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Spring 2024 > A&P1 > Flashcards

A&P1 Flashcards

Numbers, Formulas, Facts

1
Q

What is the pressure of the left ventricle?

A

120-0 mmHg

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2
Q

What is the average pressure of the aorta?

A

100 mmHg

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3
Q

What’s the formula for MAP?

A

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

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4
Q

What’s a normal CVP?

A

0 mmHg

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5
Q

What’s normal left atrial pressure?

A

~2 mmHg

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6
Q

What is normal PAP?

A

25/8

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7
Q

What is normal MPAP?

A

16 mmHg

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8
Q

What is ΔP for flow in the capillaries?

A

20 mmHg

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9
Q

What is capillary hydrostatic pressure (Pc)?

A

30 mmHg

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10
Q

What is interstitial fluid pressure (Pif)?

A

-3 mmHg

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11
Q

What is plasma colloid osmotic pressure (∏p)?

A

28

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12
Q

What is interstitial fluid colloid osmotic pressure (∏if)?

A

8 mmHg

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13
Q

PVR is ( / ) of SVR

A

1/7th

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14
Q

What is the X-sectional area of capillaries?

A

2500 cm2

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15
Q

What is the X-sectional area of the aorta?

A

2.5 cm2

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16
Q

The veins, venules, and venous sinuses contain what percentage of blood?

A

64% or 3200mL

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17
Q

Arteries contain what percentage of blood?

A

13%

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18
Q

Arterioles and capillaries contain what percentage of blood?

A

7%

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19
Q

What percentage of blood is in pulmonary circulation?

A

9%

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20
Q

What percentage of blood is in the heart?

A

7%

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21
Q

Systemic circulation contains what percentage of blood?

A

84%

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22
Q

Where do the lymphatic ducts empty?

A

Subclavian veins

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23
Q

Where is the isogravimetric point?

A

Level of the tricuspid valve. Also known as the phlebostatic axis.

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24
Q

Where is the isogravimetric point in relation to the foot?

A

1.5 meters above it

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25
Q

How much pressure does 1.5 meters add to the foot?

A

90 mmHg

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26
Q

What is the arterial pressure in the foot?

A

190 mmHg

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27
Q

Every ____ below the heart increases the pressure by ____.

A

1.36 cm; 1 mmHg

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28
Q

What’s the venous pressure at the isogravimetric point?

A

7 mmHg

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29
Q

What’s the equation for Reynold’s number?

A
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30
Q

What does Reynold’s number mean?

A

The higher the number the more likely you are to have turbulent flow.

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31
Q

What’s the formula for vascular compliance?

A
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32
Q

What’s the formula for vascular distensibility?

A
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33
Q

What does vascular distensibility tell us?

A

The higher the original volume the less distensible it is.

Ex: If the veins start out being full, they will not be able to increase volume as much as if they were not as full.

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34
Q

What is normal RAP?

A

0 mmHg

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35
Q

What are two things that arteriosclerosis causes?

A
  1. Increased pulse pressure
  2. Rigid and non-compliant arteries
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36
Q

Why would the kidneys decrease DBP?

A

To maintain MAP

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37
Q

What is the set point for the aortic arch receptors?

A

130-150 mmHg

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38
Q

What is the set point for the carotid baroreceptors?

A

100 mmHg

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39
Q

What low-pressure feedback system reflex increases HR by 10-15%?

A

Direct Atrial Stretch Reflex

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40
Q

What low-pressure feedback system reflex increases HR by 50-60%?

A

Bainbridge Reflex

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41
Q

What does ANP or ANF do?

A

Increases prostaglandin production in the kidneys, which leads to increases in renal blood flow and increased filtration (urine output increases).

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42
Q

What’s the pathway for the carotid high-pressure reflex?

A

Herring’s Nerve to the Glossopharyngeal nerve to vasomotor center in the brainstem

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43
Q

What’s the nerve pathway for the aortic arch reflex?

A

Sends info to the brain stem via the vagus nerve

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44
Q

How do stretch receptors work?

A

Stretching of the vessel increases Na+ permeability and increases the frequency of action potentials, which the brainstem then detects.

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45
Q

At what pressure does the aortic valve open?

A

80 mmHg diastolic

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46
Q

What’s the normal afterload pressure?

A

80 mmHg

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47
Q

The ability of the heart to change its SV independently of preload or afterload.

A

Contractility

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48
Q

What’s phase 4 of the pressure-volume loop?

A

Isovolumetric Relaxation

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49
Q

What’s phase 2 of the pressure-volume loop?

A

Isovolumetric Contraction

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50
Q

What’s phase 3 of the pressure-volume loop?

