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Physiology > Cardiovascular Physiology I (EXAM III) > Flashcards

Cardiovascular Physiology I (EXAM III) Flashcards

1
Q

The three principal components of the circulatory system are:

A
  1. The heart
  2. The blood vessels
  3. The blood
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2
Q

The pump:

The pipes:

The fluid to be moved:

A

Heart

Blood vessels

Blood

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3
Q

Cardiovascular function is regulated by ____ & _____ and strongly impacted by _______

A

Endocrine factors & autonomic nerves

Renal function

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4
Q

Number one cause of death worldwide

A

Cardiovascular disease

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5
Q

____ & _____ are the most common cardiovascular diseases

A

Atheroscerosis
HTN

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6
Q

Cardiovascular disease affects many organs including:

A

Brain, Eyes, kidneys

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7
Q

Multiple risk factors for cardiovascular disease include:

A

Smoking
Obesity
DM
Genetics

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8
Q

Build-up of plaque on the wall of the vessel causing narrowing of the lumen

A

Athersclerosis

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9
Q

The beats to generate ____ to push the blood through the vessels

A

Pressure

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10
Q

The heart beats to ultimately allow blood to reach the _____

A

Capillary system

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11
Q

Exchange at the capillary system occurs between

A

Plasma & interstitial fluid

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12
Q

Supplies O2 and nutrients to the tissue & removes waste

A

Systemic circulation

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13
Q

Adds O2 and removes CO2

A

Pulmonary circulation

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14
Q

Blood always enters the heart through the:

A

Atria

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15
Q

Blood always exits the heart through the:

A

Ventricles

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16
Q

Blood vessels that return blood to the heart:

A

Veins

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17
Q

Blood vessels that carry blood away from the heart:

A

Arteries

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18
Q

Blood vessels attached to the atria, returning blood to the heart

A

Veins

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19
Q

Blood vessels attached to the ventricles, carrying blood away from the heart

A

Ventricles

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20
Q

What is the pump for systemic circulation:

A

Left ventricle

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21
Q

What is the ultimate goal of systemic circulation:

A
  1. supply O2 and nutrients to tissues
  2. removes waste
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22
Q

Describe the path of systemic circulation

A

The left ventricle pumps the blood out into systemic vessels & then into systemic capillaries & then to systemic veins. The systemic veins then bring the blood back to the right atrium (end of systemic circulation)

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23
Q

What is the pump in pulmonary circulation?

A

Right ventricle

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24
Q

Describe the pathway of pulmonary circulation:

A

The right ventricle pumps blood into vessels that will it to the pulmonary capillaries, from here, the pulmonary vein will bring it back to the left atrium (this ends pulmonary circulation)

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25
Q

What are the ultimate functions of pulmonary circulation:

A

Add O2 and remove CO2

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26
Q

Function to keep blood flowing in one direction

A

Heart valves

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27
Q

Heart valves open and closed due to:

A

Changes in pressure

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28
Q

When we see vessels color-coded red, what type of vessels are these and describe the blood within them:

A

Systemic arteries

Blood is high in O2 low in CO2

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29
Q

When we see vessels color-coded blue, what type of vessels are these and describe the blood within them:

A

Systemic veins

Blood is high in CO2 and low in O2

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30
Q

What is the one artery that is carrying blood low in O2 and high in CO2:

A

Pulmonary artery

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31
Q

What is the one vein that is caring blood high in O2 and low in CO2:

A

Pulmonary vein

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32
Q

The blood flow out of the left ventricle into systemic circulation is _____ compared to the blood that is pumped out into the right ventricle into pulmonary circulation

A

Is EQUAL

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33
Q

Unequal blood flow (between pulmonary and systemic circulation) would result in:

A

Blood pooling

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34
Q

Oxygen is loaded & CO2 is unloaded in the:

A

Pulmonary capillaries

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35
Q

Oxygen is unloaded & CO2 is loaded in the:

A

Systemic capillaries

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36
Q

Veins attached to the left atrium:

A

Pulmonary veins

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37
Q

Large systemic artery attached to the left ventricle:

A

Aorta

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38
Q

Large vein attached to the right ventricle:

A

Pulmonary trunk

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39
Q

The pulmonary trunk will branch into:

A

Right and left pulmonary arteries

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40
Q

Attached to the right atrium (returns blood to the right atrium):

A

Vena cava

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41
Q

Valves are not _____ and are considered _____

A

Muscle
Passive structures

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42
Q

Passive structures that open and close based on pressure gradients & function to keep blood flowing in one direction

A

Heart valves

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43
Q

Valves found between the atria and their respective ventricles:

A

Atrioventricular valves (AV)

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44
Q

What are our two AV valves?

