A&P2 Blood Vessels, A/P-Blood Vessels/Anatomy of Blood Vessels, A and P blood vessels, A&P Heart & Blood Vessels, Mastering A&P blood vessels, A & P Lab blood and vessels, A&P blood vessels and immune, A&P Blood vessels, Blood Vessels A&P, A&P Blood...

Proposed Local Metabolic Vasodilators

"not well understood" Adenosine, ATP-ADP, O-CO, K, H, Nitric Oxide, Prostaglandins

Hypertension

(high blood pressure) #1 risk factor for stroke, CAD, heart attack, kidney disease

Net filtration

** SEE pg 94-95

3. Blood Vessel Diameter

***Primary Factor in Resistance Frequently changes in arterioles Primary physiological determinant of peripheral resistance.

Endothelial Control of Local Blood Flow

**See pic

_____ have a thick wall, especially the tunica media, and they have a small lumen

Arteries

_____ take blood away from the heart

Arteries

(Systemic circuit) blood flows into _____ and then into _____

Arteries Arterioles

Name 5 major types of blood vessels

Arteries Arterioles Veins Venules Capillaries

Stretch, Contract

Arteries are elastic meaning they can ________ and _____________

Which of the following are involved directly in pulmonary circulation? A) superior vena cava, right atrium, and left ventricle B) right ventricle, pulmonary artery, and left atrium C) left ventricle, aorta, and inferior vena cava D) right atrium, aorta, and left ventricle

B

Fibrous plaques

Atheromas composed almost exclusively of smooth cells and fibrous tissue

P wave

Atria contract (systole)

How does ANP affect blood pressure

Atrial natriuretic peptide, promotes NA excretion and water excretion to decrease blood volume/BP

Papillary Muscles

Attach the chordae tendinae to ventricular walls

Anti-myeloperoxidase (MPO-ANCA)/p-ANCA

Autoantibody against MPO which is a lysosomal granule constituents normally involved in generating oxygen free radicals Characteristic of microscopic polyangiitis and Churg-Strauss syndrome

Anti-proteinase-3 (PR3-ANCA)/c-ANCA

Autoantibody against PR3 which is a neutrophil azurophilic granule constituent that shares a homology to several microbial peptides Typical of Wegener ganulomatosis

Autoregulation

Automatic adjustment of blood flow to each tissue relative to its requirements Controlled intrinsically by modifying diameter of local arterioles feeding capillaries (independent of MAP) Organs regulate own blood flow by varying resistance of own arterioles Metabolic and myogenic controls

What is the proper term for tissue monitoring its own perfusion?

Autoregulation

How can we regulate peripheral resistance?

Autoregulation Neural

Hereditary Hemrrhagic Telangiectasia (Osler-Weber-Rendu disease)

Autosomal dominant disorder wherein the malformations are composed of dilated capillaries and veins

Blood flow to the skin ________. A) is controlled mainly by decreasing pH B) increases when environmental temperature rises C) increases when body temperature drops so that the skin does not freeze D) is not an important source of nutrients and oxygen for skin cells

B

Hemorrhage with a large loss of blood causes ________. A) a lowering of blood pressure due to change in cardiac output B) a rise in blood pressure due to change in cardiac output C) no change in blood pressure but a slower heart rate D) no change in blood pressure but a change in respiration

B

In the dynamics of blood flow through capillaries, hydrostatic pressure ________. A) and osmotic pressure are the same B) is the same as capillary blood pressure C) generally forces fluid from the interstitial space into the capillaries D) is completely canceled out by osmotic pressure

B

Mechanisms that do not help regulate blood pressure include ________. A) nervous control that operates via reflex arcs involving baroreceptors, chemoreceptors, and higher brain centers B) the dural sinus reflex C) renal regulation via the renin-angiotensin system of vasoconstriction D) chemical controls such as atrial natriuretic peptide

B

Modified capillaries that are lined with phagocytes are called ________. A) sinuses B) sinusoids C) thoroughfare channels D) anastomoses

B

Normal average blood pressure for a newborn baby is ________. A) 120/80 B) 90/55 C) 150/90 D) 130/80

B

The arteries that are also called distributing arteries are the ________. A) elastic arteries B) muscular arteries C) arterioles D) capillaries

B

The hepatic portal vein ________. A) is actually an artery B) carries nutrient-rich blood to the liver C) carries oxygen-rich blood from the liver to the viscera D) carries blood from the liver to the inferior vena cava

B

The influence of blood vessel diameter on peripheral resistance is ________. A) the only factor that influences resistance B) significant because resistance is inversely proportional to the fourth power of the vessel radius C) significant because resistance is directly proportional to the blood vessel diameter D) insignificant because vessel diameter does not vary

B

The pulse pressure is ________. A) systolic pressure plus diastolic pressure B) systolic pressure minus diastolic pressure C) systolic pressure divided by diastolic pressure D) diastolic pressure plus 1/3 (systolic pressure plus diastolic pressure)

B

The short-term controls of blood pressure, mediated by the nervous system and bloodborne chemicals, primarily operate via all but which of the following? A) reflex arcs involving baroreceptors B) altering blood volume C) reflex arcs associated with vasomotor fibers D) chemoreceptors

B

Where in the body would you find low oxygen levels causing vasoconstriction and high levels causing vasodilation? A) kidney B) lungs C) liver D) heart

B

Which of the choices below explains why the arterioles are known as resistance vessels? A) Their prime function is the exchange of nutrients and wastes between the blood and tissue cells. B) The contraction and relaxation of the smooth muscle in their walls can change their diameter. C) They distribute blood to various parts of the body. D) They contain a large quantity of elastic tissue.

B

Which statement best describes arteries? A) All carry oxygenated blood to the heart. B) All carry blood away from the heart. C) All contain valves to prevent the backflow of blood. D) Only large arteries are lined with endothelium.

B

Which tunic of an artery is most responsible for maintaining blood pressure and continuous blood circulation? A) tunica intima B) tunica media C) tunica externa D) basement membrane

B

What occurs in red bone marrow

B and T cells originate and B cells mature

Clonal selection of a B cell

B cells make clones of themselves after the T cells activate them most clones become plasma cells which secrete antibodies against the same antigen as the B cell parent others become memory cells which provide an immediate response to the antigen on second exposure

Vertical line

BACK; posterior interventricular line

veins

BLUE--> back to the heart

A. Oxygen B. Nutrients C. Carbon Dioxide D. Waste

Capillaries have only one layer of endothelial cells whose cell membranes are the semi-permeable membrane that allows ______, _________, ______ _______, and _____ to be exchanged between the tissues of the body and the blood.

Sinusoids

Capillaries with large gaps (pores) found in red marrow, liver, and spleen. -Allow blood cells and plasma proteins to enter or exit bloodstream.

Exchange vessels

Capillaries. Allow for exchange of nutrients and waste between blood and interstitial space

Th wall of the _____ has only a single layer, tunica interna (endothelium with basement membrane)

Capillary

Oblterative endarteritis

Characteristic of late-stage syphilis which has a predilection for small vessels leading to ischemic injury of the aortic media and aneurysmal dilation

Wegener granulomatosis

Characterized by a triad of: acute necrotizing granuloma of respiratory tract; necrotizing or granulomatous vasculitis affecting small to medium sized vessels; and renal disease Resemble polyarteritis nodosa except there is also respiratory involvement Now termed as Granulomatosis with polyangiitis Features include persistent pneumonitis with bilateral nodular and cavitary infiltrates, chronic sinusitis, mucosal ulcerations of the nasopharynx, and evidence of renal disease

Monckeberg medial sclerosis

Characterized by calcific deposits in muscular arteries in persons typically older than 50

Inflammatory AAA

Characterized by dense periaortic fibrosis containing abundant lymphoplasmacytic inflammation with many macrophages and often giant cells

Thromboangiitis Obliterans (Buerger Disease)

Characterized by segmental, thrombosing, acute and chronic inflammation of medium-sized and small arteries, principally the tibial and radial arteries, with occasional secondary extension into the veins and nerves of the extremities Occurs in heavy cigarette smokers before age 35 Thrombus can contain small microabscesses composed of neutrophils surrounded by granulomatous inflammation Early manifestations include cold-induced Raynaud phenomenon and instep claudication

Chemoreceptor Reflexes

Chemoreceptors respond to rise in CO2, drop in pH or O2: Increases blood pressure via the vasomotor center and the cardioacceleratory center More important in the regulation of respiration

Hypertension

Chronically elevated blood pressure -"Silent killer" -Systolic above 140 Diastolic over 90 -Strains heart and damages blood vessels

The arterial supply to the brain=

Circle of Willis

Accelerated or malignant hypertension

Clinical syndrome characterized by severe hypertension, renal failure, retinal hemorrhages and exudates, with or without papilledema

Tunica externa

Collagen fibers

Thoracic Aortic Aneurysm

Commonly associated with hypertension

Spider telangiectasia

Commonly seen on the face, neck, or upper chest and is associate wit hyperestrogenic states such as pregnancy and liver cirrhosis Involves arteries and arterioles

Arteriolar Vasodilation

Decreased vasomotor output so arterioles dilate, peripheral resistance falls, and there is a decrease in blood pressure

Parasympathetic (vagus nerve) stimulation

Decreases SA node activity = decreased heart rate. Decreases speed of cardiac impulse travels from SA node thru AV node

False/Pseudo-aneurysm/Pulsating hematoma

Defect in the vascular wall leading to an extravascular hematoma that freely communicates with the intravascular space Examples: 1. Ventricular rupture after MI that is contained by a pericardial adhesion, or a leak at the sutured junction of a vascular graft with a natural artery

Marfan syndrome

Defective snthesis of scaffolding protein fibrillin leads to aberrant TGF-B activity and progressive weakening in the elastic tissue leading to progressive aortic dilation due to remodelling of the inelastic media

Ehlers Danlos Syndrome (Vascular forms)

Defective type III collagen synthesis which leads to weak vessel walls

Muscular arteries

Deliver blood to specific body organs

Muscular Arteries (Distributing)

Deliver blood to specific body systems Less elastin in Tunica Media Examples: Mesenteric arteries, Renal arteries, Hepatic arteries

(Structure of tunica externa) ______ containing many ____ and _____. These cells and fibers run longitudinally- which is perpendicular to the orientation of the muscle cells of the media

Dense connective tissue Elastic fibers Collagen fibers

What is the tunica externa made up of?

Dense connective tissue "protection"

Starling's Law of the Heart

Depends on the degree of stretch of they myocardial fibers Changes force of contraction by stretching myocardium One way to increase stroke volume

Carry blood away from the heart, they're more elastic, higher pressure and thick walls.

Describe arteries and arterioles.

Thin walls, semipermeable, and does real work of the vascular system.

Describe capillaries.

Carry blood to the heart, have valves, lower pressure and thin walls.

Describe veins and venules.

Skeletal Muscle Circulation

Blood flow at rest (75% muscle capillaries closed) 1.4-4 ml/min100g Streneous Exercise (flow can increase more than 20x fold, up to 40-100 ml/min/100g) Thus, during strenous exercise, 3x more (wut)

heart

Blood flow is carefully regulated to supply tissue needs without unnecessary burden on the ______.

Brain Circulation

Blood flow to brain constant as neurons intolerant of ischemia; averages 750 ml/min Metabolic controls Myogenic Controls

What is another term for BP?

Blood hydrostatic pressure

Pressures that promote FILTRATION

Blood hydrostatic pressure (BHP) generated by pumping action of heart -Falls over capillary bed from 35 to 16 mmHg Interstitial fluid osmotic pressure (IFOP): 1 mmHg

Ductus arterioles

Blood in pulmonary artery to flow directly into descending aorta to bypass pulmonary circulation

Force per unit area exerted on wall of blood vessel by blood expressed as mm Hg

Blood pressure

______ is defined as the pressure exerted by the blood on the walls of the vessels

Blood pressure

Hypertension

Blood pressure in excess of normal range for age and gender (>140/80mmHG) Afflicts 20% of adults Primary or Essential

connection between blood typing and immune system

Blood types have certain antigens and antibodies so like in the immune system, if the wrong blood type is transfused, the antibodies will attack the unwelcome antigen

Vasodialation

Blood vessel dialation

The pressure in the vessels changes as it moves through the different types of _____

Blood vessels

Anastomoses

Blood vessels that join together Between: Artery and artery (collaterals) Artery and vein (thoroughfare channel in capillary beds) Vein and vein (most common)

All blood vessels, except for ______, have 3 layers in their walls. The _____ of each layer will vary depending on what blood vessel we are looking at

Capillaries Thickness

What elements of the cardiovascular circulatory system is the cross-sectional area the GREATEST?

Capillaries Venules they also have the LOWEST velocity

Real Work

Capillaries are the minute vessels where the ____ ____ of the vascular system is accomplished.

Vagaries of vascular hemodynamics

Determines the focality of atherosclerotic lesions despite the uniform exposure of vessel walls to such factors ascigarette smoke toxins, elevated LDL, hyperglycemia, etc.

Congenital anomalies of blood vessels

Developmental or berry aneurysm Arteriovenous fistula Fibromuscular dysplasia

What is the effect of a decreased amount of ADH

Diabetes insipidus

(Systemic circuit) veins inferior to the _____ empty into the ______

Diaphragm Inferior vena cava

(Systemic circuit) veins superior to the _____ empty into the _____

Diaphragm Superior vena cava

Mean arterial pressure

Diastolic BP + pulse pressure / 3

Mean arterial pressure=

Diastolic+pulse pressure/3

Blood Pressure Gradient

Differences in blood pressure within the vascular system provide the driving force that keeps blood moving, always from an area of higher pressure to an area of lower pressure.

True fusiform aneurysm

Diffuse, circumferential dilation of a long vascular segment and can involve extensive portions of the aortic arch, abdominal aorta, or even the iliac arteries

Varicose Veins

Dilated veins due to leaky valves -Can be hereditary, or due to prolonged standing, obesity, or pregnancy -Can also be due to straining/hemorrhoids

Caput Medusae

Dilated veins on the abdomen of a patient with cirrhosis.

Homan sign

Dorsiflexion of foot produces calf pain; observed in DVT

What become the ligamentum arteriosum?

Ductus arterious

Hydrostatic pressure

Due to fluid pressing against boundary, due to blood pressure "pushes" fluid across boundary

Milroy disease

Familial primary lymphedemawhich causes lymphatic agenesis or hypoplasia AKA Heredofamilial congenital lymphedema

Speed of Blood Flow

Fastest in aorta Slowest in capillaries Picks up speed in veins

Which type of capillary is found in the intestines/kidneys?

Fenestrated

Have pores covered by a membrane More permeable than continuous capillaries Function in absorption or filtration

Fenestrated capillaries

______ have openings, or fenestrations, in their walls that allow for increased exchange of substances with the surrounding fluid

Fenestrated capillaries

Umbilical arteries

Fetus to placenta

How do fevers help the body?

Fever is a part of the body's way of fighting off infection Reducing it can cause the illness to last longer

Chordae Tendinae

Fibrous bands of tissue that attach cusps to ventricular wall

Auricles

Flaps on top

39. What is P (i.e., "delta P")? How does P influence blood flow?

- pressure gradient. increases blood flow (direct relationship)

Pulmonary Circuit

-*Arteries* carry *deoxygenated* blood away from heart. -Veins carry oxygenated blood to the heart.

Systemic Circuit

-*Arteries* carry *oxygenated* blood away from heart. -Veins carry deoxygenated blood to the heart.

how do you measure bp? what instraments are used? what artery? what do the sounds you hear relate too?

--auscultation -sphygmomanometer and stheoscope --brachial artery --first sound is systolic pressure(ventricular systole) and the second sound is dystolic pressure (ventricular dystole)

What are systolic and diastolic pressure? What heart action do they correspond to? How do you record BP and what is the average?

--systolic- highest pressure exerted on arterial walls during ventricular contraction --diastolic- lowest level of arterial pressure during ventricular relaxation -- mm hg -average is 110/70 but anything from 90-120 and 60-80 is acceptable

neutrophil

-3 nucleus -most common -swallowing and digesting pathogens

process of atherosclerosis

-plaque forms in artery wall -damage to epithelium -platelets and fibrin deposit on a plaque forming a clot -plaque ruptures, and blood clot forms limiting blood flow

influences on blood flow

-pressure -resistance

What does the pulse represent, where is it typically/easily measured

-pressure wave caused by the expansion and recoil of elastic arteries -radial artery is easily measured

ID all the pulse points

-radial -brachial -femoral -dorsal pedis -posterior tibial artery -popliteal -corotid -temporal -facial

Describe venous BP

-steady and changes little during cardiac cycle -a cut vein has even flow a lacerated artery flows in spurts

Atherosclerosis clot formation risk

-stroke -myocardial infarction

Identify all the pulse points

-temporal -facial -common carotid -brachial -radial -femoral -popliteal -posterior tibial -dorsalis pedis

Veins contain

-thinner walls, and larger lumen than arteries -little smooth muscle -valves to prevent back flow

1 block (time)

0.04 sec

muscular arteries

1 cm to 3mm . Take blood to specific body regions, greater amounts of muscle, less elastic tissue, *two layers of elastic tissue*, branch into arterioles *better vasodilators and vasoconstrictors due to increased muscle tissues*

1 block

1 mm

Triglycerides should be under..

200

Be below what number..

200 cholesterol

Venous Return

1. Volume of blood flowing back to heart through systemic veins 2. Occurs due to pressure generated by constriction of left ventricle 3. Small pressure difference from venule (16 mmHg) to right ventricle (0 mmHg) sufficient

describe the three types of capillaries and what makes each unique. give one example of where you would find each type

1. continous capillaries-- abundant in the skin and muscles, endothelial cells provide and uninterrupted lining, adjacent cells are connected with tight junctions, intercellular clefts allow the passage of fluids into and out of capillaries 2. fenestrated capillaries-- found wherever active secretion, absorption, or filtration occurs, have an endothelium riddles with pores, exhibit greater permeability than other capillaries 3. sinusoids-- highly modified, leaky, fenestrated capilliares with large lumens, found in the liver, bone marrow, lymphoid tissue, and in some endocrine organs, allow large molecules to pass between the blood and surrounding tissues, blood flows sluggishly

in what directions are the different materials exchanged between capillaries, and the tissues

1. oxygen and nutritents pass from blood to tissues 2. carbon dioxide and metabolic wastes pass from tissues to the blood 3. water soluble solutes pass through clefts and fenestrations 4. lipid-soluble molecules diffuse directly through endothelial membranes

Short Term Regulation by PNS

1. parasympathetic neurons decrease HR, decreasing cardiac output 2. Sympathetic neurons inhibited by para neurons, causing vasodilation and lower PR RESULT: DECREASE BP

Short Term Regulation by SNS

1. sympathetic neurons increase HR and contractility which increase CO 2. sympathetic neurons cause vasoconstriction in arterioles, increasing PR RESULT: INCREASE BP

consequences of edema

1. tissue necrosiss-oxygen delivery and waste removal impaired 2. pulmonary edema- suffocation 3. cerebral edema- headaches, nausea, seizures, coma 4. circulatory shock-excess fluid in tissue spaces casues low blood volume and low bp

Describe the three tunics and the types of tissues contained in each

1. tunica interna-- smooth endothelium that lines the lumen of all vessels 2. tunica media-- smooth muscle and elastic fiber layer assists blood flow via vasoconstriction and vasodilation 3. tunica externa-- collagen fibers that protect and reinforce vessels

true capillaries

10 to 100 exchange vessels per capillary bed, branch of metarteriole or terminal arteriole.

Secondary Hypertension

10% of cases Can pinpoint what the cause is -Arteriosclerosis -Kidney disease -Obstructed renal arteries -Hyperthyroidism -Cushing's syndrome

Dermal (Skin) Circulation

10-15% of total body mass Functions of skin: protect and conserve/dissipate heat Lowest metabolic rate of organs in body

Normal range of blood pressure

120/80

... Hypertension is defined physiologically as a condition of sustained arterial pressure of __________ or higher. 120/80 130/90 130/80 140/90

140/90

blood circulation distribution (% where)

18% pulmonary, 12% heart, 70% systemic (55% systemic veins, 5% systemic capillaries, 10% systemic arteries)

Umbilical blood vessels

2 arteries, 1 vein

Arterioles

20-100 um in diameter Principal points of physiologic resistance to blood flow

The 5 non specific body defense mechanisms

Acid- inhibits bacterial growth Enzymes- lysozomes destroy bacteria Mucin- trap microorganisms Defensins- control bacterial and fungal colonization Chemicals- toxic to bacteria

True Capillaries

Actual vessels involved in exchange 10-100 exchange vessels per capillary bed. Branch off metarteriole or terminal arteriole. True capillaries normally branch from metarteriole and return to thoroughfare channel

Lymphangitis

Acute inflammation elicited when bacteria; infections spreaad into the lymphatics Commonly caused by Group A streptococci Recognized as red, painful subcutaneous streaks and painful enlargement of draining lymph nodes (acute lymphadenitis)

Total blood volume

Adding volume to the circulatory system increases blood pressure; loss of volume, as by hemorrhage, will lower blood pressure. The kidneys are important regulators of blood volume.

Short-Term Hormonal Mechanisms

Adrenal Medulla Hormones norepinephrine and epinephrine increase blood pressure ADH causes intense vasoconstriction in cases of low BP Angiotensin II kidney release of renin generate Angiotensin II which causes vasoconstriction Endothelium-derived factors -endothelin and PDGF are both vasoconstrictors ANP - causes blood volume and pressure to decline

Identify the hormone released by the adrenal gland cortex that regulates na level

Aldosterone

Net filtration Pressure (definition and formula)

All forces acting on capillary bed NFP = (HPc - HP if) - (OPc -OP if) Excess fluid is returned to blood via lymphatic system.

Foramen ovale

Allow blood into left side

Foramen ovale

Allows blood to flow directly from R atrium into L atrium; bypass pulmonary circulation

(Circle of Willis) function of circle of Willis:

Allows the potential for different routes of blood flow in an emergency. Thus the neurons will continue to receive the necessary oxygen and glucose Ex: if the anterior cerebral arteries were damaged or occluded, neurons in the anterior cerebrum could still receive blood from the posterior cerebral arteries

Elastic arteries

Allows vessels to withstand high pressures and allows continuous blood flow

Neural Controls of Peripheral Resistance

Alter blood distribution in response demands Maintain MAP by altering blood vessel diameter

Myogenic Response

Alteration of vascular tone in response to change in pressure -increased pressure/stretch elicit vasoconstriction

Lipoprotein (a)

Altered form of LDL that contains apo-B100 portion of LDL linked to apo-A

Endothelial dysfunction

Altered phenotype that impairs vasoreactivity or induces a surface that is thrombogenic or abnormally adhesive to inflammatory cells

Collateral Circulation

Alternate pathway for blood flow in a region if one vessel becomes blocked (damaged).

