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mic cabatu Physiology > Cardiovascular Physiology > Flashcards

Cardiovascular Physiology Flashcards

1
Q

Secreted at cardiac ventricles

Increased BNP - Dix: Left sided heart failure

A

BNP

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2
Q

Indomethacin

A

Gout

PDA

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3
Q

Arteries

A

Deoxygenated

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4
Q

Veins

A

Oxygenated

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5
Q

Semilunar Valve

A

Aortic

Pulmonic

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6
Q

AV Valve

A

Tricuspid

Mitral

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7
Q

Systemic Arterioles

A

Vasodila te

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8
Q

Pulmonary Arterioles

A

Only Arterioles that vasoconstric in response to hypoxia

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9
Q

Thick-walled, under high pressure (stressed volume)

A

Arteries

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10
Q

Control conduits for blood flow

A

Arterioles

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11
Q

Vasoconstriction

A

Alpha 1

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12
Q

Vasodilation

A

Beta 2

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13
Q

Blood flow velocity in the aorta: fastest

A

Arterioles

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14
Q

Blood flow velocity in the capillaries slowest

A

Arterioles

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15
Q

Site of exchange of nutrients, gases, waste products

A

Capillaries

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16
Q

Thin-walled, under low pressure (unstressed volume)

With one way valves

A

Veins

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17
Q

Largest percentage of blood in the circulatory system

A

Veins

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18
Q

The greatest pressure decrease in the circulation occurs across the Arterioles because

A

They gave the greatest cross-sectional area

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19
Q

Systemic Arterioles vasoconstrict

A

TPR/SVR: increases

Blood flow: decreases

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20
Q

Systemic Arterioles vasodilate

A

TPR/SVR: decrease

Blood flow: increase

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21
Q

Blood pressure when TPR increases

A

Blood pressure: increase

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22
Q

Veins vasoconstrict

A

Venous return: increase

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23
Q

Which of the following parameters is decreased during moderate exercise?

A

Total peripheral resistance

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24
Q

MAP formula

A

2/3 (D) + 1/3 (S)

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25
Q

The smaller the radius, the greater the resistance

The greater the radius, the lesser the resistance

A

Poiseulle’s Law

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26
Q

Inversely proportional to ELASTANCE

A

Compliance.Capacitance

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27
Q

Streamlined(straight line) flow

Velocity: highest at the center, lowest at the walls

A

Laminar Flow

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28
Q

Disorderly flow

Assoc with High Reynold’s number

A

Turbulent Flow

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29
Q

Reynold’s number for laminar flow

A

<2000

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30
Q

Reynold’s number for turbulent flow

A

> 2000

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31
Q

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

A

Shear

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32
Q

Shear: Highest in

A

Walls of the blood vessel

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33
Q

Shear: lowest

A

Center of the blood vessel

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34
Q

Shear: consequence

A

Decreased blood viscosity

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35
Q

Compliance of Veins (vs Arteries)

A

24x higher compliance

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36
Q

Compliance: effects of aging

A

24x lower compliance

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37
Q

End diastolic volume, immediate before it contracts

A

Preload

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38
Q

Aortic pressure that pump against

A

After load

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39
Q

Highest arterial blood pressure

A

Systolic pressure

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40
Q

Lowest arterial blood pressure

A

Diastolic pressure

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41
Q

= systolic pressure - diastolic pressure

A

Pulse Pressure

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42
Q

= stroke volume / arterial compliance

A

Pulse Pressure

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43
Q

Most important determinant of Pulse Pressure

A

Stroke volume

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44
Q

= 2/3 (Diastole) + 1/3 (systole)

A

Mean Arterial Pressure

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45
Q

Synonym: Right Arterial Pressure

A

central venous pressure

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46
Q

Estimates left atrial pressure

A

Pulmonary Capillary wedge pressure

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47
Q

Pulse Pressure

A

Determined by stroke volume

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48
Q

Considered the most important determinant of pulse pressure

A

Stroke volume

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49
Q

Pulse pressure is increased during aging because of which of the following pwede infant physiologic changes?

A

Decreased capacitance of the arteries

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50
Q

Which of the following factors forms the predominant component of diastolic blood pressure?

A

TPR

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51
Q

What is the predominant contributor of TPR?

