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Pathophysiology I: Exam I > Cardiac Physiology > Flashcards

Cardiac Physiology Flashcards

1
Q

Blood pathway

A

toe/finger ►inferior/superior vena cava►RA►tricuspid valve►RV►pulmonary valve►PA►lung

Pulmonary vein►LA►Mitral valve►LV►aortic valve►aorta►coronary arteries►body

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2
Q

S1

A

associated with ventricular contraction

sound when tricuspid and mitral valves close

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3
Q

S2

A

associated with ventricular relaxation (repolarization)

sound of aortic and pulmonic valve closing

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4
Q

Auscultation of the heart (4 areas)

A
  • aortic
  • pulmonic
  • tricuspid
  • mitral
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5
Q

auscultation of the heart

aortic area

A

2nd to 3rd right intercostal space

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6
Q

auscultation of the heart

pulmonic area

A

2nd to 3rd left intercostal space

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7
Q

auscultation of the heart

tricuspid area

A

lower left sternal border

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8
Q

auscultation of the heart

mitral valve

A

apex

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9
Q

A

A

aorta

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10
Q

B

A

right coronary artery

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11
Q

C

A

coronary vein

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12
Q

D

A

left main coronary artery

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13
Q

E

A

left circumflex coronary artery

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14
Q

F

A

left anterior descending coronary artery (LAD)

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15
Q

coronary arteries

A

right coronary artery

left anterior descending coronary artery

circumflex coronary artery

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16
Q

coronary arteries

RCA supplies:

A

right side of heart

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17
Q

coronary arteries

LAD supplies:

A

left anterior

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18
Q

coronary arteries

circumflex supplies:

A

left posterior

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19
Q

A

A

circumflex coronary artery

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20
Q

B

A

coronary sinus

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21
Q

C

A

right coronary artery

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22
Q

cardiac conduction pathway

A
  1. SA node
  2. AV node
  3. Bundle of His
  4. Right and left bundle branches
  5. Purkinje fibers
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23
Q

P wave

A
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24
Q

QRS complex

A

activation of the ventricles

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25
Q

T wave

A
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26
Q

3 layers of a blood vessel

A
  1. Tunica intima
  2. Tunica media
  3. Tunica adventitia
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27
Q

blood vessels

outer layer

A

tunica adventitia

contains:

  1. connective tissue
  2. vaso vasorum
  3. nerve
  4. lymph
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28
Q

vaso vasorum

A

blood supply to the blood vessels

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29
Q

Tunica media

A

smooth muscle cells

controlled by ACE

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30
Q

tunica media

ACE

A

Angiotensin Converting Enzyme

controls blood volume, kidneys

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31
Q

blood vessels

tunica intima

A

single epithelial layer

  1. prevents substance transfer from blood into vessel
  2. anti and prothrombotic secretions
  3. dilation metabolites
  4. constriction metabolites
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32
Q

How does the tunica intima prevent substance transfer from blood into the vessel?

A

acts as a barrier to cholesterol

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33
Q

tunica intima

dilation metabolites

A

NO

Prostaglandins

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34
Q

tunica intima

constriction metabolites

A

endothelin

superoxide

thromboxane

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35
Q

blood vessels

valves

A

only in veins,

prevent blood flow back to the extremities

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36
Q

blood vessels

decreased venous return

A

causes swelling in the feet due to fluid retention

must excrete or increase blood volume

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37
Q

A

A

tunica intima

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38
Q

B

A

elastin

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39
Q

C

A

tunica media

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41
Q

D

A

tunica externa

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42
Q

common causes of atrial clots

A

atrial fibrillation

bruits

bifurcations

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43
Q

A-fib

A

multiple messages, sporadic contractions in the atria

can lead to clotting

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44
Q

venous clots cause

A
  • stasis of blood
  • lack of movement
45
Q

medication to break up a clot

46
Q

risks associated with DVT

A

pulmonary embolus

flows through the heart into the increasingly smaller airways

47
Q

What medication should someone with a DVT be on?

A

blood thinners (Coumadin/Warfarin, Heparin)

needed to prevent platelet aggregation

48
Q

SV

A

stroke volume

amount (in L) of blood pumped in one beat

49
Q

what is SV a measure of?

A

preload (venous return)

x

contractility (how hard the muscle is squeezed)

50
Q

CO

A

cardiac output

HR x SV

51
Q

BP

A

CO x TPR

  • *TPR = total peripheral resistance**
  • whether vasodilated or vasoconstricted affects
52
Q

What regulates blood pressure? (3)

A
  1. Heart-pumping pressure
  2. Blood vessel tone
  3. Kidney
53
Q

3 layers of blood vessels

A
  • Tunica adventitia
  • Tunica media
  • Tunica intima
54
Q

vaso vasorum

A

blood supply to the blood supply

55
Q

Tunica adventitia components

A
  • nerve
  • lymph
  • connective tissue
  • vaso vasorum
56
Q

Tunica media

A

smooth muscle cells

angiotensin converting enzyme (ACE) controls

57
Q

Tunica intima

actions

A
  • prevents substance transfer from blood into the vessels
  • antithrombotic and prothrombotic secretions
  • dilation metabolites
  • constriction metabolites
58
Q

dilation metabolites

A

NO

prostaglandins

59
Q

dilation constrictors

A

endothelin

superoxide

thromboxane

60
Q

tunica intima

turbulent blood flow

A

can damage tunica indica

turbulent blood flow at bifurcation points can cause scarring over time

61
Q

valves

A

only present in the veins

prevent backflow into the extremities

62
Q

fluid retention

A

decreased venous return causes swelling in the extremities

63
Q

how to decrease fluid retention

A

increase blood volume

excrete fluid

64
Q

DVT

A

deep vein thrombosis

blood clot in a vein

65
Q

risk of DVT

A

pulmonary embolus

flows through the heart to increasingly smaller pathways of the lungs

66
Q

Why is there a greater risk of DVT after surgery?

