Anatomy and Physiology II; Chapter 19, 20, and 21 Study Guide Chapter 19: Blood 1. What is the blood and interstitial fluid relationship? a. Blood is liquid connective tissue that consist of cells surrounded by plasma (liquid extracellular matrix) b. The fluid is reneIf you want to learn more check out o how do you describe your level of satisfaction?
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wed by blood and bathes the body cells 2. Functions of blood a. Transports: oxygen (lungs to body cells), hormones (from endocrine glands to body cells), nutrients (from GI tract to body cells), heat, and waste b. Regulates: pH and temperature c. Protects: clotting mechanisms; immune system 3. Physical properties and components of Blood a. Physical properties i. PH: average 7.357.45 ii. Temperature: 38 degrees Celsius iii. Color: bright red when oxygenated; dark red when deoxygenated iv. Volume: 5 to 6 liters v. Aldosterone, antidiuretic hormone, and RAAS helps regulate blood volume and osmotic pressure b. Components i. Blood plasma 55% 1. Water 91.5% 2. Proteins 7% a. Albumins b. Globulins i. Antibodies c. Fibrinogen d. Others 3. Other solutes 1.5% a. Electrolytesb. Nutrients c. Gasses d. Hormones e. Waste products ii. Formed Elements 45% 1. Erythrocytes (red blood cells) 2. Platelets a. Plateletderived growth factor: a hormone that cause proliferation and helps repair damaged blood vessel cells during platelet plug formation 3. Leukocytes (white blood cells) a. Neutrophils b. Lymphocytes c. Monocytes d. Eosinophils e. Basophils 4. Blood Diagnostics and their affecters a. Hematocrit (percentage of total blood volume occupied by RBCs): affected by testosterone and EPO b. Anemia ( a condition of less oxygen being carried) i. Iron deficiency anemia – affected by low iron levels ii. Hemorrhagic anemia – affected by a large loss of RBCs iii. Sickle cell disease iv. Megaloblastic anemia – affected by low vitamin b12 intake or folic acid v. Pernicious anemia – affected by insufficient hemopoiesis vi. Thalassemia – affected by deficient synthesis of hemoglobin 2vii. Aplastic anemia – affected by destruction of red bone marrow c. Polycythemia (a high percentage of RBCs); affected by high RBC production, blood doping, and hypoxia d. White blood cell differential ( a count of each WBCs to detect infection of inflammation); affected by percentage of WBCs e. Leukemia ( a group of red bone marrows cancers); affected by abnormally multiplying white blood cells f. Leukocytosis ( an increase of WBCs above normal); affected by stress, invading microbes, strenuous workout, anesthesia, and surgery g. Leukopenia (low level of WBCs); affected by radiation, shock, and certain chemotherapeutic agents 5. How and where blood cells are formed... I. Hemopoiesis: the process of formed elements developing II. Red bone marrow: site of all blood cell production; located in all bone marrows in children and in only marrow cavity of long bones in adults III.How erythrocytes are formed from pluripotent stem cells in red bone marrow? a. pluripotent stem cell > myeloid stem cell > proerythroblast > reticulocyte (nucleus ejected) > RBC b. How the process works on all blood cells i. Pluripotent stem cells 1. Myeloid stem cells a. Reticulocytes > erythrocytes b. Megakaryocytes > platelets c. Eosinophils d. Basophils e. Neutrophils f. Monocyte > macrophage 32. Lymphoid Stem cells a. Lymphocyte 6. Life Cycle of Red Blood Cell I. 120 day average life cycle; shorter because it does not have a nucleus II. Ruptured and worn out RBCs phagocytized in the spleen and liver. III.Hemoglobin splits into the heme and globin a. Globin breaks down into amino acids b. Iron stores and transports i. Transferrin – plasma protein that transports iron ii. Ferritin iron storage protein c. Heme is striped of iron; noniron protein is converted i. Bilirubin: once removed from the blood, it is stored in the liver then the small and large intestine. d. The bacteria of the large intestine converts bilirubin into urobilinogen. e. Urobilin is a yellow pigment that gives urine its color; and stercobilin is a brown pigment that gives feces its color IV. Erythyropoiesis: the production of RBCs a. Erythropoietin: increases numbers of RBC precursors; releases from cells in the kidneys; release is stimulated by hypoxia (little oxygen in the blood) V. Hemoglobin: an oxygen carrying protein and gives blood its color a. Iron b. Globin