Ap Ii: Exam 2: Heart Ch 20 Pt 2

Front 1

Arteries carry blood _____ the heart

Back 1

away from

Front 2

Ateries provide rapid _______

Back 2

transport

Front 3

They are the main _____ reservoir in the vascular system (+100 mm Hg)

Back 3

pressure

Front 4

They have a large radii which allows ____ flow

Back 4

greater (high pressure- like a firemans hose)

Front 5

What kind of blood flows through vessels, oxygenated or deoxygenated?

Back 5

Both
Pulmonary Arteries: deoxy blood
Systemic Arteries: oxy blood

Front 6

Layers of an artery: Tunica ____, basement membrane, internal elastic lamina, Tunica ____, Tunica ____

Back 6

Interna, Media, Externa IME

Front 7

The tunica _____ allows for a smooth internal arterial passage

Back 7

interna: Endotheliem

Front 8

The ______ ______ holds the artery into place

Back 8

basement membrane

Front 9

The ____ ____ _____ provides stretchiness in the artery

Back 9

Internal elastic lamina

Front 10

The tunica _____ is made up of smooth muscle and is the thickest layer in the artery

Back 10

media

Front 11

The tunica _____ is the outer layer of the artery

Back 11

externa

Front 12

BLOOD VESSEL FLOW
Arteries-->Large/elastic-->medium/muscular-->Arterioles-->tissue-->capillaries-->venules-->veins/vasavasorum-->heart

Back 12

After blood leaves the medium arteries, it spreads out to head, arms, legs into arteriols

Front 13

ARTHERSCLEROSIS:
Progessive degenration arterial disease that leads to a gradual blockage of the vessel. This can lead to clots which cause _____ or _____

Back 13

Clots-->head=stroke
Clots-->heart=MI

Front 14

Arterioles are major _____ vessels because of their small radii

Back 14

resistance

Front 15

Arterioles are the main controller for blood distribution to local ______

Back 15

tissue

Front 16

Arterioles have: ____ ____, which is smooth muscle constricts/expands randomly with NO neural or hormonal control

Back 16

vascular tone

ARTERIOLES CONTROL WHERE BLOOD GOES

Front 17

Capillaries are the site of exchange of material between _____ and ____

Back 17

blood and tissue

Front 18

Capillaries bring blood to _______

Back 18

cells

Front 19

Capillaries are composed of a single layer of _______ cells with a basal lamina

Back 19

endothelial

Front 20

Can a capillary constrict or dialate?

Back 20

No, there is no muscle

Front 21

Continuous capillaries have no pores and allow only ____ and ____ to pass, everything else has to be transported

Back 21

O2 and CO2

Front 22

Continuous capillaries are found in the _____ _____ and blood/brain barrier

Back 22

skeletal muscle

Front 23

Fenestrated capillaries allow Glucose, Na+, and K+ to pass through because of holes in the membrane called _______

Back 23

fenestrations

Front 24

Fenestrated capillaries are found in the _____ and in the ventricles of the brain

Back 24

kidneys

Front 25

DIFFUSION/BULK FLOW:CAPILLARY
Serum proteins are made in the _______

Back 25

liver

Front 26

DIFFUSION/BULK FLOW:CAPILLARY
Serum proteins cannot leave the capillaries, so they create ______, where there is more stuff in the blood

Back 26

gradient

This works because:
WATER FLOWS TO AREAS OF GREATER CONCENTRATION

Front 27

DIFFUSION/BULK FLOW:CAPILLARY
Because water flows where there is stuff, the proper amount of serum proteins are crucial for proper _____ _____

Back 27

blood volume

Front 28

DIFFUSION/BULK FLOW:CAPILLARY
The capillaries has a ____-_____ membrane, allowing only certain things to pass through (O2, CO2, Na, K, Glucose, Amino Acids) and not other things (Serum proteins)

