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Physiology > Cardiovascular Physiology > Flashcards

Cardiovascular Physiology Flashcards

1
Q

3 organs that receive the most percentage of cardiac output:

A

Renal (25%), Gastrointestinal (25%), Skeletal muscle (25%)

Others: Brain 15%, Coronary 5%, Skin 5%

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2
Q

2 arteries that carry deoxygenated blood:

A

Pulmonary artery

Umbilical artery

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3
Q

The veins are called the reservoir of blood. How much of systemic blood is found in veins?

A

64%

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4
Q

What is the normal right atrial pressure?

A

0 - 4 mmHg

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5
Q

What is the normal pressure in the systemic capillaries?

A

17 mmHg

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6
Q

Blood flow velocity is fastest in the:

A

Aorta

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7
Q

Control conduits for blood flow, mainly under sympathetic control:

A

Arterioles

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8
Q

Blood flow velocity is slowest in the:

A

Capillaries

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9
Q

The capillaries cannot constrict or dilate because they lack:

A

Tunica media (only composed of a single layer of endothelial cells)

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10
Q

These structures allow capillary beds to be open or closed

A

Meta-arterioles and pre-capillary sphincter

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11
Q

What happens when systemic arterioles vasoconstrict?

A

TPR/SVR: increases

Blood flow: decreases

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12
Q

What happens when systemic arterioles vasodilate?

A

TPR/SVR: decreases

Blood flow: increases

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13
Q

What happens to blood pressure when TPR increases?

A

BP increases

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14
Q

What happens when veins vasoconstrict?

A

Venous return increases

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15
Q

Flow that is streamlined, highest at the center and lowest at the walls

A

Laminar flow

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16
Q

Flow that is disorderly, associated with high Reynold’s number; seen in anemia (dec blood viscosity) and vessel narrowing (inc blood velocity)

A

Turbulent flow

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17
Q

Normal pressure in the pulmonary arteries:

A

25/8 mmHg

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18
Q

Normal pressure in the pulmonary capillaries:

A

7 mmHg

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19
Q

3 organs that receive the most percentage of cardiac output:

A

Renal (25%), Gastrointestinal (25%), Skeletal muscle (25%)

Others: Brain 15%, Coronary 5%, Skin 5%

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20
Q

Reynold’s number for laminar flow

A
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21
Q

Reynold’s number for turbulent flow

A

> 2000

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22
Q

A strain in the structure of a substance produced by pressure, when its layers are laterally shifted in relation to each other

A

Shear

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23
Q

Shear is highest in:

A

walls of the blood vessel

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24
Q

Shear is lowest in:

A

center of the blood vessel

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25
Q

What is the consequence of shear?

A

Decreased blood viscosity

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26
Q

Compliance of veins vs arteries

A

24x higher compliance

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27
Q

Effects of aging on the compliance of arteries

A

Decreases compliance

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28
Q

Highest arterial blood pressure

A

Systolic pressure

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29
Q

Lowest arterial blood pressure

A

Diastolic pressure

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30
Q

____ = systolic pressure - diastolic pressure

A

Pulse pressure

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31
Q

____ = stroke volume/arterial compliance

A

Pulse pressure

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32
Q

____ = 2/3 (diastole) + 1/3 (systole)

A

Mean arterial pressure

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33
Q

Estimates left atrial pressure

A

Pulmonary capillary wedge pressure

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34
Q

Estimates left atrial pressure

A

Pulmonary capillary wedge pressure

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35
Q

2 arteries that carry deoxygenated blood:

A

Pulmonary artery

Umbilical artery

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36
Q

The veins are called the reservoir of blood. How much of systemic blood is found in veins?

A

64%

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37
Q

What is the normal right atrial pressure?

A

0 - 4 mmHg

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38
Q

What is the normal pressure in the systemic capillaries?

