Cardio-Pulmonary 1 Flashcards
1
Q
Elastic Systemic ________ are a pressure reservoir that maintains blood flow during ventricular relaxation
A
Arteries
2
Q
Systemic _____ serve as an expandable volume reservoir.
A
Veins
3
Q
Closure of atrio-ventricular valves at end of diastole indicates which sound? “LUB”
A
S1
4
Q
Pressure during LV filling is known as
A
Diastolic blood pressure (DBP)
5
Q
Ventricular relaxation (filling)=
A
Diastole
6
Q
Ventricular Contraction (ejection) =
A
Systolic
7
Q
Volume after filling = _______ (Preload)
A
End Diastolic volume (EDV)
8
Q
Pressure during contraction=
A
Systolic blood pressure (SBP)
9
Q
Volume after contraction=
A
End Systolic Volume (ESV)
10
Q
Closure of semilunar valves at end of systole has which sound? “DUB”
A
S2
11
Q
Rapid filling of ventricles during early diastole yields what sound? “Gallop”
A
S3
12
Q
A Stiff Left Ventricle during atrial contraction will create an __ “atrial gallop” sound.
A
S4
13
Q
SBP-DBP=____
A
Pulse Pressure (PP)
14
Q
EDV-ESV=
A
Stroke Volume (SV)
15
Q
Volume of blood pumped over time
HR x SV =
A
Cardiac Output
16
Q
Load (stretching/filling) placed on ventricle prior to contraction
A
Preload
17
Q
Load against which the LV contracts (and must overcome aortic valve to eject blood)
A
Afterload
18
Q
The majority of left ventricular coronary arterial blood flow occurs during the rapid ejection phase of the cardiac cycle. T/F
A
False
19
Q
LV contractility or pressure development over time (+dP/dt)
A
Ionotropic State
20
Q
An increase in total peripheral vascular resistance (TPR) results in a decrease in left ventricular afterload. T/F
A
False
21
Q
What is the expected effect of administering a β1-adrenergic receptor agonist (activator) on left ventricular end systolic volume, assuming no change in end diastolic volume?
Increase/Decrease/No change
A
Decrease
22
Q
T/F
S1 represents the opening of the atrioventricular (mitral and tricuspid) valves during a normal cardiac cycle.
A
False
23
Q
T/F
S3 represents the closure of the semilunar (aortic and pulmonic) valves during a normal cardiac cycle.
A
False
24
Q
T/F
S4 represents the forceful contraction of the atria, typically when LV compliance is low.
A
True
25
If left ventricular pressure exceeds left atrial pressure in a normal functioning heart, which one of the following statements must be true?
-the left ventricle contains its full end diastolic volume
-the mitral valve is closed
-the left ventricle is undergoing isovolumetric contraction
-the aortic valve is open
Mitral valve is closed
26
What protein binds calcium to promote contraction in vascular smooth muscle?
Calmodulin
27
What is the expected effect of aortic stiffening on aortic pulse wave velocity?
Increase/Decrease/No change
Increase
28
T/F
Hypertrophic cardiomyopathy is associated with a pathological increase in left ventricular end diastolic volume.
False
29
What is the effect of increase venous return on LV stroke volume (under conditions)?
Increase/Decrease/No Change
Increase
30
What is the effect of an increase in end diastolic volume on ejection fraction if stroke volume is unchanged?
Increase/Decrease/No Change
decrease
31
What is the effect of widespread arterial and arteriolar vasoconstriction on left ventricular afterload?
Increase/Decrease/No Change
Increase
32
______tropic function
Heart rate (SA node firing rate)
___tropic function
Ventricular “contractility” (+dP/dt)
____tropic function
Ventricular relaxation rate (-dP/dt)
_____tropic function
Cardiac AP conduction rat
Chronotropic
Inotropic
Lusitropic
Dromotropic
33
What is the effect of increased heart rate (decreased cardiac cycle time) on preload (LV filling)?
