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Phys 3 > Cardiac Physiology > Flashcards

Cardiac Physiology Flashcards

1
Q

Number 1 cause of death

A

Cardiovascular disease

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2
Q

Major underlying cause of cardiovascular disease

A

Ischemia

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3
Q

Ischemia can be due to

A

Atherosclerosis

Artery spasm

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4
Q

White thrombus

A

Platelet plug

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5
Q

Red thrombus

A

Blood coagulation

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6
Q

Inflammatory mechanisms couple dyslipidemia to

A

Atheroma formation

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7
Q

2 things that characterize early atherogeneis

A

Leukocyte recruitment

Proinflammatory cytokines

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8
Q

Inflammatory pathways promote

A

Thrombosis

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9
Q

___ responsible for MI and most strokes

A

Thrombosis

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10
Q

___ can modulate inflammation

A

NS

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11
Q

Hemostasis

A

Prevention of blood loss

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12
Q

Mechanisms of hemostasis

A

Vascular spasm
Platelet plug
Blood coagulation
Fibrous tissue

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13
Q

Vascular constriction can be due to

A

Neural reflexes
Local myogenic spasms
Local humoral factors

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14
Q

Local humoral factors include

A 
Thromboxane A2 (from platelets) 
Serotonin
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15
Q

___ important in small vessels

A

Local humoral factors

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16
Q

Responsible for most constriction

A

Local myogenic spasms

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17
Q

Platelets cannot

A

Divide

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18
Q

Platelet cell membrane contains

A

Phospholipids with platelet factor 3

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19
Q

Mechanisms of platelet activation

A
  1. Swell
  2. Irregular form (spikey)
  3. Contractile proteins cause granule release
  4. Secrete ADP, thromboxane A2, and serotonin
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20
Q

Constrictors

A

Thromboxane A2

Serotonin

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21
Q

___ potentials release of granule contents but is not essential

A

Thromboxane A2

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22
Q

Platelets are important in

A

Minute ruptures

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23
Q

Platelets are eliminated primarily by

A

Macrophage action

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24
Q

Endothelium prevents

A

Platelet aggregation

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25
Q

Endothelium produces

A

PGI2

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26
Q

PGI2 acts as a _____ and stimulates platelet adenyl cyclase, which ____

A

Vasodilator

Suppresses release of granules

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27
Q

Endothelium produces ___ important in clotting

A

Factor VIII

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28
Q

COX2 pathway produces prostacyclin, which is

A

Cardioprotective

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29
Q

Aspirin and ibuprofen both block ____ and ____

A

Thromboxane A2 and prostacyclin

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30
Q

COX inhibitors are a type of

A

NSAID

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31
Q

Inhibition of COX1 effects

A

Low thromboxane A2

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32
Q

Inhibition of COX2 effects

A

Endothelium (low PGI2)

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33
Q

Anticoagulants

A

Prevents clots form forming

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34
Q

Lysis of clots

A

Dissolves clots

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35
Q

Anticoagulants

Chelators

A

Tie up calcium

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36
Q

Anticoagulants

Heparin

A

Complexes with antithrobin 3

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37
Q

Anticoagulants

Dicumarol

A

Inhibition of Vit k dependent factors

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38
Q

___ is needed for lysis of clots

A

Plasmin

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39
Q

There are both ___ and ____ activators or plasminogen

A

Endogenous activators

Exogenous activators

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40
Q

Endogenous activators of plasminogen

A

Tissues
Plasma
Urine

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41
Q

Exogenous activators of plasminogen in

A

Streptokinase

TPA

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42
Q

Administration of tPA has a ____ for MI and stoke

A

3 hr window

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43
Q

Reperfusion injury

A

ROS flood damaged area when pressure on tissues relieved and blood returns

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44
Q

Collateralization

A

Ability to open up alternative routes of blood flow to compensate for blocked vessel

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45
Q

3 methods of collateralization

A
  1. Angiogenesis
  2. Vasodilation
  3. SNS
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46
Q