A
  1. Tricuspid valve
  2. Mitral/Bicuspid valve
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45
Q

Where is the Tricuspid valve located:

A

Between right atrium & right ventricle

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46
Q

Where is the Mitral/bicuspid valve located:

A

Between the left atrium & left ventricle:

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47
Q

Valve located between the right atrium & right ventricle:

A

Tricuspid

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48
Q

Valve located between the left atrium & left ventricle:

A

Mitral/Bicuspid

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49
Q

If P(A)>P(V)=

A

Open

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50
Q

If P(A)<P(V)=

A

Closed

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51
Q

Valves located between the ventricles and their respective arteries:

A

Semilunar valves

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52
Q

Valve located between the right ventricle & pulmonary trunk:

A

Pulmonary valve

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53
Q

Valve located between the left ventricle & the aorta:

A

Aortic valve

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54
Q

Where is the pulmonary valve located:

A

Between the right ventricle & pulmonary trunk

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55
Q

Where is the aortic valve located:

A

Between the left ventricle and the aorta

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56
Q

If P(V)>P(art)=

A

Open

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57
Q

If P(V)<P(art)=

A

Closed

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58
Q

When semilunar valves are open, the blood will be:

A

Ejected out into the arteries

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59
Q

Prevents the back flow of blood into the ventricles when ventricular pressure falls

A

Closing of the semilunar valves

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60
Q

Once we get blood from the atria into the ventricles we don’t want:

Once we get the blood from the ventricles into the arteries we don’t want:

A

Backflow

Backflow

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61
Q

Two loops in the cardiovascular system:

A

Systemic loop & pulmonary loop

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62
Q

Loop that carries oxygen rich blood to the systemic capillaries and oxygen poor blood back to the heart:

A

Systemic loop

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63
Q

The systemic loops carries oxygen rich blood to the ____ & oxygen poor blood ____

A

Systemic capillaries; back to the heart

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64
Q

The systemic loop carries ___ blood to the systemic capillaries and ___ blood back to the heart

A

Oxygen rich
Oxygen poor

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65
Q

Loop that carries oxygen poor blood to the lungs and oxygen poor blood back to the heart

A

Pulmonary loop

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66
Q

The pulmonary loop carries oxygen poor blood to the ____ and oxygen rich blood ____

A

Lungs; back to the heart

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67
Q

The pulmonary loop carries ____ blood to the lungs and ____ blood back to the heart

A

Oxygen poor
Oxygen rich

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68
Q

What occurs between the plasma and interstitial fluid at the capillaries

A

Exchange

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69
Q

Exchange occurs between the ___ & ____ at the ____

A

Plasma & interstitial fluid; capillaries

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70
Q

How is blood supply to tissue arranged:

A

Parallel

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71
Q

The cardiovascular system is considered a ____ system

A

Closed

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72
Q

What considered “bad” due to the cardiovascular system being a closed system?

A

Leaks

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73
Q

A bleeding paper cut would be considered a _____ in the cardiovascular system

A

Leak

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74
Q

What repairs leaks in the cardiovascular system?

A

Hemostasis

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75
Q

Vessels and capillary beds have a ____ arrangement

A

Parallel

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76
Q

Why is it significant that all capillaries in systemic circulation are arranged in parallel?

A

Allows body to selectively change blood flow to a certain tissue without affecting the blood flow to another area

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77
Q

There is around ______ of blood moving through the body every minute at rest:

A

5 liters

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78
Q

Each tissue gets a different amount of blood because you can regulate how much blood goes into each tissue and this is due to the:

A

Parallel arrangement

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79
Q

During strenuous exercise where might the body increase blood flow to?

