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2 Systems of the circulatory system: High pressure, high energy ________ reservoir |
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2 Systems of the circulatory system: A _________ pool of low pressure energy |
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The two systems of the circulatory system are connected by the ________ |
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Consisting of arterioles, capillaries, & venules |
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Arteries progressively decrease in size from Aorta (largest) to the smallest called the _______. These are considered resistance vessels because they are dynamic [help regulate blood flow by contracting (vasoconstriction) & relaxing (vasodilation)] |
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Arterioles measure ____ microns in diameter & cannot see!! |
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Increased state of contraction |
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Decreased state of contraction (This mechanism is most important for the arterial side of the circuit) |
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Multi-branched elastic conduit set into oscillation by each beat of the heart |
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Arterial system: Each beat pumps about ______ milliliters of blood into the aorta causing a blood pressure pulse (about 1/3rd of a cup) |
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Cardiac Contraction Begins: 1. Pressure elevates in the _____ ventricle rises rapidly |
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Cardiac Contraction Begins: 2. Pressure of the left ventricle exceeds that of the _________ |
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Cardiac Contraction Begins: 3. ________ opens, blood is ejected, BP rises |
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Tachycardia/Increased heart rate= ________ blood volume |
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Patient's cardiac status does/does not play an important role in the movement of blood throughout the vascular system |
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Pressure changes determine __________ and direction of blood flow through the heart |
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Period of cardiac cycle either when ventricles or atria are contracting |
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Resting phase of atria and ventricles |
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Heart valves open & close in response to differences in _____________ on their two sides. |
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Do both atria contract at the same time? |
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Do both Ventricles contract at the same time? |
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Every time the heart beats pressure (potential) energy is generated and moves the blood!! Producing an arterial pressure wave that, travels rapidly throughout the _________ system, demonstrating a gradual transformation as it travels distally |
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The pumping action of the heart results in _______ volume of blood in arteries to maintain a ______ pressure gradient between the arteries & veins |
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Pressure is greater at the ________, gradually decreasing as the blood moves farther ______; This is necessary to maintain blood flow |
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The amount of blood that enters the arteries |
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The amount of blood that leaves depends on the arterial pressure and on the total _____________ [which is controlled in turn by the amount of vasoconstriction in the arterioles (microcirculation)] |
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If an artery directly feeds an organ the microcirculation is vasodilated or vasoconstricted? |
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If the microcirculation is feeding a muscle that is currently not working will it be vasoconstricted or vasodilated? |
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Each cardiac contraction _____the arteries |
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During this instant in time (cardiac contraction), the arteries serve as _________ to store some of the blood volume and potential energy supplied to the system |
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Circulation of blood in the vascular system utilizes the basic principles of _________ |
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What determines whether blood flow exists in a vessel? |
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A difference in energy of the fluid at 2 locations |
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The greater the energy gradient the ______ the volume flow |
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On side of tube 70 mmHg, the other side 50mmHg...will flow exist? |
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Yes...towards the side with 50mmHg |
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2 vessels...Vessel A=100mmHg & 80mmHg...Vessel B=100mmHg & 20mmHg....which will have greater volume of flow? |
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Vessel B (the difference is greater) |
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Amount of blood that moves through a vessel in a time period; Units of volume divided by time (7 Liters per minute) |
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Measure of swiftness or speed of blood flowing through through the circulation; Has direction; Units of distance divided by time (100 cm per second) |
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Do the following have the same velocity? Vessel A 1000 RBC's at 100cm/sec...Vessel B 5000 RBC's at 100 cm/sec. |
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Do the following have the same volume flow? Vessel A 1000 RBC's at 100cm/sec...Vessel B 5000 RBC's at 100 cm/sec. |
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No (B has 5 times the flow) |
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T/F? Direction of flow is from higher energy level to lower energy level. |
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Vessel on the right side 50mmHg...on the left 70mmHg...what is direction of flow? |
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Right to Left (high to low) |
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The total energy contained in moving fluid is the sum of pressure (potential), kinetic, and gravitational (if standing) energies (This is the proper to use NOT Pressure gradient) |
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Typically the difference in energy levels are due to ________ level difference |
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Main form of energy present in flowing blood; distends the vessels; form of potential energy; created by the pumping action of the heart |
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Pressure energy (Potential) |
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Ability of flowing blood to do work as a result of its velocity (blood is moving); A small component of the energy in blood when compared to potential energy; In normal circumstances: Equivalent to a few mmHg's |
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Proportional to the blood's density (stable); squared to the velocity of blood (therefore, significant increases of this energy occur when flow is high Ex: Exercise, stenotic lesions with an increase in blood velocity); Converted back to pressure (potential) energy when velocity has normalized/decreased (Ex: Normal segment of the artery distal to a stenosis) |
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Due to the gravitional pull; Variations in the energy of blood is associated with differences in the levels of the body parts |
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The weight of a column of blood; Equals the weight of blood pressing on the vessels from heart level to the point of measurement (standing); Transmural pressure and distension of the vessels increases |
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Could arterial blood flow be improved by standing or laying down? Due to which pressure? |
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How can venous distention due to standing be relieved? |
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Movement (The muscles push the blood upwards) |
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What patient position can eliminate hydrostatic pressure? |
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Low peripheral resistance=_____Flow rate |
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High peripheral resistance=_______Flow rate |
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Flow that is continuous and 'steady' throughout systole & diastole |