Back 28

Semi-permeable

Front 29

DIFFUSION/BULK FLOW:CAPILLARY
1. When blood is normal (high protein), water tends to stay in the blood.
2. When there is a liver or kidney failure (low blood protein), water will leave the blood and go into the tissue resulting in _______

Back 29

edema

Front 30

In CHF, the high pressure forces water out causing a backflow and resulting in ______

Back 30

edema

Front 31

Venules are little veins which _______ drain into

Back 31

capillaries

Front 32

Venules help carry blood to _____

Back 32

to veins; away from capillaries

Front 33

Veins return blood to the _____

Back 33

heart (capillaries carry blood away from heart)

Front 34

Veins have a low _____ and _____ at about 5 mm Hg

Back 34

resistance and pressure (as opposed to arteries which are stiff and don't strech which creates high flow 100-200 mm Hg)

Front 35

Veins have a low vascular tone and are able to ______ and accomadate more blood

Back 35

stretch

Front 36

________ vessels hold 64% of the body's blood

Back 36

Capacitance (veins/venules)

Front 37

How does blood travel so far? There are _____ in the lumen of veins which promote a one way flow

Back 37

valves

Front 38

MUSCULAR/RESPIRATORY PUMPS: VEINS
Because the pressure in the venous system is so ____, it needs something to get it to the heart quicker if the need arises (exersice)

Back 38

low

Front 39

MUSCULAR/RESPIRATORY PUMPS: VEINS
Working muscles ____ veins to push blood back to the heart

Respiratory pumps work because the pressure of the expanding lungs squeezes the _____ veins

Back 39

squeezes

thoracic

Front 40

VENOUS VALVE FAILURE: VERICOSE VEINS
Occurs when the valves can't hold the column of blood above them

The vein expands and dilates to accommodate the extra blood

Back 40

VENOUS VALVE FAILURE: VERICOSE VEINS
Superficial veins become more visible while in deep veins there is an increase risk of DVT

They are aggravated by prolonged standing

Front 41

Would the statement "all deoxygenated blood flow through veins" be accuarate? Why or why not?

Back 41

Systemic Arteries & Pulmonary Veins= oxygenated
Pulmonary Arteries= deoxygenated

Front 42

Do arteries have valves? Why or why not?

Back 42

No, they are high pressure blood distributors. Veins do, expand + contract= = control

Front 43

How does blood in veins get from the tip of your tow back up to the heart? Is there anything that helps it along?

Back 43

Muscles squeezes the veins which forces the blood to move up; the valves prevent backflow

Front 44

TOTAL PERIPHERAL RESISTANCE

TPR adjusts blood to the various areas of our body depending on the need of the body or the local tissue

For example, in exercising muscle needs more glucose/O2, so it gets more blood but do all the muscles need more blood?

Back 44

No, so in non-exercising muscles we actually see a decreased blood flow

This distribution of blood to the areas that need it is the job of the TPR

Front 45

Vasoconstriction = smaller radius / _____ flow

Back 45

higher

Front 46

TPR SCHEMATIC
TPR is controlled by 2 things _____ and _____

Back 46

Arteriole radius and Blood viscocity

Front 47

TPR SCHEMATIC
TPR controlled by:
1. Arteriolar Radius is controlled by Intrinsic Control and Extrensic Control

2. Blood viscocity is controlled by the number of _____ and the concentration of ______ ______ (thickness)

Back 47

RBC; plasma proteins

Front 48

TPR SCHEMATIC
TPR controlled by:
Arteriolar radius controlled by:
I. Intrinsic control:
1. Local metabolite build-up (O2, CO2, etc)
2. Local heat (dialate) or cold (constrict)
3. Histamine release (injury)
4. NO release

Back 48

TPR SCHEMATIC
TPR controlled by:
Arteriolar radius controlled by:
II. Extrinsic control:
1. Ang II (vasoconstriction)
2. ADH
3. Atrial natriuretic protein (ANP opposite of ADH)
4. Epi/norepi (vasoconstrict)
5. SNS

