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Medicine > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Primary function of the cardiovascular system (5)b

A
  • Respiratory gas exchange
  • Nutrient supply/waste removal
  • Hormone signalling
  • Fluid maintenance
  • Body temperature regulation
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2
Q

Types of capillary

3

A
  • Sinusoid (discontinuous) capillary
  • Continuous capillary
  • Fenestrated capillary
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3
Q

Locations of sinusoid capillary

3

A
  • Spleen
  • Liver
  • Marrow
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4
Q

Locations of continuous capillary

A

Capillaries of most tissues

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5
Q

Location of fenestrated capillary

A

Glomerular capillaries

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6
Q
  1. Structure of large elastic arteries
  2. Function
  3. Example
A
  1. thick tunica media with lots of elastin
  2. Windkessel stretch to accommodate high blood pressure in systole
  3. Aorta, pulmonary artery, carotid
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7
Q
  1. Structure of muscular arteries
  2. Function
  3. Example
A
  1. Media composed of smooth muscle
  2. Distributing vessels
  3. Radial, femoral, coronary
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8
Q
  1. Structure of arterioles

2. function

A
  1. contain 1 - several layers of smooth muscle

2. Resistance vessels that act as the gateway for microcirculation

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9
Q
  1. structure of capillaries

2. function

A
  1. Endothelial cell layer resting on basement membrane. no smooth muscle
  2. Exchange vessels, diffusion occurs here
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10
Q
  1. structure of venules

2. function

A
  1. some smooth muscle present

2. collecting vessels. as blood leaves the capillaries

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11
Q
  1. structure of veins
  2. purpose
  3. examples
A
  1. thinner walls than arteries, less elastic tissue. valves present in limbs
  2. transporting deoxygenated blood back to the heart
  3. Vena cava, jugular vein
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12
Q

Valve between right atrium and right ventricle

A

Tricuspid valve

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13
Q

Valve between the left atrium and left ventricle

A

Mitral valve

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14
Q

Valve between left ventricle and aorta

A

Aortic semilunar valve

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15
Q

Valve between Right ventricle and pulmonary arteries

A

Pulmonary semilunar valve

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16
Q

Difference between cardiac and skeletal muscle

A

Presence of intercalated disks and gap junctions between the filaments in cardiac muscle

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17
Q

Calcium induced calcium release

  • definition
  • role of T tubule
  • AP
  • SR
A
  • Cardiac muscle requires an influx of Ca2+ ions through voltage-gated Ca2+ channels for contraction
  • T-tubule membranes act as voltage gated Ca2+ channels.
  • During AP these open, allowing Ca2+ to enter heart cell
  • triggering release of Ca2+ from SR for muscle contraction
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18
Q 
Cardiac muscle 
-Excitation?
- Organisation?
- Action potential duration? 
- tetanus?
Dependance on Ca2+ influx?
A
  • Electronic spread from pacemaker region
  • striated, branching
  • long (350ms)
  • No
  • great
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19
Q 
Skeletal muscle 
-Excitation?
- Organisation?
- Action potential duration? 
- tetanus?
Dependance on Ca2+ influx?
A
  • neuromuscular junction
  • striated, isolated motor unit cells
  • brief (5ms)
  • yes
  • little
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20
Q 
Smooth muscle 
-Excitation?
- Organisation?
- Action potential duration? 
- tetanus?
Dependance on Ca2+ influx?
A
  • Neurohumoral/electrical
  • non-striated, electrically coupled
  • only exceptionally
  • slow tension development
  • great
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21
Q

From where does autonomic regulation of heart rate originate in the brain?

A

The medulla oblongata

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22
Q
  • How many days for the primordial heart to develop in a foetus?
  • What shape does it form?
  • What happens at 4-5 weeks
A
  • Primordial heart is developed by 23 days
  • Forms a tube which forms different bulbs, blood vessels begin to form and join
  • At 4-5 weeks the heart tube begins to fold in on itself, forming primitive L/R atria and ventricles
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23
Q

Comparison of foetal and adult circulation (3)

  • Reliance?
  • Supportive organs?
  • UV?
A
  • The foetus is completely reliant on maternal circulation for oxygen and nutrients
  • These come from the placenta and are delivered by the umbilical cord and umbilical vein
  • Umbilical vein carries oxygenated blood into the liver and the inf. Vena Cava, via the ductus venosus, of the foetus
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24
Q

Foramen ovale?

