The Cardiovascular System

Front 1

What are the five general functions of blood?

Back 1

1. Transporting dissolved gases, nutrients, hormones and metabolic wastes

2. Regulating the pH and ion concentration in interstitial fluid

3. Restricting fluid loss at injury sites through clotting.

4. Defending against toxins in pathogens via white blood cells and antibodies

5. Stabilizing body temperature

Front 2

What is the volume of blood in an adult male in an adult female respectively

Back 2

5-6 L in a male, 4-5L in a female

Front 3

What is the hematocrit

Back 3

The percentage of formed elements in a sample of blood

Front 4

What is a normal hematocrit, or packed cell volume, (PCV)

Back 4

Males 46%

Females 42%

This difference reflects the fact that androgens stimulate red blood cell production where as estrogens do not

Front 5

What are formed elements in blood?

Back 5

Blood cells and cell fragments suspended in plasma. There are three types, platelets, white blood cells, and red blood cells

Front 6

Which cells are responsible for the production of formed elements?

Back 6

Myeloid stem cells and lymphoid stem cell

Front 7

What are platelets

Back 7

Small membrane-bound cell fragments that contain enzymes and other substances important for clotting

Front 8

What are white blood cells and what are the five classes

Back 8

Also known as leukocytes, they play a role in the body's defense mechanisms.

1. Neutrophils

2. Eosinophils

3. Basophils

4. Lymphocytes

5. Monocytes

Front 9

What are the three types of plasma proteins

Back 9

1. Albumins – most abundant proteins, major contributors to osmotic pressure, transporting fatty acids, thyroid hormones and some steroid hormones.

2. Globulins – 35% of proteins. Include antibodies, or immunoglobulins, and transport globulins, which bind ions and hormones

3. Fibrinogen – functions and clotting. 4% of plasma proteins

Front 10

What is the pH of blood

Back 10

Between 7.35 and 7.45

Front 11

What is a metalloprotein

Back 11

A globulin protein in plasma which transports metal ions

Front 12

What is an apolipoprotien

Back 12

A plasma globulin which carries triglycerides and other lipids in the blood. When bound to lipids it is known as a lipoprotein

Front 13

What is a steroid binding protein

Back 13

A plasma globulin which transports steroid hormones in the blood

Front 14

What is serum

Back 14

A plasma without clotting proteins (fibrinogen)

Front 15

Which organ synthesizes most of the plasma protient

Back 15

Liver

Front 16

What is a normal red blood cell count in males and females respectively

Back 16

Males 4.5–6.3 million/microliter

Females 4.2–5.5 million/microliter

Front 17

What are three effects of the biconcave shape of red blood cells

Back 17

1. Increases surface area to volume ratio

2. Enables red blood cells to form stacks (roulex) that smooth the flow through narrow blood vessels

3. Increases flexibility of red blood cells

Front 18

Why is the lifespan of a red blood cell relatively short

Back 18

Red blood cells lack nuclei and most organelles including mitochondria

Front 19

What are the normal ranges of hemoglobin content of whole blood

Back 19

Males, 14 – 18 g/dL

Females, 12 – 16 g/dL

Front 20

Describe the structure of hemoglobin

Back 20

Two alpha chains and two beta chains, Each with a single molecule of heme which holds an iron ion which interacts with an oxygen molecule

Front 21

What is oxyhemoglobin

Back 21

HbO2, hemoglobin with oxygen

Front 22

What is deoxyhemoglobin

Back 22

Hemoglobin molecules who's iron is not bound to oxygen

Front 23

How does oxygen-carbon dioxide exchange occur

Back 23

When oxygen levels are low as in the capillaries, hemoglobin releases oxygen and Under these conditions carbon dioxide levels are elevated and the alpha and beta chains of hemoglobin bind carbon dioxide forming carbaminohemoglobin

Front 24

What is hemoglobinuria

Back 24

The presence of alpha and beta chains from hemoglobin in urine which gives it a red or brown color. This is caused by an abnormally large number of hemolyzed RBCs

Front 25

What is hematuria, and what does it indicate

Back 25

The presence of intact RBCs in urine. Indicates kidney damage or damage to a vessel along the urinary tract

Front 26

What happens when a phagocytic cell engulfs a broken down rbc

Back 26

The globular proteins are broken apart into amino acids which are either metabolized by the cell or are released into the bloodstream.

Each heme unit is converted to Biliverdin, A green colored compound which gives bad bruise its greenish tint, then to Bilirubin which is excreted in the bile

Front 27

What is jaundice

Back 27

The inability of the liver to excrete Bilirubin which results in diffusion into peripheral tissues giving them a yellow color

Front 28

How is iron carried in the blood and why is this transport mechanism necessary

Back 28

Large quantities of free iron are toxic to the cell so Iron is transported on the protein transferrin.

