Notes in 3- Circulation

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Published	02/10/2024	Lumen of artery is lined by {{c1::endothelial cells}}Endothelial cells make {{c1::basal lamina (basement membrane)}} to adhere to and sit on{{c1::Smoo…
Published	02/10/2024	Lumen of artery contains:- {{c1::Plasma}} - water & proteins- {{c1::Red}} blood cells- {{c1::White}} blood cells- {{c1::Platelets}}- {{c1::Fibrin}…
Published	02/10/2024	Platelets are {{c1::not}} normally exposed to interstitial collagen fibres around vessel
Published	02/10/2024	Plasma vs SerumWhat's the difference?
Published	02/10/2024	{{c1::Clotting factors}} are an amplification system, resulting in thrombin production• Thrombin converts soluble fibrinogen&…
Published	02/10/2024	Initial Damage (Trauma) 1. Exposure of interstitial collagens to Plasma  2. Release of Tissue Factor (TF)Initiation of clotting cascade…
Published	02/10/2024	Activation of Clotting factors:clotting factors use {{c1::serine proteases}} - cleave other clotting factors to form the active molecule.
Published	02/10/2024	Clotting cascade leads to production of {{c2::thrombin}} from {{c1::prothrombin}}{{c2::Thrombin}} converts soluble {{c3::fibrinogen}} to insoluble {{c…
Published	02/10/2024	{{c1::Platelets}} are produced in bone marrow from a cell called {{c2::megakaryocyte}} (large cell & many nuclei)They bud off as fragments fr…
Published	02/10/2024	Megakaryocytes undergo {{c1::nuclear division}} but not cell division → get huge with many nuclei
Published	02/10/2024	Function of Platelets:{{c1::Trauma}} to vessel {{c1::Exposure}} of platelets to interstitial collagen{{c1::Adhere}} together try to form bridge t…
Published	02/10/2024	What's the function of platelets?
Published	02/10/2024	{{c1::Coagulation}} is the solidification of blood.Two types:1- {{c2::Thrombus}} formation2- {{c2::Clot}} formation
Published	02/10/2024	{{c1::Thrombus formation}} is a type of blood coagulation that:→ occurs in {{c2::flowing}} blood→ pale cream coloured→ consists of {{c2::platelets}} a…
Published	02/10/2024	{{c1::Thrombosis}} is the process of thrombus formation which occurs in flowing blood
Published	02/10/2024	Why does a thrombus of platelets and fibrin occur in flowing blood?
Published	02/10/2024	Platelets have molecules on their surfaces which allow {{c1::adherence}} to interstitial collagen, even when blood is flowing past them.
Published	02/10/2024	{{c1::Clot formation}} is a type of blood coagulation where blood leaks out of a vessel and becomes {{c2::stationary/stagnant}}→ Within the stagnant b…
Published	02/10/2024	Typical wound:[1] Trauma disrupts vessel[2] Leakage of blood[3] Clotting system is activated by collagen and by the stagnant blood, forming a clot[4] …
Published	02/10/2024	Give an example of haemostasis in normal skin with wound
Published	02/10/2024	In any wound:• {{c1::Vasoconstriction}} helps reduce bleeding • {{c1::Clot formation}} occurs in space around vessel and may fill void of wounded tiss…
Published	02/10/2024	{{c1::Wound healing}} involves the process of {{c2::angiogenesis}} to form granulation tissue.→ oxygenation of the wounded area
Published	02/10/2024	Removal of thrombus:Plasma protein called {{c2::Plasminogen}} → {{c3::Plasmin}}{{c3::Plasmin}} cuts up fibrin into smaller fragments.This process is c…
Published	02/10/2024	How is thrombus removed?
Published	02/10/2024	Fibrinolytic system depends on:• Plasma protein called plasminogen being converted to plasmin • Plasmin cuts up fibrin into fibrin degradation product…
Published	02/10/2024	{{c1::Thrombosis}} and {{c1::Clotting}} are two processes used in wound healing and stopping bleeding during menustration.
Published	02/10/2024	{{c1::Virchow's triad}} are three predisposing situations that may result in thrombus formation.1. Changes in the {{c2::intimal surface of a vessel}}2…
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Published	02/10/2024	Physiological vs Pathological ThrombosisWhat is the difference?
Published	02/10/2024	Pathological Thrombosis (e.g. Coronary artery thrombosis) [1] Changes in the intimal surface of a vessel e.g. atheroma lipid coming through …
Published	02/10/2024	{{c1::Atheroma}} is a disease of coronary arteries which results in a build up of lipid under the intimal surface→ slow & turbulent flow
Published	02/10/2024	How do cigarettes make it more likely that a thrombosis occurs?