Front 49

MEAN ARTERIAL PRESSURE (MAP)
This is the main driving force for propelling blood into the ______

Back 49

tissues

Front 50

MEAN ARTERIAL PRESSURE (MAP)
It is highly regulated to ensure proper flow to the brain and other tissues

MAP is controlled by: 2 things

Back 50

MAP = CO x TPR

CO= SV X HR
SV= volume of blood ejected from a ventricle into aorta or pul. trunk each minute
TPR = viscocty and arteriole radius

Front 51

BLOOD PRESSURE REGULATION
_______ keeps blood regulated

Back 51

BLOOD PRESSURE REGULATION
Homeostasis

Front 52

BLOOD PRESSURE REGULATION
Two major system of Adjustment: ___ ___ and ____ ___

Back 52

BLOOD PRESSURE REGULATION
Short term and long term

Front 53

BLOOD PRESSURE REGULATION
1. Short Term: Neural/seconds
Alters CO & TPR via autonomic nerves; influences heart, veins, and arterioles

Back 53

BLOOD PRESSURE REGULATION
2. Long Term: Hormonal/min or days
-Adjusts salt & H2O
-Regulates urine output/thirst
-ADH (raise BP, gain salt)
- Ang II (raise BP)
- ANP (lower BP, salt loss)

Front 54

Short term BP Regulation is Neural (SNS, PNS); get up fast and feel dizzy

Back 54

Long Term BP Regulation is Hormonal; more effects on blood volume, which then effects BP

Front 55

Baroreceptors are pressure receptors located in the ____ ____ and the ____ ____

Back 55

carotid sinus; aortic arch

Front 56

Baroreceptors detect change in _____

Back 56

MAP (pressure)

Front 57

Chemoreceptors are located in the ____ ____ and ____ ____, next to the baroreceptors

Back 57

aortic arch and carotid sinus

Front 58

Chemoreceptors respond to very low ___ levels or high acid levels in the blood

Back 58

O2

Front 59

Chemoreceptors mainly alters ______ to increase O2 levels but will also increase MAP

Back 59

respiration

Front 60

Cardiovascular changes due to exercise: the body's goal is to _____ blood flow to get it to where it is needed

Back 60

increase

Front 61

CV CHANGES: EXERCISE
1. HR increases why
2. Venous Return increases why
3. SV increases why
4. CO increases why

Back 61

CV CHANGES: EXERCISE
1. SNS increases; PNS decreases
2.Repiratory and muscle pumps= Venoconstriction
3. Increases venous return and increased contractility due to SNS
4. Increased SV and HR

Front 62

CV CHANGES: EXERCISE
Blood flow to heart and skeletal muscle increases due to vasodilation that overrides systemic constrictor; Beta 2 receptor dilation

Back 62

Beta 2 is an SNS receptor and only dialates (vasodilation and bronchioles) stimulated by epinephrine

Increased blood--> increased noepi and epi--> Beta 2 =dilation

Front 63

CV CHANGES: EXERCISE
Blood flow to the brain changes?

Back 63

CV CHANGES: EXERCISE
No, cerebral flow is LOCAL ONLY

Front 64

CV CHANGES: EXERCISE
Blood flow to the skin?

Back 64

CV CHANGES: EXERCISE
Increases due to release of heat (=vasodilation)

Front 65

CV CHANGES: EXERCISE
Blood to viscera?

Back 65

CV CHANGES: EXERCISE
Decreases b/c of SNS vasoconstriction

Front 66

NET EFFECTS OF EXERCISE
TPR: Total Peripheral Resistance
Decreases; vasodilation to muscles/skin more effect than organ vasoconstriction

Back 66

NET EFFECTS OF EXERCISE
more openening than closing = drop in TPR

Front 67

NET EFFECTS OF EXERCISE
MAP: Mean Arterial Pressure
Modest Increase; the rise in CO is more than drop in TPR

Back 67

NET EFFECTS OF EXERCISE
MAP: Mean Arterial Pressure
In normal people, exercise should only increase BP around 20-30 mm Hg (resting=120; exercise=150)

Front 68

CIRCULATORY SHOCK
classic signs are 1 2 3

Back 68

CIRCULATORY SHOCK
1. Rapid resting HR
2. Weak Pulse
3. Skin is pale, cool, clammy

Front 69

A 21 y/o man brought into ED. He has a gunshot wound in abdomen that is bleeding continuously. His skin is pale, weak, and clammy. He has a weak resting pulse.

