Vessels

Question 1

Blood Volume Distribution

Answer 1

Systemic Veins 64%
Systemic Arteries 13%
Pulmonary vessels 9%
Heart 7%
Systemic Capillaries 7%

Question 2

What is the Adventitia of the arterial wall composed of?

Answer 2

Strong fibrous tissue

Question 3

What is the Media of the arterial wall composed of?

Answer 3

smooth muscles
elastic tissue
fibrous tissue

Question 4

What is the Intima of the arterial wall composed of?

Answer 4

single layer of endothelial tissue

Question 5

Describe the anatomy of the artery wall

Answer 5

• Thick and firm
• Dilate with systole to a small degree
• Low capacitance

Question 6

In ASCVD initially, within the endothelial cells there is an inflammatory response with accumulation of what type of cells?

Answer 6

WBCs

Macrophages

Question 7

In ASCVD, after WBCs and macrophages accumulate what happens next?

Answer 7

1. Accumulation of cholesterol and triglycerides into a fatty deposit called and atheroma
2. Accumulation of Ca2+
3. Mass reduces elasticity of the artery (stiff) and narrow the lumen (hardening)

Question 8

What is the progression of endothelial dysfunction?

Answer 8

1. Initial lesion
2. Fatty streak
3. Intermediate lesion
4. Atheroma
5. Fibroatheroma
6. Complicated lesion

Question 9

What is a granuloma?

Answer 9

Accumulation of inflammatory cells 2/2 to an inflammatory process
(seen in Arteritis)

Question 10

In Takayasu’s Arteritis what main vessel in involved?

Answer 10

Carotid artery (will see thickening of the wall on imaging)

Question 11

There is one place you can actually see the arteries and veins..where is it?

Answer 11

The fundus of the eye

arteries appear redder sat. = 90-95%

Question 12

Arteriole function

Answer 12

• Control amount of resistance through vasoconstriction and vasodilation
• Greatest drop in pressure occurs

Question 13

Distal arterioles have only what 2 layers?

Answer 13

• media (smooth muscle)

- intima

Question 14

What are the intrinsic mechanisms (autoregulation) for arterioles?

Answer 14

-Metabolic or myogenic controls

Distribute blood flow to individual organs and tissues as needed

Question 15

What are the extrinsic mechanisms for arterioles?

Answer 15

• Neuronal or hormonal controls
• Maintain MAP
• Redistribute blood during exercise and thermoregulation

Question 16

What metabolic factors will cause vasodilation of the arterioles?

Answer 16

Dec O2
Inc CO2, H+, K+
Prostaglandins
Adenosine
Nitric oxide

Question 17

What neuronal and hormonal factors will cause vasodilation of the arterioles?

Answer 17

• Dec sympathetic tone

- Atrial natriuretic peptide (ANP - maintains fluid level and BP)

Question 18

What neuronal and hormonal factors cause vasoconstriction of arterioles?

Answer 18

• Inc sympathetic tone
• Angiotensin II
• Antidiuretic hormone
• Epi and NE

Question 19

Capillary anatomy

Answer 19

• single layer of endothelium (continuous with intima)
• small, short 5-10 micrometers in diameter
• 1 mm long

(est. 62,000 miles long)

Question 20

Capillaries have the ____ total area and cross sectional diameter of any component of vascular bed

Answer 20

largest

Question 21

The single cell layer of endothelium in capillaries facilitates the passage of?

Answer 21

• water
• electrolytes
• O2
• CO2
• waste & nutrients (glucose)

Question 22

T/F: There are no large fluctuation in blood pressure in the veins or capillaries?

Answer 22

True

Question 23

Venule walls have what two layers?

Answer 23

Intima and media

Question 24

Veins have what layers?

Answer 24

Adventitia
Media
Intima

Question 25

T/F: The adventicia and media are much thinner than in the arteries

Answer 25

True Veins have much thinner walls and are collapsible (increased capacitance and lower BP)

Question 26

Veins have ____ diameter lumens which offer little resistance to flow

Answer 26

large

Question 27

Valves of the veins help to?

Answer 27

direct flow to the heart

Question 28

Are veins usually pulsatile?

Answer 28

No - not unless transmitted by cardiac pulsations

Question 29

Increased venous return to the heart is one of the primary mechanisms by which cardiac output is?

Answer 29

Increased rapidly | This can be done by increased sympathetic tone (smooth muscle in veins contract)

Question 30

What factors increase Venous Return to the Heart?

Answer 30

- Sympathetic nerve stimulation (constriction) - Skeletal muscle pump (calves) - Breathing (neg intrathoracic pressure) - Inc Blood volume (urine and tissue fluid volume)

Question 31

There is a ____ and an ____ component to influencing venous return to the heart.

Answer 31

respiratory and abdominal

Question 32

What does the Valsalva Maneuver do?

Answer 32

Increases intra-thoracic and intra-abdominal pressures

Question 33

What does the increased pressured created by the Valsalva Maneuver cause?

Answer 33

It prevents blood from flowing into the vena cavae with resultant decreased venous return to the heart and decreased CO.

Question 34

There is also a ____ component to venous return.

Answer 34

positional lying down will increase venous return to the heart

Question 35

What is phasicity?

Answer 35

The ebb and flow in the veins in response to respiration and cardiac right atrial contraction

Question 36

With standing respiration what happens to the pressure in the thorax and what does this cause?

Answer 36

The pressure decreases and venous blood flows into the chest vena cavae. The intra abdominal pressure increases, increasing abdominal vein pressure.

Question 37

Due to the veins having about 60-70% of the blood in your circulatory system, what are they responsive to?

Answer 37

Gravity

Question 38

What is the primary factor in determining intravascular pressure?

Answer 38

Hydrostatic pressure

Question 39

What is the pressure in the legs while supine vs while standing?

Answer 39

``` Supine = to RA pressure 10 mmHG Standing = 90+ mmHg and negative pressure in the head ``` (250mL of blood pools into LE)

Question 40

When enough blood pools in the lower extremity veins, you have a decreased amount of blood flow to the heart and this results in?

Answer 40

Syncope "Coldstream Guard Down"

Question 41

When blood pools in the lower extremity veins the increased hydrostatic pressure causes?

Answer 41

Leakage of fluid from the capillaries causing peripheral edema

Question 42

What is Virchow's Triad?

Answer 42

Stasis Hyper-coagulability Endothelial Injury

Question 43

Healthy valves in the veins of the muscles should open when muscles contract and ___ when they relax

Answer 43

close

Question 44

When blood clots, the RBCs tend to organize themselves into layers and this requires?

Answer 44

More energy to break the clot up than if the RBCs were just randomly clumped together

Question 45

What occurs when there is decreased protein in the blood (albumin)

Answer 45

Edema

Question 46

An average of how many liters of plasma remain in the interstitial fluid?

Answer 46

3 L | 20 L out - 17 L reabsorbed