c. Heme VI. Vitamin B12: used in synthesis of hemoglobin and assist in erythyropoiesis 7. Leukocytes in the Blood I. Neutrophils: phagocytosis (destroys bacteria) 4a. High levels indicate bacterial infection, stress, burns, and inflammation b. Low levels indicate radiation exposure, drug toxicity, vitamin B12 deficiency II. Lymphocytes: mediate immune responses a. High levels indicate viral infections, some leukemias, infectious mononucleosis b. Low levels indicate prolonged illness, HIV infection, immunosuppression, treatment with cortisol III.Monocytes: phagocytosis (fixed/wandering macrophages) a. High levels indicate viral or fungal infections, TB, some leukemias, chronic diseases b. Low levels indicate bone marrow suppression, treatment with cortisol IV. Eosinophils: fight allergic reactions in histamine and parasitic worms a. High levels indicate allergic reactions, parasitic infections, autoimmune diseases b. Low levels indicate drug toxicity, stress, acute allergic reactions V. Basophils: inflammatory responses a. High levels indicate allergic reactions, leukemias, cancers, hypothyroidism b. Low levels indicate pregnancy, ovulation, stress, hypothyroidism 8. Platelets are fragments of megakaryocytes that come from red bone marrow and helps stop blood loss from damaged blood vessels through platelet plug 9. Three Mechanisms that regulate hemostasis I. Hemorrhage: loss of a large amount of blood from the vessels 5II. Vascular Spasm: when arteries or arterioles are damaged, muscle walls constrict III.Platelet Plug Formation a. Platelet adhesion: platelets stick to parts of a damaged blood vessel b. Platelet aggregation: the gathering of platelets IV. Blood Clotting (coagulation) a. Clotting factors: calcium ions, inactive enzymes, and molecules b. Extrinsic initiated by blood clotting without direct contact with blood and intrinsic pathways are initiated by blood clotting within direct contact with blood i. The end result of both pathways is prothrombinase c. The common pathway is when prothrombinase and calcium ions assist in the conversion of prothrombin to thrombin; thrombin converts fibrinogen to fibrin d. Clot retraction is the consolidation or tightening of the fibrin clot; caused by the number of platelets and factor XIII e. Fibrinolytic system : dissolves small inappropriate clots and clots at a damage site once the damage is repaired 10. ABO and Rh blood groups I. Blood typing a. Type A i. Antigen A ii. Antibody anti B b. Type B i. Antigen B ii. Antibody anti A c. Type AB i. Antigen A and B ii. Antibody none d. Type O 6i. Antigen none ii. Antibody anti A and B II. Blood type matching is necessary for transfusion because.. a. Agglutination: clumping of RBCs b. Hemolysis: rupture of RBCs causing hemoglobin to be released into the blood plasma c. Type AB are universal recipients because they can receive blood from any type due to the lack of antibodies to fight against it; type O is the universal donor because they give blood to any one because they lack antigens III.Rh blood group a. Rh factor: Rh antigen b. Blood that contains Rh antigens are called Rh positive; those who lack it are called Rh negative c. Hemolytic disease of the newborn: fetus is attacked in the blood by the mother during childbirth which can result in fetal death or pregnancy complications i. Rh negative mothers and Rh positive child is at risk ii. Prevented by a drug called RhoGAM (causes the baby's Rh antigens to inactive so the mother's immune system won't fight against the child's by producing Rh antigens of her own during childbirth) Chapter 20: Heart 1. Location and function of the heart: a. The heart lies in the mediastinum (region the extends from the sternum to vertebral column, from first rib to diaphragm) and pericardial cavity ( a fluid filled cavity that protects and surrounds the heart/ superficial layer) b. The base of the heart is made up by mostly the left atrium and the apex of the heart is the tip of the left ventricle 72. Structure and Functions of the Pericardium and its Components and Tissues a. Pericardium (membrane) : functions to protect and surround the heart as well as allow vigorous and rapid constrictions... has two portions i. Fibrous Pericardium/ Superficial Layer (tough, inelastic, dense, irregular connective tissue): it functions to prevent overstretching of the heart, provide protection, and anchor the heart in the mediastinum. ii. Serous pericardium/ Inner Layer: a thin, delicate membrane that makes up a double layer around the heart. 