Physiology II - PB 3325
Course Director: Mrs. Kay Brashear

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STUDY GUIDE                        Exam 3

Lecture 9 – Local Flow Regulation

1.  Know how local blood flow is regulated.  Q = P/R
2. How is resistance controlled?  where is it controlled?
3. What component of the circulation has no innervation and is controlled by local factors?
4. What effect does metabolism have on blood flow?
5. What effect does oxygen saturation have on blood flow?
6.  Know the metabolic vasodilator and oxygen demand theories and how they interrelate.
7. What are the major vasodilator substances?
8. Understand the examples of reactive hyperemia and active hyperemia.
9. What effect does blood pressure have on the regulation of local blood flow?
        what are the two mechanisms for autoregulation?
           metabolic theory
           myogenic theory
10. Know the special local control mechanisms in the kidney and brain.
11. Know how the endothelium controls local flow:
            a. EDNO or EDRF
                    what causes release?   where is EDNO effective?  what are functions?
            b. endothelium
                    what causes release?  what is function?
12. What is the difference between acute or short-term local blood flow regulation and long-term local blood flow regulation?
13. What causes angiogenesis and collateral development?
14. Know which hormones and ions are vasoconstrictors and which are vasodilators.

1. What are the characteristics of the circulatory system relating to blood pressure regulation?
2. What are the two mechanisms for blood pressure regulation?
3. In what ares of CV control is the ANS most effective?
4. How does sympathetic and parasympathetic control of the heart and circulation differ?
5. Know the sympathetic innervation and the areas of the circulation innervated.
6, Where is the vasomotor center located?  what are the components (areas) of the vasomotor center?  what are the functions of each area?
7. Know what is meant by vascular tone, vasomotor tone, etc.  Why is vasomotor tone important?
8. How does vasomotor control affect cardiac function?
9. What is the function of the sympathetic vasodilator system?
        a. in exercise
        b. vasovagal syncope
10. Know the effects of a mass sympathetic response.
12.  Know the ANS reflexes
        a.  Baroreceptor reflex - reflex for maintaining normal blood pressure
                    types of receptors, mode of action, buffering of blood pressure
                    effectiveness, duration of reflex response
        b. Chemoreceptor reflex
                    types of receptors, what is monitored?
        c.  Atrial-Pulmonary stretch receptors
                    type of receptors, function
                    two reflexes - how do they decrease atrial volume
                                        overload?
                             volume reflex
                             Bainbridge reflex
13.  What causes a CNN ischemic response?  Cushing reaction?
       What is the effect of prolonged ischemia on the brain?
14. Know the effect of: Abdominal compression, Muscle spindle bodies and golgi tendon neurons, and chemoreceptors on arterial blood pressure..

1. What are the roles of  rapid arterial blood pressure regulation and long-term arterial blood pressure regulation?   How do they work together?
2. Looking at the renal output curve, how does arterial blood pressure affect renal filtration and urine output?
3. What is pressure diuresis and and pressure natruresis?
4. What are the two determinates of long-term blood pressure regulation?
5. What is the effect of TPR on long-term blood pressure regulation? changes in fluid volume?  increase in sodium?
6. How do changes in plasma volume affect arterial blood pressure?
7. How does the Renin-Angiotensin-Aldosterone mechanisim regulate plasma volume?
TPR?
8. What cells secrete renin?  what is the fuction of renin?  what are the functions of angiotensin II?   what is the function of angiotensin converting factor?  where is most angiotensin converting factor located?
9. What role does aldosterone play in the regulation of blood pressure?
10. What is the funciton of ADH?   when does secretion of ADH increase or decrease?
11. What is the direct effect of angiotensin II on renal function?
12. Know the definition of hypertension.
            what are the effects of hypertension on the heart? on the blood vessels?
13. Know the types of hypertension
14. Know some of the causes of hypertension:
        volume-load
        vasoconstriction
        toxemia of pregnancy
        neurogenic
15.  Know the acute or rapid mechanisms of arterial blood pressure regulation.
       Know the intermediate mechanisms of arterial blood pressure regulation.
       Know the long-term mechanism of arterial blood pressure regulation.
       Review the chart to see how they are integrated to regulate blood pressure

1. What is the cardiac index and what is the average cardiac index?
2. How does cardiac output change with age?
3. How are venous return and cardiac output regulated?
 C.O. = HR x SV   or C.O. = P/R
4. What determines VR and CO?
5.. What is the long-term effect of a change in resistance (TPR) on venous return and cardiac output?
6. Be familiar with the cardiac output function curve.  How do the following affect right atrial pressure?   C.O. at rest, maximum C.O. regulated by intrinsic mechanisms, max. C.O. regulated by ANS?  What is the minimum cardiac output?
7. How is cardiac output controlled during exercise?
            isotonic - moderate, severe
            isometric - moderate, severe
8. What are the high cardiac output conditions?
9. What are the factors that determine venous return?  right atrial pressure, MSFP and resistance to venous return
10. What is the pressure gradient for venous return and what factors determine the pressure gradient?
11. Be familiar with the venous return function curve.  how does right atrial pressure affect venous return?

1. Know the general pattern of blood flow in the coronary circulation.
2. What are the pressure gradients for flow during diastole? systole?  Are there differences between the left and right ventricles?
3. How does epicardial blood flow differ from endocardial blood flow?
4. How is flow controlled in coronary circulation?
            local control
            ANS
5. How does myocardial ischemia affect cardiac metabolism? cause cell death?
6. What is atherosclerosis and how does it affect coronary circulation?
   Thrombus, Embolus and local spasms
7. What is a myocardial infarction?  How does collateral circulation alter circulation after an infarction and during healing?
8. What are the immediate causes of death following a MI?  what are some that occur after a few days?
9. Know stages of recovery.
10. What is Angina Pectoris?  causes?  treatment?

Cardiac Failure

1. What  are the acute effects of moderate cardiac failure?  chronic effects?
2. What are the mechanisms for compensated cardiac failure?
3. How does renal filtration pressure lead to decompensated cardiac failure?
4. How do left ventricular and right ventricular heart failure affect flow in the circulation?
 

Copyright, Kay Brashear and James B. Parker, 1999