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A&P exam 2 > A&P exam 2 > Flashcards

A&P exam 2 Flashcards

1
Q

Extrinsic regulation is influenced by what two systems?

A
  1. nervous system

2. endocrine system

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2
Q

Bradycardia is an anticipated side effect of which type of medication?

A

beta blocker

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3
Q

Patients experiencing AFIB will often be given coumadin in order to prevent ___ in the ___

A

prevent clotting of blood in the atria

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4
Q

The QRS complex in an ECG represents

A

ventricular depolarization

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5
Q

TPR is regulated by changing the diameter of :

A

arterioles

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6
Q

Small changes in radius produce:

A

large changes in resistance

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7
Q

increasing release of epinephrine via B2 adrenergic receptors causes:

A

vasodilation

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8
Q

increase Ach release from cholinergic postganglionic sympathetic fibers causes vaso___:

A

vasodilation

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9
Q

alpha 1 and beta 1 release:

A

both NOREPI and EPI

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10
Q

beta2 releases:

A

only epinephrine

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11
Q

CO= ___ and is proportional to ____

A

venous return; metabolism

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12
Q

norepi and epi via B1 adrenergic receptors do what to HR?

A

increase HR

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13
Q

Acetylcholine via muscarinic cholinergic receptors do what to HR?

A

decrease HR

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14
Q

Stroke volume can be increased by:

A

increasing preload, increasing contractility and decreasing afterload

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15
Q

The heart pumps what it gets; therefore the heart will pump more when it gets more blood. so to increase preload __ venous return

A

increase

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16
Q

Afterload=

A

the load the heart has to content with after contraction starts; the load that cardiac muscle fibers must overcome before they can begin to shorten, before the heart can eject blood

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17
Q

Major causes of increased afterload:

A

high TPR/high MAP; high local resistance (ex: aortic stenosis)

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18
Q

ECG: one second=

A

5 large squares/ 25 small squares

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19
Q

ECG: one large square=

A

0.2 sec

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20
Q

ECG: one small square=

A

0.04 sec

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21
Q

P wave=

A

atrial depolarization

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22
Q

QRS wave=

A

ventricular depolarization

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23
Q

T wave=

A

ventricular repolarization

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24
Q

P wave triggers:

A

atrial systole

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25
Q

QRS wave triggers:

A

ventricular systole

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26
Q

T wave occurs:

A

just before ventricular systole

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27
Q

All arrhythmias are thought to be due to abnormal __ or __ of electrical impulses

A

generation or conduction

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28
Q

Abnormal sinus rhythms=

A

tachycardia and bradycardia

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29
Q

two types of ectopic foci=

A

PACs and PVCs

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30
Q

normal sinus rhythm= __ beats/min

A

75

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31
Q

tachycardia can be due to:

A

sympathetic stimulation, increased body temperature, deficient parasympathetic discharge

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32
Q

Bradycardia can be due to:

A

increased parsaympathetic tone and/or beta blockers

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33
Q

Timing between T wave of previous cycle and P wave of next cycle is small (P wave comes early)=

A

Premature atrial contraction (PAC)

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34
Q

In ___, QRS comes before P wave

A

PVCs

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35
Q

__ are among the most common arrhythmias and occur in people with and without heart disease. This is the skipped heart beat we occasionally experience

A

PVC

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36
Q

A dilated heart must work harder b/c when the radius of the ventricular lumen increases it takes greater ___ to produce the same increase in BP. This hemodynamic principle is known as the ___ law

A

tension; laplace’s

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37
Q

In a blood vessel with a high degree of compliance, a 200% increase in blood volume will affect pressure in the vessel in what way?

A

minimally

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38
Q

The direct effect of increasing TPR is:

A

increased afterload

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39
Q

The __ vessels provide blood supply to the heart

A

coronary

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40
Q

The __ vessels provide blood supply to the brain

A

carotid

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41
Q

When blood leaves the heart via the aorta what is the path of vessels that it most often takes to supply tissues?

A

arteries –> arterioles –> capillaries –> venules –> veins –> vena cava

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42
Q

__ are responsible for exchange of materials with tissues

A

capillaries

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43
Q

major site of vascular resistance=

A

systemic arterioles

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44
Q

__ have high compliance as compared to arteries

A

veins

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45
Q

The term venous return refers to what?

A

The amount of blood that returns to the heart following systemic circulation

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46
Q

What are some factors that promote venous return?