A
  • A junction between atria in the foetal heart
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25
Q

Foetal lung structure?

A
  • Foetal lungs are collapsed and not functioning
  • Pulmonary arteries are constricted due to low oxygen levels in the lungs
  • causes lower left atrium pressure, so blood flows into the left ventricle from the right
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26
Q

What causes an acceleration in heart rate? (3)

  • Fibres?
  • Ligands?
  • Chronotropism??
A
  • Sympathetic fibre activity
  • Noradrenaline binds to b1-adrenoreceptors, resulting in increased slope of the pacemaker potential
  • positive chronotropism
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27
Q

What causes the heart rate to slow? (3)

  • Fibres?
  • Ligand and receptor
  • Chronotropism
A
  • Parasympathetic fibre activity slows the heart
  • Acetylcholine binds to muscarinic receptors causing a decrease in the slope of the P.P / slight hyperpolarisation
  • negative chronotropism
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28
Q

Cardiac cycle: atrial systole

A

corresponds to the P wave of the ECG, completes ventricular filling. mitral valve is open

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29
Q

Ventricular systole (1):

A

Q wave of the ECG, mitral valve closes, isovolumetric contraction (no volume change), aortic valve closed

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30
Q

Ventricular systole (II):

A

Ejection phase, blood is expelled into the aorta as aortic valve opens

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31
Q

Ventricular diastole (I):

A

Isovolumetric relaxation, the aortic valve closes and the ventricle relaxes

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32
Q

Ventricular diastole (II)

A

Passive filling as mitral valve reopens

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33
Q

Cardiac Output: defintion

A

= Volume of blood(L) / Minute

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34
Q

Stroke Volume (SV)

A

= Litres per beat

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35
Q

calculate CO using SV and HR

A

CO = SV X HR

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36
Q

Resting cardiac output =

A

4 - 7 L.min^-1

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37
Q

Exercise cardiac output =

A

16 - 42 L.min^1

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38
Q

Factors affecting cardiac output (3)

A
  • Preload: filling pressure, starling’s law of the heart
  • Afterload: Atrial pressure opposing ejection
  • Contractility: sympathetic nerves, circulating agents
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39
Q

Laplace’s Law (P) =

T= tension, r=radius, S=stress, W=wall thickness P=pressure

A

P = 2T/r = 2Sw/r

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40
Q

Starling’s law of the heart

A

The energy of contraction of a cardiac muscle fibre is proportional to the initial fibre length at rest

41
Q

Preload:

A
  • The wall stress in resting myocardium
42
Q

Afterload:

A
  • the wall stress opposing shortening of muscle fibres, atrial pressure
43
Q

Autonomic control of the heart

  • influence from
  • Sympathetic innervation:
A
  • influence from higher brain centres and cardiovascular receptors
  • Sympathetic innervation arrises at T1-T5
44
Q

Contractility definition:

A

The energy of contraction independent of fibre length at rest

45
Q

Positive inotropy:

Positive inotropes:

A
  • increased contractility

- Noradrenaline, adrenaline, digoxin

46
Q

Negative inotropes:

A
  • decrease contractility

- Ca channel blockers, beta-blockers

47
Q

Positive lusitropy:

A
  • Increased rate of relaxation
47
Q

Positive lusitropy:

A
  • Increased rate of relaxation
48
Q 
Cardiac output (Q):
MAP,CVP,TPR equation
A 
Q = (MAP - CVP)/TPR 
MAP = Mean arterial pressure 
CVP = Central venous pressure 
TPR = Total peripheral resistance
48
Q

Cardiac output (Q):

  • MAP
  • CVP
  • TPR
A 
Q = MAP - CVP 
             TPR 
MAP = Mean arterial pressure 
CVP = Central venous pressure 
TPR = Total peripheral resistance
49
Q

Pulse Pressure (PP) =

A 
PP = SBP - DBP 
SBP = Systolic blood pressure 
DBP = Diastolic blood pressure
50
Q

Mean Arterial Blood Pressure (MABP) =

A

MABP = DBP + 1/3 PP

= 2/3 DBP + 1/3 SBP

51
Q

Microcirculation

A

-Smooth muscle cells surrounding the arterioles control the entry of blood into the capillary network and the resistance to flow around the systemic circulation

52
Q

Laminar flow:

