Cardiovascular Physiology Flashcards
The largest artery in the body
Aorta
Weight of the heart
250 grams to 300 grams
Innervation of the heart
Spinal nerves C3-T4
Arch of Aorta branches
Brachiocephalic, Left Common Carotid, Left Subclavian
Point of Maximal Pulse
Apex
The orientation of the apex of the heart
Downward, forward, and to the left
Location of the apex of the heart
5th ICS, midclavicular line
Site of Foramen Ovale
Fossa Ovalis
Fibrous cords that support the valve cusps
Chordae Tendinae
Responsible to give atrium a rough surface
Pectinate Muscle
Projecting ridges that give the ventricular wall a spongelike appearance
Trabeculae Carnae
The fibrous sac that encloses the heart
Pericardium
Lubrication inside the serous pericardial provides the smooth movement of the heart
Pericardial Fluid
Inelastic connective tissue that lines the heart to anchor, protect and prevent it from overfilling
Fibrous Pericardium
Two layers of Serous Pericardium
Parietal and Visceral Layer
Wall of the heart that is responsible for the pumping action of the heart
Myocardium
Smooth lining of the chambers that continues as epithelial tissue in the heart valves
Endocardium
Another name of Visceral Pericardium
Epicardium
Wall of the heart that contains the coronary valve
Epicardium
Movement of the blood in the heart
From high pressure to low pressure
Vena Cava drains the head, neck, and upper extremity
SVC
Vena Cava drains the lower extremity
IVC
Largest blood vessel
IVC
Four coronary sinuses that drains in the heart
Posterior vein, Small cardiac vein, Great cardiac vein, and Middle vein
Fetal Circulation: Communication between the aorta and pulmonary trunk
Ductus Arteriosus
The time when the ductus arteriosus should close
2 weeks of life
Two branches of (R) Coronary Artery
Posterior Descending and Marginal Artery
Two branches of (L) Coronary Artery
Anterior Descending and Circumflex Artery
“Posterior Interventricular Artery”
(R) Posterior Descending Artery
“Anterior Interventricular Artery”
(L) Anterior Descending Artery
The coronary vein that has a direct connection to the Right Atrium
Anterior Vein
The artery that is 75% affected with MI
LADCA
The ability of the heart to spontaneously generate its own action potential
Automaticity
The pacemaker of the heart
SA node
Thru what structure allows the SA node to directly send an impulse to Left Atrium?
Bachmann’s Bundle
Thru what structure allows the SA node to directly send an impulse to the AV node?
Internodal pathway
What are the two reasons for the slow conduction of AV node?
(+) Lesser gap junctions and Small diameter of fibers
SA node rhythm
60-100 bpm
AV node rhythm
40-60 bpm
Purkinje Fibers rhythm
35 bpm
ECG: “Atrial Depolarization”
P wave
ECG: “Ventrical Depolarization”
QRS wave
ECG: “Ventrical Repolarization”
T wave
The time required for the impulse to travel from the atria to the conduction system
PR interval
The normal time of PR interval
0.12 - 0.20 ms
The normal time of QT interval
0.32 - 0.40 ms
The time before the beginning of ventricular repolarization
ST interval
What does ST-elevation mean?
Infraction (>2mm)
What does ST-depression mean?
Ischemia
How many phases does the Nodal Intrinsic Conduction Pathway have?
3
How many phases does the Contractile Intrinsic Conduction Pathway have?
5
What are the phases that are absent in the nodal but present in the contractile intrinsic conduction pathway?
Phase 1 and 2
The phase of Intrinsic Contractile Pathway that represent the upstroke
Phase 0
The phase of the Intrinsic Contractile Pathway that represent the RMP
Phase 4
The phase of the Intrinsic Contractile Pathway that represents the repolarization
Phase 3
The phase of the Intrinsic Contractile Pathway that represents the initial repolarization
Phase 1
The phase of the Intrinsic Contractile Pathway that represents the plateau
Phase 2
What triggers the upstroke in the nodal intrinsic conduction pathway?
Calcium influx
What triggers the upstroke in the contractile intrinsic conduction pathway?
Sodium Influx
What triggers the initial repolarization in the contractile intrinsic conduction pathway?
Sodium Influx and Potassium Efflux
Around what time does the L-type calcium channels will be triggered to close?
250 ms
What is the threshold potential of the nodal intrinsic conduction pathway?
-40 mv
The intracellular cell in the heart that allows the transfer of molecules from one cell to another
Gap Junctions
The intracellular junctions that adhere two cells to each other
Desmosomes
The combination of gap junction and desmosomes
Intercellular Discs
Opening of what channels trigger the upstroke of contractile intrinsic conduction pathway?
Voltage-gated sodium channels
Opening of what channels trigger the upstroke of nodal intrinsic conduction pathway?
L-type calcium channels
What type of protein does the calcium bind in the sarcoplasmic reticulum after it is released in the T-Tubules?
Calmodulin
What type of receptor does the calcium-calmodulin complex bind to the sarcoplasmic reticulum?
Ryanodine Receptors
What do you call the release that happened after the CCC induced the release of calcium in the sarcoplasmic reticulum?
Calcium-induced - Calcium-release
True or False: Calcium-induced - Calcium-release only happens in the heart?
True
What triggers the repolarization in the heart muscle?
Continuous opening of potassium channels and closure of L-type calcium channels
What is the receptor of SNS in the nodal intrinsic conduction pathway?
Beta-1 adrenergic receptor
What is the receptor of PSNS in the nodal intrinsic conduction pathway?
