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Physiology Exam #4 - Flashcards

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Class:BIOL 2150 - PRINCIPLES OF PHYSIOLOGY
Subject:Biology
University:The Richard Stockton College of New Jersey
Term:Fall 2012
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What are the 6 functions of the Circulatory System 1) Transports Oxygen to tissues and CO2 out
2) Brings nutrients to cells
3) Transports hormones/signal molecules
4) Immunity
5) Removes waste
6) Regulates temperature
What are the three main structures (anatomy) of the Circulatory System 1) The heart

2) The blood

3) The blood vessal
How many Chambers are there in a fish heart? Two chambers
How many Chambers are there in amphibians (most reptiles) heart? Three chambers
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How many Chambers are there in a mammal/bird heart? Four chambers

(our heart )
Do heart valves travel one way or two? Heart Valves travel in one direction
What are the two types of heart valves called? 1) Atrioventricular Valves

2) Semilunar Valves
Where does the bicuspid valve lie?
-This  valve in the heart that lies between the left atrium (LA) and the left ventricle (LV).
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What type of valve is a bicuspid valve? And what is it sometimes referred to as? A bicuspid valve is a type of atrioventricular valve

Some times is referred to as the "mitral" valve
Where is the Tricuspid Valve located?


-This valve is located between the right atrium and the right ventricle.
What type of valve is a tricuspid valve? A tricuspid valve is a atrioventricular valve.
What type of valve is the Aortic Valve? And where is it located?
The aortic valve is a semilunar valve. 

-Located between the left ventricle and aorta 
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What type of valve is the pulmonary valve? And where is it located? The pulmonary valve is the semilunar valve of the heart t

It lies between the right ventricle and the pulmonary artery 
What will usually be the result of a ruptured chordae tendineae? Usually a sudden death
What is the Fibrous Skeleton of the heart? And what does it separate? - The structure of dense connective tissue in the heart that support's the valves.

-It separates the atria from the ventricles.
What structure/tissue in the heart prevents back-flow? the fibrous skeleton 
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What structure of the heart is where insertion of the cardiac muscles takes place? The fibrous skeleton 
What structure of the heart acts as an insulator of AP's ? The fibrous skeleton
What are the four tissues that make up the heart? 1) Endocardium
2) Myocardium
3) Epicardium
4) Pericardium 
What is the Endocardium made out of? And where is it located? Made from endothelium cells (is smooth)

Is the inner most lining of the heart
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What is the Myocardium made out of? Where is it located? Made from cardiac muscle

found all over heart, but mostly between epithelium and connective tissue
Where is the Epicardium located? The outer layer of the heart
What is the pericardium made from? And where is it located? -made from fibroue

-it is the sac around the heart
What holds the heart in place? The pericardial sac
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Can the heart function without the pericardial sac? Yes, but its better to have it's support
Is cardiac muscle unicellular or multicellular? Unicellular
Do cardiac muscle cells divide to make new ones? What is the issue with this? No, they do not.

Cardiac Cells do not go through mitosis.

This is an issue because, once its damaged, its done. This fact is why heart disease is so problematic
What are two features of cardiac cells that are found in between the cells and allow them to be connected? -gap junctions

-desomones

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What are the four types of proteins that the cardiac muscle cells have? 1) Myosin

2) Actin

3) Troponin 

4) Tropomyosin 
Cardiac muscle cells have an SR, what is its size like in comparison to skeletal muscle? It is smaller than in skeletal muscle cells
Cardiac muscle cells have T-Tubules, what are their size like in comparison to skeletal muscle? They are larger than in the skeletal muscle cells.
What is the function of T-Tubules in cardiac cells? to store calcium
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What is the size of the mitochondria in the cardiac muscle cells, and how much of the cell does it take up? They are HUGE

-take up 1/3 of the cell's volume
What can a blood clot in the heart lead to? It can lead to dead tissue

Blood clots lead to this because the cells in cardiac muscle do not reproduce (no mitosis). This can kill tissue around the clot.

They've found that dead tissue can lead/cause more dead tissue.
The heart contracts as a Syncytium, which is when? - when the cells contract together like one single unit via gap junctions (connections between cells)
What is Ventricular Fibrillation? What does it do to the muscles in the heart? - a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart (they contract all on their own/different types)

-makes muscles quiver rather than contract properly.

-looks like a bowl of worms

MALFUNCTION
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What is Autorhythymicity ? means "self excitable"
What can Autorhythymicity allow? This allows the heart to still beat after you're dead.
What are Autorhythymic cells? What are they also called? They are cardiac cells that spontaneously and rhythmically depolarize and fire action potentials .

They set the rate of the heartbeat

Also called pacemaker cells
Do pacemaker cells have a resting membrane? No they do not
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At about what percent do pacemaker cells make up ? they make up 1% of cardiac cells

they are non-contractile
What are the three types of cells in the heart? 1) pacemaker cells
2) ventricular cells
3) atrial cells

Where is 90% of the calcium in a pacemaker cell's process from? The SR
Where are the Four Places that Pacemaker cells are found? 1) the sinoatrial node of the RIGHT atrium (SA)

2) then to the  Atrioventricular node, in fibrous ring 

3) then to the right and left bundles of His - in the interventricular septum

4) AND lastly come together in the purkinje fibers of the ventricles
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What is the rate of action potentials of the pacemakers cells located in the sinoatrial node? 70-80 / min
What is the rate of action potentials of the pacemakers cells located in the atrioventricular node? 40-60 /min
What is the rate of action potentials of the pacemakers cells located in the bundles of His and purkinje fibers? 20-40 / min
If you block one route of the pacemaker cells, what will happen? The next node/area takes over 
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If you block the atrioventricular node for the pacemaker cells, what is this called? this is called "complete heart block"

When a bundle branch is blocked for the pacemaker cells, what can result? example? A sudden death may occur