Increase/Decrease/No Change
Increase
34
What is the effect of widespread arterial and arteriolar vasoconstriction on total peripheral resistance?
Increase/Decrease/No Change
Increase
35
Depolarization of cardiomyocytes initiates in increase in cytosolic _____
Calcium [Ca2+]i (Myosin Interaction)
36
Increased release of _____________ neurotransmitter during PSNS stimulation
It will bind to Muscarinic __ (Gi) and __ (Gq) receptors
Acetylcholine
M2 (heart)
M3 (Blood Vessels)
37
An increase of Parasympathetic stimulation will:
________ Cardiac Output
________ Heart Rate (Bradycardia
________ Contractility (dP/dt)
________ Stroke Volume
Decrease all of the above
38
An Increase in Sympathetic Stimulation will:
________ Cardiac Output
________ Heart Rate (Tachycardia)
________ Contractility
________ Relaxation rate
Blood Vessels
__ Signal Vasoconstriction (receptor)
__ signal vasodilation
Increase to all of the above
a1 receptor
B2 Adrenergic receptors
39
Diastolic Dysfunction:
_________ LV Filling
_________ LV Stiffening
_________ End Diastolic Pressure
Decrease
Increase
Increase
40
Increase in vascular smooth intracellular CA2+ on arteriolar diameter
Increase/Decrease/No Change
Decrease
41
widespread phosphorylation of myosin light chain in arteriolar smooth muscle on total peripheral resistance
Increase/Decrease/No Change
Increase
42
Widespread phosphorylation of myosin light chain kinase in arteriolar smooth muscle on total peripheral resistance
Increase/Decrease/No Change
decrease
43
Increased levels of cAMP in vascular smooth muscle on arteriolar diameter
Increase/Decrease/No Change
Increase
44
inhibition of calcium-calmodulin binding on myosin light chain kinase activity
Increase/Decrease/No Change
Decrease
45
Laminar blood flow inducing arteriolar shear stress on vascular endothelial intracellular calcium levels (Ca2+)
Increase/Decrease/No Change
Increase
46
Chronic effect of increasing total peripheral resistance on left ventricular compliance
Increase/Decrease/No Change
Decrease
47
LV stiffening on the degree (slope) of the EDPVR
Increase/Decrease/No Change
Increase
48
Dilated cardiomyopathy on the degree (slope) of the ESPVR
Increase/Decrease/No Change
Decrease
49
Ca2+ triggers Vascular Smooth Muscle contraction by binding _______ which activates ______ _____ _____ kinase.
This kinase phosphorylates ______ _____ _____, favoring vasoconstriction
Calmodulin
Myosin Light Chain kinase (MLCK)
Myosin Light Chain
50
Vascular Smooth Muscle is vasodilated by dephosphorylation of what enzyme?
Myosin Light Chain Phosphatase
51
Nitric Oxide stimulates the enzyme ________ ______ in VSM to increase conversion of GTP to cyclic ___.
This acts as a second messenger to activate ___ which promotes smooth muscle relaxation
-Guanylyl cyclase
-cGMP (cyclic guanosine monophosphate)
PKG (Protein Kinase G)
52
facilitate electrical coupling between endothelial cells and smooth muscle cells
Myoendothelial gap junctions
53
T/F: Acetylcholine is an endothelium dependent vasodilator.