A

Arterioles

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52
Q 
All of the following will lead to an increase in cardiac output except?
A. Increased after load
B. Increased contractility
C.Increased stroke volume
d. Increased heart rate
A

A. Increased after load ( decrease)

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53
Q

All of the following will lead to an increase in mean arterial pressure except?
A. Increase in systemic vascular resistance
B. Increase in cardiac output
C. Increase in heart rate
D. Nota

A

D. Nota

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54
Q

Master pacemaker

A

SA node

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55
Q

Latent pacemaker/inactive

A

AV
Bundle of his
Purine fiber

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56
Q

Atrial depolarization

A

P wave

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57
Q

Corresponds to AV Node Conduction

A

PR Segment

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58
Q

Correlates with conduction time/Velocity through the AV Node

A

PR Segment

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59
Q

Correlates with conduction time/velocity through the AV Node

A

PR Interval

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60
Q

Ventricular depolarization

A

QRS interval

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61
Q

Ventricular Repolarization

A

T wave

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62
Q

Period of depolarization + Repolarization of ventricles

A

QT Interval

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63
Q

Correlated with plateau of ventricular action potential

A

ST segment

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64
Q

What happens when Sympathetic NS stimulates the AV node?

A

Conduction velocity: increases

PR Interval: decreases

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65
Q

What happens when Parasympathetic NS stimulates the AV Node?

A

Conduction Velocity: decreases

PR Interval: increases

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66
Q

Shorter QT interval

A

Increase Calcium

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67
Q

Prolonged QT Interval

A

Decrease Calcium

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68
Q

High plasma K

A

Increase T waves

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69
Q

Hypokalemia

A

Flat/ inverted T waves with U waves

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70
Q

Hyperkalemia

A

Low P waves, tall T waves

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71
Q

Hypocalcemia

A

Prolonged QT interval

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72
Q

Hypercalcemia

A

Shortened QT interval

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73
Q

STEMI / Q wave MI

A

ST segment elevation

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74
Q

NSTEMI

A

ST segment depression

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75
Q

Full thickness infarct

Transmutation

A

STEMI

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76
Q

Partial thickness

Sub endocardium

A

NSTEMI

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77
Q

Na influx

A

Depolarization / Phase 0

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78
Q

K Efflux

A

Partial Repolarization/ Phase 1

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79
Q

Ca Influx

A

Plateau / Phase 2

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80
Q

K Efflux

A

Complete Repolarization / Phase 3

81
Q

RMP

82
Q

Slow Na influx towards threshold/ stable MP

A

Phase 4 SA node AP

83
Q

CA influx

A

Depolarization / pHase 0

84
Q

K Efflux

A

Repolarization / phase 3

85
Q

Slowest conduction velocity

86
Q

Fastest conduction velocity

A

Bundle of His, Purkinje fibers, ventricles

87
Q

The ventricle are completely Depolarizes during when isoelectric portion of the ECG?

A

ST segment

88
Q

Duration of the AP of the heart is greater than the nerve

89
Q

Compatible with life

90
Q

Not compatible with life

Mcc of sudden cardiac death

91
Q

What is the basis for AV Nodal delay

A

Decrease GAP junctions in the area

92
Q

Which Na channel accounts for SA node automaticity?

A

If channels (slow “funny” Na channels

93
Q

Which is responsible for setting the heart rate?

A

Rate of Phase 4 depolarization

94
Q

Inhibition of pacemaking of latent pacemakers by the SA node?

A

Overdrive suppression

95
Q

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

A

Strokes-Adams Syndrome

96
Q

Condition when latent pacemaker assume pace making activity?

A

Ectopic pacemaker

97
Q

Conduction velocity is dependent on which phenomenon?

A

Size of inward current during upstroke of AP

Not dependent on duration of AP

98
Q

Long conduction pathway

A

Dilated cardiomyopathy

99
Q

Decreased conduction velocity

A

Ischemic heart, hyperkalemia, blocked Purkinje

100
Q

Short refractory period

A

Epinephrine, electrical stimulation

101
Q

Absolute refractory period (ARP)

A

All Na inactivation gates close

AP cannot be generated

102
Q

Effective Refractory Period (ERP)

A

At the end, some Na inactivation channels start to open

AP cannot be conducted

103
Q

Relative Refractory Period (RRP)

A

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

104
Q

SupraNormal Period (SNP)

A

All Na inactivation gates are open & membrane potential is higher than RMP (nearer to threshold)

Cell is more excitable than normal

105
Q

Produces changes in Contractility

A

Inotropic effect

106
Q

Produces changes in Rate of Relaxation

A

Lusitrophic effect

107
Q

Produces changes in Heart Rate

A

Chronotrophic effect

108
Q

Produces changes in Conduction Velocity

A

Dromotrophic effect

109
Q

Inotropes affect

A

stroke volume

110
Q

Chronotropes affect

111
Q

Dromotropes affect

112
Q

dromotropes are affected by

A

Inward calcium current

113
Q

Beta-1 stimulation of the heart would cause

A 
STRONGER (positive into rope)
BRIEFER (positive suit rope) &amp; 
MORE FREQUENT (positive chronotrope) Contractions
114
Q

Adverse effect of Digoxin

A

Arythmia
Gynecomastia
Yellow vision “STARRY NIGHT”

115
Q

An increase in Pre-load will increase Stroke Volume within certain physiologic limits

A

Frank Starling Mechanism

116
Q

LV EDV is directly proportional to what?

