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PHGY 210 > cardiovascular physiology 2 > Flashcards

cardiovascular physiology 2 Flashcards

1
Q

what does the ECG look like when patient has premature ventricular contractions?

A

at some point instead of a P wave a new QRS and T wave appears

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2
Q

what causes for premature ventricular contraction?

A

abnormal site will dire an AP

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3
Q

the beat produced by the abnormally fired AP is called what?

A

ectopic beat

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4
Q

what may cause for an abnormal site to produce an AP?

A

-clot formation in Arterie

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5
Q

what happens if the patients then enters sinus tachycardia and heart beats 5x per second?

A

o Heart doesn’t have time to fill since time of contraction is too slow thus no blood is being pumped in/out

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6
Q

what is the cardiac output if no blood gets pumped in/out

A

zero

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7
Q

what happens if the cardiac output and pressure and sroke volume are = 0?

A

ventricular fibrillation

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8
Q

what do the ventricles look like during v fibrillation and why?

A

like a bag of worms become APs get fired from anywhere

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9
Q

what happens if treatment is not recieved within 5 minutes of V fibrillation?

A

death

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10
Q

what is used to treat v fibrillation?

A

defibrillation of the heart using AED

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11
Q

what portion of the heart gets observed during mapping of cardiac electrical activity?

A

apex of the heart

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12
Q

what does mapping of cardiac electrical activity involve?

A

o Insert catheters which open into the heart on the epicardial where electrons are deflected

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13
Q

in patients who have already had a heart attach what is being tested by electrical cardiac mapping? how is it tested?

A

circular path known as reentry. due to presence of scar tissue. induce of ventricle tachycardia in patient

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14
Q

what can be observed through electrical mapping when a patient goes from VT to Vfib?

A

refractory period due to difference of speed causes for different afferents to propagate

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15
Q

cardiac cells are full of what type of cells?

A

actin and myosin

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16
Q

what induces contraction in the heart?

A

calcium which diffuses from T tubules to the cytosol this allows for transition from electrical signal to contraction

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17
Q

in excitation-contraction coupling, what enters the cardiac cells when an AP is fired?

A

Ca2+

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18
Q

with the entry of calcium into the heart what is released and what does this cause?

A

more calcium gets released and this causes contraction of the heart

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19
Q

how is contraction of the heart induced?

A

binding of calcium to actin and myosin

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20
Q

is contraction evaluted in ECGs?

A

no

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21
Q

how does the heart cycle function?

A

cyclic process

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22
Q

what happens during systole

A

pressure in RA is quite small causing for the ventricles to begin to contract
Pv > Pa causing for AV valves to close and semilunar valves
pressure in ventricles increases until Pv > Paorta
opening of aortic valve and blood enters pulmonary trunk

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23
Q

what happens during diastole?

A

muscles relax as pressure falls
Paorta > Pav valve
P pulmonary trunk > P RV causes for the semilunar valves to close
pressure falls near 0
during this time the atrium has been filling with deoxigenated blood from SVC/IVC where Patrium > P ventricle

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24
Q

what is the name of the phase when Patrium > P ventricle

A

ventricular filling phase

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25
Q

what is the duration of ventricle contraction and relaxation?

A

1/3 s. contraction

2/3 s. relaxation

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26
Q

does autoregulation require presence of hormones?

A

no, its accomplished by the organs themselves

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27
Q

what is regulated via coronary regulation?

A

conorary flow

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28
Q

what happens to flow in the coronary A. if the pressure in the Arteries drops?

A

flow will drop but will quickly reestablish due to autoregulation

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29
Q

what are the autoregulation mechanisms that take place? do they occur at the same time or in a sequence?

A

metabolic and myogenic mechanisms they take place at the same time

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30
Q

what is the main function of the metabolic mechanism of autoregulation?

A

 Decrease in arterial pressure in organ
 Decrease blood flow to the organ
 Decrease O2 and Increase metabolites

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31
Q

what is the main function of the myogenic mechanism of autoregulation?

A

 Decrease in stretch of wall vessels of organs
 Arteriolar dilation in organs
 Restoration of blood flow towards normal in organ

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32
Q

what do the mechanisms of autoregulation share in common what is different?

A

overall they produce the same effect to increase blood flow to organs however the consequences differ due to local metabolites

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33
Q

what composes the autonomic NS?

A

parasympathetic NS

sympathetic NS

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34
Q

what branch(es) of the ANS innervate the SA node?

A

both Parasympathetic and sympathetic

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35
Q

how does the parasympatic NS innverate the SA node

A
  • preganglionic neuron in spinal cord goes to axon via vagus N.
  • synapses with the postganglioic axon to reach the SA node
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36
Q

What Neurotransmitter is involved in the parasympathetic NS (pre/postganglionic) and what’s its receptor?