A

17 mmHg

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39
Q

Blood flow velocity is fastest in the:

A

Aorta

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40
Q

Control conduits for blood flow, mainly under sympathetic control:

A

Arterioles

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41
Q

Blood flow velocity is slowest in the:

A

Capillaries

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42
Q

The capillaries cannot constrict or dilate because they lack:

A

Tunica media (only composed of a single layer of endothelial cells)

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43
Q

These structures allow capillary beds to be open or closed

A

Meta-arterioles and pre-capillary sphincter

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44
Q

What happens when systemic arterioles vasoconstrict?

A

TPR/SVR: increases

Blood flow: decreases

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45
Q

What happens when systemic arterioles vasodilate?

A

TPR/SVR: decreases

Blood flow: increases

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46
Q

What happens to blood pressure when TPR increases?

A

BP increases

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47
Q

What happens when veins vasoconstrict?

A

Venous return increases

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48
Q

Flow that is streamlined, highest at the center and lowest at the walls

A

Laminar flow

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49
Q

Flow that is disorderly, associated with high Reynold’s number; seen in anemia (dec blood viscosity) and vessel narrowing (inc blood velocity)

A

Turbulent flow

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50
Q

Normal pressure in the pulmonary arteries:

A

25/8 mmHg

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51
Q

Normal pressure in the pulmonary capillaries:

A

7 mmHg

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52
Q

Reynold’s number for laminar flow

A
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53
Q

Reynold’s number for turbulent flow

A

> 2000

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54
Q

A strain in the structure of a substance produced by pressure, when its layers are laterally shifted in relation to each other

A

Shear

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55
Q

Shear is highest in:

A

walls of the blood vessel

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56
Q

Shear is lowest in:

A

center of the blood vessel

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57
Q

What is the consequence of shear?

A

Decreased blood viscosity

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58
Q

Compliance of veins vs arteries

A

24x higher compliance

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59
Q

Effects of aging on the compliance of arteries

A

Decreases compliance

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60
Q

Highest arterial blood pressure

A

Systolic pressure

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61
Q

Lowest arterial blood pressure

A

Diastolic pressure

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62
Q

____ = systolic pressure - diastolic pressure

A

Pulse pressure

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63
Q

____ = stroke volume/arterial compliance

A

Pulse pressure

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64
Q

____ = 2/3 (diastole) + 1/3 (systole)

A

Mean arterial pressure

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65
Q

Synonym of right atrial pressure

A

Central venous pressure

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66
Q

Estimates left atrial pressure

A

Pulmonary capillary wedge pressure

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67
Q

ECG: atrial depolarization

A

P wave

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68
Q

ECG: AV node conduction

A

PR segment

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69
Q

ECG: correlates with conduction time/velocity through the AV node

A

PR interval

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70
Q

ECG: ventricular depolarization

A

QRS complex

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71
Q

Causes of circus movements:

A

long conduction pathway, decreased conduction velocity, short refractory period

72
Q

ECG: period of depolarization + repolarization of ventricles

A

QT interval

73
Q

ECG: correlates with plateau of ventricular action potential

A

ST segment

74
Q

What happens when sympathetic NS stimulates the AV node?

A

Increase in conduction velocity, decrease in PR interval

75
Q

What happens when parasympathetic NS stimulates the AV node?

A

Decrease in conduction velocity, increase in PR interval

76
Q

ECG: hypokalemia

A

flat/inverted T waves

77
Q

ECG: hyperkalemia

A

low P waves, tall T waves

78
Q

ECG: hypocalcemia

A

prolonged QT interval

79
Q

ECG: hypercalcemia

A

shortened QT interval

80
Q

ECG: STEMI

A

ST segment elevation

81
Q

ECG: NSTEMI

A

ST segment depression

82
Q 
Ventricular action potential:
Na influx (depolarization)
83
Q 
Ventricular action potential:
K efflux (complete repolarization)
84
Q

Ventricular action potential:

RMP

85
Q

Ventricular action potential:

Ca++ influx (plateau)

86
Q 
Ventricular action potential:
K efflux (partial repolarization)
87
Q

SA node action potential:

Slow Na influx towards threshold

88
Q 
SA node action potential:
Ca influx (depolarization)
89
Q 
SA node action potential:
K efflux (repolarization)
90
Q

Why is the SA node capable of authorhythmicity?

