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Chapter 14: Circulation

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Section A. Blood

  1. Blood is composed of:

    answer

  2. Three types of cells or fragments of cells in blood are:

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  3. The major function of each of the above cell types is:


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  4. Calculate the hematocrit (hct) for an individual whose blood has been "spun down" in a hematocrit tube. The formed elements compose 4 mm and the plasma 6 mm of this tube.


    answer

  5. The normal hematocrit value for a female is and for a male is .
    answer

  6. If the total blood volume is 5 L for the individual whose hematocrit you determined in the previous question, calculate this person's erythrocyte volume: and plasma volume: . Show your work here:


    answer

PLASMA
  1. The three major proteins in plasma are:

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  2. The most abundant type of plasma protein is: .
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  3. Serum is: .
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  4. Other components in plasma include: .
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  5. The normal color of plasma is as a result of the hemoglobin breakdown products called .
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BLOOD CELLS

Erythrocytes
  1. Draw an erythrocyte and indicate the diameter in micrometers. (Pay special attention to the shape.)


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  2. Why is this shape advantageous?


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  3. The most abundant protein in erythrocytes is .
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  4. Erythrocytes are produced in .
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  5. Mature erythrocytes (do, do not) have nuclei.
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  6. How do reticulocytes differ from mature erythrocytes?
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  7. The average life span of an erythrocyte is approximately days.
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  8. Erythrocytes are destroyed in the and .
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  9. What happens to the iron when erythrocytes are destroyed?


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  10. The major breakdown product of heme is .
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Iron
  1. What is iron's role in erythrocytes?


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  2. List some dietary sources of iron.


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  3. How does dietary iron become available to erythrocytes?


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  4. Iron is stored in the body in the in a protein called .
    answer

  5. The iron-transport protein in plasma is .
    answer

Folic acid and vitamin B12
  1. Folic acid is necessary for erythrocyte production because it .
    answer

  2. Vitamin B12 is necessary for erythrocyte production because it .
    answer

  3. Why may a strict vegetarian be deficient in vitamin B12?
    answer

Regulation of erythrocyte production (erythropoiesis)
  1. Diagram the sequence of events for erythropoiesis. Include the kidney, the hormone erythropoietin, and the bone marrow.


    answer

  2. increases erythropoietin release from the kidneys.
    answer

Anemia
  1. Define anemia.


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  2. List 5 different causes of anemia.

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  3. Define polycythemia.


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Leukocytes
  1. Define polymorphonuclear (PMN) granulocytes.


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  2. List the three types of PMN granulocytes.

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  3. List two leukocyte types that have no (or very few) granules in their cytoplasm.

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  4. Of the five leukocyte types, which is the most numerous?
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  5. Where are granular leukocytes made?
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  6. Where are agranular leukocytes made?
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Platelets
  1. Are circulating platelets fragments of cells or whole cells?
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  2. What is the major function of platelets?
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Regulation of Blood Cell Production
  1. List the major bones of an adult which are involved in blood cell production.


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  2. The name of the bone marrow cells that give rise to precursors for all the blood cell types is .
    answer

  3. Protein hormones (12 or more) involved in blood cell production are collectively termed .
    answer

  4. List three of these protein hormones.

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  5. List the following clinical values: (Be sure to include units.)
    1. Erythrocytes:
    2. Leukocytes:
    3. Platelets:
    4. Hematocrit:
    5. Hemoglobin:

    answer

    6. Review the SECTION SUMMARY and the REVIEW QUESTIONS at the end of this section in your textbook.

Section B. Overall Design of the Cardiovascular System
  1. Gases, nutrients and metabolic end products move from the capillaries to all cells of the body (or from the cells to the capillaries) by processes known as and .
    answer

  2. Approximately percent of the total circulating blood volume is present in the capillaries.
    answer

  3. Diagram the heart, labeling the four chambers. Draw arrows to indicate how blood flows through these four chambers.
    (Remember: The right pump and the left pump are not in direct communication with each other.)