Muscarinic-2 receptor
The enzyme that catalyzes the breakdown of ATP to Cyclic AMP (CAMP)
Adenylate cyclase
What is the protein of SNS that gets activated in the nodal intrinsic conduction pathway?
G stimulatory protein
What is the protein of PSNS that gets activated in the nodal intrinsic conduction pathway?
G inhibitory protein
What is the protein of SNS that gets activated and triggers the opening of L-type calcium channels in the nodal intrinsic conduction pathway?
Protein Kinase A
What is protein does the Protein Kinase A (PKA) binds into in the sarcoplasmic reticulum in the contractile intrinsic conduction pathway?
Phospholamban
What types of G inhibitory protein trigger the activation of potassium channels?
Beta-1 and Gamma-1
What type of G inhibitory protein inhibits adenylate cyclase?
Alpha-1
What phase of the cardiac cycle will you hear the heart sound S1?
Isovolumetric Contraction
What phase of the cardiac cycle will you hear the heart sound S2?
Isovolumetric Relaxation
What phase of the cardiac cycle has a higher ventricular pressure than arterial pressure?
Ventricular Ejection
What phase of the cardiac cycle has a higher atrial pressure than ventricular pressure?
Ventricular Filling
What phase of the cardiac cycle do the AV valves open?
Ventricular Filling
What phases of the cardiac cycle have both AV valves and SL valve closed?
Isovolumetric Contraction and Isovolumetric Relaxation
What phase of the cardiac cycle do the SL valves open?
Ventricular Ejection
The volume of blood present in the ventricles after atrial contraction?
End Diastolic Volume
The volume of the blood ventricles after ventricular ejection
End Systolic Volume
What is the normal range of End Diastolic Volume?
120 - 140mL (ave: 130mL)
What is the normal range of End Systolic Volume?
50 - 70mL
What closure of the valve creates the heart sound S1?
AV valve
What closure of the valve creates the heart sound S2?
SL valve
Heart sound: “Atrial Gallop”
S4
Heart sound: “Ventricular Gallop”
S3
Heart sound that is caused by the blood turbulence during ventricular filling
S3
Heart sound that is caused by the extra work of atria to pump out the blood to the ventricles
S4
True or False: Ventricular Gallop is normal in adults
False (normal in CHILDREN)
The amount of blood pumped out per minute
Cardiac Output
The amount of blood pumped out per beat
Stroke Volume
The formula of Cardiac Output
CO = HR x SV
The formula of Stroke Volume
SV = EDV - ESV
What is the normal range of Cardiac Output?
5-6L/min
What are the factors that talk about the positive or negative changes in heart rate?
Chronotrophy
What are the factors that talk about the positive or negative changes in contractility of the heart?
Inotrophy
The amount of stretch of ventricles
Preload
Law that states an increase in stretch will cause an increase of contraction
Frank-Starling Law
Increase of what volume induces an increase in the stretch?
EDV
What are the factors that increase venous return?
(+) vein valves, milking action of the muscle and breathing
The amount of resistance the heart must overcome to push blood out the heart?
Afterload
What is the other name of Afterload?
Systemic Vascular Resistance
What components of stroke volume have a direct correlation to it?
Preload and Contractility
What component of stroke volume has an indirect correlation to it?
Afterload
The formula of blood pressure
BP = CO x TPR
What structure has the highest CSA with the slowest velocity of blood flow?
Capillaries
What structure has the smallest CSA with the fastest velocity of blood flow?
Aorta
The formula of Total Peripheral Resistance flow
TPR flow = Change in Pressure / Resistance
Formula: R = 8nl / πr4
Pouiseuille’s equation
The most important factor in the resistance
Diameter
The area with the least resistance inside the blood vessels
Center area
The area with the greatest resistance inside the blood vessels
Peripheral area
The two types of blood vessel flow
Laminar and Turbulent
The formula of change in pressure or perfusion
P = MAP - CVP
The normal amount of Central Venous Pressure (CVP)
3-8 mmHg
The normal amount of SBP
120 mmHg
The normal amount of DBP
80 mmHg
The normal amount of MAP
93 mmHg
The formula of Mean Arterial Pressure (MAP)
MAP = DBP + 1/3 Pulse Pressure
The formula of Pulse Pressure
PP = SBP - DBP
Two areas with baroreceptors/chemoreceptors
Aortic sinus and Carotid Sinus
Which cranial nerve does the aortic sinus send signals to when activated?
CN X
Which cranial nerve does the carotid sinus send signals to when activated?
CN IX
Where does the aortic and carotid sinus send signals in the hypothalamus?
Nucleus Tractus Solitarius
What are the two centers that get activated by the Nucleus Tractus Solitarius?
Cardiac Accelatory Center and Vasomotor Center
What is the stimulus of the chemoreceptor reflex of the cardiac system?
Amount of oxygen
What reflex acts upon the right atrium distention?
Bainbridge reflex
RAAS: What hormone does the liver releases when there is a decrease blood pressure?
Angiotensinogen
RAAS: What enzyme activates the angiotensinogen?
Renin
RAAS: What organ releases Renin?
Kidney
RAAS: What enzyme catalyzes Angiotensin I?
ACE
RAAS: What organ releases ACE?
Lungs
RAAS: What hormone is a potent vasoconstrictor?
Angiotensin II
RAAS: What organ does the Angiotensin II activate?
Adrenal Gland (zona glomerulosa)
RAAS: How does Aldosterone decrease blood pressure?
Sodium and Water reabsorption
