Circulatory System Quiz
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Questions and Answers

What is the primary role of the systemic circulation?

  • Return deoxygenated blood to the right heart.
  • Exchange nutrients and waste products in the capillaries. (correct)
  • Transport oxygenated blood to the lungs.
  • Pump blood directly to the left ventricle.

How does deoxygenated blood return to the heart in pulmonary circulation?

  • From the systemic arteries.
  • Via the superior vena cava.
  • Through the aorta.
  • Using the pulmonary veins. (correct)

Which component of the circulatory system is responsible for driving blood flow?

  • The expansion of the systemic veins.
  • The right atrium contracting.
  • The aorta contracting.
  • The contraction of the heart's ventricles. (correct)

What distinguishes the pulmonary circulation from the systemic circulation?

<p>It involves the exchange of oxygen and carbon dioxide in the capillaries. (C)</p> Signup and view all the answers

Which vessels carry oxygenated blood back to the heart?

<p>Pulmonary veins and systemic veins. (A)</p> Signup and view all the answers

Which characteristic is associated specifically with arterial ulcers?

<p>Pale to black ulcer base (B)</p> Signup and view all the answers

What is a notable symptom of venous insufficient ulcers?

<p>Aching and cramping pain (A)</p> Signup and view all the answers

Which of the following characteristics is true for arterial insufficiency?

<p>Deep ulcers often involving joint space (A)</p> Signup and view all the answers

Which factor is NOT a characteristic of venous ulcers?

<p>Location on the heel (A)</p> Signup and view all the answers

How does skin temperature typically present in arterial insufficiency?

<p>Cool to cold (D)</p> Signup and view all the answers

What is the primary neurotransmitter responsible for vasoconstriction in the peripheral vascular system?

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

Which hormone is produced from the conversion of angiotensin I and is known for its vasoconstricting effects?

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

What physiological response causes vasodilation when sympathetic activity is decreased?

<p>Decreased norepinephrine release (D)</p> Signup and view all the answers

Which of the following substances is primarily responsible for promoting vasodilation in skeletal muscle, the heart, and the brain at lower concentrations?

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

Which local regulatory factor affects blood flow through changes in local oxygen availability?

<p>Local pH changes (D)</p> Signup and view all the answers

What condition may arise if there is a high demand for tissue oxygen but reduced blood flow?

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

Which of the following plays a role in arteriolar vasoconstriction and continued platelet aggregation at the injury site?

<p>Pro-inflammatory cytokines (A)</p> Signup and view all the answers

What is often a result of reduced blood flow in peripheral vessels due to vascular diseases?

<p>Ischemia and tissue death (D)</p> Signup and view all the answers

What is the characteristic symptom of intermittent claudication?

<p>Pain and discomfort in the extremities that is relieved by rest (C)</p> Signup and view all the answers

Which condition indicates a critical state of arterial insufficiency?

<p>Rest pain in the forefoot that interferes with sleep (C)</p> Signup and view all the answers

How can the location of claudication pain help in diagnosing arterial diseases?

<p>It can deduce the specific vessel that is diseased (D)</p> Signup and view all the answers

What percentage of an artery's lumen must be obstructed to likely see symptoms of intermittent claudication?

<p>50% obstruction (A)</p> Signup and view all the answers

What physiological change primarily contributes to the pain experienced during intermittent claudication?

<p>Accumulation of blood metabolites due to ischemia (B)</p> Signup and view all the answers

What assessment method is used to monitor the progression of arterial disease in patients?

<p>Measuring the distance a patient can walk before pain occurs (C)</p> Signup and view all the answers

Which peripheral pulse characteristic is key in diagnosing arterial disorders?

<p>Quality and symmetry of peripheral pulses (B)</p> Signup and view all the answers

What is a common recommendation to improve perfusion to distal tissues for patients with arterial insufficiency?

<p>Maintaining the extremities in a dependent position (D)</p> Signup and view all the answers

What is the primary consequence of heart failure with reduced left ventricular ejection fraction (HFrEF)?

<p>Blood accumulation in the lungs (B)</p> Signup and view all the answers

Which factor does NOT contribute to arterial damage and obstruction?

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

Which condition can lead to increased capillary hydrostatic pressure and fluid leakage into the interstitial space?

<p>Reduced venous flow (A)</p> Signup and view all the answers

What symptom is associated with peripheral vascular diseases due to ischemia?

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

Which of the following would be a consequence of sudden arterial occlusion?

<p>Irreversible tissue ischemia (B)</p> Signup and view all the answers

What type of heart failure is characterized by preserved left ventricular ejection fraction?

<p>Diastolic heart failure (B)</p> Signup and view all the answers

What complication arises from edema in edematous tissues?

