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Cardiology > Cardiac Physiology > Flashcards

Cardiac Physiology Flashcards

1
Q

What are the components and structure of the vasculature ?

A

Arteries ( Elastic and Muscular)
Arteriorles
Capillaries
Venules
Veins (Medium and Large)

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2
Q

Which has a bigger lumen artery of veins ?

A

Veins

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3
Q

What are the three layers of the veins arteries and veins ?

A

Tunica Intima
Tunica Media
Tunica adventicia

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4
Q

What is the tunica intima composed of ?

A

Endothelial cells

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5
Q

The Tunica intima relax and contract by relaxing which substance

A

Endothelial Nitric Oxide

These nitrates can be used for angina !!!

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6
Q

Nitrates can be used for angina, what does this do ?

A

Relax the tunica intima

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7
Q

What is the Tunica Media composed of ?

A
  • Made of smooth muscles
  • Has gap junctions
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8
Q

What is the Tunica adventitia composed of ?

A
  • Collagen and Elastic fibres
  • Elastic tissue
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9
Q

What type of arteries are there

A

Elastic (large_ - Distribution
Muscular (medium) - Distribution and resistance
Small - resistance

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10
Q

What is another name for elastic arteries ?

A

Windkessel vessel

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11
Q

What is the tole of the elastic artery?

Where are they found?

A

Elastic arteries are those nearest the heart (aorta and pulmonary arteries) that contain much more elastic tissue in the tunica media than muscular arteries.

This feature of the elastic arteries allows them to maintain a relatively constant pressure gradient despite the constant pumping action of the heart.

EG there is always blood in the aorta despite the intermediate pumping of the heart.

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12
Q

What is the role of the arterioles?

A

Arterioles play a major role in the control of blood flow to organs or tissues.

By constricting and dilating

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13
Q

Explain how arteriorles are involved in autoregulation

A

Autoregulation is the ability of an organ or tissue to adjust its blood flow.
Arterioles control blood flow to organs and play an important role in Autoregulation

They do this by
- Myogenic theory
-Metabolic theory

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14
Q

Explain the myogenic theory in regard to arteriole autoregulation

learn

A

Vascular smooth muscles contract in response to increased wall tension and relax in response to decreased wall tension

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15
Q

What are the two theories of autoregulation

A
  • myogenic theory
  • Metabolic theory
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16
Q

Explain the metabolic theory of arteriole autoregulation

A

According to metabolic theory, blood flow to an organ or tissue is controlled by the metabolic activity of the tissue.

When blood flow decreases to the tissue, decreased oxygen supply results in formation of vasodilator metabolites that dilate the blood vessels and restore the flow.

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17
Q

Explain an aneurysm

A

An aneurysm is a bulge in a blood vessel caused by a weakness in the blood vessel wall, usually where it branches.
As blood passes through the weakened blood vessel, the BP causes a small area to bulge outwards like a balloon.

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18
Q

Explain the structure of a vein in comparison to artery

A

Veins are thin-walled
Veins have a larger lumen
Veins have valves

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19
Q

What contains more blood veins or arteries

A

Venules and veins are called capacitance vessels (blood reservoirs) because they contain approximately 2/3 of the blood supply at any given time.

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20
Q

What is venous return

A

Any blood returning to the heart

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21
Q

How is venous blood returned to the heart?

A

Skeletal Muscle Pump
Respiratory Pump

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22
Q

What is the central venous pressure?

A

Central venous pressure refers to the pressure in the right atrium because all the systemic veins open into the right atrium.

The normal right atrial pressure is about 0 mmHg, but it can rise to as high as 20–30 mmHg under abnormal conditions such as heart failure and massive blood transfusion

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23
Q

What is the peripheral venous pressure ?

A

The pressure in the venules (peripheral venous pressure) is about 7 - 10 mmHg.

As the veins approach the heart, there is a gradual decrease in the venous pressure.
In the great veins, near the heart, venous pressure is approximately 5 mmHg.