A

Brain, heart, skeletal muscle, skin

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80
Q

During strenuous exercise where might the body decrease blood flow to?

A

Kidneys, abdominal organs, etc.

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81
Q

List the types of arteries:

A
  1. Elastic arteries
  2. Muscular arteries
  3. Arterioles
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82
Q

The largest arteries that are attached to the heart:

A

Elastic arteries

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83
Q

Muscular arteries may also be called:

A

Distribution arteries

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84
Q

Type of artery that branches off the aorta and functions to distribute blood to & around different organs of the body:

A

Muscular artery (Distribution artery)

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85
Q

Represent the end of arteries:

A

Arterioles

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86
Q

Smallest arteries, connected to the capillaries

A

Arterioles

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87
Q

Blood flows out of the arteriole system into the ____ through _____

A

Capillaries
Arterioles

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88
Q

Function to carry blood to tissue capillaries from the heart

A

Arteries

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89
Q

What is responsible for regulating blood pressure?

A

Arterioles

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90
Q

What are the three types of veins?

A
  1. Large veins
  2. Medium sized veins
  3. Venuoles
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91
Q

Large veins are attached to the:

A

Heart

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92
Q

What are some examples of large veins?

A

Vena cava & pulmonary vein

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93
Q

Medium-sized veins are considered our ____ veins

A

Collection

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94
Q

Collect blood from different tissues that the muscular arteries delivered it to:

A

Medium-sized veins (Collection veins)

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95
Q

Smallest of veins, that capture the blood that flows out of the capillaries:

A

Venules

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96
Q

Represent the beginning of the venous system:

A

Venules

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97
Q

Venules collect into ______

A

Medium-sized veins

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98
Q

Carry blood to the heart from tissue capillaries:

A

Veins

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99
Q

The process of carrying blood to the heart from tissues capillaries is referred to as:

A

Venous return

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100
Q

Veins serve as:

A

A reservoir of blood

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101
Q

Veins have a very high compliance and can hold a large volume of blood with very little change in pressure and this can be referred to as:

A

Peripheral venous pool

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102
Q

Describe what peripheral venous pool means:

A

The ability of veins to act as a reservoir of blood

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103
Q

At rest how much of our blood volume is contained within the veins?

A

Around 60%

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104
Q

The aorta is an example of an:

A

Elastic artery

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105
Q

The aorta is attached to the:

A

Heart

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106
Q

Describe blood flow through an aorta:

A

Blood is ejected out at a forceful pressure

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107
Q

Muscular arteries branch off of the:

A

Aorta

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108
Q

Example of muscular arteries:

A

Renal artery & celiac artery

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109
Q

Muscular arteries enter into the _____ and get smaller & smaller until they become _____

A

Organs
Arterioles

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110
Q

_____ will end with capillaries and this is where exchange will occur:

A

Arterioles

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111
Q

After exchange occurs in the capillaries this blood will be picked up by the:

A

Venules

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112
Q

For every artery we have a ____ component to it

A

Venous

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113
Q

The force exerted by fluid in a tube:

A

Pressure (Hydrostatic pressure)

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114
Q

Force exerted by a fluid in a tube:

A

Pressure (Hydrostatic pressure)

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115
Q

Pressure is measured in:

A

mmHg

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116
Q

In the cardiovascular system what pressure are we measuring?

A

Pressure of blood in blood vessels

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117
Q

The volume of fluid moved in a given amount of time:

A

Flow

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118
Q

Flow is measure in:

A

mL/min

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119
Q

How difficult it is for blood to flow between two points at any given pressure difference:

A

Resistance

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120
Q

Resistance is a measure of:

A

Friction that impedes flow

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121
Q

Ohms law =

A

F= Change in Pressure/Resistance

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122
Q

Flow is directly related to _______

Flow is inversely related to ____

A

Pressure gradient

Resistance

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123
Q

What is the unit for resistance?

A

Poiseuille

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124
Q

If the change in pressure is constant and the resistance increases, flow:

A

Flow decreases

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125
Q

The driving force to move blood through the cardiovascular system:

A

Pressure gradients generated by the heart

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126
Q

From a mechanistic standpoint, which one would be better to alter to change blood flow to specific tissues?

