1.

Which of the following layer of the blood vessel is in direct contact with the red blood
cells?
a. Tunica media
b. Tunica externa
c. Tunica intima
d. Tunica submucosa

2. In a typical flow in blood vessel, which of the following has the most significant influence
on the resistance in the blood vessel?
a. Length of the blood vessel
b. Diameter of the blood vessel
c. Viscosity of the blood vessel
d. Reynolds number of the blood vessel

3. With a given flowrate, blood flowing through a narrowed (stenosis) region of a blood
vessel will have
a. Reduced velocity and reduced pressure
b. Increased velocity and reduced pressure
c. Increased velocity and increased pressure
d. Reduced velocity and increased pressure

4. Which is NOT applicable to the Bernoulli’s Equation

a. Pulsatile flow
b. Steady flow
c. Laminar
d. Streamline

5. Capillary filtration occurs when

a. Hydrostatic pressure is lower than the oncotic pressure
b. Oncotic pressure is higher than the hydrostatic pressure
c. Oncotic pressure is equal to the hydrostatic pressure
d. Hydrostatic pressure is higher than oncotic pressure

6. Small molecules are typically flow limited because

a. Their diffusion across the capillary wall happen very slowly
b. The only limitation to net movement across the capillary wall is the rate at which
blood flow transports the molecules to the capillary
c. There are low concentration of small molecules at the precapillary vessels
d. In comparison to large molecules, the permeability of a capillary to a small solute
molecule limits its transport across the capillary wall
7. T-tubules is deep invagination of the
a. Sacromere
b. Sacroplasmic Reticulum
c. Sacrolemma
d. Syncytium

8. Which of the following is the CORRECT electrical propagation sequence in the heart ?
a. AV -> SA -> Bundle of His -> Atria -> Purkinje fibers -> Ventricles
b. SA -> AV -> Atria -> Bundle of His -> Purkinje fibers -> Ventricles
c. SA -> Bundle of His -> AV -> Atria -> Ventricles -> Purkinje fibers
d. SA -> Atria -> AV -> Bundle of His -> Purkinje fibers -> Ventricles

9. Which of the statement is INCORRECT

a. Electrical conduction is fastest in the SA and AV nodes
b. AV node ensures that the atria is sufficient contracted before the ventricles contract
c. Myocardium conduction refers to the atria and ventricles
d. Bundle of His has fast action potential

10. Which is the INCORRECT statement of smooth muscle cells

a. Have rudimentary sarcoplasmic reticulum but no transverse tubules
b. Electrically coupled at gap junction—function as a syncytium
c. Irregularly shaped, joined into bundles or sheets by adherens junctions
d. Have Actin/myosin ratio of 1:3

11. What is 25 dynes/cm2 in Pascal (n/m2)?

2.5N/m2

12. What is 3.5 cP in Pascal second?

3.5 x 10-3 Pa.s

13. What is the difference between Dynamic viscosity and Kinematic viscosity?
ν = µ/ρ , kinematic viscosity is usually used in cases where the specific gravity of the
solution changes with time like in some oils when they degrade. For our CV lecture,
blood viscosity is constant, so we use Dynamic Viscosity, µ instead

14. If you have a Casio watch with a water resistant rating of 20bar, how many meters
depth of water can you dive to?
Use the equation pressure, P = ρgh, if water density is assumed to be 1000 kg/cm3, and
g is 9.81 m/s2, P = 20 bar or 2000000 N/m2, h = 2000000/(1000 x 9.81) = 203 meters

15. What are the major assumptions for Poiseuille’s law?

See slide #17 of CV1
16. What are the major assumptions for Bernoulli’s equation?
See slide #14 of CV1

17. Sketch in the figure below the likely location of the boundary layer?

If you look closer you will see that the red dotted line follow the outer limit of the
boundary layer where the 'wall effect' becomes negligible. The velocity beyond that
limit or B. C. layer is no longer affected by the wall effect, and they become the same.

18. If you have an abdominal aortic aneurysm (AAA) of diameter that is triple the size of
your normal aorta, and blood velocity through the aorta is 0.5 m/s. Approximate the
blood pressure in the aneurysm. Assume blood density of 1060 kg/m3 . (clue: use
Bernoulli’s equation). Explain why patient with untreated aneurysm is at risk of
aneurysm rupturing.