Front 29

Where does erythropoiesis take place

Back 29

In adults it takes place in the red bone marrow, or myeloid tissue.

From the 2nd to 5th months of development The liver and spleen are the primary site

Front 30

What is pernicious anemia

Back 30

Anemia caused by deficiency of vitamin B 12, which is necessary for stem cell division

Front 31

Erythropoietin

Back 31

A glycoprotein formed by the kidneys and liver when exposed to low oxygen which stimulates erythropoiesis.

Front 32

What are the two effects of EPO

Back 32

Increases Cell division rates in erythroblasts and speeds up the maturation of RBCs by accelerating hemoglobin synthesis.

Front 33

What is mean corpuscular volume

Back 33

MCV, average volume of one red blood cell. Normal is 82–101µm³. Elevated levels are macrocytic, depressed levels are microcytic.

Front 34

Mean corpuscular hemoglobin concentration

Back 34

(MCHC) average weight of hemoglobin in one red blood cell.

Normal is 27–34 µg per red blood cell (Normochromic)

Elevated levels are turned hyperchromic, depressed levels are hypochromic

Front 35

Antigens

Back 35

Substances that can trigger a protective defense mechanism called in the immune response

Front 36

How is blood type determined

Back 36

By the presence or absence of surface antigens in rbc plasma membrane

Front 37

What constitutes type a blood type

Back 37

Surface antigen A only

Front 38

What constitutes a type B blood type?

Back 38

Surface antigen B only

Front 39

What constitutes type AB blood

Back 39

Red blood cells with both A and B antigens

Front 40

What constitutes type O blood type

Back 40

Red blood cells have neither A nor B surface antigens

Front 41

What is RH

Back 41

A surface antigen on red blood cells. Blood is either RH positive or Rh negative.

Front 42

Agglutinogens

Back 42

A collective term for surface antigens on RBCs

Front 43

If a person had a type a B blood what anti-bodies would we expect to see

Back 43

Anti-A antibodies

Front 44

What happens if a inappropriate blood type is used in a blood transfusion

Back 44

The cross-reaction. Antibodies will interact with surface antigens and cause red blood cells to clump or break up. These can cause obstruction in small vessels of the kidneys, lungs, heart and brain.

Front 45

What is the most common blood type

Back 45

O positive

Front 46

What are the four characteristics of circulating white blood cells

Back 46

1. All can migrate out of the bloodstream. Once activated adhere to walls in a process called margination. There they squeeze between endothelial cells and enter the surrounding tissue in a process called emigration

2. All are capable of amoeboid movement.

3. All are attracted to specific chemical stimuli. (Positive chemotaxis)

4. Neutrophils, eosinophils and monocytes are capable of phagocytosis

Front 47

What is hemolytic disease of the newborn

Back 47

A red blood cell related disorder caused by cross reaction between fetal and maternal blood types.

Front 48

Neutrophils

Back 48

Also called PMNs. Highly mobile nonspecific white blood cells. Cytoplasm packed with granules containing lysosomal enzymes and bactericidal compounds.

Neutrophils also release prostaglandins and leukotrienes which increase Capillary permeability and inflammation.

Front 49

Eosinophils

Back 49

Generally stain red and have a bilobed nucleus.

Primary mode of attack is exocytosis of toxic compounds such as nitric oxide and cytotoxic enzymes.

Especially effective against parasitic infection.

Also sensitive to allergens and sites injury where they release enzymes that reduce inflammation produced by mast cells and neutrophils

Front 50

Basophils

Back 50

Discharge granules which contain histamine, which dilates blood vessels, and heparin, a compound that prevents blood clotting

Front 51

Monocytes

Back 51

Kidney shaped nucleus. Monocytes enter peripheral tissues and become macrophages

Front 52

Lymphocytes

Back 52

Have three functional classes

1. T cells – cell mediated immunity

2. B cells – humoral immunity (activated B cells differentiate into plasma cells)

3. Natural killer cells- perform immune surveillance, detection and subsequent destruction of abnormal cells.

Front 53

What is cell mediated immunity

Back 53

The defense mechanism against invading foreign cells

Front 54

What is humoral immunity

Back 54

A specific defense mechanism that involves the production of antibodies. These antibodies are distributed by blood, limph and interstitial fluid and are capable of attacking foreign antigens throughout the body

Front 55

What is leukopenia

Back 55

Inadequate numbers of WBCs

Front 56

What is leukocytosis

Back 56

Excessive WBCs. Modest leukocytosis is normal during infection but extreme leukocytosis generally indicates the presence of some form of leukemia

Front 57

What types of white blood cells are classified as granulocytes

Back 57

Neutrophils, basophils, and eosinophils.