1. Direct Renal Mechanisms **Draw

Alters Blood Volume independently of Hormones (Increased BP or blood volume causes the kidneys to eliminate more urine, thus reducing BP) Decreased BP or blood volume causes the kidneys to conserve water, and BP rises

Cerebral Autoregulation

Flow constant over a WIDE pressure range 60-160 mmHg Protects brain against changes in arterial pressure (if pressure drops below 60 mmHg, function of brain is affected. If pressure is greater than 160 mmHg leads to edema)

Flow, Blood Pressure, and Resistance

Flow is directly proportional to the difference in Blood pressure between two points in the circulation Blood flow is inversely proportional to the peripheral resistance (R) in the systemic circulation F = (change in P) / R

Microcirculation

Flow of blood through bed

HP > OP

Fluid forced out of capillary, Filtration

Bulk FLow

Fluid leaves capillaries at arterial end; most returns to blood at venous end -determines fluid volumes in blood and interstitial space

OP > HP

Fluid moves into capillary, reabsorption

Fibromuscular dysplasia

Focal irregular thickening of the walls of medium and large arteries by a combination of irregular medial and intimal hyperplasia and fibrosis Involves Renal, carotid, splanchnic, and vertebral vessels commonly seen in young women Results in luminal stenosis, and in the renal arteries may be a cause of renovascular hypertension

Parietal pericardium

Folded back epicardium

Capillaries

Form a bridge between arterioles and venules so arteries and veins can exchange goods; like CO2 and oxygen

ANP

From: Atria Causes of release: high fluid volume in atria Target: kidney Effect: increases Na+ excretion Result: lowers peripheral resistance, ultimately lowers BP

ADH

From: produced by hypothalmus, stored in posterior pituitary Causes of release: increased blood viscosity, high BP Target: Kidney Effect: Decreases urinary output Result: raises BP, increase fluid volume

Pulmonary circulation

Function: bring blood into close contact with alveoli to exchange gases -Exchange occurs in pulmonary capillaries -Drain into 2 pulmonary veins from each lung

Systemic Circulation

Function: delivers nutrients and oxygen to tissues cells and carries away waste and carbon dioxide -Drains into veins and then into vena cava to right atrium

... The hepatic portal system collects blood from the __________ and then routes it to the __________. liver; GI tract GI tract; liver kidneys; liver liver; kidneys

GI tract; liver

(Pulmonary circulation) there is ____ at the lungs and then the blood is returned to the heart by the pulmonary veins

Gas exchange

Vasculitis

General term for vessel wall inflammation Causes: 1. Immune mediaed inflammation 2. Direct invasion of vascular walls by infectious pathogens 3. Irradiation 4. Mechanical trauma 5. Toxins

Large vessel vascuitis

Giant cell (temporal) arteritis Takayasu arteritis

Long Term Regulation of BP by Urinary System

If BP increases: water flows quickly through kidneys, water is lost if BP decreases: water flows through slowly, more time for reabsorption

Atherosclerotc plaque

Impinge on the lumen of the artery and grossly appear white to yellow; superimposed thrombus over ulcerated plaques appear red brown Patchy and appear "eccentric" on cross section Composed of (1) cells, including smooth muscle cells, macrophages, and T cells; (2) ECM, including collagen proteoglycans, and elastic fibers; and (3) intracellular and extracellular lipid Parts: Fibrous cap Shoulder Necrotic core

Baroreceptor

In carotid/aortic arch

What is Vasa Vasorum

In larger arteries, they have to have blood to supply itself, so it is a blood vessel inside of a blood vessel

Sinusoid Capillaries

In liver, bone marrow, spleen, and adrenal medulla. Have large intercellular clefts as well as fenestrations; few tight junctions. Incomplete basement membranes, irregularity shaped and larger lumen. Allow large molecules and cells to pass across their walls, blood flows slowly through their tortuous channels. Macrophages may extend processes through the clefts to catch "prey" or in liver, form part of the sinusoid wall.

A. Oxygen B. Nutrients C. Minerals D. Hormones

In the capillaries ______, ________, ________, and ________ move from the blood to the body cells and carbon dioxide and waste products move from the body cells into the blood.

Neointima

Intimal thickening from migration and proliferation of smooth muscle cells with associated ECM synthesis in response to vascular injury/reconstruction Have a proliferative, synthetic, and noncontractile phenotype distinct from tunica media smooth muscle cells

Weibel-Palade bodies

Intracellular membrane bound storage organelles for von Willebrand's factor

Local Metabolic Control of Blood Flow

Intrinsic local mechanism that regulates blood flow to match changes in tissue metabolism Active tissues produce metabolites in proportion to metabolic needs in order to balance oxygen supply w/ metabolic requirements for Oxygen

Bayliss Effect

Intrinsic property of smooth muscle that allows them to respond to changes in mechanical load

Blood Flow through Body Tissues

Involved in delivery of O2 and nutrients and removal of waste from tissues Gas exchange (lungs) Absorption of nutrients (digestive) Urine formation (kidney) Rate of flow is precisely the right amount to provide for proper function

how does blood flow change during strenuous exercise?

Lots of blood flow to skeletal muscles, skin heart and brain. little to digestive organs

What is located in the Tunica Media

Lots of smooth muscle Elastic Connective tissue

Venous and Capillary Pressures

Low capillary pressure is desirable b/c high BP would rupture fragile, thin-walled capillaries (most are permeable, so low pressure forces filtrate into interstitial spaces) Venous changes little during the cardiac cycle Small pressure gradient, about 15mmHg Low pressure due to cumulative effects of peripheral resistance.

Ventricles

Lower chambers; pump blood out of heart

Central blood containing space

Lumen

(Pulmonary circulation) there is gas exchange at the ____ and then the blood is returned to the ____ by the pulmonary veins

Lungs Heart

What is the proper term for the pressure entering the arteriole?

MAP

What is the proper term for the pressure entering a capillary bed?

MAP (Mean arterial pressure)

Short term Regulation of BP

MAP= HRxSVxR modify stroke volume, heart rate, or resistance done by endocrine or ANS

MHC I

MHC I interacts with Cytotoxic T cells, are present on most body cells, and are synthesized inside the cell, CD8 cells

What cells follow the neutrophils to the site of inflammation and what is their function?

Macrophages Wander around searching for foreign invaders to kill Together they acidify the phagolysosome and digest its contents with lysosomal enzymes kill whatever the neutrophils leave behind

Portal vein

Made up by the Union of superior mesenteric vein and splenic. Carries blood rich in products of digestion from organs of digestion to the liver. Low is O2

MHC II

Mainly interacts with helper T cells, present on antigen presenting cells, synthesized outside of the cell, CD4 cells

What is the function of the baroreceptor?

Monitor BP and tell the medulla oblangata via nerves 9 & 10. 2 options if BP is high sends signal to cardiovascular center 1.) alter CO, send signals to parasympathetic 2.) goes to vasomotor center- causes decrease in sympathetic

Proximal/Type A dissection/DeBakey Type I and II

More common and dangerous lesions involving either both the ascending and descending aorta or just the ascending aorta

Diffusion

Most Important Method Substances move down their concentration gradient -O2 & Nutrients from blood to interstitial fluid to body cells -CO2 & Wastes move from body cells to interstitial fluid to blood Can cross capillary wall through intracellular clefts, fenestrations, or through endothelial cells -most plasma proteins cant cross -Except in Sinusoids: proteins/even blood cells leave -blood brain barrier: tight junctions limit diffusion

AIDS-associated (epidemic) KS

Most common HIV-related malignancy Involves lymph nodes and disseminates widely to viscera early in its course

Nevus flammeus

Most common ectasia Ordinary "birthmark" which is characteristically a flat lesion on the head or neck, ranging in color from light pink to deep purple

Capillary hemangioma

Most common variant of hemangioma which are bright red to blue in color. These are unencapsulated aggregates of thin wallled capillaries; with SCANT CT stroma separating the blood vessels

Atherosclerosis

Most frequent and clinically important arteriosclerosis Characterized by intimal lesions called atheromas that protrude into vessel lumens

Capillary Exchange

Movement of substances btwn blood & interstitial fluid Methods -Diffusion -Transcytosis -Bulk flow

Thick tunica media with more smooth muscle Active in vasoconstriction Deliver blood to body organs (more smooth muscle, less elastin)

Muscular arteries

Which of the 3 vessels regulate BP the most?

Muscular arteries

Venous Return consists of what

Muscular pump Respiratory pump Sympathetic Venoconstriction

Arteries

Muscular, elastic vessels -Carry blood *AWAY* from the heart.

Blood Pressure Homeostasis

Must be able to "fine-tune' blood pressure during movement, etc. Cooperation of heart, blood vessels, kidneys; supervision by brain.

Loeys-Dietz syndrome

Mutations in TGF-B receptors lead to abnormalities in elastin and collagen I and III

(Coronary circulation) a _____, or heart attack, is when cardiac muscle fibers are damaged or even die due to blockage of coronary arteries

Myocardial infarction

Short term neural and hormonal controls - raising BP

NE & epinephrine, angiotensin II, ADH/Vasopressin, baroreceptor inhibited, vasomotor simulated, cardioinhibitory stimulated

What is the proper term for the combination of the 3 pressures in the capillary bed

NFP (net filtration pressure)

Net Filtration Pressure (NFP)

NFP = (BHP + IFOP) - (BCOP + IFHP) -BHP: Blood Hydrostatic Pressure -IFOP: Interstitial Fluid Osmotic Pressure -BCOP: Blood Colloid Osmotic Pressure -IFHP: Interstitial Fluid Hydrostatic Pressure Balance of two pressures

Define and be able to calculate net filtration pressure (you do not need to memorize values for each of the terms in the equation, but know how to use values supplied in a problem

NFP = (forces that promote filtration) - (forces that promote reabsorption) Negative= reabsorption Positive=filtration

How to find Net filtration pressure

NFP= BP-COP-capillary interstitial fluid

Tunica Adventia

Outer layer; consists of a connective tissue sheath with some of its collagen fibers fusing with those of the surrounding tissue to hold the vessel in place. The elastic connective tissue allows the artery to expand, recoil with each contraction of the ventricle as an increased volume of blood is pumped through the vessel.

Location of tunica externa=

Outermost layer

Atherosclerotic stenosis

Occurs in small vessels wherein plaques can gradually occlude vessel lumens compromising blood flow and causing ischemic injury

Transplant-associated KS

Occurs in solid organ transplant recipients in the setting of T-cell immunosuppression

Aortic dissection

Occurs when blood splays apart the laminar plans of media to form a blood filled channel within the aortic wall May or may not be associated with aortic dilation Classified into proximal or distal lesions (Check #86 and #87) Classic clinical symptoms include sudden onset of excruciating pain, usually beginning in the anterior chest, radiating to the back between the scapulae, and moving downward as the dissection progresses

Long-Term Autoregulation

Occurs when short-term autoregulation cannot meet tissue nutrient requirements

Portal Hypertension

Occurs when there is an obstruction of blood flow through the liver and pressure rises within the portal vein Causes: alcohol abuse, Hepatitis, Fatty Liver. Basically a hard beer belly

Tachycardia

Over 100 bpm

Valves

One-way cusps in veins that help keep blood flowing towards the heart. -Skeletal muscle pumps -Respiratory pump

differentiate between lymph nodes and the other organs

Only lymph nodes filter lymph, but they all protect the body

Semilunar valves (exit valves)

Open upwards and out of heart Pulmonic Valve & Aortic Valve

Define Vascular Resistence

Opposition to blood flow due to friction between blood and walls of blood vessels

Resistance to blood flow

Opposition to blood flow due to friction generated as blood slides along the vessel walls

Tunica Externa

Outer layer of the blood vessel. -Fibrous connective tissue: gives strength, elasticity.

Tunica adventitia

Outer layer. Support and protect blood vessels. Prevents artery from bursting. Tough connective tissue.

PECAM-1/CD31

Platelet-Endothelial Cell Adhesion molecule-1 Protein localized to interendothelial junctions and thus can be used to identify endothelial cells immunohistochemically

Medium vessel arteritis

Polyarteritis nodosa Kawasaki disease

What is the proper term for increased thirst?

Polydypsia

What is the proper term for increased urinary output?

Polyuria

Liver

Portal Circulation

Hepatic Portal System

Portal vein between 2 capillary beds Function: carries nutrient rich blood to liver, excess nutrients are stored, toxins are taken care of & phagocytic cells rid blood of bacteria

(Circle of Willis) composed of 3 cerebral arteries: And 2 connecting arteries:

Posterior, middle, and anterior cerebral arteries Anterior and posterior communicating arteries

regulates blood flow into true capillaries

Precapillary sphincters

Atrial natriuretic peptide (ANP)

Released by cells of atria Lowers blood pressure by causing vasodilation and promoting loss of salt and water in urine Reduces blood volume

Kidneys

Renal Circulation

blood viscosity total blood vessel length blood vessel diameter

Resistance

Sympathetic

The ___________ nervous system causes peripheral vessels to constrict; heart rate and respiratory rate goes up.

Parasympathetic

The _______________ nervous system causes peripheral vessels to relax and dilate; heart rate and respiratory rate goes down.

plasma cells

The antibody secreting effector cells of humoral response

2. Total blood vessel length

The longer the vessel, the greater the resistance. Greater resistance in adults than in infants

Diastolic Blood Pressure

The lowest pressure measured in the arteries after relaxation of the heart muscle.

*Blood flow to venous plexuses below skin surface regulate body temperature...

Varies from 50ml/min to 2500ml/min, depending on body temperature Controlled by sympathetic nervous system reflexes initiated by temperature receptors and central nervous system

Capillary beds consist of two types of vessels

Vascular Shunt, True capillaries

Kaposi sarcoma (KS)

Vascular neoplasm caused by human herpesvirus 8 (HHV8) that is highly associated with acquired immunodeficiency syndrome (AIDS)

high blood pressure stimulates

baroreceptors stimulate cardioinhibitory center (vagus nerve) , 1) sympathetic impulses to heart go down, *decrease in heart rate, contractility, cardiac output* 2) decrease in vasomotor reflexes = vasodilation causing resistance to decrease. *Basically CO and R decrease*

how does the brain maintain bp

baroreflex-barorecpetors in vessel walls detect changes in pressure and send constant signals to brainstem, sympathetic control stimulates most vessels to constrict -if bp drops, vasomotor center is stiumlated which stiumaltes vessels to vasoconstrict and increase bp -if bp increases, vasomotor center is inhibited which allows vessels to vasodilate and bp decreases -overall control

location venous anastomoses

basilic, brachial, or cephalic draining upper limbs

mitrol valve =

bicuspid valve

What is the primary force that resists fluid movement out of the capillaries (keep being specific!)?

blood colloid osmotic pressure

What are the specific factors that promote reabsorption in the capillaries?

blood colloid osmotic pressure interstitial fluid hydrostatic pressure

COP_b

blood colloid osmotic pressure, draws fluids into blood due to blood proteins, *promotes reabsorption opposing hydrostatic pressure*

What is happening during diastolic pressure?

Ventricular diastole

T wave

Ventricular diastole (relaxation)

What is happening in the heart during systolic pressure?

Ventricular systole

QRS wave

Ventricular systole contraction

the actual volume of blood flowing through a vessel, an organ, or the entire circulation in a given period, measured in ml er min, equivelent to cardiac output, relatively constant when at rest

blood flow

the volume of blood flowing through a vessel, an organ, or the entire circulation in a given period is what

blood flow

11. Why are the arterioles called the resistance vessels of the vascular system?

blood flow into capillaries depends on diameter--> changes in response to hormonal or neural changes.

Pressure

blood flow is directly proportional to pressure gradient

resistance

blood flow is inversely proportional to resistance

tissue perfusion

blood flow, exchange of vessel

portal system

blood flowing through two capillary beds. Beds separated by portal vein which delivers blood to other organ first. Hypothalamo-hypophyseal portal (anterior pituitary, neural -ADH oxytocin). Hepatic portal system

HP_b

blood hydrostatic pressure, force exerted per unit area of blood on wall, *promotes filtration from capillary*

force per unit area exerted on the wall of a blood vessel by ts contained blood, expressed in mm Hg

blood pressure

the force per unit area exerted on a vessel wall by the contained blood is what

blood pressure

When you spin the tube what happens?

blood separates into layers

Coronary sinus

blood that has been used up by heart, place where HEART blood is recycled

example of simple pathway?

blood transport to spleen

greatest influence on resistance

blood vessel diameter

longer vessel = greater resistance encountered

blood vessel length

Anyerism

blood vessels expand in certain spots causing it to become super thin and leak or burst

what is circulatory shock?

blood vessels inadequately fill blood cannot circulate normally

a source of resistance related to the thickness, or "stickiness," of the blood is what

blood viscosity

stickiness of blood due to formed elements and plasma proteins

blood viscosity

factors affecting resistance/peripheral resistance

blood viscosity, total blood vessel length, blood vessel diameter

sinusoidal capillary

capillaries w/ large openings allowing for easy movement of materials in & out of the vessel; *found at the LIVER allowing the hepatocytes (liver cells) intimate contact w/ blood moving through the liver lobules

sinusoidal capillaries

capillaries with a discontinuous epithelium, very large pores, irregular basal lamina located in liver, lymphs, bone marrow, and spleen leakiest

fenestrated capillary

capillaries with small openings; *found at the KIDNEYS allowing for filtration of blood

three types of blood vessels

capillaries, arteries, veins

ranges from 17-35 mm Hg low is desirable

capillary BP

what connects veins and arteries?

capillary bed attached to vasa vasorum / tunica externa

Most blood from the brain flows down the internal jugular veins and then into a. the external jugular veins b. the vertebral veins c. the superior vena cava d. the subclavian veins e. the brachiocephalic veins

d

The growth of new blood vessels to better perfuse a tissue

d (angiogenesis)

Receives blood that has circulated through the myocardium

d (coronary sinus)

causes of plaques

damage to endothelium -high blood pressure -cholesterol -previous infections -toxins like smoke -prolonged high blood glucose level vessels become inflamed and attract phagocytes

chordea tendinae

dangle of cusp

Pulse

What are the throbs of your heartbeat called?

R/L internal carotid, basilar artery (R/L vertebral) Fxn: penetrate tissues deep w/in brain

What arteries make up Circle of Willis and its function

Brachial

What artery is used most often to measure BP?

AB

What blood type is the universal recipient?

O

What blood type is universal donor?

Arteries

What carries blood away from the heart?

The veins

What carries deoxygenated blood back to the right side of the heart?

The arteries

What carries oxygenated blood away from the left side of the heart to the body tissues?

Rapid breakdown of RBCs

What causes jaundice?

The vibrations caused by the closure of valves

What causes the heart sounds?

Eosinophils

What cells are elevated in allergies and parasitic disease?

Neutrophils & monocytes

What cells are phagocytes?

RBCs, WBCs, platelets

What cells are produced by bone marrow?

Leukocytes

What cells fight infection?

Basophils

What cells secrete heparin?

Vitamin K

What clotting factor is produced by the liver?

Dark purple-red

What color is the blood in your veins actually?

Fibrinogen & prothrombin

What components function to coagulate blood?

Polycythemia

What condition leads to excessive red blood cell production?

The Capillaries

What connects the arterioles to the venules?

Myogenic controls

decreased MAP causes cerebral vessels to dilate, increased MAP causes cerebral vessels to constrict

Jugular

What vein drains the vessels in the brain?

Renal artery

What vessel carries oxygenated blood to the kidneys?

Portal vein

What vessel carries unoxygenated blood to the liver?

Aorta

What vessel does all other arteries emerge from?

Capillaries

What vessels are the exchange vessels?

Arteries

What vessels carry blood away from the heart?

Veins

What vessels carry blood to the heart?

Agglutination

When blood clumps in response to an interaction in antigens & antibodies?

53. What stimulus causes baroreceptor activity to increase?

arteriolar vasodilation: v peripheral resistance=vMAP Venodilation: blood to venous reservoirs=v venous return&CO v CO= stimulated parasympathetic, v HR& contractile= vMAP

12. Which arterial vessels play the most important role in regulating blood flow into capillary beds and in regulating blood pressure?

arterioles

All but which of the following blood vessels contain intercellular clefts? sinusoidal capillaries fenestrated capillaries continuous capillaries arterioles

arterioles

Blood flows directly from __________ into capillary beds.

arterioles

smallest of the vessels that lead into capillary beds describes what

arterioles

heart releases what to cause vasodilation?

atrial natriuretic peptide (ANP)

The ability of a tissue to control its own blood supply is called ____.

auto regulation

Arteries carry blood _____ heart

away from

A weakened vessel that bulges during systole is called a. an atheroma b. an aneurysm c. a hematoma d. a varicose vein e. an embolism

b

Blood flow will decrease if a. vessel radius increases b. viscosity increases c. pi increases d. pressure increases e. afterload increases

b

Blood solutes can pass through the walls of continuous capillaries by passing through either the endothelial a. the thoroughfare channels b. the intercellular clefts c. the filtration pores d. the sinusoids e. the fenestrations

b

In a puncture of the dural sinus there is great danger of blocking cardiac output because of a (an) a. aneurism b. air embolism c. hypertensive event d. transcytosis e. varicose vein

b

In humans there is no such thing as a. a right common carotid artery b. a left brachiocephalic artery c. a left brachiocephalic vein d. a right subclavian vein e. a right brachiocephalic artery

b

The anterior and posterior communicating arteries are found in a. the neck b. the arterial circle (or the circle of Willis) c. branches of the celiac trunk d. the forearm e. the azygos-hemiazygos system

b

The human body has only one ____ but has two of each of the rest of these vessels a. inferior phrenic artery b. superior mesenteric artery c. gastroepiploic artery d. femoral artery e. plantar arch

b

The human body has only one ____ but has two of each of the rest of these vessels a. median cubital vein b. brachiocephalic artery c. brachiocephalic vein d. common iliac vein e. anterior communicating artery

b

Which of these is not below the knee a. the medial plantar artery b. the obturator artery c. the small saphenous vein d. the anterior tibial vein e. the dorsalis pedis artery

b

Small blood vessels that perfuse the larger blood vessels

b (vasa vasorum)

septic shock

bacterial toxins trigger vasodialation and increased capillary permeability- causes fluids to leave the blood entering the tissues

LDL

bad cholesterol (goes to lumen)

In the aortic arch and carotid arteries there are pressure sensors called _____ which help to monitors and regulate blood pressure

baroreceptors

long term high or low BP?

baroreceptors adapt, kidneys use direct renal mechanism or indirect renal (renin-angiotensin)

What is the muscular artery, provide examples. name 1 characteris for its function

distributing arteries that deliver blood to body organs, ex: arterioles 1. contain thick tunica media to be active in vasoconstriction and vasodilatio to locally control bp

Septum

dividing wall

general purpose veins

drain blood from capillaries, transport it back to heart

What is atherosclerosis? How does it affect resistance and blood flow

fatty plague deposits on the endothelium decrease radius and increase resistance, cause turbulent blood flow

what is atheroslerosis? how does it affect resistance and blood flow?

fatty plaques deposited on the endothelium decreases radius and increase resistance; causes turbulent blood flow

In _____ capillaries there are numerous filtration pores through the endothelial cells

fenestrated

Placental Supply

fetal blood flow to placenta is supplied by umbilical arteries (deoxygenated blood from fetus to placenta!) Single umbilical vein drains from placenta to ductus venosus (collects Oxygenated blood from umbilical vein and liver and empties into inferior vena cava)

sinusoidal capillaries

fewer tight junctions, larger intercellular clefts, usually fenestrated, allow large molecules and blood cells to pass between blood and surrounding tissue. most permeable

What processes account for the movement of fluid into and/or out of the capillaries?

filtration osmosis

filtration and pressure gradients?

filtration occurs on arterial end - HP_b is greater than net osmotic pressure, net flow pressure out. (net HP- net COP= +NFP (out)). Concentration gradient higher on arterial side, water wants out

location arteriovenous anastomoses

fingers, toes, palms, ears (think areas to avoid during hypothermia)

How do you record BP and what is the average?

first sound/ last sound you heard average= 120/80

relationship between pressure and flow?

flow directly proportional to hydrostatic pressure gradient. F= P/R

blood flow and peripheral resistance?

flow inversely proportional to resistance. If R increases, flow decreases. F= P/R

36. Define blood pressure.

force exerted by the blood against the inner walls of the blood vessels.