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

Which type of circulatory insufficiency does NOT encompass peripheral vascular disease?

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

What is the primary function of a Doppler ultrasound device in evaluating blood flow?

<p>To detect the blood flow by emitting and receiving signals (C)</p> Signup and view all the answers

How does the frequency of the Doppler probe affect its function?

<p>Lower frequencies allow for detection of blood flow at greater depths (B)</p> Signup and view all the answers

Why is it important for patients to understand the purpose of diagnostic studies?

<p>To enhance their compliance with instructions and expectations (A)</p> Signup and view all the answers

What information can trends in diagnostic results provide?

<p>Insights into both disease progression and therapy response (A)</p> Signup and view all the answers

What is a potential downside of using a Doppler ultrasound for blood flow detection?

<p>It cannot provide instantaneous feedback as it takes time to interpret signals (C)</p> Signup and view all the answers

What is the significance of the ankle-brachial index (ABI) in the assessment of peripheral pulses?

<p>It indicates the presence of arterial disease. (A)</p> Signup and view all the answers

Which step is crucial after applying the Doppler transducer to identify arterial blood flow?

<p>Gently angle the Doppler device to locate arterial flow. (C)</p> Signup and view all the answers

Why is it important to avoid excessive pressure when using the Doppler ultrasound on severely diseased arteries?

<p>It risks collapsing the artery being assessed. (C)</p> Signup and view all the answers

What is one of the factors that can influence the detection of arterial flow during an ABI assessment?

<p>Presence of collateral circulation. (D)</p> Signup and view all the answers

What can be inferred from a progressive decrease in systolic pressure distally in the context of the ABI?

<p>There may be an arterial stenosis at the involved sites. (A)</p> Signup and view all the answers

What primarily determines the amount and direction of fluid movement across the capillary walls?

<p>The equilibrium between hydrostatic and osmotic forces as well as capillary permeability (C)</p> Signup and view all the answers

What condition leads to edema due to an imbalance in fluid exchange?

<p>Damage to capillary walls increasing permeability (D)</p> Signup and view all the answers

Which of the following factors has the most significant impact on vascular resistance?

<p>Vessel radius (C)</p> Signup and view all the answers

What occurs primarily at the venous end of the capillary regarding fluid exchange?

<p>Net reabsorption of fluid predominates over hydrostatic pressure (B)</p> Signup and view all the answers

What is the primary consequence of an elevated venous pressure in relation to fluid exchange?

<p>Increased hydrostatic pressure pushing more fluid into the tissues (B)</p> Signup and view all the answers

Which statement about capillary permeability is true under normal conditions?

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

Which component is primarily responsible for creating osmotic pressure that pulls fluid back into the capillary?

<p>Plasma proteins in the blood (B)</p> Signup and view all the answers

How does a large increase in hematocrit affect capillary blood flow?

<p>It increases blood viscosity and reduces flow (C)</p> Signup and view all the answers

What is the primary significance of inspecting skin color and temperature in physical assessments?

<p>It aids in diagnosing arterial disorders. (C)</p> Signup and view all the answers

Which of the following best describes 'rubor' in skin assessment?

<p>A reddish-blue discoloration after placing an extremity in a dependent position. (D)</p> Signup and view all the answers

What complication can arise when palpating pulses in edematous extremities?

<p>Potential misidentification of pulses. (D)</p> Signup and view all the answers

What does a lack of peripheral pulse suggest about arterial conditions?

<p>It suggests potential stenosis or occlusion. (B)</p> Signup and view all the answers

How should pulses be palpated for an accurate assessment?

<p>Both sides should be compared simultaneously for symmetry. (A)</p> Signup and view all the answers

What might bilateral edema in an extremity indicate?

<p>Chronically dependent position due to rest pain. (C)</p> Signup and view all the answers

Which sign might indicate necrosis due to reduced nutrient supply?

<p>Brittle nails. (C)</p> Signup and view all the answers

What is necrosis primarily caused by in the context of arterial disorders?

<p>Prolonged ischemia or lack of blood flow. (A)</p> Signup and view all the answers

What is the primary purpose of exercise testing in patients?

<p>To determine walking distance and ankle blood pressure response (B)</p> Signup and view all the answers

What is a normal response of ankle systolic pressure after exercise?

<p>No change in pressure (B)</p> Signup and view all the answers

What preparation is required for a patient undergoing abdominal vascular duplex ultrasound?

<p>Stay NPO for at least 6 hours (C)</p> Signup and view all the answers

Which factor could disqualify a patient from completing an exercise test?

<p>Severe orthopedic problems (D)</p> Signup and view all the answers

What does duplex ultrasonography predominantly use for imaging?

