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Chiro Essentials Physiology > Cardiovascular and Hematology Review > Flashcards

Cardiovascular and Hematology Review Flashcards

1
Q

Atrial Natriuretic Peptide (ANP) is secreted in response to?

A

Atrial pressure

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2
Q

B-type Natriuretic Peptide (BNP) is secreted in response to?

A

Overstretched ventricles

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3
Q

Individual cells in cardiac muscles are connected by what?

A

Intercalated discs

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4
Q

How do ions pass between myocytes in the heart?

A

Gap junctions

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5
Q

In the resting state there which ions are more concentrated on the outside? Inside?

A

Na+, Ca++

K+

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6
Q

Describe the four phases of muscle contraction of cardiac muscle.

A

Sodium influxes into cardiac myocytes causing deopolarization and then the channels close and K+ leaves via leaky channels causing some repolariztion, thencalcium enters through L-type Ca++ channels leading to the plateau phase, and then inactivation of Ca++ into cell leads to rest of repolarization as K+ continues to leave via leaky channels and than excess Na+ and Ca++ with restoration of membrane potential and K+ comes back into cell w/Na+/K+ ATPase

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7
Q

Absolute refractory period:

A

no action potential can be initiated regardless of the stimulus strength because sodium channels are closed in Phase 1 to mid Phase 3

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8
Q

Relative refractory period:

A

no action potential can be elicited, however a greater stimulus is needed - extends between the middle of Phase 3 to the start of Phase 4

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9
Q

Frank-Starling law:

A

Cardiac output is directly proportional to the venous return
Force of contraction is directly proportional to length of fiber
Greater amount of blood entering heart during diastole the greather the stretching on cardiac myocytes
The greater stretch results in greater F of contraction causing increase in cardiac output

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10
Q

What causes the first heart sound? (LUB)

A

Closure of tricuspid and mitral valves

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11
Q

What causes the second heart sound? (DUB)

A

Closure of the pulmonary and aortic valves

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12
Q

When is the third heart sound heard? (DUBup)

A

After second in patients with congestive heart failure

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13
Q

When is the fourth heart sound heard? (beLUB)

A

Before the 1st in hypertrophic ventricle

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14
Q

Systole (contraction) occurs between which heart sounds?

A

1 and 2

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15
Q

Diastole (relaxation) occurs between which heart sounds?

A

2 and 1

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16
Q

What is measured in an electrocardiogram?

A

Electrical activity in heart as the impulse generated in the SA node and propagated to the rest of the heart

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17
Q

How many times does the SA node go off in a minute?

A

80-100

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18
Q

What spreads the electrical impulse of the SA node through the heart?

A

Intra-atrial bundles

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19
Q

What is the rate of depolarization of the AV node per minute?

A

40-60X

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20
Q

When the SA node rhythm is superimposed upon AV node rhythm the heart rate is?

A

70 bpm

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21
Q

The impulse of the AV node is sent into what and then into what located in the muscular part of the interventricular septum?

A

Bundle of His

R/L bundle branches

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22
Q

Where is the conduction velocity slowest in the heart? Fastest?

A

Slow: AV node
Fast: Purkinje fibers

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23
Q

The rate of depolarization is slowest where in the heart? Fastest?

A

Purkinje fibers

SA node

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24
Q

P wave?

A

Atrial depolarization, precedes atrial contraction

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25
Q

PR interval:

A

P wave to Q wave

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26
Q

1st degree AV block causes?

A

Prolonged PR interval >200 ms

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27
Q

2nd degree AV block causes?

A

Progressive prolongation of PR interval w/dropped beats

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28
Q

3rd degree AV block causes?

A

No association btw P and QRS complex

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29
Q

QRS complex?

A

Ventricular depolariztion

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30
Q

QT interval?

A

extends from beginning of Q wave to end of T wave

31
Q

ST segment

A

End of S wave to start of T wave

32
Q

T wave?

A

Represents ventricular repolarization

33
Q

Atrial repolarization is not seen on ECG because?

A

It is buried by the QRS complex

34
Q

Isovolumic contraction?

A

Increase in pressure w/o change in volume - btw closure of AV valves and opening of aortic valve

35
Q

Ejection of blood (End diastolic volume) is how many ml? What is the usual ejection fraction?

A

70 ml

60%

36
Q

Isovolumic relaxation?

A

Decrease in Pressure w/o a change in volume, occurs btw closing of aortic valve and opening of AV valves

37
Q

Sympathetic heart rate control comes from which nerves/ganglia?

A

T1-5

Middle and inferior cervical ganglia

38
Q

What does the sympathetic innervation of the heart do?

A

Increase rate of contraction (+chronotropism)
Increase speed of conduction (+dromotropism)
Increase force of contraction (+inotropism)

39
Q

Parasympathetic heart rate control comes from which nerves/ganglia?

A

Vagus N via cardiac branches

40
Q

What does the parasympathetic innervation of the heart do?