1. Parietal layer of the serous pericardium: outer layer/ superficial layer 2. Visceral layer of the serous pericardium: inner layer/ middle layer; also called the epicardium 3. Pericardial Fluid: located between the two layers of serous pericardium; functions to reduce friction between the two layers as the heart moves. 4. Acute pericarditis is inflammation of the pericardium that results in a chest pain from the left shoulder down the right arm or pericardial friction rub. It can be treated by drugs. Chronic pericarditis is an inflammation of the pericardium that lasts longer and is due to a buildup of pericardial fluid. Cardiac tamponade occurs because the built up fluid compresses the heart causing ventricular filling to decrease which results in slow cardiac output, blood pressure dropping, and breathing difficulties 83. Layers of the Heart Wall, Their Functions, and Tissue Types a. Epicardium/ outer layer: visceral layer of the serous pericardium; made of mesothelium, fibroelastic, and adipose tissue; imparts a smooth, slippery texture to the outermost surface of the heart and contains blood vessels, lymphatics, and vessels that supply the myocardium b. Myocardium/ middle layer: made of cardiac muscle tissue; responsible for the heart pumping blood; involuntary muscle movements i. Myocarditis: inflammation of myocardium; usually occurs as complications to viral infection, rheumatic fever, or exposure to radiation; has no symptoms, but might have fever, breathlessness, fatigue, vague chest pain, joint pain; is usually mild and recovery is two weeks; treatments include vigorous exercise, low salt diet, electrocardiographic monitoring, and cardiac failure treatments c. Endocardium/ inner layer: made of a thin endothelium layer and connective tissue; provides a smooth lining for the chambers of the heart, covers the valves of the heart, and reduces surface friction as blood passes through the heart i. Endocarditis: inflammation of endocardium; typically involves the heart valves; caused by bacteria; symptoms include fever, fatigue, heart murmur ,irregular or fast heartbeat, loss of appetite, night sweats, and chills; treatment is intravenous antibiotics 4. Four Heart Chambers, Their Locations, Their Functions, and Where They Pump Blood To.. a. The heart consist of two superior chambers, the atria, that receive blood from veins and two inferior chambers, ventricles, that eject blood into arteries. 9b. Auricles: pouchlike structure on each side of the atria; holds blood c. Coronary Sulcus: located and marks the boundary line between the superior atria and inferior ventricles d. Anterior interventricular sulcus: marks the boundary between the right and left ventricle. Posterior interventricular sulcus: marks boundary between ventricles on posterior side of the heart e. About all chamber of the heart i. Right atrium receives blood from three veins (superior vena cava, inferior vena cava, and coronary sinus) and pumps it to the right ventricle. The right ventricle receives blood from the tricuspid valves from the right atrium and pump it into the pulmonary trunk to the lungs. From the lungs, the blood goes to the left atrium by four pulmonary veins which is then pumped into the left ventricle by the bicuspid valve. ii. The right atrium and ventricle receives deoxygenated blood while the left atrium and ventricle receives oxygenated blood. iii. Bicuspid valve (right AV valve) is in the left atrium, and it pumps blood to the left ventricle. The tricuspid valve (left AV valve) is in the right atrium, and it pumps blood to the right ventricle. The Aortic valve (SL valve) sends blood from the left ventricle to the ascending aorta. Pulmonary valve (SL valve) sends blood from the right ventricle to the pulmonary trunk. iv. Systemic circulation consist of the left atrium and left ventricle. Pulmonary circulation consist of the right atrium and right ventricle. f. The right and left atria i. Tricuspid valve ( right AV valve) 10ii. Bicuspid valve (left AV valve) iii. Structure 1. Interatrial septum : lies between the two atriums 2. Fossa ovalis: oval depression; a remnant of the opening in the septum at childbirth that closes g. The right and left ventricles i. Pulmonary valve ( right SL valve) ii. Aortic (left SL valve) iii. Structures 1. Trabeculae carneae: cardiac