1) increase in pressure
2) decrease in resistance

A

Reduce resistance to flow bc the driving pressure is your blood pressure and we don’t want to alter that too much

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127
Q

Flow will be regulated by ______ and NOT _____

A

regulating resistance
changing pressure

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128
Q

As the blood flows through systemic circulation (aorta to arteries to arterioles to capillaries to venues to veins to vena cava) what happens to the pressure and why?

A

Pressure decreases due to friction as you move away from the heart

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129
Q

Where is pressure the highs in the CV system?

A

Immediately outside the left ventricle

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130
Q

Where is the biggest pressure drop in systemic circulation?

A

Through the arterioles

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131
Q

The biggest pressure drop occurs in the arterioles due to:

A

Most resistance/friction there

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132
Q

What are the three factors that contribute to cardiovascular resistance?

A
  1. Blood viscosity (n)
  2. Total blood vessel length (l)
  3. Blood vessel radius (r)
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133
Q

Resistance is directly related to:

Resistance is indirectly related to:

A

Blood viscosity, Blood vessel length

Blood vessel radius

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134
Q

How thick the blood is=

A

Viscosity

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135
Q

Viscosity is determined by:

A

Hematocrit

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136
Q

The percentage of RBCs per unit of whole blood:

A

Hematocrit

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137
Q

The more red blood cells present per unit of whole blood =

A

Higher viscosity

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138
Q

How much tubing is needed:

A

Total blood vessel length

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139
Q

The longer the blood vessel the ____ the resistance

A

Greater

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140
Q

What determines blood vessel length?

A

Genetics

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141
Q

Vasodilated blood vessels increase ____ and decrease ____

A

Radius; resistance

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142
Q

Vasoconstricted blood vessels decrease ____ and increase ____

A

Radius, resistance

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143
Q

What is the main contributor to minute-to-minute control of resistance in the vascular system?

A

Blood vessel radius

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144
Q

Small changes in blood vessel radius lead to:

A

Big changes in resistance

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145
Q

If we want to increase blood flow to an area, we can _____ the blood vessel

If we want to reduce blood flow to an area, we can ____ the blood vessel

A

Dilate

Constrict

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146
Q

What is Poiseuille’s law?

A

Resistance = 8(n)(l) / pi(r^4)
n= viscosity
l= length
r= radius

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147
Q

By combing Poiseuille’s law and Ohm’s law we get:

A

Q=P(pi)(r^4) / 8(n)(l)

Hagen-PoiseuIlle’s Equation

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148
Q

Regarding pressure & flow in vessels, its not the _____ of the pressures that is important rather the _______

A

Absolute value
Difference between them

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149
Q

Diameter of the vessel is a major determinant of:

A

Flow

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150
Q

A two fold increase in radius will lead to a:

A

16 fold increase in blood flow

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151
Q

Describe the effects the following have on flow:

  1. Increased radius
  2. Decreased radius
  3. Increased tube length
  4. Decreased tube length
A
  1. Increased flow
  2. Decreased flow
  3. Decreased flow
  4. Increased flow
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152
Q

What is the equation for velocity regarding blood flow through vessels:

A

V= Q/A

V= Velocity
Q= blood flow
A= total cross sectional area

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153
Q

How something happens:

A

Mechanistic explanation

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154
Q

Why something happens:

A

Teleological explanation

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155
Q

The velocity of blood flow is slowest through the capillaries, what is the mechanistic explanation of this:

A

Greatest total cross sectional area leads to lowest velocity

(One aorta= low cross sectional area compared to many capillaries= highest cross sectional area)

(V=Q/A)

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156
Q

The velocity of blood flow is slowest through the capillaries, what is the teleological explanation of this:

A

We want velocity to be slow at the capillaries to allow time for maximum exchange to occur

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157
Q

Describe the following at the aorta:

  1. Total cross-sectional area
  2. Velocity of blood
  3. Blood pressure
A
  1. Low cross-sectional area
  2. High velocity of blood flow
  3. High blood pressure
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158
Q

Describe following at the capillaries:

  1. Total cross-sectional area
  2. Velocity of blood
  3. Blood pressure
A
  1. Large cross-sectional area
  2. Low velocity of blood flow
  3. Low blood pressure (but higher than in the venules, veins & vena cava)
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159
Q

Connective tissue cords that are attached to the AV valves on one end and papillary muscle (inside the ventricles) on the other end:

A

Chordae tendonae

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160
Q

What does the chordae tendonae connect to?

