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physiology > Cardiology > Flashcards

Cardiology Flashcards

0
Q

The resting membrane potential for the cardiac muscle cell is about _____mV. The change in membrane potential when an AP occurs is aboout _____ mV

A

-90

105

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1
Q

The plateau in the cardiac action potential is ________secs long which is _____ longer than skeletal muscle

A

.2

15

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2
Q

The 3 main ions responsible for the cardiac AP are _____ (wants to be at 120mV), ______ (wants to be at 67mV), and _____ ( wants to be -90mV)

A

Ca
Na
K

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3
Q

The threshold for an action potential is ______ mV.

A

-70mv

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4
Q

The plateau allows for _________ and ____________ of the heart.

A

Filling and contraction

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5
Q

The increase in________ ions and decrease in ________ ion permeability cause the cardiac AP plateau.

A

Ca++

K+

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6
Q

Preventing outflow of ______ takes cell longer to reach RMP.

A

K

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7
Q

The velocity of excitatory fibers in the atria/ventricles is _____- _____m/sec. It is 1/10th the velocity of skeletal muscles due to the ____ channels being slower. This allows time for _______ to develop.

A

.3 - .5m/sec
Na
TENSION

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8
Q

The ________________ allows for cardiac rest but another AP can come along and cause another depolarization … it will just need a bigger ___________ though.

A

Relative refractory period

stimulus/ potential

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9
Q

The heart will not pump as well with an AP generated during the _______________ period.

A

Relative Refractory

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10
Q

During the ____________ period, no contraction can occur. This correlates to the ___________. The membrane is too ____________.

A

Absolute refractory
Ca++ plateau
positive +

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11
Q

The AP in the heart is generated by the _____ or ______. It then travels into the __________ where depolarization causes extracellular ______ ions to enter the cell.

A

SA or AV node
T Tubule
Ca++

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12
Q

The increase in intracellular Ca++ is detected by Ryanodine receptors in the ____________ which causes ________ to be released. This is called the ______________.

A

Sarcoplasmic Reticulum
more Ca++
Calcium Spark

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13
Q

The T-tubules in the heart are ________ times the size than in skeletal muscle. In cardiac muscle the T Tubules open directly into the ________________ fluid, so their ________ concentration depends highly on extracellular concentration

A

5
extracellular
Ca++

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14
Q

In cardiac cells, there is a slight delay between_________ and _________.

A

Excitation and contraction

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15
Q

The__________ node is the pacemaker of the heart. The ________ delays conduction through the heart which allows for ___________ contraction

A

SA
AV
atrial

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16
Q

In cardiac cells, the wave of depolarization propagates to adjacent cells via ________________ located on ________________.

A

Gap Junctions

Intercalated Disks

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17
Q

The AV valves are only completely shut during ______________.

A

Ventricular Systole

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18
Q

On your CVP, the ______ wave shows you how well the atria are contracting. This correlates to _____ % of your stroke volume

A

A

20%

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19
Q

The most sensitive organ to perfusion is the ______________

A

Kidney

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20
Q

The Four phases of the pressure volume loop are: ____________, ____________, __________, ____________

A

Filling, Isovolumic contraction, Ejection, Isovolumic Relaxation

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21
Q

At End diastolic, the AV valves will _________ and you will start the ____________ contraction

A

Close

Isovolumic

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22
Q

At the end of the isovolumic contraction, the _________ valve will open and you will start the _________ phase. The

A

atrial

Ejection

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23
Q

The pulse pressure can be measured on the P-V loop by subtracting the ________________ from the _________________.

A

start of the ejecting phase pressure

peak of the ejecting phase pressure

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24
Q

S1 heart sound would be heard at ______________ on the PV loop and S2 would be heard at ________________

A 
End Diastolic (mitral valves closing)
End Systolic (aortic valve closing)
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25
Q

The End systolic volume will be around ________ in a healthy heart.

A

50ml

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26
Q

The Stroke volume represents “___________” and can be measured on the PV loop by subtracting start of __________ from the end of ________ phase on the loop.

A

Net-Work
Filling
filling

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27
Q

The average stroke volume will be around _____ ml. The ejection fraction is the stroke volume divided by ________ and the average will be around _______.

A

65ml/beat
peak volume
60%

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28
Q 
Name the cardiac pressures
RA:
RV:
PA:
LA:
LV:
A 
4
25
25/10
8-10
80-100
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29
Q

About _____% of ventricular filling occurs during diastole before contraction of the atria. The remaining is called the ___________.

A

75

atrial kick

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30
Q

The ____- wave is atrial contraction
The ____-wave is ventricular contraction
The ____-wave is the in-filling of the atria from venous return.

A

A
C
V

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31
Q

The fraction of the end-diastolic volume that is ejected is the _____________. It is normally 110-120ml.

A

ejection fraction

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32
Q

What 3 things affect stroke volume?

A

Preload, afterload, Contractility

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33
Q

Excess _______ ions will cause dilation of myocardium. Excess _______ ions will cause spastic contractions.