Front 58

What are the functions of platelets

Back 58

1. Release enzymes and factors at appropriate times to initiate and control process

2. Forming a temporary patch in the walls of damage vessels

3. Platelets contain filaments of actin and myosin which contract to shrink the clot and the size of the break in the vessel wall

Front 59

How do platelets form

Back 59

Megakaryocytes manufacture structural proteins enzymes and membranes. They begin shedding cytoplasm and small membrane enclosed packets within the red bone marrow

Front 60

What three substances influence the rate of platelet formation

Back 60

1. Thrombopoeitin - A peptide hormone produced in the kidneys that accelerates platelet formation and stimulates production of megakaryocytes

2. Interleukin 6 - a hormone that stimulates platelet formation

3. Multi CSS – stimulates platelet production promoting formation growth of megakaryocytes.

Front 61

Hemostasis

Back 61

Stopping of bleeding

Front 62

What are the three phases of hemostasis?

Back 62

Vascular phase, the platelet phase, the coagulation phase,

Front 63

What is a vascular spasm

Back 63

Local contraction of smooth muscle fibers of the vessel wall caused by cutting the wall of the blood vessel

Front 64

Describe the vascular phase

Back 64

Endothelial cells contract and release endothelins, which stimulates smooth muscle contraction and endothelial division. Endothelial cells become sticky and Adhere to platelets and each other

Front 65

Describe the platelet phase

Back 65

Platelets adhere to endothelial surfaces and form a platelet plug. They release ADP, which stimulates platelet aggregation, thromboxane A2 and serotonin, which stimulate vascular spasm, clotting factors, platelet derived growth factor and calcium ions

Front 66

How is growth of the platelet plug regulated?

Back 66

Prostacyclin, a prostaglandin that inhibits platelet aggregation is released by endothelial cells.

WBCs entering the area release inhibitory compounds.

Front 67

Describe the coagulation phase of hemostasis

Back 67

Complex sequence leading to the conversion of circulating fibrinogen into fibrin which traps blood cells and additional platelets to form a blood clot

Front 68

What are pro enzymes

Back 68

Proenzymes are inactive enzymes which can be converted to active enzyme

Front 69

Describe the extrinsic pathway of the coagulation phase of hemostasis

Back 69

The extrinsic ipathway begins outside the bloodstream in the vessel wall

Damaged endothelial cells release factor 3, also known as tissue factor.

Tissue factor then combines with calcium ions and clotting factor 9 to form an enzyme complex capable of activating factor X

Front 70

Describe the intrinsic pathway of the coagulation phase of hemostasis

Back 70

Intrinsic pathway begins in the bloodstream.

Activation of factor 12 in conjunction with PF-3 leads to activation of factors 8 and 9 which form an enzyme complex capable of activating factor 10

Front 71

Describe the common pathway of the coagulation phase of hemostasis

Back 71

Factor X, Activate's Prothrombin activator, which converts prothrombin into thrombin which completes the clotting process by converting fibrinogen into fibrin

Front 72

What kind of feedback loop is blood clotting

Back 72

Positive feedback loop

Front 73

How would low calcium ion levels or vitamin K levels affect clotting

Back 73

A calcium deficiency would impair blood clotting as all three pathways require calcium to proceed.

Vitamin K deficiency would prevent the liver from synthesizing four of the clotting factors including prothrombin

Front 74

Fibrinolysis

Back 74

The process of dissolving a clot.

Thrombin and tissue plasminogen activator Activate the proenzyme plasminogen, which turns it into plasmin.

Plasmin digests the fibrin strands and erodes the clot

Front 75

Right atrium

Back 75

Receives blood from the systemic circuit and passes it to the right ventricle

Front 76

Right ventricle

Back 76

Receives blood from the right atrium and pumps blood into the pulmonary circuit

Front 77

Left atrium

Back 77

Receives blood from the pulmonary circuit and pumps Blood into the left ventricle

Front 78

Left ventricle

Back 78

Receives blood from the left atrium and pumps blood into the systemic circuit

Front 79

Pericarditis

Back 79

Inflammation of percardial services.

The two surfaces can be heard rubbing against each other with the stethoscope

Front 80

Cardiac tamponade

Back 80

Increased fluid in the pericardial cavity which restricts movement of the heart

Front 81

What are the three layers of the heart?

Back 81

1. Epicardium

2. Myocardium

3. Endocardium

Front 82

Epicardium

Back 82

The visceral pericardium covering the outer surface of the heart.

Consists of exposed mesothelium and underlying loose areolar connective tissue

Front 83

Myocardium

Back 83

Muscular wall of the heart. Concentric layers of cardiac muscle tissue

Front 84

Endocardium

Back 84

The simple squamous epithelium which covers the inner surfaces of the heart and heart valves.