A

Venous Return

Right Atrial Pressure

117
Q

What happens when Pre-load increase?

A

Stroke volume & Cardiac Output: increase

118
Q

What happens when afterload increases

A

Stroke volume & cardiac output: decrease

Velocity of Sarcomere Shortening: decrease

119
Q

What happens when TPR increases

A

Cardiac output and Venous return: decreases

120
Q

What happens when blood volume increases or venous compliance decreases

A

Cardiac output and venous return: increases

121
Q

Stroke volume

122
Q

Ejection Fraction

123
Q

Cardiac Output

124
Q

Stroke Work

A

SV X Aortic Pressure

125
Q

Cardiac Minute Work

A

CO X Aortic Pressure

126
Q

Considered as the main source of fuel for the heart?

127
Q

An ECG on a person shows ventricular extrasystoles, which of the following terms pertain to this condition?

A

Premature ventricular complexes

128
Q

An ECG on a person showed ventricular extrasystoles, the extrasystolic beat would produce

A

Decrease pulse pressure because stroke volume is decreased

129
Q

What is the rationale behind the answer in the previous question above?

A

Decreased stroke volume due to decreased ventricular filling time

130
Q

After an extrasystoles, the next normal heart beat or ventricular contraction produces?

A

Increased pulse pressure because of increased ventricular contractility

131
Q

What is the rationale behind the answer in the previous question above?

A

Accumulation of intracellular Ca from previous contraction increases contractility

132
Q

Isovolumetric contraction

1-2

A

All heart valves close
Mitral valve closes ( S1 hear)
2: aortic valve opens, VP > Aortic pressure

133
Q

Ventricular Ejection

2 - 3

A

Width: stroke volume
3: volume is ESV

134
Q

Isovolumetric Relaxation

3 -4

A

All valve close
Aortic valve closes (S2)
4: mitral valve opens; Atrial pressure > ventricular pressure

135
Q

Ventricular filling

4 - 1

A

4: volume is EDV

136
Q

7 Phases of cardiac cycle

A 
Atrial contraction / systole
Isovolumic contraction
Rapid ventricular ejection
Slow/reduced ventricular ejection
Isovolumic relaxation
Rapid ventricular filling
Slow/reduced ventricular filling
137
Q

A wave

A

Atrial contraction

138
Q

C wave

A

Contraction of ventricles

139
Q

V wave

A

Venous blood going to atrium

140
Q

4th heart sound heard

A

Atrial contraction

141
Q

S1

A

Isovolumic contraction

142
Q

Atrial filling begins

A

Rapid ventricular ejection

143
Q

T wave occurs

A

Reduced ventricular ejection

144
Q

Incisura of aortic pressure is seen

V wave

A

Isovolumic relaxation

145
Q

S2 heard

A

Isovolumic relaxation

146
Q

S3

A

Rapid ventricular filling

147
Q

Longest phase of the cardiac cycle

A

Reduced ventricular filling (Diastasis)

148
Q

S1

A

Closure of AV valves

Isovolumic contraction

149
Q

S2

A

Closure of semilunar valves

Isovolumic Relaxation

150
Q

S3

A

Rapid ventricular filling

Rapid ventricular filling

151
Q

S4

A

Stiff ventricles

Atrial contraction/ systole

152
Q

Portion of the cardiac cycle where ventricular volume is lowest?

A

Isovolumetric relaxation

153
Q

The aortic valve closure marks the beginning of which phase of the cardiac cycle?

A

Isovolumetric relaxation

154
Q

The 1st heart sound is heard in which part of the cardiac cycle?

A

Isovolumetric contraction

155
Q

The 3rd heart sound if present is most likely heard during which phase of the cardiac cycle?

A

Rapid filling

156
Q

Aortic

A

2nd ICS R parasternal border

157
Q

Pulmonic

A

2nd ICS L parasternal border

158
Q

Tricuspid

A

4th ICS L parasternal border

159
Q

Mitral

A

5th ICS L MCL

160
Q

Physiologic murmurs occur only during systole or diastole?

161
Q

Inspiration splits the second heart sound because?

