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A1 > APEX Cardiovascular AP > Flashcards

APEX Cardiovascular AP Flashcards

1
Q

What spreads the wave of depolarization?

A

Gap junctions

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2
Q

How does K affect RMP

A

Hyper K increases RMP
HypoK decreases RMP

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3
Q

How does CA affect THP

A

HyperCA increases THP
HypoCA decreases THP

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4
Q

Phases of ventricular AP

A

0 na in
1 cl in, k out
2 ca in, k out
3 k out
4 k seeps out, nakatpase

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5
Q

What is THP?

A

Voltage change that is required to achieve depolarization

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6
Q

SA and AV AP phases

A

4 depolarization, na in(i-f), ca in (t type)
0 depolarization CA in (l type)
3 Repolarization- k out

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7
Q

Cardiac accelerator fibers

A

T1-T4

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8
Q

CaO2 is what?

A

Artierial oxygen content
20ml/O2/dL

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9
Q

DO2 is what range

A

Oxygen delivery
1000ml/min

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10
Q

VO2 is what

A

Oxygen consumption
250ml.min

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11
Q

cVO2 is what

A

Venous oxygen content
15ml/dl

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12
Q

CaO2 formula

A

(1.34 x hgb x SaO2) + (PaO2 x 0.003)
about 20m/dl is goal
Oxygen content

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13
Q

DO2 formula

A

CO x 10 x [(1.34 x hgb x SaO2) + PaO2 x 0.003)]
Delivery of oxygen- how much o2 is carried andhow fast its being delivered
reference- 1000ml

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14
Q

EO2 reference

A

reference - 25%

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15
Q

VO2 reference

A

250ml/min

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16
Q

cVO2 formula range

A

(1.34 x hgb x sao2) + (PvO2 x .003)
15ml/dl
NOT PaO2!!!

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17
Q

SVR and PVR normal ranges

A

800-1600
150-250
dynes/sec/cm-5

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18
Q

SVR and PVR formula

A

(map-cvp/co) x 80
(meanPAP-PCWP/CO) x 80

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19
Q

Frank starling is associated with what two variables?

A

Ventricular output (SV)
Ventricular volume (PCWP=LVEDV)

20
Q

Conditions that reduce myocardial compliance

A

Hypertrophy
Age
Fibrosis
Diastolic HF

21
Q

Atrial kick %, and when is it most important?

A

20-30%
In high heart rates bc heart doesnt have enough time to fill passively

22
Q

Conditions that impair inotropy

A

Hyper K (acidosis)
Hypercarbia (acidosis)
Hypoxia / ischemia (Lactate= acidosis) /
Propofol, CCB, volatile anesthetics

23
Q

What increases contractility?

A

SNS
Catecholamines
Dig
PDE inhibitors

24
Q

How does B1 stimulate contractility?

A

ATP to cAMP
cAMP increases PKA
More calcium in and made available via l type ca channel, serca 2 pump is sped up, and ryanodine2 receptor causes CICR

25
Q

Most important electrolyte for contractility?

A

Calcium

26
Q

LV pressure volume loop (square graph chart)

A

ACAO
MOMC
Right (isovolumetric contraction) and top (contraction) are systole
Left (isovolumetric relaxation) and bottom (ventricular filling) are diastole

27
Q

Myocardial stress is reduced by what 3 factors

A

Increased thickness (muscle causes less stress)
Decreased radius (doesnt have to stretch as much)
Decreased Decreased pressure (same as above)

28
Q

EF formula

A

(Edv-Esv)/EDV
or
SV/EDV

29
Q

Mild EF dysfunction

A

41-49%

30
Q

When looking at a cross section from above, what parts of the heart are being fed by what arteries?

A

R side- Circumflex
Middle bottom to half way up septum- LAD
Left side, top side, and half way down septum- inferior RCA

31
Q

Where does SA node get its blood from? AV?

A

RCA in 70% of people
AV node in 80% of people

32
Q

Coronary perfusion pressure formula

A

DBP-LVEDP

33
Q

H1 vs H2 to coronary vessels

A

Vasoconstricts
Vasodilates

34
Q

Aortic pressure vs LCA flow pressure vs RCA flow pressure

A

A line tracing
A line with low peak,
unevenly high dicrotic notch/ low systolic pressure,
just a mini a line

35
Q

Which myocardial bed is most susceptible to MI?

A

endocardium, its far down

36
Q

PLC

A

PLC IP3 CONTRACTION
Constriction
Think Phenyl

37
Q

PKA

A

B1 stimulation - cAMP- PKA ativation
activation of Ca channels
Stimulates release of Ca from SR
Facilitation of CA into SR by SERCA2 to speed up the next ca release

38
Q

How does preload effect Myocardial oxygen?

A

Decreases supply (heart beating too hard now)
Increases demand

39
Q

What is wall tension synonymous with?

A

Preload

40
Q

DO2 formula

A

(1.34 x hgb x sao2 + [pao2x.003]) x CO x 10
or
ci x hgb x 1.34 x sao2

41
Q
A
42
Q

NO effect on afterload, NO MOA

A

Decreases RV afterload by causing a decrease in PVR
Activates guanlyl cyclase, synthesize GTP to cGMP, decreases CA inside cell, causes smooth muscle relaxation

43
Q

2 mediators of coronary vessel dilation

A

Adenosine
B2

44
Q

Severe EF dysfunction

A

<25%

45
Q

SERCA2 pump

A

Sarco Endoplasmic Reticulum Calcium ATPase pump
Resequesters CA, if you speed this up, then you can speed up the following release of more calcium for another contraction

46
Q

How can we influence(increase) SA node AP?

A

Increase rate of phase 4 via sns
decrease THP
Increase RMP

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