Like in the news you may hear of a football player out of no where dropping dead on the field, etc.
What is ectopic pacemaker cells? abnormal packermaker tissue in another area of the heart
The contraction of the heart is what and what? -synchronous and simultaneous 
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What responsible for 20% of heart pump? When the two atria that contract first 
What do the AV nodes transmit to? They transmit to the ventricles
What happens after the AV node transmits to the ventricles? Then both ventricles contract
What does the Atrioventricular node do to allow complete filling ? It delays the impulse 
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Where does the pathway of the heart's contraction start at? Starts going thru the intercalated discs with gap junctions in the cardiac muscle cells
What is the cardiac cycle? A term referring to all or any of the events related to the flow or blood pressure that occurs from the beginning of one heartbeat to the beginning of the next.
What is ventricular systole? -contraction 
-filling of the heart
What is the Pressure in Left atrium ? 0-10 mmHg
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What is the Pressure in Left ventricle? 0-120 mmHg
What is the Pressure in the Aorta? 80-120 mmHg
What is the Pressure in the right atrium? 0-10 mmHg
What is the Pressure in the right ventricle? 0-25 mmHg
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What is the Pressure in the pulmonary artery? 8-25 mmHg
What is a Systole ? the time when the heart is contracting 
What is a Diastole? The time when the cardiac muscle relaxes 
Which part does the heart spend more time in, systole? or diastole? the diastole 
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What is happening during atrial systole? -extra blood is being squeezed into ventricle 
What happens in the first stage of the cardiac cycle ("early diastole")? - the semilunar valves shut off

- the atrioventricular valves open

- the whole heart is relaxed
What happens during stage two of the cardiac cycle? And what is it called?
called "atrial systole"

- the atrium contracts

-the blood flows from the atrium to the ventricles

Get max blood into ventricle (EDV)
What happens during the third stage of the cardiac cycle (3parts)? And what is this called? This is called : "ventricle systole" 

1st- isovolumetric contraction - against closed valves
- is when the ventricles begin to contract
- the AV and semilunar valves close
- there is no change in volume. 
2nd- ejection = aortic valve opens , obtain max end systolic volume 

3rd- aortic valve closes 
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What is the EDV? "end diastolic volume"

- the max. blood in the ventricle = 135 ml
What happens during the fourth stage of the cardiac cycle? And what is this called? This stage is called "isometric ventricular relaxation"

-both AV and semilunar valves close

-onset of ventricular diastole 

-pressure decreases
What happens during the fifth and last stage of the cardiac cycle?
-atrioventricular valve opens

-ventricle fills rapidly during the first part of diastole (this part brings us back to the beginning of process)
What is ESV? "end systolic volume"

- blood left after contraction (reserve) = 65ml
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What is SV? "stroke volume"

This is the EDV - ESV = 70 ml

(The end diastolic volume minus the end systolic volume)
What happens when the atrioventricular valve opens? the ventricle fills rapidly during the first part of diastole
What is the Cardiac Output "CO"? CO = HR x's SV

(cardiac output = heart rate times the stroke volume)

SO its the amount of blood pumped per ventricle per unit of time.
What is the onset of ventricular diastole? isometric ventricular relaxation
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What is the Resting CO? - 5  L / min 
What is the Active CO? 30-35 L / min
What is the stroke volume intrinsically controlled by? The preload 
(the degree to which the ventricles are stretched prior to contracting)
                                                                                         ^ BEFORE

aka venous filling with blood
What does the "Frank Starling Law of the Heart" state? 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.

SO:
increased venous return = stronger ventricular contractions
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For stroke volume, what is the "afterload"? the arterial blood pressure
What two things is the stroke volume extrinsically controlled by? 1) the sympathetic nervous system

2) the adrenal medulla

They both cause STRONGER contractions (aka less End systolic vol)
Blood supply needs to have what? (like the brain) needs oxygen 

aerobic for the most part

only a little bit anaerobic 
What is Vasodilation ? the widening of blood vessels resulting from relaxation of smooth muscle cells within the vessel walls

particularly in:
- the large veins 
-large arteries
- smaller arterioles.
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Where does the heart's blood supply get it's adenosine from? hypoxic cells
Where is most blood flow at? Mostly at diastole

-location: coronary arteries behind the semilunar valves
What is Atherosclerosis ?  artery wall thickens as a result of the accumulation of fatty materials such as cholesterol.
What can high blood pressure lead to? can lead to heart failure
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What can stenotic valves lead to? can lead to heart failure
What are stenotic valves? they are tightened valves /abnormal narrowing of the valves
What can leaky valves lead to? can lead to heart failure
What can "stiff" arteries lead to? can lead to heart failure
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What can damage to cardiac muscle lead to ? can lead to heart failure
What can conduction disturbances lead to? can lead to heart failure
What can metabolic diseases (alterations in Ca++, K+) lead to? can lead to heart failure
What are the seven things that can lead to heart failure? 1) high blood pressure
2) stenotic valves (tight)
3) leaky valves
4) cardiac muscle damage
5) metabolic disease ( Ca++, K+ alterations)
6) stiff arteries 
7) conduction disturbances
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Pressure drops from what to what? drops from the aorta to the vena cava 
What is flow? The volume of blood past a point in a given time
What is velocity? The distance a fixed volume travels in a given time
When the pressure gradient is higher what happens to the flow? the higher the pressure gradient, the faster the flow
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What is happens with resistance of the flow? the higher the resistance, the slower the flow


What three things does the resistance of flow depend on? 1) The vessel diameter
2) the viscosity of the blood
3) the length of the vessel
What happens if the length and viscosity of blood pressure remain the same? (this is the usual case) the "R" is proportional to the radius of the vessel
What three things does Poiseuille's Law for blood pressure state? 1) the resistance to fluid flow in by a tube, increases as the length of the tube increases

2) resistance increases as the viscosity increases 

3) resistance decreases as the tube's radius increases
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What is the Poiseuille's Law equation? R = 1 / r^4)

*if the radius doubles, the flow increases 16 times
What is it called when the blood is thin? anemic 
What are arteries ?  blood vessels that carry blood away from the heart.
What are Arterial Conduits? -main part of arteries (type) that contains elastin that is governed by birth 

-loose elastin with age
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What can happen as you age with the elastin in the arteries? What can this lead to? The elastin amounts decrease with age, therefore arteries may become "stiff" 

-this can lead to high blood pressure
What is thick blood caused by? dehydration 
What is the systolic pressure of the arteries? 120 mmHg
What is the diastolic pressure of the arteries? 80 mmHg
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What is a Sphygmomanometer ? a device to measure blood pressure

-has an inflatable cuff and a mercury manometer to measure pressure

-used with stethoscope
-put on arm usually at a place parallel with the heart 
What is MAP? "mean arterial pressure"

- average blood pressure in the arteries

-diastolic pressure plus 1/3 of the pulse pressure
What is the pulse pressure of an artery? the systolic pressure - the diastolic pressure
What are arterioles ? a small diameter blood vessel 


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Where do arterioles come from?(structure) they stem from arteries 
Where do arterioles lead to? lead to capillaries.
What type of muscle are arterioles made out of? smooth muscle 
What are two functions of arterioles? 1) dilate
2) constrict 
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What is hyperemia ? the increase of blood flow to different tissues in the body.

