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Cardiopulmonary PT > Cardiac Physiology > Flashcards

Cardiac Physiology Flashcards

1
Q

What is the metabolic-cardiovascular-ventilatory coupling?

A

Cellular activity in periphery: increased O2 demand and increased CO2 production in the peripheral circulation

This leads to dilation of vessels causing increased SV and increased HR

Then the heart recruits the pulmonary system and there is an increase in tidal volume and breathing frequency

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2
Q

What are the 2 antagonistic subdivisions of the cardiopulmonary system?

A

Parasympathetic and sympathetic NS

Afferent/Efferent nerves

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3
Q

What are parts of the parasympathetic NS?

A 
Vagus nerve (CN X)
Thorax and upper abdomen
~75% of nerve fibers
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4
Q

Where do preganglionic sympathetic fibers originate?

A

Preganglionic cardiac and pulmonary sympathetic fibers originate in the spinal cord at T1-T5

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5
Q

What do sympathetic postganglionic fibers do?

A

Reach viscera
Run along surface of great vessels
Bronchi and vascular muscle

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6
Q

What are 2 neurotransmitters?

A

Acetylcholine (cholinergic): postganglionic parasympathetic

Norepinephrine (adrenergic): postganglionic sympathetic, there are exceptions (few blood vessels, sweat glands, and piloerector muscles

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7
Q

what are the cholinergic receptors?

A

Muscarinic: post-synaptic and effector
Nicotinic: pre/post synaptic neurons in ANS
Found in smooth muscle of lungs, bronchioles, cardiac tissue

Pair up with parasympathetic system

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8
Q

What are the adrenergic receptors?

A

Alpha 1: vascular smooth muscle
Alpha 2: help decrease sympathetic activity
Beta 1: located in atria, SA node, ventricle; increase in HR, this is where beta blocker drugs come from
Beta 2: in bronchiole smooth muscle

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9
Q

Where are dopaminergic receptors found?

A

receptors in adrenal gland, blood vessels, heart

Found in sympathetic nervous system

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10
Q

What is the pacemaker of the heart?

A

SA node

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11
Q

What is important of pulmonary ventilation?

A

Exchange of O2 (actively)
Exchange of CO2 (passively)
Control blood acidity
Oral communication: vibration of vocal cords

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12
Q

What controls normal/autonomic breathing versus forced breathing?

A

Brain stem regulates normal breathing.
Corticospinal tract can override the brain stem to make us breathe deeper.
Neurons in medulla fire when breathing needs increased (activated by chemo receptors)

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13
Q

What happens to lung pressures during inspiration?

A

External intercostals (move ribs up), and diaphragm (move ribs out) contract
Increases lung volume
Chest cavity pressure lowers
AIR FLOWS IN

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14
Q

What happens to lung pressure during expiration?

A

AIR FLOWS OUT
Inspiratory muscles relax and chest cavity recoils
Chest cavity pressure is greater than atmospheric pressure

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15
Q

What about A-V O2 difference?

A

Difference between what’s in arterial system versus venous system.
In the lung: capillaries full of oxygen rich blood
After muscles: CO2 is higher than O2 because we have used it all up with the muscle

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16
Q

What is typical tidal volume, anatomic dead space, breathing frequency?

A

500 mL
Area where gas exchange doesn’t occur
12-15 breaths/minute

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17
Q

What is tidal volume?

A

Volume of air that is normally exhaled/inhaled per breath

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18
Q

What is IRV?

A

Inspiratory reserve volume

Additional volume taken in

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19
Q

What is ERV?

A

Expiratory reserve volume

Additional volume let out

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20
Q

What is RV?

A

Residual volume

Volume of air that remains in the lungs after a forceful expiratory effort

21
Q

What is IC?

A

Inspiratory capacity
Sum of tidal and inspiratory reserve volumes
Maximum amount of air that can be inhaled after a normal tidal exhalation

22
Q

T/F: IC is the sum of tidal and inspiratory reserve volumes?