Hydrostatic Pressure

force of a fluid against a vessel wall -pushes

Describe blood pressure

force per unit area exerted on the wall of a blood vessel by its contained blood -expressed in mmHG

blood pressure

force per unit area exerted on wall of blood vessel by the blood. mm Hg, measured as systemic arterial blood pressure in large arteries near heart, *pressure gradient driving force*

hydrostatic pressure

force that a liquid exerts on a wall

What is angiogenesis?

formation of new blood vessels

What is a baroreceptor, where is it found?

found in vessel walls, detect changes in pressure and send constant signals to the brainstem

HTL

good cholesterol (takes cholesterol to liver to be destroyed)

Which of the following veins is the longest in the body? inferior vena cava femoral vein great saphenous vein hepatic portal vein superior vena cava

great saphaenous vein

Functions of memory T cells

have previously encountered and know to fight against the specific antigen

What is hypertension

hbp

Cariogenic shock

heart is inefficient and cannot circulate blood adequately

Functions of CD4 (helper)

help activate B cells, other T cells, macrophages, and direct the adaptive immune system

Hormones and Blood Pressure

help regulate BP & blood flow by: -Altering CO -Changing systemic vascular resistance -Adjusting total blood volume

hepatic artery cat

hepatic artery

Intestinal blood enters the inferior side of the liver by way of the _____ vein

hepatic portal

What is systolic pressure?

highest point of pressure

Systolic BP

highest pressure attained in arteries during systole

lymphocyte

huge nucleus, narrow rim of cytoplasm; mount immune response

capillary pressures

hydrostatic and osmotic pressures

What pressure are they referring to in the equation F=P/R

hydrostatic pressure of blood (HP_b)

opposing forces creating net pressure for bulk flow?

hydrostatic pressure v colloid osmotic. Net flow calculated through these values.

two elastic layers of muscular arteries?

internal elastic laminae - between tunica intima and media. external elastic laminae - between tunica media and externa

57. The umbilical arteries branch off of the ________________ arteries and carry blood to the ______________.

internal illiac, umbilicus

COP_if

interstitial fluid colloid osmotic pressure. Draws fluid into interstitial fluid. Few proteins here so kinda low pressure

HP_if

interstitial fluid hydrostatic pressure - force of interstitial fluid on external blood vessel, *close to 0 in most tissues*

capillary beds

interwoven networks of capillaries form microcirculation between arterioles and venules. Two types of vessels - vascular shunt and true capillaries *arterial and venous end with true capillaries in middle*

describe the structure of the capillary bed with an arrangment of vascular shunt and true capillaries.

interwoven networks of capillaries that allow fluids nutrients, gasses and wbc to pass from the blood stream to tissues, composed of vascular shunts and true capillaries

Myogenic tone

intrinsic vascular tone at a constant level of pressure

Platelets

involved in blood clotting; small purple specks

Short-Term Neural Control

is an important short term regulator of cardiac output and blood pressure

Autoregulatory Mechanism opposite that in most tissues

low O2 levels cause vaoconstriction; (picking blood up); high levels promote vasodilation Allows blood flow to Or rich areas of lung

anemia

low amount of oxygen

Hypotension

low blood pressure 90 mm Hg systolic 60 mm Hg diastolic Severe Hypotension: Circulatory Shock

Diastolic BP

lowest arterial pressure during diastole

What is diastolic pressure?

lowest point of pressure

Cardiovascular changes at birth

lungs and pulmonary vessels expand -ductus arteriosus constricts and becomes ligamentum arteriosum -a valvular flap closes the foramen ovale leaving the fossa ovalis

What occurs in the secondary organs(spleen, lymph nodes, MALT)

lymphocytes first encounter their antigens and are activated

Valves

make sure blood does not flow backwards

Leukemia

malignant disorder of the lymphoid tissues characterized by uncontrolled proliferation of abnormal WBCs accompanied by a reduction in the number of RBCs and platelets

Phagosome

matter engulfed within a phagocyte

pressure that propels blood to the tissues correlates to

mean arterial pressure

Muscular arteries

medium-sized, most numerous, more smooth muscle than most arteries; better ability to constrict, distribute blood to specific areas

Adrenal Medulla hormones and BP?

medulla oblongata stimulates adrenal medulla via sympathetic nerve fibers to produce norepinephrine (NE) and ephedrine. Vasoconstriction, increased CO (stimulants increase heart rate)

where are capillary beds found

mesenteric circulation

13. Identify and describe the arterial vessel which directly supplies a capillary bed.

metarterioles

general purpose capillaries

microscopic porous blood vessels, exchange substances between blood and tissue

muscular arteries

mid-sized arteries with a large amount of smooth muscle in their tunica media & prominent internal & external elastic lamina in their tunica intima & media; the large amount of smooth muscle helps regulate blood flow into organs via vasoconstriction & vasodilation

Which of the layers of an artery wall is regulated by the sympathetic nervous system and many hormones? subendothelial layer middle layer inner layer outer layer

middle layer

The cerebral cortex can ____

modify arteriole pressure through the medulla oblongata

Chemoreceptors

monitor blood acidity (H+), CO2, & O2 concentrations -reflex

arteries

monitor blood pressure

Baroreceptors

monitor blood pressure changes & stretch in blood vessel walls -reflex

chemoreceptors

monitor carbon dioxide, pH, and oxygen

Proprioceptors

monitor joint movements & muscles to provide input during physical activity -reflex

What causes kidney's to release renin?

more sympathetic nervous stimulation (baroreceptors inhibited due to low BP)

Hypovolemic shock

most common form of shock Large scale blood loss Causes: hemorrhage, extensive burns, vomiting/diarrhea Leads to: increased HR and intense vasoconstriction Signs: weak pulse and drop in BP

bulk flow - reabsorption

movement of fluid back into blood *venous end* water enters through venous end

Bulk flow - filtration

movement of fluid out of blood through capillaries, fluid and small solutes flow easily. larger solutes blocked. *occurs on arterial end of capillary* think water exits through arterial end

capillary exchange: Bulk flow

movement of large amounts of fluids and dissolved substances. Move in *one direction down a pressure gradient, depends on net pressure of opposing forces*. two types: Filtration and resorption.

Venous Anastomoses

much more common than arterial, in your hands

... Cardiogenic shock is most likely to result from __________. multiple heart attacks a systemic allergic reaction large-scale blood loss a severe bacterial infection

multiple heart attacks

myocardium

muscle layer

10. Which arterial vessels help to distribute blood to specific body organs or regions of the body?

muscular

factors affecting venous return?

muscular "pump", respiratory "pump", vasoconstriction of veins under sympathetic control

smaller vessels that distribute blood to specific body organs describes what

muscular arteries

An elastic lamina on both sides of the tunica media is a characteristic of __________. elastic arteries muscular arteries all arteries conducting arteries

muscular arterioles

contraction of skeletal muscles milks blood toward heart

muscular pump

Promotes the upward flow of blood in the inferior vena cava

n (oncotic pressure)

The presence of __________ stabilizes the wall of capillaries. pericytes gap junctions valves elastic fibers

pericytes

what stabilizes the walls of capillaries and helps control permeability?

pericytes

Alter BP by changing

peripheral resistance and cardiac output

hydrostatic pressure

physical force exerted by fluid on a structure. HP_b, HP_if

SNS and heart rate control

physical stress or activity causes medulla oblongata to stimulate sympathetic nervous fiber > this stimulates adrenal medulla to produce catecholines

continous and fenestrated capillaries contain what?

pinocyte vesicles- a mechanism by which cells ingest extracellular fluid and its contents; it involves the formation of invaginations by the cell membrane, which close and break off to form fluid-filled vacuoles in the cytoplasm

58. Nutrient-rich, oxygenated blood is carried from the __________ to the embryo/fetus.

placenta

Umbilical vein

placenta to fetus

What is atherosclerosis?

plaque buildup in arteries

Non-living portion of blood?

plasma

Vascular shock

poor circulation due to extreme vasodilation

vascular shock

poor circulation resulting from extreme vasodilation after long periods of sitting or standing

Name the venules which directly drain capillary beds

post-capillary venules.

Which of the following regulates blood flow at the entrance to each true capillary? valves precapillary sphincter lymph nodes tunica intima tunica externa

precapillary sphincter

what regulates blood flow into true capillaries?

precapillary sphincters

how is blood flow regulation altered during strenuous exercise?

precapillary sphincters. Thermal regulation sends blood to (besides skeletal muscles) heart, brain and skin for this purpose.

respiratory "pump" - venous return

pressure changes created during breathing move blood towards heart by squeezing abdominal vein as thoracic veins expand

name the other lymphoid organs of the body

red bone marrow Thymus Secondary organs Spleen Lymph nodes MALT

vasomotor centers and fibers

sympathetic nerves in medulla oversee changes in blood vessel diameter, part of cardiovascular center along with cardiac centers, regulate vasomotor tone. Input from baroreceptors, chemoreceptors, higher brain centers

Blood Flow

the volume of blood flowing through a vessel, an organ, or the entire circulation in a given period of time (ml/min)

continuous capillary

these are characterized by tightly arranged endothelial cells connected via tight junctions; materials are prevented from moving b/n cells so they must be able to penetrate the endothelial cell itself in order for exchange to occur; lipid soluble material & material small enough to penetrate the endothelial cell membrane can be transported from the blood into tissues; *found in the BRAIN

15. What is the relationship between a metarteriole and a thoroughfare channel?

they are both continuous with each other.

what is a baroreceptor? where are they found?

they detect changes in pressure and send constant signals, found in the vessel walls

how do kidneys maintain blood pressure?

they maintain blood volume, reasorbing water increases bp and excreting water decreases bp

Why are the veins considered the capacitance vessels of the cardiovascular system?

they serve as the blood reservoir: blood held in systemic veins: 65%

what is an elastic artery. provide examples. Name 3 characteristics for their function

thick walled arteries near the heart; ex: aorta and its major branches, 1. Large lumens allows low resistance conduction of blood 2. contains losts of elastin to expand and recoil as blood leaves the heart.

what is an elastic artery. provide examples. Name 3 characteristics for their function

thick walled arteries near the heart; ex: aorta and its majore branches, 1. Large lumens allows low resistance conduction of blood 2. contains losts of elastin to expand and recoil as blood leaves the heart.

muscular arteries

thick walled structures with lots of tunica media regulate blood pressure

Blood viscosity

thickness or stickiness of fluid -Greater viscosity= slower flow

arterioles

thin walled vessel with 3 tunics control blood flow to tissues and feed capillary beds

vein description

thin walled vessel with large lumen, little smooth muscle, and valves return vessels to heart

blood flow that provides adeuate supplies and removes waste. important for: delivery of o2 and nutrients, gas exchange, absoroption of nutrients, urine formation

tissue perfusion

what blood vessel layer is composed largely of loosely woven collagen fibers that protect and reinforce the vessel

tunica externa [tunica adventita]

Which of the following is the correct sequence of layers in the vessel wall from outside to inside? tunica media, tunica intima, tunica externa tunica intima, tunica externa, tunica media tunica intima, tunica externa, tunica media tunica externa, tunica media, tunica intima It varies from vessel to vessel.

tunica externa, tunica media, tunica intima

what are of blood vessel has its flat cells fit closely together to form a slick surface that minimizes friction as blood moves through

tunica interna

what blood vessel layer contains the endothelium (made of simple squamous epithelium)

tunica interna (tunica intima)

6. Which layer of the blood vessel wall is continuous with the endocardium of the heart?

tunica intima

What is the proper term for the intermost layer?

tunica intima

wraps around luma ( epithelium)

tunica intima

3. Name from innermost to outermost the three distinct tissue layers (i.e., tunics) of the blood vessel walls.

tunica intima (internal) tunica media tunica adventitia (externa)

The middle layer of a blood vessel is called the _____

tunica media

middle layer (smooth muscle)

tunica media

the vessel layer that has a direct role in vasoconstrictions is

tunica media

what area of blood vessel is capable of undergoing vasoconstriction or vasodilation to influence blood flow and blood pressure

tunica media

what blood vessel layer is mostly circularly arranged smooth muscle cells and sheets of elastin

tunica media

Arteries have thicker..

tunica media (more smooth muscle); resists bursting

how does blood vessels maintain bp

tunica media containing smooth muscle can change the diameter of the vessel -vasoconstriction increases bp amd decreases blood vessel diameter -vasodialation decreases bp and increase blood vessel diameter -PERIPHEAL RESISTANCE

how do arteries and veins differ in tunica media

tunica media is thicker in arteries than veins

Stiffening of arteries

turbulence, higher pressure, increased load on heart

62. What happens to the umbilical vein and umbilical arteries after birth?

umbilical vein: ligamentum teres umbilical arteries: medial umbilical ligaments

Auscultatory Method of measuring blood pressure

using brachial artery and sphygmomanometer

Varicose veins

valves no longer work, blood pools up

Loss of vasomotor tone that results in a huge drop in peripheral resistance is known as __________. vasoconstriction atherosclerosis varicose veins hypertension vascular shock

vascular shock

poor circulation resulting from extreme vasodilation after long periods of sitting or standing

vascular shock

how do the vascular shunt and true capillaries function

vascular shunts metarteriole thoroughfare channel allows blood to bypass the capillary bed true capillaries branch of the metarteriole and return to the thoroughfare channel at the distal end of the bed.

Reduction in the lumen diameter of a blood vessel as the smooth muscle contracts is known as __________. vasodilation arteriosclerosis atherosclerosis vasoconstriction varicose veins

vasoconstriction

reduces the diameter of a vessel

vasoconstriction

how does epinephrine and norepinephrine affect bp

vasoconstricts most blood vessels to increase blood pressure, vasodilates skeletal and cardiac muscle blood vessels to reduce resistance and increase blood flow

increases the diameter of a vessel

vasodilation

stages of inflammation

vasodilation emigration of phagocytes chemotaxis and microbial attack

Inhibiting vasomotor one does what?

vasodilation - R goes down

7. What effect does the sympathetic nervous system have on vascular smooth muscle tone?

vasomotor tone: constant contraction of the smooth muscle. vasoconstriction vasodilation

Up to 65% of the body's blood supply is found in __________. capillaries veins arterioles arteries

veins

contain valves to assist blood flow back toward heart describes what

veins

Which blood vessels serve as the blood reservoir?

veins: capacitance vessels

changes little during cardiac cycle

venous BP

steady and changes little during the cardiac cycle -pressure gradient in the venous system is only 20 mm HG

venous blood pressure

flattened veins with extremely thin walls

venous sinuses

Prevent backflow of blood most abundant in veins of limbs

venous valves

what converges to form a venule? vein?

venule- capillary beds converge veins- venules converge

smallest vessels leading away from capillaries describes what

venules

18. Identify and describe the structure of the major types of venous vessels.

venules: small. thin-walled. post-capillary venules. Veins: larger lames, thinner walls. - tunica media is thin, tunic external is thickest layer. - Collagen fibers arranged longitudinally: increases lumen and collapse easier. -

40. Which blood vessels play the most important role in determining peripheral resistance? Explain your answer.

vessel diameter: - arterioles ~ constrict or dilate ~ numerous

what area of blood vessel provides a space for blood to travel through the vessel

vessel lumen

what blood vessel layer has blood-containing space in the center of the vessel

vessel lumen

venules

vessels small that have only a tunica intima large have all three tunics drain capillary beds

peripheral systemic circulation

vessels not in chest or abdomen (peripheral system is where most resistance encountered.)

blood flow

volume of blood flowing through a vessel, organ, or entire circulation in a given period, measured in mL/minute , equivalent to CO for entire cardiovascular system, based on needs of organs (varies)

35. Define blood flow.

volume of blood moved through a vessel/organ, or the entire circulation per unit of time

Prothrombotic molecules produced by endothelium

von Willebrand factor (Cofactor VIIIa) Tissue factor (FActor 3) Plasminogen activator inhibitor (PAI)

general composition of vessels

walls composed of tunics: tunica externa, tunica media, tunica intima. Lumen= inside of vessel. Capillaries, veins and arteries all vary in composition

more about capillaries

walls of thin tunica intima one cell thick, size only allows one rbc to pass at a time, functions: exchange gases, hormones, nutrients, wastes, etc.

hepatic portal system

what carries blood from GI tract, spleen and pancreas to liver, superior and inferior mesenteric merged with splenic veins

When would the capillary beds surrounding the gastrointestinal organs be open? while sleeping between meals when digesting a meal during exercise

when digesting meals

vesicular transport

when endothelial cells use pinocytosis. fuses fluid filled vehicles with plasma membrane, transports *between blood and interstitial fluid*, certain *hormones and fatty acids transported by this method*.

Active Humoral immunity

when the b cells encounter antigens and produce antibodies against them

Where is blood flow the slowest?

where total cross sectional area is greatest farther distance from the heart slowest in capillaries due to exchange

What makes up the formed elements of blood?

white blood cells, platelets, and red blood cells

function of humoral immunity

works against extracellular pathogens (viruses, bacteria, fungi) that are in fluids outside the cells

Do WBCs contain a nucleus?

yes

Abnormally fast heart rate

z (tachycardia)

superior mesenteric artery

肠系膜上动脉

celiac trunk

腹腔的

basilic vein

贵要静脉

Carry blood away from the heart

Arteries

superior vena cava vein

Identify the blood vessel.

Which tunic does the valve come from?

Intima

What is involved in long term regulation?

The kidneys

Which of the 2 vessels affect/regulate blood flow or blood pressure?

Arteries

Which one will have thicker walls?

Arteries

What are the three types of blood vessels

arteries, capillaries, veins

Path of blood

arteries->arterioles->capillaries->venules->veins

2nd line of defense

internal defenses; phagocytes, fever, *inflammation*

red blood

low CO2 and high O2

blue blood

low O2 and high CO2

Water-soluble solutes...

pass through clefts and fenestrations

Functions of Suppressor T cells

suppresses antibody production

Cause of immobilization

swelling hampering movement while healing

nervous system control of blood flow correlates to

sympathetic impulses

continuous capillaries

*abundant in skin and muscles* - *tight junctions* connect endothelial cells, *intercellular clefts* allow the passage of fluids and small solutes. *in the brain tight junctions are complete, forming blood brain barrier* *least permeable capillary, most common*

tight junctions and relation to lumen?

*apical surface faces lumen*

how are capillaries composed differently than arteries and veins?

*composed of endothelium and basement membrane* (in capillary bed). *only had tunica intima* *lack of sub endothelial layer* *allows for rapid gas an nutrient exchange* largish lumen

Vascular shunt

*metarteriole and thoroughfare channel*, directly connects terminal arteriole and post-capillary venule.

Reabsorption and pressure gradients?

*reabsorption* occurs on venous end. Net HP less than net osmotic pressure - *net pressure flow in*. (HP - COP = -NFP). Concentration gradient lower in veins, water wants in

sphincter contraction v relaxation (capillaries)

*when sphincters relaxed, capillary bed perfused*. *when sphincter contracted, blood bypasses true capillaries/capillary bed and goes directly between terminal arteriole to postcapillary venue circulation to true capillaries shut off* metarteriole and thoroughfare

43. Define systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP).

- SBP: BP @ end of vent. systole. - DBP: right before next systole - PP: difference between the two extension and retraction of blood vessel wall used to make MAP (mean arterial pressure)

46. Define mean arterial pressure (MAP) and tell why it is important.

- amount of force to drive blood thru circulation -90-100 mmhg MAP= DBP + 1/3PP

Arterioles

-Abundant microscopic vessels -Metarteriole has precapillary sphincter, monitors blood flow into capillary -Sympathetic innervation and local chemical mediators can alter diameter, & thus blood flow and resistance -RESISTANCE vessels : resistance is opposition to blood flow -Vasoconstriction can raise blood pressure

What effects increased blood volume

-Angiotensin II -ADH -Aldosterone -Increased H2O retention

How does ADH affect blood pressure

-Antidiuretic hormone, causes Na and water retention -increases blood volume/BP

Pressure in Systemic Circuit

-Arteries 120 mm Hg (systolic) 80 mm Hg (diastolic) -Arterioles 80-35 -Capillaries 35-15 -Venules 15-5 -Veins 5-0 mm Hg

Blood Vessel Types

-Arteries: carry blood AWAY from heart -Arterioles -Capillaries: sites of exchange -Venules -Veins: carry blood TO heart

Atherosclerosis

-Begins with injury to endothelium -Lipids accumulate -Smooth muscle cells deposit collagen forming a fibrous plaque -Plaque enlarges and becomes unstable and prone to rupture

Sinusoid

-Found in bone marrow, spleen, adrenal medulla, and liver -Very porous -Permit entry & exit of large molecules and cells -Slow blood flow

Fenestrated capillary

-Found in kidneys, small intestines & endocrine glands -Have intercellular clefts and holes/fenestrations through plasma membrane -Needed for active absorption

Continuous Capillary

-Found in skin & muscle -Has tight junctions -Allows limited passage of fluids

Elastic Arteries

-Largest arteries -relatively THIN walls -Pressure Reservoir -Help propel blood forward while ventricles relaxed -aka CONDUCTING arteries--conduct blood to medium sized arteries

Location of Cardiovascular Center (CV)

-Medulla Oblongata -Groups of neurons regulate heart rate, contractility of ventricles, and blood vessel diameter -Cardiostimulatory and cardioinhibitory centers

How does aldosterone affect blood pressure

-Promotes Na and water retention by kidneys -increases blood volume/ BP

Veins

-Structural changes not as distinct as arteries -very thin walls in relation to total diameter Same 3 layers as arteries 1. TUNICA INTERNA thinner than arteries w/ little smooth muscle 2. TUNICA EXTERNA: thickest layer -Not Designed to withstand high pressure Valves: folds on tunica interna, forming cusps -aid in venous return by preventing back flow

Venules

-Thinner walls than arteriole counterparts -postcapillary venule=smallest venule -form part of microcirculatroy exchange unit w/ capillaries -muscular venules have thicker walls w/ 1-2 layers of smooth muscle

Muscular Arteries

-Tunica media contains more smooth muscle and fewer elastic fibers than elastic arteries -THICK walls Capable of great vasoconstriction/ vasodilatation to adjust rate of blood flow aka DISTRIBUTING arteries

What is edema?

-accumulation of excess fluid in the tissue, fluid filters into a tissue faster than it is reabsorbed

What is the net filtration pressure? How does it determine the amount and direction of fluid flow

-all the forces acting on a capillary bed -at the arterial end of the bed hydrostatic forces dominate so fluid flow out of the capillaries -at the venous end of the bed osmotic pressure dominates so fluids flow into the bed

surgical treatment of atherosclerosis

-angioplasty -stent -bypass grafting

factors effecting decreased blood volume

-atrial natriuretic peptide -decreased water retention

Describe how you measure blood pressure, what instruments are used, what artery is measured, what sounds you hear relate to?

-auscultation method using a sphygmomanometer and stethoscope - brachial artery -Systolic and diastolic pressure

Describe perfusion

-blood flow that provides adequate supplies and removes waste. -It is important for delivery of oxygen and nutrients to and removal of wastes from tissue cells, gas exchange in the lungs, absorption of nutrients from the digestive tract and urine formation by the kidneys

Tissue Perfusion in Brain

-brain extremely intolerant of ischemia -myogenic/metabolic controls maintain blood flow at constant rate

Why is it important to be able to take a pulse at many different points on the body

-can vary with health, body position and activity -can point to blocks in arteries

Describe the 3 types of edema

-capillary filtration-increased capillary activity, poor venous return, histamine makes capillaries more permeable -capillary reabsorption- hypoproteinemia fluid stays in the tissues -obstructed lymphatic reabsorption- lymphatic system drains excess tissue fluid if it is obstructed, fluid is retained in the tissues

How does Angiotension II affect blood pressure?

-part of the angiotension-renin mechanism, causes vasoconstriction -increases BP

Three Key Sources of Resistance

1. Blood viscosity 2. Total Blood vessels length 3. Blood vessel diameter

Define hypertension, the 4 different types and causes

-condition of sustained elevated arterial pressure of 140/90 or higher -temporary elevations normal, can be caused by fever, physical exertion and emotional upset -chronic elevation is major cause of heart failure, vascular disease, renal failure and stroke -primary or essential hypertension, risk factors by body charc. diet, obesity, age, race, heredity, stress and smoking -secondary hypertension caused by identifiable disorders, excessive renal secretion, arteriosclerosis, and endocrine disorders

factors decreasing peripheral resistance

-decreased renin secretion -increased PNS

treatment of atherosclerosis

-dietary modification -physical activity -meds to slow cholesterol, monitor blood glucose level, lower high blood pressure -stop smoking

capillary exchange

-diffusion through gaps and fenestrations or diffusion through membranes -osmosis -transcytosis

Hormones that control resistance

-e/ne -angiotensin II -atrial natriuretic peptide (ANP)

factors increasing peripheral resistance

-e/ne -renin secretion -angiotensin II -increased SNS

When is BP the highest naturally? What extrinsic factors might influence it?

