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Fundies First Module--First Exam > Cardiac Physiology > Flashcards

Cardiac Physiology Flashcards

1
Q

vessels with elastic, smooth muscle, and connective tissue

A

arteries

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2
Q

smallest branches of arteries

A

arterioles

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3
Q

site of highest resistance to flow

A

arterioles

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4
Q

arterial system innervated by the _______ NS

A

Sympathetic

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5
Q

single cell endothelium walled blood vessels

A

capilaries

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6
Q

site of exchange of nutrients, waste products, (H2O, glucose, CO2)

A

capillary beds

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7
Q

vasoactive substance examples

A

epinephrine( will close capillary beds), acids (normal pH 7.4ish), histamine

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8
Q

for hives or allergic reaction

A

antihistamines

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9
Q

histamine released by

A

mast cells

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10
Q

_______ is related to the volume of blood inside a blood vessel

A

capacitance

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11
Q

more blood in ______ blood tree than ______

A

venous (64%), arterial

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12
Q

Volume/Pressure =

A

compliance

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13
Q

if volume of vessel increases with only small changes in pressure that vessel is said to be _______

A

compliant

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14
Q

if small change in volume results in large change in pressure, vessel is

A

non-compliant

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15
Q

blood vessels vary widely in______

A

compliance– based on vessel wall make-up

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16
Q

Veins have much less _______ and ______ than arteries in wall

A

elastin and smooth muscle

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17
Q

sympathetic activation of veinous smooth muscle (lower compliance) for purpose of

A

shifting blood to arterial system

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18
Q

veins have higher ability to change ________ over arteries

A

capacitance

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19
Q

nociceptive afferent fiber synapses on dorsal horn interneuron which synapses on ipsilateral ventral horn motor neurons which excite flexion and inhibit extension of limb (this is reciprocal innervation)

A

withdrawal reflex

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20
Q

decreased venous compliance =

A

decreased capacitance

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21
Q

for congestive heart failure

A

decrease amount of blood being delivered to heart by makeing veins more compliant w/ nitroglycerin, sodium nitropusside–increases veinous CAPACITANCE and COMPLIANCE

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22
Q

nitric oxide is a natural potent

A

vasodilator–to treat angina

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23
Q

the tension or stress in the wall of the LV during ejection

A

afterload

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24
Q

blood velocity slowest in ________ due to ___________

A

capillaries, large surface area

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25
Q

velocity is inversely proportional to ____

A

area

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26
Q

Velocity of blood flow =

A

flow/ cross sectional area

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27
Q

Blood flow Q =

A

pressure difference P / resistance R

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28
Q

more resistance =

A

less flow (vol/unit of time)

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29
Q

Q is inversely proportional to ____

A

resistance (ex. viscosity of fluid, length/width of vessel) Radius biggest player

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30
Q

resistance to blood flow

A

Poiseulle equation

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31
Q

resistance to flow types– ________ and __________

A

series and parallel

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32
Q

series resistance

A

Rtotal = R1 + R2 + R3….

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33
Q

parallel resistance

A

1 / Rtotal = 1/R1 + 1/R2 + 1/R3….

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34
Q

more open capillary beds =

A

raise resistance

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35
Q

when fluid flows in parallel layers

A

laminar flow

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36
Q

when obstructions build up in vessels

A

non-laminar flow–makes noises

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37
Q

unusual sound blood makes as it rushes past obstruction

A

bruit

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38
Q

lowest pressure that occurs during cardiac cycle

A

diastolic pressure

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39
Q

systolic - diastolic pressure =

A

pulse pressure

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40
Q

volume of blood ejected from the one ventricle on a single cardiac cyclte (heartbeat)

A

stroke volume

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41
Q

volume of blood pumped by heart/ minute.

