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Cardiopulm > 1- Anatomy and Physiology > Flashcards

1- Anatomy and Physiology Flashcards

1
Q

__ side: heart extends from 2nd costal cartilage to 5th intercostal space

A

right

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2
Q

___ side: heart extends from the 3rd to 6th costal cartilage about 10-15 mm from sternum

A

left

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3
Q

___ of heart is the largest portion: lies to the left of the mid sternal line

A

apex

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4
Q

4 layers of heart?

A

outer to inner:
1. parietal pericardium
2. visceral pericardium
3. myocardium
4. endocardium

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5
Q

___: encloses the heart, contains two layers

A

pericardium

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6
Q

___ pericardium: a fibrous relatively unyielding outer layer that forms a sac, contains terminal branches of several blood vessels

A

parietal

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7
Q

___ pericardium: inner layer forms pericardial fluid to moisten the heart to prevent friction and maintains the heart in position

A

visceral

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8
Q

another word for visceral pericardium?

A

epicardium

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9
Q

___: cardiac muscle fibers provide the work in distributing blood to the heart

A

myocardium

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10
Q

____: innermost layer that lines the heart contains smooth muscle

A

endocardium

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11
Q

Left atrium: receives oxygen rich blood from the ___ ___ and sends it to the left ventricle through the ____ (____) valve

A

pulmonary vein, mitral, bicuspid

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12
Q

Right atrium: receives blood from the superior and inferior vena cava and sends it to the right ventricle through the ____ valve

A

tricupsid

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13
Q

left ventricle: ejects blood through the ___ valve into the aorta

A

aortic

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14
Q

right ventricle: ejects oxygen deficient blood through the _____ valve into the ___ ___ which becomes the left and right pulmonary artery

A

pulmonic, pulmonary trunk

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15
Q

___: carry oxygen rich blood to peripheral tissues via pressure exerted by the heart and the elastic and contractile properties of the vessels

A

arteries

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16
Q

___: carry oxygen deficient and CO2 rich blood back to the heart via pressure exerted by contractions by the skeletal mm (large veins) and smooth mm (venules)

A

veins

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17
Q

large veins are made of ___ muscle

A

skeletal

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18
Q

venules are made of ____ muscle

A

smooth

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19
Q

larger muscle mass - arteries or veins?

A

arteries

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20
Q

has valves - arteries or veins?

A

veins

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21
Q

if blood is backflowing into the lungs, which side of the heart is most likely impaired?

A

left

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22
Q

if blood is backflowing into the body, which side of the heart is most likely impaired?

A

right

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23
Q

What two myofilaments does myocardial tissue contain, similar to skeletal muscle?

A

actin and myosin

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24
Q

Myocardium undergoes ___-___ phenomena similar to skeletal muscle?

A

excitation-coupling

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25
Q

3 properties of myocardial cells?

A
  1. automaticity
  2. rhythmicity
  3. conductivity
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26
Q

___: able to contract without external stimuli

A

automaticity

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27
Q

___: able to contract in a rhythmic manner

A

rhythmicity

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28
Q

___: nerve impulses can be transmitted from one myocardial ell to another due to intercalated disks that form a syncytium

A

conductivity

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29
Q

intercalated disks contain what two junctions?

A
  1. desmosomes
  2. connexins
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30
Q

Intercalated disks contains two junctions:
1. ___: attach one cell to another

A

desmosomes

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31
Q

intercalated disks contains two junctions:
2. ____: allow electrical impulses to spread from one cell to another

A

connexins

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32
Q

___ arteries supply the myocardium

A

coronary

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33
Q

___ coronary artery: supplies most of the right ventricle, AV node (55% of people) and SA node

A

right

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34
Q

parts of right coronary artery?

A

right posterior descending, right marginal

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35
Q

parts of left coronary artery?

