Cardiovascular Phys review Flashcards

1
Q

on a basic level, what are the two things the heart does during systole?

A
  1. pressurizes

2. Ejects

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2
Q

on a basic level, what are the two things the heart does during diastole?

A
  1. Depressurizes

2. Refills

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3
Q
On pressure volume loop, indicate where each of these are found
A. Mitral valve Closes 
B. isovolumetric contraction
C. Aortic valve opens
D. Ejection
E. Aortic valve closes
F. Isovolumetric relaxation
G. Mitral valve opens
H. Filling
I. Stroke volume
A

Draw it out and label it.

since stupid free version of brainscape won’t let me upload a pic, check yourself with a reference

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4
Q

In an ECG when are ventricular myocytes depolarized?

A

At the tip of the R wave (at the tip of the QRS complex)

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5
Q

In a ventricular Action potential graph indicate what’s happening in each phase and what ion is responsible for each phase.

A

Phase 0: UPstroke caused by inward Na conductance –> depolarize cell

Phase 1: brief period of initial repolarization caused by outward current of K+ and decrease in Na+ inward

Phase 2: Plateau of action potential: transient increase in Ca++ inward conductance

Phase 3: repolarization. Ca conductance decrease, K conductance increase and large outward K current I(k) hyperpolarizes cell

Phase 4: resting membrane potential during which inward and outward current (Iki) are equal

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6
Q

In a SA and AV node action potenial, indicate what’s happening in each phase and what ion is responsible for that change

A

Phase 0: Upstroke of action potential caused by inward Ca++ conductance.

Phase 3: repolarization caused by outward K conductance

Phase 4: slow depolarization caused by inward Na current called I(f) funny Na channels

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7
Q

The P wave of the ECG corresponds with which phase of the cardiomyocyte action potential?

A

Phase 0 (Na conductance)

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8
Q

Which part of the ECG would indicate when ventricular filling is occurring?

A

At the start of P wave up until right before Q wave.

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9
Q

Indicate what each wave of the ECG represents:
A. P wave
B. QRS?
C. T wave

A

A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular depolarization

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10
Q

P wave corresponds with what wave on the right ventricle?

A

a wave. Lines up right as P wave is ending

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11
Q

Indicate when you’d see SA node action potential in relation to the P wave?

A

the AP will slightly precede the P wave.

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12
Q

Indicate when the Fast ventricular AP would occur in relation to the QRS complex.

A

The atrial AP will right round the P wave, and that’ll end at the peak of R wave and right after that the ventricular AP will start and that will end at the end of T wave.

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13
Q

In relation to the QRS, indicate status of these ions:
A. Na+
B. Ca++
C. K+

A

A. steep increase at the same time as the QRS is happening. the graph resembles the QRS shape.
B. Starts midway of the QRS and rises and falls back down to normal towards the start of the T wave
C. Starts midway of the QRS just like Ca, but dips down and comes back up to normal towards the start of T wave just like Ca.

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14
Q

Isovolumetric contraction of left ventricle corresponds with what part of the QRS?

A

The curve starts at the tip of R wave and ends at S wave.

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15
Q

S1 is heard during what phase of the ECG and what part of the left Ventricle/atrium pressure wave?

A

Right after the tip of the R wave. At wave c on the left atrium pressure wave.

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16
Q

The beginning of afterload and ejection corresponds with what part of the ECG? On what left ventricular pressure wave?

A

S wave on ECG

At the end of isovolumetric contraction on LV pressure wave

17
Q

The end of LV ejection corresponds to end of what wave on the ECG?

A

End of T wave

18
Q

S2 corresponds with what part of the ECG?

A

End of T wave

19
Q

The start of isovolumetric relaxation corresponds with what part of the ECG?

A

After the peak of T wave and ends at the end of T wave.

20
Q

Diastolic dysfunction is the inability to fill the heart during diastole so the heart contracts with reduced preload/volume. What are some conditions that can lead to that?

A

Elevated end diastolic pressure leading to diastolic dysfunction can be due to cardiac hypertrophy, thickening of walls, tamponade, fibrotic cardiac tissue.

21
Q

Does depolarization of ventricles occur concurrently with ventricular contraction?

A

No, there’s a slight delay in time between depolarization of the ventricles and contraction of the ventricles.

22
Q

During which segment of the ECG is the LV depolarized?

A

ST segment

23
Q

During what point in the ECG are ventricles at their peak of contraction/ejection?

A

At the beginning of T wave

24
Q

Rapid filling of the ventricle is marked by what wave of the left ventricular volume curve?

A

Wave o. This is also when the mitral valve opens.

25
Q

At the end of isovolumetric contraction, indicate conductance of Na, Ca and K

A

Na conductance has returned to normal
Ca conductance is high
K conductance is low

26
Q

Peak of Na conductance is during which part of the ECG?

A

QRS complex

27
Q

Diastole begins at the end of what wave of the ECG?

A

T wave

28
Q

Swelling of legs and abd over several months with BP of 90/60. X ray shows cardiac enlargement and pleural effusions. Elevated jugular venous pressure and presence of S3. All these findings are indicative what cardiac pathology? How would the Volume pressure loop change due to this condition?

A

LV end diastolic volume increase as seen in congestive heart failure.

The pressure volume curve would be shifted lower and further to the right.

29
Q

Indicate how pressure volume loop would change with each of the following:
A. Increased contractility due to catecholamines
B. Increase in preload
C. Increase afterload

A

A. Loop gets bigger all around: wider and taller
B. Loop gets shorter and wider towards higher volume.
C. Loop gets taller and narrower. Narrows from the left towards higher volume on the right.

30
Q

With cardiac injury leading to decrease in stroke volume indicate what happens to
A. Preload
B. CO
C. BP

A

A. increases
B. Decreases
C. decrease

31
Q

In response to decreased BP indicate what happens to:
A. JG cells
B. Vasopressin
C. Thirst
C. Carotid/aortic baroreceptors firing rate

A

A. stimulated to start the RAAS system
B. Increases to preserve volume
C. Increase thirst to take in fluid
D. decreases which then stimulates sympathetic stimulation on the vasomotor center and decrease parasymp outflow.

32
Q

Due to decrease BP indicate what the sympathetic system does to correct BP. (7)

A
  1. Inc norepi, beta1 to inc HR –> increase CO –> inc BP
  2. inc norpei, beta1 to inc heart contractility –> inc SV –> inc CO –> BP
  3. inc alpha 1 –> constrict veins –> inc preload –> inc SV –> Inc CO –> inc BP
  4. Inc alpha 1 –> constrict arterioles –> inc TPR –> inc BP
  5. Decr renal fluid excretion
  6. Inc renin
  7. decr parasymp –> ach, musc –> increase HR , CO, BP