-highest in morning --age,sex,weight, race,mood, posture, socioeconomic status, and physical activity

Hypotension Causes

-hypovolemia -decreased CO -excessive dilation

When is BP highest naturally? What extrinsic factors might influence it

-in the morning -age, sex, weight, race, mood, posture, socioeconomic status, physical activity

Define hypotension and the 3 different types and causes

-low BP in which systolic pressure is below 100 mmHg -orthostatic hypotension- temporary low BP and dizziness when suddenly rising from a lying or sitting position -chronic hypotension- hint of poor nutrition and warning signs for Addison's Disease -acute hypotension-important sign of circulatory shock

Direction of flow of blood through blood vessels: (5)

1- arteries (carry blood away from the heart) 2- arterioles (smallest arteries that lead to capillaries) 3- capillaries (smallest blood vessel) 4- venules (smallest veins that receive blood from capillaries) 5- veins (return blood back to heart)

3 Types of Capillaries

1. Continuous -endothelial cell membranes form continuous tube 2. Fenestrated -have fenestrations or pores 3. Sinusoids -wider, more winding -unusually large fenestrations

Most extensively involved vessels in atherosclerotic lesions

1. Lower abdominal aorta 2. Coronary arteries 3. Popliteal arteries 4. Internal carotid arteries 5. Vessels of the circle of WIllis 6. Ostia of mesenteric and renal arteries

Poiseuille's Law 4 factors influence fluid flow through a tube

1. Pressure Gradient 2. Tube Radius 3. Tube Length 4. Fluid Viscosity

Baroreceptor Reflexes

1. Pressure-sensitive receptors in internal carotid arteries and other large arteries in neck and chest -Carotid sinus reflex helps regulate blood pressure in brain -Aortic reflex regulates systemic blood pressure 2. When blood pressure falls, baroreceptors stretched less, slower rate of impulses to cardiovascular center 3. Cardiovascular center decreases parasympathetic stimulation and increases sympathetic stimulation

Chemoreceptor Reflexes

1. Receptors located close to baroreceptors of carotid sinus (carotid bodies) and aortic arch (aortic bodies) 2. Detect hypoxia (low O2), hypercapnia (high CO2), acidosis (high H+) and send signals to cardiovascular center -Cardiovascular center increases sympathetic stimulation to arterioles and veins, producing vasoconstriction and an increase in blood pressure 3. Receptors also provide input to respiratory center to adjust breathing rate

Renin-angiotensin-aldosterone (RAA) system

1. Renin (released by kidney when blood volume falls or blood flow decreases) and angiotensin converting enzyme (ACE) act on substrates to produce active hormone angiotensin II 2. Raises BP by vasoconstriction and secretion of aldosterone (increases water reabsorption in kidneys to raise blood volume and pressure)

List the hormones that help regulate BP

1. Renin-angiotensin-aldosterone (RAA) system 2. Epinephrine & Norepinephrine 3. Antidiuretic Hormone (ADH) 4. Atrial Natriuretic Peptide (ANP)

Factors That Determine Vascular Resistence

1. Size of lumen - vasoconstriction makes lumen smaller meaning greater resistance 2. Blood viscosity - ratio of RBCs to plasma and protein concentration, higher viscosity means higher resistance 3. Total blood vessel length - resistance directly proportional to length of vessel -400 miles of additional blood vessels for each 2.2lb. of fat

Factors Aiding Venous Return

1. Skeletal muscle pump -milks blood in 1 direction due to valves 2. Respiratory pump -due to pressure changes in thoracic and abdominal cavities 3. Arterial recoil

Mechanisms in which oxidized LDL causes damage

1. Stimulates the release of growth factors, cytokines, and chemokines that increase monocyte recruitment into lesions; 2. Cytotoxic to endothelial cells and smooth muscle cells and can induce endothelial cell dysfunction

Blood Vessel Layers

1. TUNICA INTERNA (INTIMA) -Inner lining, direct w/ blood -endothelium continuous w/ endocardial lining of heart -active role in vessel related activities 2. TUNICA MEDIA -muscular, connective tissue layer -greatest variation among vessel types -smooth muscle regulates diameter of lumen 3. TUNICA EXTERNA -elastic, collagen fibers -Vasa Vasorum: capillaries that supply blood to tissues of the vessels -helps anchor vessel to surrounding tissue

When does the heart begin beating?

21 days after conception

Anatomy of Blood Vessels

3 Layer (tunics) -Tunica interna -Tunica media -Tunica externa

What percentage of blood is distributes in the arteries, heart, and capillaries?

30-35%

arterioles

3mm to 10 micrometers diameter, fewer layers of smooth muscle, regulate systemic blood pressure and flow, smooth muscle usually somewhat constricted

Peak time of onset of acute MI

6:00 am- 12:00 noon

Capillaries

7-8 um in diameter (approximately the same with RBC)

Primary hypertension

90% of cases -Cannot pinpoint the cause Due to many factors including; Heredity Diet Obesity Age Stress Smoking

LDL Cholesterol cut-off to connote low risk

<160 mg/dL

Small arteres

<2mm in diameter

Mean Arterial Pressure (Map) formula

=diastolic pressure + 1/3 (pulse pressure) ex: 80 + 1/3 (120-80) must be maintained at 95 mm Hg

Pulse Pressure

=systolic- diastolic ex: 120-80= 40 mm when audible sounds stop is the diastolic pressure

Aldosterone will ________. A) promote an increase in blood pressure B) promote a decrease in blood volume C) result in a larger output of urine D) decrease sodium reabsorption

A

Histologically, the ________ is squamous epithelium supported by a sparse connective tissue layer. A) tunica intima B) tunica media C) tunica externa D) tunica adventitia

A

The circulatory route that runs from the digestive tract to the liver is called ________. A) hepatic portal circulation B) pulmonary circulation C) coronary circulation D) cerebral circulation

A

Which of the choices below reflects the balance (or imbalance) between the direction and amount of fluid that flows across the capillary walls? A) hydrostatic and osmotic pressure B) hydrostatic pressure only C) blood volume and viscosity D) plasma and formed element concentration

A

Which tunic of an artery contains endothelium? A) tunica intima B) tunica media C) tunica externa D) basement membrane

A

Where do arterioles enter?

A capillary bed

Vaso constriction

A decrease in a blood vessel's internal diameter, causing a decrease in blood flow.

Chronic KS/Classic/European KS

A disorder of older men of Mediterranean, Middle Eastern, or Eastern European descent (especially Ashkenazic Jews Not associated with HIV infection Manifests as multiple red-purple skin plaques or nodules, usually in the distal lower extremities and otherwise ASYMPTOMATIC

Pyogenic granuloma

A form of capillary hemangioma which is a rapidly growing red pedunculated lesions on the skin, gingival, or oral mucosa that bleed easily and are often ulcerated

ANCA

A heterogeneous group of autoantibodies directed against constituents of neutrophil primary granules, monocyte lysosomes, and endothelial cells n directly activate neutrophils to release ROS and proteolytic enzymes

Opsonization

A pathogen being coated with opsonins, which accelerates the phagocytosis of that pathogen "to make tasty"

Behçet Disease

A small- to medium-vessel neutrophilic vasculitis that classically presents as a clinical triad of recurrent oral aphthous ulcers, genital ulcers, and uveitis Associated with certain HLA haplotypes (HLA-B51, in particular) and TH17 cells

Port wine stain/ Hemangioma

A special form of nevus flammeus which tend to grow with a child, thicken the skin surface, and demonstrate no tendency to fade

Vasodilation

A widening of the diameter of a blood vessel/lumen

VC produced by endothelium

ACE Endothelin

Sturge Weber syndrome

AKA Encephalotrigeminal angiomatosis Associated with port wine stains in a trigeminal distribution Congenital disorder ssociated with venous angiomatous masses in the cortical leptomeninges and ipsilateral facial port wine nevi; mental retardation, seizures, hemiplegia, and skull radioopacities

Aortic Valve

AKA Left semilunar valve Located between L ventricle and the aorta

Bicuspid (mitral) valve

AKA left AV valve Located between the L atrium and L ventricles

Kawasaki disease

AKA mucocutaneous lymph node syndrome because it presents with conjunctival and oral erythema and erosion, edema of the hands and feet, erythema of the palms and soles, a desquamative rash, and cervical lymph node enlargement Leading cause of acquired heart disease in children An acute febrile, usually self-limited illness of childood associated with an arteritis affecting large to medium sized and even small vessels Thought to result from a delayed type of hypersensitivity reaction of T cells

Tricuspid valve

AKA right AV valve Located between the R atrium and R ventricle

Pulmonic Valve

AKA right semilunar valve Located between R ventricle & Pulmonary artery

In which vessels is the tunica intima present?

ALL VESSELS

Short term neural and hormonal controls - lowering BP

ANP, baroreceptors stimulated, cardioacceleratory stimulated, vasomotor inhibited

What is an antigen presenting cell (APC)?

APCs engulf antigens and then present fragments of them on their own surface where T CELLS can recognize them

Describe Autoregulation of Blood Pressure

Ability of tissue to automatically adjust its blood flow to match metabolic demands Demand of O2 and nutrients can rise tenfold during exercise in heart and skeletal muscles Also controls regional blood flow in the brain during different mental and physical activities

Compliance

Ability to expand to accommodate increased content

Arteriovenous fistula

Abnormal, typically small. direct connections between arteries and veins Can be caused by: 1. Developmental defect 2. Rupture of arterial aneurysm into an adjacent vein 3. Penetrating injuries that pierce arteries and veins 4. Inflammatory necrosis of adjacent vessels 5. Intentionally created to provide vascular access for chronic hemodialysis When significantly large, can shunt blood from the arterial to venous circulations and force the heart to pump additional volume resulting in high-output cardiac failure

(Hepatic portal system) primary function of intestinal cells of capillary bed #1 is to _____ and these nutrients diffuse into this capillary bed. These nutrients need to be sent to the _____ for further processing

Absorb nutrients Liver

ENaC

Absorbs the remaining 2% of the filtered sodium not filtered by constitutively active ion channels, exchangers and transporters Tightly regulated by RAAS system in the cortical collecting tubule Note: 2% lang ang regulated, thus if masyadong malaki ang sodium intake, only a small amount can be limited and the rest will be absorbed by the constitutively active ion channels.

Preload

Amount of blood in ventricles at the end of its resting phase (diastole). AKA end-diastolic volume (EDV)

Cardiac Output

Amount of blood pumped by each ventricle in 1 min Normal = 5L/min Determined by heart rate and stroke volume

Stroke Volume

Amount of blood pumped by ventricle per beat Average resting stroke volume = 60-80 mL/beat Can be increased by greater force of contraction

Mycotic aneurysm

An aneurysm arising from bacterial infection of the arterial wall or from syphilis (rare) Can originate from: 1. Embolization of a septic embolus 2. Extension of an adjacent suppurative process 3. By circulating organisms directly infecting arterial wall

Vaso dilation

An increase in a blood vessel's internal diameter

Function of tunica externa=

Anchors and protects the vessel

Fibrous pericardium

Anchors heart

True aneurysm

Aneurysm involving an intact attenuated arterail wall or thinned ventricular wall of the heart Examples: 1. Atherosclerotic, syphilitic, and congenital vascular aneurysms 2. Ventricular aneurysms that follow transmural MI

Atherosclerosis

Another name for hardening of the arteries

Coronary vessels supplying and draining the _____ surface of the heart

Anterior

Humoral Immunity

Antibody mediated immunity B cells transform into plasma cells which synthesize and secrete specific proteins called antibodies

ADH

Antidiuretic hormone- vasopressin. Vasoconstriction. (baroreceptors or osmoreceptors > hypothalamic neuron> posterior pituitary > ADH > kidneys and blood vessels)

How to antigens affect the adaptive defenses?

Antigens are the ultimate target of all adaptive immune system and cause their activation

(Systemic circuit) the ____ receives the blood from the left ventricle

Aorta

Where does the ductus arterious dump blood?

Aorta

(Coronary circulation) the right and left coronary arteries branch off of the _____. These 2 arteries branch multiple times to provide the _____ with the substances they need

Aorta Cardiac cells

Large or elastic arteries

Aorta Innominate Subclavian Common Carotid Iliac

What is most affected from atherosclerosis

Aorta, carotid and coronary arteries

Double barreled aorta with a false channel

Aortic dissecting hematoma reenters the lumen of the aorta through a second distal intimal tear creating a new vascular channel

Arterial dissection

Arises when blood enters the arterial wall itself, as a hematoma dissecting between its layers

Can arteries or veins constrict?

Arteries

... Which of the following is true when comparing arteries and veins? At any given time, there is more blood present in arteries than in veins. Arteries carry blood away from the heart; veins carry blood to the heart. Arteries have valves; veins do not. Arteries are less muscular than veins.

Arteries carry blood away from the heart; veins carry blood to the heart.

difference between artery v vein composition?

Arteries, *lumen smaller, thicker tunica media*- *more elastic/collagen fibers* between tunica externa and media AND tunica media and intima. *More resistant to changes in bp, can spring back to shape*

Blood flow

Arteries, arterioles, capillaries, venules, veins

Conductance vessels

Arteries. Conduct blood from the heart to the arterioles

Smallest arteries lead to capillary beds

Arterioles

The _____ are very important because vasodilation and vasoconstriction of these vessels helps to control blood pressure

Arterioles

What is the proper term for the smallest artery?

Arterioles

Which blood vessel regulates the MAP the most and affects capillary function?

Arterioles

There is a major drop in blood pressure as it moves through the ______ (this occurs primarily because of the many branches of the arterioles). This is important because single-layer of the capillary walls couldn't withstand _____

Arterioles High blood pressure

Hyaline arteriolosclerosis

Arterioles show homogenous, pink hyaline thickening with associated luminal narrowing

Resistance vessels

Arterioles. Contraction and relaxation of muscle change vessel diameter, which alters resistance to blood flow

Arteriosclerosis patterns

Arteriolosclerosis Monckeberg medial sclerosis Atherosclerosis

Glomus bodies

Arteriovenous structures involved in thermoregulation

When blood pressure is measured by a nurse or doctor, it is measured in an _____

Artery

In the endocrine system was introduced a "portal system." Instead of artery ➡️ capillary bed ➡️ vein and return of blood to the heart, in a portal system there is a second capillary bed in the series:

Artery ➡️ capillary bed #1 ➡️ portal vessel ➡️ capillary bed #2 ➡️ vein and then blood is returned to the heart

Blood Volume

As blood volume increases, BP increases effects on bv: water gain or water loss

Reactive Hyperemia

Assess tissue response to a brief episode of ischemia by occluding artery Dilator metabolites accumulate in ischemic tissue - result in marked increase in flow when occlusion is released

venous return

Assisted by: -valves -venoconstriction -skeletal muscle pumps -respiratory pump

At arterial end... At venous end...

At arterial end, hydrostatic forces dominate At venous end, osmotic forces dominate.

If a decrease in blood pressure occurs, the ______ will increase blood pressure

Baroreceptor reflex

If an increase in blood pressure occurs, the ______ will reverse the direction of change, so it will decrease blood pressure

Baroreceptor reflex

There is a reflex in the body that offers a short-term control to changes in blood pressure and this is called the ______

Baroreceptor reflex

Neural Controls Operate via Reflex arcs involve:

Baroreceptors Vasomotor Centers and Vasomotor Fibers Cardioacceleratory/Cardioinhibitory centers and fibers Vascular Smooth Muscle Nodal Cells in the heart

Long Term Renal Mechanisms

Baroreceptors quickly adapt to chronic high or low BP Long-term mechanisms step in the control BP by altering blood volume Kidneys act directly and indirectly

Move and exercise their bodies

Because veins depend on the muscles around them to squeeze blood towards the heart, it is important that humans do what?

Hypotension

Below 90/60 Often associated with long life and health May cause dizziness or fainting

Glomus Tumor (Glomangioma)

Benign but exquisitely painful tumors arising from modified smooth muscle cells of the glomus bodies Commonly found in the distal portion of the digits, especially under the fingernails

Bacillary angiomatosis

Benign capillary skin papules found in AIDs patients caused by bartonella henselae infections, frequently mistaken for Kaposi sarcoma A reactive vascular proliferation in immunocompromised hosts caused by opportunistic gram-negative bacilli of the Bartonella family: 1. Bartonella henselae- cat scratch disease 2. Bartonella quintana- trench fever

Lymphangioma

Benign lymphatic analogs of hemangioma

Histamine

Besides heparin, what else is secreted by basophils?

The smallest veins are the venules, which receive _____ from the ______

Blood Capillaries

(Circle of Willis) The 3 cerebral arteries supply ____ to various parts of the _____

Blood Cerebrum

Capillaries is the only blood vessel that allows the exchange of substances between the _____ and the ______. The single layer of the capillary wall allows for rapid exchange

Blood Surrounding fluid

Pressures that promote REABSORPTION

Blood colloid osmotic pressure (BCOP) -Due to presence of blood plasma proteins too large to cross walls -Averages 36 mmHg Interstitial fluid hydrostatic pressure (IFHP) -Close to zero mmHg

volume of blood flowing through vessel, organ, or entire circulation in given period measured as ml/min equivalent to cardiac output for entire vascular system relatively constant when at rest

Blood flow

____ are the smallest blood vessel and their lumen is just large enough for a single-file passage of RBCs

Capillaries

48. Identify the three factors which influence mean arterial pressure.

Blood volume Cardiac output: increases TPR: increases

Where does the Cardiovascular Center receive input from?

Both higher brain regions & Sensory Receptors

Brain blood flow autoregulation ________. A) is less sensitive to pH than to a decreased oxygen level B) causes constriction of cerebral blood vessels in response to a drop in systemic blood pressure C) is abolished when abnormally high CO2 levels persist D) is controlled by cardiac centers in the pons

C

Cerebral blood flow is regulated by ________. A) skin temperature B) ADH C) intrinsic autoregulatory mechanisms D) the hypothalamic "thermostat"

C

If blood pressure is almost normal in a person who has lost blood, does that mean the tissues are receiving adequate blood flow? A) yes B) no C) not necessarily

C

Peripheral resistance ________. A) decreases with increasing length of the blood vessel B) increases as blood vessel diameter increases C) increases as blood viscosity increases D) is not a major factor in blood pressure in healthy individuals

C

Secondary hypertension can be caused by ________. A) obesity B) stress C) arteriosclerosis D) smoking

C

The arteries that directly feed into the capillary beds are called ________. A) muscular arteries B) elastic arteries C) arterioles D) venules

C

The form of circulatory shock known as hypovolemic shock is ________. A) the form of shock caused by anaphylaxis B) any condition in which blood vessels are inadequately filled and blood cannot circulate normally C) shock that results from large-scale loss of blood volume, or after severe vomiting or diarrhea D) always fatal

C

Which of the choices below does not explain why low capillary pressures are desirable? A) Capillaries are fragile and high pressures would rupture them. B) Most capillaries are extremely permeable and thus even low pressures force solute-containing fluid out of the bloodstream. C) Low blood pressure is more desirable than high blood pressure. C) Low blood pressure is more desirable than high blood pressure.

C

Which of the following blood pressure readings would be indicative of hypertension? A) 120/80 in a 30-year-old man B) 140/90 in a 70-year-old woman C) 170/96 in a 50-year-old man D) 110/60 in a 20-year-old woman

C

Which of the following is a type of circulatory shock? A) hypovolemic, caused by increased blood volume B) cardiogenic, which results from any defect in blood vessels C) vascular, due to extreme vasodilation as a result of loss of vasomotor tone D) circulatory, where blood volume is normal and constant

C

Which of the following is likely during vigorous exercise? A) Blood will be diverted to the digestive organs. B) The skin will be cold and clammy. C) Capillaries of the active muscles will be engorged with blood. D) Blood flow to the kidneys increase.

C

Which of the following is not one of the three main factors influencing blood pressure? A) cardiac output B) peripheral resistance C) emotional state D) blood volume

C

Which of the following would not result in the dilation of the feeder arterioles and opening of the precapillary sphincters in systemic capillary beds? A) a decrease in local tissue oxygen content B) an increase in local tissue carbon dioxide C) a local increase in histamine D) a local increase in pH

C

Sensory neeves

CN 9 n 10 ( glossopharyngral/vagus) carry info to brain

Essential Hypertension

CO and HR are elevated Chronically elevated secretion of renin High BP causes thickening of arterial walls resulting in atherosclerosis

Cardiac Output

CO=HRxSV

50. How do variations in heart rate and stroke volume influence mean arterial pressure?

CO=HRxSV Since an increase of CO, increases MAP, then in increase in heart rate and stroke volume will also increase MAP.

BP=

COxPR

(Systemic circuit) arterioles regulate flow into _____ where nutrients are delivered to the cells and waste is carried away

Capillaries

Microscopic blood vessels Thin tunica intima functions: exchange of gases, nutrients, wastes, hormones etc between blood and interstitial fluid

Capillaries

The only blood vessel that allows the exchange of substances between the blood and the surrounding fluid

Capillaries

Which of the 5 vessels are capable of diffusion/permeability?

Capillaries

Which of the 5 vessels are made of simple squamous cells?

Capillaries

What are the specific factors that promote filtration in the capillaries?

Capillary blood pressure (Capillary hydrostatic pressure) interstitial fluid osmotic pressure: opposes CHP

Three Key Variables

Cardiac Output (blood flow of entire circulation) Peripheral resistance Blood Volume

The baroreceptor reflex alters _____ and the amount of ______ and ______ in the _____ of the body in response to changes in _____

Cardiac activity Vasodilation and vasoconstriction Arterioles Blood pressure

Variables that influence blood flow and pressure

Cardiac output Compliance Volume of blood Viscosity of blood Blood vessel length and diameter

49. How are mean arterial pressure, cardiac output, and total peripheral resistance related to each other?

Cardiac output has a direct relationship. TPR has an direct relationship

Heart rate and stroke volume

Cardiac output is a product of two factors:

Cardiovascular center contains

Cardioacceleratory Cardioinhibitory Vasomotor centers

Chemoreceptors are located in the

Carotid Sinus Aortic Arch Large arteries of the neck

52. Describe the baroreceptor-initiated reflex for control of blood pressure.

Carotid sinuses, aortic arch, large arteries of the neck and thorax. When stretched, sends rapid impulses to to cardiovascular system: inhibits vasomotor and cardioacceleratory centers stimulates cardioinhibting center Dec. in BP

Pulmonary circulation

Carries blood from R ventricle to lungs and back to L atrium

Ductus venosus

Carries blood from umbilical vein to IVC; bypass liver

Motor nerves

Carries info to heart n vessels

Arteries

Carry blood away from heart

Arteries

Carry blood away from heart. Carry oxygenated blood.

Veins

Carry blood back to the heart. Unoxygenated blood

55. Explain the effects on blood pressure of the following factors: catecholamines, ADH, the renin-angiotensin-aldosterone system, atrial natriuretic peptide (ANP).

Catecholamines: ^CO, vasoconstriction ADH: Kidneys conserve H2o, very low BP: intense vasoconstriction Renin: v pressure, kidneys release renin---> Angiotensin2 - stimulates aldosterone: ^Na...^H2o...^Blood volume. - stimulates ADH release---> H2no reabsorption - stimulates thirst - vasoconstriction

Superior vena caval syndrome

Caused by neoplasms such as: 1. Bronchogenic CA 2. Mediastinal lymphoma Manifests as marked dilation of the veins of the head, neck, and arms with cyanosis or respiratory distress

Inferior vena caval syndrome

Caused by neoplasms such as: 1. Hepatocellular CA 2. Renal cell CA Induces marked lower extremity edema, distention of the superficial collateral veins of the lower abdomen, and—with renal vein involvement—massive proteinuria.

cause of Pain

Caused by swelling pressing on adjacent nerve endings

S1 -1st heart sound

Caused by the closure of the AV valve at beginning of ventricular contraction, heard at apex

S2 -2nd heart sound

Caused by the closure of the semilunar valve at beginning of ventricular relaxation, heard at base

Brain

Cerebral Circulation

High Brain Centers that input nerve impulses to CV

Cerebral Cortex Limbic System Hypothalamus

(Circle of Willis) the 2 connecting arteries link the _____, creating a complete circle of blood vessels

Cerebral arteries (posterior, middle, & anterior)

Chronotropic Effect

Change in heart rate

Dromotropic effect

Change in speed at which cardiac impulse travels

Velocity of Blood Flow

Changes as it travels through systemic circulation Inversely related to total cross-sectional area Is fastest in aorta, slowest in capillaries, increases again in veins Slow capillary flow allows adequate time for exchange between blood and tissues

Vascular Shunt

Channel that connects arteriole directly w/ venule (metarteriole-throughout channel) Terminal Arteriole to Metarteriole (between arteriole and capillary) to Thoroughfare Channel (capillary and venule) to Postcapillary venule (drains bed)

Diagonal line

FRONT; anterior inter ventricular sulcus

Circulatory Shock

Condition in which cells of the body receive inadequate amounts of oxygen secondary to changes in perfusion -Systolic Blood Pressure (<90 mmHg)

Circulatory shock

Condition where blood vessels are inadequately filled and blood cannot circulate normally to meet tissue needs -If it persists, cells will die and organs will fail

Ligamentum arteriosum

Connects aorta and pulmonary artery (only found in adults)

Atheroma/Atheromatous or Atherosclerotic Plaque

Consists of a raised lesion with a soft, yellow, grumous core of lipid (mainly cholesterol and cholesterol esters) covered by a white fibrous cap Can mechanically obstruct or rupture and lead to vessel thrombosis Also weaken the underlying media and thereby lead to aneurysm Dynamic lesions consisting of dysfunctional endothelial cells, recruited and proliferating smooth muscle cells, and admixed lymphocytes and macrophages

Vasoconstriction

Constricting the blood vessels

Which type capillaries is most common?

Continuous

Which type of capillary is made up of simple squamous cells, packed together very tightly? (tight junction)

Continuous

17. Identify and describe the structure of the three types of capillaries.

Continuous: most common, skin and muscles. tight junctions---> leave gaps (intercellular clefts: allows passage of fluids and small solutes. Fenestrated: oval pores. more permeable to small solutes and fluids. used for filtration. Sinusoid: leaky. liver, bone marrow, spleen, medulla. fenestrated. larger inter clefts--> allow large molecules and blood cells to pass.

Skeletal Muscle Pumps

Contraction of limb muscles compresses veins to help return blood to heart.