A

AV valves and papillary muscle

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161
Q

The walls of the atria are _____ compared to the walls of the ventricles

A

Thinner

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162
Q

What is the mechanistic explanation to the walls of the atria being thinner than the walls of the ventricle:

A

Walls of the atria are thinner because the atria only have to contract to push blood into the ventricles (not a ton of work)

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163
Q

Compare the walls of the right ventricle to the left ventricle:

A

Wall of the left ventricle is much thicker

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164
Q

What is the mechanistic explanation of the left ventricle wall being thicker than the right ventricle wall:

A

Left ventricle is responsible for systemic circulation meaning that it has to forcefully contract to get blood all the way to the toes (a lot of work)

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165
Q

Separates the right ventricle from the left ventricle

A

Interventricular septum

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166
Q

List the AV valves and where they are located:

A
  1. Tricuspid (right atrium-right ventricle)
  2. Bicuspid/mitral (left atrium-left ventricle)
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167
Q

The AV valves are supported by ___ when closed

A

Chordae tendonae & papillary muscles

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168
Q

When the AV valves are open, the semilunar valves are:

A

Closed

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169
Q

When are all valves open at the same time?

A

Never

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170
Q

When the AV valves are open, blood is flowing into the:

A

Ventricles

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171
Q

Describe the chordae tendonae when the AV valves are open:

A

Lots of slack, not drawn tight

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172
Q

When the AV valves are closed, the semilunar valves are:

A

Open

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173
Q

Describe the chordae tendonae when the AV valves are closed:

A

Chordae tendonae stretched tight and supported by papillary muscle

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174
Q

The function of the chordae tendonae is to:

A

Prevent backflow

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175
Q

What would happen if the chordae tendonae were not functioning?

A

Valve prolapse

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176
Q

Caused by weakened/stretched chordae tendonae & can be due to HTN

A

Valve prolapse

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177
Q

Valve dysfunction creates:

A

Heart murmurs

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178
Q

Valves open and close due to:

A

Pressure gradients

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179
Q

Valves function to:

A

Keep blood flowing in one direction

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180
Q

Which valve is considered the tricuspid?

A

Right AV valve

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181
Q

Which valve is considered the bicuspid?

A

Left AV valve

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182
Q

Cardiac myocytes may also be called:

A

Cardiocytes, cardiac muscle cells

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183
Q

There are two types of cardiac myocytes found in cardiac muscle, these include:

A
  1. Conductive muscle fibers (autorhythmic cells/AR cells, pacemaker cells)
  2. Contractile muscle fibers
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184
Q

Conductive muscle fibers may also be called:

A

Autorhythmic cells (AR cells)
Pacemaker cells

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185
Q

Makes up 1% of cardiac myocytes:

A

Conductive muscle fibers

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186
Q

Spontaneously generate AP that leads to heart beat:

A

Conductive muscle fibers

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187
Q

______ stimulates an excitation (AP) which stimulates _____

A

Conductive muscle fibers; Contractile cells

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188
Q

Type of cardiac myocyte that contract very weakly:

A

Conductive muscle fiber

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189
Q

Conductive muscle fibers are located:

A

In conduction system of heart

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190
Q

99% of myocytes in the heart:

A

Contractile muscle fibers

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191
Q

Contract & generate heartbeat:

A

Contractile muscle fibers

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192
Q

What are the two types of contractile muscle fibers:

A
  1. Atrial myocytes
  2. Ventricular myocytes
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193
Q

Cardiac muscle cell that contracts in response to the electrical signal that is generated by conductive muscle cells:

A

Contractile muscle cells

194
Q

Contractile muscle cells located in the atria

A

Atrial myocytes

195
Q

Contractile muscle cells located in the ventricle

A

Ventricular myocytes

196
Q

What stimulates a SKELETAL muscle to contract?

A

Action potentials in somatic motor neurons

197
Q

What are the steps (simplified_ to stimulating a SKELETAL muscle to contract?