Blood loss by haemorrhage or loss of body fluids through: severe sweating, vomiting, or diarrhoea will decrease circulating blood volume and significantly reduce the volume of blood in the veins and thus decrease the peripheral venous pressure.

Conversely, transfusion, fluid retention by the kidney, or transcapillary fluid reabsorption will increase circulating blood volume and venous blood volume.

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24
Q

What are Varicose veins ?

A

Varicose veins are swollen and enlarged veins that usually occur on the legs and feet. They may be blue or dark purple, and are often lumpy, bulging or twisted in appearance.
Other symptoms include:
aching, heavy and uncomfortable legs
swollen feet and ankles

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25
Q

What is deep vein thromobosis ?

A

Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs.
Deep vein thrombosis can cause leg pain or swelling. Sometimes there are no noticeable symptoms.

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26
Q

What are the three types of cappilaries ?

A

1- continuous or non-fenestrated capillaries -
Found in most of the body tissues like skeletal muscle, adipose tissue, connective tissue & pulmonary circulation

2- fenestrated capillaries - Found in organs like renal glomeruli, intestinal villi, most endocrinal glands, ciliary processes in the eye & choroid plexus

3 - discontinuous capillaries or sinusoids-
Such capillaries are also called sinusoids and are found in bone marrow, liver and spleen.

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27
Q

What are the structure of capillaries?

A

Capillary bed: network of connecting capillaries that join the arterial and venous systems.
Capillary beds control of blood distribution
Under neural, hormonal and local control
Capillary beds have precapillary sphincters at the junction of capillaries and the meta arteriole.
Constriction of these sphincters reduces the blood flow through their respective capillaries.
When this occurs, blood is diverted to tissue or organs elsewhere.

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27
Q

Explain the three reasons for oedema in the dynamics of capillary exchange

GO OVER THIS

A

1- Disruption of balance between filtration and absorption
2- Increase in hydrostatic pressure
3- Decrease in plasma protein concentration
Increase in interstitial proteins

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28
Q

What is blood pressure ?

A
  • BP is the lateral pressure exerted by the moving column of blood on the walls of the vessels.
  • Only applicable to arteries
29
Q

What is the mean arterial pressure (MAP)

A

The average pressure measured throughout the cardiac cycle.

30
Q

Why is blood pressure always an arterial reading?

A

The reading comes from the aorta

31
Q

What is cardiac otuput?

A

CO = HEART RATE (HR) X STROKE VOLUME (SV)

32
Q

What detect the change in Blood pressure and responds to it rapidly ?!

A

Baro receptors reflex
Chemoreceptor reflex
CNS ischemic refluex

33
Q

Where are the baroreceptors reflex ?

A

Carotid sinus &
Aortic sinus

34
Q

Where are the chemoreceptor’s reflex?

A

Central Chemoreceptors
Medulla
Peripheral Chemoreceptors
Carotid body &
Aortic body

35
Q

Explain the baroreceptor reflex in regards to blood pressure

A
36
Q

Explain chemoreceptor reflex in regards to blood pressure

A
37
Q

Explain the cushings (CNS) ischemic response in regards to Blood pressure

A

Cushing’s Reflex
In conditions of gross hypotension as seen in acute severe haemorrhage, blood flow is compromised to the vital organs of the body.
Decreased cerebral blood flow pro­duces hypoxia and hypercapnia of vasomotor center, which stimulates vasomotor center to cause intense vasocon­striction.
So that raised pressure maintains minimum blood flow to important organs.
The reflex response is called as CNS ischemic response.
This is activated when BP falls below 40 mm Hg.
This is the last physiological reflex to correct BP, failure of which leads to irreversible shock

38
Q

What is an intermediate term BP control mechanism?

A

1- Renin- Angiotensin - aldosterone system

2- Capillary fluid shift mechnism

39
Q

Explain the Renin angiotensin aldosterone system

A

Happens when BP is LOW

40
Q

What is the function of aldosterone ?