A

left anterior descending, left circumflex arteries, left marginal

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36
Q

___ coronary artery: supplies left ventricle, left atrium, ventricular septum and SA node (45% of people)

A

left

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37
Q

___ ___: functions as “pacemaker” of the heart; must set a pace of depolarization faster than any other myocardial cell

A

sinoatrial node

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38
Q

sinoatrial node paces the heart to beat >___ bpm without any other input

A

100

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39
Q

____ nervous system: neurotransmitter (norepinephrine) increases heart rate and myocardial contractility

A

sympathetic

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40
Q

____ nervous system (via vagus nerve): neurotransmitter (acetylcholine): decreases heart rate and myocardial contractility to 60-90 bpm

A

parasympathetic

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41
Q

Cardiac conduction:
1. SA node transmits impulses to the ___ to cause them to contract first
2. excitation impulses are then sent to the ___ ___ (located at the floor of the right atrium) to cause the ventricles to contract; about ___ seconds later

A

atria
AV node
0.04

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42
Q

AV node can spontaneously discharge without external stimuli at a rate of ___ bpm

A

40-60

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43
Q

AV node impulses are transmitted to the ventricular myocardium through ___ ___ ____

A

bundle of His

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44
Q

Bundle of His:
- divides into a left and right bundle branch at the ___ ____ to innervate each respective ventricle
- bundle branches further divide into smaller nerve fibers called ___ ___ to cause the ventricles to contract

A

intermuscular septum
pukinje fibers

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45
Q

Why is the SA node susceptible to disease?

A
  1. proximity to the epicardium (pericarditis)
  2. coronary artery occlusion
46
Q

Why is the AV node susceptible to disease?

A

right coronary artery occlusion

47
Q

possible manifestations of hypokalemia?

A

arrhythmias, mm cramps especially if taking a diuretic

48
Q

possible manifestations of hyperkalemia?

A

nausea and vomiting

49
Q

normal potassium levels?

A

3.5-5.0 mEq/L

50
Q

possible manifestations of hypercalcemia?

A

erratic cardiac contraction

51
Q

possible manifestations of hypocalcemia?

A

decreased myocardial contractility

52
Q

normal calcium levels?

A

9-11 mg/dl

53
Q

one cardiac cycle lasts about ___ second for a HR of 75 bpm

A

0.8

54
Q

cardiac cycle contains two primary phases based on ventricular activity:

A

systole and diastole

55
Q

equation for cardiac output?

A

CO= HR x SV

56
Q

___ L of blood at rest?

A

5-6

57
Q

blood volume may increase by ___x the resting level with exercise

A

4-7x

58
Q

equation for BP?

A

BP = HR x SV x total peripheral resistance

59
Q

Cardiac output affects ___ BP

A

systolic

60
Q

TPR affects ___ BP

A

diastolic

61
Q

MAP equation?

A

MAP = DBP + 1/3(SBP-DBP)

62
Q

normal MAP assuming a BP of 120/80?

A

about 93

63
Q

MAP is an important measure to assess for patients with ___?

A

hypotension

64
Q

at what MAP would you question whether to get patients up?

A

< 60 mmHg

65
Q

4 factors that mean arterial blood pressure (MAP) is determined by?

A
  1. blood volume
  2. effectiveness of the heart as a pump (cardiac output)
  3. resistance of the system to blood flow
  4. relative distribution of blood between arterial and venous blood vessels
66
Q

what would have a higher BP? standing or laying supine

A

laying supine

67
Q

term for the difference between systolic and diastolic pressure?

A

pulse pressure

68
Q

term for end diastolic volume?

A

preload

69
Q

cardiac ____: amount of left ventricular blood volume prior to contraction

A

preload

70
Q

4 factors cardiac preload is dependent on?

A
  1. venous return
  2. total blood volume
  3. left atrial contraction
  4. frank starling law
71
Q

cardiac __: amount of resistance (pressure) encountered by the left ventricle (aortic pressure)

A

afterload

72
Q

___ ___: neural and hormonal influences to the myocardium that affects strength of contraction

A

myocardial contractility

73
Q

During exercise, SV increases up to about ____% of VO2 max then levels off

A

40-60%

74
Q

if preload increases, does SV increase or decrease?

A

increase

75
Q

if afterload increases, does SV increase or decrease?

A

decrease

76
Q

if inotropy increases, does SV increase or decrease?

A

increase

77
Q

___: strength of contraction

A

inotropic

78
Q

___ ___: amount of ventricular blood volume pumped per heart beat

A

ejection fraction

79
Q

ejection fraction equation?

A

EJ = SV / EDV

80
Q

normal ejection fraction values at the left ventricle?

A

55-70%

81
Q

systolic heart failure: results in ____ ejection fraction

A

low

82
Q

diastolic heart failure: results in ___ ejection fraction

A

normal (in some cases elevated)

83
Q

if stroke volume decreases, does EJ increase or decrease?

A

decrease

84
Q

AV valves are attached to respective ventricular surfaces via fibrous and muscular structures:
fibrous structure: ___ ___
muscular structure: __ __

A

chordae tendinae
papillary muscles

85
Q

Most (64%) of the blood volume is located where?