Front 85

Describe the structure of an intercalated discs

Back 85

Interlocking membranes are held together by desmosomes and linked by gap junctions

Front 86

What are four histological characteristics that distinguish cardiac muscle cells from skeletal muscle cells

Back 86

1. Small size

2. A single central nucleus

3. Branching interconnections between cells

4. The presence of intercalated discs.

Front 87

What 3 veins open into the right atrium and which parts of the body do they service

Back 87

1. Superior vena cava – delivers blood from the head, neck, upper limbs and chest

2. Inferior vena cava – delivers blood from the trunk, viscera, and lower limbs.

3. Coronary sinus – delivers blood from the cardiac means draining the myocardium

Front 88

Foramen ovale

Back 88

A structure present in embryonic development that penetrates the interatrial septum and connects the two atria of the fetal heart. This permits blood flow between the atria while the lungs are developing.

* usually sealed off within three months of delivery leaving the fossa ovalis.

Front 89

Where would you find pectinate muscles

Back 89

The anterior atrial wall and inner surface of the auricle

Front 90

How does blood travel from the right atrium to the right ventricle

Back 90

Via the right atrioventricular valve, also known as the tricuspid valve. The free edges of each cusp are anchored by Chordae tendineae which originate at papillary muscles. This prevents backflow during ventricular contraction

Front 91

What happens to blood during contraction of the right ventricle?

Back 91

What is forced through the conus arteriosus, a cone shaped pouch at the superior end of the right ventricle, which ends at the pulmonary valve. It then enters the pulmonary trunk which is the start of the pulmonary circuit.

Front 92

Where does the left atrium receives blood from?

Back 92

Via the left and right pulmonary veins

Front 93

Through what structures does blood pass in route from the left atrium to the left ventricle

Back 93

The bicuspid (or mitral) valve

Front 94

Blood leaves the left ventricle through which valve

Back 94

The aortic semilunar valve

Front 95

What is the function of the atrioventricular valves

Back 95

Prevents the backflow of blood from the ventricles to the atria when the ventricles are contracting.

Front 96

What is the function of the semilunar valves

Back 96

Prevent the backflow of blood from the pulmonary trunk and the aorta

Front 97

What are aortic sinuses

Back 97

Saclike expansions at the base of the ascending aorta that prevent individual cusps of the aortic valve from sticking to the wall of the aorta

Front 98

Where do the right and left coronary arteries originate

Back 98

At the left and right aortic sinuses.

Front 99

What is rheumatic fever?

Back 99

And inflammatory autoimmune response to infection by streptococcal bacteria that can lead to carditis which in turn can lead to valvular heart disease

Front 100

What is the cardiac skeleton

Back 100

Four bands of tough elastic tissue that encircle the heart valves and the bases of the pulmonary trunk aorta.

The bands stabilize the positions of the valves and ventricular muscle cells

Front 101

Where is the right coronary artery and what does it service

Back 101

Follows the coronary sulcus around the heart.

Services the right atrium, portions of both ventricles, portions of the conducting system of the heart, including the SA node in the AV node

Supplies the posterior interventricular artery

Front 102

Where is the posterior interventricular artery and what does it service

Back 102

Travels toward the apex of the heart within the posterior interventricular sulcus.

Services the interventricular septum and adjacent portions of the ventricles.

Front 103

What does the left coronary artery service

Back 103

Left ventricle, left atrium, and interventricular septum

Front 104

Describe the SA node

Back 104

The SA node is embedded in the posterior wall of the right atrium. Contains pacemaker cells which establish the heart rate. Generally depolarizes at a rate of 80–100/min

Front 105

Describe impulse conduction through the heart

Back 105

1. SA node depolarizes

2. Stimulus spreads across atrial surfaces and reaches AV node

3. Atria contract

4. Action potential travels along the intraventricular septum to Purkinje fibers and the moderator band.

5. Impulse is distributed by Purkinje fibers and ventricular contraction begins

Front 106

What is an ectopic pacemaker

Back 106

If a abnormal conducting cell or ventricular muscle cell begins generating action potentials at a higher rate and overrides the SA or AV nodes

Front 107

Describe the components of an EKG

Back 107

P- wave, Depolarization of the atria

QRS complex – ventricular depolarization. Ventricles begin contracting shortly after the peak of the R wave.

T-wave – ventricular repolarization

Front 108

What is the PR interval on an EKG

Back 108

Time measurement from the start of atrial depolarization to Q, the start of the QRS complex. Extension of the PR interval to more than 200 ms can indicate damage to the conducting pathways or AV node

Front 109

What is the Q – T interval in an EKG

Back 109

Time for ventricles to Depolarize and repolarize.

Measured from the end of the P – R interval to the end of the T-wave.

Longer than normal indicates electrolyte disturbances, conduction problems, coronary ischemia, or myocardial damage

Front 110

Describe the action potential in cardiac muscle cells

Back 110

1. At threshold, voltage gated fast sodium channels open and the sarcolemma is rapidly depolarized.

2. Fast sodium channels close as slow voltage gated calcium channels are opening. This maintains the membrane potential near 0 mV for an extended period.

