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Anaesthetic FRCA Primary - Teaching Days > Basic Sciences - Cardiovascular Physiology > Flashcards

Basic Sciences - Cardiovascular Physiology Flashcards

1
Q

Definition of flow

A

Quantity of fluid being moved passed a point in a given time

Not velocity

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2
Q

Cardiac output equation

A

CO = SV x HR

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3
Q

Approximate CO in average person

A

5 L/min

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4
Q

Approximate SV in average person

A

70 ml

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5
Q

Requirement to generate flow of a fluid

A

Pressure gradient

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6
Q

Main types of receptor present in the heart

A

Muscarinic cholinergic receptors - parasympathetic

Beta 1 adrenergic - sympathetic

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7
Q

Main types of receptor present in peripheral blood vessels

A

Alpha 1 adrenergic - sympathetic

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8
Q

Factors which impact flow of fluid

A
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9
Q

Most efficient type of flow

A

Laminar flow

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10
Q

Correlation between pressure, flow and resistance

A

Pressure = Flow x Resistance

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11
Q

Correlation of pressure, flow and resistance in human circulation

A

MAP = CO x SVR

Mean arterial pressure
Cardiac output
Systemic vascular resistance

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12
Q

How to calculate flow under laminar flow conditions

A

Poiseuille’s law

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13
Q

Poiseuille’s law

A
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14
Q

Which factor has greatest influence on flow

A

Radius of vessel / pipe (according to Poiseuille’s law)

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15
Q

Calculations for MAP

A

MAP = CO x SVR

MAP = 2/3 Diastolic BP + 1/3 (Systolic - Diastolic BP)

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16
Q

Reason for MAP representing 2/3 Diastole and 1/3 Systole

A

Cardiac cycle is 2/3 in diastole

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17
Q

Arterial BP waveform

A

Dicrotic notch - the change in wave form on the descent

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18
Q

Dicrotic notch on arterial waveform representation

A

Elastic recoil of aortic wall immediately after aortic valve closure

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19
Q

Normal pressures of right atrium

A

Systole 5 mmHg
Diastole 2 mmHg

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20
Q

Normal pressures of right ventricle

A

Systole 25 mmHg
Diastole 0 mmHg

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21
Q

Normal pressures of left atrium

A

Systole 6 mmHg
Diastole 3 mmHg

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22
Q

Normal pressures of left atrium

A

Systole 120 mmHg
Diastole 0 mmHg

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23
Q

Reason for large pressure difference in left ventricle between systole and diastole

A

Diastole pressure must be less than left atrial pressure in order to fill

Systole pressure must overcome aortic resistance

24
Q

Reason right ventricle has lower systolic pressure than left ventricle

A

Pulmonary circulation has lower resistance than systemic circulation

Less pressure needed to perfuse it

25
Pressure changes in different circulation vessels
26
Why does biggest drop in pressure occur in the arterioles
Small radius produces high resistance Resistance is inversely proportional to radius^4 according to Poiseuille's law
27
What happens to coronary vessels during systole
Pressure generated by LV in systole occludes the coronary vessels running through which provides cardiac blood supply
28
During which cardiac cycle phase does most coronary blood flow occur
Diastole - LV is relaxed
29
Two main systems that regulate cardiovascular system
Nervous (autonomic nervous system) Humoral (essentially Renin-angiotensin-aldosterone system)
30
Speed of response of autonomic nervous system to hypotension
Seconds - minutes
31
Sensor of autonomic nervous system to hypotension + location
Baroreceptors Carotid sinus
32
Effector of autonomic nervous system response to hypotension
Sympathetic outflow
33
Response caused by autonomic nervous system from hypotension
Vasoconstriction Tachycardia
34
Speed of response of Humoral system to hypotension
Minutes - hours
35
Sensor of Humoral system to hypotension + location
Juxtaglomerular apparatus Kidney
36
Effector of Humoral system response to hypotension
Renin-angiotensin and subsequently aldosterone
37
Response caused by Humoral system from hypotension
Vasoconstriction Na+ / water retention
38
Duration of action of nervous vs humoral systems
Humoral system is longer lasting but slower onset
39
Actions of renin
Activates cascade which produces angiotensin II Stimulates aldosterone release from adrenal cortex
40
Where is angiotensin I converted to angiotensin II
Lung
41
Effects of hypervolaemia to reduce circulating volume
Distention of atria Causes release of ANP (atrial natriuretic peptide) Results in sodium and water excretion
42
Stages of hypovolaemic shock
43
Other useful measurements to assess hypovolaemia
Urine output Respiratory rate Central venous pressure
44
Cardiac myocyte action potential
45
How is simultaneous cardiac muscle fibre contraction achieved
Specialised conduction system Syncitial nature of cardiac muscle Prolongation of action potential
46
How is cardiac action potential prolonged
Slow Ca2+ inflow through L type channels
47
Duration of cardiac action potential
300 ms
48
Duration of nerve cell action potential
1 to 2 ms
49
How is tetanic / sustained contraction of cardiac muscle prevented
Ion channel inactivation - prolonged refractory period
50
Natural firing rate of the SA node
100 - 120 bpm
51
Why is heart rate slower than intrinsic firing rate of SA node
Dominant vagal parasympathetic activity
52
Ionic sequence of SA node action potentials
1) Continuous slow inward leak of Na+ until the threshold potential of -40 mV is reached 2) Main depolarization brought about by Ca2+ (not Na+) inflow through L-type channels 3) Repolarization from K+ outflow There is no resting phase or resting membrane potential, and phases 1 and 2 of the action potential are absent. The cycle length determines the heart rate.
53
How is heart rate changed from an action potential / ionic perspective
Phase 4 slope is altered to make cycle length shorter or longer Increased Na+ permeability -> Tachycardia Increased K+ permeability -> Bradycardia
54
Pacemaker cell action potential graph
55
Time delay applied to impulse by AV node
~100 ms
56

Anaesthetic FRCA Primary - Teaching Days (64 decks)

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