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Physiology > Cardiac Cycle 14 > Flashcards

Cardiac Cycle 14 Flashcards

1
Q

What are the three types of plasma proteins?

A
  1. Albumins
  2. Globulins
  3. Fibrinogen
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2
Q

Albumin

A

Accounts for 60-80% of PP and smallest; made by liver

- creates colloid osmotic pressure

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3
Q

Globulins

A

3 types : alpha, beta, and gamma globulin

  • Alpha and Beta globulins are made by the liver and transport lipids and fat soluble vitamins.
  • Gamma globulins are antibodies produced by lymphocytes
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4
Q

Define anemia

A

Any condition in which there is an abnormally low [hemoglobin] or RBC
- spencer doesn’t like this definition b/c there is actually plenty of Hb but not enough iron for hemoglobin

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5
Q

Iron-deficiency anemia

A

Caused by deficiency of iron

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6
Q

Pernicious anemia

A

Caused by inadequate [vitamin b12], which is needed for RBC production

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7
Q

Aplastic anemia

A

Due to the destruction of bone marrow

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8
Q

Polycythemia

A

Abnormal increase in RBC

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9
Q

What is Rh factor ?

A

It is another type of antigen found on RBC’s

  • Rh+ has Rho(D) antigens; Rh- does not
  • can cause problems when Rh- mother has Rh+babies
  • at birth mother may be exposed to Rh+ blood of fetus
  • in later pregnancies mom may produce antibodies against Rh
  • in Erythroblastosis fetalis, this happens and antibodies cross placenta causing hemolysis of fetal RBC’s
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10
Q

Hemostasis

A

Cessation of bleeding that happens in 3 ways:

  1. Vasoconstriction restricts blood flow to area
  2. Formation of platelet plug
  3. Production of web of fibrin proteins
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11
Q

Anticoagulants

A

Clotting can be prevented by

  • Ca++ chelators (things that attatch ca++ to them, so not available for clotting to happen)
  • heparin which activates anti thrombin 3
  • coumarin blocks clotting by inhibiting activation of vit K
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12
Q

What percent of plasma do plasma proteins constitute?

A

7-9%

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13
Q

Define Cardiac cycle

A

repeating pattern of contraction and relaxation of heart.

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14
Q

define end-systolic volume

A

is amount of blood left in ventricles at the end of systole

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15
Q

define stroke volume

A

is amount of blood ejected from ventricles during systole

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16
Q

Define end-diastolic volume

A

is amount of blood left in ventricles at the of diastole

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17
Q

What is isovolumetric contraction?

A

as the ventricles begin contraction, pressure rises closing the AV valves. This is isovolumetric because all the valves are closed.

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18
Q

What happens when the pressure in the ventricles exceeds that in aorta?

A

the semilunar valves open and ejection begins and as pressure in the ventricle falls below that in aorta, back pressure closes semilunar valves.

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19
Q

What occurs when the pressure in the ventricles falls below atria?

A

AV’s open and ventricles fill

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20
Q

how much do the ventricles fill during ventricular diastole?

A

about 80%

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21
Q

How much does atrial systole send of total ventricular blood into the ventricles

A

about 20%

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22
Q

What is the first sound of the heart called ?

A

Lub (1st sound)- produced by closing of AV valves (btw atria and ventricles)

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23
Q

What is the 2nd sound of the heart called?

A

Dub (2nd sound)- produced by closing of seminars (btw ventricles and aorta or pulmonary artery)

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24
Q

What is a heart murmur?

A

abnormal sounds produced by abnormal patterns of blood flow in heart. (irregular blood flow)

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25
Q

What can heart murmurs be caused by?

A

many caused by defective heart valves

  • can be of congenital origin
  • in rheumatic fever, damage can be from antibodies made in response to strep infection
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26
Q

What occurs in mitral stenosis, 1st stage.

A

the mitral (A-V) valve becomes thickened and calcified impairing the blood flow from left atrium to left ventricle. this causes accumulation of blood in left ventricle that can lead to pulmonary hypertension

27
Q

2nd stage of mitral stenosis

A
  • the valves are incompetent when they do not close properly.
  • can be damage to papillary muscles
28
Q

Murmurs caused by septal defects are usually congenital due to…

A

holes in septum btw left and right sides of heart

-pressure causes blood to pass from left to right.

29
Q

Are myocardial cells short or long?

A

They are short, branched and interconnected by gap junctions

30
Q

the myocardium works in what ?

A

functional syncytium, because AP’s originating in any cell are transmitted to all others.
-chambers separated by nonconductive tissue.