Use Bernoullis equation, P1 + ½ ρv21 + ρgh1 = P2 + ½ ρv22 + ρgh2

If patient lying on the bed, then ignore ρgh, so you are left with
P1 + ½ ρv21 = P2 + ½ ρv22
P2 – P1 = ½ ρv21 - ½ ρv22
∆P = ½ ρv21 - ½ ρv22

Use continuity equation, ρ1A1v1 = ρ2A2v2, density ρ can be removed since blood density
assumed the same throughout. You are left with
A1v1 = A2v2
Solving for v2 = A1v1/ A2 = A1(0.5m/s)/ 9.0 x A1 = 0.0556 m/s
 Now going back to
∆P = ½ ρv21 - ½ ρv22
∆P = ½ρ (v21 - v22) = ½ (1060)(0.52 – 0.05562) = 130.9 Pa

19. Calculate the absolute pressure at a depth of 5m in a swimming pool (in Pascal).
In our case, absolute pressure is atm pressure + gauge pressure.
Absolute pressure = atm pressure + pressure at the depth of 5 m swimming pool
Pabsolute = Patm + ρgh1 = 101325 N/m2 + (1000 x 9.81 x 5)N/m2 = 150375 N/m2

20. What is the difference between laminar and turbulent flow and how does the latter
alter the pressure-flow relationship?

See slides #17 and #21 of CV1 for the difference in velocity vectors. In turbulence, there
is significant crossing of velocity vectors that lead to dissipation of energy (pressure) into
eddies. As a result, we see higher pressure drop in turbulence flow than in laminar flow.

You can see similar energy lost in constricted or stenosis flow where pressure energy is
dissipated into other flow like recirculation flow. Pressure will tend to recover after the
stenotic region but not completely, invariably some useful pressure energy is lost.

21. What stimulates the formation of nitric oxide and what are its vascular effects?
See slide #31 and #32
22. Describe the anatomy of the heart, including: cardiac chambers and valves, and the
great vessels entering and leaving the heart.
See slide #4 of CV2.

23. Sketch the flow profile through a tube as shown below and label where it is for
a. Boundary layer
b. Recirculation flow
c. Flow separation

The profile is similar to stenosic vessel as shown above.

24. What causes the murmur sounds in our heart?

Heart valves closing and opening, and the turbulence nature of the flow through these
valves. Diseased heart valves that do not open or close completely will increase the
chance of turbulence flow through them, leading to murmur sounds from the heart.

25. The following exercise will help you understand the physiological and clinical relevance
of Laplace Law. For sphere as in heart muscle, Laplace law can be written as s = P.r/2.h
where P is pressure, r is radius of the heart chamber, and h is the thickness. The ratio
r/h is a main determinant of the wall stress. The radius of curvature of the left ventricle
is smaller at the apex than at the base, and so is the wall thickness h. The ratio r/h at the
apex and base is, however, the same, resulting in similar wall stress at these locations in
the wall. In cases of hypertension (high blood pressure), and based on the Laplace Law,
 what will happen to the left ventricle when it is subjected to chronic elevated level of
blood pressure? (Clue: What do you think the heart will do in order the s is maintained
at normal level?). What is the long term repercussion of this remodeling? What is the
clinical term for this?
Please see separate attachment (question 25) in IVLE.

26. Calculate the Reynolds number at the aorta. (CO is 6 litre/mins, aorta radius is 1.5cm,
blood density and viscosity is 1.06 g/cm3 and 3.5 cP, respectively)
Use these equations Re = ρud/µ and Q = uA
Convert 6 litre/min to SI unit, is 0.0001 or 1.0 x 10-4 m3/s
1.0 x 10-4 m3/s = u x (πr2) = u x (3.1415 x 0.0152)
u = 0.141 m/s
Re = ρud/µ = (1060 x 0.141 x 0.03)/3.5 x 10-3 = 1281

27. Figure below shows a stenotic vessel, sketch the flow profile through this stenosis and
label where turbulence can happen.

Pretty much similar to question 23 above.

28. Calculate the flowrate at the end of the L-shape tube (label point B). Assume atm
pressure at point B
a. Calculate for water
b. Calculate for blood
c. Which has the higher flow rate at point B and why.

