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PGY 300 > Cardio > Flashcards

Cardio Flashcards

1
Q

Why do humans require a circulatory system?

A

Transportation of materials to allow exchange between cells of the body and the external environment

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2
Q

overall design of cardiovascular system

A

series of tubes (blood vessels), filled with fluid (blood), and connected to a pump (heart)

  • closed circuit
  • operates by pressure differences
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3
Q

pulmonary circulation

A

oxygen depleted blood from right heart to lungs

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4
Q

systemic circulation

A

oxygen rich blood from left heart to rest of body

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5
Q

arteries

A

take blood away from heart

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6
Q

veins

A

return blood to heart

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7
Q

two main components of blood

A

plasma and cells

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8
Q

blood plasma

A

mostly water

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9
Q

red blood cells

A

contain hemoglobin which plays important role in transporting oxygen (erythrocytes)

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10
Q

white blood cells

A

immune function (leukocytes)

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11
Q

platelets

A

blood clotting

split off from megakaryocytes

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12
Q

flow of blood in the cardiovascular system

A
  • directly proportional to pressure gradient

- inversely proportional to resistance to flow

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13
Q

Pouiselle’s Law

A

resistance is proportional to: length x viscosity x radius^4

-small changes in radius lead to big changes in resistance

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14
Q

what part of hemoglobin binds oxygen

A

iron

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15
Q

three ways carbon dioxide can be transported

A

1) bind with hemoglobin
2) form bicarbonate ions (what most does)
3) dissolved in plasma

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16
Q

erythropoieten

A

hormone produced in the kidneys and can induce RBC production

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17
Q

4 chambers of heart

A

R and L atria: receive blood

R and L ventricles: eject blood

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18
Q

base of heart

A

the top, round

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19
Q

apex of heart

A

bottom, point of cone

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20
Q

aorta

A

receives blood from left ventricle to send to systemic arteries

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21
Q

pulmonary vein

A

receives blood from veins of the lungs and sends to left atrium

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22
Q

vena cavae (superior and inferior)

A

receive blood from systemic veins and send to right atrium

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23
Q

pulmonary trunk (artery)

A

receives blood from right ventricle and send to lungs

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24
Q

what path does blood take

A

Systemic veins –> RA–> RV–> PA–>Lungs–>PV –>LA–> LV –> Systemic arteries

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25
Q

systole

A

ventricular contraction

  • AV valves close to prevent backflow into atria
  • semilunar valves open
  • pushing blood into aorta
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26
Q

diastole

A

ventricular relaxation

  • semilunar valves closed to prevent backflow into ventricles
  • mitral valve (bicuspid) open
  • allow ventricles to fill with blood
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27
Q

electrical signal pathway in heart

A

SA node –> Atria–> AV Node –> Bundle of His–> Bundle Branches–> Ventricles

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28
Q

mechanical contraction

A

electrical signal is stimulus for coordinated mechanical contraction of atria then ventricles

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29
Q

how are electrical signal and mechanical contraction linked?

A

an increase in cytosolic calcium levels within cardiac contractile cells

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30
Q

contractile cells

A
  • sarcomeres

- generate tension that causes muscle contraction

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31
Q

autorhythmic cells

A
  • initiate electrical signal for contraction a SA node
  • smaller than contractile cells
  • no sarcomeres
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32
Q

excitation-contraction coupling

A

occurs through cytosolic calcium

-contracts when Ca is high (systole)

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33
Q

SA node

A
  • pacemaker of the heart

- AV node and purkinje fibers can act as pacemaker is SA node not functioning

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34
Q

autorhythmic action potentials

A
  • unstable membrane potentials

- depolarization is due to calcium channels opening

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35
Q

Funny channels

A

allow sodium to enter and depolarize cell

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36
Q

calcium channels in autorhythmic cells

A

T-type open first

L-type open second

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37
Q

contractile cell action potentials

A
  • depolarization due to sodium entry
  • repolarization due to potassium exit
  • plateaus due to calcium entry in the cell preventing tetanus
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38
Q

