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Medical Physiology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Cardiac output equation

A

SV x HR

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2
Q

What initiates HR?

A

Autorhythimic cells in SAN

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3
Q

SNS affects HR how and what receptors?

A

Increases HR by B1 receptors

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4
Q

Norepinephrine is what?

A

Catecholamine

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5
Q

Define length-tension relationship

A

Greater the stretch of myocardium= greater the force of ventricular contraction

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6
Q

EDV is determined by what? (4)

A

Skeletal muscle pump
B.volume
Venous constriction
Respiratory pump

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7
Q

How does digitalis affect contractile state?

A

Increases contractile state

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8
Q

Afterload definition

A

Stress on wall DURING contraction

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9
Q

Afterload is dependent on what two things?

A

Volume of blood in ventricles and TPR around aorta

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10
Q

Increasing afterload does what (3)?

A

Reduces EF, SV, CO,

Increases ESV

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11
Q

Sv/EDV x100

A

Ejection fraction

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12
Q

Heart failure definition

A

Heart is incapable of maintaining a CO
that is adequate to meet metabolic requirements
and accommodate venous return

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13
Q

How is afterload increased? (2)

A

Increasing aortic pressure/systemic vascular resistance

Aortic valve stenosis

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14
Q

Whats % is considered the normal ejection fraction?

A

55%

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15
Q

Acute failure example would be?

A

Myocardial infarction

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16
Q

Pulmonary oedema is what? What symptom can it show?

A

Liquid in tissues/organs.

Dyspnea

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17
Q

Pulmonary hypertension results from what artery pressure increasing?

A

Pulmonary artery pressure imcreasing

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18
Q

Pulmonary hypertension results when

MAP>?

A

19mmHg

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19
Q

Decreasing cardiac output can lead to low blood pressure and what is this called?

A

Hypotension

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20
Q

Hypo perfusion leads to lack of energy for muscles why?

A

Blood conserved for heart/brain due to lack of CO to meet metabolic needs

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21
Q

Peripheral oedema occurs in what areas of the body?

A

Ankles/sarcral region

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22
Q

Impaired cardiac reserve leads to what?

A

Impaired exercise tolerance due to heart not being able to work hard enough during exercise

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23
Q

Why can nausea occur from heart failure?

A

Movement of blood from GI to vital organs

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24
Q

Why do palpitations occur?

