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Medical Physiology > Cardiovascular > Flashcards

Cardiovascular Flashcards

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USMLE® Step 1 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
Q

Why can wheezing occur?

A

Increased pressure in pulmonary capillary bed due to ineffective blood flow from left ventricle

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26
Q

A cause of heart failure is a lack of oxygen. What is this called?

A

Ischaemic heart disease

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27
Q

How does one get cardiomyopathy?

A

Inherited intrinsic disease of myocardium

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28
Q

Chronic hyper….. and aortic st….. from pressure overload can lead to?

A

Hypertension, stenosis can lead to heart failure

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29
Q

Infections of these 3 areas of the heart can lead to heart failure?

A

Myocarditis, pericarditis, endocarditis

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30
Q

Abnormal valves can occur from congenital …… or aortic/mitral valve reg……. as a result from volume overload

A

Congenital defects and mitral valve regurgitation

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31
Q

Systolic failure can lead to what 4 things?

A

Reduced contractility
EF is reduced below 45%
Increased ESV
Increased EDV

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32
Q

Diastolic failure can lead to what 3 things?

A

Reduced ventricular compliance
Reduced ventricular relaxation
Reduced ventricular filling

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33
Q

Define ejection fraction

A

Amount of blood pumped per contraction

34
Q

Whats the first 2 stages of right heart failure?

A

Impaired contractility reduces Rside CO

RVEDP increases

35
Q

Whats the last two stages of right hear side failure?

A

Systemic venous pressure/capilliary pressure increases

Extravasation of fluid into tissues/organs

36
Q

Whats the normal values of venous pressure? Whats unhealthy?

A

10mmHg unhealthy

5mmHg healthy

37
Q

What type of oedema occurs because of right side failure?

A

Peripheral oedema

38
Q

Stable angina

A

Coronary BF cant meet metabolic demands

Pain at exertion

Relieved by rest

39
Q

Unstable angina

A

Pain at rest

MI due to occlusion of Coronary

HF from scar tissue formation

40
Q

NSTEMI

A

ST depression

41
Q

STEMI

A

ST elevation

42
Q

Low HDL value

A

<60mg/dl

43
Q

High LDL value

A

> 100mg/dl

44
Q

Goal of drug treatments of angina

A

Increase myocardial OXYGEN SUPPLY

Decrease oxygen DEMAND/workload

45
Q

Venous dilation does what for preload /workload / O2 demand

A

Decreases preload

Decreases oxygen demand

Decreases workload

46
Q

B adrenoreceptor blocks decrease what?

A

HR and contractility

Cardiac workload decreases

47
Q

Potassium channel openers cause what?

A

Hyperpolarize SM

Decrease in intracellular calcium

Relaxation

48
Q

Stents increase what

A

Size of lumen

Decreasing TPR

Decreasing BP

49
Q

Asymptomatic plaque disruption

A

Thin capped fibroatheromas
(TCFA)

Tears in cap

Leads to intraluminal coronary thrombus

Or leads to symptomatic coronary occlusion

50
Q

Symptomatic coronary occlusion

A

Developed from asymptomatic

STEMI

Myocardium necrosis

MI

51
Q

What are the main features of exercise on CO/BP/Skeletal muscle BF

A

All increased

Including redistribution of blood flow

52
Q

What type of pressure is present during Inspiration

A

Negative Intrathoracic Pressure

53
Q

How does the Skeletal Pump Affect CO?

A

Compression / Relaxation of veins acts as Pump

VR / Preload Increases = SV/CO increases

54
Q

What happens to BP during exercise? Why?

A

Decreases

TPR decreases

55
Q

What is BP dependent on?

A

Baroreceptor Reflex

56
Q

Name a drug which inhibits Parasympathetic Nervous System

A

Atropine

57
Q

If SNS activates B1 receptors, what happens?

A

ON heart –> Increases Contractility/HR

58
Q

If SNS activates A1 receptors, what happens?

A

Aterial Constriction –>Increases VR/Preload

59
Q

If SNS activates B2 receptors, what happens?

A

Skeletal muscle –> Vasodilates = Increase BF

60
Q

What Controls the Autonomic Nervous System

A

Central Command Through Feed Forward Mechanisms

61
Q

What occurs in anticipation of exercise?

A

Suppression of Vagal Tone

Leads to Increase in HR/CO

62
Q

What is the Central Command?

A

Medullary Controller

63
Q

What does the Central Command do to baroreceptors?

A

Increases their operating set point (+15mmHg)

Allows BP to be regulated at a higher MAP

64
Q

With the Mechanoreflex, what group of afferents are activated? How are they activated?

A

Group III

Muscle/Length tension changes

65
Q

With the Metaboreflex, what group of afferents are activated? How are they activated?

What do they then cause?

A

Group IV

Metabolicis (Lactic acid)

Increased arterial BP

66
Q

How do III and IV travel to the medulla?

A

Via the spinal cord

67
Q

what is the main way that blood is redistributed to exercising muscle/heart/skin?

A

Catecholamines

Constrict Splanchnic/renal beds = Reduced BF to visceral organs

68
Q

what is the Carotid Chemoflex stimulated by?

What does it then stimulate

A

Hypoxia / Hypercapnia

Increases HR via SNS

69
Q

Thermalflex modulates what?

What muscle afferents respond to heat?

A

SNS

III and IV

70
Q

In training, What happens to the ventricular wall thickness?

What does this then increase?

A

Hypertrophy due to increased demand

Wall thickness increases

Increase in SV

71
Q

Why does doing exercise decrease the heart rate?

What does this then allow?

A

Increase in Vagal Tone (para)

Allows CO to increase more during exercise

72
Q

What happens to capilliary density in skeletal muscle during training?

A

Increases allowing more gas exchange

73
Q

What can happen to mitochondria levels in muscle fibres during training

A

Increase

Promotes oxygen extraction

74
Q

HF stats (2)

A

50% 5yr mortality

1/3 deaths in US

75
Q

What happens to compensatory Frank starling?

A

Myocardial cells degenerate

Drop in CO

76
Q

SNS compensatory system leads to what 2things

A

Overstimulation of SNS = myocardial toxicity

Increase wkload/O2 demand =worsen HF

Tachycardia

77
Q

RAAS leads to what eventually

A

Ag2 vasoconstriction=increase Cardiac wkload +accelerates HF

Salt retention from aldosterone=increase HP
Aggregates oedema in tissue

78
Q

What do natriuretic peptides do

A

Act as counterbalance to maintain BP

Prevent excess H2O + salt excretion

79
Q

Ventricular remodelling leads to what eventually?

A

Contractile dyssynchrony

Less effective pumping

80
Q

Vasopressin leads to what?

A

Increased cardiac wkload + worsening of symptoms

81
Q

What is cardiac output

A

Amount of blood pumped through the entire circulatory system in a minute

4-8L

82
Q

Stroke volume

A

Amount of blood ejected by the ventricle in a single contraction

Medical Physiology (17 decks)

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