A

preganglionic: achetylcholine & nicotinic receptor
postganglionic: achetylcholine & muscarinic receptor

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37
Q

what is the role of Ach in parasympathetic innervation of the SA node?

A

-allows to fire more AP to the postganglionic axons

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38
Q

what happens when ACH binds to muscarinic receptor in the parasympathetic innervation of the heart

A

, the rate of the sinus node slows down.

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39
Q

overall, an increase in the parasympathetic tone causes what in the heart?

A

slows down

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40
Q

who is the target group fro atropine? how does it function?

A
  • used in patients with brachycardia

- prevents ACh from binding thus increasing heart rate, cardiac output and BP

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41
Q

what receptor is found in the sympathetic NS when the AP reaches the SA node

A

Noreepinephrine binds to B-adrenergic receptor

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42
Q

what happens to the heart rate when Noreepinephrine binds to B-adrenergic receptor? in what pathway of the ANS does this occurs?

A

increase in heart rate

-occurs in the sympathetic pathwat

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43
Q

in the case of low BP, what medication can be given to patients? what are its effects? it replicated the effects of what?

A

b-agonist

  • activates receptors allowing for increased heart rate
  • replicated effect of norepinephrine
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44
Q

in the case of high BP, what medication can be given to patients? what are its effects?

A

B-blocker as it doesn’t activate the B andregenic receptors causing for lac of binding to the SA node thus causing HR to drop

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45
Q

what is the effect of the sympathetic pathway on the contractility of the ventricles?

A

increases force of contraction of the ventricular muscle

46
Q

what happens to the sympathetic contractility if B agonist is supplied?

A

increase in force of contraction
increase stoke volume
increase MAP
increase CO

47
Q

what happens to the sympathetic contractility if B blocker is supplied?

A

force of contraction will no increase as much

drop in stoke volume and in CO

48
Q

does increasing volume increase contractility?

A

no, contractility is not increased by volume

49
Q

what happens when stimulating sympathetic nerve while keeping end diastolic volume constant?

A

leads to increased contractility

50
Q

what vessels are not innervated by the sympathetic NS?

A

capillaries

51
Q

for the neural control of vessels, what NT are involved?

A

ACh and NE

52
Q

what is the receptor involved in neural control of the vessels for NE?

A

a-adrenergic receptor.

53
Q

what does binding of NE lead to in the vessels?

A

constriction of the vessels

54
Q

what happens to the vessels if a-adrenergic is supplied?

A

causes constriction
BP will increase
TPR increases

55
Q

the adrenal gland is part of which nervous system?

A

sympathetic NS

56
Q

What does the adrenals lack due to evolution?

A

lacks axons

57
Q

what happens when ACh is released in the adrenals?

A

realeases

catecholamines; epinephrine and norepinephrine

58
Q

what may happen to the baroreceptor reflex with age?

A

autonomic disfunction causes delay of the reflex causing for fainting when standung

59
Q

are the time scales the same for different operations?

A

no, times scales differ in different opperations

60
Q

what organ has the stongest reflex?

A

kidney

61
Q

what does gain in force refer to?

A

Gain refers to the strength of the reflex; capacity to bring you back where you should be

62
Q

systems work over different ranges of what?

A

of BP

63
Q

in the baroreceptor reflex, where are the receptor located?

A
  • common carotid A. at bifurcation

- aortic arch

64
Q

where do the signals sent from the carotid sinus go to?

A

to the brain

65
Q

what is found embedded within the aortic arch?

A

nerve terminals

66
Q

how is signal from the aortic arch sent to the brain?

A

receptors and nerve terminals are embedded and stretch causes to signal AP up to the brain

67
Q

how many archs does each reflex have? what are they?

A

2 archs

senory and motor archs

68
Q

what is the other name given to the sensory reflex arch?

A

afferent arch of reflex

signal sent to the brain

69
Q

what is the other name given to the motor reflex arch? where is the signal send?

A

efferent arch of reflex

signal sent into ANS

70
Q

when does the baroreceptor fire APs?

A

then the BP increases

71
Q

what happens to the baroreceptor reflex if HR increases?

A

increases in HR leads to increase CO and MAP leads to negative feedback; drop of BP

72
Q

what happens to the baroreceptor reflex if contractility increases?

A

BP will fall; increases sympathetic output, increased contraction
increased stroke volume
increased CO and MAP

73
Q

what happens in the baroreceptor reflex if arterioles constrict?

A 
increases TPR (decrease in size thus resistance to blood increases)
This causes for an increase in MAP
74
Q

what is an increase in TRP known as?

A

arteriolar constriction

75
Q

what happens if BP falls in baroreflex?