3. Repolarization – slow calcium channels clothes and slow potassium channels open which restores resting potential

Front 111

Systole

Back 111

Contraction phase of heart muscle

Front 112

Diastole

Back 112

Relaxation phase of heart muscle. Chamber fills with blood

Front 113

What is end – diastolic volume

Back 113

The amount of blood in each ventricle after atrial systole.

Usually 130 mL in a resting adult

Front 114

Isovolumetric contraction

Back 114

The early stage of ventricular contraction when the semi lunar valves remain closed

Front 115

What is stroke volume

Back 115

The amount of blood ejected from each ventricle during systole.

Roughly 60% of end diastolic volume, approximately 70 to 80 mL of blood

Front 116

Isovolumetric relaxation

Back 116

The ventricles are in diastole, but blood cannot flow into them as pressure in the ventricles remains higher then the atria

Front 117

What is the primary method of ventricular filling

Back 117

Low pressures in the ventricles during diastole allow blood to pour freely through the atria and into the ventricles

Front 118

What are the S1 and S2 heart sounds

Back 118

S1 - Occurs at the beginning of ventricular contraction when the atrioventricular valves close.

S2- Occurs at the beginning of ventricular filling when the semilunar valves close

Front 119

What is a heart murmur

Back 119

A sound made when heart valves do not close properly and AV valve regurgitation occurs during ventricular systole

Front 120

What is cardiac output

Back 120

The amount of blood pumped by the left ventricle in one minute

Front 121

What two factors affect heart rate

Back 121

Autonomic innervation, and hormones

Front 122

What is the cardioaccelatory center and where is it found?

Back 122

Control sympathetic neurons that increase the heart rate and is found in the medulla oblongata

Front 123

What is the cardio inhibitory center and where is it found?

Back 123

Controls parasympathetic neurons that slow the heart rate and is found in the medulla oblongata.

Front 124

What is the atrial (Bainbridge) reflex?

Back 124

Also known as the Bainbridge reflex. When the walls of the right atrium are stretched, stretch receptors trigger a reflexive increase in heart rate by stimulating sympathetic activity

Front 125

What is the Frank-Starling principal

Back 125

Increasing the end diastolic volume results in a corresponding increase in the stroke volume

Front 126

What are three factors that influence end systolic volume

Back 126

Preload, contractibility of the ventricle, and after load

Front 127

What is contractibility?

Back 127

The amount of force produced during a contraction at a given preload.

Factors that increase contractibility have a positive inotropic action.

Factors that decrease contractibility have a negative inotropic action.

Front 128

Describe the Tunica media

Back 128

Smooth muscle and loose connective tissue which is mostly elastic fibers in arteries and collagen fibers in veins. The external elastic membrane is present in arteries and separates the Tunica media from the tunica externa

Front 129

Tunica externa

Back 129

The connective tissue sheath. In veins it contains some smooth muscle cells.

Front 130

What are vaso vasorum

Back 130

Small arteries and veins that supply the smooth muscle cells and fibroblasts of the Tunica media and tunica externa

Front 131

Elastic arteries

Back 131

Carry large volumes of blood away from the heart. High concentration of elastic fibers make these arteries extremely resilient to the pressure waves that accompany ventricular contraction

Front 132

Muscular arteries

Back 132

Thick Tunica media. Distribute blood to the body skeletal muscles and internal organs. Includes external carotid artery's, brachial arteries, and femoral arteries

Front 133

What are the two types of capillaries

Back 133

Continues Capillaries – The endothelium is a complete lining. Found in all tissue except cartilage and epithelium

Fenestrated capillaries - endothelium contains pores which allow rapid exchange of water and solutes between blood and interstitial fluid. Fenestrated capillaries are found the choroid plexus of the brain and in a variety of endocrine organs and along the digestive tract.

Front 134

What is afterload?

Back 134

Amount of tension that the contracting ventricle must produce to open the semilunar valve and eject blood.

As afterload increases stroke volume decreases

Front 135

Coronary artery disease

Back 135

Partial or complete blockage of coronary circulation generally caused by the build up of artherosclerotic plaque or a thrombus

Front 136

What diagnostic tests would be used to diagnose a myocardial infarction

Back 136

Elevated cardiac troponin T, elevated cardiac troponin I, and a special form of creatine phosphokinase CK – MB

Front 137

Cardiomyoplasty

Back 137

Surgical procedure that uses stimulated latissimus dorsi muscle to assist with cardiac function.

Front 138

Commotio cordis

Back 138

Sudden cardiac arrest as a result of a blunt hit or impact to the chest

Front 139

Congestive heart failure

Back 139

Condition of weakness, edema, and shortness of breath caused by the inability of the heart to maintain adequate circulation in the peripheral tissues and the lungs

Front 140

Cor pulmonale

Back 140

Weakness of the right ventricle due to prolonged hypertension in the pulmonary artery.