A

increased venous tone, increased blood volume, skeletal muscle pumping and venoconstriction

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47
Q

What adjective describes enlarged, overstretched superficial veins with compromised valves?

A

varicose

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48
Q

The ___ nervous system has chronotropic effects on the heart

A

parasympathetic

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49
Q

The __ nervous system displays chronotropic and inotropic effects on the heart

A

sympathetic

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50
Q

Autoregulation refers to the ability of a tissue to regulate its own ___

A

blood flow

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51
Q

A drop in pH will typically cause which response in a blood vessel?

A

vasodilation

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52
Q

The baroreceptors involved in the baroreceptor reflex are located where?

A

aortic arch and carotid sinus

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53
Q

ACE inhibitors are frequently used clinically for treatment of HTN. Which process is caused by ACE?

A

Angiotensin I to angiotensin II

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54
Q

Intrinsic cardiovascular control mechanisms=

A
  1. starlings law

2. autoregulation

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55
Q

The vasomotor center is located in the ___. It is responsible for coordinating ____ ___ information in the CV system and sending out an appropriate response by the autonomic nervous system

A

medulla oblongata; visceral sensory

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56
Q

HTN can result in cardiac hypertrophy and dilation. This occurs b/c the heart must work harder to overcome the increased ___ associated with high blood pressure.

A

afterload

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57
Q

In chronic HTN, the myocardium enlarges until it is overstretched and inefficient, resulting in decreased ___ of the heart

A

contractility

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58
Q

When blood backs up into the veins, the resulting condition is called venous ___

A

congestion

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59
Q

In HTN, which cardiovascular parameters are likely increased?

A

CO, TPR or both

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60
Q

Which of the following are used to treat HTN? B blockers; ACE inhibitors; sympathetic nervous system stimulants; thiazides; vasodilators

A

B-blockers; ACEi; thiazides; vasodilators

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61
Q

The leading cause of death in the US for men and women is ___

A

corondary artery disease

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62
Q

The pain associated with angina pectoralis is a symptom that the myocardium is what?

A

ischemic (oxygen deprivation)

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63
Q

Heart failure occurs when the heart doesn’t pump what it gets (low stroke volume- starlings law isn’t working). As a consequence, CO is decreased. The kidneys often try to compensate: the volume loading that occurs in chronic heart failure is an indication that renal control mechanisms are doing what?

A

working to increase blood pressure and cardiac output up to normal

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64
Q

Myocardial infarction is often the result of which of the following?
atherosclerosis; coronary artery disease; embolism in coronary vessel; stroke; hypotension

A

atherosclerosis; coronary artery disease; embolism in coronary vessel

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65
Q

ECGs are used to:

A

monitor the electrical events in cardiac conduction

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66
Q

The P wave on an ECG represents:

A

atrial depolarization

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67
Q

Tachycardia can result from activation of which receptor?

A

B1 adrenergic

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68
Q

calcium channel blockers are sometimes used to treat sinus tachycardia b/c CCBs:

A

slow the action potentials of pacemaker cells

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69
Q

In atrial flutter, the atria contract so quickly that:

A

ventricular filling is compromised

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70
Q

In a blood vessel with a high degree of compliance, a 200% increase in blood volume will affect pressure in which way?

A

minimally

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71
Q

If a vessel constricts so that its radius is half the original width, the rate of blood flow will change by how much?

A

blood flow will decrease by 16-fold

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72
Q

Relatively thin muscular walls and large diameter lumen refers to:

A

systemic vein

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73
Q

Arteries carry bloow __ the heart and __ the tissues

A

away; toward

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74
Q

Veins carry blood __ the heart and __ the tissues

A

towards; away from

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75
Q

An increase in sympathetic tone at systemic arterioles results in:

A

increased total peripheral resistance (TPR)

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76
Q

The sympathetic nervous system aids in venous return by:

A

constriction of veins

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77
Q

The kidneys promote venous return by:

A

increasing blood volume

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78
Q

When blood pools in vessels for significant lengths of time, one is at risk for:

A

inappropriate clotting

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79
Q

When you stand up, what force causes pooling of blood in the legs?

A

gravity

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80
Q

Vampires drink blood from which blood vessel located in the neck?

A

jugular vein

81
Q

The femoral vein carries blood from the __ to the __ (drains into ___)

A

thigh; heart; common iliac veins

82
Q

The iliac vein carries blood from ___ to the ___

A

pelvis and lower limbs to the inferior vena cava

83
Q

In response to an increase in perfusion pressure, an organ will do what to keep its local blood flow constant?