A

cardiac output

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42
Q

cardiac output =

A

stroke volume X heart rate

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43
Q

highest arterial pressure in cardiac cycle–

A

systolic pressure

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44
Q

systolic pressure happens ____-_______

A

mid-systole

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45
Q

diastolic pressure + 1/3 pulse pressure (estimates mean pressure)

A

mean arterial pressure

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46
Q

memorize mean pressures on outline

A

*

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47
Q

Pressure of aorta/ large arteries

A

100 mm Hg – measured with catheter through internal jugular

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48
Q

arterioles pressure

A

50 mm Hg – on exam numbers will be way off

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49
Q

capillary pressure

A

20 mm Hg

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50
Q

Vena cava pressure

A

4 mm Hg

51
Q

Right atrium pressure

A

0-2 mm Hg

52
Q

Pulmonary artery pressure

A

Sys-25 dia-8 mm Hg – 15 mm Hg mean

53
Q

pulmonary capillaries pressure

A

10 mm Hg

54
Q

pulmonary vein pressure

A

8 mm Hg

55
Q

left atrium pressure

A

2-5 mm Hg

56
Q

the end diastolic PRESSURE that stretches the right or left ventricle of the heart to its greatest geometric dimensions under variable physiologic demand

A

ventricular preload

57
Q

preload

A

end diastolic volume of ventricle–measure of optimal actin-myosin arrangement– related to sarcomere length at end of distole

58
Q

if BP is low and pressure is low it can be assumed that

A

preload is low and normal saline should be infused

59
Q

RV pressure

A

15-30 mm Hg

60
Q

LA pressure

A

6-12 mm Hg

61
Q

dyastoli

A

ventricle relaxed

62
Q

S1 sound

A

mitral valve closure

63
Q

S2 sound

A

aorta/ pulmonic closure—may be split due to vast difference in pressure

64
Q

S2 split

A

A2 – aortic 1st (higher pressure)

P2 – pulmonic 2nd

65
Q

capacitance vessels

A

veins

66
Q

specialized myocardial cells for purpose of generation and conduction of depolarization

A

nodes of heart–SAVe HIS KIN

67
Q

EKG Depolarization of atria

A

P wave– SA node

68
Q

Holds SA node stimulation of brief period

A

AV node–for purpose of complete atrial contraction

69
Q

Depolarization of ventricles

A

QRS complex–AV node

70
Q

more free intracellular Ca =

A

stronger heart contraction

71
Q

stimulates intracellular Ca release

A

Ca induced Ca release–extracellular Ca AP excitation

72
Q

SA resting membrane potential

A

not stable–decays to threshold 60-100 times/sec –> QRS automatically
its automaticity establishes heart rate

73
Q

sympathetic tone on SA node

A

make phase 4 steeper–faster heart rate–slide 31

74
Q

parasympathetic activity on heart

A

make phase 4 flatter–slows heart rate– slide 31

75
Q

SA node arrest due to

A

parasympathetic NS tone– slide 35

76
Q

imp anticholinergic drug

A

atropine–parasympathetolytic

77
Q

SA node intrinsic firing rate

A

70-80 BPM

78
Q

AV node intrinsic firing rate

A

40-60 BPM

79
Q

Bundle of His intrinsic firing rate

A

40 BPM

80
Q

Purkinje fiber intrinsic firing rate

A

15-20 BPM

81
Q

examples of when you’d see latent pacemakers “take over” driving heart rate

A

vagal tone and “heart blocker drugs”

82
Q

Slow depolarization of phase 4 result of

A

“funny” inward Na+ current

83
Q

“Funny” inward current turned on by

A

repolarization from the previous action potential–ensures another AP will follow

84
Q

Dopamine’s action on heart

A

speeds up heart rate by stimulating nerve release of norepi

85
Q

If SA node not firing or firing at same time as AV node

A

“Junctional Rhythm”–no P wave–passive filling of ventricles–20% loss of Cardiac output

86
Q

subunit of troponin

A

C, I, T – looked for in blood after MI

87
Q

allows small amount of Ca in to induce Ca release from sarcoplasmic reticulum

A

VOLTAGE GATED Ca channels

88
Q

voltage change inducing voltage gated Ca channels to open from outside cell

A

mediated by Na and K as any other cell

89
Q

STRENGTH of heart contraction directly related to

A

amount of FREE Ca within cell

90
Q

as with skeletal muscle–cardiac muscle must be stretched to ideal length to get

A

optimal contraction

91
Q

without atrial kick

A

loss 20% of cardiac output because myocardium not stretched to optimal level pre-systole

