAL WALLS OF ALVEOLI ARE FULLY DEVELOPED
56
19 Year pulmonary
SMOOTH MUSCLE IN ARTERIAL WALLS OF ALVEOLI ARE FULLY DEVELOPED efficient control of blood flow through vasoconstriction and vasodilation
57
When do functional impairments of pulmonary present
7th decade (60s)
58
Thoracic wall and muscular changes in pulmonary aging (and their result)
stiffer bony thorax, decreased joint mobility decreased expansion of chest wall during breathing decreased strength and endurance of inspiratory muscles (accessory muscles have to work harder) altered length-tension relationship of muscles = INCREASED WORK OF BREATHING
59
Pulmonary adulthood/aging LUNG changes;
decreased compliance and elasticity decrease vital compacity *body responds to these changes with an increase in breathing rate in order to increase minute ventilation
60
Alveolar changes in adult/aging
decreased elasticity - risk for collapse increased size of lungs and alveoli due to increased residual volume = MORE TIME REQUIRED FOR INSPIRED AIR TO REACH ALVEOLI
61
Vascular changes (pulmonary) in adult/aging:
smaller capillary bed around alveoli decreased blood flow/volume in capillary bed
62
Big picture adulthood/aging
PULMONARY SYSTEM IS WORKING HARDER AND LESS OXYGEN IS IS DELIVERED TO THE BODY
63
Newborn
HR: 120-125 BP: 73/75 RR: 30-40
64
2 years
HR: 110 BP: 91/56 RR: 25-32
65
10 years
HR: 90 BP: 102/62 RR: 20-26
66
16 years
HR: 75-80 BP: 117/67 RR: 16-20
67
Adult < 45 and 45-65
HR: 74-76 BP; 120/80 (140/85) RR: 10-20
68
Older adult
HR" 74-76 BP; 150/85
69
CV Adaptations to long term exercise
increased: max cardiac output and SV, plasam volume, hemoglobin, HDL Decreased; resting HR, BP, LDL
70
Pulmonary Adaptations to long term exercise
increased; minute ventilation, vital capacity, tidal volume decreased: inspiratory/expiratory reserve, respiratory rate at submax exercise
71
What reflect the efficiency of the cardiopulmonary system
cardiac output, minute ventilation, maximal aerobic capacity
72
minute ventilation
tidal volume x respiratory rate = minute ventilation
73
maximal aerobic capacity
determined by level of CV and pulmonary fitness