 It can have medical implications, but is also a regulatory response, allowing change in blood supply to different tissues through vasodilation.
What do arterioles control? -blood pressure
-blood distribution to the body
What are the two main Local intrinsic controls for arterioles? -heart

-skeletal muscle 
What are seven Chemical control factors for arterioles? 1) CO2 and O2
2) pH
3) K+ levels
4) adenosine
5) osmolarity
6) histamine
7) EDRF aka NO ( "endothelial derived relaxing factor")
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What are the two Physical controls for arterioles? 1) temperature

2) smooth muscle stretch (which opens the Ca++ channels)
What is the extrinsic control of arterioles? the autonomic nervous system = sympathetic for all blood vessels
What is the extrinsic sympathetic control factor for arterioles? And what does it do? The Cardiovascular Control Center = adrenal medulla 

- distributes mediators (hormones)
What are two hormones that the Adrenal Medulla distributes and their receptors? And what do they do? -NE = receptor is Alpha ---> vasoconstricts arterioles 

-E = receptor is Beta 2 ----> vasodilates arterioles 
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What does the hormone vasopressin do to arterioles? This hormone constricts the arterioles 


What does the hormone Angiotensin II do to arterioles? And what does it do to blood pressure? This hormone constricts arterioles 

-increases blood pressure 
What does the hormone "ANP" (atrial natriuretic peptide) do to arterioles? This hormone dilates the arterioles
What does constriction of the arterioles do to the capillary beds? Constriction of arterioles = decreases blood flow to the capillary beds
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Redistribution of blood at rest digestive 
urinary

brain stays same
Redistribution of blood during activity heart
muscle
skin

brain stays the same

Which how do capillaries exchange? they exchange via diffusion 

aka active transport in brain
What are capillaries ? The smallest of a body's blood vessels 
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Where is there the maximum amount of surface area for the circulatory system? And why? capillaries 

-because there is minimal distance between cells and endothelium 
What is the equation for FICK's LAW (for capillaries) Q  =  ∆C x P x a
          mw x ∆x

Basically:

the rate           =     concentration x's permeability x's surface area
of diffusion              molecular weight x's thickness(distance)
How many capillaries do we have, roughly? There are about 10-40 billion 
What percent of blood in body is in the capillaries? About 5% is stored here
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Is diffusion slow or fast for capillaries? And why? slow

because it allows for exchange

- flow stays the same, but velocity is decreased (like the river into the lake example)
What type of molecules can go through capillaries ? lipids can go through these
What is the basic structure of a capillary ? And what do all of them have except for one area of the body? a one celled layer of endothelium tissue

-all cells have pores except for those in the brain
Where on the capillaries are the pores located? located at junctions of the cells
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Where are pores on capillaries the largest? (3 places) -the liver
-the kidneys
-in bone marrow
What is endocytosis ? a process by which cells absorb molecules by engulfing them. 
What is pinocytosis ?  a form of endocytosis in which small particles are brought into the cell, forming an invagination, and then suspended within small vesicles (pinocytotic vesicles) that subsequently fuse with lysosomes to hydrolyze, or to break down, the particles.
How do capillaries take on large molecules? via vestibular transport
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What two ways do capillaries take in molecules? 1) endocytosis 
2) pinocytosis 
What are pericytes? Where are they found? - a type of cell found in the central nervous system.

- located surrounding the endothelial cell layers of the capillary network in the brain.


What is helpful about pericytes ? These cells aid in tightness 
What two things does the blood flow through capillary tissues depend on? (circulation) 1) arteriole resistance
2) number of capillaries open
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What type of diffusion do capillaries undergo? And what does this exclude? They undergo passive diffusion

-most of exchange through this

-not protein 
Is pinocytosis common with capillaries? What sized molecules does it involve? No, not as common 

-but does involve larger sized molecules/substances 
How much energy is needed for capillary exchange? not a lot of energy needed
What are Metarterioles? -short vessel that links arterioles and venules.

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What do Metarterioles form? They form precapillary sphincters that encircle the entrance to that capillary bed
What do Metarterioles do? they regulate capillary beds
What percentage of Metarterioles are open at a time ? 10% are open at one time
What is the main control of capillary exchange? "Bulk Flow"
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What is the general process of the "bulk flow" in capillaries ? What does it regulate? -plasma diffuses out then is reabsorbed 

-regulates ECF
What are the Four Factors dealing with Bulk Flow? 1) capillary blood pressure (Pc)  [[[outward]]]

2) plasma colloid osmotic pressure (π p)

3) interstitial fluid hydrostatic pressure (P IF)

4) interstitial fluid colloid osmotic pressure  (π IF)
What is the equation for Bulk Flow of Capillaries ( Pc + π IF )  -   ( π p + PiF )


What pushes plasma out of capillaries via bulk flow? -arterial pressure pushes

(aka blood pressure)
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What pulls plasma back into the capillaries via Bulk Flow? plasma proteins pull

(albumin) 
What happens when you hemorrhage? -blood pressure goes down

-protein levels raise to keep blood leveled properly
What is edema? and where does it occur? Edema or oedema (British English) (; from the Greek -odma, "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid in the interstitium, which are locations beneath the skin or in one or more cavities of the body.
If a person gets liver disease what can they develop? Can cause Edema, swelling of the limbs

b/c the liver makes most of the body's albumin 
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What is the quantity of plasma proteins if the person has Edema? -low amount of plasma protein
What does edema do to the capillaries? -increases capillary permeability 
What effect does Edema have on venous pressure? -increases venous pressure
What does Edema do to the lymph in the body? -blocks lymphatics 
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What does heart failure do to capillaries? What can this lead to? -increases hydrostatic pressure in capillaries 