<p>B-mode grayscale imaging (B)</p> Signup and view all the answers

Which technology can help identify vessels during a duplex ultrasound?

<p>Color flow techniques (D)</p> Signup and view all the answers

What does the combination of hemodynamic information and walking time help determine?

<p>If intervention is necessary (B)</p> Signup and view all the answers

Which statement is true regarding the modification of exercise testing?

<p>It may be adjusted based on the patient's condition (B)</p> Signup and view all the answers

Flashcards

Systemic Circulation

The circulation of blood throughout the body, delivering oxygen and nutrients to tissues and removing waste products.

Pulmonary Circulation

The flow of blood from the heart to the lungs and back, where it picks up oxygen and releases carbon dioxide.

Aorta

The large artery carrying oxygenated blood from the left ventricle to the rest of the body.

Superior Vena Cava

The large vein that returns deoxygenated blood from the upper body to the right atrium of the heart.

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Inferior Vena Cava

The large vein that returns deoxygenated blood from the lower body to the right atrium of the heart.

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Capillary Filtration

The process of fluid moving from the blood plasma inside capillaries into the surrounding tissue spaces.

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Capillary Reabsorption

The process of fluid moving from the tissue spaces back into the capillaries.

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Hydrostatic Pressure

The force exerted by the pressure of blood inside capillaries that drives fluid out.

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Osmotic Pressure

The force exerted by plasma proteins, primarily albumin, that pulls fluid back into the capillaries.

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Peripheral Vascular Resistance

The resistance to blood flow within blood vessels, mainly influenced by the vessel diameter.

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Vasoconstriction

The narrowing of the blood vessels that increases resistance to blood flow.

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Vasodilation

The widening of the blood vessels that decreases resistance to blood flow.

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Edema

The accumulation of excess interstitial fluid in the tissues, often due to imbalances in capillary filtration and reabsorption.

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How does the sympathetic nervous system regulate blood flow?

The sympathetic nervous system, regulated by the hypothalamus, is the primary controller of blood vessel size and flow, affecting all vessels except capillaries and precapillaries.

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What neurotransmitter is responsible for vasoconstriction by the sympathetic nervous system?

When the sympathetic nervous system is activated, it releases norepinephrine which causes blood vessels to constrict, reducing blood flow.

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How do hormones influence peripheral vascular resistance?

Hormones like epinephrine (from the adrenal medulla) and angiotensin II (produced by the kidneys) can also constrict blood vessels, but their effects vary depending on the tissue and concentration.

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What substances regulate blood flow locally?

Nitric oxide, prostacyclin, histamine, bradykinin, prostaglandins, and muscle metabolites are some examples of substances that can locally dilate or constrict blood vessels.

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How do local factors affect blood flow?

Changes in oxygen levels, nutrient availability, and pH within tissues directly affect blood flow, along with inflammatory signals released from damaged vessels.

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What happens when there is reduced blood flow in peripheral vessels?

Ischemia, malnutrition, and tissue death may result if blood flow is inadequate to meet the needs of tissues.

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Why is restoring blood flow important?

Restoring adequate blood flow is crucial for tissue recovery and function.

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What determines the effects of reduced blood flow?

The balance between tissue oxygen and nutrient demand and supply determines whether reduced blood flow leads to tissue damage.

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Inadequate Peripheral Blood Flow

Reduced blood flow to tissues due to inefficient heart pumping action.

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Heart Failure with Reduced Left Ventricular Ejection Fraction (HFrEF)

Heart failure where the heart can't pump blood effectively, causing blood to build up in the lungs and reduce forward blood flow.

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Heart Failure with Preserved Left Ventricular Ejection Fraction (HFpEF)

Heart failure where the heart can't relax properly, leading to congestion and reduced blood flow.

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Arterial Damage or Obstruction

Damage or obstruction of arteries, caused by factors like plaque, clots, or trauma, leading to decreased blood flow.

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Reduced Venous Blood Flow

Reduced blood flow in veins due to blockage, valve problems, or muscle weakness, leading to increased venous pressure and edema.

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Peripheral Vascular Diseases

Conditions where the blood supply to the extremities is inadequate, leading to symptoms like pain, skin changes, and edema.

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Peripheral Vascular Disease (PVD)

A category of peripheral vascular disease affecting arteries, veins, or lymph vessels, causing reduced blood flow and various symptoms.

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Intermittent Claudication

Pain that occurs with exertion and subsides with rest, often in the legs due to insufficient blood flow.

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Dependent Rubor

Redness of the skin that appears when the limb is dependent, but turns pale when elevated. Indicates poor blood supply.

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Arterial Ulcers

Ulcers that typically occur on the toes, web spaces, or heels due to poor blood flow to the extremities.

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Gaiter Area

An area of skin discoloration, usually around the ankles, a sign of venous insufficiency.