A

Decrease heart rate (- chronotropism)
Decrease conduction velocity (- dromotropism)
Decrease force of contraction (- inotropism)

41
Q

Blood pressure is the product of?

A

cardiac output x peripheral resistance

42
Q

Cardiac output is the product of?

A

stroke volume x heart rate

43
Q

Describe the baroreceptor mechanism for high blood pressure?

A

Baroreceptors in the carotid sinus and aortic arch (afferents carried by CN IX, X) relay information to the medulla cause a reflex to drop blood pressure via AND

44
Q

Where are low pressure baroreceptors located?

A

SVC, IVC, R atrium

45
Q

Poiseuille’s law?

A

Peripheral resistance is directly proportional to the viscosity of blood and to length of the vessel and inversely proportional to the radius of the vessel to the 4th power

46
Q

If the blood vessel radius decreases by half, then the resistance increases by a factor of?

A

16

47
Q

Where is the greatest resistance in the vascular system?

A

Arterioles

48
Q

La Place’s Law:

A

pressure w/in a blood vessel is related to the tension, size, shape of the vessel

49
Q

T/F Blood flow is directly proportional to the diameter of the blood vessel?

A

F Blood flow is inversely proportional to the diameter of the blood vessel

50
Q

Blood flow is greatest where? Least where?

A

Arteries, veins

Capillaries

51
Q

Which Starling Force (capillary pressure) forces fluids out into the interstitial space?

A

Intracapillary hydrostatic pressure +

52
Q

Which Starling Force (capillary pressure) pulls fluids into the capillary?

A

Intracapillary oncotic pressure -

53
Q

Which Starling Force (capillary pressure) forces fluids into the capillary?

A

Interstitial hydrostatic pressure -

54
Q

Which Starling Force (capillary pressure) pulls fluids out of the capillary?

A

Interstitial oncotic pressure +

55
Q

When there is imbalance in Starling Force (capillary pressure) what might occur?

A

Edema

56
Q

Stimulation of sympathetic nervous system in response to exercise effect on B1 receptors?

A

Increase heart rate, conduction velocity, cardiac contractility

57
Q

Stimulation of sympathetic nervous system in response to exercise effect on alpha receptors?

A

Vasoconstriction in skin, gut, inactive muscles

58
Q

Stimulation of sympathetic nervous system in response to exercise effect on B2 receptors?

A

Vasodilation of blood vessels to activate skeletal muscle and dilation of the coronary arteries

59
Q

Athletic heart syndrome

A

Prolonged exercise leading to cardiac muscle hypertrophy

60
Q

Function of blood?

A

Gas transport, immunity, clotting, transport of nutrients, waste

61
Q

What makes up blood?

A

RBC, WBC, platelets, plasma (55%)

62
Q

All blood cells are derived from what type of stem cell?

A

Pluripotent hemopoietic stem cell

63
Q

Where are pluripotent hemopoietic stem cells located in the adult? Fetus?

A

Marrow in adults

Liver, spleen, lymph nodes, bone marrow in fetus

64
Q

Lymphoid cell line gives rise to? Where are they found?

A

B cells: blood, lymphoid tissue

T cells: blood

65
Q

Myeloid cell line gives rise to? Develop into?

A

Erythroblasts: RBCs
Granulocytes: Basophils, eosinophils, neutrophils
Monocytes: macrophages
Megakaryocytes: platelets

66
Q

WBC types and their main function?

A

Neutrophils: bacterial infections
Lymphocytes: Viral/chronic infections
Monocytes: Phagocytosis (dead tissue, foreign particles)
Eosinophils: Parasitic infection
Basophils: Hypersensitivity reactions (i.e. allergies)

67
Q

Which WBCs carry lysosomes?

A

Neutrophils and macrophages

68
Q

Which WBCs produce bactericidal agents?

A

Neutrophils and macrophages

69
Q

Where are macrophages found?

A

Skin, subcutaneous tissue, lungs, lymph nodes, liver (Kupffer cells), spleen, bone marrow

70
Q

Intrinsic pathway of blood clotting is triggered by what?

A

Vascular damage

71
Q

What is the intrinsic pathway of blood clotting?

A

Factor XII activated by chemical derived by damaged tissue, activates Factor XI, activates Factor IX, activated IX and VIII activate X
Activated Factor X convertes Factor II (Prothrombin) to thrombin (activated Factor II) which converts fibrinogen (Factor I) to fibrin which forms the clot

72
Q

Extrinsic pathway of blood clotting is triggered by what?

A

Tissue damage

73
Q

What is the extrinsic pathway of blood clotting?

A

Factor VII activated by chemical released by vascular damage, Activated Factor VII activate Factor X
Activated Factor X convertes Factor II (Prothrombin) to thrombin (activated Factor II) which converts fibrinogen (Factor I) to fibrin which forms the clot

74
Q

What test is for the extrinsic blood clotting pathway? Intrinsic?

A

Prothrombin test

Partial Thromboplastin test

Chiro Essentials Physiology (5 decks)

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