03b: EKG and CO Flashcards
ECG records changes in (X) versus (Y).
X = electrical potential Y = time
Upward deflection of ECG is indicative of (X) at (positive/negative) electrode.
X = positivity at positive electrode OR negativity at negative electrode
The same size dipole can generate smaller or larger signal, depending on (X).
X = orientation with lead axis
Lead I positive and negative electrodes.
Neg: RA
Postiive: LA
Lead II positive and negative electrodes.
Neg: RA
Positive: LL
Lead III positive and negative electrodes.
Neg: LA
Positive: LL
(X) event in cardiac cycle accounts for most of PR interval in ECG.
X = AV nodal delay
T wave: (upward/downward) deflection of (de/re)-polarization is due to (endo/epi)cardial fibers repolarizing before (endo/epi)cardial fibers.
Upward;
Repolarization (ventricles);
Epicardial;
Endocardial
Resultant vector of T wave points in which direction(s)? This is the same orientation as which other ECG deflection?
Down and to the left;
R-wave
T wave lasts (shorter/longer) than QRS complex. This is because (depolarization/repolarization) spreads at slower velocity.
Longer;
Repolarization
Sympathetic stimulation of ventricular muscle increases (X) of contraction.
X = force and velocity
Since (X) of (veins/arteries) is (Y) times greater than (veins/arteries), to achieve the same change in pressure in vessels of same dimensions, (Y) times the volume would have to be added.
X = distensibility;
Veins;
Y = 5-6
Arteries
The volume of blood flowing through
the circulatory system during a given time period.
CO
T/F: CO of LV equals CO of RV.
True
CO units.
L/min
CO is equal to product of (X) and (Y).
X = SV Y = HR
Cardiac index is based on the fact that (X) is (directly/indirectly) proportional to (Y).
X = CO
Directly;
Y = body surface area
The Fick principle is a (direct/indirect) method to measure (X). What’s the equation?
Indirect;
X = CO
CO = (O2 uptake by lung)/([O2]a-[O2]v)
Indicator dilution method is one in which (known/unknown) quantity of (X) is injected into (Y).
Known;
X = dye
Y = blood stream in central vein or heart
Indicator dilution method: where is the detector?
Downstream artery
Increase venous return results in (increase/decrease) in SV. This is due to (increase/decrease) in (X) in (Y) chamber.
Increase;
Increase;
X = P and V
Y = RA
Starling stated the Law of the Heart:
E of contraction is function of length of muscle fiber
EDV increases. This results in (increase/decrease) preload, aka (X). Explain.
Increase;
X = EDP
Increase in length of muscle fibers, leading to increase in passive P in ventricle
For given sarcomere length, (cardiac/skeletal) muscle is likely to have more active tension.
Skeletal
The heart normally functions along (ascending/descending/both) limb(s) of PV curve.
Ascending
Cardiac Length v Active Tension curve is (more/less/equal) in steepness as Skeletal muscle.
More
Cardiac Length v Passive Tension curve is (more/less/equal) in steepness as Skeletal muscle.
More
The shortest sarcomere length at which active tension can be developed is (shorter/longer/equal) in cardiac muscle compared to skeletal muscle.
Longer
Length-Tension curve: It’s been demonstrated that an increase in (X) of cardiac muscle causes increase in (Y). This accounts for steep curve rise.
X = sarcomere length Y = myofilament sensitivity to Ca
For given sarcomere length, (cardiac/skeletal) muscle is likely to have more passive tension. What’s the reason for this?
Cardiac;
Prevents chambers from over-filling
Heterometric regulation explains the regulation of (X) in response to changes in (Y). This is considered a(n) (intrinsic/extrinsic) property of the heart.
X = SV
Y = venous return
Intrinsic
Stimulation of sympathetic nerves or infusion of (X) results in (increased/decreased) contractility. This is simply defined as increased (Y) at a given (Z).
X = epi
Increased;
Y = force capability
Z = EDV
Regulation of (X) is “homeometric”, because it’s (dependent/independent) of (Y).
X = contractility
Independent
Y = change in length
T/F: Sympathetic stimulation increases ESV.
False - decreases ESV (by increasing SV)
T/F: Sympathetic stimulation increases EF.
True
EF at rest is typically (X)% of (Y). How does that change during exercise?
X = 50-67 Y = EDV;
Can increase to 80% during exercise
Maximum rate of rise of ventricular pressure is a measure of (X) of the ventricle.
X = contractility
Binding of Epi to (X) receptor in heart activates G protein that (increases/decreases) activity of (Y).
X = B1
Increases;
Y = AC
Epinephrine results in (increase/decrease) of cAMP, resulting in direct (activation/suppression) of (X). What does this then do?
Increase;
activation;
X = PKA
Phosphorylates:
- Phospholamban
- L-type Ca channels
- Troponin I
- Titin
Epi’s effect on (X)-type Ca channels results in (increase/decrease) Ca conductance. This has which effect on Ca release from SR?
X = L
Increase;
Also increases Ca release from SR
Phospholamban, under normal conditions, has which function?
Blocks SR Ca reuptake pump
Epi causes (dephosphorylation/phosphorylation) of (X), removing its restraint on (Y) and causing (increase/decrease) in Ca reuptake by SR.
Phosphorylation;
X = Phospholamban
Y = SR Ca reuptake pump
Increase
Epi causes (increase/decrease) in duration of contractile response and (increase/decrease) rate of relaxation. This is done via (phosphorylation/dephosphorylation) of (X).
Decrease;
Increase;
Phosphorylation;
X = Phospholamban
What’s Epi’s effect on titin via (X) of titin?
X = phosphorylation
Decreases its stiffness (reduced passive wall tension), facilitating ventricular filling
T/F: Changes in heart rate affect contractility.
True
Increase in HR has (positive/negative) ionotropic effect due to (increase/decrease) in (X).
Positive;
Increase
X = cytoplasmic Ca availability
The (X) is commonly considered the left ventricular muscle’s afterload.
X = aortic diastolic P
A high afterload affects ejection in which ways?
- Delayed ejection
2. Reduced rate of ejection
Why would high afterload result in ejection delay?
Longer time required for ventricular pressure to reach aortic pressure
T/F: Afterload for heart is essentially identical during ejection period.
False - changing, tracking ventricular chamber pressure
Stroke work is product of (X) and (Y).
X = average P Y = SV
Minute work is product of (X) and (Y).
X = average P Y = CO (HR*SV)
Area of PV loop represents:
Stroke work
The Law of Laplace: the (X) that ventricle must develop to produce given (Y) is influenced by (Z).
X = wall tension Y = P Z = radius
Wall stress increases proportionally with (X) and is inversely proportional to (Y).
X = radius Y = wall thickness
Wall stress equation: stress increases with increase in (X).
X = P and radius
Wall stress equation: stress increases with decrease in (X).
X = h (thickness of wall)