31
Q

Ectopic pacemakers

A

other tissues in heart are spontaneously active but are slower than SA node
-heart beat is way out of range

32
Q

Myocardial AP’s

A

myocardial cells have RMP of -90mV; depolarized to threshold by AP’s originating in SA node

33
Q

Plateau results from what

A

From balance btw slow Ca++ influx and K+efflux

-repolarization due to opening of extra K+channels

34
Q

does the AP’s from SA node that spread through the atrial myocardium via gap junction need a special pathway to ventricles ?

A

yes b/c of non-conducting fibrous tissue

-AV node at base of right atrium and bundle of His conduct AP’s to ventricles.

35
Q

In the septum of ventricles the bundle of His does what?

A

divides into right and left bundle branches which gives rise to Purkinje fibers in walls of ventricles; these stimulate contraction of ventricles.

36
Q

excitation contraction coupling

A

depolarization of myocardial cells open V-gated Ca++ channels in sarcolemma
-causes opening of V-gated and Ca++ channels release channels in SR(calcium-stimulated-calcium-release)

37
Q

Calcium-stimulated-calcium-release does what

A

Ca++ binds to troponin and stimulates contraction (as in skeletal muscle); during depolarization Ca++ pumped out of sarcoplasm and into SR.

38
Q

Refractory periods contain what

A

heart contracts as syncytium and thus cannot sustain force; its AP lasts about 250msec

39
Q

what is an EKG/ECG?

A

it is a recording of the electrical activity of the heart conducted thru ions in body to surface and recorded by electrodes placed on the skin.
- Note: ECG is not recording of AP!! it is a recording of the electrical activity of the heart!

40
Q

What are the 3 distinct waves produced during cardiac cycle?

A

P wave- caused by atrial depolarization
QRS complex- results from ventricular depolarization
T wave- results from ventricular re-polarization

41
Q

where is the atrial repolarization?

A

it is hidden by the QRS complex

42
Q

what are the correlations of ECG with heart sounds

A 
1st sound (lub) comes immediately after QRS wave as AV valves close
2nd heart sound (dub) comes as T wave begins and semilunar valves close.
43
Q

what is arteriosclerosis?

A

it is a heart disease that causes the hardening of the arteries. it accounts for 50% of deaths in US, Europe, and Japan.

44
Q

what happens in arteriosclerosis?

A

localized plaques (artheromas) reduce flow in an artery and act as sites for thrombus (blood clots)

45
Q

Is high cholesterol associated with risk of atherosclerosis?

A

YES

46
Q

where is cholesterol carried in the blood ?

A

is carried in blood attached to LDL’s (low density lipoproteins) and HDL’s (high density lipoproteins)

47
Q

where are HDL and LDL produced?

A

in the liver and taken into cells by receptor mediated endocytosis

  • in blood vessels LDL is oxidized & cause damage.
  • liver has receptor for HDL and don’t get oxidized
48
Q

Arteries have receptors for LDL or HDL?

A

LDL, only the liver has HDL receptors, which is why HDL is not atherosclerotic

49
Q

what is ischemia?

A

a lack of oxygen anywhere in the body

-causes increased lactic acid from anaerobic metabolism.

50
Q

what is angina pectoris

A

substernal pain or left shoulder and arm pain

51
Q

what is a MI?

A

Myocardial infraction= heart attack

  • caused by prolonged (minutes) periods of ischemia resulting in necrosis
  • leading cause of death in the world
  • diagnosed by high levels of CPK and troponin
52
Q

define arrhythmias?

A

they are abnormal heart rhythms which are detectable by changes in EKG

53
Q

What is tachycardia?

A

heart rate above 100bpm

54
Q

what is brachycardia?

A

heart rate below 60bpm

55
Q

what is a flutter

A

coordinated contraction rates can be 200-300/min

56
Q

fibrillation

A

contraction of myocardial cells is uncoordinated and pumping ineffective

57
Q

Ventricular fibrillation is …

A

LIFE THREATENING

58
Q

electrical defibrillation does what

A

resynchronizes heart by depolarizing all cells at same time

59
Q

what is AV node block

A

occurs when node is damaged

60
Q

First degree AV node block is

A

is when conduction through AV node >0.2 sec

-causes long P-R interval

61
Q

second degree AV node block is

A

when only 1 out of 2-4 atrial AP’s can pass to ventricles

-causes P waves with no QRS

62
Q

third degree or complete AV node block is

A

no atrial activity passes to ventricles. Ventricles driven slowly by bundle of His or Purkinjes

63
Q

fibrinogen

A
  • Fibrinogen 4% PP: produced by the liver; serves as a clotting factor, converted to insoluble threads called fibrin during clotting process.

Physiology (6 decks)

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