B3W3 Cardiac Regulation

Question 1

Afferent Cardio Receptors

Answer 1

Arterial Baroreceptor (Inhibitory)
Arterial Chemoreceptors (Excitatory)
Cardiopulmonary Baroreceptors (Inhibitory)
Muscle Metaboreceptors (Excitatory)

Question 2

Parasympathetic Innervation of the heart

Answer 2

Parasympathetics are always on at the heart at the SA and VA nodes
Parasympathetics decrease sympathetic NE release
Causes decreased heart rate, conduction velocity, and contractility

Question 3

Sympathetic Innervation of the Heart

Answer 3

NE binds to beta-1 receptors on the SA node, AV node, and Cardiac Muscle
Causes increased heart rate, conduction velocity, and contractility

Question 4

Innervation of Vasculature

Answer 4

Arteries and Vein mainly innervated by the sympathetic Nervous System
Arteries have more Alpha 1 than Beta 2
Arteries are vasoconstricted
Pulmonary Arteries have more Beta 2
Pulmonary Arteries are vasodilated

Question 5

Alpha Receptor Effects

Answer 5

Vasoconstriction

Question 6

Beta Receptor Effects

Answer 6

Beta 1 increase heart function
Beta 2 vasodilation

Question 7

Arterial Baroreceptor

Answer 7

Detects arterial pressure in the carotid sinus and aortic arch
Decreases sympathetic outflow to decrease pressure and maintain high blood flow

Question 8

Aortic Arch Baroreceptor

Answer 8

High threshold and mainly only responds when the carotid baroreceptors are saturated
Afferent through Vagus Nerve

Question 9

Carotid Sinus Baroreceptors

Answer 9

low threshold and highly sensitive to change in MAP
Afferent through glossopharyngeal nerve

Question 10

Baroreceptors

Answer 10

Stretch Receptors

Question 11

Cardiopulmonary Baroreflex

Answer 11

Sensitive to pressure during diastole, low pressure baroreceptor based on the amount of cardiac filling
Increased sympathetic outflow to heart
Decreased sympathetic outflow to kidneys

Question 12

Decreased Sympathetic outflow to Kidney

Answer 12

Inhibits ADH causing increased H2O excretion
ANP release causes increased Na+ excretion
This lowers blood volume overall

Question 13

Peripheral Chemoreceptors

Answer 13

Triggered by low pO2 and high CO2
Chemosensitive fibers that signal through the carotid sinus nerve and aortic depressor nerve
Increases sympathetic and vagal response

Question 14

Central Chemoreceptors

Answer 14

Triggered by only high pCO2 and low pH
Increases sympathetic outflow

Question 15

Skeletal Muscle During Exercise

Answer 15

Stimulated by H+ and K+ ions
Signal goes through muscle afferents
Increases Sympathetic Tone and decreases parasympathetic
Active muscle site however are effected more by local vasodilators than the sympathetic nervous system

Question 16

Reflex from Lung

Answer 16

Stimulated by lung inflation
Signal through the vagal nerve
Decreases Vagal and sympathetic signal

Question 17

Mutual Inhibition

Answer 17

Combined signal is less than the sum of two signals

Question 18

Additive Summation

Answer 18

Output is equal to the sum of two inputs

Question 19

Mutual Facilitation

Answer 19

Combined signal is larger than the sum of two inputs

Question 20

Heart Failure

Answer 20

Syndrome characterized by elevated cardiac filling pressure or inadequate peripheral oxygen delivery, at rest or during stress caused by cardiac dysfunction

Question 21

P-V Relationship Systolic Dysfunction

Answer 21

End Systolic point has the heart at a higher volume and lower pressure and lower contractility by shifting it downward and to the right

Question 22

P-V Relationship Diastolic Dysfunction

Answer 22

Ventricle can only fill at a higher pressure resulting in higher pressure at the end of diastole and a smaller stroke volume

Question 23

Causes of Left Sided Heart Failure

Answer 23

Systolic dysfunction
Impaired Contractility
Increased Afterload

Diastolic Dysfunction
Impaired LV Relaxation
Obstruction of LV Filling

Question 24

Pathogenesis of Chronic Heart Failure

Answer 24

Coronary heart disease, hypertension, or cardiomyopathy

Question 25

Effects of left ventricle lack of function

Answer 25

Lower Cardiac output, abnormal reflexes, chronic activation of the sympathetic nervous system

Question 26

Index Event

Answer 26

An event that triggers the progressive onset of heart failure

Question 27

Secondary Damage

Answer 27

Permanent damage caused by excessive activation of neural hormonal symptoms

Question 28

Compensatory Mechanisms

Answer 28

Mechanisms that attempt to undo detrimental effects caused by secondary damage

Question 29

Angiotensin II

Answer 29

Active form of Angiotensin Very powerful abnormal vasoconstrictor

Question 30

Further Constriction effects of Angiotensin II

Answer 30

Activation of the sympathetic nervous system, increased aldosterone, increased vasopressin, and increased endothelin

Question 31

Clotting effects of Angiotensin II

Answer 31

Increased Pa-1 (causes thrombosis), platelet aggregation, and superoxide production

Question 32

Smooth Muscle Remodeling effects of Angiotensin II

Answer 32

Myocyte growth, increased vascular muscle growth, and increased collagen

Question 33

Functional Classification of Heart Failure

Answer 33

Class I -No limitations -no symptoms with ordinary activity Class II -Slight limitations -Symptoms with ordinary activity Class III - Marked Limitations - Symptoms with less than ordinary activity Class IV - Symptoms of cardiac insufficiency at rest

Question 34

Symptoms of Heart Failure

Answer 34

Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, Fatigue, RUQ Fullness/Pain, anorexia, nausea, or vomiting

Question 35

Heart Failure Treatment

Answer 35

Neurohormonal treatment with ace inhibitors beta blockers and other agents to block neurohormonal activation