Systole

Contraction of the myocardium (working phase)

Function of tunica media=

Contracts and relaxes to change the diameter of the blood vessel lumen

Medium or muscular arteries

Coronary Renal Regional blood flow and BP are by changes in lumen size through smooth muscle contraction (VC) or relaxation (VD)

Heart

Coronary Circulation

Within the systemic circulatory pathway there are a number of unique regions of blood flow. These unique structural features always meet important functional needs: (3)

Coronary circulation Circle of Willis Hepatic Portal Circulation

(Coronary circulation) all of the unoxygenated blood of the coronary circulation ultimately is delivered to the _____. This large vein delivers the unoxygenated blood to the ____

Coronary sinus Right atrium

Short-Term Neural and Hormonal Controls

Counteract fluctuations in blood pressure by altering peripheral resistance and CO

Long-Term Renal Regulation

Counteracts fluctuations in blood pressure by altering blood volume.

Capillary Colloid Osmotic Pressure

Created by nondiffusible plasma proteins, which draw water toward themselves 26 mmHg

What cells are involved in cell mediated immune response?

Cytotoxic T cells

Cytotoxic T cells vs. NK cells

Cytotoxic cells are more specific and recognize the antigen and respond to the infection NK cells destroy any and all cancerous and virus infected cells

A patient with essential hypertension might have pressures of 200/120 mm Hg. This hypertensive state could result in all of the following changes except ________. A) increased work of the left ventricle B) increased incidence of coronary artery disease C) increased damage to blood vessel endothelium D) decreased size of the heart muscle

D

A thrombus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to the ________. A) left side of the head and neck B) myocardium of the heart C) left upper arm D) right side of the head and neck and right upper arm

D

Arteriole blood pressure increases in response to all but which of the following? A) increasing stroke volume B) increasing heart rate C) rising blood volume D) falling blood volume E) all of these

D

Factors that aid venous return include all except ________. A) activity of skeletal muscles B) pressure changes in the thorax C) venous valves D) urinary output

D

Fenestrated capillaries ________. A) are not more permeable than continuous capillaries B) are not common in endocrine organs and in areas where capillary absorption is an important function C) do not occur in the glomerular capillaries of the kidneys D) are not found in the brain

D

Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary function of ________. A) arterioles B) arteries C) veins D) capillaries

D

Select the correct statement about blood flow. A) It is relatively constant through all body organs. B) It is measured in mm Hg. C) It is greatest where resistance is highest. D) Blood flow through the entire vascular system is equivalent to cardiac output.

D

Select the correct statement about factors that influence blood pressure. A) An increase in cardiac output corresponds to a decrease in blood pressure, due to the increased delivery. B) Systemic vasodilation would increase blood pressure, due to diversion of blood to essential areas. C) Excess protein production would decrease blood pressure. D) Excess red cell production would cause a blood pressure increase.

D

The term ductus venosus refers to ________. A) a fetal shunt that bypasses the lungs B) damage to the valves in the veins, leading to varicose veins C) a condition of the aged in which the arteries lose elasticity D) a special fetal vessel that allows umbilical blood to bypass the liver

D

The velocity of blood flow is ________. A) in direct proportion to the total cross-sectional area of the blood vessels B) slower in the arteries than in capillaries because arteries possess a relatively large diameter C) slower in the veins than in the capillaries because veins have a large diameter D) slowest in the capillaries because the total cross-sectional area is the greatest

D

What do the ductus arteriosus and the foramen ovale become at birth? A) ligamentum teres; fossa ovalis B) fossa ovalis; ligamentum arteriosum C) ligamentum arteriosum; ligamentum teres D) ligamentum arteriosum; fossa ovalis

D

Which of the choices below does not involve tissue perfusion? A) delivery of oxygen and nutrients to, and removal of wastes from, tissue cells B) gas exchange in the lungs C) absorption of nutrients from the digestive tract D) blood clotting

D

Which of the following chemicals does not help regulate blood pressure? A) ADH B) atrial natriuretic peptide C) angiotensin II D) nitric acid

D

Which of the following do not influence arterial pulse rate? A) activity B) postural changes C) emotions D) the vessel selected to palpate

D

Which of the following is true about veins? A) Venous valves are formed from the tunica media. B) Up to 35% of total body blood is in venous circulation at any given time. C) Veins have a small lumen in relation to the thickness of the vessel wall. D) Veins are called capacitance vessels or blood reservoirs.

D

Which of the following processes provides a long-term response to changes in blood pressure? A) neural controls B) baroreceptor-initiated reflexes C) chemoreceptor-initiated reflexes D) renal regulation

D

Which of the following signs of hypovolemic shock is a relatively late sign? A) cold, clammy skin B) increased heart rate C) rapid, thready pulse D) rapidly falling blood pressure

D

Vasculogenesis

De novo formation of blood vessels during embryogenesis

Infarction

Death of tissue due to blockage of blood flow into a tissue.

If a _____ in blood pressure occurs, the baroreceptor reflex will _____ blood pressure

Decrease Increase

(To decrease blood pressure) sympathetic activity will ____ and parasympathetic activity will _____. This will _____ cardiac output and cause ______, both of which will help to decrease blood pressure

Decrease Increase Decrease Vasodilation

Ischemia resulting in infarction (MI)

Decreased blood flow to the heart can cause?

- dromotropic effect

Decreased cardiac impulse

Vasoconstriction

Decreased diameter, less blood flow to tissue.

- inotropic

Decreased force

- chronotropic effext

Decreased heart rate

renal vein

Identify the blood vessel.

subclavian artery

Identify the blood vessel.

subclavian vein

Identify the blood vessel.

Respiratory Pump

During inhalation intrathoracic pressure becomes more negative, like suction Pressure in the abdominal cavity increases (like SM contracting) Action serves to force blood back to RA During exhalation the valves will prevent any backflow of blood in the venous system.

Fatty streak

Earliest lesion of atherosclerosis composed of lipid filled foamy macrophages Begin as multiple minute FLAT yellow spots which eventually caolesce into elongated streaks 1 cm or more in length

There are 3 classes of arteries, based in their size. From largest to smallest, they are _____, _____, and _____

Elastic Muscular arteries Arterioles

Large thick walled arteries with elastin in all 3 tunics Aorta and its major branches Inactive in vasoconstriction (less smooth muscle, more elastin)

Elastic arteries

Which vessel is closest to the heart?

Elastic artery

Layers of the heart

Endocardium, Myocardium, Epicardium

Inner layer (veins)

Endothelial flaps (valves). The valves open and close with each contraction of the surrounding muscles. Purpose of the valves is to assist blood in returning to the heart.

What is located in the tunica Intima

Endothelium, made of simple squamous. Has lots of proteins Basement membrane is located here

Tunica intima

Endothelium,Loose connective tissue,Internal elastic lamina (artery only)

Churg-Strauss syndrome

Eosinophilia-rich small-vessel necrotizing vasculitis classically associated with asthma, allergic rhinitis, lung infiltrates, peripheral hypereosinophilia, and extravascular necrotizing granuloma Associated with MPO-ANCAs and manifests as palpable purpura, GI bleeding, focal and segmental glomerulosclerosis and cardiomyopathy AKA Allergic granulomatosis and angiitis

Adrenal medulla hormones

Epinephrine and norapenephrine

Endothelial activation

Event wherein structurally intact endothelial cells respond to pathophysiologic stimuli by expressing newly acquired (inducible) properties

Raynaud phenomenon

Exaggerated VC of digital arteries and arterioles which induce paroxysmal pallor or cyanosis of the digits of the hands or feet; infrequently, the nose, earlobes, or lips

Cavernous hemangioma

Exhibit large, dilated vascular channels, less well circumscribed and more frequently involve deep structures Red-blue, soft, spongy masses Not ecapsulated, and composed of large, cavernous blood-filled vascular spaces, separated by a MODEST CT stroma A component of von Hippel-Lindau disease

Plaque hemorrhage into the atheroma

Expanding its volume

Plaque rupture/fissuring

Exposing highly thrombogenic plaque constituents

Plaque erosion/ulceration

Exposing the thrombogenic subendothelial basement membrane to blood

Capillaries Structure

Extremely thin-walled, microscopic vessels within tissues. -Only endothelium and basement membrane. -Found in most tissues; number depends on metabolic needs of tissue.

Takayasu arteritis

Granulomatous VASCULITIS of medium and larger arteriescharacterized principally by ocular disturbances and marked weakening of the pulses in the upper extremities occuring in patients younger than 50 AKA Pulseless disease Manifests with transmural fibrous thickening of the aorta and severe luminal narrowing of the major branch vessels which leads to weakness of peripheral pulses

Giant cell (temporal) arteritis

Granulomatous inflammation occuring in patients older than 50 and is associated with polymyalgia rheumatica Chronic inflammatory disorder of large to small-sized arteries that principally affects arteries in the head—especially the temporal arteries—but also the vertebral and ophthalmic arteries (blindness)

Arteries

Have the 3 layers of a typical blood vessel THICK Muscular-Elastic TUNICA MEDIA -Plentiful elastic fibers provide high compliance : walls stretch/expand in response to pressure w/o tearing -Smooth muscle innervated by ANS sympathetic fibers that provide for vasoconstriction/dilation

CO = _____________________

Heart Rate (HR) x Stroke Volume (SV)

(Coronary circulation) a myocardial infarction, or _____, is when _____ are damaged or even die due to blockage of _____

Heart attack Cardiac muscle fibers Coronary arteries

Functions of the Cardiovascular Center (CV)

Helps Regulate -heart rate & -stroke volume Controls -neural -hormonal, & -local negative feedback systems ...that regulate blood pressure & blood flow to specific tissues

Function of tunica interna=

Helps to minimize friction as blood flows through vessel

Angiomatosis

Hemangiomas that involve large portions of the body

Varicose veins in the anal region are known as ______

Hemorrhoids

Growth inhibitor produced by endothelium

Heparin TGF-beta

(Hepatic portal system) ______ drains the blood from the 1st capillary bed in the intestines to the 2nd capillary bed in the liver

Hepatic portal vein

Risk Factors for Hypertension

Hereditary, Diet high in salt, saturated fat, cholesterol, diet lacking in K, Ca, Mg, Obesity, Age, Diabetes Mellitus, Chronic Stress, Smoking

hypertension

High blood pressure

Chemicals involved with inflammation

Histamine Kinins Prostaglandins Complement

The brain and spinal cord are where the important integrative functions occur in the battle to maintain _____. Combined with the high metabolic demands of the neurons, it is necessary to have a constant and consistent flow of blood. Knowing this, one can see how a "circle" of blood vessels at the base of the brain would certainly be an evolutionary benefit. In this setting, an obstruction in one vessel could potentially be circumvented by flow from the other direction. Great advantage!

Homeostasis Circle of Willis

Valves

How do veins promote one way blood flow?

3

How many layers do veins have?

Vascular Pathology in Hypertension

Hyaline arteriolosclerosis Hyperplastic arteriolosclerosis

Direction and Amount of fluid depend on two opposing forces

Hydrostatic and Colloid Osmotic Pressures

Modifiable risk factors for atherosclerosis

Hyperlipidemia Hypertension Cigarette smoking Diabetes C-reactive protein

High blood pressure =

Hypertension

Low blood pressure =

Hypotensiion

Types of Shock

Hypovolemic (acute sudden hemorrhage) Cardiogenic (heart fails to pump) Vascular (decrease B)

femoral vein

Identify the blood vessel (cut).

brachiocephalic vein

Identify the blood vessel.

common carotid artery

Identify the blood vessel.

common iliac vein

Identify the blood vessel.

hepatic portal vein

Identify the blood vessel.

hepatic vein

Identify the blood vessel.

inferior vena cava

Identify the blood vessel.

internal jugular vein

Identify the blood vessel.

(To increase blood pressure) sympathetic activity will ____ and parasympathetic activity will _____. This will _____ cardiac output and cause _____ in the body, both of which will increase blood pressure

Increase Decrease Increase Vasoconstriction

If an ______ occurs, the baroreceptor reflex will reverse the direction of change, so it will _____. Generally it does this by changing activity levels of the _____. Recall, the sympathetic system _____ heart rate and _____ blood vessels, causing ______. The parasympathetic system ______ heart rate (remember parasympathetic does NOT affect blood vessels)

Increase in blood pressure Decrease in blood pressure Autonomic nervous system (ANS) Increases Innervates Vasoconstriction Decreases

+ dromotropic effect

Increased cardiac impulse

Vasodilation

Increased diameter, more blood flow to tissues.

Fenestrated capillaries have openings, or fenestrations, in their walls that allow for _____ of substances with the surrounding fluid

Increased exchange

+ inotropic

Increased force

+ chronotropic effect

Increased heart rate

Non-modifiable risk factors for atherosclerosis

Increasing age Male gender Family history Genetic abnormalities

Describe how the heart, blood vessels, kidneys, and brain maintain BP

Increasing cardiac output increases blood pressure and vice versa, you can change the diameter of the blood vessel by constricting or dilating them, the kidneys maintain blood volume. The reabsorption of water increases BP, excretion of water decreases BP. vasomotor center in medulla oblongata (brain) control flight or fight response. Can dilate or constrict blood vessels.

(Systemic circuit) veins inferior to the diaphragm empty into the ______ and veins superior to the diaphragm empty into the ______

Inferior vena cava Superior vena cava

Additional risk factors for atherosclerosis

Inflammation Hyperhomocyteinuria Metabolic syndrome Lipoprotein (a) Increased PAI-1 or thrombin Obesity Type A personality

Chemokines

Influences the monocytes and T cells to adhere to endothelium and migrate into the intima

Tunica Intima

Inner layer of the arteries; consists of a single layer of smooth endothelial cells.

Tunica interna

Inner layer of the blood vessel. -Endothelium: Simple squamous epithelium

Visceral pericardium

Innermost layer of pericardium

Tunica intima

Innermost layer, an endothelium

Location of tunica interna (intima)=

Innermost layer, next to lumen

Reflex arc: ***SEE PIC pg 42

Input- Receptors in various parts of the body Control Center = Cardiovascular center in the medulla oblongata Output to the effectors

Medulla oblongata

Interprets info

Capillary Bed

Interwoven network of capillaries between arterioles and venules

(Hepatic portal system) capillary bed #1=

Intestines

(Hepatic portal system) hepatic portal vein drains the blood from the 1st capillary bed in the _____ to the 2nd capillary bed in the _____

Intestines Liver

Bicuspid valve

LEFT

Red blood

LEFT

______side is thicker and stronger because has to pump all through the body.

LEFT

bicuspid valve

LEFT

come from lungs to rest of body

LEFT

oxygenated

LEFT

pumps through aortic arch

LEFT

Stroke caused by

Lack of blood flow to the brain due to a clot or whatever

Heart attack caused by

Lack of blood flow to the cardiac muscles of the heart due to a clot or whatever

Types of blood flow

Laminar Flow: smooth sailing Turbulent Flow: disruption in vessel causes disruption of flow

Elastic Arteries (Conducting)

Large lumens-conduits Contain a lot of elastin in tunica media Examples: aorta, carotid, pulmonary artery

Great Vessels

Large vessels attached to heart: Superior Vena Cava, Inferior Vena Cava, Pulmonary Artery, 4 Pulmonary Veins, Aorta

Veins

Large, relatively thin-walled vessels. -Carry blood *TO* the heart.

Veins Structure

Large, thin-walled vessels with reduced muscle and elastic fibers. -Valves

Systemic circulation

Larger circulation. Provides blood supply to the rest of the body

Blood Distribution

Largest portion of blood at rest is in systemic veins/venules -Blood reservoir Venoconstriction -Reduces volume of blood in reservoirs -Allows greater blood volume to flow where needed

(Systemic circuit) the aorta receives the blood from the _____

Left ventricle

Systemic circuit is a high-pressure circuit where the blood flows from:

Left ventricle of the heart (pump) ➡️ body ➡️ right atrium of the heart

VAscular ectasias

Lesions characterized by local dilation of preexisting vessels NOT a true neoplasm

Mycotic AAA

Lesions that have become infected by the lodging of circulating organisms particularly Salmonella

Treatment of Essential Hypertension

Lifestyle changes Beta-blockers decrease HR ca blockers decrease SV pressure ACE inhibitors decrease formation of Angiotensin II

__________ inhibits fibrinolysis by competing with plasminogen and may contribute to the formation of atherosclerotic plaques. Lipoprotein (a) Cytomegalovirus Cholesterol Foamy macrophages

Lipoprotein (a)

Arteries, Arterioles, Capillaries, Venules, and veins

List the 5 blood vessels.

(Hepatic portal system) where is capillary bed #2?

Liver

Regional Functional Hyperemia

Local supply of blood flow to local demand -regional cortical flow is associated w/ regional neural activity (EX: move hand)

Aneurysm

Localized abnormal dilation of a blood vessel or heart

Atrioventricular Valve (entrance valve)

Located between the atria and ventricles Have cusps or flaps, open downward

Great saphenous

Longest vein in the body

Arterial Blood Pressure

Maintains blood flow through capillary beds. Rises during ventricular systole and falls during ventricular diastole

What is the main importance for the Tunica Media

Maintains blood pressure

Abdominal aortic aneurysm (AAA)

Majorly influenced by the production of MMP by inflammatory cells Atherosclerosis is a major cause Usually positioned below the renal arteries and above the bifurcation of the aorta Frequently contains a bland, laminated, poorly organized mural thrombus that may fill some or all of the dilated segment Variants include inflammatory and mycotic AAA

Pathogenesis of aneurysm

Marfan syndrome Loeys-Dietz syndrome Ehlers Danlos Syndrome Vitamin C deficiency

Cystic medial degeneration

Marked elastin fragmentation and formation of areas devoid of elastin that resemble cystic spaces Commonly seen in aortic dissection Collective histological term for ischemia-induced degenerative changes whereby smooth muscle cell loss—or change in synthetic phenotype—leads to scarring (and loss of elastic fibers), inadequate extracellular matrix synthesis, and production of increasing amounts of amorphous ground substance (glycosaminoglycan)

pressure that propels blood to tissues

Mean arterial pressure (MAP)

Cardiac Output What increases it What decreases it

Measurement of blood flow from the heart through the ventricles -Inc: sympathetic stimulation, thyroid hormone, inc in calcium -Dec: parasympathetic stimulation, dec calcium

Increased local oxygen free radical production wich reduces vasodilator activity

Mechanism in which chronic hyperlipidemi, particularly hypercholesterolemia, directly impair endothelial cell dysfunction

Non-infectious vasculitis

Mechanisms: 1. Immune complex deposition 2. Antineutrophil cytoplasmic antibodies (ANCA) 3. Antiendothelial cell antibodies

Cardiovascular/Vasomotor Center

Medulla Oblongata Receives input from higher brain centers Limbic system and cerebral cortex, directs the appropriate output by increasing or decreasing sympathetic/parasympathetic nerve activity (ANS)

Consequences of flow-limiting stenoses

Mesenteric occlusion and bowel ischemia Chronic IHD Ischemic encephalopathy Intermittent claudication

Tunica Media

Middle layer and is composed of smooth muscle layer of the artery; receives nerve stimulation from the sympathetic nervous system. The suppleness of the smooth muscle allows the vessel to vaso constrict (decrease in diameter) and vaso dilate (increase in diameter).

Tunica Media

Middle layer of the blood. -Circular smooth muscle: regulates vessel diameter.

Myocardium

Middle layer, thickest of all 3 layers, composed of cardiac muscle. Contain actin and myosin; arranged in sacomeres

Tunica media

Middle layer. Thickest layer Composed of elastic tissue and smooth miscle

Location of tunica media=

Middle layer; intermediate to the interna and externa

Liddle syndrome

Moderately severe form of salt-sensitive hypertension caused by mutations in an ENaC protein that lead to increased distal tubular reabsorption of sodium induced by aldosterone

Hyperplastic arteriolosclerosis

Occurs in severe (malignant) hypertension; Vessels exhibit "onion-skin lesions" characterized by concentric, laminated thickening of the walls, and luminal narrowing

VD produced by endothelium

NO

Para effect on smooth muscle

NOTHING

Starling's Law

Nearly as much reabsorbed as filtered

Polyarteritis nodosa

Necrotizing inflammation typically involving renal arteries but sparing pulmonary vessels Systemic VASCULITIS of small or medium sized arteries (but not arterioles, capillaries, or venules) which is characterized by segmental transmural necrotizing (FIBRINOID NECROSIS) inflammation of the vessels of the kidney, heart, liver, and GI (descending order) Common manifestations are malaise, fever, and weight loss; hypertension; abdominal pain and melena; diffuse muscular aches and pains; peripheral neuritis

Microscopic polyangiitis

Necrotizing small vessel (capillaries, as well as venules and arterioles smaller than those involved in polyrteristis nodosa) vasculitis with few or no immune complex deposits (pauci-immune injury) Necrotizing glomerulonephritis and pulmonary capillaritis are common Associated with MPO-ANCAs AKA Hypersensitivity vasculitis or Leukocytoclastic vasculitis Characterized by same age lesions (unlike in Polyarteritis nodosa) which typically spare medium and large arteries; segmental fibrinoid necrosis of the media with focal transmural necrotizing lesions; granulomatous inflammation is absent Clinical features include hemoptysis, hematuria and proteinuria; bowel pain or bleedin; muscle pain or weakness; and palpable cutaneous purpura

The basoreceptor reflex is regulated through _____

Negative feedback

NFP

Net filtration pressure- difference between net hydrostatic pressures and Net colloid osmotic pressures. Variation of starlings law *NFP= (HP_b - HP_if) - (COP_b-COP_if)*

Capillary Bed

Network of 10-100 capillaries suppling a tissue region. -Arterioles supplying bed open and close based on needs of tissue.

Control of Muscle Circulation Rest

Neural, myogenic mechanisms predominate (stretching vascular muscle results in constriction)

(Function of circle of Willis) allows the potential for different routes in an emergency. Thus the ____ will continue to receive the necessary _____ and _____

Neurons Oxygen Glucose

Differential WBC count: organize from most to least common

Never Let Monkeys Eat Bananas (Neutrophil, lymphocyte, monocyte, eosinophil, basophil)

Do venules have a tunica media?

No

Is the tunica media present in capallaries?

No

Is the tunic externa present in arterioles?

No.

Baroreceptors

Notify the brain when blood pressure is really high so it can do a number of things like diolate veins and arteries or reduce the heart rate. These are not long term solutions

Angiogenesis

Number of vessels to region increases and existing vessels enlarge Common in heart when coronary vessel occluded, or throughout body in people in high-altitude areas

(Hepatic portal system) capillary bed #2's function is to receive the _____. This blood then diffuses into the ____ and the liver cells (_____) process and modify the nutrient biomolecules from the ____ so that the body can effectively use them for survival

Nutrient-rich blood Liver Hepatocytes Intestines

What do RBCs carry?

O2 and CO2

Capillary Exchange Diffusion:

O2 and nutrients from blood to tissues CO2 and metabolic wastes from tissues to the blood

Arterial Anastomoses

Occur around joints, common in abdominal organs, heart and brain

Developmental or berry aneurysm

Occur in cerebral vessels

Peripheral Resistance formula

P=COxR CO and R determine pressure gradient that drives blood flow

Growth stimulator produced by endothelium

PDGF CSF FGF IL-1 IFN-gamma

Growth factors implicated in smooth muscle cell proliferation and ECM synthesis

PDGF FGF TGF-alpha

5 Cardinal signs of inflammation

Pain Swelling Redness Heat Immobilization

Shunt

Passageway that diverts blood from its normal pathway Left to right shunt/right to left shunt

Bulk Flow

Passive process in which large numbers of ions, molecules, or particles in a fluid move together in the same direction (Based on pressure gradient) Diffusion is more important for solute exchange Bulk flow more important for regulation of relative volumes of blood and interstitial fluid -Filtration - from capillaries into interstitial fluid -Reabsorption - from interstitial fluid into capillaries

Pulmonary Circuit (unusual)

Pathway is short, arteries/arterioles are more like veins/venules (thin walls w/ large lumens) Arterial resistance and pressure low (24/10 mmHg)

Dangers of Hypertension

Patients are often asymptomatic until substantial vascular damage occurs -contributes to atherosclerosis -increases workload of heart, ventricular hypertrophy, congestive heart failure -damages cerebral blood vessels leading to stroke "silent killer"

Simple orthostatic edema

Pedal edema even in essentially normal veins

contractile cells that wrap around the endothelial cells that line the capillaries and venules throughout the body.

Pericytes

What is the proper term for the opposition of the flow of blood?