muscle fibers that form ridges inside the right ventricle 2. Interventricular septum: separates the right and left ventricles 5. Major Veins and Arteries Connected to the Heart and Blood Flow a. Superior and inferior vena cava: carry blood to the right atrium from the body b. Coronary sinus: carry blood to the right atrium form the body c. Pulmonary trunk: carry blood from the right ventricle to the left and right arteries to the lungs d. Pulmonary veins: carry blood from the lungs into the left atrium e. Aorta: carry blood from the left ventricle to the body 6. Valves of the Heart and Their Functions/ When are they open and closed? a. Right and left atrioventricular valves (AV valves); they open when the ventricles are relaxed and close when the ventricles constrict i. Tricuspid valve: located in the right atrium; pumps blood to the right ventricle; ii. Bicuspid valve: located in the left atrium; pumps blood in the left ventricle iii. Associated structures 111. Cusps: open and close to allow blood to flow through the valves 2. Chordae tendineae: connects the cusps of the valves 3. Papillary muscles: chordae tendineae are connected by this b. Right and left semilunar valves (SL valves); they open when the pressure of the ventricles exceeds the pressure of the arteries; they close when blood start to back flow into the ventricles i. Pulmonary valve: located in the right ventricle; pumps blood in the pulmonary trunk to the lungs ii. Aortic valve: located in the left ventricle; pumps blood into the aorta to the body 7. The thickness of the myocardium effects its functions. Because the right and left ventricles pump blood under higher pressures over greater distances, their myocardium is thicker that atrium. However, the left ventricle is thicker than the right ventricle because its workload is much bigger 8. Fibrous skeleton of the heart: prevents overstretching of the valves as blood passes through them; serves as a point of insertion for bundles of cardiac muscle fibers; acts as an electrical insulator between the atria and ventricles. 9. Circulatory Routes and Their Functions a. Pulmonary Circuit: sends the deoxygenated blood from the body to the lungs; right atrium, tricuspid valve, right ventricle, pulmonary trunk b. Systemic Circuit: send oxygenated blood from the lungs to the body; pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic valve, aorta 12c. Coronary Circuit: network of blood vessels; sends oxygenated blood from the aorta to the heart chambers; aorta, coronary arteries, capillaries, coronary veins 10. Cardiac and Skeletal Muscle Tissue a. Cardiac muscles tissue are branching and have astirstep appearance; skeletal are parallel cells b. Intercalated discs: where the ends of cardiac muscle fibers connect with neighboring fibers c. Autorhythmic fibers: functions to generate action potentials that trigger heart constricts (natural pacemaker) and form conduction system; if depolarization is to high (tachycardia) if to low (bradycardia) i. SA node sets the natural pacemaker ii. AV node (atrioventricular) iii. AV bundle iv. Left and right bundles branches, v. Purkinje fibers d. The cardiac and skeletal muscle fibers have different contraction cycles i. Plateau phrase (lengthens contraction time): increased amount of Ca+ ions cause K+ ion channels to open (balances the two out) 1. This stage is caused by depolarization due to Na+ ions channels opening 2. Roles of voltagegated ion channels a. Fast Na+ (sodium) channels: causes depolarization of contractile fibers b. Slow Ca+ (calcium) channels: trigger an influx of calcium ions that opens K+ ions channels 13c. K+(potassium) channels: helps maintain depolarization and balance out the Ca+ ions 11. Basic Tracings of Electrocardiogram, ECG. a. P wave: represents atrial depolarization b. QRS complex: represents ventricular depolarization c. T wave: represents ventricular repolarization d. PQ interval: beginning of atrial depolarization to beginning of ventricular depolarization e. ST segment: from the end of depolarization to the start of ventricular repolarization f. QT interval: the beginning of ventricular depolarization to ventricular repolarization g. Systole: phrase of contraction. Diastole: phrase of relaxation 12. Basic events of Cardiac Cycle a. Atrial systole and enddiastolic volume (max fil of ventricles) b. Ventricular systole and endsystolic volume (minimum fil of the ventricles) c. Relaxation