Cardiovascular Physiology 1 (9/17b) [Biomedical Sciences 1] Flashcards

1
Q

Path of RBC from vena cava to vena cava

A
Vena cava
Right atrium
-Tricuspid Valve
Right Ventricle
-Pulmonary Valve
Pulmonary Circulation
-Pulmonary artery → vein
Left atrium
-Mitral/Bicuspid Valve
Left Ventricle
-Aortic Valve
Systemic circulation
-Aorta → Vena Cava
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2
Q

Atrioventricular valves

A

tricuspid and mitral valves

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3
Q

Semilunar valves

A

aortic and pulmonary valves

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4
Q

When do arteries carry deoxygenated blood?

A

Pulmonary artery carries deoxygenated blood to the lungs to get oxygenated

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5
Q

Main functions of cardiovascular system

A

Deliver enough blood to satisfy metabolic needs

Deliver O2 and nutrients, remove waste

Redistribute cardiac output

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6
Q

Range of metabolic demand

A

measure respiration/oxygen consumption rate to understand metabolic demand

Resting = about 250 mL O2/min

Exercise = about 5000 mL O2/min

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7
Q

Cardiac Output (CO)

A

measure cardiac output (L/min) by Heart Rate (beats/min) x Stroke Volume (mL/beat)

CO = HR * SV

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8
Q

Cardiac output increases as heart rate does, but not enough to keep up with oxygen consumption. What is needed?

A

redistribution of blood

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9
Q

During heavy exercise, more of cardiac output will be directed to ___ ___ ___

A

active skeletal muscle

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10
Q

___-____ fold increase in blood flow to active muscle

A

20-30

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11
Q

Sodium-Potassium (Na+/K+) pump

A

sets up electrochemical gradients

Lots of K+ inside cell, little outside → pumped out

Lots of Na+ outside cell, little inside → pumped in

Creates an electrical potential of about -90 mV in a resting cardiac/muscle cell

An electric current is needed to depolarize the current → action potential

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12
Q

Na+/K+ pump creates an electrical potential of about ___ mV in a resting cardiac/muscle cell

A

-90 mV

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13
Q

Action Potential - Skeletal Muscle (Myocytes)

A

Threshold reached → Na+ channels open quickly and Na+ rushes in (upstroke)

Depolarizes the cell, brings it up a little past neutral

Na+ channels close → K+ channels open and K+ rushes out (downstroke)

All of this happens in about 1-2 milliseconds

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14
Q

Action Potential - Cardiac Muscle (Nodal Cells)

A

Slow calcium (Ca2+) channels open and calcium comes in while potassium is leaving → they oppose each other and makes it a slow process → creates a plateau

Calcium has positive charge, so it keeps depolarizing the membrane; but potassium leaving hyperpolarizes it

Once Ca2+ channels close → membrane potential brought back to -90 mV

Upstroke rapid influx of Na+, plateau is balanced influx of Ca2+ and efflux of K+, downstroke is efflux of K+

happens in about 300 milliseconds

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15
Q

Contraction Ability - Skeletal vs Cardiac Muscle

A

Skeletal muscle → needs innervation to cause contraction, some electrical stimulation needed

Cardiac muscle → could beat on its own without innervation, has sinus or AV nodal cells

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16
Q

Automaticity

A

Nodal cells have an unstable resting potential → creates automaticity (able to beat on its own)

Gradual inward current of Na+ creates funny current

Once threshold is reached → action potential spreads to other myocytes

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17
Q

Flow of Signal Conduction

A

Sinoatrial (SA) node (60-100 bpm)

Atrioventricular (AV) node (40-60 bpm)

Bundle of His (15-40 bpm)

Bundle branches

Purkinje fibers

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18
Q

Overdrive suppression

A

high intrinsic rate of SA node makes it the dominant pacemaker

Ectopic foci can become pacemakers in pathological states

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19
Q

AV node delay allows time for…

A

atrial contraction and ventricular filling

aka leads to coordinated heart beat

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20
Q

How do we evaluate the signal of the heart?

A

with an ECG

21
Q

Normal sinus rhythm is defined by

A

Regular rhythm

rate between 60-100 bpm

normal shape of waveform (shape of P, QRS, T waves) (duration of PR, ST, and QT intervals)

22
Q

What do P, QRS, and T segments of ECG correspond to in the heart?

A

P = atrial depolarization

QRS complex = ventricular depolarization (also partly atrial repolarization) (mitral valve closing)

T wave = ventricular repolarization

23
Q

What parts of ECG correspond to ventricular systole and diastole?

