Special Circulations cerebral and coronary
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Questions and Answers

What is the primary mechanism for matching blood flow to the metabolic needs of a tissue?

  • Extrinsic control
  • Intrinsic control (correct)
  • Sympathetic control
  • Hormonal control

Which arteries provide the entire blood supply to the myocardium?

  • Carotid arteries
  • Aorta
  • Pulmonary arteries
  • Coronary arteries (correct)

What is the estimated difference in effectiveness between myocardial and skeletal muscle capillaries in exchanging small molecules?

  • 5 times
  • 15 times (correct)
  • 2 times
  • 10 times

What determines coronary blood flow?

<p>A and B (D)</p> Signup and view all the answers

During which phase of the cardiac cycle does the majority of coronary blood flow occur?

<p>Diastole (B)</p> Signup and view all the answers

What percentage of total coronary flow occurs during systole in the left ventricle?

<p>20% (C)</p> Signup and view all the answers

Does intramyocardial pressure in the left ventricle exceed ventricular intracavity pressure during systole?

<p>Yes (A)</p> Signup and view all the answers

Does intramyocardial pressure in the right ventricle exceed aortic pressure under normal conditions?

<p>No (A)</p> Signup and view all the answers

Which organ system experiences more continuous blood flow that follows aortic pressure changes?

<p>Right ventricle myocardium (B)</p> Signup and view all the answers

How does blood return to the right atrium?

<p>Through the coronary sinus (B)</p> Signup and view all the answers

Why does the capillary density in the heart exceed that in skeletal muscle?

<p>Because cardiac muscle fibers are smaller in diameter than skeletal muscle fibers (B)</p> Signup and view all the answers

How effective are myocardial capillaries compared to skeletal muscle capillaries in exchanging small molecules?

<p>Myocardial capillaries are estimated to be 15 times more effective (A)</p> Signup and view all the answers

What percentage of the total coronary resistance to blood flow under resting conditions is accounted for by myocardial compression?

<p>Approximately 25% (A)</p> Signup and view all the answers

When does blood flow to the left ventricle reduce to approximately zero?

<p>During early ventricular systole (B)</p> Signup and view all the answers

When does maximal left coronary inflow occur?

<p>Early in diastole (C)</p> Signup and view all the answers

What is the primary mechanism for matching blood flow to the metabolic needs of a tissue?

<p>Local metabolic control (A)</p> Signup and view all the answers

Which of the following is true about changes in the duration of diastole under normal conditions?

<p>Changes in diastole are not important in determining total coronary blood flow. (A)</p> Signup and view all the answers

What happens to coronary blood flow during tachycardia?

<p>Coronary blood flow increases due to increased metabolic activity. (D)</p> Signup and view all the answers

What happens to coronary blood flow during bradycardia?

<p>Coronary blood flow decreases due to reduced metabolic activity. (B)</p> Signup and view all the answers

Where is intramyocardial pressure greater during systole?

<p>In the inner layers of the myocardium. (A)</p> Signup and view all the answers

Under normal conditions, how is the distribution of coronary blood flow across the heart wall?

<p>The distribution is uniform. (A)</p> Signup and view all the answers

What may contribute to the greater frequency of sub-endocardial myocardial infarctions under pathological conditions?

<p>Increased pressure gradient within the myocardial muscle. (D)</p> Signup and view all the answers

What is autoregulation of the coronary arteries?

<p>The process by which coronary blood flow is maintained at a constant rate. (C)</p> Signup and view all the answers

What happens to blood flow when perfusion pressure is varied between 60 and 160 mmHg?

<p>Blood flow varies very little. (B)</p> Signup and view all the answers

What happens to the autoregulatory curve when myocardial oxygen consumption increases?

<p>The curve shifts upward. (B)</p> Signup and view all the answers

During which phase of the cardiac cycle is endocardial blood flow greater than epicardial blood flow?

<p>During diastole. (D)</p> Signup and view all the answers

During diastole, which type of blood flow is greater in the heart?

<p>Endocardial blood flow (B)</p> Signup and view all the answers

Which vessels in the heart can maintain coronary flow when arterial pressure drops?

<p>Epicardial vessels (A)</p> Signup and view all the answers

What happens to average flow when myocardial oxygen consumption decreases?

<p>Average flow decreases (C)</p> Signup and view all the answers

Which of the following is true about the control of coronary blood flow during exercise?

<p>Increased metabolic activity leads to vasodilation (C)</p> Signup and view all the answers

What happens to the myocardium during ischemia?

<p>Decrease in contractility (A)</p> Signup and view all the answers

What is a common symptom of myocardial ischemia?

<p>Change in the ST segment of the EKG (B)</p> Signup and view all the answers

What is the role of collateral circulation in chronic myocardial ischemia?

<p>Increase coronary blood flow reserve (C)</p> Signup and view all the answers

What happens to collateral arteries in the presence of coronary artery stenosis?