period: atria and ventricles relax and reset between heart beats 13. Heart Sounds a. Lubb dupp.... lubb (AV valves closing) dupp (SL valves closing) 14. Cardiac Output: is determined by the amount of blood ejected from the left ventricle into the aorta in a minute a. Stroke volume: blood ejected by the ventricle each heartbeat; regulators are preload, contractility, and afterload i. Preload: degree of ventricular stretch before contraction; increased preload causes large resting 14stroke volumes; decreased preload caused shorter stroke volumes 1. FrankStarling Law of the Heart: the more the heart fills with blood during diastole, the greater the force of contraction during systole. 2. Preload is proportional to enddiastolic volume a. Increased duration of ventricular diastole= increased preload b. Increased venous return= increased preload ii. Contractility: force of contraction of ventricular myocardium 1. FrankStarling Law of the Heart 2. Chemicals a. Positive ionotropic agents (epinephrine, extracellular Ca+ levels) increases contractility b. Negative ionotropic agents (anesthetics, extracellular K+ levels) decreases contractility iii. Afterload : resistance to blood before being ejected from the ventricles or increased pressure required to pass from isovolumetric to volumetric contraction b. Heart Rate i. Autonomic nervous system cardiovascular center in the medulla oblongata receives input from numerous centers in the brain and receptors throughout the body 1. Limbic system in anticipation to activity, especially competition 2. Receptors 15a. Proprioceptors: receptors that monitor stretch and tension of muscles b. Chemoreceptors: CO2 and H+ receptors in hypothalamus c. Baroreceptors: stretch receptors in vessels and heart ii. Sympathetic and Parasympathetic 1. Sympathetic cardiac accelerator nerves, terminate at cardiac conduction system and most of myocardium, release norepinephrine at synapses a. Cardiac conduction system (SA node) speeds rate of depolarization b. Myocardium increases contractility (increasing Ca+ flow cause slow Ca+ channels) 2. Parasympathetic fibers of the vagus nerve (CN X), also terminate at cardiac conduction system and most of myocardium, release acetylcholine at synapses a. Cardiac conduction system (SA node) speeds rate of depolarization/ slows rate of depolarization b. Myocardium few synapses so little effect on contractility iii. Chemical regulation 1. Hormones can cause an increased heart rate (tachycardia) epinephrine, norepinephrine, thyroid hormones iv. Other factors 1. Age 16a. Newborns have a very rapid heart rate, decreases through life 2. Gender – females have, on average, higher resting heart rates 3. Physical fitness a. Physically fit individuals tend to have a decreased resting heart rate (bradycardia) 4. Body temperature heart rate proportional to body temperature due to effect on depolarization of SA node c. Cardiac output = stroke volume x heart rate d. Cardiac reserve: difference between a person's maximum cardiac output and cardiac output at rest Chapter 21 1. Structures and Functions of the 5 Major Types of Blood Vessels a. Arteries i. Function: carry blood away from the heart to other organs ii. Elastic arteries: aorta and pulmonary trunk 1. Elastic recoil/energy is stored (pressure reservoir) 2. Also called conducting arteries 3. Function to propel blood onward while the ventricles relax iii. Muscular arteries: brachial artery and radial artery 1. Are also called distributing arteries b. Arterioles i. Function to regulate the flow of blood into the capillary networks from arteries by resistance ii. Precapillary sphincters: monitors the blood flow into the capillary 17c. Capillaries: smallest unit of blood vessels i. Primary function: the exchange of substances between the blood and interstitial fluid ii. Continuous capillaries: most capillaries; gaps between neighboring endothelial cells; found in the central nervous system, lungs, muscle tissue, and the skin iii. Fenestrated capillaries: found in the kidneys, villi of the small intestine, choroid plexuses of the ventricles, ciliary processes of the eyes, and endocrine glands iv. Sinusoids: more wider and windier; found in the liver, spleen, anterior pituitary, parathyroid, and adrenal glands d. Venules: drain the capillary blood and begin the return flow of blood back toward the heart e. Veins i. Functions to carry blood toward the heart ii. Vascular