Front 141

What are the three layers of the walls of the arteries and veins

Back 141

The Tunica intima, Tunica media, and tunica externa

Front 142

Describe the Tunica intima

Back 142

The inner layer. Includes an endothelial lining which appears rippled in arteries and smooth in veins.

The internal elastic membrane is present in arteries.

Front 143

Collaterals and arterial anastomosis

Back 143

Collaterals are when multiple arteries supply a capillary bed. they fuse before giving rise to arterioles which is called arterial anastomosis

Front 144

What is an arteriovenus anastomoses and what happens when it is dilated

Back 144

Direct connections between arterioles and venules that when dilated allow blood to bypass the capillary beds.

generally occurs during sympathetic activation

Front 145

What triggers angiogenesis

Back 145

Vascular endothelial growth factor

Front 146

What is vasomotion

Back 146

Rhythmic contraction and relaxation of precapillary sphincter's which occurs perhaps 12 times per minute.

Front 147

Describe venous valves

Back 147

Folds of the Tunica intima that project from the vessel wall and point in the direction of blood flow.

Blood is then squeezed toward the heart by skeletal muscles.

Front 148

What is capacitance

Back 148

The ability of a blood vessel to expand at higher pressures. Veins have a higher capacitance than arteries, and can accommodate large changes in blood volume or pressure

Front 149

What happens during hemorrhaging

Back 149

Vasomotor center of the medulla oblongata stimulate sympathetic nerves which innervate smooth muscles in medium sized veins.

1. Venoconstriction decreases the blood volume within the venous system.

2. Constriction of veins in the liver, skin and lungs redistributes a significant proportion of the total blood volume.

Front 150

What is venous reserve?

Back 150

Amount of blood that can be shifted from veins in the liver, skin, and lungs to the general circulation.

Front 151

How is the mean arterial pressure calculated

Back 151

MAP = diastolic pressure + pulse pressure/3

*pulse pressure is the difference between systolic and diastolic pressure

Front 152

Distinguish between stage one hypertension and pre-hypertension

Back 152

Stage one hypertension is systolic blood pressure's from 140-159 or diastolic pressures 90–99

Prehypertension - systolic blood pressure is 120 - 139, diastolic pressures 80-89

Front 153

What two factors contribute to venous return to the heart?

Back 153

Muscular compression, and the respiratory pump

Front 154

What are the four functions of water movement from the capillaries to the lymphatic system

Back 154

1. Keeps plasma and interstitial fluid in constant contact

2. Accelerates distribution of nutrients, hormones, and gases

3. Assist in transport of insoluble lipids and tissue proteins that cannot enter the bloodstream via capillary walls

4. Carries toxins to lymphatic tissues

Front 155

What three factors affect tissue perfusion

Back 155

1. Cardiac output

2. Peripheral resistance

3. Blood pressure

Front 156

What are vasodilators.

Back 156

Factors that promote the dilation of precapillary sphincters

Front 157

Describe the process of autoregulation in regards the cardiovascular system

Back 157

Autoregulation involves changes in the pattern of blood flow within capillary beds as precapillary sphincters open and close in response to chemical changes in the interstitial fluid.

Front 158

Describe the process of autoregulation in regards the cardiovascular system

Back 158

Autoregulation involves changes in the pattern of blood flow within capillary beds as precapillary sphincters open and close in response to chemical changes in the interstitial fluid.

Front 159

Describe central regulation in regards to the cardiovascular system

Back 159

Central regulation involves both neural and endocrine mechanisms.

Cardioacceleratory center, and vasomotor center stimulate the heart and constrict vessels.

Endocrine response produces long term increases in blood volume and blood pressure

Front 160

Control vasoconstriction by the vasomotor center

Back 160

Neurons and everything peripheral blood vessels are adrenergic, they release norepinephrine, which stimulates smooth muscles causing constriction.

Front 161

Control vasoconstriction by the vasomotor center

Back 161

Neurons and everything peripheral blood vessels are adrenergic, they release norepinephrine, which stimulates smooth muscles causing constriction.

Front 162

Describe the control of vasodilation by neurons of the vasomotor center

Back 162

Cholinergic neurons release ACH, which stimulates endothelial cells to release NO causing relaxation of the vascular smooth muscle cells.

Front 163

Diagram the baroreceptor reflexes of the carotid and aortic sinuses

Back 163

Front 164

Chemoreceptor reflex

Back 164

Front 165

Diagram hormonal regulation which compensates for decreasing blood pressure or volume.

Back 165

Back (Definition)

Front 166

Diagram hormonal regulation of factors which compensate for increasing blood pressure or volume.