-can lead to edema 
What is lymph ? - the fluid that circulates throughout the lymphatic system. 
What four things compose lymph ? 1) bacteria
2) protein
3) fat
4) excess fluid 
What are lymph capillaries ? tiny thin-walled vessels that are closed at one end

act as one way valves
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Where are lymph capillaries located? located in the spaces between cells throughout the body
What do lymph nodes do? they filter 
What is thoracic duct ? the largest lymphatic vessel in the body.
What is the four step chain of lymphatic vessels? 1) thoracic duct

2) into left subclavian vein

3) right lymphatic duct 

4) into right subclavian vein
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Lymphatics do what? pick up excess fluid that is left over and not going back to the capillaries 
What type of vessels are Veins considered ? What does this mean? -"capacitance" vessels 
 
means = little resistance / they store blood
What size radius do veins have? LARGE radius
What percentage of blood in the circular system is in the veins? 60% of blood
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Is there high or low amounts of pressure in veins? There is low amounts of pressure here
What is the radius of the veins like? the radius is LARGE

-so if they constrict a little bit - nothing really happens 
Are the walls of veins thick or thin? thin walls
What type of control are veins under? Sympathetic control via smooth muscle 
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What type of valves do veins have? One-way valves 
What happens to the veins if the valves of them dilate? - the vein will dilate as well

-gravity
What is the cause of varicose veins ? -standing too much
-the veins stretched out too much and can't bounce back

-can be from hemorrhoids and in esophagus( from liver disease)  
If all veins dilate (aka capacitance increases) what happens? -blood volume decreases
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What are the 6 factors that venous return depends on? 1) cardiac force (pressure from heart)
2)sympathetic vasoconstriction (contracts smooth muscle)
3) skeletal muscle activity 
4) one way valve function
5) breathing - low intrathoracic pressure
6) cardiac suction 
What does "cardiac suction" entail in venous return? -ventricle contraction pulls AV valve into ventricle 

-(right atrium can sometimes have negative pressure = suction)
What two factors could change blood pressure? 1) arteriole radius

2) blood viscosity 
What are the two afferents of blood pressure? 1) Carotid-sinus

2) Aortic-arch

(major blood pressure monitors)
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What does the process of the afferents entail? (4 steps) ON TEST 1) pressure increases
2) firing increases
3) CCC (cardiovascular control center) 
4) Vasodilation (decreases SV and heart rate)
Some non-specific afferents of blood pressure are? -mechanoreceptors 
-baroreceptors 

(O2 and CO2)
What does exercise do to blood pressure? increases blood pressure
What does exercise do to the vessels in our body? the muscle arterioles dilate 
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Which atria helps monitor blood pressure? And what two things help do so? the left atrium 

1) the stretching of the atrial /volume receptors
2) ANP (atrial natriuretic peptide)
What is ANP? And what does it do/help? "atrial natriuretic peptide"

- gets rid of Na+ and water
- lowers fluid volume in atrium 
What role does the hypothalamus play for monitoring blood pressure? - it measures osmolarity 

-
What effect does heat have on blood pressure? - decreases blood pressure

-minor adjustment
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What effect does cold have on blood pressure? -increases blood pressure
What is hypertension ? high blood pressure

140/90 and above
What percent of all high blood pressure is from hypertension? And what are the causes? -90% is "essentially" hypertension

-there is no known cause, although genetics may be key
What is atherosclerosis? What can it cause? - a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol.

- causes high blood pressure
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What can an adrenal medulla tumor do/cause? - periodical high blood pressure

- but then back down to low

- it is hard to diagnose 
What can problems in the adrenal cortex cause? - can produce aldosterone with is a hormone of the adrenal cortex associated with Na+

- increases Na+
- thus increases H2O
-and increases BLOOD pressure
What is Pheochromocytoma? What does it do?  a neuroendocrine tumor of the medulla of the adrenal glands 
 or extra-adrenal chromaffin tissue that failed to involute after birth 

- secretes high amounts of catecholamines
( norepinephrine and epinephrine)

-can increase blood pressure
Does Conn's Syndrome create? an aldosterone-producing adenoma (benign tumor). 

-creates sodium retention

- associated with high blood pressure
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What are three treatments for the renal diseases that cause high blood pressure? 1) sodium restrictions

2) diuretics to get ride of excess H20

3) angiotensin inhibitors   
What are two neurogenic factors that can cause high blood pressure? 1) baroreceptor defects

2) reduced cerebral blood flow
What is the common cause of hypotension (low blood pressure)? - an over treatment of hypertension
What is orthostatic?  a human position in which the body is held in an upright position and supported only by the feet.

aka standing
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What is hypotension? = low blood pressure

100/60 and below
What do orthostatic actions lead to? And why? - they can lead to low blood pressure

-because when you are laying down, blood pools
-when you stand up, blood doesn't = can cause u to faint
What type of reflex is fainting? A vaso-vagal reflex
What happens when your body experiences low blood pressure from emotional causes (fainting)? - the heart stops for a second

-massive parasympathetic stimulation 
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What does idiopathic mean? an adjective used primarily in medicine meaning arising spontaneously or from an obscure or unknown cause.

aka they don't know what its from.
What type of hormone is vasopressin? A  "ADH" = antidiuretic hormone 

this means that it stops the body from getting rid of fluid.
(retains water)

Where is the hormone vasopressin produced from? the posterior pituitary 
Where is ANP (atrial natriuretic peptide hormone) primarily produced from? the right atrium 
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What does the hormone ANP (atrial natriuretic peptide) measure? measures stretch of right atrium 
If the right atrium is stretched too much, what will be produced? ANP = the anti natriuretic peptide hormone 
What is hypoxia? low amounts of oxygen 
What comes before hyperemia? hypoxia (low oxygen) 
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What to vasodilators cause the cell to produce? NO = nitric oxide 
What are three examples of vasodilators? 1) Epinephrine 
2) Adenosine 
3) Acetylcholine 
Most blood vessels are sympathetically controlled except for this? And what controls it? - The penis