A

Potassium

calcium

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34
Q

The sympathetic NS effects on the heart will be to _____________ & ________________

A

Increase HR and Contractility

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35
Q

The sympathetic NS ___________ contractility by stimulating _______ receptors

A

Increases

Beta

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36
Q

Most of the sympathetic NS innervates the _____________, while the Parasympathetic goes to the ____________

A

ventricles

atria(SA& AV nodes)

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37
Q

_________ is calculated with End Diastolic Pressure

A

Preload

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38
Q

Preload is affected by _________ and rate of ______________.

A

Venous BP

Rate of venous return

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39
Q

______________ is the pressure the ventricle must generated to EJECT blood.

A

Afterload

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40
Q

Cardiac Output at rest is __________.

A

4-6L/min

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41
Q

_________ are the last small branches of arteries. They are the ____________ and can vastly change blood flow.

A

arterioles

control conduits

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42
Q

___________ is where the exchange of fluids, nutrients, and O2 occurs

A

Capillaries

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43
Q

________ collect blood from capillaries and _______ are the major conduit of transport of blood to the heart

A

venules

veins

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44
Q

___________ are the major reservoir of blood in the body

A

Veins

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45
Q

To increase PRELOAD we want to work on the __________ side

A

venous

46
Q

cardiac output of the LV is ___________ the CO of the RV

A

Equal

47
Q

The Systemic circulation is _________ pressure and resistance and the pulmonary circulation is ____________ pressure and resistance.

A

HIGH

LOW

48
Q

The largest pulse pressure is in the _____________ which is ______mmHg

A

LV

120/0

49
Q

As the pressure gradient increases, so does ___________.

A

Flow

50
Q

Blood flow is determined by ________________ and _______________. This is related to _________ Law which is ….___________

A

Pressure gradient
Vascular Resistance
OHMs
(P1-P2)/R

51
Q

Blood flow is __________ related to resistance

A

inversely

52
Q

Flow is talked about in the context of __________.

A

time

53
Q

___________ flow is parabolic and has uniform flow. Its Reynold’s number is _____________. It is proportional to _____________.

A

Laminar
<2000
Pressure

54
Q

_____________ flow has a rapid rate, with resistance and obstruction. Its Reynolds number is ______________.

A

Turbulent

>2000

55
Q

The equation for Reynolds number is:

A

DpV/n

Diameter x density x velocity // viscosity

56
Q

Flow will continue to be streamline laminar with increased pressure until it hits the ___________

A

Critical velocity

57
Q

If you increase your diameter of a vessel from 1 to 2 then your Flow rate will be _________ ml/min

A

2^4 …..16

58
Q

The most important factor when looking at blood flow is ___________.

A

Radius! It’s to the 4th power!

59
Q

Resistors help flow be more _________. Organ are perfused in a _________ fashion that will have __________ resistance

A

efficient
parallel
less

60
Q

The total resistance in a parallel series is _________ than in any single vessel. This means _________ blood will flow through them.

A

far less

far more

61
Q

Resistance in parallel makes for greater local perfusion to the _________. The equation is

A

organs

1/R = 1/R1 + 1/R2 + 1/R3

62
Q

Capillaries are ruled by _____________ Law when referring to pressure, radius, and tension. It states : ___________

A

LaPlaces Law

T= Pr

63
Q

when wall tension is so great to pull apart the capillaries slits…this deals with _____________________ force

A

hydrostatic pressure

64
Q

With altitude sicknesss, the lungs will _____________ in response to low O2.

A

vasoconstrict

65
Q

Acute control in local blood flow is mostly related to changes in ____________. This will cause release of __________, __________, ___________, ________, ________ which cause vasodilation. This is considered the ____________ theory.

A

Oxygen
histamine, adenosine, CO2, H+, K+
Metabollic

66
Q

The ____________ theory of local tissue blood flow regulation states that a sudden stretch causes __________ of vascular muscles

A

Myogenic

Contraction

67
Q

___________ is a potent vasodilator that is all over our bodies and will be released in response to CHEMICAL and PHYSICAL stimuli

A

Nitric Oxide

68
Q

_____________ are proteins that upon release cause vasoconstriction to help regulate vascular homeostasis

A

Endothelin

69
Q

The first thing that will happen in response to a decrease O2 delivery to tissue is ___________ release which causes direct _________.

A

Adenosine

vasodilation

70
Q

________ & _________ work as second messengers following a decrease in O2 delivery to tissues to cause _____________

A

ADP an ATP

vasodilation

71
Q

_____ works especially in the brain to cause vasodilation

A

CO2

72
Q

The brain, heart, and skeletal muscles all use more _____________ means to maintain adequate oxygenation to the tissues

A

Metabolic

73
Q

Angiogenesis uses ___________, ___________, & _____________ for its long term regulation.

A

VEGF
Fibroblast Growth factor
Angiogenin

74
Q

Need BP within ______% of baseline to have autoregulation

A

20

75
Q

If you have Hypertension, your autoregulation curve will shift to the __________.