True
54
T/F: Nitric oxide is endothelium = dependent vasodilator
FALSE (Endothelium-derived vasodilator (relacing factor))
55
T/F: Lactate, H+ and adenosine promote vasoconstriction in arterioles supplying active skeletal during intense exercise
FALSE
56
Vascular endothelial sheer stress on vascular smooth muscle intracellular Ca2+ levels (assuming a healthy endothelium)
Increase/Decrease/No Change
Decrease
57
Intrinsic response of vascular smooth muscle Ca2+ to increase stretch
Increase/Decrease/No Change
Increase
58
Expected effects of lactate, H+ and adenosine on arteriolar diameter when norepinephrine is bound to VSMC to a1-Ars
Increase/Decrease/No Change
Increase
59
Relative blood flow (as % total cardiac output) to the liver in response to increased SNS outflow (e.g., during exercise)
Increase/Decrease/No Change
Increase
59
Effect of aortic stenosis on LV afterload
Increase/Decrease/No Change
Increase
60
Decrease of aortic compliance on aortic wave velocity
Increase/Decrease/No Change
Increase
61
Relative blood flow (as% total cardiac output) to cardiac muscle in response to increased SNS outflow (e.g., during exercise)
Increase/Decrease/No Change
No Change
62
-_______ Hyperemia -Response to transient vessel occlusion
- ______ hyperemia
In response to increased metabolism
- ________ response -In response to increased pressure and Autoregulation of blood flow.
Reactive
Active
Myogenic
63
______________ reflex
-Senses arterial pressure (stretch)
___________ reflex
-Senses stretch or volume (increased VR)
________________ reflex
-Senses changes in circulating O2, CO2, H+
Arterial Baroreceptor
Atrial (Bainbridge)
Chemoreceptor
64
An increase in Arterial Pressure will increase firing of Arterial Baroreceptors will cause:
A decrease of _________ outflow to heart, arterioles, and veins.
An increase of _______________ outflow to heart
Overall will ________(Increase/decrease) BP & CO
Sympathetic
Parasympathetic
Decrease
65
An increased stretch (filling) of right atrium will increase ________ (SNS/PSNS) to _______ (increase/decrease) HR and Contractility.
SNS
Increase
66
________ Chemoreceptors in the aortic arch and carotid arteries fire in response to a decrease of PaO2 and an Increase of H+ (decreased blood pH)
Peripheral
67
__________ Chemoreceptors in CNS medulla oblongata, fire in response to an increase of PaCO2
Central
68
T/F: Acetylcholine is an endothelium dependent vasodilator.
True
69
T/F: Nitric oxide is endothelium =- dependent vasodilator
False
70
T/F: Lactate, H+ and adenosine promote vasoconstriction in arterioles supplying active skeletal during intense exercise
FALSE
71
Fluid sheer stress is sensed by vascular endothelial cells , resulting in _________ (Increased/decreased) Ca2+, which activates eNOS to produce NO favoring vasodilation
Increased
72
this lipid molecule produced and released by the vascular endothelium, induces vasodilation binding a cell membrane receptor on vascular smooth muscle cells?
prostacyclin (PGl2)
73
What is the expected effect of vascular endothelial sheer stress on vascular smooth muscle intracellular Ca2+ levels (assuming a healthy endothelium)?
Increase/Decrease/No Change
Decreases
74
What is the expected effect of an acute increase in arteriolar vascular smooth muscle stretch on vascular smooth muscle intracellular Ca2+ levels?
Increase/Decrease/No Change
Increase
75
Activation of phospholipase C (PLC) by Gq-coupled alpha1-adrenergic receptors in vascular smooth muscle ultimately favors greater phosphorylation of myosin light chain (MLC20).
T/F
True
76
Local vascular smooth muscle hyperpolarization can be conducted via gap junctions to adjacent cells to cause vasoconstriction and decrease blood flow to the surrounding tissue.
T/F
False
77
Endothelial Calcium influx activates phospholipase A2 liberates ___________ ____ (AA) from membrane phospholipids. AA is then metabolized by ________________ (COX) pathway to ______________ (PGl2) causing Vasodilation
Arachidonic acid
Cyclooxygenase
Prostacyclin
78
_________ pressure: Pushes fluid / electrolytes out of the capillary and into the interstitial space.
Hydrostatic
79
___ __________ pressure: Pull fluid / electrolytes into the capillary from the interstitial space.
Net oncotic
80
NDF > 0 = ________ occurs: fluid / electrolytes move
from the capillary into the interstitial space.
Filtration
81
NDF < 0 = ____________ occurs: fluid / electrolytes move into the capillary from the interstitial space
reabsorption