- It is controlled parasympathetically 
What area of the body does not have its arterioles innervated? the brain arterioles are not innervated 
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What does "vaso" mean?  "blood vessel" 
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 What are the 6 functions of the Circulatory System1) Transports Oxygen to tissues and CO2 out
2) Brings nutrients to cells
3) Transports hormones/signal molecules
4) Immunity
5) Removes waste
6) Regulates temperature
 What are the three main structures (anatomy) of the Circulatory System1) The heart

2) The blood

3) The blood vessal
 How many Chambers are there in a fish heart?Two chambers
 How many Chambers are there in amphibians (most reptiles) heart?Three chambers
 How many Chambers are there in a mammal/bird heart?Four chambers

(our heart )
 Do heart valves travel one way or two?Heart Valves travel in one direction
 What are the two types of heart valves called?1) Atrioventricular Valves

2) Semilunar Valves
 Where does the bicuspid valve lie?
-This  valve in the heart that lies between the left atrium (LA) and the left ventricle (LV).
 What type of valve is a bicuspid valve? And what is it sometimes referred to as?A bicuspid valve is a type of atrioventricular valve

Some times is referred to as the "mitral" valve
 Where is the Tricuspid Valve located?


-This valve is located between the right atrium and the right ventricle.
 What type of valve is a tricuspid valve?A tricuspid valve is a atrioventricular valve.
 What type of valve is the Aortic Valve? And where is it located?
The aortic valve is a semilunar valve. 

-Located between the left ventricle and aorta 
 What type of valve is the pulmonary valve? And where is it located?The pulmonary valve is the semilunar valve of the heart t

It lies between the right ventricle and the pulmonary artery 
 What will usually be the result of a ruptured chordae tendineae?Usually a sudden death
 What is the Fibrous Skeleton of the heart? And what does it separate?- The structure of dense connective tissue in the heart that support's the valves.

-It separates the atria from the ventricles.
 What structure/tissue in the heart prevents back-flow?the fibrous skeleton 
 What structure of the heart is where insertion of the cardiac muscles takes place?The fibrous skeleton 
 What structure of the heart acts as an insulator of AP's ?The fibrous skeleton
 What are the four tissues that make up the heart?1) Endocardium
2) Myocardium
3) Epicardium
4) Pericardium 
 What is the Endocardium made out of? And where is it located?Made from endothelium cells (is smooth)

Is the inner most lining of the heart
 What is the Myocardium made out of? Where is it located?Made from cardiac muscle

found all over heart, but mostly between epithelium and connective tissue
 Where is the Epicardium located?The outer layer of the heart
 What is the pericardium made from? And where is it located?-made from fibroue

-it is the sac around the heart
 What holds the heart in place?The pericardial sac
 Can the heart function without the pericardial sac?Yes, but its better to have it's support
 Is cardiac muscle unicellular or multicellular?Unicellular
 Do cardiac muscle cells divide to make new ones? What is the issue with this?No, they do not.

Cardiac Cells do not go through mitosis.

This is an issue because, once its damaged, its done. This fact is why heart disease is so problematic
 What are two features of cardiac cells that are found in between the cells and allow them to be connected?-gap junctions

-desomones

 What are the four types of proteins that the cardiac muscle cells have?1) Myosin

2) Actin

3) Troponin 

4) Tropomyosin 
 Cardiac muscle cells have an SR, what is its size like in comparison to skeletal muscle?It is smaller than in skeletal muscle cells
 Cardiac muscle cells have T-Tubules, what are their size like in comparison to skeletal muscle?They are larger than in the skeletal muscle cells.
 What is the function of T-Tubules in cardiac cells?to store calcium
 What is the size of the mitochondria in the cardiac muscle cells, and how much of the cell does it take up?They are HUGE

-take up 1/3 of the cell's volume
 What can a blood clot in the heart lead to?It can lead to dead tissue

Blood clots lead to this because the cells in cardiac muscle do not reproduce (no mitosis). This can kill tissue around the clot.

They've found that dead tissue can lead/cause more dead tissue.
 The heart contracts as a Syncytium, which is when?- when the cells contract together like one single unit via gap junctions (connections between cells)
 What is Ventricular Fibrillation? What does it do to the muscles in the heart?- a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart (they contract all on their own/different types)

-makes muscles quiver rather than contract properly.

-looks like a bowl of worms

MALFUNCTION
 What is Autorhythymicity ?means "self excitable"
 What can Autorhythymicity allow?This allows the heart to still beat after you're dead.
 What are Autorhythymic cells? What are they also called?They are cardiac cells that spontaneously and rhythmically depolarize and fire action potentials .

They set the rate of the heartbeat

Also called pacemaker cells
 Do pacemaker cells have a resting membrane?No they do not
 At about what percent do pacemaker cells make up ?they make up 1% of cardiac cells

they are non-contractile
 What are the three types of cells in the heart?1) pacemaker cells
2) ventricular cells
3) atrial cells

 Where is 90% of the calcium in a pacemaker cell's process from?The SR
 Where are the Four Places that Pacemaker cells are found?1) the sinoatrial node of the RIGHT atrium (SA)

2) then to the  Atrioventricular node, in fibrous ring 

3) then to the right and left bundles of His - in the interventricular septum

4) AND lastly come together in the purkinje fibers of the ventricles
 What is the rate of action potentials of the pacemakers cells located in the sinoatrial node?70-80 / min
 What is the rate of action potentials of the pacemakers cells located in the atrioventricular node?40-60 /min
 What is the rate of action potentials of the pacemakers cells located in the bundles of His and purkinje fibers?20-40 / min
 If you block one route of the pacemaker cells, what will happen?The next node/area takes over 
 If you block the atrioventricular node for the pacemaker cells, what is this called?this is called "complete heart block"

 When a bundle branch is blocked for the pacemaker cells, what can result? example?A sudden death may occur