    answer

  4. Fill in the blanks to indicate the flow of blood:

    Right atrium (a) Pulmonary circulation (lungs) (b) (c) Systemic circulation (body)


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  5. Vessels that carry blood from the heart are called .
    answer

  6. Vessels that carry blood from the lungs and all other parts of the body and return it back to the heart are called .
    answer

  7. List the vessels through which blood passes as it flows from the left ventricle and returns to the right atrium:

    Left ventricle right atrium.
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  8. The large vein which collects blood from the upper part of the body is the .
    answer

  9. The large vein which collects blood from the lower part of the body is the . Both of these veins empty into the .
    answer

  10. Blood going to the lungs has a (high, low) oxygen content.
    answer

  11. Blood coming from the lungs has a (high, low) oxygen content.
    answer

  12. All blood returning form the systemic veins is (oxygenated, deoxygenated) before returning to the systemic arteries.
    answer

  13. All blood flowing from the pulmonary arteries to the pulmonary veins is (oxygenated, deoxygenated).
    answer

  14. All blood pumped by the right heart goes to the .
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  15. All blood pumped by the left heart goes to the .
    answer

PRESSURE, FLOW AND RESISTANCE
  1. Write the equation that relates pressure, flow and resistance.


    answer

  2. In your own words, state what this equation says.


    answer

  3. For this equation, R = , identify the following:
    1. R =
    2. =
    3. =
    4. =

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  4. Based on the above equation, if increases (due to increased hematocrit for example), will (increase, decrease). If increases, will (increase, decrease).
    answer

  5. Of the three major factors that affect resistance to blood flow (), which factor is most important?
    answer

  6. Increasing the radius of a vessel twofold will decrease its resistance -fold.
    answer

    7. Review the SECTION SUMMARY and REVIEW QUESTIONS at the end of this section in your textbook.

Section C. The Heart

ANATOMY
  1. The fibrous sac surrounding the heart is the .
    answer

  2. The thick wall of the heart composed primarily of cardiac muscle is called the .
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  3. The thin layer of cells lining the cardiac chambers is the .
    answer

  4. Diagram the heart, labeling the four valves. Draw arrows to indicate the direction of blood flow through the heart.


    answer

  5. List the cardiac valves.
    AV Valves Semilunar Valves

    answer

  6. The papillary muscles are attached to the valves by fibrous strands called .
    answer

    7. Review Fig. 14-14, page 389, in your textbook.

CARDIAC MUSCLE
  1. Compare and contrast cardiac muscle with skeletal and smooth muscle.


    answer

  2. Special cardiac muscle cells are modified to form a special conducting network known as the .
    answer

  3. The peptide hormone secreted by special atrial muscle cells is .
    answer

Innervation
  1. Cardiac muscle is innervated by both divisions of the autonomic nervous system. Fill in the following blanks:

    Divisions of the ANS


    Postganglionic transmitter released


    Receptors on cardiac muscle


    answer

Blood Supply
  1. The arteries supply oxygen-rich blood to the myocardium.
    answer

HEARTBEAT COORDINATION

Cardiac Action Potentials
  1. Draw a ventricular muscle cell action potential and a SA nodal action potential.
    Ventricular muscle-cell APAtrial muscle-cell

    answer

  2. In the figure above, the gradual depolarization, A, is known as the . B is the .
    answer

  3. This unstable resting membrane potential, A, is the cause of .
    answer

  4. The firing rate of the SA-node in humans is around beats/min.
    answer

  5. Membrane permeability changes of the followings ions responsible for the generation of the pacemaker potential in the SA-node are:
    1. PNa: (increase, decrease, no change)
    2. PK: (increase, decrease, no change)
    3. PCa2+: (increase, decrease, no change)

    answer

Sequence of Excitation
  1. The pacemaker of the heart resides in the cells.
    answer

  2. Draw the electrical conducting system of the heart.


    answer

  3. The greatest delay in the electrical conducting system of the heart occurs in the .
    answer

The Electrocardiogram
  1. Draw a typical ECG tracing for two sequential heartbeats. Label the P, QRS, and T waves.