Back 166

Back (Definition)

Front 167

What are the carotid sinus

Back 167

Expanded Chambers near the basis of the internal carotid artery's

Front 168

What are the aortic sinuses

Back 168

Pockets in the walls of the ascending aorta adjacent to the heart.

Front 169

What are baroreceptors and where are they found in the cardiovascular system?

Back 169

Specialized receptors that monitor the degree of stretch in the walls of expandable organs.

Found in the carotid sinuses, aortic sinuses, and the wall of the right atrium.

Front 170

What are baroreceptors and where are they found in the cardiovascular system?

Back 170

Specialized receptors that monitor the degree of stretch in the walls of expandable organs.

Found in the carotid sinuses, aortic sinuses, and the wall of the right atrium.

Front 171

What happens to baroreceptors when blood pressure rises?

Back 171

Cardiac output decreases due to Parasympathetic stimulation in the inhibition of sympathetic activity.

Peripheral vasodilation due to inhibition of excitatory neurons in the vasomotor center

Front 172

What are baroreceptors and where are they found in the cardiovascular system?

Back 172

Specialized receptors that monitor the degree of stretch in the walls of expandable organs.

Found in the carotid sinuses, aortic sinuses, and the wall of the right atrium.

Front 173

What happens to baroreceptors when blood pressure rises?

Back 173

Cardiac output decreases due to Parasympathetic stimulation in the inhibition of sympathetic activity.

Peripheral vasodilation due to inhibition of excitatory neurons in the vasomotor center

Front 174

What effects are triggered by baroreceptors when blood pressure falls below normal

Back 174

Decreased baroreceptor activity, increases cardiac output through stimulation of sympathetic innervation in the cardioaccelatory center, as well as peripheral vasoconstriction caused by sympathetic vasoconstrictor neurons

Front 175

How can the Valsalva maneuver be used to check for normal cardiovascular responses to changes in arterial pressure and venous return

Back 175

The Valsalva maneuver causes increased inter-thoracic pressure which impedes venous return to the right atrium. The resulting drop in cardiac output and blood pressure stimulates the aortic and carotid baroreceptors causing a reflexive increase in heart rate and peripheral vasoconstriction.

When the maneuver ends blood pressure increases suddenly as does cardiac output, Which results in stretching of the baroreceptors.

Front 176

Where are chemo receptors located?

Back 176

In the carotid bodies, situated near the carotid sinus, and the aortic bodies, near the arch of the aorta.

Front 177

What four hormones are involved with long term regulation of blood volume

Back 177

1. Antidiuretic hormone

2. Angiotensin II

3. Erythropoietin

4. Natriuretic peptides

Front 178

What does antidiuretic hormone have on the cardiovascular system

Back 178

Stimulates water conservation by the kidneys, brings about vasoconstriction which elevates blood pressure.

ADH release is stimulated by decrease in blood volume, increase in osmotic concentration of plasma, or by circulating angiotension 2

Front 179

What effect does angiotensin II have on the cardiovascular system?

Back 179

1. Stimulates adrenal production of aldosterone, causing sodium retention and potassium loss in the kidneys.

2. Stimulate secretion of ADH

3. Stimulates thirst

4. Increases cardiac output and triggers constriction of arterials raising blood pressure.

Front 180

What effect does angiotensin II have on the cardiovascular system?

Back 180

1. Stimulates adrenal production of aldosterone, causing sodium retention and potassium loss in the kidneys.

2. Stimulate secretion of ADH

3. Stimulates thirst

4. Increases cardiac output and triggers constriction of arterials raising blood pressure.

Front 181

How is angiotensin II produced?

Back 181

Angiotensin II is produced when juxtaglomerular cells release renin in response to fall in renal blood pressure. Renin converts angiotensinogen to angiotensin 1. Angiotensin one is converted by angiotension – converting enzyme in the lungs to angiotension two.

Front 182

What are the effects of EPO on the cardiovascular system

Back 182

EPO causes vasoconstriction as well as stimulates production and maturation of red blood cells.

Front 183

What effect do natriuretic peptides have on the cardiovascular system?

Back 183

They reduce blood pressure and blood volume by.

1. Increasing sodium ion excretion

2. Increasing volume of urine produced

3. Reduce thirst

4. Block release of ADH, aldosterone, epinephrine, and norepinephrine.

5. Stimulate peripheral vasodilation

Front 184

Where are natriuretic peptide's produced and what triggers production?

Back 184

Atrial natriuretic peptide is produced in response to excessive stretching of the right atrium during diastole.

Brain Natriuretic peptide is produced when ventricular muscle cells are stretched during diastole

Front 185

How does exercise affect cholesterol levels?

Back 185

Exercise stimulates enzymes that move LDLs from the blood to the liver where they are converted to bile and excreted from the body. Exercise also increases the size of lipoprotein particles that carry cholesterol, making it harder for small proteins to lodge in vessel walls creating arthrosclerosis

Front 186

Diagram the cardiovascular responses to blood loss

Back 186

Back (Definition)

Front 187

What happens when compensatory mechanisms for blood loss fail?