Like in the news you may hear of a football player out of no where dropping dead on the field, etc.
 What is ectopic pacemaker cells?abnormal packermaker tissue in another area of the heart
 The contraction of the heart is what and what?-synchronous and simultaneous 
 What responsible for 20% of heart pump?When the two atria that contract first 
 What do the AV nodes transmit to?They transmit to the ventricles
 What happens after the AV node transmits to the ventricles?Then both ventricles contract
 What does the Atrioventricular node do to allow complete filling ?It delays the impulse 
 Where does the pathway of the heart's contraction start at?Starts going thru the intercalated discs with gap junctions in the cardiac muscle cells
 What is the cardiac cycle?A term referring to all or any of the events related to the flow or blood pressure that occurs from the beginning of one heartbeat to the beginning of the next.
 What is ventricular systole?-contraction 
-filling of the heart
 What is the Pressure in Left atrium ?0-10 mmHg
 What is the Pressure in Left ventricle?0-120 mmHg
 What is the Pressure in the Aorta?80-120 mmHg
 What is the Pressure in the right atrium?0-10 mmHg
 What is the Pressure in the right ventricle?0-25 mmHg
 What is the Pressure in the pulmonary artery?8-25 mmHg
 What is a Systole ?the time when the heart is contracting 
 What is a Diastole?The time when the cardiac muscle relaxes 
 Which part does the heart spend more time in, systole? or diastole?the diastole 
 What is happening during atrial systole?-extra blood is being squeezed into ventricle 
 What happens in the first stage of the cardiac cycle ("early diastole")?- the semilunar valves shut off

- the atrioventricular valves open

- the whole heart is relaxed
 What happens during stage two of the cardiac cycle? And what is it called?
called "atrial systole"

- the atrium contracts

-the blood flows from the atrium to the ventricles

Get max blood into ventricle (EDV)
 What happens during the third stage of the cardiac cycle (3parts)? And what is this called?This is called : "ventricle systole" 

1st- isovolumetric contraction - against closed valves
- is when the ventricles begin to contract
- the AV and semilunar valves close
- there is no change in volume. 
2nd- ejection = aortic valve opens , obtain max end systolic volume 

3rd- aortic valve closes 
 What is the EDV?"end diastolic volume"

- the max. blood in the ventricle = 135 ml
 What happens during the fourth stage of the cardiac cycle? And what is this called?This stage is called "isometric ventricular relaxation"

-both AV and semilunar valves close

-onset of ventricular diastole 

-pressure decreases
 What happens during the fifth and last stage of the cardiac cycle?
-atrioventricular valve opens

-ventricle fills rapidly during the first part of diastole (this part brings us back to the beginning of process)
 What is ESV?"end systolic volume"

- blood left after contraction (reserve) = 65ml
 What is SV?"stroke volume"

This is the EDV - ESV = 70 ml

(The end diastolic volume minus the end systolic volume)
 What happens when the atrioventricular valve opens?the ventricle fills rapidly during the first part of diastole
 What is the Cardiac Output "CO"?CO = HR x's SV

(cardiac output = heart rate times the stroke volume)

SO its the amount of blood pumped per ventricle per unit of time.
 What is the onset of ventricular diastole?isometric ventricular relaxation
 What is the Resting CO?- 5  L / min 
 What is the Active CO?30-35 L / min
 What is the stroke volume intrinsically controlled by?The preload 
(the degree to which the ventricles are stretched prior to contracting)
                                                                                         ^ BEFORE

aka venous filling with blood
 What does the "Frank Starling Law of the Heart" state?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.

SO:
increased venous return = stronger ventricular contractions
 For stroke volume, what is the "afterload"?the arterial blood pressure
 What two things is the stroke volume extrinsically controlled by?1) the sympathetic nervous system

2) the adrenal medulla

They both cause STRONGER contractions (aka less End systolic vol)
 Blood supply needs to have what? (like the brain)needs oxygen 

aerobic for the most part

only a little bit anaerobic 
 What is Vasodilation ?the widening of blood vessels resulting from relaxation of smooth muscle cells within the vessel walls

particularly in:
- the large veins 
-large arteries
- smaller arterioles.
 Where does the heart's blood supply get it's adenosine from?hypoxic cells
 Where is most blood flow at?Mostly at diastole

-location: coronary arteries behind the semilunar valves
 What is Atherosclerosis ? artery wall thickens as a result of the accumulation of fatty materials such as cholesterol.
 What can high blood pressure lead to?can lead to heart failure
 What can stenotic valves lead to?can lead to heart failure
 What are stenotic valves?they are tightened valves /abnormal narrowing of the valves
 What can leaky valves lead to?can lead to heart failure
 What can "stiff" arteries lead to?can lead to heart failure
 What can damage to cardiac muscle lead to ?can lead to heart failure
 What can conduction disturbances lead to?can lead to heart failure
 What can metabolic diseases (alterations in Ca++, K+) lead to?can lead to heart failure
 What are the seven things that can lead to heart failure?1) high blood pressure
2) stenotic valves (tight)
3) leaky valves
4) cardiac muscle damage
5) metabolic disease ( Ca++, K+ alterations)
6) stiff arteries 
7) conduction disturbances
 Pressure drops from what to what?drops from the aorta to the vena cava 
 What is flow?The volume of blood past a point in a given time
 What is velocity?The distance a fixed volume travels in a given time
 When the pressure gradient is higher what happens to the flow?the higher the pressure gradient, the faster the flow
 What is happens with resistance of the flow?the higher the resistance, the slower the flow


 What three things does the resistance of flow depend on?1) The vessel diameter
2) the viscosity of the blood
3) the length of the vessel
 What happens if the length and viscosity of blood pressure remain the same? (this is the usual case)the "R" is proportional to the radius of the vessel
 What three things does Poiseuille's Law for blood pressure state?1) the resistance to fluid flow in by a tube, increases as the length of the tube increases

2) resistance increases as the viscosity increases 

3) resistance decreases as the tube's radius increases
 What is the Poiseuille's Law equation?R = 1 / r^4)

*if the radius doubles, the flow increases 16 times
 What is it called when the blood is thin?anemic 
 What are arteries ? blood vessels that carry blood away from the heart.
 What are Arterial Conduits?-main part of arteries (type) that contains elastin that is governed by birth 

-loose elastin with age
 What can happen as you age with the elastin in the arteries? What can this lead to?The elastin amounts decrease with age, therefore arteries may become "stiff" 

-this can lead to high blood pressure
 What is thick blood caused by?dehydration 
 What is the systolic pressure of the arteries?120 mmHg
 What is the diastolic pressure of the arteries?80 mmHg
 What is a Sphygmomanometer ?a device to measure blood pressure

-has an inflatable cuff and a mercury manometer to measure pressure

-used with stethoscope
-put on arm usually at a place parallel with the heart 
 What is MAP?"mean arterial pressure"

- average blood pressure in the arteries

-diastolic pressure plus 1/3 of the pulse pressure
 What is the pulse pressure of an artery?the systolic pressure - the diastolic pressure
 What are arterioles ?a small diameter blood vessel 


 Where do arterioles come from?(structure)they stem from arteries 
 Where do arterioles lead to?lead to capillaries.
 What type of muscle are arterioles made out of?smooth muscle 
 What are two functions of arterioles?1) dilate
2) constrict 
 What is hyperemia ?the increase of blood flow to different tissues in the body.