A

constrict its precapillary sphincters (vasoconstriction)

84
Q

Baroreceptors transmit signals via ___ ___ pathways

A

visceral sensory

85
Q

Increased venous return causes an increase in cardiac output b/c it increases

A

end diastolic volume (preload)

86
Q

Sympathetic stimulation of arterioles through alpha1 adrenergic receptors causes __ and __ blood flow

A

vasoconstriction; decreased

87
Q

Adrenal epinephrine acting through alpha2 adrenergic receptors causes __ and __ blood flow

A

vasodilation; increased

88
Q

when BP falls, then renin is released by the ___

A

kidney

89
Q

Angiotensin II raises BP by:

A

stimulating vasoconstriction, increasing blood volume, increasing CO, and stimulating hypothalamic thirst centers

90
Q

Angiotensin converting enzyme (ACE) converts __ to ___

A

antiotensin I to angiotensin II

91
Q

When blood pressure drops, baroreceptors signal the brainstem to increase sympathetic output resulting in all of the following except: vasoconstriction; increased contractility of the heart; venoconstriction; decrease in heart rate

A

decrease in heart rate

92
Q

One frequent consequence of “right sided” heart failure is :

A

systemic edema

93
Q

One frequent consequence of “left sided” heart failure is:

A

pulmonary edema

94
Q

A blood pressure of 129/80 is categorized as:

A

pre-hypertensive

95
Q

The pain in the left arm and shoulder that develops during myocardial ischemia is an example of:

A

referred pain

96
Q

The volume loading by the kidneys that occurs in heart failure is an attempt to:

A

restore CO to normal

97
Q

Left ventricular hypertrophy is one result of:

A

hypertension

98
Q

Which of the following is associated with circulatory shock? a sudden drop in blood pressure; hemorrhaging; massive vasodilation; loss of autonomic nervous system tone

A

all of the above

99
Q

What type of vessels supply blood to the myocardium?

A

coronary arteries

100
Q

What type of vessels supply blood to the brain?

A

carotid arteries

101
Q

___ inhibit myocardial contractility and heart rate

A

beta blockers

102
Q

Angina pectoralis=

A

crushing pain of the chest

103
Q

___ inhibit the activity of an enzyme located in the lungs

A

ACE inhibitors

104
Q

___ is a consequence of sudden hypotension

A

shock

105
Q

___ decrease blood volume and ultimately CO and MAP

A

diuretics

106
Q

The ___ transmits parasympathetic signals to the heart

A

vagus nerve

107
Q

___ decrease TPR by causing arteries to dilate

A

calcium channel blockers

108
Q

The main secretion of the adrenal medulla is ___

A

epinephrine

109
Q

The amount of blood returned to the heart from systemic circulation=

A

venous return

110
Q

___ dilates veins to decrease venous return, preload and stroke volume

A

nitroglycerin

111
Q

Stroke volume is regulated by all of the following except: heart rate; contractility of the heart; afterload; preload/EDV

A

heart rate

112
Q

A heart with an expanded ventricular radius (a dilated heart) must work harder than a heart with a normal ventricular radius (law of laplace). A dilated heart must develop higher __ to accomodate a given ___

A

tension; pressure

113
Q

Compared with a normal heart, a dilated heart has:

A

a higher oxygen demand

114
Q

As we age, our blood vessels lose some of their elasticity. As a consequence they lose the ability to fill with blood without experiencing a significant elevation of pressure in the vessel. This principle is known as:

A

compliance

115
Q

Most systemic vascular resistance and regulation of this resistance occurs at __

A

arterioles

116
Q

One of the main effects of calcium channel blockers is to:

A

dilate arteries

117
Q

In general blood FLOW is slowest in:

A

capillaries

118
Q

Blood pressure is read from:

A

the brachial artery

119
Q

The superior and inferior mesenteric arteries deliver oxygenated blood to:

A

the intestines

120
Q

The __ runs from the foot to the groin, where it empties into the femoral vein

A

Great saphenous vein

121
Q

CO=

A

MAP/TPR

122
Q

Increased venous return causes an increased CO because it increases __

A

end diastolic volume

123
Q

What is the effect of epinephrine at beta 2 adrenergic receptors?

A

decreased smooth muscle tone

124
Q

Hardening of the arteries due to the development of cholesterol laden plaques is called:

A

atherosclerosis

125
Q

When standing, what allows blood to flow “uphill” from the legs to the heart?