why do we have long refractory period in cardiac muscle

A

to prevent tetanus and allow ventricles to refill

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39
Q

P wave

A

atrial depolarization

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40
Q

QRS complex

A

wave of ventricular depolarization

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41
Q

T wave

A

ventricular repolarization

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42
Q

atrial repolarization

A

part of QRS complex, occurs at same time as ventricular depolarization

43
Q

PR segement

A

corresponds to delay at AV node

44
Q

ST segment

A

time between ventricular depolarization and repolarization

45
Q

excitation-contraction coupling in contractile cells

A

1) AP from adjacent cell depolarizes membrane
2) Ca influx triggers more release of Ca from SR
3) Ca binds to troponin to initiate contraction
4) relaxation when Ca unbinds troponin and is pumped back into SR

46
Q

ventricular diastole

A 
ventricles filling (includes atrial systole)
LA pressure > LV pressure
47
Q

isovolumic contraction

A

ventricles contract without change in volume

LA pressure < LV pressure < Aortic pressure

48
Q

ventricular ejection

A

SL valves open and blood in ejected into PA/aorta

LV pressure > Aortic pressure

49
Q

isovolumic relaxation

A

ventricles relax without change in volume

LA pressure < LV pressure < Aortic pressure

50
Q

S1

A

“lubb” 1st heart sound

occurs when AV valves close

51
Q

S2

A

“dub” 2nd heart sound

occurs when SL valves close

52
Q

timing of mechanical and electrical events

A

electrical events followed by mechanical

  • depolarization followed by contraction
  • repolarization followed by relaxation
53
Q

cardiac ouput

A

volume of blood ejected by each ventricle in one minute

-product of heart rate and stroke volume

54
Q

stroke volume

A

amount of blood ejected from ventricle in each heart beat

End diastolic volume - End systolic volume

55
Q

ejection fraction

A

percentage of EDV ejected during each contraction

56
Q

regulation of heart rate

A

initiated at SA node and modulated by ANS

57
Q

parasympathetic branch

A

slows heart rate

58
Q

sympathetic branch

A

increases heart rate

59
Q

parasympathetic neurons

A
  • release ACh that binds to muscarinic receptors
  • K out, Ca in
  • hyperpolarize cell and decrease rate of depolarization
  • slow HR
60
Q

sympathetic neurons

A
  • release NE that binds to beta-1 receptors
  • Na and Ca influx
  • increase rate of depolarization
  • speed up HR
61
Q

stroke volume regulation

A
  • length of muscle fibers at beginning of contraction: increased length as muscles stretch
  • contractility: more Ca released and able to bind to troponin to generate greater force of contraction
62
Q

Frank Starling Law of the Heart

A
  • stroke volume is proportional to end diastolic volume
  • EDV = “preload” determines length of muscle fibers prior to contraction
  • “the heart pumps the blood it receives”
63
Q

EDV is determined by

A

Venous return:

  • skeletal muscle pump
  • respiratory pump
  • constriction of veins
64
Q

ionotropic agent

A

any chemical that affects contractility

65
Q

positive ionotropic effect

A

epinephrine and norepinephrine

66
Q

negative ionotropic effect

A

beta blockers and calcium channel blockers

67
Q

phospholamban

A

regulates activity of sarcoplasmic ATPase pump

68
Q

arteries and arterioles

A

take blood away from heart

  • elastic walls
  • thick layers of vascular smooth muscle
  • constriction and relaxation to influence blood distribution
69
Q

capillaries

A

facilitate exchange of materials between blood and tissue

70
Q

venules and veins

A

take blood back to heart

  • thin walls of vascular smooth muscle
  • constriction can increase venous return
71
Q

determinant of blood flow

A

blood flows if there is a pressure gradient

high to low pressure

72
Q

determinants of blood pressure

A

flow x resistance
blood flow follows a pressure gradient that is highest in the aorta/large arteries and moving to arterioles and lowest in the veins

73
Q

resistance

A

inversely proportionally to radius^4

proportional to length and viscosity (usually stay same)