<p>They enlarge greatly (C)</p> Signup and view all the answers

What is the primary determinant of coronary blood flow?

<p>Metabolic activity (A)</p> Signup and view all the answers

What happens to coronary blood flow during tachycardia?

<p>Increases (D)</p> Signup and view all the answers

What happens to coronary blood flow during bradycardia?

<p>Decreases (B)</p> Signup and view all the answers

What is the effect of hypoxia on coronary blood flow?

<p>Increases (D)</p> Signup and view all the answers

What happens to coronary blood flow when oxygen supply does not meet oxygen demand?

<p>Decreases (B)</p> Signup and view all the answers

Which of the following is a treatment option for myocardial ischemia that aims to increase blood flow?

<p>Increase blood flow with thrombolytic agents and balloon angioplasty (A)</p> Signup and view all the answers

Which organ is the least tolerant of ischemia?

<p>Brain (A)</p> Signup and view all the answers

What happens if flow to the brain is interrupted for only 5 seconds?

<p>Loss of consciousness (C)</p> Signup and view all the answers

What is the major function of sympathetic innervation of cerebral vessels?

<p>Protect against increase in perfusion pressure (A)</p> Signup and view all the answers

What happens when intracranial pressure increases?

<p>Increase in cerebral vascular resistance (C)</p> Signup and view all the answers

What is the purpose of the Cushing reaction?

<p>Protect the brain from ischemia (D)</p> Signup and view all the answers

What is the role of autonomic control in the normal regulation of cerebral blood flow?

<p>Not involved in regulation (A)</p> Signup and view all the answers

What happens when the arterial pressure rises above the cerebrospinal fluid pressure?

<p>Blood flow to the brain resumes (B)</p> Signup and view all the answers

What is the effect of chronic exposure to high blood pressure on autoregulation of cerebral blood flow?

<p>Impairs autoregulation (C)</p> Signup and view all the answers

What mediators have been thought to be involved in the regulation of cerebral blood flow?

<p>Prostaglandins and adenosine (C)</p> Signup and view all the answers

What is the function of the blood-brain barrier?

<p>Limit permeability to non-lipophilic molecules (B)</p> Signup and view all the answers

Which of the following is a sign or symptom of a transient ischemic attack (TIA)?

<p>All of the above (D)</p> Signup and view all the answers

What is the leading cause of a cerebrovascular accident (CVA) or stroke?

<p>Blockage of blood flow in an artery of the brain (B)</p> Signup and view all the answers

What percentage of strokes are hemorrhagic?

<p>15% (C)</p> Signup and view all the answers

What is the duration of a transient ischemic attack (TIA)?

<p>5-50 minutes (C)</p> Signup and view all the answers

What happens to collateral arteries in the presence of coronary artery stenosis?

<p>They dilate to increase blood flow (B)</p> Signup and view all the answers

What is the primary cause of death in a cerebrovascular accident (CVA) or stroke?

<p>Formation of a blood clot in the brain (C)</p> Signup and view all the answers

What are the signs and symptoms of a transient ischemic attack (TIA)?

<p>Impaired vision, speech, and paralysis (C)</p> Signup and view all the answers

Which arteries supply the arterial blood to the brain?

<p>Internal carotid and vertebral arteries (B)</p> Signup and view all the answers

What happens to cerebral blood flow when blood or cerebrospinal fluid CO2 increases?

<p>Cerebral blood flow increases (D)</p> Signup and view all the answers

What happens to the autoregulatory curve in individuals with chronic exposure to high blood pressure (hypertension)?

<p>It shifts to the right (B)</p> Signup and view all the answers

What happens to cerebral vascular resistance when there is reflex sympathetic stimulation resulting from systemic hypotension?

<p>It remains unchanged (D)</p> Signup and view all the answers

What happens to intracranial pressure when there is an increase in volume of any of the intracranial structures?

<p>It increases (C)</p> Signup and view all the answers

What happens to cerebral vascular resistance when intracranial pressure increases?

<p>It increases (C)</p> Signup and view all the answers

What happens to blood pressure when cerebral spinal fluid pressure rises to equal arterial pressure?

<p>It increases (C)</p> Signup and view all the answers

What is the innervation of cerebral vessels?

<p>Both sympathetic and parasympathetic nerve fibers (B)</p> Signup and view all the answers

What happens to the blood supply to the brain when cerebral spinal fluid pressure rises to equal arterial pressure?

<p>It is cut off (D)</p> Signup and view all the answers

Which individuals are better protected against increases in systemic pressure but are more vulnerable to reductions in blood pressure?

<p>Individuals with chronic exposure to high blood pressure (hypertension) (A)</p> Signup and view all the answers

What can happen if pressure is rapidly lowered in individuals with chronic exposure to high blood pressure (hypertension)?

<p>They may experience drastic consequences (A)</p> Signup and view all the answers
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