0.6 cm
1m

0.2 cm
B

1.2 m

Assuming densities of water and blood are 1000 and 1060 kg/m3 respectively.
 Use ρgh to calculate the hydrostatic pressure exerted by the water/blood column. The
diameter of the vertical tubing has no effect to the hydrostatic pressure.
ρgh = 1000 x 9.81 x 1 = 9810 Pa or N/m2
This will be your driving pressure, or P0
Next use Poiseuille's law, which states that Q = (π(P0 – P1) r4)/8ηL
Assume P1 is atm, which is zero for this case.
Water viscosity is 1cP and blood is 3.5 cP
Q = (3.1415 x (9810 - 0) x (1 x 10-3)4)/8 x 1 x 10-3 x 1.2 = 3.2 x 10-6 m3/s
Repeat the above for blood and you will get 9.72 x 10-7 m3/s

Water has higher flow rate because of the viscosity of the blood which is higher.

29. Why do most pressure drop occur in the arterioles?

Please see separate attachment (question 29) in IVLE.

30. Suppose that a catheter is inserted into the aorta, the largest artery of the body, to
measure the local blood pressure and velocity (found to be 1.4 x 104 Pa and 0.4 m/s) as
well as to view the interior of the artery. If the inside diameter of the aorta is found to
be 0.02 m and a region of the aorta is found with a deposit due to atherosclerosis where
the effective diameter is reduced by 30%, find the blood velocity through the
constricted region and the blood pressure change in that region. For this problem
assume that blood is an ideal fluid and its density is 1060 kg/m3

The unknown velocity can be determined from the continuity equation to be

v 2 = v 1(A1/A2) = v 1(d1/d2)
where the diameters d are given in the ratio of 1:0.7. The blood velocity in the constricted
region is then found to be v2 = 0.4(1.0/0.7)2 = 0.82 m/s. Knowing the velocities and the
density of blood, we can use Equation (8.12) to find the pressure difference at the
constricted region. We find
 P1 – P2 = 1/2ρ(v22 – v21) = 0.5(1060)(0.822 – 0.42) = 270 Pa
so that the local pressure in this region is reduced by only about 2%.

31. In giving a transfusion, blood drips from a sealed storage bag with a 1 m pressure head
through capillary tubing of 2 mm inside diameter, passing through a hypodermic needle
that is 4 cm long and has an inside diameter of 0.5 mm. If the blood pressure within the
vein into which the blood is being transfused is at a gauge pressure of 18 mmHg, find
how long it will take to give the patient 1 L of blood. How long will it take if the inside
diameter of the needle is only 0.4 mm?

Since the flow rate depends so strongly on the radius of the capillary, the most
resistance to flow will occur within the hypodermic needle and relatively little within the
delivery tubing. We can therefore apply the Poiseuille's law (slide 17 of CV1 lecture
notes) using the radius and length of the needle, ignoring the dimensions of the tubing.
For the net driving pressure across the column of blood up to the vein we use a value of
P = (ρgh - 18 mmHg) = (ρgh - 2400 N/m2), where the density of blood is assumed to be
density is 1060 kg/m3
We find a flow rate of

Q = (π(P0 – P1) r4)/8hL = (π[(1.06 x 103)(9,8)(1) – 2400](0.00025)4)/8(4 x 10-3) (0.04)

= 7.7 x 10-8 m3/s = 0.077cm3/s

With this flow rate, each cm3 of blood will take 13 seconds to flow into the vein, so that
it will take a total time of 3.6 hours for a liter of blood to be transfused. If the r value is
0.2 mm then the flow rate will decrease by the factor (2/2.5)4 = 0.41 and so it will take
3.6/0.41 = 8.8 h. We see that a decrease in the radius by a factor of only 0.8 increases
the time required by almost 2.5 times, pointing out the very strong dependence on r.

32. Your blood pressure varies not only periodically in time with your heartbeat, but also
spatially at different heights in the body. This variation is due to differences in the
weight of the effective column of blood in your blood vessels as a function of height in
the body. Assuming that the average blood pressure at the heart is 13.2 kPa
(corresponding to the average of a high and low pressure of 120/80), find the blood
pressure at foot level (1.3 m below the heart) and at head level (0.5 m above the heart).

At the level of the feet, the blood pressure is increased over that at the heart by the
amount

ΔP = ρgh = 1060 x 9.8 x 1.3 = 13.5 kPa

so that the blood pressure there is 26.7 kPa (twice that at the heart, or roughly 200 mm
Hg, by simple proportion).
ΔP = ρgh = 1060 x 9.8 x 0.5 = 5.2kPa
Similarly the blood pressure in the head is, using the same expression, reduced by to a
value of 8.0 kPa (or 61 mm Hg).

Blood pressure taken at the arm near the heart will ensure a more accurate measurement
of blood pressure at the heart.