A

Right

76
Q

Autoregulation works by using __________& ___________ responses to maintain adequate BP.

A

Myogenic and Metabolic

77
Q

The vasoconstrictor control of the brain is located in the ________________. The vasodilator area is in the _________________.

A

Upper medulla

Lower Medulla

78
Q

The sensory center of the brain for neurogenic control of BP is in the __________ _________ in the posterolateral ____________ & ______________

A

Tractus Solitarius
Medulla
Lower Pons

79
Q

The sensory area for neurogenic control receives signals from the __________ & _____________ nerves and sends signals to vasoconstrict or dilate. This is a ____________ control and an example is the ________________

A

Vagus
Glossopharyngeal
Reflex
Baroreceptor

80
Q

The vagus nerve stimulation will cause ______ in HR and _______ in Contracitility. This is via the __________ receptors

A

Decrease
decrease
Muscarinic

81
Q

The sympathetic NS works on _______ receptors to give autonomic control to _________ HR and contractility

A

Beta1

Increase

82
Q

The baroreceptor reflex is a ____________ reflex that says as BP/ blood volume ____________, HR ____________. These receptors are located in the _________, ___________, and the __________ nerve

A 
neurogenic
increases
decreases
carotid body
aorta
glossopharyngeal
83
Q

The Bainbridge reflex will __________ the heart rate as the pressure increases. It detects _____________ and sends two signals… one to the ___________ nerve to the medulla and the other to the ______________.

A

increase
RA and LA stretch
Vagus
SNS

84
Q

The ________________ reflex prevents the pooling of blood in the veins, atria, and pulm. circulation with increase blood volume.

A

Bainbridge

85
Q

Definition of CO

A

The amount of blood pumped each minute into circulation

86
Q

The ____________ is the sum of flow to all tissues of the body

A

Cardiac Output

87
Q

The cardiac output mostly relies on _____________

A

venous return

88
Q

The average CO is _________. Males are ________ and females are _______

A

5 L/min

  1. 6
  2. 9
89
Q

The 4 main patient factors that have an effect on CO are:

A

age
body size ( cardiac index)
metabolic rate — o2 consumption rate
exercise

90
Q

The average cardiac index is _________

A

3L/min/m^2

91
Q

So under resting conditions, CO is controlled almost entirely by ___________ mechanisms. The 2 main are :

A

peripheral
SVR
Blood flow to the RA (venous return)

92
Q

The 2 CO equations are:

A

CO = arterial pressure/ SVR

CO = HR x SV

93
Q

Contributors to CO include : ________ system control, _______, _______, HR, ___________.

A

nervous
preload
afterload
contractility

94
Q

We normally breath under ___________ pressure. With intubation we need to __________ pressure to get same CO. This would be shown with a shift to the ___________ on the curve.

A

Negative
Increase
Right

95
Q

Surgically opening the thoracic cage would make the internal pleural pressure on the heart ________mmHg and would shift the curve to the ______.

A

0

Right

96
Q

Cardiac tamponade shifts the CO/ RA pressure curve to the _________.

A

Right.

97
Q

Normal Intrapleural pressure is _____mmHg.

A

-4

98
Q

Normal filling pressure is ______mmHg

A

7

99
Q

The pressure that pushes venous blood from system to heart is the ______________ pressure

A

mean systemic filling pressure.

100
Q

If you completely inhibit the SNS you shift the venous return/RA pressure curve to the __________. You will have increased __________.

A

RIght

Volumes

101
Q

If you have strong SNS stimulation you shift the Venous Return/RA pressure graph to the ___________. You will have __________ volumes.

A

Left

Lower

102
Q

Venous Return is basically the same as your ____________ unless you are bleeding

A

Cardiac Output

103
Q

Venous Return is about _____ L/min
Mean systemic filling pressure is about ______mmHg
RA pressure is _______mmHg
Resistance to Venous Return is ________mmHg

A

5
7
0
1.4

104
Q

______________ is directly related to the Mean Systemic Filling Pressure

A

Venous Return

105
Q

If you increase RA pressure, you will _________ venous return

A

decrease

106
Q

___________ pressure is the pressure pushing venous blood from the periphery to the heart it is about ____mmHg

A

Filling

7

107
Q

Most of the resistance to venous return comes from the _________ (about 2/3rds).

A

veins

108
Q

The heart gets _____% of the total CO (______ml/min)

A

5

225

109
Q

The LCA supplies the _________ and ________ LV. The RCA supplies the _______ and posterior part of the __________.

A

anterior and lateral
RV
LV

110
Q

The Coronary Sinus returns _______% of venous blood from the _____to the RA after supplying the cardiac muscle

A

75

LV

111
Q

The __________ venous network is considered an alternative pathway of venous drainage of the myocardium that empties blood directed into the chambers of the heart

A

Thebesian veins

112
Q

The _________ vessels supply the cardiac muscle with blood during diastole and the ______________ vessels compensate and supply during systole.

A

Epicardial vessels

Subendocardial vessels

physiology (5 decks)

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