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CVS Physiology > Microcirculation > Flashcards

Microcirculation Flashcards

1
Q

بسم الله الرحمن الرحيم
فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !

“إن أصحاب الجنة اليوم في شغل فاكهون “

“إذ يقول أمثلهم طريقة إن لبثتم إلا يوما” !!!!

describe artetrioles metartrioles

A

arterioles : Its diameter 10-15 microm
and it is highly musclar
divides 2-5 times

metartrioles : it is diamete 5-9 micrometre
its musclar layer encircle the vessels at intermittent segemtnts

there is pre and post capillary sphincters

only 5% of circulating blood found in capillaries

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2
Q

Functions of microcirculation mention

A

1-Connection between arterial and venous circulation
2-Gas nutrients and metabolites for hmoeostasis
3-Fluid distribution between intra and extravascular spaces

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3
Q

Not ture capillaries inculde :

A

1-met arterioles
2-throughfare vessels
3-AV shunt

for rapid conduction of blood from arterial side to venous side

function :
Temperature regulation  why ? because they contain smooth muscle fibers and nerves

they are large capacitance vessels
they are larger than terminal arterioles
they have low resistance

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4
Q

True capillaries describe .

A

They are disnged for exchange

they arise from the metarterioles and throghfare vessels and for every capillary arise from the connecting vessels there is precapillary sphincter is affected by
the neural control but the most potenet effector is the metabloic activity of the tissues
and there is only 25%of the capillaries that are open !

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5
Q

Structure of the capillaries and types

A

single layer of enodthelium lying on surrounded by basement membrane
there is no smooth muscles

types :

1-Fenestrated
2-non fenstrated
3-siunsoidal

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6
Q

Describe non fenestrated capillaries

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

A

They are non fitering tissue with continuous endothelium and no fensetations :
1- in Skeletal and smooth and cardiac muscles they have 4-10nm pores allowing passage of water and water soluble ions
2-in brain it is contiunous + tight junctions preventing passage of substances between blood and brain called BBB and only permit small molecules

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7
Q

describe the Fenestrated capillaries

the

A

they have gaps pores in the endothelial cells differ among tissues 20-100nm
found in kidney intestine ,endocrine glands
the fenestrations allow passage :
Kideny : waste products
intestine : digestive substances
endocrine glands : the hormones in blood

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8
Q

describe sisuoidal capillaries

A

The capillaries have large fenestrations 600-3000nm
allow passage of large particles like proteins and cells
occur in RES Liver spleen and Bone Marrow

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9
Q

GR /the capillaries are the vessels of the body of the extremely slowest blood flow

A

This is due to The larges TCA

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10
Q

Although the capillaries are of 5um thickness but the RBCS OF 7um can move through why ?

A

This due to the defomability of the RBCS called Parachute RBCs during its enetry into the capillary .
the centre is ahead of the edges

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11
Q

GR/the capillaries don’t rupture if the pressure reaches 30-40 mm Hg

A

Due to its very small diameter according to the Law of Laplace
T= P x R

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12
Q

Why dilated capillaries rupture at 20 mm Hg pressure ?

A

Due to its large radius and this leads to high tension casuing its rupture accoding to Law of Laplace

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13
Q

Defintion of Vasomotion property of capillaries

A

It is alternating openinig and closure of the capillary casuing intemettncy of the flow inside the capillary 6-12 times/minute according to the metabolic needs of tissue

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14
Q

Show the concept of Vasomotion in capillaries

A

This is alternting opeing and closure of the capillaries due to :
1-Persistant Vasomotor tone causing the closure of the precapillary sphincter and this leads to accumulation of metabolites in the capillary due to tissue activity
2-accumulation of metabolites causes opeining of the precapillary sphincter and wash out of the metabolites and this leads to return of the effect of the vasomotor tone and closing the precapillary sphincter causing decrease in pressure of capillary and the surrounding tissue will compress it

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15
Q

Factors affecting vasomotion mention

A 
Metabolic
Myogenic
Neurogenic 
Temperature 
chemicals
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16
Q

describe the metabolic factor on vasomotion

A

the accmulation of metabolites causes increasing the times opeining phase of the vasomtion cycle
lack of o2 and high co2

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17
Q

What is the evidnce of the effect of the Metabolites on precapillarty sphincters ?