Published	02/10/2024	In reality - thrombus and clots form multiple layers that build up in lumen.{{c1::Lines of Zahn}} are multiple layers of thrombus (platelets & fib…
Published	02/10/2024	Consequences of thrombus blockage:[1] {{c1::Complete obstruction}}→ tissue receives no flow ({{c2::ischaemia}})→ no oxygenation ({{c2::hypoxia}})→ loc…
Published	02/10/2024	{{c1::Ischaemia}} is reduced blood flow to tissue.{{c1::Hypoxia}} is decreased oxygen delivery to tissue.{{c1::Necrosis}} is the process of tissue dyi…
Published	02/10/2024	{{c1::Coronary artery thrombosis}} – infarct in heart {{c1::Cerebral artery thrombosis}} – infarct in brain {{c1::Mesenteric artery thrombosis}} – inf…
Published	02/10/2024	An {{c1::embolism}} is a mass of material moving in the vascular system and able to become lodged in a vessel and block its lumen.→ derived from …
Published	02/10/2024	When a thrombi/clot embolises it is called {{c1::thromboembolism}}Example → Pulmonary embolism[1] Sluggish flow in leg veins leads to thrombosis and c…
Published	02/10/2024	Explain how a pulmonary embolism occurs, beginning with leg vein.
Published	02/10/2024	{{c1::Marrow embolism}}Fracture a leg → marrow enters ruptured vein → marrow embolises to lung vessels {{c1::Air embolism}} - never inject a…
Published	02/10/2024	{{c1::Circulatory shock}} is a profound circulatory failure causing poor perfusion of vital organs.Features:→ Low blood pressure (hypotension) an…
Published	02/10/2024	Whats the function of the elasticity of a blood vessel?
Published	02/10/2024	Blood pressure in normal usage is {{c1::arterial}} pressureNormally = 120/80 mm/Hg (venous pressure much lower)Systolic/Diastolic
Published	02/10/2024	Normal blood pressure relies on:1. Enough blood in system (about 5 litres in an adult)→ No blood in vessel causes it to collapse and blood pressure be…
Published	02/10/2024	What does normal blood pressure rely on?
Published	02/10/2024	Detection of blood pressure and oxygen:→ using {{c1::carotid body}} and {{c1::sinus}}Located on either side of the bifurcation of carotid artery
Published	02/10/2024	There are {{c1::two}} carotid bodies and {{c1::two}} carotid sinuses on either side of the neckThe {{c1::carotid bodies}} → sense the partial pre…
Published	02/10/2024	Function of carotid sinuses:[1] Blood pressure drops (carotid sinuses ‘sense’ the drop)[2] Nerve signals sent to the brain stem[3] Heart pumps harder …
Published	02/10/2024	Describe the function of carotid sinuses
Published	02/10/2024	Functions of brainstem:Stimulates SNS which leads to:[1] Increased {{c1::heart rate}}[2] Increased {{c1::vascular tone}} in vessels located in li…
Published	02/10/2024	What are the functions of the brainstem?
Published	02/10/2024	Main Causes of Circulatory Shock:[1] {{c1::Hypovolaemic}} → low volume of blood[2] {{c1::Septic}} → infection causing generalised vasodilation[3] {{c1…
Published	02/10/2024	35 year old man walking across road.  Hit by car.  Fractured left rib goes through spleen. Spleen ruptures with loss of 3 lit…
Published	02/10/2024	In hypovolaemic shock:• {{c1::Low blood pressure}} reflects severe reduction in amount of blood in circulation • {{c1::High pulse}} reflects phys…
Published	02/10/2024	Case:• 70 year old man with heart disease • Heart starts failing and eventually can no longer pump enough blood to maintain blood pressure
Published	02/10/2024	Case:• 30 year old woman gets urinary tract infection which then causes kidney infection then bacteria go into blood (= septicaemia)Explain what …
Published	02/10/2024	Infection in blood causing {{c1::generalised vasodilatation}} and shock is called ‘{{c2::septic shock}}'
Published	02/10/2024	Complications of Shock:[1] {{c1::Decreased perfusion of brain (ischaemia)}}→ initially reversible but then permanent (infarction)→ brain injury[2] {{c…
Published	02/10/2024	In severe septic shock, {{c1::Bradycardia}} occurs in muscle of heart, it loses its tone and gets slow heart rate.
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