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  2. The P wave represents .
    answer

  3. The QRS complex represents .
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  4. The T wave represents .
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  5. Draw an ECG tracing with a ventricular muscle cell action potential. (Be sure the ventricular depolarization and repolarization occur at the same time for both tracings!)


    answer

  6. The ECG provides information concerning the (electrical, mechanical) events of the heart.
    answer

Excitation-Contraction Coupling
  1. List in order the sequence of events by which the action potential causes increased release of calcium from the sarcoplasmic reticulum.

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Refractory Period of the Heart
  1. Define refractory period.


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  2. Based upon your understanding of refractory period, explain why cardiac muscle cannot be tetanized.


    answer

MECHANICAL EVENTS OF THE CARDIAC CYCLE
  1. The phase of the cardiac cycle which represents ventricular contraction is . The phase which represents ventricular relaxation is .
    answer

  2. Ventricular contraction and blood ejection (approx. 0.3 sec) represents: .
    answer

  3. Ventricular relaxation and blood filling (approx. 0.5 sec) represents: .
    answer

  4. Identify the following from the left ventricular volume curve:

    A:
    B:
    C:
    D:


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  5. What part(s) of the above ventricular volume curve occur(s) during systole? Diastole? .
    answer

  6. The volume represented by the line labeled X above is called .
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  7. In an individual at rest, percent of ventricular filling occurs before atrial contraction.
    answer

Mid-to-Late Diastole
  1. During ventricular diastole, the valves are closed and the valves are open.
    answer

  2. The amount of blood in the ventricle at the end of diastole is called . This volume is approximately ml.
    answer

Systole
  1. As ventricular pressure increases, the valves close and the valves open.
    answer

  2. The amount of blood remaining in the ventricle at the end of ejection is called the . This volume is approximately ml.
    answer

  3. End diastolic volume - end systolic volume = .
    answer

Early Diastole
  1. The isovolumetric ventricular relaxation period is characterized by a(n) (increase, decrease, no change) in ventricular pressure and a(n) (increase, decrease, no change) in ventricular volume.
    answer

  2. A significant increase in heart rate (from 70 beats/min to 200 beats/min) will (increase, decrease, not change) ventricular filling time.
    answer

Pulmonary Circulation Pressures
  1. Fill in the blank:
    Pulmonary Pressures Systemic Pressures
    1. Systolic mm Hg
    2. Diastolic mm Hg
    1. Systolic mm Hg
    2. Diastolic mm Hg

    answer

  2. Right ventricular stroke volume is normally ml.
    answer

  3. Left ventricular stroke volume is normally ml.
    answer

  4. How does the anatomy of the right ventricular wall correlate with the low pressure pulmonary circulation?


    answer

Heart Sounds
  1. The first heart sound (lub) is due to .
    answer

  2. The second heart sound (dup) is due to .
    answer

CARDIAC OUTPUT
  1. Define cardiac output (CO):


    answer

  2. CO = HR .
    answer

  3. At rest, a cardiac output of L/min = 72 beats/min ml/beat.
    answer

  4. During exercise, if heart rate increases to 80 beats/min and stroke volume increases to 120 ml/beat, the CO will be . (Be sure to include units.)
    answer

Control of Heart Rate
  1. (With, without) neural innervation, the heart rate at rest is approx. 100 beats/min.
    answer

  2. Parasympathetic innervation (increases, decreases, does not change) heart rate.
    answer

  3. Sympathetic innervation (increases, decreases, does not change) heart rate.
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  4. In the resting state, the heart rate is predominately under (parasympathetic, sympathetic) innervation.
    answer

Control of Stroke Volume
  1. Define stroke volume (SV). (Remember: The ventricles never completely empty during contraction.)


    answer

  2. Two factors that change SV are:

    answer

  3. Define Starling's law of the heart:


    answer

The sympathetic nerves
  1. Sympathetic nerves release the neurotransmitter which interacts with the receptors on the myocardium to ventricular contractility.
    answer