A

Period of Ejection

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51
Q

What’s phase 1 of the pressure-volume loop?

A

Period of Filling

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52
Q

What’s our normal ESV?

A

50 mL

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53
Q

What’s normal EDV?

A

120 mL

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54
Q

What’s normal SV?

A

70 mL

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55
Q

What is our highest CO at rest?

A

13 L/min

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56
Q

How high can CO get with sympathetic stimulation?

A

25 L/min

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57
Q

What are three things that can change SV?

A
  1. Preload
  2. Afterload
  3. Contractility
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58
Q

What does 1-2% of the population have?

A

Congenital Bicuspid Aortic Valve

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59
Q

Everyone over the age of 60 will have what?

A

Aortic Stenosis

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60
Q

What’s the formula for coronary perfusion pressure?

A

Coronary Perfusion Pressure =
Aortic Pressure - Wall Pressure

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61
Q

Concentric LV failure can be caused by what 2 things?

A
  1. Chronic HTN
  2. Aortic Stenosis
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62
Q

What type of dysfunction is concentric LV failure?

A

Diastolic dysfunction - filling problem

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63
Q

What four things can cause eccentric LV failure?

A
  1. MI
  2. Aortic/Mitral Regurgitation
  3. VSD
  4. Congenital Dilated CM
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64
Q

What type of dysfunction is eccentric LV failure?

A

Systolic Dysfunction

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65
Q

Sarcomeres are added end to end “in series”

A

Eccentric

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66
Q

sarcomeres are added side by side

A

Concentric

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67
Q

What is the normal coronary blood flow?

A

225 mL/min or 70 mL /100g of heart muscle

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68
Q

What two arteries does the LCA split into?

A
  1. LAD
  2. Left Circumflex
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69
Q

What branches off of the left circumflex in 15% of people?

A

Posterior Descending Artery (PDA)

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70
Q

What branches from the RCA in 85% of people?

A

Posterior Descending Artery (PDA)

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71
Q

What would the normal resting HR be if parasympathetic stimulation was removed?

A

110

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72
Q

What controls motor innervation for the diaphragm?

A

Phrenic Nerves

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73
Q

What are the 2 layers of the serous pericardium?

A
  1. Parietal - outer layer attached to the fibrous pericardium
  2. Visceral - inner layer attached to the heart
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74
Q

What is causing the 3rd heart sound?

A

Rattling of the Right Fibrous Anulus

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75
Q

At what part of the cardiac cycle is the 3rd heart sound heard?

A

At the beginning 2nd 1/3 of diastole or 2/3 into diastole

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76
Q

When is the 4th heart sound heard?

A

At the beginning of the last 1/3 of diastole or the 3rd part of diastole.

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77
Q

What is the normal hearing wavelength for humans?

A

20 Hz - 20 kHz

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78
Q

What is the loudest heart murmur?

A

Aortic Stenosis

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79
Q

How long does 2nd heart sound last for?

A

0.11 s

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80
Q

How long does the 1st heart sound last for?

A

0.14 s

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81
Q

What makes the 1st heart sound?

A

Closure of the AV valves

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82
Q

What makes the second heart sound?

A

Closure of the Aortic and Pulmonic (Semi-Lunar) valves

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83
Q

When is most of the volume ejected from the LV?

A

During the 1st 1/3 of Ejection

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84
Q

At what point during diastole is most of the ventricle filled?

A

The 1st 1/3rd of filling

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85
Q

a wave

A

Contraction of the atria

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86
Q

X Descent

A

relaxation of the atria

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87
Q

c wave

A

AV valve bulge backward, isovolumetric contraction

88
Q

Atrial Pressures increase during systole as the atria fill

A

v wave

89
Q

h plateau

A

diastasis, occurs during filling

Occurs just before the a wave

90
Q

During rapid filling of the ventricle in the 1st 1/3 of diastole

A

y descent

91
Q

What’s the order of the CVP waveform?

A

a
c
x
v
y
h

92
Q

2 seconds, followed by 2 seconds, followed by 2 seconds

A

inspiration, expiration, and then nothing

93
Q

What is our thoracic pressure at the end of expiration?

A

~ -4 mmHg

94
Q

What is our thoracic pressure during inspiration?

A

~ -6 mmHg

95
Q

What’s the venous return or resistance to venous return equation?

A
96
Q

At what pressure will the aortic valve close?

A

100 mmHg

97
Q

When does systole end on an ECG?

A

When the T-wave ends

98
Q

When do the ventricles contract on an ECG?

A

R-wave

99
Q

What is normal arterial oxygen content? Units?