A

Friction between the blood and the wall of the blood vessel slows flow at the edge of the vessel

53
Q

Turbulent flow:

A

Eddies and swirls appear, determined by the Reynold’s number (Re)

54
Q

Reynolds number (Re):

A

Re = (v X D X p)/n

v: velocity,D: diameter, p=density, n=viscosity

55
Q

Single-file flow:

A

the internal diameter of capillaries is 6 micrometers, less than the 7 micrometer diameter of red blood cells. Cells are squeezed through one by one

55
Q

Single-file flow:

A

the internal diameter of capillaries is 6 micrometers, less than the 7 micrometer diameter of red blood cells. Cells are squeezed through one by one

56
Q

Metabolic hyperaemia:

A
  • Caused by a build up of metabolites, relaxation of smooth muscle in the medial layers of the arterioles supplying the tissue causes vasodilation , blood flow increases, metabolites get used up, returns to normal
57
Q

Reactive hyperaemia:

A

An increase in blood flow after a period of arrested blood flow. Tissue in occluded limbs continue to metabolise, causing a build up of metabolites. when blood flow returns, the metabolites cause vasodilation, increasing blood flow

58
Q

Orthostasis: (5)

A
  • When lying down (supine) venous blood is evenly distributed
  • When standing venous blood pools in the legs
  • Central venous pressure drops, reducing SV
  • Reducing MABP
  • Causing transient hypotension
59
Q

Vasovagal syncope:

A
  • psychogenic reduction in blood pressure
  • Vagal bradycardia and vasodilation in response to psychological stress
  • (e.g. sight of blood)
60
Q

White coat hypertension:

A
  • Anxiety results in increase in blood pressure due to increased sympathetic output
  • Increasing HR and TPR
61
Q

Capillary types: sinusoid (discontinuous capillary)

A
  • Found in spleen, liver, bone marrow

- RBCs and large lipophobic molecules can pass through

62
Q

Capillary types: fenestrated capillaries

A
  • Glomerular capillaries

- Small lipophobic molecules can diffuse

63
Q

Types of capillaries: continuos capillaries

A
  • Fast diffusion: gases, lipophilic molecules
  • Slow diffusion: small lipophobic molecules
  • Very slow diffusion: large lipophobic molecules \
  • E.g. most tissues
64
Q

Ultrafiltration in capillaries:

- Interstitial fluid

A
  • Pressure of interstitial (Pi) is slightly negative to Pressure inside the capillary (Pc)
  • H2O diffuses out of capillary, creating interstitial fluid
65
Q

Oedema:

A
  • Excess tissue fluid, leads to water-logged interstitium
  • Arises when:
    Fluid production by capillaries becomes greater than fluid removal by lymphatics
66
Q

Excess fluid drainage:

A
  • Drained by the lymphatic system
67
Q

The red blood cell (erythrocyte): functional adaptations

A
  • Bioconcave shape: maximises SA
  • Strong yet flexible
  • No internal organelles: maximises space for haemoglobin
68
Q

Erythropoiesis:

A
  • Production of red blood cells
69
Q

Locations of erythropoiesis:

  • In utero
  • In children
  • In adults
A
  • In utero: liver
  • In children: bones with red marrow, liver and spleen
  • In adults: ends of long bones, skull, vertebrae, ribs, sternum, pelvis (liver and spleen)
70
Q

Erythropoiesis steps: (7)

  • HSC
  • Pro-E
  • Baso
  • Poly
  • Ortho
  • R
  • RBC
A
  • Haematopoietic stem cell (1)
  • Pro-erythroblast (2)
  • Basophilicc (4)
  • Polychromatic (8)
  • Orthochromatic (16)
  • Reticulocyte (16)
    _ RBC (16)
71
Q

Erythroid cell differentiation: Proerythroblast to orthochromatic

A
  • Massive synthesis of erythroid specific proteins
72
Q

Erythroid cell differentiation:

Whole cycle

A
  • Increasing production of systolic proteins (haemoglobin)
73
Q

Erythroid cell differentiation: polychromatic to erythrocyte

A
  • Loss of organelles
74
Q

What stimulates erythropoiesis:

A
  • Erythropoietin (EPO)

- Secreted by the kidneys, increases RBC count

75
Q

Where does erythropoiesis occur in the bone marrow: (3)