A

Opening of the K channels always triggers the opening of the Na channels (phase 3 is always followed by phase 4)

91
Q

What happens to the slope of phase 4, action potential and heart rate when you stimulate the B1 receptors of the heart?

A

Slope: more steep
AP: shorter
HR: increase

92
Q

What happens to the slope of phase 4, action potential and heart rate when you stimulate the M2 receptors of the heart?

A

Slope: more flat
AP: longer
HR: decrease

93
Q

The SA node is called the master pacemaker. The AV node, bundle of His and Purkinje cells are called?

A

Latent pacemaker

94
Q

Which node has the slowest conduction velocity?

95
Q

Which node has the fastest conduction velocity?

A

Bundle of His, Purkinje fibers, ventricles

96
Q

What is the basis for AV nodal delay (0.13secs)?

A

Decreased gap junctions in that area

97
Q

Which Na channel accounts for SA node automaticity?

A

If channels (slow “funny” Na channels)

98
Q 
Isovolumic contraction:
Preceded by \_\_\_\_\_\_ in the ECG
\_\_\_\_\_\_ of atrial pressure is seen
Semilunar valves are: \_\_\_\_\_
Ventricular pressure: \_\_\_\_\_\_
Ventricular volume: \_\_\_\_\_\_
A 
QRS complex
c-wave
SL valves are closed
VP: increases
VV: remains the same
99
Q

Inhibition of “pacemaking” of latent pacemakes by the SA node

A

Overdrive suppression

100
Q

AV block that causes fainting in patients due to initially suppressed state of Purkinje fibers

A

Stokes-Adams syndrome

101
Q

Condition when latent pacemaker assume pacemaking activity

A

Ectopic pacemaker

102
Q

Reduced ventricular ejection:
_____ occurs in the ECG
Ventricular pressure: _____
Ventricular volume: _____

A

T wave
VP: decrease
VV: decrease

103
Q

Occurs when, in the propagation of AP around the ventricles, the signal never reaches an area with absolute refractory period; basis for Vfib

A

Circus movements

104
Q

Causes of circus movements:

A

long conduction pathway, decreased conduction velocity, short refractory period

105
Q

All Na inactivation gates close, AP cannot be generated

A

Absolute refractory period

106
Q

Some Na inactivation channels start to open, AP cannot be conducted

A

Effective refractory period

107
Q

AP can be conducted and generated but higher than normal stimulus is required

A

Relative refractory period

108
Q

All Na inactivation gates are open and membrane potential is higher than RMP; cell is more excitable than normal

A

Supranormal period

109
Q

Produces changes in contractility

A

Inotropic effect

110
Q

Produces changes in rate of relaxation

A

Lusitrophic effect

111
Q

Produces changes in heart rate

A

Chronotrophic effect

112
Q

Produces changes in conduction velocity

A

Dromotrophic effect

113
Q

Inotropes affect the:

A

Stroke volume

114
Q

Chronotropes affect the:

115
Q

Dromotropes affect the:

116
Q

Beta 1 stimulation of the heart would cause:

A

Stronger (positive inotrope), Briefer (positive lusitrope) and more frequent (positive chronotrope) contractions

117
Q

An increase in preload will increase stroke volume within certain physiologic limits

A

Frank-Starling mechanism

118
Q

Left ventricular end diastolic volume is directly proportional to what?

A

Venous return, right atrial pressure

119
Q

What happens to SV and CO when preload increases?

A

Both increase

120
Q

What happens to SV and CO, and velocity of sarcomere shortening when afterload increases?

