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ACOLS > Microcirculation and Physiology > Flashcards

Microcirculation and Physiology Flashcards

1
Q

What is diffusion?

A

Migration of particles from higher to lower concentration
- equilibrating movement
- random movement

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2
Q

What causes diffusion to happen more quickly? (3)

A
  • as temperature increases
  • the greater the difference in concentration
  • smaller molecules diffuse faster
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3
Q

To ensure sufficient gas exchange and metabolism a ______ ________ distance is imperative.

A

short diffusion

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4
Q

What is the normal distance between cells and blood capillaries?

A

1/10 mm

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5
Q

What increases the diffusion distance by 100x?

A

Swelling of just 1cm

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6
Q

When swelling is present what happens to the immune response and why?

A

The immune system is compromised due to the increased distance defence cells have to travel. Also, there is a decrease in nutrition that reaches the cells.

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7
Q

Movement of water molecules that occurs in ONE direction across a semi-permeable membrane.

A

Osmosis

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8
Q

To move water back across the cell membrane, pressure _______ to the osmotic pressure must be applied.

A

pressure equal

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9
Q

Protein molecules are hydrophilic - the force of protein molecules attracting water is called ___-____ ______.

A

colloid-osmatic pressure

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10
Q

In 24hs what percentage of circulating protein will leave the blood capillaries into the interstitial space?

A

50%

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11
Q

The concentration of proteins in the plasma is ____ more than the interstitial fluids. Thus plasma proteins cause a _______ colloid-osmatic pressure.

A

3x - higher

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12
Q

COP pl represents and is equal to ____ mmHg.

A

Colloid Osmotic Pressure of the blood plasma proteins - 25 mmHg

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13
Q

COP ip represents and is </> COP pl.

A

Colloid Osmotic Pressure - less than

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14
Q

A sufficient return of venous blood to the heart depends on: (5)

A

1) Muscle pump
2) Valves
3) Diaphragmatic breathing
4) Suction effect of the hears
5) Pulsation of adjacent arteries

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15
Q

Distribution of blood vessels in the body.
Systemic Venous System _____%
Systemic Arterial System _____%
Pulmonary Circuit _____%

A

64%
13%
9%

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16
Q

BCB is blood capillary pressure is _____ mmHg in the arteriole capillaries vs ____mmHg in the venous capillaries.

A

29mmHg - 14mmHm

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17
Q

The blood supply to the capillary beds is based on the demand of the ______.

A

tissues

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18
Q

A band of smooth muscle located in the media of the precapillary arterioles controlling the blood flow.

A

Precapillary sphincter

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19
Q

If the precapillary sphincter contracts this means (more/less) volume and (increase/decrease) BCP.

A

less - decreased (increase in water reabsorption)

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20
Q

If the precapillary sphincter dilates this means (more/less) volume and (increase/decrease) BCP.

A

more - increased (more filtration or water into the interstitial area)

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21
Q

What internal factors control the precapillary sphincters (2) using what portion of the autonomous nervous system (ANS)?

A

1) Oxygen receptors in the tissues
2) Tissue Hormones
-Sympathetic Nervous System

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22
Q

What external factor control the precapillary sphincters? (2)

A

Temperature (heat/cold)
Massage (releases histamines which cause dilation)

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23
Q

What force tears away the water from protein molecules in the arterial capillaries?

A

Hydrostatic (filtration)

24
Q

The higher BCP arterial can overcome the force of which protein holds onto water molecules. This causes what to happen?

A

Forces water through the blood capillaries into the tissues.

25
Q

What occurs at the venous end of the capillary due to BCPven < COPpl?

A

REABSORPTION - Water is reabsorbed back into the blood capillaries.

26
Q

Water leaving the blood (capillaries) via _________ washes over the tissue cells carrying nutrients and solutes with it.

A

filtration

27
Q

Water returning to the capillary system via _______ deposits waste products from the cells back into the venous system.

A

reabsorption

28
Q

What percentage of water remains in the tissues and what is this called?

A

10-20% - Net Filtrate or Lymphatic Load of H2O

29
Q

BCPart and COPip are ________ forces.

A

Outward (pulling water out)

30
Q

COPpl and Tissue pressure are _____forces.