Back 69

He is experiencing hypovolemic shock

Front 70

TYPES OF CIRCULATORY SHOCK:
1. Hypovolemic
2. Cardiogenic
3. Vasogenic
4. Neurogenic

Back 70

TYPES OF CIRCULATORY SHOCK:
1. fluid loss
2. heart failure
3. widespread vasodilation
4. excruciating pain

Front 71

TYPES OF CIRCULATORY SHOCK:
1. Hypovolemic:
Severe hemmorage OR excessive vomiting, diahrrea, urination --> loss of fluid from plasma = BLOOD VOLUME LOSS = DECREASED CV = DECREASED MAP = SHOCK

Back 71

Not enough blood is getting back to the heart, it won't beat as strong, Decreases CO --> decreases MAP = shock

Front 72

TYPES OF CIRCULATORY SHOCK:
2. Cardiogenic- heart failure
Weakened heart (CHF, drugs)-->decreased CO-->decreased MAP = shock

Back 72

TREATMENT: IONOTROPH= makes heart work harder/stronger (Beta 1 agonsists) Dopamine

Front 73

TYPES OF CIRCULATORY SHOCK:
3. Vasogenic: widespread vasodilation
Septic shock (infection)=vasodilator (bacteria) OR Anaphylactic shock (allergy)=histamine release-->WIDESPREAD VASODILATION-->Decreased TPR-->Decreased MAP=Shock

Back 73

TREATMENT:
Epinephrine for allergy
Antibiotic for infection

Front 74

TYPES OF CIRCULATORY SHOCK:
4. Neurogenic: pain (crushing injuries with no real blood loss)
Decreased SNS nerve activity-->Loss of vascular tone-->Widespread vasodilation-->Decreased TPR-->Decreased MAP=shock

Back 74

TREATMENT:
Treat the pain

Front 75

IRREVERSIBLE SHOCK:
There is a finite amount of time for shock to be treated

Back 75

IRREVERSIBLE SHOCK:
Initially, when the body senses shock, it will REDIRECT blood flow to critical areas, the heart and brain

Front 76

IRREVERSIBLE SHOCK:
All non critical areas have dramatic decreased blood flow (viscera, skin, extremeties)

Back 76

IRREVERSIBLE SHOCK:
This is ok for a short amount of time, but then the local metabolites are building up in these tissues (O2 is being used up)

Front 77

IRREVERSIBLE SHOCK:
Eventually, the local control will override the systemic vasoconstriction and result in a MASSIVE VASODILATION that no drugs can correct

Back 77

IRREVERSIBLE SHOCK:
Further drop in venous return and CO, total fall in MAP = coma and death

Front 78

HYPERTENSION:
Normal BP in male is?
Normal BP in female is?

Back 78

HYPERTENSION:
120/80 mm Hg
110/80 mm Hg

Front 79

HYPERTENSION:
anything over 140/90 mm Hg

Only ___% of hypertensive have definite causes (genetic or adrenal tumor)

Back 79

HYPERTENSION:
10%; 90% is unknown (ediopathic) origin

Front 80

HYPERTENSION:
Treatment of hypertension:
Drug Regiments:
1. One drug + lifestyle changes
____ ____ or diuretics- "water pill"
2. 2 drugs + lifestlye changes
One of the above meds & ____ inhibitors or Ca channel blockers
3. Non-compliant patient + lifestyle changes
3 or more drugs

Back 80

1. BETA BLOCKER

2. ACE INHIBITOR