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cardio pulm midterm > cardiovascular anatomy and physiology > Flashcards

cardiovascular anatomy and physiology Flashcards

1
Q

what are the 4 layers of the heart

A

parietal pericardium
visceral pericardium
myocardium
endocardium

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2
Q

what is the inner most layer that lines the heart contains smooth muscle

A

endocardium

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3
Q

which layer of the heart has cardiac muscle fibers the provide the work in distributing blood
to the heart

A

myocardium

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4
Q

what is the visceral pericardium also known as

A

epicardium

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5
Q

what layer of the heart has coronary blood vessels

A

epicardium

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6
Q

which part of the heart can be compressed due to exc3ss fluid accusation that ends to reduce cardiac output

A

pericardium

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7
Q

valve issues can lead to

A

endocarditis

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8
Q

peripheral restriction is key to what

A

blood pressure

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9
Q

what property of the myocardial cells is able to contract without external stimuli

A

automaticity

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10
Q

which property of the myocardial cells can contract in a rhythmic manner

A

rhythmicity

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11
Q

which property of the myocardial cellls can nerve impulses can be transmitted from one myocardial cell to another due to intercalated disks that form a syncytium (protoplasm of one cell is continuous with that of another)

A

conductivity

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12
Q

what are the 2 junctions that the intercalated disk contain

A

desmosomes and connexins

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13
Q

what does desmosomes do

A

attach one cell to another

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14
Q

what does connexins do

A

allow electrical impulses to spread

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15
Q

what artery supplies the myocardium

A

coronary artery

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16
Q

how many beats per minutes does teh SA and AV node allowed

A

60-100

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17
Q

what neurotransmitter decreases heart rate and myocardial contractility to 60-90 bpm and what system is it in

A

acetylcholine & PNS

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18
Q

which neurotransmitter increased heart rate and myocardial contracility and what system

A

norepinephrine and SNS

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19
Q

where does the SA node receive input from

A

autonomic nervous system:

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20
Q

the SA node paces the heart to beat how many BPM without any other input

A

> 100

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21
Q

what functions as the pacemaker of the heart

A

SA node

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22
Q

where does the SA node send its signals to

A

the R atrium to contract first

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23
Q

what sends signal for ventricles to contract

A

AV node

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24
Q

AV node impulses are transmitted to the ventricular myocardium through

A

bundle of His

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25
Q

what Divides into a left and right bundle branch at the intermuscular septum to
innervate each respective ventricle

A

bundle of his

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26
Q

Bundle branches further divide into smaller nerve fibers called ______ to cause the ventricles to contract

A

Purkinje fibers

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27
Q

why is the SA node susceptible to disease

A

proximity to the epicardium (pericarditis)
coronary artery occlusion ( blockage )

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28
Q

why is the AV node susceptible to disease

A

right coronary artery occlusion

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29
Q

what generates the 1st heart beat

A

the closure of the tricuspid and mitral valve

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30
Q

what does teh 1st heart beat signal

A

onset of ventricular systole

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31
Q

what is hypokalemia associated with

A

arrhythmias and mm cramps esp if taking diuretics

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32
Q

what is an effect of hyperkalemia

A

nausea and vomiting

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33
Q

what is an effect of hypercalcemia

A

erratic cardiac contraction

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34
Q

what is a effect of hyocalcemia

A

decreased myocardial contractilty

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35
Q

what is systole

A

myocardial contraction

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36
Q

what is diastole

A

myocardial/ ventricular relaxation

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37
Q

when all heart muscles are relaxed and all valves are closed and there is blood returning to the atria what is that called

A

atrial diastole

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38
Q

what happens in atrial systole

A

atria in contraction
av valves are open
blood to ventricles

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39
Q

what happens during ventricular systole

A

vent. in contraction
semilunar valves are open
blood passing to arties

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40
Q

what happens after ventricular systole

A

vent diastole

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41
Q

how do u measure cardiac output

A

sv x HR

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42
Q

what is the equation for BP

A

HR x SV x total peripheral resistance

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43
Q

what is the total peripheral resistance

A

the pressure w/in the aterial system during diastolic phase while the heart is filling