A

sodium reabsorption

sodium and water are besties? increases volume of blood

41
Q

Explain Capillary fluid shift mechanism

A
  • Restores both low and high BP back to normal.
  • When BP is raised, the mean capillary pressure is also high, resulting in shift of fluid from circulation to the interstitial fluid compartments.
  • This reduces the blood volume to restore the arterial pressure.
    When BP is lowered, the mean capillary pressure is also low, resulting in absorption of fluid from the interstitial compartments to circulation. Thus, the blood volume is increased which helps to return the BP back to normal.
42
Q

What is Diuresis

A

Urinating

43
Q

What is a long term BP control mechanism

A

Pressure Diuresis and Natriuresis.

Happens whenever BP is high

44
Q

How much fluid does the heart get per minute ?

A

250ml per minute (5% of the resting cardiac output)

45
Q

What does CBF stand for ?

A

Cerebral blood flow

46
Q

How do you measure Cerebral blood flow ?

A

Kety’s Nitrous oxide method.

47
Q

What is Kety’s Nitrous oxide method?

A

The method entails placement of jugular venous and arterial catheters.

48
Q

The major factors determining blood pressure are what?

A

Cardiac output and peripheral resistance

49
Q

What starlings force move fluid out of the capillaries

A

Blood hydrostatic pressure

50
Q

The colloid osmotic pressure of the blood is caused by what

A

the presence of protein in the blood

51
Q

Which of all the vessles have the highest total cross-sectional area in the body and is involved in the exchange of gases ?

A

Capillaries

52
Q

In a 21-year old health male college student, which of the following blood vessels has the capability to offer resistance to the blood flow in his circulation system?

A

Arterioles

53
Q

Rank blood vessels in order of decreasing wall thickness starting from artery

A

Artery, arteriole, metarteriole, capillary.

54
Q

A continuous capillary has ____ but not _____

A

Intercellular clefts

but not

tight junctions

55
Q

If a person’s blood pressure is 110/70, then the pulse pressure is what ?

A

40 mm/hg

56
Q

Informaiton about changes in blood pressure is collected and sent to the brain by _______

A

baroreceptors

57
Q

If blood pressure is too low the cardiovascular control center in the medulla oblongata attempts to compensate by causing what ?

A

Increased heart rate and vasoconstriction

58
Q

According to the metabolic theory, blood flow to a tissue increases if _________

A

the level of carbon dioxide in the tissue increases

59
Q

The long-term mechnism for regulation of blood pressure involves regulating what ?

A

Kidneys to regulate blood volume

60
Q

What is the blood pressure in the pulmonary circuit ?

A

28/8 mmhHg

61
Q

What is the blood pressure in the systemic circuit ?

A

120/80

62
Q

How long is one cardiac cycle ?

A

0.8 seconds

63
Q

What is the definition of heart failure ?

A

When the heart is unable to pump blood at a rate required by metabolism tissues or can do so only with an elevated filling pressure.

It can result in an issue with the left ventricle to

1- fill - diastolic preformance

2- Eject pump - systolic performance.

64
Q

What is diastole ?

A

the relaxation phase

65
Q

what is systole ?

A

The contraction phase

66
Q

What is a ventricular isovolumetric contraction?

A

Occurs when both calves are closed.

During this early contraction, ventricular pressure rises but there is no change in ventricular volume (isovolumetric contraction).

67
Q

What are the phases of the cardiac cycle ?

A
68
Q

What is special about the cardiac muscle ?

A
  • Intercalated discs link musle cells together and contain desmosomes and gap junctions.
  • Desomosomes hold the muscle cells together tighly.
  • Gap junctions allow passage of action potential from one cell to the next very quickly allowing the cardiac muscle to function together as a syncitum.
69
Q

What do gap junctions in the cardiac muscle do ?

A
  • Gap junctions allow passage of action potential from one cell to the next very quickly allowing the cardiac muscle to function together as a syncitum.
70
Q

What do desmosomes do in the cardiac muscle?

A
  • Desomosomes hold the muscle cells together tighly.

Cardiology (18 decks)

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