Peripheral resistance

Capillaries in the body vary in their _____

Permeability

The 2 non specific cellular and chemical defenses

Phagocytes (macrophages and neutrophils) Natural Killer Cells

Foam cells

Phagocytes (macrophages and smooth muscle cells) that ingest and accumulate oxidized LDL through a scavenger receptor

Types of Stimuli

Physical - temperature changes, myogenic response Vasodilating and vasoconstricting chemicals which alter blood vessel diameter

Atherosclerosis

Plaque buildup in Arteries

Vulnerable plaques

Plaques that contain large areas of foam cells and extracellular lipid. and those in which the fibrous caps are thin or contain few smooth muscle cells or have clusters of inflammatory cells that are more likely to rupture

MIgratory thrombophlebitis/Trosseau sign

Presets in patients with cancers, particularly adenocrcinooma, in which hypercoagulability occurs as a paraneoplastic syndrome wherein venous thromboses typically appear in one site, disappear, and then reoccur

Respiratory Pump

Pressure changes in the thoracic cavity during breathing to help return blood to the heart.

Distribution of CO depends on....

Pressure differences that drive blood through tissue -Flows from higher to lower pressure Resistance to blood flow in specific blood vessels -Higher resistance means smaller blood flow

Veins Function

Pressure in veins is normally very low, can stretch out to store blood. -Constrict or dilate to *regulate amount of blood returning to the heart*.

Baroreceptor Reflexes

Pressure receptor Located in carotid (brain), arteries, aortic arch, and elastic arteries of neck and thorax

Interstitial Fluid Hydrostatic Pressure

Pressure that pushes fluid INTO vessel Usually assumed to be zero b/c of lymphatic vessels

Venous Valves

Prevent Backflow of blood in veins Prevent "pooling" of blood Most common in extremities

Ductus arterious

Prevents blood from going to lungs

Capillaries

Primary exchange vessels Carry blood from arterioles to venules

(Hepatic portal system) what occurs at capillary bed #1?

Primary function of intestinal cells is to absorb nutrients and these nutrients diffuse into this capillary bed. These nutrients need to be sent to the liver for further processing

VEGF

Primary growth factor involved in vasculogenesis

Primary vs secondary immune response

Primary: occurs on first exposure to a particular antigen, lasts 3-6 days after the antigen encounter Secondary: occurs during reexposure to the same antigen

Antidiuretic Hormone (ADH) or Vasopressin

Produced by hypothalamus, released by posterior pituitary Responds to dehydration or decreased blood volume Causes vasoconstriction which increases blood pressure

Anticoagulant, antithrombotic, and fibrinolytic regulators produced by endothelium

Prostacyclin Thrombomodulin Heparin-like molecules Plasminogen activator

Carotid sinus reflex

Protect blood supply to the brain Short term changes Ineffective in protecting us from sustained pressure changes

What is located in the Tunica Externa

Proteins, lots of collagen, nerve endings

Importance of blood flow to myocardium

Provided by the coronary arteries. Nourishes and oxygenates they myocardium. Must be a constant supply of oxygenated blood

Lungs

Pulmonary Circulation

_____ is a low-pressure circuit where the blood flows from: right ventricle of the heart (pump) ➡️ lungs ➡️ left atrium of the heart

Pulmonary circuit

When the blood flows through either the ____ or _____ circuit, it goes through the blood vessels in a specific order

Pulmonary or systemic

(Pulmonary circulation) the right ventricle pumps blood into the _____ which then divides into the pulmonary arteries

Pulmonary trunk

Mean Arterial Pressure (MAP)

Pulse Pressure / 3 MAP changes throughout the systemic circuit

The difference between the two pressures (systolic & diastolic) is the _____

Pulse pressure

What is the proper term for the average of systolic and diastolic pressure?

Pulse pressure

The heat is the _____ for the circulation. During a single minute, liters of blood flow through the chambers of this organ. However, all of this flowing blood does not provide the required oxygen and nutrients for the _____. So, the heart requires its own collection of arteries, capillaries, and veins to nourish the cardiac muscle cells. This collection of vessels, is referred to as the ______

Pump Cardiac cells Coronary circulation

Pulmonary circulation

Pump blood to lungs to pick up O2, get rid of CO2

Right heart (deoxygenated blood)

Pumps blood to lungs for oxygenation (pulmonary circulation) receives unoxygenated blood from SCV/IVC

Left heart

Pumps oxygenated blood throughout the rest of the body (systemic circulation)

The inferior vena cava brings blood from the lower regions of the body and empties into the __________. left ventricle left atrium right atrium right ventricle aorta

R atrium

what factor influences blood flow more, P or R?

R influences local blood flow more because it is more easily changed by altering blood vessel diameter.

erythrocytes

RBCs; bio-concave

arteries

RED --> away from heart

Blood has been used up by body

RIGHT

Tricuspid vale

RIGHT

Tricuspid valve

RIGHT

pumps blood to lungs

RIGHT

side of blue blood

RIGHT

side of coronary sinus

RIGHT

Capillary Pressures ranges

Ranges from 15-35mmHg

(Hepatic portal system) what occurs at capillary bed #2?

Receive the nutrient-rich blood. This blood then diffuses into the liver and the liver cells (hepatocytes) process and modify the nutrient biomolecules from the intestines so that the body can effectively use them for survival

Angiopoietin 1 bound to Tie2 receptors

Recruits pericytes and smooth muscle cells for the subsequent stabilization of endothelial tubes during development and induction of endothelial cell quiescence

Long term high blood pressure solution

Reduce blood volume using the kidneys which can regulate sodium and fluid in the blood

Vasoconstriction

Reduces blood flow and heat transfer by decreasing the diameter of superficial blood vessels/lumen

Arterial Blood Pressure

Reflects 2 factors: - how much elastic arteries can stretch -the volume of blood forced into them

Pre capillary sphincters

Regulate blood flow

Precapillary Sphinctners

Regulate blood flow into true capillaries. Blood may go into true capillaries or to shunt Regulated by local chemical conditions and vasomotor nerves

Diastole

Relaxation of the myocardium (resting phase)

Epinephrine & Norepinephrine

Released by adrenal medulla in response to sympathetic stimulation Increases cardiac output by increasing rate and force of heart contractions

Afterload

Resistance or opposition to the flow of blood To open the valves Caused by blood pressure

T cells

Respnsible for the chronic inflammatory state

Brachycardia

Resting rate below 60 bpm

(Systemic circuit) both vena cava empty into the _____

Right atrium

(Pulmonary circulation) The _____ pumps blood into the pulmonary trunk which then divides into the ______

Right ventricle Pulmonary arteries

Pulmonary circuit is a low-pressure circuit where the blood flows from:

Right ventricle of heart (pump) ➡️ lungs ➡️ left atrium of the heart

Critical stenosis

Rubicon/bounding or limiting line at which chronic occlusion significantly limits flow, and demand begins exceeding supply

Possible changes in athrosclerotic plaques

Rupture, ulceration, or erosion Intraplaque hemorrhage Atheroembolism/MIcroemboli Aneurysm formation

Pace maker of the heart

SA node

Endemic African KS/ Lymphadenopathic KS

Same general geographic distribution as Burkitt lymphoma Not associated with HIV infection Skin lesions are sparse, and patients present instead with lyphadenopathy due to KS involvement

Chemoreceptors

Sensory neurons in carotid and aortic bodies -Activated by a drop in pH or oxygen, or a rise in carbon dioxide levels -Raises blood pressure

Anaphylactic

Severe allergic reaction

Instep claudication

Severe pain in the instep of the foot induced by exercise, even at rest

What is the tunica intima made up of?

Simple squamous endothelia

(Structure of tunica interna) a layer of ______ and like any other epithelium, it has an underlying _____

Simple squamous epithelium Basement membrane

Fewer tight junctions usually fenestrated large lumens found only in liver, bone marrow, spleen, adrenal medulla macrophages in lining to destroy bacteria blood flow sluggish

Sinusoid capillaries

Which type of capillary is found in the red bone marrow and liver?

Sinusoidal

Which type of capillary is the leakiest?

Sinusoidal

Exchange Vessels

Site of diffusion of materials between blood and tissues.

44. What adaptations enable blood to continue flowing through the veins toward the heart, in spite of the low blood pressure in the veins?

Skeletal muscle pump: contraction creates pressure---> pushing blood to heart relaxation=backflow: venous valves close. sympathetic venoconstriction respiratory pump

Simple (Capillary) lymphangioma

Slightly elevated or sometimes pedunculated lesions up to 1 to 2 cm in diameter that occur predominantly in the head,neck, and axillary subcutaneous tissues

Pericardium

Sling like structure that supports the heart; attaches the heart to surrounding structures

Arterioles

Small arteries that go into the capillaries

Transcytosis

Small quantity of material Substances in blood plasma become enclosed w/in pinocytotic vessicles that enter endothelial cells by endocytosis and leave by exocytosis Important mainly for large, lipid-insoluble molecules that cannot cross capillary walls any other way

If blood pressure goes up...

Stretches the receptors Inhibitory to the vasomotor area Vasodilation of vessels and decrease in blood pressure

Antigen

Substances that can mobilize the adaptive defenses

Venules

Small vessels that carry blood from capillaries to larger veins.

Capillaries

Smallest Blood Vessels -connect arterial outflow & venous return MICROCIRCULATION -flow from metarteriole through capillaries, into postcapillary venule EXCHANGE Vessels -Primary function is exchange between blood and interstitial fluid -Lack tunica media and tunica externa -Substances pass through just one layer of endothelial cells and basement membrane CAPILLARY BEDS: arise from single metarteriole -Vasomotion: intermittent contraction/relaxation -Thoroughfare Channel: bypasses capillary bed

Capillaries are the _____ and their _____ is just large enough for a single-file passage of ______

Smallest blood vessel Lumen RBCs

Capillaries

Smallest blood vessels; exchange vessels -permeates all active tissues, increases surface area

Capillaries

Smallest, most numerous of all blood vessels. Very delicate

What kind of muscle should you expect to see in the tunica media?

Smooth involuntary muscle.

(Structure of tunica media) one or more circular sheets of ______. In some vessels _____ and ______ are found between muscle cells, and in some other vessels the elastic fibers form a layer called _____ along the inner or outer boundary of the tunica media

Smooth muscle cells Elastic fibers Collagen fibers Lamina

Sympathetic Venoconstriction

Smooth muscle in tunica media contract following sympathetic activation

Tunica media

Smooth muscle,Elastic fibers,External elastic lamina(artery only)

Systemic Arterial BP *Lab book

Sounds first occur as blood starts to spur through artery Sounds disappear when artery is no longer constricted and blood flows freely

Anastomoses

Special interconnections that provide alternate channels.

Venous Sinuses

Specialized flattened veins with thin walls. Collect blood from veins

True saccular aneurysm

Spherical outpouchings involving only a portion of the vessel wall and often contain thrombus

Angiotensin II

Stabilizes arterial blood pressure and extracellular fluid volume in 4 ways: 1. Stimulates release of aldosterone 2. stimulates the release of ADH 3. triggers sensation of thirst 4. it acts as a potent vasoconstrictor

Tunica intima Thickening

Stereotypic response to vascular injury

1. Blood viscosity

Stickiness of blood from formed elements and plasma proteins Fairly constant (except for some disorders)

At the same time in the cardiac center

Stimulate parasympathetic (inhibitory) Inhibit Sympathetic (cardioacceleratory)- reduce heart rate and contractile force

Juvenile hemangioma

Strawberry type of capillary hemangioma of the newborn

Inotropic Effect

Strengthening the force of myocardial contraction w/out stretching myocardial fibers. 2nd way to increase stroke volume

Baroreceptors

Stretch receptors in the carotid sinuses, aortic arch & large arteries of the neck and thorax. Results in a lower blood pressure

Anatomy of Arteries Function

Stretch to accommodate surge of blood from heart, then recoil to push blood forward through vessels. -The elasticity maintains pressure in the arteries when the heart is relaxed.

Sometimes, the valves within veins fail. This leads to the pooling of blood within the vessels- causing the vessels to _____ and _____. We call these ______

Swell Twist Varicose veins (in addition to being unsightly, they can be very painful and lead to tissue damage)

Fenestrations

Swiss cheese like holes that tunnel through endothelial cells

What neural mechanism regulates blood vessel diameter for peripheral resistance?

Sympathetic

To decrease blood pressure: (2)

Sympathetic activity will decrease and parasympathetic activity will increase This will decrease cardiac output and cause vasodilation, both of which will help to decrease blood pressure

To increase blood pressure: (2)

Sympathetic activity will increase and parasympathetic activity will decrease This will increase cardiac output and cause vasoconstriction in the body, both of which will increase blood pressure

Epinephrine and norapenephrine function

Sympathetic stimulation

Control of Muscle Circulation Exercise

Sympathetic vasoconstriction of all muscle vasculature Local metabolic vasodilation in active muscles (predominates, override sympathetic constriction, functional sympatholysis)

Whole Body circulation

Systemic Circulation

______ is a high-pressure circuit where the blood flows from: left ventricle of the heart (pump) ➡️ body ➡️ right atrium of the heart

Systemic circuit

2. Describe the general difference(s) between the systemic and pulmonary circulation.

Systemic: carries blood throughout the entire body Pulmonary: carries blood to the lungs to perform in gas exchange.

Pulse pressure =

Systolic Pressure - Diastolic Pressure

There are two valves for the measured blood pressure:

Systolic pressure (generated during the ventricular systole- average value 120 mmHg) Diastolic pressure (measured during the ventricular diastole- average value 80 mmHg)

Pulse pressure=

Systolic pressure - diastolic pressure

Symptoms of Shock

Systolic pressure <90 mmHg Tachycardia (sympathetic activation) Weak pulse (decrease CO) Cool, pale, clammy skin (sympathetic constriction) Altered mental state (decrease oxygen to brain) Decreased urine output (more ADH and aldosterone) Thirsty Low blood pH (lactic acid buildup) Nausea (sympathetic constriction gut)

What occurs in the thymus

T cells mature

Capillary Hydrostatic Pressure

Tends to force fluids OUT through capillary walls Greater arterial end (35 mmHg) than venule end (17 mmHg)

Leukocytoclastic vasculitis

Term used for areas (typically postcapillary venules) wherein only infiltrating and fragmenting neutrophil are seen

41. Describe how pressure varies across the vascular system. Where is pressure highest? lowest?

The arteries closest to the heart have the highest pressure (elastic) and the pressure diminishes as it gets farther away from the heart and returning, with the lowest pressure being in the vena cava.

Arterioles

The arteries divide and branch into smaller vessels called __________ which are smaller arteries. The same three layers are present in the walls, but as they approach the capillaries, their walls become thinner.

Blood Pressure through Circulation

The closer the blood is to the pump, the greater the pressure Steepest pressure drop occurs in arterioles

Outer layer (veins)

The fibrous connective tissue.

Blood pressure

The force exerted by the blood against the walls of the vessels; sphygmomanometer measures it in mm of mercury.

16. What is the relationship between the metabolic activity of a tissue and the number of capillaries it contains?

The higher the metabolic rate of the tissue, more true capillaries that are filled with blood.

Systolic Blood Pressure

The maximum pressure that develops in the arteries after heart muscle contraction.

Lumen

The middle open space of the veins and arteries where the blood is

Heart rate

The number of times the heart beats per minute.

Describe systematic BP, in what structures along the flow would you find the highest and lowest pressures

The pumping action of the heart generate blood flow through the vessels along a pressure gradient, always moving from high to low pressure -highest- aorta -lowest- superior and inferior vena cava

Venules

The smallest vein unit that sucks blood out of the capillaries

Capillaries

The thinnest blood vessels are called?

Mural thrombus

Thrombus that is attached to the wall of the vessel frequently causing vascular obstruction (mural=wall)

Stroke volume

The volume of blood ejected from the ventricle with each beat.

changing

The volume of blood flowing to a particular organ can be regulated by ________ the size of blood vessels supplying the organs.

Cardiac output

The volume of blood pumped out of each ventricle.

The development of immunocompetence and self tolerance in B and T cells

They are both requirements for the maturation of B and T cells Only about 2% survive selection and become successful cells

Epicardium

Thin outermost layer; helps form pericardium

Middle layer (veins)

Thinner layer, having less smooth muscle and elastic tissue. This allows the walls to dilate more easily.

Veins compared to arteries, have _____ and a _____

Thinner walls Larger lumen

Capillaries

Tiny, thin-walled vessels -Site of *EXCHANGE* of substances between blood and tissues.

What does MAP dictate?

Tissue health

Coronary Circulation

Tissue pressure/contraction affects flow High resting O2 extraction (75% O2 extraction at rest. Coronary venous PO2 ~20 mmHg) Autoregulating vascular bed Neural-Metabolic mechanisms active ***Example pg 85

Neurogenic

Trauma to head, damage CV center

Atrioventricular (AV) valves (entrance valves)

Tricupsid valve & Bicuspid (mitral) valve

Name the layers of the blood vessels from deep to superficial

Tunica Intima Tunica Media Tunica Externa (adventitia)

4. Describe the general composition of each of the tissue layers named above (#3). How does the layer composition vary among the six types of vessels you identified above (#1)?

Tunica Intima: endothelium---> continuos with endocardium. secretes paracrine---> helps regulate blood flow. Has a sub endothelial layer. Tunica Media: elastic fibers ad smooth muscle. Vasomotor: small amounts of contraction of smooth muscle. vasoconstriction: smooth muscle constricts. vasodilation: smooth muscle dilates. Tunica adventitia: thin layer of CT-->elastic, collagen, Dense irregular. protects blood vessels and anchors it to other structures. Elastic: high elastic fibers, normal smooth muscle. Low adventitia Muscular: normal elastic and high smooth. high fibrous (adventitia) Arterioles: low elastic, normal smooth, normal adventitia capillaries: no elastic, no smooth, no adventitia venules: no elastic, low smooth, low adventitia vein: low elastic, normal smooth, high adventitia(fibrous)

Outermost layer of blood vessel Collagen fibers protect and reinforce contains nerve fivbers and lymphatic vessels

Tunica externa

The wall of the capillary has only a single layer, _____

Tunica interna (endothelium with basement membrane)

Arteries and veins are composed of

Tunica interna, tunica media, and tunica externa

Innermost layer of blood vessel Endothelium lines lumen of all vessels slick surface reduces friction

Tunica intima

3 layers of a blood vessel wall:

Tunica intima (interna) Tunica media Tunica externa (adventicia)

Layers of blood vessels

Tunica intima Tunica media. Tunica adventitia

Three walls in veins and arteries?

Tunica intima, tunica media, tunica externa

Middle layer of blood vessel smooth muscle and sheets of elastin influences blood flow and BP

Tunica media

What is the proper term for the middle/muscle layer?

Tunica media

Which tunic regulates BP?

Tunica media

Arteries have a thick wall, especially the _____, and they have a small _____

Tunica media Lumen

If one takes a cross-section through the wall of a blood vessel tnere are usually three different layers. These layers, or _____, surround the _____, or channel, where blood flows

Tunics Lumen

Cavernous lymphangiomas (cystic hygromas)

Typically found in the neck or axilla of children, and more rarely in the retroperitoneum Common in Turner syndrome Composed of massively dilated lymphatic spaces lined by endothelial cells and separated by intervening connective tissue stroma containing lymphoid aggregates

Anastomoses

Union of the branches of 2 or more arteries supplying the same body region Provide alternate routes - collateral circulation

Atria (atrium)

Upper chambers; receive blood

Distal/Type B dissections/DeBakey Type III

Usually begin distal to the subclavian artery and arise beyond the takeoff of the great vessels

Valves are only found in..

VEINS

56. Three blood vessels are carried in the umbilical cord, one large umbilical vein and two smaller umbilical arteries. Which carries oxygenated blood? Which carries oxygenated blood?

VEINS: oxygenated blood arteries: deoxygenated

How do vaccines work?

Vaccines expose the body to a dead version of a virus so it does not make you sick but it counts as the 2nd exposure so your body is able to develop specific immunity to the virus

What do veins have that arteries do not?

Valves

The low pressure found within veins makes for a very sluggish flow of blood. To aid the forward movement of blood, _____ within the _____ play an important role as they keep blood from flowing back. However, blood flow in veins also benefits form the _____ of surrounding _____

Valves Lumen Contractions Skeletal muscles

What is the proper term for decreasing the size of the lumen?

Vasoconstriction

Arterioles. Smooth Muscle Contracts

Vasoconstriction -decrease blood flow into capillary bed

Cardiovascular Center--->Vasomotor Nerves (Sympathetic/Stimulatory)

Vasoconstriction of blood vessels

Arterioles. Smooth Muscle Relaxes

Vasodilates -increase blood flow into capillary bed

What is the proper term for increasing the size of the lumen?

Vasodilation

The arterioles are very important because _____ and _____ of these vessels helps to control _____

Vasodilation Vasoconstriction Blood pressure

Septic

Vasodilator release by bacteria

What controls blood vessel diameter?

Vasomotor Center

54. What effect does increased baroreceptor activity have on the vasomotor center? on vascular smooth muscle?

Vasomotor: vasodilation Vascular smooth mscle: v HR, Contractility, CO

Carry blood towards the heart formed when venules converge thinner walls, larger lumen act as blood reservoir have valves

Veins

The _____ return the blood back to the heart

Veins

Which one will have a larger lumen?

Veins

The ____ have a much lower pressure compared to the _____

Veins Arteries

The _____ have much lower blood pressure than the _____, and so their walls don't need to be able to withstand higher pressure

Veins Arteries

Venodilation

Veins dilate, shifting blood to venous reservoirs, decreases venous return to heart and decreases cardiac output which leads to a decrease in blood pressure

difference when comparing vein to artery composition

Veins- *larger lumen, thicker tunica externa*, have valves, *less elastic and collagen fibers* elastic fibers only between tunica externa and tunica media. *wall will collapse if no blood in it*

Capacitance Vessel

Veins. Store and hold blood

45. How do changes in cross-sectional area affect the velocity of blood flow? At which level of the vascular tree is the velocity of blood flow lowest?

Velocity and Cross sectional area are inversely proportional. The larger the cross sectional area, the slower the velocity. Capillaries have the largest cross sectional area and therefore the lowest blood flow velocity. (Aorto is smallest cross sectional, so highest velocity.

What measurement is inversely related to cross sectional area?

Velocity of blood flow (cm/sec)

What elements of the cardiovascular circulatory system is the cross-sectional area the LOWEST?

Venae Cavae Aorta This is where velocity is GREATEST (greater in arteries than veins)

Four Mechanisms return blood to Heart

Venous Valves Sympathetic Venoconstriction Two Pumps (Skeletal Muscle, Respiratory Pump)

Right side

What side of the heart collects deoxygenated blood to be sent to the lungs for oxygenated?

There are different sized veins. The smallest veins are the _____, which receive blood from the capillaries

Venules

What is the proper term for the smallest vein?

Venules

formed when capillary beds unite very porous ; allow fluids and WBC's into tissues

Venules

(Systemic circuit) _____ receive blood from capillaries and delivers it to the _____

Venules Veins

Factors Affecting Vascular Resistance

Vessel Length (increases resistance) Vessel Diameter (decreases resistance) Blood Viscosity (increases resistance) Turbulence (increases resistance)

Which factor that effects peripheral resistance is the most important to monitor?

Vessel diameter

What are the 3 different ways to alter peripheral resistance?

Vessel length- longer the vessel, the more resistance Blood viscosity- the thicker the blood, the higher the resistance, BLOOD VOLUME Vessel diameter- lumin

Anatomy of Arteries Structure

Vessels are thick, muscular tunica media, and lots of elastic fibers. -Arteries branch to deliver blood to all tissues. -Muscle determines vessel diameter.

Response-to-injury Hypothesis

Views atherosclerosis as a chronic inflammatory and healing response of the arterial wall to endothelial injury wherein lesion progression occurs through the interaction of modified lipoproteins, macrophages, ad T lymphocytes with the normal cellular constituents of the arterial wall Pathogenic events: Endothelial iinjury Accumulation of lipoproteins Monocyte adhesion to endothelium Platelet adhesion Factor release from activated platelets Smooth muscle cell proliferation and ECM production Lipid accumulation

Monitoring Circulatory Efficiency

Vital signs: pulse and BP, respiratory rate and body temp. Pulse: pressure wave caused by expansion and recoil of arteries

Cardiac Output (CO)

Volume of blood that circulates through systemic or pulmonary blood vessels ea. minute Total blood flow equals cardiac output (CO)

Blood Flow

Volume of blood that flows through any tissue in a given time period (in mL/min)

Small vessel vasculitis

Wegener granulomatosis Microscopic polyangiitis Churg-Strauss syndrome Goodpasture disease Henoch-Schonlein purpura SLE

Tiny arteries thinner than hairs that carry food, water and oxygen to your body

What are capillaries?

Reticulocytes

What are immature red blood cells?

Tunica Intima, Tunica Media, Tunica Adventia

What are the 3 layers of the arteries?

A,B,AB,& O

What are the blood types?

Transportation, regulation, protection

What are the functions of the blood?

An inside layer, a layer of involuntary muscle, and an outside layer/covering

What are the layers of your large arteries, such as the Aorta?