sinus: dural venous sinuses and coronary sinus iii. Superficial veins: subcutaneous layer deep to the skin. Deep veins: travel between the skeletal muscles iv. Veins are considered blood reservoirs because they can quickly divert blood if the need arises f. Lumen: a blood vessels interior opening g. Tunica interna: inner layer; in direct contact with blood as it flows through the lumen i. Endothelium ii. Basement membrane iii. Internal elastic lamina (thicker in the arteries) iv. Valves in veins h. Tunica media: i. made of smooth muscular and connective tissues 18ii. External elastic lamina (thicker in the arteries) iii. Regulate the diameter of the lumen iv. Involved in vasoconstriction and vasodilation I. Tunica externa v. Made of collagen and elastic fibers/ connective tissue vi. Helps anchor vessels to surrounding tissues vii. Veins are thinner than arteries and less elastic J. Vasoconstriction: a decrease in the diameter of the lumen of the blood vessel (arteries and arterioles). Vasodilation: increase in lumen diameter (arteries and arterioles). K. Anastomosis: a union of two or more arteries that helps blood flow an alternate way to reach a tissue or organ 2. Capillaries Function as an Exchange Surface Between Blood and Tissues a. Capillary Exchange: transport materials between blood and tissues i. Simple diffusion: most important method; move down concentration gradients into interstitial fluid and then into body cells ii. Transcytosis (pinocytosis): mainly large watersoluble molecules; substances enter endothelial cells and move across the cell and exit by exocytosis; only way to cross capillary walls iii. Bulk Flow: a passive process in which large numbers of ions, molecules, or particles in a fluid move together in the same direction 1. Filtration: pressure driven mass movement of large quantities of solutes in fluid (faster than diffusion can account for) 2. Reabsorption: pressure driven movement from interstitial fluid into blood capillaries 19b. Pressures that drive filtration and reabsorption. i. Net filtration pressure: determines whether the volumes of blood and interstitial fluid remain steady of change ii. Pressures that promote filtration 1. Blood Hydrostatic pressure (BHP) : pressure that water in blood plasma exerts against blood vessel walls 2. Interstitial Fluid Osmotic pressure (IFOP): pushes fluid from interstitial spaces back to capillaries iii. Pressures that promote reabsorption 1. Blood Colloid Osmotic pressure (BCOP): a force caused by colloidal suspension of these large proteins in plasma 2. Interstitial Fluid Hydrostatic pressure (IFHP): pulls fluid out of capillaries into interstitial fluid iv. NFP= BHP+ IFOP – BCOP + IFHP v. The main pressure promoting filtration at the arterial end of a capillary is the net of outward pressure. vi. The main pressure promoting reabsorption at the venous end of a capillary is a net inward pressure. 3. How Blood Flow and Regulate Throughout Circulatory System? a. Blood Pressure is generated by ventricular constriction during systole i. Systolic blood pressure: the highest pressure attained in arteries during systole ii. Diastolic blood pressure: the lowest arterial pressure during diastole iii. Mean Arteriole pressure: the average blood pressure in arteries b. Factors that affect blood pressure 20i. Vascular resistance affects blood pressure because it affects blood flow due to friction between blood and the walls of blood vessels 1. The effects of vascular resistance a. Blood viscosity b. Total length of vessels c. Diameter of vessels ii. Cardiac output also affects blood pressure. 1. Heart rate 2. Venous return a. Vasoconstriction b. Skeletal muscle pump c. Respiratory pump 4. Blood Pressure Regulation a. Neural regulation via cardiovascular center i. Inputs to cardiovascular center (helps regulate heart rate and stroke volume) 1. Higher brain centers (cortex, limbic, hypothalamus) 2. Sensory receptors a. Proprioceptors (in muscles and tendons, responsible for fast rise in heart rate with exercise) b. Baroreceptors (carotid sinuses, aortic arch; measure pressure and stretch in walls of blood vessels) i. Increased stretch increases parasympathetic and decreases sympathetic output ii. Stimulates secretion of epinephrine and norepinephrine from adrenal medulla 21c. Chemoreceptors (oxygen, carbon dioxide, hydrogen receptors in carotid bodies and aortic arch; measure concentration of