A

20 mL/dL

100
Q

What is normal oxygen consumption? Units?

A

250 mL/min

101
Q

What is normal arteriovenous oxygen difference? Units?

A

5 mL/dL

102
Q

What is normal mixed venous O2 saturation?

A

75%

103
Q

Where do we auscultate the mitral valve?

A

5th intercostal space, midclavicular line

104
Q

Where do we auscultate the tricuspid valve?

A

5th intercostal space, left sternal border

105
Q

What two things dampen the a-line waveform?

A
  1. Clot in the a-line
  2. Air in the a-line
106
Q

Where does the superior thyroid artery branch off?

A

External Carotid

107
Q

Where does the inferior thyroid artery branch from?

A

Subclavian Arteries

108
Q

How many arteries supply the thyroid?

A

4

109
Q

How many parathyroid glands are there?

A

4

110
Q

How long does thyroid hormone get stored for?

A

2-3 months

111
Q

What is the blood flow per minute in the thyroid gland?

A

5x its mass

112
Q

What nerves branch from the vagus nerves?

A

Recurrent Laryngeal nerves

113
Q

Which recurrent laryngeal nerve wraps around the back of the brachiocephalic artery and then ascends to the larynx?

A

The right recurrent laryngeal nerve

114
Q

Which recurrent laryngeal nerve wraps around the front of the aortic arch and then ascends to the larynx?

A

The left recurrent laryngeal nerve

115
Q

What controls the skeletal muscles in the voicebox?

A

Recurrent laryngeal nerves

116
Q

Where is the thyroid gland located?

A

Under the base of the thyroid cartilage

117
Q

What’s inside of the thyroid cartilage?

A

Larynx “Voice Box”

118
Q

What is the exchange rate for the Na+ / I- pump? What type of transport is it?

A

2:1. 2 Na+ and 1 I- enter into the cuboidal epithelial cells via cotransport

119
Q

What’s the exchange rate for I- and Cl-? Where are they transported?

A

1:1 exchange. Iodine gets pushed out into the colloid space and Cl- comes in from the colloid space.

120
Q

Who oxidizes iodine?

A

H2O2. Removes negative charge using oxidation.

121
Q

What is TRH? Where does is it come from? Where does it go?

A

Thyrotropin Releasing Hormone (TRH); Released from hypothalamus and goes to pituitary gland.

122
Q

What is TSH? Who releases it?

A

Thyroid Stimulating Hormone (TSH); Released by the anterior pituitary in response to TRH.

123
Q

Where does TSH bind? What does it cause?

A

Binds on receptors on the thyroid gland “cuboidal epithelial cells”; Causes proteases and lysosomes to breakdown thyroglobulin to release T3 and T4.

124
Q

What are the three carrier proteins for TH?

A
  1. Thyroxine-binding globulin (TBG)
  2. Pre-Albumin
  3. Albumin
125
Q

Which form of TH is more free circulating in the plasma? Why?

A

T3; because T4 is more lipophilic and more likely to be bound to a carrier protein.

126
Q

What is PTU? What does it do?

A

Propylthiouracil; Inhibits thyroid peroxidase

127
Q

What causes exophthalmos in Grave’s disease?

A

Inflammation from the thyroid antibodies.

128
Q

What type of shock can you recover from without intervention?

A

Non-progressive or compensatory

129
Q

What type of shock requires intervention to survive?

A

Progressive

130
Q

Which type of shock will you not survive from even with intervention?

A

Irreversible/Uncompensated or “Decompensated” shock

131
Q

What is myocardial depressant factor? Where does it come from? What does it do?

A

Endotoxin; From Gram ( - ) bacteria in the gut; Decreases CO

132
Q

How much of our blood volume can we lose and still autoregulate our BP?

A

20% = 1 L of blood

133
Q

Name 3 things that can inhibit the body’s autoregulation reflexes.

A
  1. Anesthesia
  2. ACEi
  3. B-Blockers
134
Q

What is a normal cardiac reserve?

A

400% or an increase to 25 L/min

135
Q

SBP drops by how much with inspiration?

A

10 mmHg

136
Q

What is dextran? What does it do?

A

Large sugar molecule; it increases colloid oncotic pressure

137
Q

At what MAP is death certain if there is no intervention?

A

45 mmHg

138
Q

Iodide

A

I- ; reduced form of Iodine that is normally found in nature.

139
Q

What is normal BSA?

A

1.7 m2

140
Q

What are the 3 causes of mitral stenosis?

A
  1. Autoimmune reactions
  2. Rheumatic fever
  3. Strep
141
Q

What are 6 causes of aortic stenosis?