A
  • squeeze down on veins
  • increases venous return
  • LV will be more filled thus greater contraction
76
Q

what is an easy way to get rid of reflex?

A

cut nerves and get rid of afferent reflex

77
Q

what type of tension was observed in dog at rest when afferent reflex is denervated?

A

labile hypertension

78
Q

what is another name used to identify baroreceptor reflex?

A

buffer reflex

79
Q

what must be done to control BP when there is an increase

A
  • kidney’s extract H20
  • Decrease of blood volume
  • fall of venous pressure and venous return
  • decrease stroke volume
  • drop in CO
80
Q

through what mechanisms can arterial pressure be restored?

A

negative feedback

81
Q

what is the RAA system?

A
  • drop BP in kidneys= increases renin produced
  • liver produced angeotensin-
  • Lungs: angeotensin 2 is then produced
82
Q

what is the function of angeotension 2?

A

constriction of arteries

83
Q

how many aa are found in angeotensin 1?

A

10

84
Q

how many aa are found in angeotensin 2?

A

8

85
Q

where are baroreceptors located?

A

in the aorta

86
Q

what happens when there is a burst of AP to the brain?

A 
arteries are bein stretched
BP increases
baroreceptor nerve terminal
increases 
increase rate of firing
87
Q

what happens if Arterial BP decreases?

A

decrease of arterial baroreceptors firing
increase of sympathetic outflow to the heart, arterioles and veins
increases HR, contractility, arteriolar constriction, venoconstriction

88
Q

what happens during venial constriction?

A

the pressure of blood int he veins increases which drives blood back to the heart

89
Q

what are some effects of venule constriction?

A

SV increases

90
Q

what causes for SV increases in venule constriction?

A

B adrenergic receptor

vein constriction

91
Q

what is pressure diaresis?

A

process that regulates water levels in urine, controlled by kidneys

92
Q

what do the 3 paths of RAA involve?

A
  1. production of angiotensin 2
  2. secretion of vasopressin (ADH)
  3. production of aldosterone
93
Q

what is the first step of RAA system

A
  • drop of BP will stimulate renin secretion
  • liver produces angiotensin
  • renin will cleave angiotensin into angiotensin 1
  • ACE produces angiotensin 2
  • angiotensin causes for constriction of arterioles
94
Q

where does angiotensin cause for the secretion of vasopressin?

A

in the brain

95
Q

what happens with the release of ADH in the RAA system?

A

decreases renal sodium and water

-increases PV, blood volume, venous return, end diastolic volume, stroke volume, cardiac output, MAP

96
Q

how do aldosterone-receptor agonist function in high blood pressure?

A

drop of blood pressure as it blocks aldosterone receptors thus doesn’t cause the kidneys to decrease sodium and h20

97
Q

what is the 3rd process that takes place in the RAA system?

A

angiotensin binds to the adrenals and increase the production of aldosterone
stimulates kidneys to decrease Na+ and water excretion, thus decrease of MAP

98
Q

how does AT-2 receptor blocker function in high blood pressure?

A

blocks angiotensin 2 receptor preventing AT2 from binding to it causing for BP to fall

99
Q

how does ACE inhibitor function in high blood pressure?

A

prevents the conversion of angiotensin 1 into angiotensin 2 thus BP will fall

100
Q

how does renin inhibitors function in high blood pressure?

A

inhibits the action of renin thus less angiotensin 1 is made, thus less angiotensin 2 is made thus drop in BP

101
Q

what is orthostatis?

A

maintenance of upright standing position

102
Q

generally in standard patient, what should happen to the MAP of a patient when standing?

A

it should be unchanged?

103
Q

what should happens to diastolic and systolic BP when standing?

A
  • diastolic should rise

- systolic should decrease

104
Q

what reflex changes as we age?

A

baroreceptor reflex

105
Q

what happens if the ventricles are fill less due to a drop in pressure?

A

the ventricles will be less stretched thus smaller force of contraction hence decreased SO

106
Q

what happen to CO if SV decreases? why does it act different as expected?

A

due to baroreceptor reflex, CO will decrease, however not as much as expected due to increase HR

107
Q

what causes for MAP to remain constant and not decrease due to CO decrease?

A

increase of TRP

108
Q

how is the TRP increased in orthostatic decrease in central blood flow?

A

the flow of blood to certain organs can be compressed and sacrificed to ensure to get the blood pressure back ip

109
Q

the contraction of what may prevent from faiting in lagging baroreceptor reflex?

A

contraction of calf muscle

110
Q

what happens when standing to the water content?

A

loss of water

111
Q

what happens when muscle pumps are activated?

A

lower of bp

112
Q

how much fluid is lost daily?

A

~4L of water, provided by lymphe flow

PHGY 210 (11 decks)

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