chemicals in the body) i. Hypoxia, acidosis, and hypercapnia stimulate sympathetic output from CV center ii. Output from the cardiovascular center 1. Parasympathetic a. Decreased heart rate (vagus nerve CN X) 2. Sympathetic a. Increased heart rate (cardiac accelerator nerves) b. Vasoconstriction (vasomotor nerves) b. Neural Regulation of Blood Pressure i. Increase 1. RAA system (increased water reabsorption= increased blood volume/pressure) a. Renin b. Angiotensin I c. Angiotensin II increased systemic vascular resistance d. Aldosterone increases blood volume 2. Epinephrine and norepinephrine increases cardiac output by increasing the rate and force of heart contractions 3. ADH increases blood volume through vasoconstriction/ decreases urine output i. Decrease 1. Atrial natriuretic peptide (released by cells in the atria) 22a. Vasoconstriction decreases systemic vascular resistance b. Increased salt and water loss in urine (opposite of aldosterone) decreases blood volume c. Autoregulation of Blood Pressure to Capillary Beds i. Factors that cause vasodilation relax precapillary sphincters so blood flow increases ii. Factors that cause vasoconstriction constrict precapillary sphincters so blood flow decreases 5.Circualtion Monitoring a. Pulse: a traveling pressure wave that is created by the alternate expansion and recoil of elastic arteries after each systole of the left ventricle b. Tachycardia: a rapid resting heart or pulse rate over 100 beats per minute, bradycardia: a slow resting heart or pulse rate under 50 beats per minute c. Systolic blood pressure: the force of blood pressure on arterial walls just after ventricular contraction. Diastolic blood pressure: the force exerted by the blood remaining in arteries during ventricular relaxation d. Korotkoff sounds: the various sounds heard will taking blood pressure e. Blood pressure is measured by a sphygmomanometer 6.Shock: a drop in blood pressure/volume due to a failure of the cardiovascular system to deliver enough oxygen to meet metabolic demands. Common causes of shock are inadequate blood flow to body tissues. a. Hypovolemic shock: due to decreased blood volume i. Hemorrhage 23ii. Extreme fluid loss b. Cardiogenic shock (literally means heart producing): due to failure of heart to pump blood I. Myocardial infraction II. Damage to cardiac muscle III.Arrhythmias (abnormal heart rhythms) c. Vascular shock: due to a sudden decrease in systemic vascular resistance I. Anaphylactic shock II. Neurogenic shock from brain trauma III.Septic shock from bacterial toxins in blood d. Obstructive shock: due to blood blockage to an area I. Pulmonary embolism e. Homeostatic responses to shock (same as any blood pressure drop) I. RAA system II. ADH III.Increased sympathetic tone i. Increases systemic vascular resistance ii. Epinephrine and norepinephrine increases cardiac output IV. Release of local vasodilators in hypoxic areas 7.Circulatory Routes a. Systemic circulation I. Left side of the heart II. Input: pulmonary veins III.Output: aorta b. Pulmonary circulation I. Right side of the heart II. Input: inferior and superior vena cava and coronary sinus III.Output: pulmonary trunk/arteries c. Coronary circulation 24I. First branch off base of aorta II. Input: right and left coronary arteries III.Output: coronary sinus d. Hepatic portal circulation I. Portal system: goes from one vein through two capillary beds to another vein II. Veins draining the GI tract (inferior esophagus to rectum), spleen, pancreas, and gallbladder do not drain directly into the inferior vena cava. Instead, they converge to form the hepatic portal vein which carries nutrient rich blood to the liver for processing. The hepatic veins drain blood from the liver into the inferior vena cava after processing e. Cerebral circulation I. Input: brachiocephalic trunk II. Output: dural venous sinus f. Fetal circulation I. Umbilical arteries (where blood passes from the fetus to the mother) II. Placenta (blood transfer takes place through simple diffusion) III.Umbilical veins (where oxygenated blood returns from the placenta/ in umbilical cord) IV. Ductus venous (ligamentum venosum)( drains into the inferior vena cava) V. Inferior vena cava VI. Right atrium i. Pulmonary trunk 1. Ductus arteriosus (ligamentum arteriosum) to aorta i. Foramen ovale (fossa ovalis) (a hole between the right and left atriums) VII. Left atrium 25VIII. Left ventricle IX. Aorta 26