The SNS may ___ or ____ collateralization

A

Impede

Augment

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47
Q

SNS may impede collateralization by

A

Vasoconstriction

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48
Q

SNS may augment collateralization by

A

NPY

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49
Q

Extrinsic thrombosis

A

Initiated by chemical factors released by damaged tissues

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50
Q

Intrinsic thrombosis

A

Components in blood and trauma to blood or exposure to collagen

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51
Q

Coumarin depresses liver formation of clotting factors by blocking

A

Vit K

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52
Q

Hemophilia is

A

Sex linked

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53
Q

85% of hemophilia defect in

A

Factor VIII

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54
Q

15% hemophilia defect in

A

Factor IX

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55
Q

Without ____, blood won’t clot

A

Calcium

56
Q

Intrinsic and extrinsic pathways of coagulation meet at formation of

A

Factor X

Factor V

57
Q

Key step in clotting

A

Conversion of fibrinogen to fibrin

58
Q

Clots are dissolved by ___ which is activated by ___

A

Plasmin

TPA

59
Q

Conversion of fibrinogen to fibrin requires

A

Thrombin

60
Q

Antiphospholipid antibody syndrome

A

Autoimmune

Body makes Ab against phospholipids

Causes abnormal clots

61
Q

Homocysteine

A

AA that may irritate blood vessels, promoting atherosclerosis

62
Q

Homocysteine can make blood more likely to

A

Clot

63
Q

Homocysteine levels can be reduced by

A

Increasing folic acid
B6
B12

64
Q

A and B antigens on RBCs are known as

A

Agglutinogens

65
Q

O is

A

Functionless

66
Q

Agglutinins are formed

A

Spontaneously

67
Q

Ab titers peak at

A

Age 10

68
Q

Hemolysis occurs to ____ in mismatched transfusion

A

Donors RBCs

69
Q

Primary Ab in lysis of RBCs

A

IgM

70
Q

____ most lethal effect on transfusion reaction

A

Kidney failure

71
Q

__ from lysed RBCs precipitates and blocks renal tubules

A

Hemoglobin

72
Q

In Rh blood types, spontaneous agglutinins _____

A

Never arise

73
Q

Rh blood: ___ antigen MC and means you are

A

D antigen

Rh+

74
Q

Lacking D antigen means you are

A

Rh-

75
Q

Erythroblastosis Fetalis aka

A

Hemolytic Disease of newborn

76
Q

Released hemoglobin is converted by ____ into ____ which can cause jaundice

A

Macrophages

Bilirubin

77
Q

Most cases of erythroblastosis Fetalis, mother is ___, father is ___, and fetus is ___

A

Rh-

Rh+

Rh+

78
Q

Erythroblastosis Fetalis only occurs after the ____

A

Initial exposure

79
Q

Kernicterus

A

Bilirubin precipitating in neurons causing mental impairment

80
Q

Prevention of erythroblastosis Fetalis

A

Rh immunoglobulin globulin (RhoGAM)

Anti-D antibody

81
Q

Heart muscle is ___ and has 1-2 centrally located __

A

Striated

Nuclei

82
Q

Heart muscle contains specialized ____ and ____ muscle fibers

A

Excitatory

Conductive

83
Q

Syncytium

A

Many acting as one

84
Q

Cardiac muscle follows “all or none” law due to presence of

A

Intercalated discs

85
Q

Gap junctions allow flux of

A

Na+

86
Q

Duration of action potential

A

.2-.3 Sec

87
Q

Channels in cardiac muscle

A

Fast Na
Slow Ca/Na
K channels

88
Q

Permeability changes in heart muscle

A

Na sharp increase as onset of depolarization

Ca increases during plateau

K increased during resting polarized state

89
Q

Time for entire heart to depolarize

A

.22 sec

90
Q

AV node delay

A

.12 seconds

91
Q

Purpose of AV node delay

A

Allows atria to contract before ventricles

92
Q

___ blocks fast Na channels

A

Tetradotoxin

93
Q

Specialized excitatory cells only have _____

A

Slow Ca/Na channels

94
Q

Nernst equilibrium potential

A

Concentration gradient favoring ion movement in one direction offset by electrical gradient

95
Q

During Er, ____ are closed, ___ is open

A

Fast Na and slow Ca/Na

K

96
Q

During Er, ___ are free to move

A

K ions

97
Q

___ binds and inhibited Na/K ATPase pump

A

Digitalis

98
Q

Digitalis is used to

A

Increase strength of contraction (make heart stronger)

99
Q

If Na/K pump inhibited, more ____ allowed to accumulate and ____ increased

A

Ca

Contractile strength

100
Q

Absolute refractory period

A

Unable to re-stimulate

Occurs during plateau

101
Q

Relative refractory period

A

Requires Supra-normal stimulus

Occurs during repolarization

102
Q

In slow response cardiac muscle cell, relative refractory period is ___ and refractory period is

A

Prolonged

25% longer

103
Q

Prolonged refractory period serves to

A

Protect ventricles from Supra-ventricular arrhythmias

104
Q

Normal pacemaker of heart

A

SA node

105
Q

SA node is ___ due to ___

A

Self excitatory

Leaky membrane to Na/Ca

106
Q

In SA node, only ___ are operational

A

Slow Ca/Na channels

107
Q

SA node spontaneously ___ at fastest rate

A

Depolarizes

108
Q

___ lacks stable resting Er

A

SA node

109
Q

Overdrive suppression

A

Drive self-excitatory cell at rate faster than inherent rate, you will suppress cell’s automaticity

110
Q

Cells of AV node and purkinje system are under overdrive suppression of

A

SA node

111
Q

Function of AV node

A

Delays wave of depolarization from entering ventricle

112
Q

In absence of SA node, ___ may act as pacemaker, but at a lower rate

A

AV node

113
Q

As HR increases, CL

A

Decreases

114
Q

At resting HR, systole ____ diastole

A

<

115
Q

As HR increases, both S and D shorten, but ___ shortens to greater extent

A

D

116
Q

During S, perfusion of myocardium is restricted by

A

Contracting cardiac muscle

117
Q

Systole associated with

A

Isovolumic contraction

118
Q

Isovolumic contraction means

A

BP increasing

119
Q

Diastole associated with

A

Isovolumic relaxation

120
Q

Isovolumic relaxation means

A

BP decreasing

121
Q

Ventricles are sealed ___ during cardiac cycle

A

2X

122
Q

Valves open under

A

Forward pressure

123
Q

Valves close under

A

Backward pressure

124
Q

End diastolic volume

A

Volume in ventricles at end of filling

125
Q

End systolic volume

A

Volume in ventricles end of ejection

126
Q

Stroke volume

A

Volume ejected by ventricles

127
Q

A wave associated with

A

Atrial contraction

128
Q

C wave associated with

A

Ventricular contraction

129
Q

V wave associated with

A

Atrial filling

130
Q

AV valves

A

Mitral and tricuspid

131
Q

Semilunar valves

A

Aortic and pulmonary

132
Q

Semilunar valves are

A

Stronger construction

133
Q

AV valves are thin so need

A

Chorda Tendineae

Papillary muscles

134
Q

Valvular dysfunction creates

A

Vibrational noise (murmurs)

135
Q

Valve not opening fully

A

Stenotic

136
Q

Heart murmur during both S and D

A

Patent ductus arteriosis

Combined valvular defect

Phys 3 (8 decks)

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