A

systemic veins and venules

86
Q

blood makes up ___% of an individuals body weight

A

7-8

87
Q

____: % of red blood cells in blood

A

hematocrit

88
Q

Blood functions:
- ___ oxygen and nutrients to the lungs and tissues
- forms blood ___ to prevent excess blood loss
- carries cells and antibodies that fight ___
- brings ___ products to the kidneys and liver, which filter and clean the blood
- regulates body ____

A

transports
clots
infection
waste
temperature

89
Q

4 main components of blood?

A
  1. plasma
  2. red blood cells
  3. white blood cells
  4. platelets
90
Q

What component of blood?
- transports red blood cells
- deliver nutrients to tissues
- act as a conduit to remove waste products
- carries antibodies, clotting proteins and hormones to select areas of the body
- maintain the body’s fluid balance

A

plasma

91
Q

___: not a blood cell, involved in the production of platelets to promote the clotting process

A

thrombocytes

92
Q

production of red blood cells is called ___. this takes place in ___ bone.

A

hematopoiesis, cancellous (spongy) aka bone marrow

93
Q

Bound O2: no increased SaO2 if PaO2 >/- ____ mmHg

A

> /- 50 mmHg

94
Q

blood oxygen concentration shift to the right = ___ release of O2

A

increased

95
Q

blood oxygen concentration shift to the left = ___ release of O2

A

decreased

96
Q

blood oxygen concentration shift depends on location:
- working muscles shift to the ___
- lungs shift towards the ___

A

right, left

97
Q

PERIPHERAL GAS EXCHANGE: autonomic nervous system
- under control of the ___
- receives input from the baroreceptors from carotid sinus and aortic arch on changes in BP
- ___ post ganglionic fibers innervate arterioles - very little input from parasympathetic nervous system
- increased activation causes ___
- reduced activation causes ____

A

hypothalamus, sympathetic, vasoconstriction, vasodilation

98
Q

4 factors that affect the movement of fluid in the microcirculation?

A
  1. capillary hydrostatic pressure
  2. capillary oncotic pressure
  3. interstitial hydrostatic pressure
  4. interstitial oncotic pressure
99
Q

PERIPHERAL GAS EXCHANGE:
___ ____ pressure:
- tends to move blood across the capillary membrane into the interstitium
- pressure originates from the blood pressure in the arterial system

A

capillary hydrostatic pressure

100
Q

PERIPHERAL GAS EXCHANGE:
____ ____ pressure:
- plasma proteins albumin increase osmolarity within the capillary vessels as compared to the interstitial fluid
- results in flow of interstitial fluid into the capillary circulation

A

capillary oncotic pressure

101
Q

PERIPHERAL GAS EXCHANGE:
___ ____ pressure:
- move fluid back into the microcirculation (capillaries)

A

interstitial hydrostatic pressure

102
Q

PERIPHERAL GAS EXCHANGE:
____ ____ pressure:
- draws fluid out of the microcirculation into the interstitium

A

interstitial oncotic pressure

103
Q

Fick equation to determine VO2?

A

VO2 = HR x SV x (a-VO2 difference)

104
Q

NET fluid exchange = ___ mmHg OUTWARDS from capillary

A

2

105
Q

PERIPHERAL CIRCULATION:
At rest:
- muscles receive about ___% of cardiac output
- mesenteric, splenic and portal tissues receive ___% of cardiac output
- brain and myocardium receive about ___ of cardiac output

A

10-15%, 20-30%, 5%

106
Q

PERIPHERAL CIRCULATION:
with vigorous exercise, muscles receive about ____% of cardiac output
- exercising muscle will require increased blood flow while tissue beds of other organs (gut) are reduced
- increased blood flow directed to the skin to promote cooling

A

80-85%

107
Q

oxygen delivery (DO2) ___ as tissue metabolism increases

A

increases

108
Q

oxygen consumption (VO2) ____ as tissue metabolism increases

A

increases

109
Q

at rest, ____ of oxygen is extracted from peripheral circulation

A

23%

110
Q

OXYGEN EXTRACTION RATIO:
normally, if DO2 decreases, VO2 does not:
- the tissues will utilize the same ___ amount of O2 that is present in the blood
- tissue metabolism will decrease to survive on a lesser ____ amount of O2

A

relative, absolute

111
Q
A

Cardiopulm (3 decks)

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