A
  1. Poor diet/HLD
  2. Diabetes
  3. Autoimmune/Rheumatic Fever
  4. Age
  5. Infection
  6. Congenital
142
Q

What percentage of adenosine can the heart restore in 30 minutes?

A

2%

143
Q

What is the function of endogenous adenosine?

A

Vasodilation

144
Q

What are the 3 cusps of the aortic valve?

A
  1. Posterior
  2. Right
  3. Left
145
Q

What are the 3 cusps of the pulmonic valve?

A
  1. Anterior
  2. Right
  3. Left
146
Q

What are the cusps of the Tricuspid valve?

A
  1. Anterior
  2. Posterior
  3. Septal
147
Q

What are the cusps of the Bicuspid/Mitral valve?

A
  1. Anterior
  2. Posterior
  3. Commissural*

Not a true cusp. Extension of posterior cusp.

148
Q

What are the cartilaginous rings of the posterior R and L sides of the heart?

A

Left & Right Fibrous anulus

149
Q

The opening for the bundle of His shares borders with which 4 cartilaginous rings?

A
  1. Right fibrous trigone
  2. Left fibrous anulus
  3. Right fibrous anulus
  4. Fibrous ring of aortic valve
150
Q

The tendon of conus links what two cartilaginous rings together?

A
  1. Fibrous ring of pulmonary valve
  2. Fibrous ring of aortic valve
151
Q

The left fibrous trigone and the right fibrous trigone cartilaginous rings link which two structures together?

A

Left heart and aorta

152
Q

V wave

A

An increase in atrial pressure during systole as the atria fill

153
Q

What phase of the cardiac cycle is the a wave?

A

end diastole

154
Q

What phase of the cardiac cycle is the c wave?

A

early systole

155
Q

What phase of the cardiac cycle is the v wave?

A

Late systole

156
Q

What phase of the cardiac cycle is the h wave?

A

mid to late diastole (diastasis)

157
Q

What phase of the cardiac cycle is the x-descent

A

Mid systole

158
Q

What phase of the cardiac cycle is y-descent?

A

Early diastole

159
Q

What is a normal PAWP?

A

10 mmHg

160
Q

What is SVR in PRU? What are the units?

A

1 mmHg/mL/sec

161
Q

What is CGS

A

Centimeters x Grams X Seconds

162
Q

What is 1 CGS equal to?

A

1 dyne x second / cm5 or mmHg/L/min

163
Q

How do you convert PRU to CGS?

A

PRU x 1333

164
Q

What is iodinase? What does it do?

A

Breaks off one iodone atom to take T4 to T3

165
Q

What is the THR? Where is the THR?

A

Thyroid Hormone Receptor (THR) and it is inside the nucleus.

166
Q

Where does the THR complex bind??

A

Retinoid-X Receptor

167
Q

What does a high dose of Iodine do?

A

Treats hyperthyroidism by overwhelming peroxidase

168
Q

What are the 4 treatments for hyperthyroidism?

A
  1. I-131
  2. PTU
  3. High Dose Iodine
  4. Surgery
169
Q

What can cause hyperthyroidism?

A
  1. Grave’s Disease
  2. Trauma
  3. Surgery
  4. Too much I in diet
170
Q

What can cause hypothyroidism?

A
  1. I deficiency
  2. Hashimoto’s
  3. Dysfunction of hypothalamus
  4. Hypophysectomy
171
Q

How do we prevent the uptake of other more poisonous forms of iodine in a nuclear war?

A

Take regular iodine.

172
Q

Which type of vessel has the largest wall thickness to internal diameter ratio?

A

Arterioles

173
Q

Who supplies most of the SVR?

A

Arterioles

174
Q

What is the pressure in the sagittal sinus?

A

~ -10 mmHg

175
Q

How long would it take you to pass out if you didn’t contract your leg muscles while standing?

A

5 minutes

176
Q

In which coronary artery will you see retrograde flow and when?

A

LCA during early systole

177
Q

What is the AP firing equation?

A

ΔI / ΔP = maximum

178
Q

What percentage of O2 is taken by the coronary arteries? The tissues?

A

75%; 25%

179
Q

1dL of arterial blood contains how many mL of O2?

A

20mL of O2

180
Q

75% of people with a bicuspid aortic valve will what type of cusp merge?

A

Left and Right

181
Q

25% of people with a bicuspid aortic valve will have what type of cusp merge?

A

Posterior and Right

182
Q

Where does the right recurrent laryngeal nerve go?

A

RRLN wraps around the back of the brachiocephalic artery and then ascends to the larynx.