 It can have medical implications, but is also a regulatory response, allowing change in blood supply to different tissues through vasodilation.
 What do arterioles control?-blood pressure
-blood distribution to the body
 What are the two main Local intrinsic controls for arterioles?-heart

-skeletal muscle 
 What are seven Chemical control factors for arterioles?1) CO2 and O2
2) pH
3) K+ levels
4) adenosine
5) osmolarity
6) histamine
7) EDRF aka NO ( "endothelial derived relaxing factor")
 What are the two Physical controls for arterioles?1) temperature

2) smooth muscle stretch (which opens the Ca++ channels)
 What is the extrinsic control of arterioles?the autonomic nervous system = sympathetic for all blood vessels
 What is the extrinsic sympathetic control factor for arterioles? And what does it do?The Cardiovascular Control Center = adrenal medulla 

- distributes mediators (hormones)
 What are two hormones that the Adrenal Medulla distributes and their receptors? And what do they do?-NE = receptor is Alpha ---> vasoconstricts arterioles 

-E = receptor is Beta 2 ----> vasodilates arterioles 
 What does the hormone vasopressin do to arterioles?This hormone constricts the arterioles 


 What does the hormone Angiotensin II do to arterioles? And what does it do to blood pressure?This hormone constricts arterioles 

-increases blood pressure 
 What does the hormone "ANP" (atrial natriuretic peptide) do to arterioles?This hormone dilates the arterioles
 What does constriction of the arterioles do to the capillary beds?Constriction of arterioles = decreases blood flow to the capillary beds
 Redistribution of blood at restdigestive 
urinary

brain stays same
 Redistribution of blood during activityheart
muscle
skin

brain stays the same

 Which how do capillaries exchange?they exchange via diffusion 

aka active transport in brain
 What are capillaries ?The smallest of a body's blood vessels 
 Where is there the maximum amount of surface area for the circulatory system? And why?capillaries 

-because there is minimal distance between cells and endothelium 
 What is the equation for FICK's LAW (for capillaries)Q  =  ∆C x P x a
          mw x ∆x

Basically:

the rate           =     concentration x's permeability x's surface area
of diffusion              molecular weight x's thickness(distance)
 How many capillaries do we have, roughly?There are about 10-40 billion 
 What percent of blood in body is in the capillaries?About 5% is stored here
 Is diffusion slow or fast for capillaries? And why?slow

because it allows for exchange

- flow stays the same, but velocity is decreased (like the river into the lake example)
 What type of molecules can go through capillaries ?lipids can go through these
 What is the basic structure of a capillary ? And what do all of them have except for one area of the body?a one celled layer of endothelium tissue

-all cells have pores except for those in the brain
 Where on the capillaries are the pores located?located at junctions of the cells
 Where are pores on capillaries the largest? (3 places)-the liver
-the kidneys
-in bone marrow
 What is endocytosis ?a process by which cells absorb molecules by engulfing them. 
 What is pinocytosis ? a form of endocytosis in which small particles are brought into the cell, forming an invagination, and then suspended within small vesicles (pinocytotic vesicles) that subsequently fuse with lysosomes to hydrolyze, or to break down, the particles.
 How do capillaries take on large molecules?via vestibular transport
 What two ways do capillaries take in molecules?1) endocytosis 
2) pinocytosis 
 What are pericytes? Where are they found?- a type of cell found in the central nervous system.

- located surrounding the endothelial cell layers of the capillary network in the brain.


 What is helpful about pericytes ?These cells aid in tightness 
 What two things does the blood flow through capillary tissues depend on? (circulation)1) arteriole resistance
2) number of capillaries open
 What type of diffusion do capillaries undergo? And what does this exclude?They undergo passive diffusion

-most of exchange through this

-not protein 
 Is pinocytosis common with capillaries? What sized molecules does it involve?No, not as common 

-but does involve larger sized molecules/substances 
 How much energy is needed for capillary exchange?not a lot of energy needed
 What are Metarterioles?-short vessel that links arterioles and venules.

 What do Metarterioles form?They form precapillary sphincters that encircle the entrance to that capillary bed
 What do Metarterioles do?they regulate capillary beds
 What percentage of Metarterioles are open at a time ?10% are open at one time
 What is the main control of capillary exchange?"Bulk Flow"
 What is the general process of the "bulk flow" in capillaries ? What does it regulate?-plasma diffuses out then is reabsorbed 

-regulates ECF
 What are the Four Factors dealing with Bulk Flow?1) capillary blood pressure (Pc)  [[[outward]]]

2) plasma colloid osmotic pressure (π p)

3) interstitial fluid hydrostatic pressure (P IF)

4) interstitial fluid colloid osmotic pressure  (π IF)
 What is the equation for Bulk Flow of Capillaries( Pc + π IF )  -   ( π p + PiF )


 What pushes plasma out of capillaries via bulk flow?-arterial pressure pushes

(aka blood pressure)
 What pulls plasma back into the capillaries via Bulk Flow?plasma proteins pull

(albumin) 
 What happens when you hemorrhage?-blood pressure goes down

-protein levels raise to keep blood leveled properly
 What is edema? and where does it occur?Edema or oedema (British English) (; from the Greek -odma, "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid in the interstitium, which are locations beneath the skin or in one or more cavities of the body.
 If a person gets liver disease what can they develop?Can cause Edema, swelling of the limbs

b/c the liver makes most of the body's albumin 
 What is the quantity of plasma proteins if the person has Edema?-low amount of plasma protein
 What does edema do to the capillaries?-increases capillary permeability 
 What effect does Edema have on venous pressure?-increases venous pressure
 What does Edema do to the lymph in the body?-blocks lymphatics 
 What does heart failure do to capillaries? What can this lead to?-increases hydrostatic pressure in capillaries 