A

skeletal muscle pumping and venous valves

126
Q

blood pressure is lowest in:

A

veins

127
Q

increased sympathetic tone results in all of the following except: dilation of systemic blood vessels; dilation of vessels supplying skeletal muscle; constriction of systemic blood vessels; increased venous return

A

dilation of systemic blood vessels

128
Q

Local vasodilation of capillaries may occur in response to which stimulus? low blood glucose; lactic acid accumulation; elevated temperature; low blood oxygen

A

all of the above

129
Q

The term “autoregulation” of blood flow refers to the ability of a:

A

tissue to regulate its own blood flow

130
Q

ACE inhibitors block:

A

conversion of Angiotensin I to Angiotensin II

131
Q

In the baroreceptor reflex, what does the cardiovascular center do in response to a decrease in blood pressure?

A

increases sympathetic tone, decreases parasympathetic tone

132
Q

One mechanism by which angiotensin II promotes salt and water retention by the kidneys is to stimulate the secretion of:

A

aldosterone

133
Q

An increase in blood volume results in release of:

A

atrial natriuretic peptide

134
Q

The stretch receptors of the aortic arch and carotid sinus are called:

A

baroreceptors

135
Q

The cardiovascular regulatory center is located in the:

A

medulla oblongata

136
Q

Cold (weather) exposure in humans results in activation of the sympathetic nervous system and vasoconstriction of peripheral vessels. The result is:

A

increased MAP

137
Q

The dividing line between normal BP and pre-HTN is:

A

120/80

138
Q

One of the main hemodynamic consequences of HTN is:

A

increased afterload

139
Q

The coronary arteries emerge from the:

A

aorta

140
Q

In most patients, first line therapy for HTN is:

A

diuretics

141
Q

The pain associated with angina pecotralis is a symptom that the myocardium is ischemic. The goal of treatment is to reduce:

A

oxygen demand by the heart

142
Q

Pulmonary edema is primarily the result of:

A

left sided heart failure

143
Q

Myocardial infarction is most often the consequence of:

A

coronary artery blockage

144
Q

In heart failure, the heart doesn’t pump what it gets. Thus a ___ EDV does not result in a greater ___

A

greater; stroke volume & cardiac output

145
Q

Severe diarrhea can lead to:

A

hypovolemic shock

146
Q

Neurogenic shock occurs when:

A

loss of sympathetic tone causse massive vasodilation

147
Q

In compensated heart failure, to restore cardiac output to normal the kidneys:

A

increase blood volume

148
Q

The kidneys receive _% of cardiac output

A

20

149
Q

Class I antiarrythmic drugs=

A

Na+ channel blockade

150
Q

Na+ channel blockers block the __ which depresses the phase __

A

fast sodium channel; phase 0 depolarization

151
Q

Class II antiarrythmic drugs=

A

B-adrenergic receptor blockage

152
Q

Beta blockers __ HR; work by ___ the hearts electricalsi gnal as it passes through the ___ on its way from the __ to the ___

A

decreases; slowing; AV node; atria; ventricles

153
Q

Class III antiarrythmic drugs=

A

Potassium blockers

154
Q

Potassium blockers prolong ___; prolongs ___ by __ potassium efflux; delay in __ and prolonged ____ period

A

repolarization; action potential; delaying; refractory

155
Q

Class IV antiarrythmic drugs=

A

Ca2+ channel blockade

156
Q

Calcium channel blockers work by ___ the hearts electrical signal

A

slowing

157
Q

flow= driving force/

A

resistance

158
Q

Q= ___/ R

A

change in pressure

159
Q

Flow= ___/ resistance

A

pressure gradient

160
Q

Q (rate of blood flow) is determined by what 3 things?

A

viscosity, vessel length and radius of vessel

161
Q

Blood flow is most importantly determined/effected by :

A

radius of vessel

162
Q

In blood vessels, tension is due to __ of smooth muscle (“active”) and the presence of structural elements such as __ and ___ (“passive”)

A

contraction; elastic and collagen fibers

163
Q

A larger blood vessel radius requires larger amount of ___ to contain a given pressure

A

tension (T)

164
Q

A dilated heart has a larger ___ which requires more __ from contraction necessary to generate a normal pressure increase during systole ; (the heart has to work much harder)