A

caused by stasis of blood and lack of movement

67
Q

stroke volume =

A

preload (venous return) x contractility (how hard the muscle is squeezed)

68
Q

Cardiac output =

A

stroke volume x HR

69
Q

BP =

A

cardiac output (SV x HR) x TPR

TPR = total peripheral resistance

70
Q

blood pressure regulation

3 factors

A
  1. heart pumping pressure
  2. blood vessel tone
  3. kidney
71
Q

Frank Starling Mechanism

A

The heart pumps all blood that comes to it within the physiologic limits

72
Q

What controls heart pumping pressure?

A

sympathetic and parasympathetic control of HR and CO

73
Q

blood vessel tone

A

systemic resistance to flow

74
Q

What does blood vessel tone rely on?

A
  • compliance of vessels
    • arteries
    • veins
    • capillaries
75
Q

Blood vessel tone

What happens when sympathetic stimulation is increased?

A

see an increase in BP

*atherosclerosis and aging altered vascular compliance, PVD, hypertension, etc.

76
Q

How do kidneys regulate blood pressure?

A

Blood volume control

Local factors

  • interstitial pressure
  • hormones
  • local control
77
Q

Local control of blood pressure by the kidneys

A

removal of water

removal of salt

78
Q

pressure diuresis

A

removal of water

79
Q

pressure natriuresis

A

removal of salt

80
Q

ejection fraction in normal adults

A

60-75% of blood expelled

81
Q

Hypertension

3 stages

A
  1. 140-159 SBP, 90-99 DBP
  2. 160-179 SBP, 100-109 DBP
  3. greater than 180, greater than 110
82
Q

hypertension

two major categories

A
  1. essential hypertension (EH)
  2. secondary hypertension
83
Q

essential hypertension

A

unknown cause in 95% of cases

  • genetics or stress possibly causes
84
Q

secondary hypertension

A

result of a known cause

i.e. kidney or bladder infection, arterial disease, Cushing’s syndrome, etc

85
Q

LVEDV

A

left ventricular end diastolic volume

occurs after atrial kick

86
Q

ejection fraction

A

amount you spit out divided by total amount of blood in the ventricle

SV/EDV

60-75% is normal

87
Q

muscle contraction in the heart

delays?

A

muscles need to contract simultaneously in the heart

88
Q

renin

A

released by kidney due to decrease in pressure

89
Q

angiotensin I

A

released systemically due to renin in circulation

90
Q

Angiotensin I is converted to (1) in the (2) by (3)

A
  1. Angiotensin II
  2. lungs
  3. ACE (Angiotensin Converting Enzyme)
91
Q

Angiotensin II causes

A
  • causes vasoconstriction and decreased excretion of salt and water by the kidneys
  • due toincreased release of aldosterone
92
Q

aldosterone

(1) Result

(2) Drug

A

produces reabsorption of salt and water

(1) Result: Elevated BP (hypertension and potential long term CHF)

(2) Drug: ACE inhibitor

93
Q

Sleep Apnea and Acute Hypertension

chemoreflexes

A

influence cardiac, vascular, and breathing control

94
Q

Sleep Apnea and Acute Hypertension

What do chemoreflexes respond to?

A

hypoxia

hypercapnia

95
Q

Sleep Apnea and Acute Hypertension

Stimulation of chemoreceptors leads to what response?

A

sympathetic response of vasoconstriction

96
Q

sleep apnea and acute hypertension

peripheral chemoreceptors

A

carotid bodies of carotid artery

respond to hypoxia

97
Q

sleep apnea and hypertensives

central chemoreceptors

A

brain stem and respond to hypercapnia

98
Q

How do hypertensives respond to hypoxia or hypercapnia?

A

exaggerated response

99
Q

renal artery stenosis

A
  1. Fibromuscular dysplasia (FMD)
  2. Atherosclerosis
100
Q

Who does fibromuscular dysplasia (FMD) typically affect?

A

young women

101
Q

S/S renal artery stenosis

atherosclerosis

A

hypertension

renal failure

refractory angina

recurrent episodes of CHF

flash pulmonary edema

102
Q

S/S renal artery stenosis

treatment

A

stent of renal artery

angioplasty

103
Q

What is this condition?

A

FMD

fibromuscular dysplasia

104
Q

What is heart failure?

A

“the inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure),

or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure), or both.”

105
Q

preload

A

amount of blood filling along with stretch

106
Q

afterload

A

what heart is pumping against

  1. hypertension
  2. blood volume
  3. vascular compliance

Pathophysiology I: Exam I (6 decks)

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