92
Q

frank-starling law says

A

increasing dyastolic pressure raises cardiac output–up to a critical point at which too much stretch from pressure causes not enough actin-myosin (too much preload) overlap and lowers cardiac output

93
Q

aortic pressure

A

after load

94
Q

ventricular end diastolic muscle fiber length

A

ventricular preload

95
Q

volume of blood ejected with each beat

A

stroke volume

96
Q

% of blood in the ventricle at the end of diastole, ejected with a single beat

A

ejection fraction – normally 55%

97
Q

cardiac output

A

stroke volume X heart rate

98
Q

with activity–heart contractility raises in stair step pattern due to

A

intracellular free Ca not pumped back into SR fast enough

99
Q

Parasympathetic tone only affects

A

decrease contractility–atria only

100
Q

sympathetic tone will

A

increase heart contractility–atria and ventricles

101
Q

pickle lady

A

rapid spike of salt in cardiac system–water follows salt–congestion of blood in lungs because heart can’t keep up. veinous backup will cause pt to cough up pink sputum. Overstretched heart, increased afterload because of raised resistance due to sympathetic tone on arteries, acedosis because of CO2 buildup, weakness due to bad blood profusion.

102
Q

central venous pressure related to

A

left ventricular pressure–> LV volume –> LA pressure–> etc.

103
Q

heart beats per munute

A

heart rate

104
Q

preload =

A

ventricular preload

105
Q

stretch of ventricle– position on frank-starling curve–aka actin-myosin positoning

A

preload–ventricular end diastolic muscle fiber length–(related to ventricular end diastolic volume or pressure)

106
Q

most important protein in blood contributing to oncotic pressure

A

serum albumin

107
Q

pressure would raise steeply in LV if

A

muscle was non-compliant due to prolonged untreated ^ BP–> hypertrophy of muscle = less compliance

108
Q

stroke volume X aortic pressure =

A

cardiac work

109
Q

cardiac work directly correlated with

A

O2 consumption

110
Q

volume work for heart MUCH easier than

A

pressure work

111
Q

Frank-Starling relationship between

A

pressure and volume

112
Q

Best way to treat ventricular hypertrophy is

A

make sure it never happens by treating ^BP–Beta blockers, Ca channel blockers–may get resistance from Pt’s due to side effects

113
Q

treat volume overload of heart with

A

diuretics

114
Q

beta-blockers and CCBs

A

decrease CONTRACTILITY –> decrease myocardial O2 requiremnts –> circumvent angina

115
Q

anti-anxiety drugs i.e. valium may help ^ BP or volume overload by

A

decreasing sympathetic tone–thereby decreasing myocardial O2 demands

116
Q

arterial side

venous side

A
  • hydrostatic pressure overpowers oncotic pressure–H2O out

- oncotic pressure overpowers hydrostatic–pulls water in

117
Q

pickle lady

A

more solutes in blood pull water into blood –> ^ blood volume–> heart must work harder (might not be able to)

118
Q

components of Starling forces

A
  • capillary hydrostatic pressure (PUSHING pressure w/in cap)
  • interstitial fluid hydrostatic pressure (pressure outside cap)
  • oncotic pressure (PULLING pressure w/in cap)
  • interstitial fluid osmotic pressure
119
Q

alpha 1 adrenergic agonis

A

constrict ARTERIAL tree–fight or flight (pale w/ fear)

120
Q

______ amount of capillary beds open at any time

A

small (10-20%) – brain, heart, kidneys always open–sympathetic

121
Q

parasympathetic NS innervates the

A

SA and AV nodes–> only atria

122
Q

^ thoracic space –> decrease in pleural pressure

A

general gas law

123
Q

difference in pressure across something (airway, lung wall, etc) “inside”-“outside” =

A

transmural pressure–general term (transplural P is subcat)

124
Q

transplural pressure=alveolar pressure - pleural pressure

A

keeps lungs inflated 0 - (-5) = 5

-1 - (-7) = 6

Fundies First Module--First Exam (13 decks)

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