A

Injection of blood with high conc of o2 causing decrasing the times of opeining of the precapilalry sphincter and vasomotion

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18
Q

the Myogenic factor in vasomotion decribe ?

A

There may be a pascemaker in the smoothe muscles of the aretrioles causuign this phenomenon
leading to VC

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19
Q

The chemical effect on vasomotion discuss

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

A

there are dilators of precapillary sphincter is Histamine , Bradykinin ,Substance B
There are constrictors of precapillary sphincters are Catecholamine adrenomedullary

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20
Q

discuss the temperature effect on the vasomotion ?

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

A

increased temperature increases the metabolic activity of the tissues causing metabolite accumulation

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21
Q

Describe the nervous effect on the VASOMOTION

A

There is no effect os symp or parasymp on the vasomotion :-
but there is a vasomotor tone on it

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

22
Q

Capillary blood pressure equals ?

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

A

30-35 mmHg at aretrial side and 10-12 at venous side and the mean capillary pressure is 17 mmHg

23
Q

the capillary blood pressure is affected by venous pressure than arterial pressure . why ?
The capillary blood pressure in nearer to the venous blood pressure . why ?
Any rise in the venous blood pressure leads to equal rise in the capillary blood pressure and
Any rise in the arterial blood pressure leads to rise in capillary pressure by 1/4 OF THE Arterial rise why ?

A

This is becasue the tone of artrioles and the precapillary resistance is 4-5t times stonger than the tone of venules and the postcapillary resistance

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

24
Q

What are the consequences of :the tone of artrioles and the precapillary resistance is 4-5t times stonger than the tone of venules and the postcapillary resistance

A

1-The capillary blood pressure is affected by venous pressure than arterial pressure.

2-The capillary blood pressure in nearer to the venous blood pressure .

3-Any rise in the venous blood pressure leads to equal rise in the capillary blood pressure and
Any rise in the arterial blood pressure leads to rise in capillary pressure by 1/4 of the arterial side

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

25
Q

Mention factors affecting the capillary blood pressure .

A

1-precapillary sphincter tone reisitance and diameter of arteriole
2-postcapillary sphincter tone resistance and diameter of venule
3-gravity

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد

26
Q

فشئ من الصبر الآن علي ألم ترك الهوي تجد بعد ذلك منه رفعة !
عند الصباح يحمد القوم السري
داوم علي المفيد
لا تذاكر للامتحان ذاكر للمستقبل !

Mention Factor affecting capilary permeability .

A

They are
1-the organ itself : high in kidney , intestine , endocrine glands low in skeletal muscles and brain
2-the activity of the tissue increasing the metabollites
3-the venular end is more than the arterial end
4-plasma proteins decrease the permeability
5-inflammatory mediators increasing the permeability like substance p , pyrogens ,toxins

27
Q

Mention hypoproteniemia causes and its effect on the capillary permeability

A 
1-Liver disease
2-kideny disease
3-malnutrition 
4-starvation 
\_\_\_\_\_\_\_\_\_\_\_\_\_--
it increases the capillary permeability !
28
Q

لاتغتر بباطل اثبته علي نفسك !
What is the value of pp at the arteriolar end of capillary and when it is vanished and why it equals 0 at the venular end ?>

A

35-30=5mmHg and it is =0 when VC

and it is =0 at venular end due to post capillary resistance

29
Q

Diapedesis ?

Vesicular transport

A

خلايا الدم البيضاء بتحشر نفسها بين خلايا الطلاء وتنزل منها

طريقة نقل للمواد الكبير مثل البروتينات من النسيح واليه عن طريق اللحم
endocytosis and exocytosis

30
Q

diffusion is ?

A

passive
no demand for energy !
according to concerntration gradient in contrast to filtration that is dependnt on pressure gradient

31
Q

Diffusion mean ?

A

it is the movement of water and water soluble substances o2 and co2 through the concentration gradient and this depends on :-

  • Capillary permeability
  • Lipid solubility
  • Molecular size of the substance itself
32
Q

Starling forces mean ?

A

The filtration pressure : the gradient between hydrostatice pressures of the capillay and ISF
The reabsorption pressure : osmotic pressure due to albumin together with its gibbs-donan effect

33
Q

why 20 litre if filtered while 18 liter are reabsorped and where do the 2liters remaining go ?