  2. Ejection fraction (EF) = = %
    answer

  3. EF (increases, decreases) with an increase in myocardial contractility.
    answer

    4. Review the SECTION SUMMARY and REVIEW QUESTIONS at the end of this section in your textbook.

Section D. The Vascular System

ARTERIES

Arterial Blood Pressure
  1. The formula for compliance is: C =
    answer

  2. Is compliance greater in the arteries or veins?
    answer

  3. How is compliance altered in people who have "hardening of the arteries"?


    answer

  4. The magnitude of the pulse pressure is a function of:

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  5. An increase in SV will result in a(n) (increase, decrease, no change) in PP.
    answer

  6. An increase in arterial compliance will result in a(n) (increase, decrease, no change) in PP.
    answer

  7. Arteriosclerosis (hardening of the arteries) will (increase, decrease, not change) PP.
    answer

  8. MAP = DP + 1/3
    answer

  9. Determine the MAP of an individual with a blood pressure of 210/160 mm Hg:
    answer

Measurement of Systemic Arterial Pressure
  1. Describe how you can determine your systolic and diastolic blood pressure using a sphygmomanometer.
    answer

ARTERIOLES
  1. Arterioles are the major vessels that distribute variable amounts of blood to individual organs. Therefore:

    Forgan =




    answer

  2. Vascular smooth muscle has tone.
    answer

  3. Arteriolar diameter is regulated by:

    answer

  4. An accumulation of local metabolites such as CO2, H+, adenosine or an O2 lack cause (vasoconstriction, vasodilation) of the local arterioles. This is known as active .
    answer

  5. In flow autoregulation, when blood flow to an organ is reduced, there is arteriolar (vasoconstriction, vasodilation) in an attempt to return blood flow to normal.
    answer

  6. According to the theory of reactive hyperemia, occlusion of blood flow to an organ or tissue will result in a(n) (increase, decrease) in blood flow to that organ when the occlusion is released.
    answer

Extrinsic Controls
  1. The smooth muscle of arterioles is innervated by sympathetic postganglionic nerve fibers which release which interacts with receptors on the arterioles.
    answer

  2. Indicate whether the following events result in vasoconstriction (VC) or vasodilation (VD):
    1. increased sympathetic firing to vascular smooth muscle
    2. decreased sympathetic firing to vascular smooth muscle
    3. epinephrine (interacting with alpha receptors)
    4. angiotensin II
    5. vasopressin
    6. ANF

    answer

Endothelial Cells and Vascular Smooth Muscle
  1. Indicate if the following endothelial derived factors cause vasoconstriction (VC) or vasodilation (VD).
    1. prostacyclin (PGI2)
    2. EDRF
    3. endothelin-1 (E1T-1)

    answer

CAPILLARIES
  1. What percent of the circulating blood volume is located in the capillaries?
    answer

  2. List the major functions of the capillaries.


    answer

  3. The diameter of a capillary is (greater than, equal to, less than) the diameter of a red blood cell and is (greater than, equal to, less than) the diameter of a human hair.
    answer

Anatomy of the Capillary Network
  1. Describe the following:
    1. Capillary wall:
    2. Metarterioles:
    3. Precapillary Sphincter:

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Velocity of Capillary Blood Flow
  1. Velocity of blood flow = .