A

radius; tension

165
Q

Compliance is a measure of ___ and the formula is compliance= __/___

A

flexibility; change in volume/ change in pressure

166
Q

Small arteries/arterioles have relatively rigid walls so a small change in volume produces a large change in ___

A

pressure

167
Q

Primary function of small arteries/arterioles=

A

transmission of blood at high pressure to the tissues

168
Q

Veins are usually partially ___; a large change in __ causes:

A

collapsed; volume; a small change in pressure

169
Q

primary function of veins=

A

storage of blood

170
Q

Increased sympathetic tone in the arteries causes increased __ and decreased ___

A

increased resistance; decreased compliance

171
Q

Increased sympathetic tone in veins causes decreased __ and increased ___

A

decreased storage; increased venous return to the heart

172
Q

There is NO parasympathetic innervation of ___

A

blood vessels

173
Q

The walls of arteries and veins are arranged in:

A

3 layers/tunics

174
Q

Large arteries can be described as having thicker __ than veins (thickness of the __), abundant ___ which are spread throughout the media; high __; and recoiling of __ during __

A

walls; tunica media; elastic fibers; compliance; fibers during diastole

175
Q

Small arteries/arterioles have __ walls and __ lumens which means they ___ during systole; Low ___; Site of most of the ___ in the vascular system

A

muscular; narrow; don’t stretch much during systole; compliance; resistance

176
Q

Veins/venules are characterized by ___ walls and __ lumens; often partially __ which accounts for much of the high ___; Low ___

A

thin; large; collapsed; compliance; low pressure (0-10 mmHg)

177
Q

Capillaries are ___ thick and consist of __ only. They have low ___ due to large cross sectional area

A

1 cell layer; endothelium; velocity

178
Q

Age effects arteries by __ collagen and ___ elastin which ___ compliance

A

increasing; decreasing; decreasing

179
Q

If venous pressure=0 how does blood get back to the heart?

A

passive filling and overcoming gravity; venous valves ensure one way flow

180
Q

Venous valves ensure:

A

one way flow

181
Q

Factors that will increase venous return include (in order of significance):

A
  1. increase mean systemic filling pressure
  2. skeletal muscle pump/ venous valves
  3. inspiratory pump
  4. gravity
182
Q

What must be done to blood volume and blood storage in order to increase mean systemic filling pressure to increase venous return?

A

increase blood volume and decrease blood storage

183
Q

___ veins are a sign of severe heart failure and are __ in location to the heart

A

bulging jugular; superior

184
Q

Varicose veins are __ in location to the heart

A

inferior

185
Q

increased metabolism has what effect on flow?

A

increases flow

186
Q

increased sympathetic tone causes __ of blood vessels supplying skeletal muscle

A

vasodilation

187
Q

Increased sympathetic tone causes vasodilation of blood vessels supplying skeletal muscle by ___ fibers and ___ at B2 receptors

A

cholinergic post ganglionic sympathetic fibers; epinephrine

188
Q

Baroreceptors are also called __ or __ receptors

A

pressure/stretch

189
Q

Baroreceptor reflex: __ pressure –> ___ –> ___

A

increase P; increase stretch; increase discharge

190
Q

Impulses from baroreceptors pass through __ nerves (aortic arch) and ___ nerves (from carotid) to vasomotor/CV center in ___

A

vagus; glossopharyngeal; medulla oblongata

191
Q

To decrease arterial pressure increase __ tone and decrease __ tone

A

parasympathetic; sympathetic

192
Q

Chemoreceptors are located in __ and __ bodies; major function=

A

carotid and aortic bodies; respiration

193
Q

Chemoreceptors: decreased Q= __ O2= __ CO2= __ pH= __ discharge= stimulate __ tone and inhibit __ tone

A

decreased; increased; decreased; increased; sympathetic; parasympathetic

194
Q

The direct effects of angiotensin II = vaso __ especially in __ to increase __

A

vasoconstriction; arterioles; TPR

195
Q

Angiotensin II causes indirect effects by stimulating __ secretion by the adrenals; it increases blood volume by increasing salt and water retention by the kidneys

A

aldosterone

196
Q

What type of drugs increase excretion of salt and water to decrease venous return?

A

diurectirs and natriuretics

197
Q

What drug inhibits effectsof baroreceptor reflexes/ decreases heart rate and contractility?

A

beta-blockers

198
Q

What type of drugs decreases TPR and venous return?

A

vasodilators

199
Q

A dilated heart or a heart with high afterload has a __ metabolic requirement

A

increased

A&P exam 2 (1 decks)

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