A

To compensate for lack of blood flow

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25
Why can wheezing occur?
Increased pressure in pulmonary capillary bed due to ineffective blood flow from left ventricle
26
A cause of heart failure is a lack of oxygen. What is this called?
Ischaemic heart disease
27
How does one get cardiomyopathy?
Inherited intrinsic disease of myocardium
28
Chronic hyper..... and aortic st..... from pressure overload can lead to?
Hypertension, stenosis can lead to heart failure
29
Infections of these 3 areas of the heart can lead to heart failure?
Myocarditis, pericarditis, endocarditis
30
Abnormal valves can occur from congenital ...... or aortic/mitral valve reg....... as a result from volume overload
Congenital defects and mitral valve regurgitation
31
Systolic failure can lead to what 4 things?
Reduced contractility EF is reduced below 45% Increased ESV Increased EDV
32
Diastolic failure can lead to what 3 things?
Reduced ventricular compliance Reduced ventricular relaxation Reduced ventricular filling
33
Define ejection fraction
Amount of blood pumped per contraction
34
Whats the first 2 stages of right heart failure?
Impaired contractility reduces Rside CO RVEDP increases
35
Whats the last two stages of right hear side failure?
Systemic venous pressure/capilliary pressure increases Extravasation of fluid into tissues/organs
36
Whats the normal values of venous pressure? Whats unhealthy?
10mmHg unhealthy 5mmHg healthy
37
What type of oedema occurs because of right side failure?
Peripheral oedema
38
Stable angina
Coronary BF cant meet metabolic demands Pain at exertion Relieved by rest
39
Unstable angina
Pain at rest MI due to occlusion of Coronary HF from scar tissue formation
40
NSTEMI
ST depression
41
STEMI
ST elevation
42
Low HDL value
<60mg/dl
43
High LDL value
>100mg/dl
44
Goal of drug treatments of angina
Increase myocardial OXYGEN SUPPLY Decrease oxygen DEMAND/workload
45
Venous dilation does what for preload /workload / O2 demand
Decreases preload Decreases oxygen demand Decreases workload
46
B adrenoreceptor blocks decrease what?
HR and contractility Cardiac workload decreases
47
Potassium channel openers cause what?
Hyperpolarize SM Decrease in intracellular calcium Relaxation
48
Stents increase what
Size of lumen Decreasing TPR Decreasing BP
49
Asymptomatic plaque disruption
Thin capped fibroatheromas (TCFA) Tears in cap Leads to intraluminal coronary thrombus Or leads to symptomatic coronary occlusion
50
Symptomatic coronary occlusion
Developed from asymptomatic STEMI Myocardium necrosis MI
51
What are the main features of exercise on CO/BP/Skeletal muscle BF
All increased Including redistribution of blood flow
52
What type of pressure is present during Inspiration
Negative Intrathoracic Pressure
53
How does the Skeletal Pump Affect CO?
Compression / Relaxation of veins acts as Pump VR / Preload Increases = SV/CO increases
54
What happens to BP during exercise? Why?
Decreases TPR decreases
55
What is BP dependent on?
Baroreceptor Reflex
56
Name a drug which inhibits Parasympathetic Nervous System
Atropine
57
If SNS activates B1 receptors, what happens?
ON heart --> Increases Contractility/HR
58
If SNS activates A1 receptors, what happens?
Aterial Constriction -->Increases VR/Preload
59
If SNS activates B2 receptors, what happens?
Skeletal muscle --> Vasodilates = Increase BF
60
What Controls the Autonomic Nervous System
Central Command Through Feed Forward Mechanisms
61
What occurs in anticipation of exercise?
Suppression of Vagal Tone Leads to Increase in HR/CO
62
What is the Central Command?
Medullary Controller
63
What does the Central Command do to baroreceptors?
Increases their operating set point (+15mmHg) Allows BP to be regulated at a higher MAP
64
With the Mechanoreflex, what group of afferents are activated? How are they activated?
Group III Muscle/Length tension changes
65
With the Metaboreflex, what group of afferents are activated? How are they activated? What do they then cause?
Group IV Metabolicis (Lactic acid) Increased arterial BP
66
How do III and IV travel to the medulla?
Via the spinal cord
67
what is the main way that blood is redistributed to exercising muscle/heart/skin?
Catecholamines Constrict Splanchnic/renal beds = Reduced BF to visceral organs
68
what is the Carotid Chemoflex stimulated by? What does it then stimulate
Hypoxia / Hypercapnia Increases HR via SNS
69
Thermalflex modulates what? What muscle afferents respond to heat?
SNS III and IV
70
In training, What happens to the ventricular wall thickness? What does this then increase?
Hypertrophy due to increased demand Wall thickness increases Increase in SV
71
Why does doing exercise decrease the heart rate? What does this then allow?
Increase in Vagal Tone (para) Allows CO to increase more during exercise
72
What happens to capilliary density in skeletal muscle during training?
Increases allowing more gas exchange
73
What can happen to mitochondria levels in muscle fibres during training
Increase Promotes oxygen extraction
74
HF stats (2)
50% 5yr mortality 1/3 deaths in US
75
What happens to compensatory Frank starling?
Myocardial cells degenerate Drop in CO
76
SNS compensatory system leads to what 2things
Overstimulation of SNS = myocardial toxicity Increase wkload/O2 demand =worsen HF Tachycardia
77
RAAS leads to what eventually
Ag2 vasoconstriction=increase Cardiac wkload +accelerates HF Salt retention from aldosterone=increase HP Aggregates oedema in tissue
78
What do natriuretic peptides do
Act as counterbalance to maintain BP Prevent excess H2O + salt excretion
79
Ventricular remodelling leads to what eventually?
Contractile dyssynchrony Less effective pumping
80
Vasopressin leads to what?
Increased cardiac wkload + worsening of symptoms
81
What is cardiac output
Amount of blood pumped through the entire circulatory system in a minute 4-8L
82
Stroke volume
Amount of blood ejected by the ventricle in a single contraction

Medical Physiology (17 decks)

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