    Using the above equation, explain how the velocity of blood flow varies in the arteries, capillaries, and veins.


    answer

Diffusion Across the Capillary Wall: Exchange of Nutrients and Metabolic End Products
  1. Three basic mechanisms by which most substances move across the capillary walls are:

    answer

  2. Nutrients diffuse across the capillary wall into the fluid and then into .
    answer

  3. Metabolic end products diffuse across cells' membranes into and then into .
    answer

  4. Glucose, oxygen, and carbon dioxide move down their gradient.
    answer

  5. Describe Starling's law of the capillaries. (Include the four forces which can lead to filtration or absorption in the capillary.)


    answer

VEINS
  1. Explain the statement: Veins are low-resistance conduits for blood flow from the tissues to the heart.


    answer

  2. The mean pressure in the following vessels is:
    1. Arteries:
    2. Capillaries:
    3. Veins:

    answer

  3. Why do veins have valves?
    answer

Determinants of Venous Pressure
  1. Enter A if the description applies to arteries and V if the description applies to veins.
    1. greater compliance
    2. higher pressure
    3. larger volume

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  2. Veins are innervated by the division of the autonomic nervous system.
    answer

  3. Three mechanisms that increase venous pressure and venous return are:

    answer

  4. What is the relationship between venous return and cardiac output?


    answer

THE LYMPHATIC SYSTEM
  1. The lymphatic system is made up of small organs called , tubes called , and a fluid called .
    answer

  2. Lymph vessels return their fluid to .
    answer

  3. Lymph vessels have valves. (true, false)
    answer

  4. Lymph fluid is an ultrafiltrate from the .
    answer

  5. If the lymph vessels are occluded by infection, there is an accumulation of interstitial fluid. This condition is known as .
    answer

Mechanism of Lymph Flow
  1. Lymphatics exert a pump-like action by inherent rhythmic contractions of muscle in the lymphatic vessel walls.
    answer

  2. Lymph flow is aided by and pumps.
    answer

    3. Review the SECTION SUMMARY and REVIEW QUESTIONS at the end of this section in your textbook.

Section E. Integration of Cardiovascular Function: Regulation of Systemic Arterial Pressure
  1. Fill in the blanks and identify:

    MAP (a.) is determined by (b.) and (c.) .


    answer

BARORECEPTOR REFLEXES

Arterial Baroreceptors
  1. The arterial baroreceptors are located in the:

    answer

  2. Draw the afferent nerves from the baroreceptors to the medulla oblongata on the above diagram. Label these nerves (glossopharyngeal and vagus).
    answer

  3. If pressure in the arterial baroreceptors increases, the afferent firing of the baroreceptor nerves (increases, decreases).
    answer

The Medullary Cardiovascular Center and Operation of the Arterial Baroreceptor Reflex
  1. Draw arrows to complete the following:
    Parasympathetic Heart
    Arterial Baroreceptors Medullary Cardiovascular Center
     
    Sympathetic Heart
    Arterioles
    Veins


    answer

  2. Fill in the blanks: I = increase, D = decrease
    Parasympathetic firing
    ­
    Baroreceptor firing Medulla CO and TPR and MAP
    ¯
    Sympathetic firing
     
    Parasympathetic firing
    ­

    Baroreceptor firing Medulla CO and TPR and MAP

    ¯
    Sympathetic firing

    answer

  3. This baroreceptor reflex is a (short, long)-term regulator of arterial blood pressure.
    answer

LONG-TERM REGULATION OF ARTERIAL BLOOD PRESSURE
  1. The major factor for long term regulation of blood pressure is .
    answer

  2. According to long term regulation of arterial blood pressure, and increase in blood pressure will lead to a(n) (increase, decrease) in blood volume which will lead to a(n) (increase, decrease) in blood pressure.
    answer

  3. According to long term regulation of arterial blood pressure, a decrease in blood pressure will lead to a(n) (increase, decrease) in blood volume which will lead to a(n) (increase, decrease) in blood pressure.
    answer

    4. Review the SECTION SUMMARY and REVIEW QUESTIONS at the end of this section your textbook.

Section F. Cardiovascular Patterns in Health and Disease

HEMORRHAGE AND OTHER CAUSES OF HYPOTENSION
  1. Immediately following a moderate hemorrhage, do the following increase (I), decrease (D), or not change (NC):
    1. baroreceptor firing
    2. stroke volume
    3. heart rate
    4. total peripheral resistance
    5. cardiac output
    6. mean arterial pressure

    answer

  2. What happens to plasma volume within 12 to 24 hours after a moderate hemorrhage?


    answer

Shock
  1. Shock involves any situation in which there in a(n) (increase, decrease) in blood flow to organs or tissues resulting in severe damage.
    answer