A

True

23
Q

What is FRC?

A

Sum of expiratory reserve and residual volume.

Amount of air remaining in lungs at the end of normal tidal exhalation.

24
Q

What does FRC represent?

A

point at which the forces tending to collapse the lungs are balanced against forces tending to expand the chest wall

25
Q

T/F: during COPD the FRC gets smaller?

A

False, it should get bigger

26
Q

What is VC?

A

Vital capacity
Sum of inspiratory reserve tidal and expiratory reserve volumes.
Maximum amount of air that can be exhaled following a maximum inhalation.

27
Q

What is TLC?

A

Total lung capacity.
Maximum volume to which the lungs can be expanded.
Sum of all pulmonary volumes

28
Q

What is Ve?

A

Minute ventilation.

Product of tidal volume and respiratory rate

29
Q

What is FVC?

A

Forced vital capacity

Maximum volume of air exhaled from a full inhalation.

30
Q

What is FEV1?

A

How much air that is blown out in first second.

If 70% or below you have COPD

31
Q

What happens to pulmonary measurements with obstructive and restrictive disease?

A

Obstructive: FEV/FVC will be less because you can’t get air out

Restrictive: FEV/FVC will be higher because you can’t get air in, no problems getting air out

32
Q

What is normal range for the body’s pH?

A

7.35-7.45

If too high or too low chemical reactions may not occur.

33
Q

What is the buffering system for the acid/base balance?

A

Carbonic Acid-Bicarbonate buffering: lungs blow off or hold CO2, kidneys absorb or regenerate bicarbonate

Body’s adjustment to pH changes: compensation
Values for bicarbonate and carbonic acid return to normal: correction

34
Q

What are normal values for bicarb and CO2 in body?

A

Bicarbonate: 22-26
CO2: 35-45

35
Q

What happens during respiratory acidosis?

A

Body has increased CO2.

Renal system compensates by increasing levels of bicarbonate.

36
Q

What are conditions that may cause respiratory acidosis?

A

COPD, pulmonary edema

Can’t blow air out so there is build up of CO2

37
Q

What happens during respiratory alkalosis?

A

Body has decreased CO2 (blowing off too much)

Kidneys compensate by decreasing amount of bicarbonate.

38
Q

What are conditions that may cause respiratory alkalosis?

A

Asthma

hyperventilating

39
Q

What is metabolic acidosis?

A

There is a decrease in bicarbonate.

Lungs compensate by blowing off more CO2 (increase respiratory rate)

40
Q

What conditions may cause metabolic acidosis?

A

Vomiting
People who use anaerobic metabolism at rest= organ failure
People who use body tissue for energy (end stage HIV, starvation)

41
Q

What is metabolic alkalosis?

A

There is increase in bicarbonate

Lungs compensate by increasing CO2 (decrease respiratory rate)

42
Q

What conditions may cause metabolic alkalosis?

A

Eat too many tums

43
Q

What controls pulmonary ventilation?

A

2 main regulatory centers: medullary inspiration center, medullary expiratory center
They establish rate and depth of breathing.
Cortex can override these centers: active respiration

44
Q

What controls respiratory muscles?

A

Motor neurons which are regulated by respiratory center.

45
Q

What happens when sensors in aveoli detect increased fluid in lung tissues?

A

Rapid, shallow breathing

46
Q

What happens when sensors in brain, carotid, and aorta detect carbon dioxide or oxygen levels in your blood?

A

Increased/decreased rate of breathing

47
Q

What happens when body sensors in your joints and muscles detect physical activity?

A

Increased breathing rate

48
Q

What are other factors that control pulmonary ventilation?

A

Peripheral chemoreceptors: sensitive to changes in PO2, PCO2, H
Lung receptors: acute stretch of alveoli (safety mechanism- decrease duration of inspiration)
Mechanical receptors: sense movement in skeletal muscles

Cardiopulmonary PT (19 decks)

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