A

Aortic valve closes before the pulmonic valve

162
Q

The following processes explain the physiology of the normal splitting of the second heart sound on inspiration

A

Inspiration decreases intrathoracic pressure or creates negative pressure
More venous blood is returned back to the heart
More blood is present on the right side of the heart
Higher pressure on the systemic circulation closes the aortic valve first
Reduction in blood coming to the left ventricle due to negative pressure from the lungs causes the left side of the heart to empty earlier
More blood on the right ventricle causes delay in closure of the pulmonic valve

163
Q

Which of the following processes can lead to fixed splitting of the second heart sound

164
Q

All of the following processes can lead to a paradoxical splitting of the second heart sound except?
A. Severe aortic stenosis
B. hypertrophic obstructive cardiomyopathy
C. LBBB
D. ASD

165
Q

Patient has a murmur described as early diastolic low intensity high pitched blowing in character decrescendo murmur hear best over the right 2nd ICS or over the left stern all border what is the most likely valvular pathology

A

Aortic regurgitation

166
Q

The patient above also has an incidental soft rumbling low pitched late diastolic murmur heard best at the apex due to back flow of blood from the aorta presses on the mitral valve leaflet of blood from the aorta presses on the mitral valve leaflet slightly occluding flow from the aorta

A

Austin flint murmur

167
Q

Sat, buffers minute to minute changes in BP

A

Baroreceptors

168
Q

Patient with chronic pains in both hands and chronic long standing repeated episodes of Raynaud’s phenomenon underwent sympathectomy, after an uneventful surgery and upon discharge, patient started complaining of episodes of dizziness and sensations of blacking out whenever he stands or gets up from bed, which of the following is the physiological explanation for these symptoms?

A

Under stimulation (suppressed response) of the barorecetors

169
Q

Sudden decrease in blood pressure is sensed by the

A

Carotid sinus

170
Q

Rank sterling Mechanism

A

Increased VR -> Increased SV - > inc CO

171
Q

Brain bridge Reflex

A

Increased VR -> Inc HR -> Inc CO

172
Q

Cushing Reaction or Cushing Reflex Triad

A

HPN
Bradycardia
Irregular respiration so

173
Q

Which of the following substances passes through water clefts/pores in the membranes?

174
Q

Describes fluid movement into (absorption) or out of (filtration) the capillary

A

Starling Forces

175
Q

Favors filtration; determined by pressure & resistance in arteries & veins

A

Capillary Hydrostatic Pressure

176
Q

Opposes filtration (favors absorption); increased by increases in plasma protein concentration

A

Capillary Oncotic Pressure

177
Q

Opposes filtration (favors absorption); slightly negative due to lymphatic pump

A

Interstitial Hydrostatic Pressure

178
Q

Favors filtration; determined by interstitial protein concentration

A

Interstitial Oncotic pressure

179
Q

Hydraulic conductance of capillary wall

A

Filtration Coefficient

180
Q

Examples of increased capillary hydrostatic pressure

A

Arteriolar dilated ion, venous constriction, inc venous pressure, heart failure, ECF volume expansion, standing

181
Q

Examples of decreased capillary Oncotic pressure

A

Decreased plasma protein concentration, severe liver disease, protein malnutrition, nephrotic syndrome

182
Q

Examples of filtration coefficient

A

Burns, inflammation, (due to release of histamine, cytokines)

183
Q

When vascular smooth muscle are stretched, there’s a reflex contraction and vice versa

A

Myogenic Theory

184
Q

May explain autoregulation, but not active or reactive hyperemia

A

Myogenic Theory

185
Q

Vasodilator metabolites are produced as a result of metabolic activity

A

Metabolic Theory

186
Q

Substances increase blood flow during deoxygenation

A

Vasodilator Theory

vasodilator - adenosine

187
Q

O2 is needed for vascular muscle contraction

A

Oxygen lack theory/ Nutrient lack theory

188
Q

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

A

Reactive hypermedia

189
Q

Blood flow increases to meet increased metabolic demand

A

Active Hyperemia

190
Q

Most potent vasoconstrictor

A

Vasopressin

191
Q

Release as a result of blood vessel damage, cause arteriolar vasoconstriction, implicated in migraine

192
Q

Release by damaged endothelium

A

Endothelin

193
Q

Vasoconstrictors

A

PGF & TXA2

194
Q

Counteracts TXA2

A

Prostacyclin / PGI2

195
Q

Vasodilator upstream blood vessels

A

Nitric Oxide (EDRF)

196
Q

Vasodilators

197
Q

Found in muscles

A

Lactate, Adenosine

198
Q

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

A

Bradykinin, Histamine

199
Q

During exercise, total peripheral resistance decreases because of the effect of

A

Local metabolites on skeletal muscle Arterioles

mic cabatu Physiology (12 decks)

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