Plasminogen

What dissolves a clot?

Carry blood back to the heart

What do veins do?

Erythroblastosis fetalis

What does Rh incompatibility cause during pregnancy?

Cyanosis

What is a sign of hypoxemia?

Hemorrhage

What is active bleeding?

Plasma protein

What is albumin?

Erythrocyte

What is an oxygen carrying blood cell?

Transport oxygen

What is hemoglobin's major role?

Myelosuppression

What is it when the bone marrow can't make enough cells?

Difference between the systolic & diastolic pressure

What is pulse pressure?

Left side

What side of the heart distributes oxygenated blood to the tissue?

Erythropoietin

What stimulates bone marrow to produce RBCs?

The superior vena cava, the inferior vena cava, and the coronary sinus empty into the left atrium. True False

false

Hemoglobin

What is the component of the red blood cell to which oxygen is attached?

Elevates blood pressure

What is the function of vasopresors?

7.35 - 7.45

What is the pH of the blood?

Hemopoiesis

What is the process of blood production?

The beat of the heart felt close to the surface through an artery

What is the pulse?

Hematocrit

What is the ration of blood cells to the volume of blood?

Plasma

What is the yellow fluid component of the blood?

Tiny valves throughout the vein.

What keeps the blood in your veins flowing only one way?

Superior mesenteric- 1st Inferior mesenteric- last

What large vein drains the intestines?

Ischemia

What results from insufficient blood flow?

Oxygen Rich

When blood is bright red you know that it is ___________ _____________

C-reactive protein

When secreted within atherosclerotic intima, can activate endothelial cells and induce a prothrombotic state and also increase the adhesiveness of endothelium for leukocytes Statins, exercise, weight loss, smoking cessation all reduce CRP

When is the inflammatory response triggered?

Whenever body tissues are injured

Arms

Where are the radial, median, & cubital veins found?

Sinoatrial (SA) Node

Where does the cardiac potential start or originate?

In the floor of the R atrium, near the interatrial septum

Where is the AV node located at?

Upper posterior wall of the R atrium

Where is the SA node located?

Aorta

Where is the blood pressure the highest?

Vena cava

Where is the blood pressure the lowest?

Postcapillary venules

Where vascular leakage and leukocyte exudation preferentially occur during inflammation

The left ventricle, it pumps blood to the aorta and to all parts of the body.

Which chamber of the heart works the hardest?

They are carrying wastes and carbon dioxide

Why do blood veins appear blue?

Phagolysosome

a phagosome fused with a lysosome

Pregnancy tumor/ Granuloma gravidarum

a pyogenic granuloma that occurs infrequently in the gingiva of pregnant women

what is an aneurysm?

a weakened area in an artery wall

What is an aneurysm

a weakened area in an artery wall, can lead to a tear in the wall that can cause life-threatening bleeding

Do arterioles have a tunica media?

Yes

Is the tunic externa present in venules?

Yes

Venules

________ are small vessels that emerge from the capillaries (bridge) and gradually increase in size. As the venules increase in size they eventually form veins.

A. Arteries B. Veins

________ are tubular, elastic, and very muscular while _____ have valves (to prevent backflow of blood) and a thinner muscle coat.

Capillaries

___________ are the minute vessels where the real work of the vascular system is accomplished.

According to the principle of ______ blood near the middle of an artery flows faster than blood near its wall just as water flows faster in the middle of a river than it does near shore a. laminar flow b. Poiseuille's law c. capacitance d. autoregulation e. Harvey's law

a

An anatomical arrangement that reduces the risk for myocardial infarctions is a. arterial anastomoses in the coronary circulation b. the desmosomes of the intercalated discs c. a double circulation d. gap junctions in the myocardium e. circumflex arteries

a

At any given moment most of the body blood is in a. the veins b. the arteries c. the heart d. the capillaries e. the lungs

a

How many pulmonary arteries empty into the right atrium of the heart a. none b. one c. two d. four e. six

a

Near the elbow, the brachial artery branches and gives rise to a. radial and ulnar arteries b. the deep brachial and radial recurrent arteries c. the radial and radial recurrent arteries d. the radial and anterior interosseous arteries e. the ulnar artery and ulnar recurrent artery

a

Peripheral resistance is directly proportional to a. blood viscosity b. vessel diameter c. cardiac preload d. systolic contraction force e. pulse pressure

a

The coronary arteries arise from a. the proximal end of the aorta b. the interventricular arteries c. the myocardium d. the coronary sulcus e. the venae cavae

a

The medullary ischemic reflex results in a. increased circulation to the brain b. reduced circulation to the brain c. ischemia of the medulla oblongata d. increased circulation to the adrenal medulla e. hormone secretion by the adrenal medulla when perfusion drops

a

The posterior intercostal veins on the right side of the thoracic cage empty into a. the azygos b. the hemiazygos vein c. the inferior vena cava d. the superior vena cava e. the subclavian veins

a

To get from the subclavian artery to the brachial artery blood must flow through a. the axillary artery b. the deep brachial artery c. the brachiocephalic artery d. the ulnar artery e. the radial artery

a

Veins are called ____ vessels because they can hold a large amount of blood a. capacitance b. resistance c. storage d. compliance e. hemodynamic

a

Route in which blood flows through two capillary beds in series before returning to the heart

a (portal system)

Histological structure of lymph nodes

a capsule of dense connective tissue that extends into the node

What is complement?

a group of 20 plasma proteins that circulate in an inactive state A major mechanism for destroying foreign substances in the body

Continuous Capillaries:

abundant in skin, muscles, lungs, and CNS have associated pericytes pinocytic vesicles ferry fluid across endothelial cell brain capillary endothelial cells lack intercellular clefts and have tight junctions around entire perimeter (Blood Brain Barrier)

What is edema? describe the three major causes?

accumulation of excess fluid in a tissue. 1. capillary filtration 2. capillary reabsorption 3. obstructed lymphatic drainage

Larger molecules (proteins)...

actively transported in pinocytotic vesicles

Describe blood flow

actual volume of blood flowing through a vessel, an organ or the entire circulatory system in a given period -equivalent to cardiac output -measured in ml/min

important sign of circulatory shock, threat to patients undergoing surgery and those in intesive care units

acute hypotension

3rd line of defense

adaptive defense response, B cells and T cells

what is net filtration pressure? How does it determine the amount and direction of fluid flow?

all the forces acting on a capillary bed -at the arterial end of a bed, hydrostatic forces dominate (fluids flow out of the capillary), at the venous end of a bed, osmotic forces dominate (fluids flow into the capillary), more fluids enter the tissue beds than return to the blood, excess fluid will later be returned to the blood via the lmphatic system

14. What role do the precapillary sphincters play in regulating blood flow to the capillaries?

allow blood to other enter to bypass capillary beds

neural controls of peripheral resistance?

alter blood pressure diameter, alter blood distribution in response to specific demands. Baroreceptors, vascular smooth muscle, vasomotor centers and fibers

long term renal regulation bp?

alter blood volume

direct renal

alters blood volume independent of hormones. Increased BP = eliminate more urine, reducing BP. lowered BP- kidneys conserve water, BP rises

Leukocytosis

an abnormally high WBC count

The Circle of Willis

an anastomosis formed by merging of branches from vertebral & internal carotid arteries forming an arterial network capable of supplying the brain with a continuous supply of arterial blood

severe immune reaction to antigen, histamine release, generalized vasodilation, increase capillary permeability, causes fluids to leave the blood entering the tissues

anaphylactic shock

provide alternate pathways for blood to reach a given body region, if one branch is blocked, the collateral channel can supply the area wit adequate blood supply common in joints, abdominal organs brain and heart

anastomes

provide alternate pathways for blood to reach a given body region, if one branch is blocked, the collateral channel can supply the area with adequate blood supply common in joints, abdominal organs brain and heart

anastomes

alternative pathways

anastomoses (more than one path). types: venous anastomoses, arterial anastomoses, arteriovenous anastomoses, portal system.

An arteriovenous ____ is a route by which blood flows from an artery to a vein without passing through capillaries

anastomosis

hormonal control of blood flow correlates to

angiotensin II

ACE inhibitor

angiotensin-converting enzyme. Blocks angiotensin II production. Because of this, lowers BP, also reduces aldosterone. Lowers BP overall

Describe the rule of thumb for arteries and veins. what are the exceptions

arteries carry blood away from the heart and veins carry blood towards the heart. The exceptions are the pulmonary arteries and pulmonary veins

1. Name the five general types of blood vessels in the cardiovascular system.

arteries, arterioles, capillaries, venules, veins

... Which of the following acts on the kidneys and blood vessels to raise blood pressure? epinephrine angiotensin II antidiuretic hormone atrial natriuretic peptide

antidiuretic hormone

describe circularoty shock and the three types

any condition in which blood vessels are inadequately filled and blood cannot circulate normally , results in inadequate blood flow to meet tissue needs 1. hypovolemic shock 2. cardiogenic shock 3. septic shock 4. anaphylatic shock

Describe circulatory shock

any condition in which the blood vessels are inadequately filled and blood cannot circulate normally, results in inadequate blood flow to meet tissue needs

peripheral resistance

any factor that hinders blood flow influenced by: -vessel diameter -blood viscosity -blood vessel length -obstructions in vessel "as R increases BP increases"

Blood enters the myocardium of the heart by coronary vessels that originate from the __________. aorta inside of the ventricles superior vena cava pulmonary artery pulmonary veins

aorta

the left ventricle sends blood into this vessel

aorta

examples of elastic arteries

aorta, brachiocephalic, common carotid

examples of elastic arteries

aorta, pulmonary trunk, common carotid and common iliac

veins

are blood resevoirs

venules

are thin & somewhat porous vessels leading from the capillaries; their tunica intima & media are very thin w/ very little smooth muscle; leukocytes leave the circulation at the venuoles; merging of venules gives rise to veins

tunica externa

areolar connective tissue with elastic and collagen fibers. anchors vessel to other structures. may contain vasa vasorum

bp that reflects two factors of the elastic arteries (Aorta and branches): thier elasticity and the amount of blood forced into them at any given time

arterial blood pressure

renin-angiotensin mechanism

arterial bp decreases > renin released > stimulates production of angiotensin II, vasoconstriction > aldosterone secretion, Na+ reabsorption and less urine formation > angiotensin II stimulates ADH release (both heighten BP)

Which has a smaller diameter: arteries or veins?

arteries

Pressure in Pulmonary Circuit

arteries 15 mm Hg veins 5 mm Hg

companion vessels

arteries and veins supplying same body region, usually lie next to each other.

Describe the rule of thumb for arteries and veins. what are the exceptions

arteries carry blood away from the heart and veins carry blood towards the heart. The exceptions are the pulmonary arteries adn pumonary veins

38. Describe how each of the following factors affects peripheral resistance: blood viscosity, vessel length, vessel diameter.

blood viscosity: inc. resistance: mostly constant vessel length: inc resistance: length of pulmonary circulation is greater. vessel diameter: most important factor influencing TPR (Total peripheral resistance). dec. diameter

Filtration vs Reabsorption

both forms of BULK FLOW, important in relation to volume of blood/interstitial fluid Filtration: from capillaries ---> interstitial fluid Reabsorption: from interstitial fluid--->capillaries

venous and arterial anastomoses

both when two or more converge to supply or drain same region. Venous more common

muscular artery traveling near the humerus bone is what

brachial artery

examples of muscular arteries:

brachial artery and radial artery

first major branch of the aortic arch is what

brachiocephalic trunk

Where is blood flow a top priority?

brain

Artery branching

branch into smaller and smaller vessels extending from heart, decrease in lumen diameter, decrease in elastic fiber, basically *decrease in size, lumen diameter, elastic fiber* but *increase in relative amount of smooth muscle*

pulmonary vein

brings RED blood back to heart

What is an aneurysm?

bulge in artery wall

Blood flow is directly proportional to a. blood viscosity b. vessel length c. vessel radius d. erythrocyte count e. peripheral resistance

c

In autoregulation all of the following chemicals tend to increase blood flow except a. nitric oxide b. carbon dioxide c. thromboxane A2 d. histamine e. lactic acid

c

The major deep veins of the forearm are the ___ on the medial side and the ____ on the lateral side respectively a. cephalic... basilic b. basilic ... cephalic c. ulnar ... radial d. radial ... ulnar e. brachial .... axillary

c

Water enters the blood capillaries by means of a. filtration b. active transport c. osmosis d. pinocytosis e. facilitated diffusion

c

Since RBC lack a nucleus they..

can't replicate

The only vessels that provide direct access to nearly every cell in the body are the __________. capillaries arteries venules arterioles veins

capillaries

Which blood vessel has the smallest diameter?

capillaries

smallest blood vessels with thin walls that allow exchange between blood and tissue cells describes what

capillaries

Exchange of gases and nutrients occurs by diffusion between the __________. artery walls and tissue cells arteries and veins arterioles and venules arterioles and tissue cells capillaries and tissue cells

capillaries and tissue cells

fenestrated capillaries

capillaries containing fenestrations located in kidneys, small intestine, endocrine glands moderately leaky

capillary exchange - water and rbcs

capillaries v narrow and thin, rbcs move single file. thin walls facilitate diffusion, water exits capillary near arterial end, water enters capillary near venous end

low pressure is desirable because high bp would rupture fragil thin wall capillaries - low pressure is sufficient to force filtrate out into interstitioal space and distribute ntrients, gases, and hormones between blood tissues --normal range: 20-40 mm Hg .

capillary blood pressure

too much fluid ends up in the tissues, poor venus return, congestive heart failure causes pumponary edema, insufficent muscular activity, kidney failure causes water retention or hypertension, histamine makes capillaries more permeable

capillary filtration increase

What is the primary force that promotes fluid movement out of the capillaries (be specific!)?

capillary hydrostatic pressure

hypoproteinemia (reduced osmotic pressure due to low blood albumins) fluid stays in the tissues, cirrhosis, famine, burns, kidney disease

capillary reabsorption

continuous capillaries

capillary with tight junctions located in skin, nervous/connective tissue, muscle tissue least leaky, permit a narrow range of substances to cross

How does the heart maintain BP?

cardiac output, increasing cardiac output increases bp -CARDIAC OUTPUT

main factors influencing blood pressure

cardiac output, peripheral resistance, blood volume

low bp and baroreceptors?

cardioacceleratory - *CO and R increase* raises BP

the heart cannot sustain adequate circulation

cardiogenic shock

All of the following are examples of venous sinuses EXCEPT __________. venous sinuses carotid sinuses coronary sinuses dural sinuses

carotid sinuses

baroreceptor locations?

carotid sinuses, aortic arch, walls of large arteries on neck and thorax

*32. Name the pulses, detect the location, and describe how you would document your findings.

carotid: medial to scm Radial: lateral wrist brachioradialis: inside of elbow femoral: inguinal area popliteal: back of knee posterior tibial: near achilles and malleolus if tibial dorsalis pedis: medial anterior foot. Scale: +3: bounding +2: normal +1: diminished, barely palpable 0: absent

Veins

carry blood from capillary beds to heart

tissues that don't have capillaries?

cartilage, epithelia, cornea, lens of eye

Secondary Hypertension

caused by known disease processes -treat disease that caused it

how does angiotesnin affect bp

causes vasoconstriction and increases blood pressure

Which of the following arteries branches to form the common hepatic artery, left gastric artery, and splenic artery? celiac trunk superior mesenteric artery gonadal arteries descending aorta inferior mesenteric artery

celiac trunk

Respiratory pump

changing pressure in thoracic & abdominal cavities moves blood towards heart

What are pyrogens?

chemicals released when leukocytes and macrophages are exposed to foreign substances in the body

what is a chemoreflex? how does it pertain to blood pressure

chemoreceptors detect changes in blood chemistry --autonomic response to any changes from normal blood levels of these chemicals can cause the brain to either stimulate co or stimulate vasoconstriction both causing bp to increase, increases lung perfusion to take care of excess CO2 or increase o2, increases blood filtration at the kidneys to remove excess hydrogen or other ions

What is a chemoreflex? How does it pertain to BP

chemoreceptors detect changes in the blood chemistry pH. autonomic response to any changes from normal levels of these chemicals can cause the brain to either stimulate CO or stimulate vasoconstriction both causing BP to rise

mother steroid

cholesterol

hint of poor nutrition and warning sign for addison's disease

chronic hypotension

The ____ is a complex of arteries on the base of the brain surrounding the pituitary gland

circle of willis

tunica media

circularly arranged month muscle cells with elastic fibers. contraction causes vasoconstriction- narrowing of lumen. relaxation = vasodilation - widening of lumen vessel

How does exercise influence cardiac output?

circulation increase overall rise atrial stretching

Any condition in which blood vessels are inadequately filled and blood cannot circulate normally is called __________. arteriosclerosis circulatory shock atherosclerosis hypertension varicose veins

circulatory shock

functions of lymph nodes

cleansing the lymph and immune system activation a type of filter

Lymph nodes

clustered along the lymphatic vessels of the body embedded in connective tissues composed of the cortex and the medulla

Venules

collect blood from capillaries Where several capillaries unite to form small veins. Collect blood from capillary bed and drain into veins. Very porous and are site where many WBCs emigrate from bloodstream to fight infection.

atria

collecting chamber

supply most of the blood to the head is what

common carotid arteries

At its inferior end the aorta branches into right and left ____ arteries

common iliac

Capillary

composed only of the tunica intma:Basement membbrane,Endothelial cells

elastic arteries

conduct blood under high pressure to organs

Cause of heat and redness

congestion of blood in that area

What type of tissue is blood?

connectie

anterior communicating artery

connects the two anterior cerebral arteries

describe the wall of a capillary

consist of a thin tunica interna that is one cell thick with a small diameter to only allow 1 rbc to pass at a time, have pericytes to stabilize walls

describe 2 constant and 1 dynamic sources of resistance

constant 1. blood viscosity--stickiness of the blood 2. blood vessel length-- the longer the vessel, the greater the resistance encountered dynamic 1. vessel diameter-- the bigger the radius the less the resistance

Describe 2 constant and 1 dynamic source of resistance

constant- blood viscosity and blood vessel length dynamic- vessel diameter

veins

contain more fibrous tissue in the tunica externa, the tunica media is thinner with a larger lumen; low pressure vessels, return blood to the heart

capillaries

contain only a tunica intima; provide for the exchange of materials between the blood and tissue cells

... The vessels that exhibit the lowest level of permeability are the __________. fenestrated capillaries sinusoidal capillaries continuous capillaries capillaries found in the glomerulus of the kidney

continuous capillaries

Abundant in skin and muscles Tight junctions connect endothelial cells Intercellular clefts allow passage of fluids and small solutes (most common)

continuous capillaries

types of capillaries?

continuous capillaries, fenestrated capillaries, sinusoidal capillaries (sinusoids)

pericytes

contractile cells, wrap around endothelial cells that line capillaries and venules

muscular "pump" - venous return

contraction of skeletal muscles "milk" blood back towards heart and valves prevent backflow.

general purpose arteries

convey blood from heart to capillaries

maintaining blood pressure requires

cooperation of heart, blood vessels and kidneys. Also supervision of brain

the only branches of the ascending aorta is what

coronary arteries

Tissue Perfusion in Heart

coronary circulation perfusion decreases during systole

short term neural and hormonal controls Bp?

counteract short term fluctuation by altering peripheral resistance.

what does a precapillary sphincter do? what is it made of

cuffs of smooth muscle cells that regulate blood flow into capillary bed, when the precapillary sphincters open blood flows through the capillary bed, when the sphincters close the blood flows through a metarteriole thoroughfar channel and the blood bypasses the capillary bed

Inadequate pumping activity of the heart is likely to cause a. neurogenic shock b. venous pooling shock c. obstructed venous return shock d. cardiogenic shock e. anaphylactic shock

d

Age-Related Changes in Cardiovascular System

decreased hematocrit constriction/blockage of veins by blood clots (thrombi) blood pools in legs due to venous valve deterioration reduced maximum CO changes in nodal and conducting cells reduced elasticity of fibrous skeleton progressive atherosclerosis replacement of damaged cardiac muscle cells by scar tissue

Metabolic controls

decreased pH of increased CO2 cause marked vasodilation

hypovolemia

decreased volume of blood circulating in the body caused by: blood or fluid loss or insufficient fluid intake

Cardiovascular Center--->Vagus Nerves (Parasympathetic/Inhibitory)

decreases heart rate

What are Natural Killer Cells?

defensive cells that lyse and kill cancer cells and virus infected body cells before the adaptive immune system is activated

2 APCS

dendritic cells - efficient antigen catchers, present antigens to T cells macrophages- prevent antigens to T cells to be activated themselves

Lumen

describes cavity of blood vessel, where blood travels

Functions of CD8 (cytotoxic)

destroy cells in the body that harbor anything foreign

Adaptive/ Specific Immunity

develops in response to contact with a specific invader

Elastic arteries

diameter - 2.5 to 1 cm, conduct blood from heart to smaller muscular arteries, larger proportion of elastic arteries which allow to stretch and recoil *propels blood through arteries during diastole*, elastic tissue throughout tunica media

The minute-to-minute blood flow through the capillary beds is determined by the __________. number of elastic fibers in conducting arteries constriction of elastic arteries diameter of arterioles elastic lamina on both sides of the tunica media in muscular arteries

diameter of arterioles

The lowest arterial blood pressure observed during the cardiac cycle is called the ____

diastolic

lowest level of aortic pressure

diastolic pressure

lowest level of aortic pressure correlates to

diastolic pressure

sound disappears when taking blood pressure

diastolic pressure

Pulse pressure

difference between systolic and diastolic pressure

Lipid-soluble molecules...

diffuse directly through endothelial membranes

What passive transport process accounts for the exchange of dissolved gases and nutrients in the capillary beds?

diffusion

Identify the forces which help move materials into and/or out of the capillaries.

diffusion, filtration, osmosis

varicose veins

dilated bulging veins caused by decreased venous return -pregnancy, standing for prolonged periods, and abdominal obesity

42. How are blood flow, blood pressure and peripheral resistance related to each other?

direct relations between flow and change in pressure. inverse relation between flow and peripheral resistance

Which of the following types of blood vessels have the proportionally thickest tunica media of all vessels? elastic arteries vasa vasorum distributing arteries arterioles

distributing arteries

59. Much of the normal metabolic functions of the liver are performed for the fetus by the maternal liver. However, the fetal liver requires a minimal blood flow to ensure that it develops normally. What shunt carries most of the nutrient-rich, oxygenated blood from the umbilical vein past the fetal liver and into the inferior vena cava?

ductuc venousus

60. As with the liver, the fetal lungs are non-functional. Name the two shunts which allow most blood flow to bypass the fetal lungs and flow into the aorta.

ductus arteriosum foramen ovale

Osmotic Pressure

due to nondiffusible solutes that cannot cross boundary, due to plasma proteins "pulls" fluids across boundary

Excessive fluid loss by perspiration or hemorrhage is most likely to cause ____ shock a. anaphylactic b. cardiac c. neurogenic d. obstructed venous return e. hypovolemic

e

Immediately lateral to the eyebrow you can palpate the pulse of a. the external carotid artery b. the ophthalmic artery c. the hemiazygos artery d. the facial artery e. the superficial temporal artery

e

The muscles between the ribs are supplied by the anterior and posterior a. subclavian arteries b. phrenic arteries c. thoracic arteries d. thoracoacromial arteries e. intercostal arteries

e

The two internal carotid arteries unite on the base of the brain to form a. the common carotid artery b. the posterior communicating artery c. the Willis artery d. the obturator artery e. the basilar artery

e

Artery that supplies the diaphragm

e (phrenic artery)

Phase of the cardiac cycle in which the AV valves close

e (ventricular systole)

*34. List the assessment findings in a patient with a DVT.

edema localized warmth erythema: change in skin color tenderness: leg pain

9. Which arterial vessels serve as a pressure reservoir between contractions of the ventricles?

elastic

8. Identify the three basic types of arterial vessels and describe the structural and functional differences between them.

elastic (conducting): aorta and major branches. largest and most elastic. closest to heart. pressure reservoir. muscular (distributing): distribute blood. thick tunica media. adjusts lumen diameter in response to signal. arterioles: blood from arteries to capillaries. metarterioles are like arterioles mixed with capillaries: arteriole thru capillary bed.

what vessel is thick-walled, large vessels near the heart that conduct blood continuously away from the heart

elastic arteries

what two factors does arterial blood pressure reflect?

elasticity and volume of blood forced into arteries at any time.

factors increasing cardiac output

endocrine: -thyroid hormone, e/ne neural: -increased SNS, decreased PNS

Effects of Complement

enhances the effectiveness of both specific and non specific defenses

Hormones that control CO

epinephrine/ne thyroid hormone (increase receptors for e/ne)

Where is cholesterol found?

every cell membrane

describe varicose veins

excessive pressure placed on the walls of leg veins causes them to strtch, swelling causes the valves to be pulled apart too far and they cannot seal off and keep veins from pooling caused from excessive standing, obesity, pregnancy, and herditary weak valves.

