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S2 Case 4 - Hypertension Monitoring > Cardiovascular Physiology > Flashcards

Cardiovascular Physiology Flashcards

1
Q

What is the role of the cardiovascular system?

A

Blow flow to tissues
Homeostasis
Transport of hormones

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2
Q

What are 2 circulations arranged in?

A

Systemic + pulmonary

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3
Q

What is systemic?

A

Left side of the heart pumping blood to the rest of the body

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4
Q

What is the pulmonary?

A

Deoxygenated to the lungs

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5
Q

Which part does blood pressure measure?

A

Systemic

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6
Q

Describe veins

A

Thin layers of muscle
=low pressure

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7
Q

Describe arteries

A

Thick, muscular walls
= high pressure

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8
Q

What is the biggest artery?

A

Aorta

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9
Q

Describe arterioles

A

Smaller arteries
Thick, muscular walls
= modest pressures

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10
Q

Describe capillaries

A

Thickness of single endothelial cell
= low pressure

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11
Q

Describe venules

A

NO thick muscular walls
= low pressure

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12
Q

Where is arteriole B.P generated?

A

In the left ventricle

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13
Q

Describe ventricular muscle relaxation

A

Diastole
Ventricular filling

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14
Q

Describe ventricular muscle contraction

A

Systole
Ejection of blood into arteries

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15
Q

Why is measuring ejection of blood important?

A

Measure of cardiac output
Called ejection factor

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16
Q

Describe the pressure gradient that is proportional to blood flow

A

Tube exerts resistance to flow
As it moves = friction = loses energy to surroundings (arteriole walls)
= pressure decreases = creation of pressure gradient

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17
Q

What is stroke volume?

A

Vol of blood pumped by one ventricle

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18
Q

What is cardiac output?

A

Vol pumped per ventricle per minute

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19
Q

What is venous return?

A

Vol of blood returning to the heart

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20
Q

What should VR be equal to?

A

CO

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21
Q

What is infarction?

A

Death of muscle

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22
Q

Describe cardiac muscle contraction

A

Similar to smooth muscle
BUT troponin

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23
Q

What are increases levels of troponin in the blood a sign of?

A

Cardiac infarction

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24
Q

Describe AP trigger ventricular contraction

A

AP enters cell
Ca2+ gates open
Entry of Ca2+
Triggers more Ca2+
Binds to troponin

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25
Describe relaxation of ventricular contraction
Occurs when Ca2+ unbinds Ca2+ pumped back into SR Ca2+ exchanged with Na+ Na+ gradient maintained by NaK pump
26
What are the specialisations of cardiac muscle?
Intercalated discs = packed full of proteins = gap junctions = connect muscles together
27
Describe the cells of the SAN
Groups of cells that can spontaneously fire APs = do NOT need external stimuli
28
What do gap junctions allow?
Adjacent cardiomyocytes to communicate chemically + electrically
29
Briefly describe the spread of electrical activity
Originates in SAN Spreads via gap junctions Waves of electrical activity lead to mechanical activity
30
What does an ECG do?
Record what happens in the whole of the heart electrically
31
What is the annulus fibrosis?
Fibrous tissue that sits between atrial + ventricular muscle Non-conducting
32
What is the annulus fibrosis?
Fibrous tissue that sits between atrial + ventricular muscle Non-conducting
33
What are the different parts of the ECG?
P wave P-R interval QRS complex Q-T interval S-T segment T wave
34
What is a P wave?
Atrial depolarisation
35
What is a P-R interval?
Interval between beginning of excitability of atria + ventricles
36
What is the QRS complex?
Ventricular depolarisation
37
What is the Q-T interval?
Contraction BUT also ventricular repolarisation
38
What S-T segment?
All ventricular tissue depolarised
39
What is T wave?
Ventricular repolarisation = SWITCHING OFF
40
What determines the no. of times the heart will beat?
No. of times SAN fires
41
How can HR be modified?
Increase sympathetic, decrease parasympathetic
42
What happens if there is a more forceful contraction?
= more blood forced out = influences SV
43
What is contractility?
Amount of Ca2+ in cystolic muscle
44
Describe Starling's Law
Stretch LV = more forceful contraction = increased blood
45
How do you calculate CO?
HR X SV
46
What do transmitters do?
Bind to receptors on cardiac cell membrane which lead to opening/closing of channels
47
What is the sympathetic transmitter?
Noradrenaline (adrenaline)
48
What is the parasympathetic transmitter?
Acetylcholine
49
What does activation of sympathetic nerves do?
Cause release of noradrenaline Increase opening of HCN channels Open Ca2+ channels HR increases
50
What does noradrenaline do?
Bind to beta1 adrenoreceptors on cardiac pacemaker + myocyte cells
51
What does sympathetic stimulation do to the SAN pacemaker activity?
Changes rate of firing = fires more quickly + reaches threshold quicker
52
What does opening of Ca2+ channels do?
Depolarises quicker
53
What does activation of parasympathetic do?
Cause release of Ach Decreases opening of HCN channels Slows opening of Ca2+ channels Opens K+ channels HR decreases
54
What does parasympathetic stimulation do to SAN pacemaker activity?
Slows down = makes it harder to reach threshold = fires less frequently
55
What does Ach bind to?
Muscarinic cholinergic receptors
56
Why is parasympathetic constantly on?
Normal intrinsic rate is too high = on SAN to decrease HR
57
Decsribe the sequence of mechanical events
Ventricular filling Atrial contraction Isovolumetric ventricular contraction Ventricular ejection Isovolumetric ventricular relaxation
58
What is isovolumetric ventricular contraction?
NO difference in blood vol = has to overcome aortic BP = then ventricular ejection ONLY BRIEF
59
What does the AVN delay allow?
Atrial systole to be complete
60
What is atrial systole?
Stretch ventricle = doesn't pump blood out
61
What is preload?
The amount of pressure/stress that is put on the heart (LV) when blood returns to the heart
62
What is End Diastolic Vol (EDV)?
Vol of blood in LV at end of diastole
63
What is the difference between LV EDV + LV ESV equal to?
SV
64
Describe heterometric (intrinsic) cardiac workload
Starling's Law = cardiac muscle stretched = more forceful contraction
65
Describe heart failure
Actin + myosin are physically separated = SV decreased = blood going in BUT not enough being pumped out = LV becomes overstretched = less forceful contractions
66
What are the effects of sympathetic nerve stimulation on cardiac workload?
Increase in SV without change in initial fibre length Increase in contractility = positive inotropic effect
67
What is an example of a positive inotropic drug?
Norepinephrine
68
Describe homeometric (extrinsic) mechanisms
Effects of catecholamines Produce more forceful BUT shorter contraction
69
Describe norepinephrine + epinephrine results
Bind to beta1 on myocardial cell Activates cAMP 2nd messenger = phosphorylation = EITHER open Ca2+ channels or phospholamban Which BOTH = more forceful contractions + shorter duration
70
What controls mean arterial BP (MAP)?
LV generates it Arteries/arterioles cause resistance
71
What are the main factors that determine MAP?
CO Total peripheral resistance
72
So how do you calculate MAP?
CO X TPR
73
What do carotid + aortic baroreceptors do?
Keep BP within limits Change their rate of firing based on pressure changes Blood vessels vasoconstrict/dilate

S2 Case 4 - Hypertension Monitoring (12 decks)

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