-can lead to edema 
 What is lymph ?- the fluid that circulates throughout the lymphatic system. 
 What four things compose lymph ?1) bacteria
2) protein
3) fat
4) excess fluid 
 What are lymph capillaries ?tiny thin-walled vessels that are closed at one end

act as one way valves
 Where are lymph capillaries located?located in the spaces between cells throughout the body
 What do lymph nodes do?they filter 
 What is thoracic duct ?the largest lymphatic vessel in the body.
 What is the four step chain of lymphatic vessels?1) thoracic duct

2) into left subclavian vein

3) right lymphatic duct 

4) into right subclavian vein
 Lymphatics do what?pick up excess fluid that is left over and not going back to the capillaries 
 What type of vessels are Veins considered ? What does this mean?-"capacitance" vessels 
 
means = little resistance / they store blood
 What size radius do veins have?LARGE radius
 What percentage of blood in the circular system is in the veins?60% of blood
 Is there high or low amounts of pressure in veins?There is low amounts of pressure here
 What is the radius of the veins like?the radius is LARGE

-so if they constrict a little bit - nothing really happens 
 Are the walls of veins thick or thin?thin walls
 What type of control are veins under?Sympathetic control via smooth muscle 
 What type of valves do veins have?One-way valves 
 What happens to the veins if the valves of them dilate?- the vein will dilate as well

-gravity
 What is the cause of varicose veins ?-standing too much
-the veins stretched out too much and can't bounce back

-can be from hemorrhoids and in esophagus( from liver disease)  
 If all veins dilate (aka capacitance increases) what happens?-blood volume decreases
 What are the 6 factors that venous return depends on?1) cardiac force (pressure from heart)
2)sympathetic vasoconstriction (contracts smooth muscle)
3) skeletal muscle activity 
4) one way valve function
5) breathing - low intrathoracic pressure
6) cardiac suction 
 What does "cardiac suction" entail in venous return?-ventricle contraction pulls AV valve into ventricle 

-(right atrium can sometimes have negative pressure = suction)
 What two factors could change blood pressure?1) arteriole radius

2) blood viscosity 
 What are the two afferents of blood pressure?1) Carotid-sinus

2) Aortic-arch

(major blood pressure monitors)
 What does the process of the afferents entail? (4 steps) ON TEST1) pressure increases
2) firing increases
3) CCC (cardiovascular control center) 
4) Vasodilation (decreases SV and heart rate)
 Some non-specific afferents of blood pressure are?-mechanoreceptors 
-baroreceptors 

(O2 and CO2)
 What does exercise do to blood pressure?increases blood pressure
 What does exercise do to the vessels in our body?the muscle arterioles dilate 
 Which atria helps monitor blood pressure? And what two things help do so?the left atrium 

1) the stretching of the atrial /volume receptors
2) ANP (atrial natriuretic peptide)
 What is ANP? And what does it do/help?"atrial natriuretic peptide"

- gets rid of Na+ and water
- lowers fluid volume in atrium 
 What role does the hypothalamus play for monitoring blood pressure?- it measures osmolarity 

-
 What effect does heat have on blood pressure?- decreases blood pressure

-minor adjustment
 What effect does cold have on blood pressure?-increases blood pressure
 What is hypertension ?high blood pressure

140/90 and above
 What percent of all high blood pressure is from hypertension? And what are the causes?-90% is "essentially" hypertension

-there is no known cause, although genetics may be key
 What is atherosclerosis? What can it cause?- a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol.

- causes high blood pressure
 What can an adrenal medulla tumor do/cause?- periodical high blood pressure

- but then back down to low

- it is hard to diagnose 
 What can problems in the adrenal cortex cause?- can produce aldosterone with is a hormone of the adrenal cortex associated with Na+

- increases Na+
- thus increases H2O
-and increases BLOOD pressure
 What is Pheochromocytoma? What does it do? a neuroendocrine tumor of the medulla of the adrenal glands 
 or extra-adrenal chromaffin tissue that failed to involute after birth 

- secretes high amounts of catecholamines
( norepinephrine and epinephrine)

-can increase blood pressure
 Does Conn's Syndrome create?an aldosterone-producing adenoma (benign tumor). 

-creates sodium retention

- associated with high blood pressure
 What are three treatments for the renal diseases that cause high blood pressure?1) sodium restrictions

2) diuretics to get ride of excess H20

3) angiotensin inhibitors   
 What are two neurogenic factors that can cause high blood pressure?1) baroreceptor defects

2) reduced cerebral blood flow
 What is the common cause of hypotension (low blood pressure)?- an over treatment of hypertension
 What is orthostatic? a human position in which the body is held in an upright position and supported only by the feet.

aka standing
 What is hypotension?= low blood pressure

100/60 and below
 What do orthostatic actions lead to? And why?- they can lead to low blood pressure

-because when you are laying down, blood pools
-when you stand up, blood doesn't = can cause u to faint
 What type of reflex is fainting?A vaso-vagal reflex
 What happens when your body experiences low blood pressure from emotional causes (fainting)?- the heart stops for a second

-massive parasympathetic stimulation 
 What does idiopathic mean?an adjective used primarily in medicine meaning arising spontaneously or from an obscure or unknown cause.

aka they don't know what its from.
 What type of hormone is vasopressin?A  "ADH" = antidiuretic hormone 

this means that it stops the body from getting rid of fluid.
(retains water)

 Where is the hormone vasopressin produced from?the posterior pituitary 
 Where is ANP (atrial natriuretic peptide hormone) primarily produced from?the right atrium 
 What does the hormone ANP (atrial natriuretic peptide) measure?measures stretch of right atrium 
 If the right atrium is stretched too much, what will be produced?ANP = the anti natriuretic peptide hormone 
 What is hypoxia?low amounts of oxygen 
 What comes before hyperemia?hypoxia (low oxygen) 
 What to vasodilators cause the cell to produce?NO = nitric oxide 
 What are three examples of vasodilators?1) Epinephrine 
2) Adenosine 
3) Acetylcholine 
 Most blood vessels are sympathetically controlled except for this? And what controls it?- The penis

- It is controlled parasympathetically 
 What area of the body does not have its arterioles innervated?the brain arterioles are not innervated 
 What does "vaso" mean? "blood vessel" 
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