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Venous Ulcers

Ulcers often found around the ankles, especially the medial and lateral malleoli, due to poor venous return.

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Peripheral Arterial Insufficiency

The inability of the arterial system to provide adequate blood flow to tissues during exercise, leading to pain and discomfort.

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Rest Pain

Persistent pain in the forefoot when resting, indicating a critical state of arterial insufficiency.

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Arterial Lumen Obstruction

The narrowing of an artery's lumen or cross-sectional area, often causing reduced blood flow.

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Claudication Distance

The amount of exercise or the distance a patient can walk before developing pain due to peripheral arterial insufficiency.

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Vascular Assessment

The evaluation of the patient's skin color, temperature, and peripheral pulses to diagnose arterial disorders.

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Claudication Localization

The process of assessing the location of the claudication to deduce the location of the diseased vessel.

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Ischemia

The condition where tissues are deprived of adequate oxygen supply due to reduced blood flow.

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Doppler Ultrasound Flow Studies

A diagnostic tool that uses sound waves to detect blood flow in vessels, particularly when pulses cannot be felt.

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Doppler Ultrasound Frequency and Depth

The depth at which Doppler ultrasound can detect blood flow is determined by the frequency of the emitted sound waves. Lower frequencies penetrate deeper tissues.

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Interpreting Doppler Signals

The Doppler signal is processed and displayed as audio output, allowing healthcare providers to interpret the sounds as arterial or venous blood flow characteristics.

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Continuous Wave (CW) Doppler

A handheld device that emits continuous sound waves to detect blood flow in vessels.

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Doppler Probe Frequency for Arteries

A probe with a frequency of 5 to 10 MHz is commonly used to examine peripheral arteries.

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What is the Ankle-Brachial Index (ABI)?

A non-invasive test that measures the blood pressure in the ankles and compares it to the blood pressure in the arms. It's used to assess for narrowing or blockage of arteries in the legs.

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What does a low ABI indicate?

When the ABI is lower than 0.9, it suggests a narrowing in the arteries, indicating potential arterial disease. A value of 0.9 or above indicates normal blood flow in the legs.

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How can collateral circulation affect ABI results?

The presence of collateral circulation can affect the results of an ABI test. It can create alternate routes for blood flow, potentially making the results appear more normal than they truly are.

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How does Doppler ultrasound contribute to ABI testing?

The Doppler transducer is used to detect the sound waves from blood flow in arteries. It's a key tool for evaluating the ABI and assessing peripheral circulation.

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Why is it essential to avoid excessive pressure during ABI testing?

Excessive pressure during ABI testing can collapse severely diseased arteries, leading to inaccurate results. This often happens in cases of advanced peripheral artery disease.

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Rubor

A reddish-blue discoloration of the skin that appears within 20 seconds to 2 minutes after placing the extremity in a dependent position. It suggests severe peripheral arterial damage where vessels cannot constrict and remain dilated.

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Cyanosis

A bluish tint of the skin caused by reduced oxygenated hemoglobin in the blood.

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Pallor

A whiter or more blanched appearance of the skin, resulting from further reduction of blood flow.

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Other skin changes

Loss of hair, brittle nails, dry or scaling skin, atrophy, and ulcerations are all signs that can indicate a chronically reduced nutrient supply.

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Gangrene

Tissue death that occurs after prolonged and severe lack of blood flow (ischemia).

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Palpation of Pulses

The process of determining the presence, absence, and quality of peripheral pulses, which is crucial for assessing the status of peripheral arterial circulation.

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Stenosis

A narrowing or constriction of a blood vessel that can impair blood flow and reduce or eliminate palpable pulsations.

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Exercise Testing

A test that measures how long a patient can walk and the change in ankle systolic blood pressure after exercise, used to assess arterial blood flow.

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Duplex Ultrasonography

An imaging technique that combines ultrasound with Doppler technology to visualize blood vessels and measure blood flow.

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Claudication

A symptom of arterial insufficiency, characterized by pain in the legs or arms due to inadequate blood flow during exercise.

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Little or No Drop in Ankle Systolic Pressure

A normal response to exercise testing, indicating healthy blood flow.

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True Vascular Claudication

A condition where the ankle pressure drops significantly after exercise, suggesting arterial insufficiency.

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Venous Duplex Ultrasonography

A noninvasive test that uses ultrasound to evaluate veins for blockages, abnormalities, and blood flow.

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Duplex Ultrasonography Imaging Techniques

The use of B-mode grayscale imaging to visualize tissues and organs, combining with Doppler technology to assess blood flow.

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NPO Status

A medical term meaning 'nothing by mouth,' instructing patients to abstain from eating or drinking prior to an examination.

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