  • MI
  • Interactions
  • What is is produced/engulfed
A
  • Macrophage islands
  • A central macrophage interacts with developing erythroid cells
  • Macrophage produces regulatory GHs and TFs and engulfs discarded nucleus’s
76
Q

Destruction and recycling of RBCs:

  • Phagocytosis
  • Globulin portion
  • Cell components
A
  • Old and damaged erythrocytes are phagocytized by macrophages
  • The globulin (protein) portion of haemoglobin is metabolised into amino acids
  • Cell components also recycled
77
Q

The fick principle: oxygen uptake rate (VO2)=

  • Q=flow rate
  • CA- Arterial O2conc.
  • CV- Venous O2conc.
A 
- VO2 = Q.CA - Q.CV
           = Q(CA-CV) 
- Q = flow rate (CO)
- CA = O2 conc. (oxygenated blood)
- CV = O2 conc. (deoxygenated blood)
- VO2 = rate of oxygen uptake (consumption)
78
Q

Metabolic hyperaemia:

A
  • Build up of metabolites causes vasodilation and local increase in blood flow
79
Q

Cardiovascular responses to dynamic exercise: (5)

A
  • Metabolic vasodilation
  • Coronary vasodilation
  • Pulmonary blood flow increases
  • SV increases
  • Splanchnic/renal vasoconstriction
80
Q

Dynamic exercise:

  • Definition
  • Systolic BP
  • Diastolic BP
A
  • Alternating contraction and reaction
  • Systolic BP increases as a result of increased cardiac output
  • Diastolic BP may decrease due to fall in TPR due to vasodilation (heat loss)
81
Q

Static exercise:

  • Definition
  • Effect on BP
  • Moderation
A
  • Sustained contraction
  • Both systolic and diastolic BP increase
  • Compression of muscles impairs blood flow
  • Muscle metaboloreceptors mediate a peripheral vasoconstriction
82
Q

Cardiovascular response to exercise:

  • Anticipation
  • Central command hypothesis
  • Effects
A
  • Anticipation of exercise causes HR and breathing increase
  • Cerebral cortex influences autonomic and respiratory neurones in the brainstem
  • This causes HR and blood pressure to increase
83
Q

Effects of aerobic training: (5)

  • H
  • R B
  • B V
  • C
  • V
A
  • Left ventricular enlargement: increases stroke volume
  • Resting bradycardia
  • 5-10% increase in blood volume
  • Increased myocardial contractility
  • Increased muscle vascularisation
84
Q

Cardiac conduction system: (2)

A
  • Excitation spreads from the Sinoatrial node (SAN) via internodal pathways to the Atrioventricular node (AVN)
  • from here it travels down the interventricular septum and across both ventricles via purkinje fibres
85
Q

Action potential of a ventricular myocyte: (4)

  1. K+
  2. Na+
  3. Na+
  4. Ca+
  5. K+
A
  1. Resting membrane potential, determined by K+ permeability
  2. Activation of voltage-gated Na+ channels, inward current, cell moves toward E(Na)
  3. Early repolarisation due to slow inactivation of Ca channels
  4. slow inward current of Na+ causes a plateau phase
  5. Depolarisation phase bought by increased permeability to K+ and Ca inactivation
86
Q

The refractory period:

A
  • When sodium channels are inactivated, ensures each AP only generates a single twitch as tetany would be fatal
87
Q

Pacemaker potential in the SA node:

A
  • SA nodal cells show an unstable resting membrane potential due to slow inward Ca and Na currents
88
Q

Effect of pacemaker potential:

A
  • Slope of the pacemaker potential sets the heart rate
89
Q

Positive chronotropism:

A
  • Sympathetic fibre activity accelerates the heart

- Noradrenaline binds to B1-adrenoreceptors, increasing slope

90
Q

Negative chronotropism:

A
  • Parasympathetic fibre activity slows the heart

- Acetylcholine binds to muscarinic receptors, decreasing slope. Slowing the heart rate

91
Q

The electrocardiogram:

A
  • Conduction of the AP through the heart creates an electrical field that can be detected at the body surface as an ECG
92
Q

P wave:

A
  • Atrial depolarisation
93
Q

PR interval:

A
  • Atrial depolarisation, atrioventricular conduction, spread through purkinje fibres
94
Q

QRS interval:

A
  • Ventricular depolarisation
95
Q

QT interval:

A
  • Ventricular depolarisation and repolarisation

Medicine (18 decks)

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