Edema

excessive water in interstitial fluid (peripheral edema and ascites)

Cause of swelling

exudate(fluid containing clotting factors and antibodies) seeping into the tissue spaces from the blood

The hormone is a strong vasoconstrictor

f (renin)

Neurogenic shock

failure of ANS regulation

... Baroreceptors are effective in long-term regulation of blood pressure. True False

false

... If the net filtration pressure (NFP) is positive, then fluid is reabsorbed into the blood. True False

false

A stroke is also know as a transient ischemic attack

false

All capillaries reabsorb about the same amount of fluid as they release

false

Blood cannot get from an artery into a vein without passing through at least on capillary bed

false

Hypotension is commonly called high blood pressure. True False

false

Orthostatic hypotension causes blood pressure to rise by increasing effects of ADH. True False

false

The inferior vena cava has one-way valves that ensure that upward flow of blood toward the heart

false

condition of sustained elevated arterial pressure of 140/90 or higher --temporary elevations are normal and can be caused by fever, physical exertion and emotional upset --chronic elevation is amajor cause of heart failure, vascular disease, renal failure, and stroke

hypertension

risk factors for cerebrovascular accident

hypertension, blood clots, smoking diabetes

low blood pressure in which systolic pressure is below 100 mm hg

hypotension

hypophyseal portal system

hypothalamus secretes releasing/inhibiting hormones. Travels through primary capillary plexus, portal vein to anterior pituitary, secondary capillary plexus

results from large scale blood loss involving trauma burns dehydration

hypovolemic shock

Category that includes neurogenic and anaphylactic shock

i (venous pooling shock)

Innate/ Non specific immunity

immunity present at birth, keeps things out and kills anything that enters always prepared to fight against foreign substances

metabolic controls

in cells that are active: decreased oxygen and increased carbon dioxide cause vasodilation and increases tissue perfusion in cells producing ATP slower: increase in oxygen cause constriction of arteriole, decreasing tissue perfusion

elastic arteries

include an internal elastic membrane in tunica intima & a tunica media with an abundant amount of elastic fibers; these arteries lead from heart & include the aorta & the major branches coming off the aorta; the elastic fibers allow the arteries to expand & recoil with fluctuations in blood pressure; the larger elastic arteries contain small blood vessels called vasa vasorum that supply the vessel itself

How does epinephrine affect blood pressure

increase BP vasoconstricts most blood vessels

Long Term Regulation of BP

increase bv and increase MAP modify: blood volume done by endocrine or urinary systems

baroreceptors

increase in bp: fire action potentials at faster rate to medulla so blood pressure decreases decrease in bp: fire action potentials lower rates of firing

myogenic mechanism

increase in pressure stretches vessel to increase velocity of blood flow, and triggers smooth muscles to contract decrease in pressure relaxes vessel, decreasing velocity, and smooth muscles relax

Sympathetic effect on peripheral resistance

increase in sympathetic-constrict decrease-dilate

increased blood pressure stimulates baroreceptors to?

increase input to vasomotor center. Inhibits vasomotor center. Arteriole dilation and venodilation. Cardioinhibitory center (in medulla oblongata)

How does norepinephrine affect blood pressure

increases BP, vasoconstricts most blood vessels

respiratory "pump" - inspiration

increases blood flow to thoracic veins, intra-abdominal pressure increases, blood moves superiorly towards heart. decreases intra-thoracic pressure.

how does antidiuretic hormone affect bp

increases blood volume, increases blood pressure, stimulates vasoconstriction in cases of extremely low bp

Cardiovascular Center--->Cardiac Accelerator Nerves (Sympathetic/Stimulatory)

increases rate & contractility of heart

... Blood flow would be increased by __________. decreasing vessel diameter decreasing blood pressure increasing blood vessel length increasing cardiac output

increasing cardiac output

what brings oxygen-poor blood from the lower body to the right atrium

inferior vena cava

Respiratory pump

inhalation increases blood flow into thoracic veins exhalation increases blood flow into heart and abdominal veins

endocardium

inner lining of heart

tunica intima

innermost layer of vessel, endothelium- *simple squamous epithelium*, facing lumen, *sub-endothelial layer of areolar connective tissue*.

Endocardium

innermost layer, lines the valves; smooth shiny surface

51. Name and describe the location of the major components (i.e., sensory receptors, integration center, motor neurons, effector) of the reflex arcs which help regulate blood pressure.

integration center (vasomotor center)- a cluster of neurons in the medualla that oversees changes in diameter of blood vessels effector effector (vascular smooth muscle)-on organs sensory receptor-baroceptor (in carotid sinus, aortic arch, and in large arteries of neck and thorax) or chemoreceptor, (aortic arch or large arteries in neck)

A metarteriole is a vessel that __________. is intermediate between a capillary and a venule auxiliary channel drains the capillary bed is intermediate between the arteriole and the capillary bed

is intermediate between the arteriole and the capillary bed

Two main causes of disruption of blood flow to brain (cerebrovascular accident)

ischemic and hemorrhagic

Origin of sympathetic control over blood vessel diameter

k (vasomotor center)

Kidney hormone and BP

kidney releases renin generating angiotensin II. Vasoconstriction (think hemostasis)

The major long-term mechanism of blood pressure control is provided by the __________. kidneys the heart the digestive tract the lungs paravertebral ganglia

kidneys

eosinophil

kills parasite; nucleus bilobed

Veins have..

lack of smooth muscle

vein sizes and differences between sizes

large, small to medium, venule. Venue has no valve. All have all Tunicas

larger v smaller arterioles

larger- three tunics smaller. smaller- thin endothelium with single layer smooth muscle

elastic arteries

largest, act as a pressure reservoir, expanding and recoiling for continuous blood flow

monocyte

largest, kidney shaped nucleus, develop into macrophages

What is hypotension?

lbp

... Blood flows from the lungs to the __________ via the __________. right atrium; pulmonary arteries left atrium; pulmonary veins right atrium; pulmonary veins left atrium; pulmonary arteries

left atrium; pulmonary veins

left gastric artery of cat

left gastric

third major branch of the aortic arch is what

left subclavian artery

During systemic circulation, blood leaves the __________. right ventricle and moves to the lungs left ventricle and goes directly to the aorta lungs and moves to the left atrium right atrium and goes directly to the lungs right ventricle and goes directly to the aorta

left ventricle and goes directly to the aorta

stimulating cardioinhibitory does what?

less sympathetic nervous impulses go to heart- hr and contractility decrease, causing a decrease in CO

63. After birth the ductus venosus becomes the _______________, the foramen ovale becomes the ________________ and the ductus arteriosus becomes the _________________.

ligamentum venosum fossa ovalis ligamentum arteriosum

atherosclerotic plaques description

lipids, cholesterol, calcium salts, and cellular debris within the tunica intima -form in regions where blood undergoes sudden changes in velocity and direction of flow

where to find sinusoidal capillaries?

liver, spleen, bone marrow

what regulates precapillary sphincters?

local chemical conditions as well as vasomotor nerves

Renal control is the ____

long term control of blood pressure

Blood vessel length

longer vessel = greater resistance

Arteries have..

lots of smooth muscle

Interstitial fluid osmotic pressure

low (1 mmHg) due to low protein content

... Fluids would be likely to leave or filter out of the capillary if __________. net filtration pressure (NFP) is negative net hydrostatic pressure (HP) is less than net osmotic pressure (OP) osmotic pressure (OP) in the capillary is high net hydrostatic pressure (HP) is greater than net osmotic pressure (OP)

net hydrostatic pressure (HP) is greater than net osmotic pressure (OP

factors decreasing cardiac output

neural: increased PNS, decreased SNS

Angiogenesis/Neovascularization

new vessel formation in mature organism

metabolic control of blood flow correlates to

nitric oxide

lymphatic system drains excess tissue fluid if it is obstructed, fluid is retained in the tissues

obstructed lymphatic drainage

*33. Which of your patients might be at risk for DVT? What are the possible nursing interventions?

obstruction of blood SYMPYOMS: Calf/ thigh discomfort swelling of the legs history of DVT conditions that make blood thicker hormone therapy birth control injury/surgery to deep vein decreased movement - after surgery, travel long time pregnancy Nursing interventions: - ambulate - foot pedals - compression stockings - blood thinner

Fenestrated Capillaries:

occur in areas of active filtration or absorption and areas of hormone secretion Fenestrations (covered by thin diaphragm made of extracellular glycoproteins) Number of fenestrations increase during active absorption of nutrients in some digestive organs

simple pathway blood vessels

one major artery delivers blood to organ or region, branches into smaller arteries then arterioles, each arteriole feeds capillary bed, drained by venule, venules merge into one major vein. End arteries

semi-lunar valves

open/close based on pressure

Colloid Osmotic Pressure

opposes hydrostatic pressure -pulls

What is resistance

opposition of flow, measure of the amount of friction blood encounters

Peripheral resistance

opposition to flow, amount of friction blood encounters, often encountered in peripheral systemic circulation

what is resistance?

opposition to flow, measure of the amount of friction blood encounters, generally encountered in teh systemic circulation

Resistance

opposition to flow; a measure of the amount of friction blood encounters as it passes through the vessels.

origin, maturation, and function of T cells

origin: red bone marrow maturation: thymus Function: cellular immune response, target intracellular pathogens both go through the same maturation process

origin, maturation, and function of B cells

origin: red bone marrow maturation; red bone marrow function: humoral immune response, target extracellular pathogens, present antigens to T cells to help with their own activation

temporary low bp and dizziness when suddenly rising from a sitting or reclining postion

orthostatic hypotension

pericardium

outside

capillary exchange - nutrient and gas concentration gradients

oxygen and nutrients diffuse out of capillaries, CO2 and waste diffuse into capillaries. Think going from oxygen rich artery to veins, so bad stuff diffusing in to supply to veins

Arteries carried _______ blood

oxygenated

Why is there more blood pressure in arteries?

oxygenated blood needs to travel as fast as possible

A function of blood viscosity vessel length and vessel radius

p (peripheral resistance)

Symptoms/Signs of disruption of blood to brain

paresis loss of vision difficulty speaking headache affect one side of body

Fibrous cap

part of the atheromatous plaque that undergoes continuous remodelling

Describe capillary BP

pressure of blood flow in capillaries -low capillary pressure is desired because high BP would rupture fragile, thin walled capillaries -sufficient to force filtrate out into interstitial space and distribute nutrients, gases and hormones btwn blood and tissure

what does the pulse represent

pressure wave caused by the expansion and recoil of elastic arteries

benefits of inflammation

prevents the spread of damaging agents to nearby tissues Disposes of cell debris and pathogens Sets the stage for the repair process

risk factors caused by body characterisitcs; diet, obesity, age, race, heredity, stress, and smoking

primary or essential hypertensino

Aldosterone purpose? Where is it produced?

production stimulated by presence of angiotensin II. increases salt levels in kidney and ultimately water retention. higher blood volume = higher BP. Produced in *adrenal cortex*

Function of all inflammatory chemicals

promote vasodilation and make capillaries leakier, and attract white blood cells to the area

How does ANP affect bp

promotes NA+ excretion and water excretion decreases blood volume and decreases blood pressure

how does aldosterone affect bp

promotes na+ and water retention by kidneys, increases blood volume and increases blood pressure

What are antibodies?

proteins secreted in response to an antigen by plasma cells and bind specifically to that antigen

end arteries

provide only one pathway for blood to organ (simple pathway)

colloid osmotic pressure

pull of water into tissue by tissue's protein concentration (colloid). Goes to area with higher solute conc. COP_b and COP_if

pulmonary artery

pulmonary SL valve

branches of pulmonary arteries; structurally like veins and venules, with thin walls and large lumens is what

pulmonary arterioles

first vessel leaving the pulmonary side of the heart to carry blood to the lungs is what

pulmonary artery

area of exchange for oxygen and carbon dioxide is what

pulmonary capillaries

the right ventricle sends blood into this vessel

pulmonary trunk

two from each lung carry blood into the left atrium are what

pulmonary veins

what brings oxygen-rich blood from the lungs to the left atrium

pulmonary veins

smallest veins; collect blood from capillaries as it flows back toward heart is what

pulmonary venules

difference between systolic and diastolic

pulse pressure

the difference between systolic and diastolic pressure correlates to

pulse pressure

Which of the following is the major force generating blood flow? pumping action of the heart peripheral resistance blood vessel diameter total blood vessel length blood viscosity

pumping action of the heart

ventricle

pumping chamber

Treatments for Hypertension

quite smoking exercise decrease salt, cholesterol, saturated fats medications to decrease resistance and blood volume

where is it easily measured

radial artery, it is most superficial l

The effects of pyrogens

raise the bodys temp above normal cause the spleen to sequester iron and zinc, making them less available to support bacterial growth Increase the metabolic rate of tissue cells and speeds up repair processes

Basophil

rarest of all; release histamine

*31. What you would assess if your patient was admitted with peripheral vascular disease?

rate: 60-100bpm, rhythm, amplitude

Passive Humoral Immunity

ready made antibodies are introduced into your body and so the B cells are not challenged by antigens

Sympathetic Venoconstriction

reduces blood volume in veins and pushes it towards the heart

P wave

reflects electrical activity associated with atrial depolarization

QRS Complex

reflects electrical activity associated with ventricular depolarization

T Wave

reflects electrical activity associated with ventricular repolarization

Describe arterial BP

reflects two factors of the elastic arteries -their elasticity -the amount of blood forced into them at any given time

higher brain centers and BP?

reflexes to control BP in medulla- *cortex and hypothalamus can control BP via relays to medullary centers*

Arteriogenesis

remodeling of existing arteries in response to chronic changes in pressure or flow

opposition to flow (a measure of the amount of friction blood encounters as it passes through the vessels) is what

resistance

37. Define peripheral resistance.

resistance to blood flow that occurs in peripheral circulation

Immunity

resistance to disease "free"

pressure changes during breathing move blood towards heart by squeezing abdominal veins as thoracic veins expand

respiratory pump

hypovolemic shock

results from large scale blood loss involving trauma, burns, dehydration

Veins

return blood to heart Collect blood from venules and lead way back to heart Very little smooth muscle, larger lumen than arteries. Capacitance vessels, very low, non-pulsatile pressures.

SA node (Where?)

right atrium

During pulmonary circulation blood leaves the __________. right ventricle and goes directly to the aorta left ventricle and moves to the lungs right atrium and goes directly to the left ventricle right atrium and goes directly to the lungs right ventricle and moves to the lungs

right ventricle and moves to the lungs

Which of the following conditions would NOT increase the chances of developing varicose veins? a potbelly in an obese person standing to attention for long periods of time pregnancy running in place

running in place

Semicircular artery that gives rise to the digital arteries of the hand

s (superficial palmar arch)

caused by identifiable disorders, excessive renin secretion, arteriosclerosis, and endocrine disorders

secondary hypertension

function of plasma cells

secrete antibodies which can bind to free antigens and mark them for destruction by other innate or adaptive mechanisms

Know the role of plasma cells and memory cells

secreting antibodies that mark antigens for destruction mounting an immune response if they encounter the same antigen again

bacterial toxins trigger vasodilation and increase capillary permeabliity, causes fluids to leave the blood entering the tissues

septic shock

anaphylactic shock

severe immune reaction to antigen, histamine release, generalized vasodilation, increased capillary permeability

Septic shock

severe systemic bacterial infection

anaphalactic shock

shock from allergic reaction

Cardiogenic shock

shock most commonly caused by heart attack/failure decreases stroke volume

septic shock

shock resulting from bacterial infections in the blood

what controls blood pressure

short-term neural and hormonal controls, long term renal regulation, neural controls of peripheral resistance

Arteriovenous anastomoses

shunts blood from arterioles to venules bypassing capillary bed. Sympathetic control

what brings oxygen-poor blood from the upper body to the right atrium

superior vena cava

5. As you study the vascular system, you will encounter the following tissues: simple squamous ET, dense fibrous CT, elastic CT, areolar tissue, smooth muscle. Describe the general structure and function of each of these tissues.

simple squamous CT- scale like; diffusion and secretion dense fibrous CT- strong rope like collagen; in tendon and ligaments elastic CT- very stretchy skin, lungs, arteries, veins, connective tissue proper, elastic cartilage, periodontal ligament, fetal tissue and other structures. areolar CT- looks like fiberglass; loose packing , support, and nourishment smooth muscle- smooth, can tense and relax, controls size of lumen of arterioles-arteries

The endothelium is composed of __________. simple cuboidal epithelium stratified squamous epithelium tunica media muscle cells simple squamous epithelium simple columnar epithelium

simple squamous epithelium

artery types and differences between types

size/proximity to heart - *elastic artery> muscular artery> arteriole* . Muscular artery has external and internal elastic laminae surrounding tunica media.

Muscular pump

skeletal muscle activity

... Which of the following would experience increased blood flow during exercise? intestines brain skin kidneys

skin

First line of defense

skin and mucosae

Vasomotion

slow and intermittent flow reflects the on/off opening and closing of precapillary sphincters.

vasa vasorum

small arteries required to supply very large vessels - i.e. aorta or vena cava

where of you find fenestrated capillaries?

small intestines, endocrine glands and kidneys

capillary exchange - small v large solutes

small solute- diffuse via endothelial cells or intercellular clefts, large solutes - pass through fenestrations or gaps in sinusoids

Blood vessel diameter

smaller tube = greater friction

what is an arteriole

smallest arteries that lead into capillary beds, control flow into capillary beds via vasodilation and vasoconstriction

arterioles

smallest arteries with a very thin tunica external and only a few layers of smooth muscle in the tunica media; blood flow from arterioles into a capillary, play a role in regulating the blood flow to specific areas of the body

Arterioles

smallest arteries, important in regulating blood flow to capillary beds

metarteriole

smallest arteriole before capillaries. connects to thoroughfare channel, the venous side/end of the capillary bed

Arterioles

smallest branches of arteries, resistance vessels -largest pressure drop across circulation

arterioles

smallest of the arteries characterized by the presence of smooth muscle at the tunica media forming pre-capillary sphincters that regulate blood flow into capillaries & tissues

venules

smallest veins, all tunics are very thin with at most 2 layers of smooth muscle and no elastic tissue; drain capillary beds and merge into veins

Venules

smallest, they join together to form veins

vasomotor tone

smooth muscle in arterioles usually somewhat constricted- regulated by vasomotor center in brainstem. *amount of tension in smooth muscle in walls of blood vessels, regulated by norepinephrine*

osmotic pressure

solutes in solution pull on water molecules

fenestrated capillaries

some endothelial cells contain pores (fenestrations). more permeable than continuous capillaries, *function in absorption and filtration formation*

what is the lumen

space within the vessels in which the blood flows

largest single mass of lymphatic tissue

spleen

PNS and heart rate control

stimulate SA and AV node through vagus nerve, acetylcholine slows heart rate

Decrease in tissue oxygen tension (PO2) is...

stimulus for production of a local vasodilator that will increase flow and oxygen delivery to the tissue

myogenic control of blood flow correlates to

stretch of vascular smooth muscle

location arterial anastomoses

superior and inferior epigastric arteries supplying abdominal wall, heart, brain, joints

... Blood from the brain is returned to the heart via the __________. abdominal aorta inferior vena cava thoracic aorta superior vena cava

superior vena cava

highest in aorta declines throughout pathway 0 mm Hg in right atrium

systemic BP

Anaphylactic shock

systemic allergic reaction

The flow of blood from the left ventricle to the right atrium is called the __________. pulmonary circulation hepatoportal circulation microcirculation systemic circulation

systemic circulation

Contraction of any heart chamber is called _____

systole

pulse pressure?

systolic - diastolic

what happens to Blood pressure on a simple pathways

systolic higher than diastolic. As goes from elastic arteries to venules to veins to vena cava, pressure decreases

1st sound in measuring blood pressure

systolic pressure

peak of aortic pressure correlates to

systolic pressure

pressure exerted in aorta during ventricular contraction

systolic pressure

arterial blood pressure measures?

systolic pressure - ventricular contraction and diastolic pressure - ventricular relaxation

What are systolic and diastolic pressure? What heart action do they correspond too?

systolic- highest pressure exerted on arterial walls during ventricular contraction, first sound diastolic- lowest level of arterial pressure during ventricular relaxation, when sound disappears is recorded as diastolic

The importance of phagocytosis in innate body defense

takes care of the pathogens that made it through the skin or mucosae to the underlying connective tissue

Orthostatic hypotension

temporary drop in blood pressure when a person stands up

Immunocompetence

the ability of each lymphocyte to be able to recognize its one specific antigen by binding to it

Which of the following blood vessels is the most susceptible to atherosclerosis? the femoral artery the pulmonary arteries the aorta the cerebral arteries

the aorta

Blood pressure

the force per unit area exerted on a vessel wall by the contained blood (mmHg)

cardiogenic shock

the heart cannot sustain adequate circulation- like during a heart attack

Autoimmune response

the immune system loses its ability to recognize and distinguish itself from non self so autoantibodies that destroy the body's own tissues are produced

What are the vein factors & adaptations that allow them to return blood to the heart? Describe the respiratory pump and the muscular pump? How do they aid vein function?

the large diameter lumuns offer little resistence to flow and the valves prevent backflow of blood. the venus sinuses are specialized flattened veins with extremely thin walls, respiratory pump is pressure changes created durinng breathing that suck blood toward the heart by squeezing local veins. muscular pump contracts skeletal muscles and milks blood towards the heart

Self tolerance

the lymphocytes being relatively unresponsive to self antigens so that it does not attack the body's own cells

Short term regulation of BP is done by

the nervous system and hormones

Be able to describe systemic blood pressure, in what structures would you here the highest and lowest pressure

the pummping action of the heart generates blood flow through the vessels along a pressure gradient always moving from higher to lower pressure areas --highest in aorta --lowest in right atrium

capillaries

the smallest blood vessels; each capillary consist of endothelium surrounded by a basement membrane; the thinness of capillaries allows for gas, nutrient & waste exchange at tissues

Frank-Starling's Law and variation?

the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end diastolic volume) when all other factors remain constant. NFP = variation

Most neural controls of blood pressure involve input from baroreceptors, which are sensitive to __________. to changes in blood pressure the level of oxygen in the blood the level of carbon dioxide in the blood the constriction of capillary beds

to changes in blood pressure

What is the purpose of valves in the veins?

to prevent back flow of blood.

Why is it important to be able to take a pulse at many different points on the body?

to see if the body is recieving full circulation

a source of resistance related to the distance blood has to travel through layers of fat to reach a destination is what

total blood vessel length

arteries

transport blood away from the heart; are large blood vessels leading from the heart; are thicker than veins due to their tunica media that is characterized by the presence of smooth muscle & elastic fibers; the thick tunica media gives arteries more structure that results in a larger, more open lumen

veins

transport blood back to the heart; blood in veins under very little pressure & that is reflected in the thin tunica media of the vessels; histologically, the tunica intima forms valves that prevent the blackflow of blood in the vessel & the tunica media consist of a thin layer of smooth muscle; the tunica externa is the thickest layer helping the vessels adhere to the surrounding connective tissue; due to the thinness of veins, their lumen appears collapsed/closed; when skeletal muscles of body contract, their proximity to veins helps to push blood forward; may contain vasa vasorum

Arteriovenous anastomoses

transports blood from artery directly to vein, allows areas to be bypassed if body hypothermic

An important factor in short-term regulation of blood pressure is peripheral resistance. True False

true

Atherosclerosis begins in youth but seldom causes noticeable problems until middle to old age. True False

true

Blood cannot flow from point A to point B in a vessel unless the pressure is higher at A than at B

true

Blood pressure in capillaries is lower than in arterioles. True False

true

Distributing arteries are larger than resistance arteries

true

Perfusion of the digestive tract drops during heavy exercise

true

The circumflex arteries around the neck of the humerus represent an arterial anastomosis

true

The femoral vein is a superior continuation of the popliteal vein

true

The heart produces a hormone called atrial natriuretic peptide (ANP) that causes blood volume and blood pressure to decline. True False

true

The lungs receive both pulmonary and a systemic blood supply

true

The only force favoring capillary reabsorption is the colloid osmotic pressure of the blood

true

The vertebral artery supplies the brain with blood. True False

true

True or False: Veins have valves whereas arteries do not

true

external (fibrous connective tissue)

tunica externa

what are of blood vessel protects and reinforces the vessel; anchors it to surrounding structures

tunica externa