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44
Q

which part of BP does CO affect

A

systolic

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45
Q

what type of BP does TRP affect

A

diastolic

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46
Q

what is an important measure to assess from patients with hypotension

A

mean artieral pressure

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47
Q

what is the normal MAP

A

93 mmHg

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48
Q

if a patients has a MAP _____ be cautious getting them out of bed

A

< 60

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49
Q

what is normal BP

A

<120 / <80

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50
Q

what is elevated BP

A

120-129 / <80

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51
Q

what is high blood pressure stage 1

A

130-139 / 80-89

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52
Q

what is high blood pressure stage 2

A

> 140 / >90

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53
Q

what is mean arterial blood pressure determined by

A

blood volume
cardiac output
resistance of the system to blood flow
relative distribution of blood between arterial and venous blood vessels

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54
Q

what is HR affected by

A
  • Baroreceptors at the carotid sinus and aortic
    arch
    • Autonomic nervous system
    • Endocrine system
    • Integrity of the cardiac conduction system
    • Temperature
    • Emotional state
    • Primary determinant for increased CO and BP during exercise
55
Q

stroke volume is affected by

A

cardiac preload
cardiac after load
myocardial contracility

56
Q

what is cardiac preload (end diastolic volume)

A

amount of left ventricular blood volume prior to contraction

57
Q

cardiac preload is dependent on

A

venous return
total blood volume
left atrial contraction
frank starting law

58
Q

what is the frank starling mechanism

A

strength of ventricular contraction increases as the precontractile myocardial cell length increases

59
Q

what is cardiac afterload

A

amount of pressure encountered by the left ventricle

60
Q

is cardiac output is to high what happens with SV

A

it decreases because the pressure to put blood out is increased

61
Q

what is stroke volume

A

the amount of blood that is pumped with each beat

62
Q

if there is an increase in preload then there will be in ___ in SV

A

increase

63
Q

if pre load increases what happens to SV and EDV

A

both increase bc if the amount of blood that is filling the heart increases than the amount of blood pumped out increases also

64
Q

if afterload increases what happens to sv and esv

A

SV will decrease because the amount of pressure in the LV to pump blood out is increased anf ESV will increase bc it is the same as after load

65
Q

if there is an increase in inotropy than what happens to SV and ESV

A

increasing inotropy means increase in contraction so SV will increase and ESV will decrease

66
Q

when is afterload increased

A

hypertension
vascocontriction

67
Q

when is preload increased

A

hypervolemia
regurgitation of cardiac valves
HF

68
Q

what is the Amount of ventricular blood volume pumped per heart beat

A

ejection fraction

69
Q

how to calculate EF

A

SV / EDV

70
Q

normal values of EF at the LV

A

55-70 %

71
Q

if you have a poor SV what happens to EF

A

decreases

72
Q

T/F EF is a ration of the volume of ejected blood relative to what was received before systole or contraction

A

T

73
Q

systolic HF results in a ____ Ef

A

low

74
Q

diastolic HF results in a _____ EF

A

normal

75
Q

what is a positive chronograph agent

A

anything that makes the HR increase

76
Q

what does contractilty increase and decrease with

A

positive and negative inotropic agents

77
Q

if there is a decrease venous pressure what happens to venous return and preload and SV and CO

A

decrease everything

78
Q

what does ESD directly affect

A

afterload

79
Q

how many leaflets does the mitral and tricuspid valves have

A

2 and 3

80
Q

how many leaflets does the aortic and pulmonic valves have

A

3

81
Q

what is making the sound of the S2

A

closure of aortic and pulmonic valves

82
Q

where is S1 the loudest

A

apex

83
Q

where is teh aortic valve located on human body

A

2nd - 3rd right interspace

84
Q

what is the pulmonic vlave loavted on the human body

A

2nd -3 rd left interspace

85
Q

where is the tricuspid valve located on the human body

A

left sternal boarder

86
Q

where is the mitral valve located on the human body

A

5th intercostal space

87
Q

what makes up 55% of the blood

A

plasma

88
Q

what are the 4 main components in the blood

A

plasma ‘
RBC
WBC
platelets

89
Q

what is not a blood cell and is invovled in the production of platelets to promote the clotting process

A

thrombocytes

90
Q

where does hematopoiesis take place

A

in cancellous spongy bone

91
Q

what is RBC production regulated by

A

hormone called erythropoietin produced in the kidney

92
Q

what does hematocrit measure

A

the o2 on RBC in the blood

93
Q

if you have low hematocrit what effects do u have

A

anemia , vitamin /nutrition deficiencies

94
Q

if you have high levels of hematocrit what effects do u have

A

dehydration , polycythemia vera, lung/heart disease

95
Q

what is the Specialized protein in RBCs that binds to O2 for delivery to all bodily tissues