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Flow that ALWAYS moves forward |
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Feeding a dilated vascular bed or organ |
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Active arms/legs, ICA, Vertebral, Renal, Celiac, Splenic, Hepatic [Post-prandial (after you eat) SMA] |
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Flow reversals are produced from the peripheral resistance |
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A normal high resistance flow pattern is called tri-phasic flow |
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Forward, reversal, & resumption of forward flow |
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Example: Resting arms/legs, ECA, subclavian, Aorta, Iliac arteries, extremity arteries, & fasting (pre-prandial) SMA |
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Diastolic flow reversal is a trademark of vessels that supply _________ peripheral vascular beds |
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Low resistance flow, broad systolic peak, sharp upstroke, delayed downstroke, High (velocity) diastolic component |
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Narrow and sharp systolic peak, Sharp upstroke, sharp downstroke, low diastolic component, High resistance flow |
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High resistance flow, narrow systolic peak, sharp upstroke, sharp downstroke, reversal component in early diastole |
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Exercise & peripheral arteries: Includes peripheral vasodilation in the microcirculation; thus _________ peripheral resistance; _________ blood flow (______ times more) |
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decreasing; increasing; 5-7 |
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Flow reversal __________ with vasoconstriction (cooling/resting) |
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If a waveform has resistance or is triphasic what type of resistance is it? |
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Flow reversal ________ with vasodilation (heating/activity) |
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Peripheral resistance can also be ________ in response to heat, cold, tobacco and emotional distress. |
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Vasoconstriction and vasodilation of the blood vessels within the skeletal muscles are also influenced by _______________ that function primarily to regulate body temperature |
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sympathetic innervation fibers |
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Tobacco ________________ the microcirculation |
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Characterized by individual layers of blood that travel at individual speeds; these layers of blood are parallel to each other & are aligned; layers at the wall are at "zero" speed; this type of flow pattern is associated with normal physiologic states |
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2 Types: Plug Flow & Parabolic Flow |
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A) Occurs when all layers of the blood travel at the same velocity (typically seen at vessel origins) EX: Renal Artery near Aorta |
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Plug Flow (Type of laminar flow) |
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B) Occurs when velocity is higher in the center of the lumen and slower at the periphery (bullet shaped profile) (typically seen downstream) EX: Renal Artery farther from Aorta |
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Parabolic Flow (Type of laminar flow) |
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Are plug or parabolic flow normal? |
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Energy is lost in the blood: due to friction between the lamina and particles, causing a decrease in pressure and energy levels from both systems |
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Energy is lost due to friction; Amount of friction & energy loss is determined MOSTLY by ______________ |
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the dimensions of the vessels |
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Small vessels: Microcirculation-Friction is increased due to the lamina rubbing against the walls resulting in resistance to flow (_________ energy loss) |
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Large Vessels: Less rubbing of layers against the walls of the vessel resulting in frictional energy losses at a minimal (resistance is at a __________) |
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Occurs due to deviations from laminar flow due to: 1.Changes in direction of flow; 2.Changes in velocity |
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What are these types of deviation of laminar flow: bifurcations & curves (p145 figure 7-4-carotid bifurcation)? |
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What are these types of deviation of laminar flow: parabolic flow profile becomes flattened; flow moves in a disorganized fashion; largest energy loss occurs at the EXIT of a stenosis? |
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Factors that affect resistance to flow: Movement of fluid is dependent upon the physical properties of the ______ & what is moving through. |
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Viscosity and length have an effect on resistance, however, a change in _____________ has a more profound effect on resistance! (L, n are typically constant) |
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The _____ the vessel, the longer the fluid is contact with the vessel, thus increasing friction, producing energy losses, increasing resistance! |
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Friction is also generated by the viscous properties of fluid; the _______ the fluid, the greater molecular attraction and the more energy required to move the fluid, increased energy losses and increase of resistance |
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High viscosity situation in the circulatory system: elevated hematocrit-erythrocytosis, polycythemia (___________ resistance) |
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Low viscosity situation in the circulatory system-low hematocrit-anemia (___________ resistance) |
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If friction goes up resistance goes _____ |
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Resistance _______ with high viscous properties & longer vessels |
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Viscosity goes up velocity goes ______ (Inversely related) |
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down (It is not enough to significantly alter our studies sonographically) |
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Calculates how much fluid is moving through a vessel |
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Volume Flow is ______ proportional to the difference between the inflow & outflow pressures |
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Volume flow is _____ proportional to the fourth power of the radius |
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Volume flow is ______ proportional to the length of the tube and viscosity |
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Helps define the relationship between: pressure, volume flow, & resistance |
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Resistance is inversely related to r4, therefore, when there is a narrowing, resistance will ________! |
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Pressure difference & blood flow can be measured, therefore _________ can be calculated |
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Therefore, Poiseuille's law can be rewritten or simplified: Q=P/R (__________=Pressure/Resistance) |
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Movement of fluid through a tube and the movement of electricity through a wire are somewhat similar; Please be aware of the similar relationship between _________ and the way movement of fluid is described |
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Poiseuille's Law can ONLY be used with __________ flow! |
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Realistically, alterations in blood flow occur MAINLY as a result of changes in the ________ of the vessels and the pressure energy available for flow. Vessel length & viscosity are pretty much stable! |
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Velocity is _______ related to cross-sectional area |
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In a closed system, Q (volume flow) is ______. v (velocity) is inversely proportional to A (area) (Ex: Area reduction from a stenosis) |
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Area goes down then velocity goes _____ |
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