Back 187

Shock

Front 188

Describe the short-term cardiovascular response to hemorrhaging

Back 188

As blood pressure begins to drop the carotid in the order reflexes increase cardiac output and cause peripheral vasoconstriction. Activation of the sympathetic nervous system triggers increase in vasomotor town as well as venoconstriction which mobilizes the venous reserve. Sympathetic activation also leads to the release of epinephrine and norepinephrine which increase cardiac output and extend vasoconstriction

Front 189

How does the body respond in the long term to blood loss

Back 189

Decrease in capillary blood pressure triggers recall of fluids from interstitial spaces.

Aldosterone and ADH promote fluid retention and reabsorption by the kidneys.

Thirst increases.

EPO stimulates maturation and production of red blood cells

Front 190

How are blood and nutrients transported into a developing fetus

Back 190

Via a single umbilical vein which carries blood from the placenta into the ductus venous of the liver where it joins fetal circulation in the inferior vena cava

Front 191

How are blood and nutrients transported into a developing fetus

Back 191

Via a single umbilical vein which carries blood from the placenta into the ductus venous of the liver where it joins fetal circulation in the inferior vena cava

Front 192

What is the ductus arteriosus

Back 192

A small muscular vessel which connects the pulmonary and aortic trunks during development.

Front 193

Intermittent claudication

Back 193

A limp which results from cramping leg pain that is typically caused by obstruction of the arteries

Front 194

Raynaud's phenomenon

Back 194

Discoloration of the fingers or toes when a person is subject to changes in temperature or to emotional stress.

Front 195

Which kinds of white blood cells contribute to the bodies nonspecific defenses

Back 195

Eosinophils, basophils, neutrophils and monocytes

Front 196

Name the 3 types of lymphocytes and identify their functions.

Back 196

1. T cells - cell mediated immunity

2. B cells - humoral immunity

3. NK cells - immune surveillance

Front 197

Which of the following is longer, the refractory period of Skeletal muscles or the refractory period of cardiac muscle

Back 197

The refractory period of cardiac muscle

Front 198

Cardiac arrhythmias - premature atrial contractions, PACs.

Back 198

Normal atrial rhythm is momentarily interrupted by atrial contraction. Often occur in healthy hearts. Stress, caffeine, and various drugs may increase the incidence of PACs.

Normal ventricular contraction follows

Front 199

Cardiac arrhythmias – paroxysmal atrial tachycardia

Back 199

A premature atrial contraction triggers a flurry of atrial activity. Ventricles are still able to keep pace heart rate jumps to approximately 180 bpm

Front 200

Cardiac arrhythmias – paroxysmal atrial tachycardia

Back 200

A premature atrial contraction triggers a flurry of atrial activity. Ventricles are still able to keep pace heart rate jumps to approximately 180 bpm

Front 201

Cardiac arrhythmias – atrial fibrillation

Back 201

Atrial impulses are too fast for the ventricles to keep up, atrial's quiver rather than producing organized contraction and are nonfunctional.

Because atrial contraction contribute so little to end diastolic volume The condition sometimes goes unnoticed, particularly in older individuals

Front 202

Cardiac arrhythmias – premature ventricular contractions

Back 202

Occur when a purkinjebcell or ventricular myocardial cell depolarizes to threshold and triggers a premature contractions.

Single PVCs are common and not dangerous, the responsible cell is in an ectopic pacemaker.

Front 203

Cardiac arrhythmias – ventricular tachycardia

Back 203

Four or more PVCs without intervening normal beats. May indicate a serious cardiac problem

Front 204

Cardiac arrhythmias – ventricular fibrillation

Back 204

Ventricles quiver and stop pumping blood. Responsible for cardiac arrest

Front 205

What are the results of alpha receptor stimulation

Back 205

Systemic arteriolar constriction

Epi and norepi stimulate

Front 206

What are the results of B1 receptor activation

Back 206

increased heart rate and force of contraction

Epinephrine stimulates

Front 207

What are the results of B2 stimulation

Back 207

Dialation of some vascular beds such as skeletal muscle and bronchodialation

Front 208

How is the Renin-Angiotensin System activated and what is the process

Back 208

Macula Densa cells in the juxtaglomerular apparatus produce renin which combines with angiotensinogen produced in the liver to form angiotensin 1. Angiotensin 1 is converted to angiotensin 2 which is a powerful vasoconstrictor. It also triggers aldosterone secretion which in turn leads Sodium --> water retention.

End result. Increased blood pressure.

Front 209

What is the Ejection Fraction and why is it important

Back 209

The percentage of the end diastolic volume pumped by the heart during each contraction.

Indicates the hearts efficiency as a pump