A

hemoglobin

96
Q

what is O2 saturation

A

amount of O2 that is bound to hemoglobin

97
Q

there is more increased in SaO2 if PaO2 is

A

> 50 mmHh

98
Q

if there is a shift to the right for the SaO2 curve what does that meant

A

increase relseae of O2

99
Q

if there is a shift to he left tin the SaO2 curve what does that mean

A

decreased release of O2

100
Q

what does the autonomic nervous system receive input from

A

barorecptors , carotid sinus and aortic arch on changes in BP

101
Q

increased activation of the autonomic nervous system causes what

A

vascocontriction

102
Q

decreased activation of the autonomic nervous system causes what

A

vasodiliation

103
Q

what is capillary hydrostatic pressure

A

move blood across the capillary membrane into the tissue

104
Q

what is capillary oncotic pressure

A

albumin (plasma protein) pulls on fluid back into the capillary

105
Q

what is interstitial hydrostatic pressure

A

move fluid back into the blood vessels

106
Q

what is interstitial oncotic pressure

A

draws fluid out of the capillaries into the tissues

107
Q

what is the net fluid exchange

A

2 mmHg outwards from capillary

108
Q

what is the oxygen extraction ratio

A

the body increases the ability to take more O2 from the blood as metabolism increase

109
Q

oxygen delivery (DO2) increase as tissue metabolism ___

A

increases

110
Q

oxygen consumption increases as tissue metabolism ___

A

increases

111
Q

at rest how much O2 is extracted from peripheral circulation

A

23%

112
Q

what is hypoxia

A

decrease O2 in the tissues

113
Q

what is hypoxemia

A

decreased O2 in the blood

114
Q

if o2 delivery decreases what happens to o2 consumption

A

stays teh same bc the tissues will utilize the same relative amount of O2 that is present in the blood

115
Q

if oxygen consumption falls below critical level what happens to anaerobic metabolism , serum lactate levels , the organs

A

anaerobic metabolism will ensue , lactate will increase and multi organ failure

116
Q

how many alveoli are present in the normal lung

A

300 mil

117
Q

where does gas exchange in the lungs happen

A

alveoli

118
Q

the pulmonary oxygen exchange allows for duffsiuon of O2 across ____ membrane to the __________ when then move to the _____ system then ____ and retuned to the heart via the ______ ____

A

alveoli , pulmonary arterial circulation , capillary , venues , pulmonary vein

119
Q

what is cool about the pulmonary vein

A

only oxygenated vein we have

120
Q

pulmonary oxygen exchange aloos for diffusion of CO2 across ___ membrane to the e_______ and them move to the capillary system to the ___ and sent o the lungs via ______

A

alveoli , pulmonary venous circulation , arterioles , pulmonary artery

121
Q

what is rich in the pulmonary arterioles

A

CO2

122
Q

Diffusion of O2 and CO2 across the alveoli to the pulmonary arterial circulation dependent on four factors

A

area of capillary membrane
diffusion capacity of alveolar capillary membrane e
pulmonary capillary volume
ventilation to perfusion ration

123
Q

what is the number 1 reason for hypoxemia

A

ventilation perfusion mismatch

124
Q

pulmonary capillary volume will increase with

A

exercise

125
Q

what is the normal ventilation perfuction ration

A

.8

126
Q

if V/Q is reduced then

A

blood is shunted to other parts of the lung and there is more perfusion then ventilation

127
Q

if V/Q is increased then there is

A

no gas exchange occurs , refered to as a dead space

128
Q

where in the lung is perfusion higher then ventilation

A

base

129
Q

when someone’s in a upright position the top of the lung has more

A

ventilation then perfusion

130
Q

what is perfusion

A

the amount of blood surrounding the alveoli’s

131
Q

what extrinsic controls is vasoconstriction and vasodiliation controlled by

A

endocrine systems
autonomic nervous system

132
Q

what controls the endocrine system

A

hypothalamus

133
Q

epinephrine released but the adrenal medulla causes

A

vascocontriction alpha receptors and vasodilation for beta receptors

cardio pulm midterm (11 decks)

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