A

Inward (pulling water in)

31
Q

Subtracting inward forces from outward forces on the capillary will determine _________ _________.

A

effective filtration

32
Q

Active Hyperemia is

A

anything that causes vasodilation.

33
Q

If the lymphatic load of H2O increases so does the lymph time volume due to activation of the Lymphatic _____ ______

A

Safety Factor

34
Q

Active Hyperemia is caused by (5)

A

1) Massage
2) Inflammation/Infection
3) Temperature/thermal modality
4) Sunbathing
5) Vigorous Exercise

35
Q

Passive Hyperemia is caused by (8)

A

1) Increased Blood capillary pressure caused by obstruction
2) Cardiac Insufficiencies
3) Pregnancy
4) Obesity
5) Chronic Venous Insufficiency
6) DVT
7) Sedentary
8) Immobility

36
Q

What happens in passive hyperemia?

A

Blood pools in the capillaries causing an increase in BCP net filtrate.

37
Q

What is Hypoproteinemia?

A

Abnormally low levels of protein in the blood.

38
Q

What Causes Hypoproteinemia? (4)

A

1) Decreased protein intake
-malnutrition
2) Decreased protein synthesis
- chronic liver disease (cirrhosis)
3) Increased protein loss
- malabsorption (intestine)
- protein-losing gastropathy
(stomach)
4) Protein-losing nephropathy- kindey (nephrotic syndrome >3.5g/24hr protein loss)

39
Q

How many grams of protein does the body attempt to maintain in the blood?

A

75gm

40
Q

With hypoproteinemia what happens to COPpl thus filtration and reabsorption?

A

COPpl - decrease
Filtration - increase
Reabsorption - decreased

41
Q

What causes a Dehydration Reaction?

A

This is the body’s response to an increase in net filtration - a decrease in circulating fluid, a drop in BP.

42
Q

What occurs during a Dehydration Reaction?

A

1) Renal blood flow decreased - low urine output
2) Feeling of thirst
3) Minimal sweating
4) Blood diverted to heart/brain

43
Q

What is the maximum amount of lymph fluid a healthy system is able to transport in a given length of time called?

A

Transport Capacity
- 10x higher than the normal Lymphatic Load

44
Q

The body’s ability to react to an increase in lymphatic load by increasing contraction frequency is called?

A

Functional Reserve

45
Q

What term represents the amount of lymph fluid the lymphatic system is able to transport?

A

Lymph Time Volume

46
Q

The functional reserve (FR) enables the lymphatic system to respond to an increase in lymph fluid volume with an increase in

A

Lymph Time Volume

47
Q

What is Lymphatic Dynamic Insufficiencies?

A

The Lymphatic system is overwhelmed. Lymph Time Volume (LTV) and thus the Total Capacity have maxed out.

48
Q

Why does Manual Lymphatic Drainage not work with Dynamic insufficiencies?

A

Since MLD increases LTV and with Dynamic Insuficiencies LVT is already at its maximum capacity it is not effective.

49
Q

What causes Dynamic Insufficiency?

A

Insufficient Venous Return - CHF, pregnancy, venous insufficiency.

50
Q

The therapeutic Approach for Dynamic Insufficiency includes what? (4)

A

Ambulation, elevation, exercises and if indicated - compression garments.

51
Q

Why does long-term dynamic insufficiency cause secondary damage to the Lymphatic System?

A

Increased intra-lymphatic pressure (max TC) results in damage to the collector walls and valve system.

52
Q

Mechanical or “Low-volume insufficiency causes what to happen to the transport capacity?

A

Drops below normal amounts

53
Q

What causes Mechanical Insufficiencies?

A

Surgery
Radiation
Infections
Trauma
Chronic Venous Insufficiency
Congenital Malformation

54
Q

In mechanical insufficiency what is damaged and unable to cope with even a normal lymphatic load?

A

Transport Capacity

55
Q

When protein, water and waste products are not removed from the interstitium what happens?

A

Causes tissue damage and increases diffusion distance for immune cells to respond leading to an increased incidence of cellulitis.

56
Q

What is the term for lymphedema caused by not only mechanical insufficiency but also an increased lymphatic load?

A

Combined Insufficiency

57
Q

How quickly can swelling occur in Combined Insufficiency?

A

1 day

ACOLS (7 decks)

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