THE UPRIGHT POSTURE
  1. Why do your feet swell during prolonged standing?


    answer

  2. Why might you faint after standing at attention for a long time?


    answer

EXERCISE
  1. Indicate if there would be an increase (I) or decrease (D) in each of the following during moderate exercise:
    1. blood flow to exercising skeletal muscle
    2. blood flow to the skin
    3. blood flow to the heart
    4. blood flow to the kidneys
    5. blood flow to the GI tract
    6. cardiac output
    7. venous return

    answer

HYPERTENSION
  1. Define hypertension:


    answer

  2. Differentiate between primary and renal hypertension.


    answer

  3. List some risk factors associated with primary hypertension.


    answer

  4. Types of drugs used in treating hypertension which reduce the workload on the heart or reduce TPR are:


    answer

HEART FAILURE
  1. Draw the Starling curve for a normal heart and indicate how this curve "shifts" for a failing heart.


    answer

  2. In uncompensated heart failure, what happens to ventricular volume? ; Ventricular contractility?
    answer

  3. Explain how heart failure can lead to:
    1. systemic edema

    2. pulmonary edema


    answer

  4. Explain how the following aid in the treatment of hypertension:
    1. Salt restriction:

    2. Diuretics:

    3. Vasodilator drugs:


    answer

CORONARY ARTERY DISEASE AND HEART ATTACKS
  1. The coronary arteries supply blood to .
    answer

  2. Define:
    1. Angina pectoris:
    2. Myocardial infarction (MI):
    3. Arteriosclerosis:
    4. Atherosclerosis:

    answer

  3. Explain how the following aid in the treatment of coronary heart disease:
    1. Nitroglycerin:
    2. Beta adrenergic blockers:
    3. Calcium channel blockers:
    4. Blood clot inhibitors:

    answer

  4. Define:
    1. Stroke:
    2. Embolism:

    answer

    5. Review the SUMMARY and REVIEW QUESTIONS at the end of this section and the THOUGHT QUESTIONS at the end of this chapter in your textbook.

Section G. Hemostasis: The Prevention of Blood Loss
  1. Define:
    1. Hemostasis:
    2. Hematoma:

    answer

FORMATION OF A PLATELET PLUG
  1. The plasma protein secreted by endothelial cells and platelets that forms a bridge between the endothelial vessel wall and platelets is .
    answer

  2. Platelet aggregation which leads to a platelet plug is enhanced when platelets release chemical agents from their secretary vesicles such as and synthesize substances such as .
    answer

  3. Platelets are able to contract and seal small breaks in blood vessel walls because platelets contain a very high concentration of .
    answer

  4. Platelet plugs do not continuously expand from the damaged site into the normal endothelium because normal endothelial cells release , which are inhibitors of platelet aggregation.
    answer

BLOOD COAGULATION: CLOT FORMATION
  1. Differentiate between the intrinsic and extrinsic pathways for blood clotting.


    answer

  2. Diagram the extrinsic pathway for clot formation.


    answer

    3.  

  3. The "final" plasma protein in the clotting process that "traps" erythrocytes is .
    answer

  4. Describe the two major roles the liver plays in the clotting process.

    answer

ANTICLOTTING SYSTEMS

Factors that Oppose Clot Formation
  1. Three naturally occurring anticoagulants or factors that limit the clotting system are:


    answer

The Fibrinolytic System
  1. The fibrinolytic system dissolves a clot by activating plasminogen to , which digests , thereby dissolving the clot.
    answer

  2. Tissue plasminogen activator (t-PA) is secreted by and is activated by .
    answer

ANTICLOTTING DRUGS
  1. List several anticlotting drugs and explain the mechanism of action of each.


    answer

    2. Review the SUMMARY and REVIEW QUESTIONS at the end of this section in your textbook.

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