183
Q

What medication mimics sympathetic nervous system in the blood vessels to increase filling pressures?

A

Phenylephrine

184
Q

What phase of the volume-loop cycle for aortic regurgitation has the most backward flow?

A

Phase I

185
Q

What phase of the volume-loop cycle for mitral regurgitation has the most backward flow?

A

Phase III

186
Q

What’s the formula for EF?

A

EF = SV / EDV x 100%

187
Q

What is PTH? Wheredoes it come from? What does it do?

A

Parathyroid hormone; Parathyroid gland; Regulates Ca2+

188
Q

What is the highest amount of TH in the body?

A

T4

189
Q

What are the starting blocks of TH?

A

Tyrosine and Iodine

190
Q

What causes Beri Beri? How?

A

Thiamine (Vitamin B1) deficiency; Renders part of the ETC ineffective

191
Q

What happens in MIs lasting 30 minutes or more?

A

No substrate to build ATP off of because it’s all been used up and adenosine has leaked out.

192
Q

The atrial stretch reflex also causes a reflex in the kidney that does what?

A

Inhibits renal sympathetic nerve activity.

193
Q

Angiotensin II and aldosterone production can be inhibited by what endogenous substance?

A

ANPeptide or ANFactor

194
Q

What are 4 things that can shift the cardiac output curve to the right?

A
  1. Positive pressure ventilation
  2. Blowing a trumpet
  3. Surgically opening the chest
  4. Cardiac tamponade
195
Q

What are 2 things that can shift the cardiac output curve to the left?

A
  1. Breathing against a negative pressure (breathing through a straw)
  2. Removing a patient from a positive pressure ventilator
196
Q

What doesn’t shift the cardiac output curve?

A

Psf

197
Q

Blowing murmurs of relatively high pitch are associated with

A

Valvular insufficiency/regurgitation

198
Q

What’s the most important factor for the progression towards irreversible/progressive/uncompensated shock?

A

Cardiac Function

199
Q

What are two things that can inhibit the secretion of TRH?

A

High level of TH or TSH

200
Q

What three thyroid disorders will we possibly see Exopthalamos?

A

Hashimoto’s
Hyperthyroidism
Graves

201
Q

What organs can we shift blood/fluid from?

A
  1. Spleen
  2. GI system
  3. Pulmonary system
  4. Liver
202
Q

What is the formula for cardiac reserve?

A

(Max CO - Resting CO) / Resting CO = % Cardiac Reserve

203
Q

What is essential for preventing coronary steal?

A

Bedrest

204
Q

What are two anatomical reasons in the failing heart that can cause arrhythmias?

A
  1. Longer AP pathway due to stretching of the heart muscle
  2. Scar tissue build-up that does not conduct electrical activity
205
Q

What is the normal total body water amount in a 70kg adult? How much are in the ICF and ECF respectively?

A

42 L; 28L ICF and 14L ECF.

BONUS: 3L Plasma Volume (out of the ECF)

206
Q

What type of shock is caused by anesthesia? How does it cause it?

A

Neurogenic; decreases Psf

207
Q

What type of shock can develop from the other types of shock? Why?

A

Septic Shock due to lack of blood flow and ischemia to the intestines.

208
Q

What does digoxin do?

A

produces an increase in blood flow and vasodilation a decrease in SVR, CVP, and HR. The vasodilation is the result of an increase in CO and direct baroreflex-mediated withdrawal of sympathetic vasoconstriction.

209
Q

What’s an example of a medication we use to override the kidney?

A

Diuretics or ACEi

210
Q

What causes the plateau at 50% of our normal CO or MAP?

A

CNS ischemic response or reflex

211
Q

During the CNS ischemic response what would you see on the arterial pressure wave?

A

Oscillations from the Baro-Rs

212
Q

If our BP drops more than 10 points during inspiration, what could that mean?

A

Hypovolemia

213
Q

What are two medication types that can decrease capillary permeability?

A

Steroids and Pressors

214
Q

How much blood in mL is in the heart and lungs?

A

350 mL; 450 mL

215
Q

What makes TBG? What is TBG?

A

Liver; Thyroid Binding Globulinis a protein that binds T3 and T4

216
Q

What percentage of T3 and T4 are released from the thyroid?

A

7%; 93%

217
Q

What’s the difference between Hashimoto’s and Grave’s?

A

Graves’ disease is caused by thyroid-stimulating antibodies to the TSH receptor (TSHR), whereas Hashimoto’s thyroiditis is associated with thyroid peroxidase and thyroglobulin antibodies.

Spring 2024 (9 decks)

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