A

Becasue the rate of filtration is more than the rate of reabsoprtion at venous side and the 2 liters go to the lymphatic capillaries to returm to the circulation if there is lymphatic obstruction there will be a non pitting lymphatic odema

34
Q

describe flow limited exchange

and diffusion limited

A

Flow limited exchange it is of rapid equilibrium of the substance near the arteriolar end depeding on the amount of blood coming through the capillary like 02

Diffusion limited when the equilibrium is slow and occur along the length of the capillary adn it dpends on the diffusion itself

35
Q

starling forces at arterial end

A

moving fluid outward
capillary pressure 30 mmHg
interstitilal colloidal pressure 8 mmHg
- interstital fluid pressure 3 mmHG SUM = 41 mmHg

Moving inward
palasma oncotic pressure =28 mm Hg

Net filtration force = 41-28=13 mm Hg

36
Q

starling forces at the venous side :

A

moving outward
capillary pressure 10
intersitial colloidal 8
- interstitial pressure 3 SUM =21 MMHG

Moving inward
Capillary oncotic pressure =28 mm Hg
net reabsorption pressure = 28-21=7mmHg

37
Q

Na reabsorption pressure reabsorp 18 litre despite it is 7mmHg although the Net filtration pressure filter 20 litres despite its is 13mmHg?

A

Becasue of the high permeability at the venous side

38
Q

Anemia probability dt hds

what is lymph ?

A

it is the excess ISF tha isnot reabdorped by t he capillaries it enters lymphatic circulaiton to return to venous criuclation and blood and it is isotonic it contains low proteins except the liver lymph and the albuimn globulin ratio is high and it is creamy due to fat and it can be coaulgted due to coagulants proteins contains lymphoctes as it passes through the lymphnodes and it has many functions :

Excess fluid reabsortion into the circulation keeping normal interstitial fluid pressure and play a role in
fluid turnover

Defense due to lymphocytes and it passes through LN

39
Q

how is interstitial fluid pressrue increased ?

A

this is due to increased capillary pressure ,capillary permaebility , hypoproteniemia
1- increased capillary pressure due to increased Venous pressure
2-increased permeability due to allergy inflammatory mediators and toxins
3-hypoproteniemia due to liver disease renal disease starvation malnutrition

40
Q

ولقد كنت في حلاوة طلبي العلم ألقى من الشدائد ما هو عندي أحلى من العسل لأجل ما أطلب وأرجو. كنت زمان الصبا آخذ معي أرغفة يابسة فأخرج في طلب الحديث، وأقعد على نهر عيسى فلا أقدر على أكلها إلا عند الماء. فكلما أكلت لقمة شربت عليها، وعين همتي لا ترى إلا لذة تحصيل العلم.

ماثمرة ذلك يا ابن الجوزي؟

A

فأثمر ذلك عندي أني عرفت بكثرة سماعي لحديث الرسول ﷺ وأحواله وآدابه، وأحوال أصحابه وتابعيهم، فصرت في معرفة طريقه كابن أجود. وأثمر ذلك عندي من المعاملة ما لا يدري بالعلم، حتى أنني أذكر في زمان الصبوة ووقت الغلمة والعزبة قدرتي على أشياء كانت النفس تتوق إليها توقان العطشان إلى الماء الزلال، ولم يمنعني عنها إلا ما أثمر عندي العلم من خوف الله عز وجل. ولولا خطايا لا يخلو منها البشر، لقد كنت أخاف على نفسي من العجب. غير أنه عز وجل صانني، وعلمني، وأطلعني من أسرار العلم على معرفة

41
Q

tissue activity and Lymph flow relation ?

A

Incraeasd tissue activity increases the metabolites casuing dilatation of the precapillary sphincters and this leads increasing flow of blood into capillary and the pressure and the filtration so intersistial fluid pressure

42
Q

Mention Lymphatic pumps .

A 
Contraction of wall of the ducts 
Contraction of skeletal muscles 
Valves prevent backward flow 
Negative intrathoracic pressure causing dilatation of the vessel decreasing its pressure increasing pressure gradient 
Arterial pulsations
43
Q

Discuss Lymphagogues .