74
Q

what regulates arteriole diameter

A

vascular smooth muscle

  • vasoconstriction
  • vasodilation
75
Q

small changes in radius have big changes in resistance

A

decrease radius –> decrease flow

increase radius –> increase flow

76
Q

local control

A

matches tissue blood flow with the metabolic needs of a given tissue
ex) adenosine in hypoxic cells can increase blood flow to match metabolism

77
Q

sympathetic reflexes

A

to maintain arterial pressure and regulate blood distribution for homeostatic needs
ex) NE release on alpha receptors

78
Q

hormones

A

either directly or by altering ANS

79
Q

ANS regulating HR

A

SNS and PNS innervation influence rate of SA node depolarization

  • SNS release NE to increase HR
  • PNS release ACh to decrease HR
80
Q

ANS regulating stroke volume

A

SNS innervation

  • NE and E from adrenal medulla influence contractility
  • SNS mediated venoconstriction
81
Q

SNS influences arteriolar resistance

A

-tonic release of NE maintains muscle tone
alpha: vasoconstriction of GI and kidneys
beta 1: pos. ionotropy and increased HR
-Epi release from adrenal medulla
beta 1: pos. ionotropy and increased HR
beta 2: vasodilation

82
Q

baroreceptor reflex

A

ensure adequate perfusion of the brain and heart by maintaining sufficient mean arterial blood pressure

83
Q

mean arterial blood pressure determinants

A

blood volume, effectiveness of heart as a pump, resistance, and relative distribution of blood (between arteries and veins)

84
Q

drop in BP

A

increased SNS/decreased PNS
increased HR and SV
vasoconstriction

85
Q

elevated BP

A

increased PNS/decreased SNS
decreased HR and SV
vasodilation

86
Q

continuous capillaries

A

endothelial cells form continuous lining with leaky junctions; muscle, connective tissue, neural tissue (most common type)

87
Q

fenestrated capillaries

A

large pores between endothelial cells; kidneys and intestines

88
Q

velocity of blood flow

A

slowest at capillaries, but they have greatest surface area

89
Q

capillary exchange

A

diffusion: small dissolves gases and solutes
bulk flow (paracellular pathway)
vesicles: larger solutes

90
Q

bulk flow

A

mass movement as a result of hydrostatic or osmotic pressure gradients

91
Q

absorption

A

fluid movement into capillaries

  • net absorption at venous end
  • caused by colloid osmotic pressure
92
Q

filtration

A

fluid movement out of capillaries

  • net filtration at arterial end
  • caused by hydrostatic pressure
93
Q

lymphatic system

A

returns fluids and proteins filtered out of the capillaries to circulatory system

94
Q

edema

A

excess fluid in the interstitial space

95
Q

causes of edema

A

1) inadequate drainage of lymph

2) blood capillary filtration exceeds absorption

96
Q

adjustments of cardiovascular system during exercise

A
  • increased cardiac output
  • increased central venous pressure (venous return)
  • decreased systematic vascular resistance
97
Q

baroreceptor reflex during exercise

A

CNS modifies and resets to a higher control point to avoid bradycardia

98
Q

adjustments to cardiovascular system during hypotension caused by an abrupt change in body posture or blood loss

A

sudden change to standing can cause hypotension (which triggers baroreceptor reflex)
-short term response by baroreceptor and long term response by hormones

99
Q

stenotic valves

A

-narrowing of valve opening
-increased resistance to flow
-increased velocity of flow
heart murmur when valves should be open

100
Q

insufficient valves

A

-valve leaflets do not completely seal when valve should be closed
-causes regurgitation of blood
heart murmur when valves should be closed

101
Q

heart failure

A

diminished contractility

  • rightward shift on SV vs. EDV curve (to maintain SV)
  • Poor pump function can ultimately cause pulmonary/systemic edema
102
Q

Atherosclerotic Vascular Disease

A

causes: stenosis of artery
consequences: increased vascular resistance
treatment: bypass surgery or angioplasty

103
Q

hypertension

A

causes: any factor that increases blood volume, CO, or TPR
consequences: Kidneys are complicit in ”allowing” chronic elevation in BP
treatment: target reductions in blood volume or TPR

PGY 300 (5 decks)

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