A

Ventricular Systole → beginning QRS complex to end of T wave

Ventricular Diastole → end of T wave to beginning of next QRS complex

24
Q

ECG abnormalities

A

Sinus tachycardia → fast rhythm

Sinus bradycardia → slow rhythm

Triplet Premature Ventricular Contraction → ectopic foci, wide bizarre signals

Ventricular fibrillation → wavy line with no distinct rhythm/shapes

Atrial fibrillation → lacks P wave

25
The signal that makes the heart beat
the depolarization of cardiac myocytes
26
How does the signal produce a heart beat?
Excitation-Contraction Coupling (E-C Coupling)
27
E-C Coupling - Contraction/Systole
Ca2+ influx during action potential triggers release of Ca2+ from sarcoplasmic reticulum (SR) (Calcium-induced calcium release) Ca2+ binds to troponin, causing it to shift, allowing myosin-actin interaction and contraction
28
E-C Coupling - Relaxation/Diastole
Ca2+ falls as it is transported - Into SR via SERCA pump (requires ATP) - Out of cell by membrane Ca2+ pump and Na+/Ca2+ exchanger Fall in Ca2+ causes troponin to shift back, blocking actin-myosin interaction and contraction
29
Echocardiography
uses sound waves to image the heart and evaluate the beat provides info about stroke volume and ejection fraction
30
Stroke Volume (SV)
the volume of blood ejected each beat SV = End Diastolic Volume (EDV) - End Systolic Volume (ESV)
31
Ejection Fraction (EF)
the fraction of end diastolic volume ejected each beat normal is about 50-70% EF = SV/EDV
32
Issues with heart response
Valve disease (stenosis and regurgitation) Decreased contractility during systole → systolic dysfunction Decreased relaxation during diastole → diastolic dysfunction
33
Valve Disease - Stenosis
narrowing of valve opening
34
Valve Disease - Regurgitation
valve allows backflow of blood
35
Phases of Cardiac Cycle
Ventricular Systole (contraction) - Isovolumetric contraction - Ejection of blood into aorta Ventricular Diastole (relaxation) - Isovolumetric relaxation - Passive filling of ventricle - Active filling of ventricle → atrial systole (“atrial kick”)
36
How can the autonomic nervous system charge heart rate?
The sympathetic and parasympathetic systems change the slope of the resting membrane potential by changing Na+/K+ levels, impacting the funny current
37
Cardiac Regulation - Sympathetic
Positive Chronotropic effect → increases slope Norepinephrine acts on beta-1 receptors in SA node to increase HR
38
Cardiac Regulation - Parasympathetic
Negative Chronotropic effect → decreases slope Acetylcholine released from vagus nerve acts on muscarinic receptors to decrease HR
39
As HR increases (above ~150 bpm), diastole duration decreases, reduces time for ___ ___
ventricular filling
40
To increase cardiac output, increased HR is accompanied by increased ventricular filling, but how?
Venoconstriction by sympathetic nervous system Muscle pump - muscles in our legs contract, squeeze veins, push blood back up to heart
41
Factors that affect stroke volume
Preload (increases) Afterload (decreases) Contractility (increases)
42
Preload
volume of blood in ventricles at the end of diastole Directly correlated with SV → increased preload = increased SV Increased preload → increased stretch on myocyte → stronger contraction → increased stroke volume Length-tension relationship (Frank-Starling Curve) Venous return and duration of diastole affect preload
43
Afterload
resistance the ventricle must overcome to eject blood The left ventricle must overcome aortic pressure Inversely correlated with SV → increased afterload = decreased SV Hypertension and aortic stenosis increase afterload, hypotension decreases afterload
44
Contractility
strength of myocardial contraction, calcium dependent Directly related with SV → increased contractility = increased SV Inotropy (+/-)affects calcium concentration in myocyte
45
Positive (+) Inotropy
Positive inotropy → increased calcium concentration → stronger contraction → increased stroke volume SNS → norepinephrine acts on β-1 receptors to increase calcium concentration Cardiac glycosides (digitalis) also increases calcium concentration
46
Negative (-) Inotropy
Negative inotropy → decreased calcium concentration → weaker contraction → decreased stroke volume Calcium channel blockers (diltiazem) decrease calcium concentration
47
At the beginning of ___ ___, mitral (on left) and tricuspid (on right) valves close
isovolumetric contraction
48
At the beginning of ___ ___, the aortic valve closes when ventricular pressure falls below aortic pressure
isovolumetric relaxation