A

They are substances maintiaing the lymph flow :
primary : peptones -bacterial endotoxinis increasing capillary permeability and filtration and isf pressure and lymph
secondary like hypertonic glucose solution as it casues initial decrease in flow due to its absorption of fluid from ISF and then when it is diluted the capillary is dilated and increeased in pressure causing increased filtration and ISF pressure and Lymph dormation

44
Q

Factor affecting lymph flow mention >?

A

lymphatic pumps
lymphagogues
ISF Pressure
Tissue activity

45
Q

EDEMA OR OEDEMA MEAN ?

A

Swelling of tissues due to accumulation of fluid in tissues dt ?

increased Filtration or
decreased reabsorption
Lymphatic obstruction

46
Q

Increased filtration due to ? in odema specific

A

increased capillary pressure
arteriolar dilation
venuloconstriction

due to increased venous pressue :
Heat failure !
Pregnancy ! : uterus comprssing the veins decreasing VR
Venous thrombosis !

increased capillary permaeability bradykinin substrance b histamine
allergy
bacterial toxins
inflammation

47
Q

decreased reabsorption casuse?:” in odema

A

Hypoproteniemia :
this is due to :> liver cirrhosis ,renal disease , Malnutrition , Starvation

Lymphatic obstruction : filaria
او بسبب ورم مثلا
التهاب جامد في الاوعية الليمفاوية مغلقها !

48
Q

Mention type of edema

A

Localized : triple response
Genralized : Pitting and non pitting edema
pitting due to : HF and renal disease hepatic disease malnutrition decreasing proteins synthesis
albumin content of fluid is not high !
non pitting : inflammatory edema and malignant edema and there is high intersitital tissue fluid pressure and high albumin content
ISF P + Albumin ?!

49
Q

The pressure in capillary in systemic circulaton / Lung must increase by …../,,,,,,,, to cause edema ?

A

1- 17 mm Hg

2- 27 mmHg

50
Q

the safety factors from odema ?

A

1- the negative ISF pressure
2-in case of increased ISF Prssure the lymph flow can be increased 10-50 folds draining the excessive fluid
3-decreasd protein concentration in ISF that is becasue the amount of removed more thant filtered and so decreasing ISF oncotic pressure :)

وقالوا الحمد لله الذي صدقنا وعده وأورثنا الأرض نتبوأ من الجنة حيث نشاء . فنعم أجر العاملين

51
Q

تأملت أحوال الناس في حالة علو شأنهم، فرأيت أكثر الخلق تبين خسارتهم حينئذ. فمنهم
من بالغ في المعاصي من الشباب،
ومنهم من فرط إكتساب العلم،
ومنهم من أكثر من الإستمتاع باللذات.
فكلهم نادم في حاله الكبر حين فوات الإستدراك لذنوب سلفت أو قوى ضعفت، أو فضيلة فاتت، فيمضي زمان الكبر في حسرات. فإن كانت للشيخ إفاقة من ذنوب قد سلفت قال
: واأسفا على ما جنيت.
وإن لم يكن له إفاقة صار متأسفا على فوات ما كان يلتذ به.

فإما من أنفق عصر الشباب في العلم فإنه في زمن الشيخوخة
يحمد جنى ما غرس

، ويلتذ بتصنيف ما جمع،
ولا يرى ما يفقد من لذات البدن شيئا

بالإضافة إلى ما يناله من لذات العلم.

هذا مع وجود لذاته في الطلب الذي كان يتأمل به إدراك المطلوب. وربما كانت تلك الأعمال أطيب مما نيل منها

A

ولقد تاملت نفسي بالإضافة إلى عشيرتي الذبين أنفقوا أعمالهم في اكتساب الدنيا، وأنفقت زمن الصبوة والشباب في طلب العلم، فرأيتني لم يفتني مما نالوه إلا ما لو حصل لي ندمت عليه. ثم تأملت حالي فإذا عيشي في الدنيا أجود من عيشهم، وجاهي بين الناس أعلى من جاههم. وما نلته من معرفة العلم لا يقاوم. فقال لي إبليس: ونسيت تعبك وسهرك؟ فقلت له:أيها الجاهل، تقطيع الأيدي لا وقع له عند رؤية يوسف. وما طالت طريق أدت إلى صديق

CVS Physiology (14 decks)

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