A

All decrease

121
Q

Blood ejected by the ventricle per heart beat; Equal to EDV-ESV

A

Stroke volume (Normal: 70mL)

122
Q

Percentage of EDV that is actually ejected by the ventricle; Equal to SV/EDV

A

Ejection fraction (Normal: 55%)

123
Q

Total blood volume ejected per unit of time; Equal to HR x SV

A

Cardiac output (Normal resting: 5L/min)

124
Q

How long can the brain, heart and skeletal muscles last without O2?

A

Brain: 4 minutes

Heart and skeletal muscles: 6 hours

125
Q

Primary source of energy for stroke work:

A

Fatty acids

126
Q

Work per unit of time; Equal to CO x Aortic pressure

A

Cardiac minute work

2 components: volume work (cardiac output) and pressure work (aortic pressure)

127
Q

Ratio of work output to total chemical energy expenditure

A

Maximum efficiency of cardiac contraction

Normal: 20 - 25%; most of energy is converted to heat

128
Q

Cardiac events that occur in a single heartbeat

A

Cardiac cycle

129
Q

Atrial contraction:
Occurs during the _______
Preceded by ______ in the ECG
______ of atrial pressure is seen

A

distal third of diastole
p wave
a-wave

130
Q

What is the cause of the 4th heart sound?

A

Due to atria contracting against stiff ventricles, as seen in LV hypertrophy

131
Q 
Isovolumic contraction:
Preceded by \_\_\_\_\_\_ in the ECG
\_\_\_\_\_\_ of atrial pressure is seen
Ventricular pressure: \_\_\_\_\_\_
Ventricular volume: \_\_\_\_\_\_
A

QRS complex
c-wave
VP: increases
VV: remains the same

132
Q

The first heart sound is heard during:

A

Closure of AV valves during isovolumic contraction

133
Q

Rapid ventricular ejection:
Ventricular pressure: _____
Ventricular volume: _____

A

VP: rapidly increase
VV: decrease

134
Q

Phase of the cardiac cycle wherein semilunar valves open and blood flows from LV to aorta; atrial filling also begin

A

Rapid ventricular ejection

135
Q

Reduced ventricular ejection:
_____ occurs in the ECG
Ventricular pressure: _____
Ventricular volume: _____

A

T wave
VP: decrease
VV: decrease

136
Q 
Isovolumic relaxation:
\_\_\_\_\_ of aortic pressure is seen
\_\_\_\_\_ of atrial pressure is seen
AV valves are: \_\_\_\_\_\_
Ventricular pressure: \_\_\_\_\_
Ventricular volume: \_\_\_\_\_
A 
Incisura
v wave
AV valves are closed
VP: decreases
VV: remains the same
137
Q

The second heart sound is heard during:

A

Closure of the semilunar valves during isovolumic relaxation

138
Q

Rapid ventricular filling:
occurs during _________
_____ heart sound may be heard

A

first 1/3 of diastole

3rd heart sound

139
Q

Reduced ventricular filling (diastasis)

occurs during _________

A

middle 1/3 of diastole

140
Q

What is the longest phase of the cardiac cycle?

141
Q

Where are murmurs best heard?

A

Aortic: 2nd ICS RPSB
Pulmonic: 2nd ICS LPSB
Tricuspid: 4th ICS LPSB
Mitral: 5th ICS LMCL

142
Q

Physiologic murmurs occur only during systole or diastole?

143
Q

What is the murmur that is heard both on systole and diastole?

A

Continuous machinery murmur of PDA

144
Q

Center responsbile for regulation of HR and BP

A

Vasomotor area of the medulla
Lateral: Excitatory
Medial: Inhibitory

145
Q

What is the 1st line in maintaining blood pressure and buffers minute-to-minute changes in BP?

A

Baroreceptors (stretch receptors)

146
Q

Where are the baroreceptors found?

A 
Carotid sinus (respond to increase/decrease in pressure from 50-180 mmHg)
Aortic arch (respond to increase in pressure >80mmHg)
147
Q

Responds to low O2 or high CO2 concentration whenever BP is

A

Chemoreceptors

148
Q

Where are the chemoreceptors found?

A

Carotid and aortic bodies

149
Q

Low pressure receptors (cardiopulmonary receptors) detect fullness of vascular system. In response to increased intravascular volume, these 4 mechanisms are activated:

A
  1. Increase ANP (increase Na and H2O excretion)
  2. Decrease ADH (increase UO)
  3. Renal vasodilation (increase UO)
  4. Increase HR (Bainbridge reflex)
150
Q

Differentiate Frank-Starling mechanism from Bainbridge reflex

A

Frank Starling: Increased VR –> Increase SV –> Increase CO

Bainbridge: Increased VR –> Increased HR –> Increase CO

151
Q

The vasomotor center itself responds directly to ischemia during low BP; all systemic arterioles vasoconstrict severely except coronary and cerebral vessels

A

CNS ischemic response

152
Q

Occurs in response to increased intracranial pressure

A

Cushing reaction or Cushing reflex

153
Q

What is the triad of Cushing reflex?

A

Hypertension, Bradycardia, Irregular respirations

154
Q

What is the mechanism of hypertension seen in Cushing reflex?

A

Activation of the CNS ischemic response causes massive vasoconstriction of all systemic arterioles

155
Q

What is the mechanism of bradycardia seen in Cushing reflex?

A

Activation of the baroreceptor reflex due to the high BP activates the parasympathetic system to decrease HR

156
Q

What is the mechanism of irregular respirations seen in Cushing reflex?

A

Compression of the brainstem where the respiratory centers are found

157
Q

How long can the brain, heart and skeletal muscles last without O2?

A

Brain: 4 minutes

Heart and skeletal muscles: 6 hours

158
Q

What is the normal net filtration?

159
Q

Lymphatic system produces how much lymph per day?

160
Q

What is the function of the lymphatic system?

A

Reabsorbs proteins and excess fluid back to the circulatory system

161
Q

Special lymphatics used to absorb fat

162
Q

Why should there be local control of blood flow?

A

For the tissues to get their proper amounts of oxygen and nutrients
For thermoregulation
For homeostasis

163
Q

Organ with the highest blood flow under basal conditions:

164
Q

Theory which states that when vascular smooth muscle are stretched, there’s a reflex contraction and vice versa

A

Myogenic theory

165
Q

Theory which states that vasodilator metabolites are produced as a result of metabolic activity

A

Metabolic theory

166
Q

Theory which states that certain substances increase blood flow during deoxygenation such as adenosine

A

Vasodilator theory

167
Q

Theory which states O2 is needed during vascular muscle contraction, thus lack of O2 would lead to vasodilation

A

Oxygen lack theory

168
Q

Theory which state that nutrients such as thiamine are needed for ATP formation thus vascular muscle contraction, thus lack of nutrients would lead to vasodilation

A

Nutrient lack theory

169
Q

Increase in blood flow in response to brief period of decreased blood flow

A

Reactive hyperemia (blood flow increased 4-7x the normal)

170
Q

Blood flow increases to meet increased metabolic demand

A

Active hyperemia

171
Q

Most potent vasoconstrictor:

A

Vasopressin

172
Q

Released as a result of blood vessel damage and causes arteriolar vasoconstriction; implicated in migraine

173
Q

Released by damaged endothelium

A

Endothelin

174
Q

Substance that causes platelet aggregation and vasoconstriction

A

Thromboxane A2

175
Q

Counteracts the effects of TXA2

176
Q

Vasodilates upstream blood vessels

A

Nitric oxide (EDRF)

177
Q

Causes arteriolar dilation and venous constriction leading to increased filtration (local edema)

A

Bradykinin and Histamine

Physiology (13 decks)

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