A
  1. Action potential in somatic motor neuron
  2. Release of acetylcholine
  3. Acetylcholine binds to nicotinic receptors on motor end
  4. Excitation leading to calcium entry for contraction
198
Q

Compare the cause of heart contraction to skeletal muscle

A

No outside electrical stimulus is needed for heart muscle to contract

199
Q

Where does the electrical signal that leads to heart contraction come from?

A

From WITHIN the heart

200
Q

Why enables the heart to beat outside the body?

A

Internal stimulation from conductive muscle fibers

201
Q

The appearance of cardiocytes can be described as:

A

Striated

202
Q

What is the functional unit of a cardiocyte?

A

Sarcomere

203
Q

The ______ & ______ of cardiac muscle is similar to skeletal muscle

A

Anatomy & function

204
Q

Cardiac muscle can be described as a:

A

Syncytium

205
Q

A group of cells that function as one:

A

Syncytium

206
Q

What feature of cardiocytes allows them to function as a syncytium:

A

Intercalated discs

207
Q

Specialized connections between one cardiac muscle cell & another:

A

Intercalated discs

208
Q

Intercalated discs are composed of:

A
  1. Interlocking plasma membrane
  2. Gap junctions
  3. Desmosomes
209
Q

Describe the interlocking plasma membrane of intercalated discs inc cardiac muscle:

A

Little hooks locking the plasma membrane together

210
Q

Describe the function of the gap junctions found in intercalated discs in cardiac muscle:

A

Allows for rapid movement of ions from one cell to the next

211
Q

Describe the function of desmosomes found in intercalated discs in cardiac muscle:

A

Structural support cell connections

212
Q

Why is it so important that the desmosomes are found in the intercalated discs of cardiac muscle:

A

Allow the cells to stay together under the extreme pressure of the heart

213
Q

In what ways are cardiac muscle cells linked?

A
  1. Mechanically
  2. Chemically
  3. Electrically
214
Q

What are the two syncytium in the heart?

A
  1. Atrial
  2. Ventricular
215
Q

The atrial syncytium & ventricular syncytium function:

A

Separate from each other

216
Q

If the atrial syncytium is contracted, the ventricular syncytium is:

A

Relaxed

217
Q

The arteries supplying the myocardium are the:

A

Coronary arteries

218
Q

The blood flowing through the coronary arteries:

A

Coronary blood flow

219
Q

Coronary arteries exit from behind the _____

A

Aortic valve cusps

220
Q

Coronary arteries exit from behind the aortic valve cusps and lead to a branching network of:

A

Small arteries, arterioles, capillaries, venues and veins

221
Q

Describe the drainage of most of the cardiac veins:

A

Most of the cardiac veins drain into a single vein- the coronary sinus

222
Q

After the cardiac veins drain into the single coronary sinus, this empties into the:

A

Right atrium

223
Q

Coronary circulation is a part of:

A

Systemic circulation

224
Q

Because coronary circulation is part of systemic circulation, it functions to:

A

Provide oxygen & nutrients to tissues of the body including the heart

225
Q

Systemic blood flow to the heart, providing fresh oxygen & nutrients to the cells

A

Coronary circulation

226
Q

What does the coronary circulation bypass?

A

Vena Cava

227
Q

The coronary sinus dumps directly into the:

Why is this unique?

A

Right atrium

Because it bypasses the vena cava

228
Q

The very first branch off of the aorta is the:

A

Coronary artery

229
Q

The coronary artery branches into:

A

Right & left coronary arteries
(travel around the heart)

230
Q

Lack of blood supply to the left ventricle=

A

Widowmaker

231
Q

What is the artery involved in the “widow-maker”

A

Left anterior descending
(coronary??)

232
Q

What the is the thing that does not use the vena cava to dump blood back into the heart?

A

Coronary sinus

233
Q

Contraction =

A

Systole

234
Q

Relaxation =

A

Diastole

235
Q

Atrial contraction =
Atrial relaxation =
Ventricular contraction =
Ventricular relaxation =

A

Atrial systole
Atrial diastole
Ventricular systole
Ventricular diastole

236
Q

What is the term describing the events that makeup a single heart beat?

A

Cardiac cycle

237
Q

The events of the cardiac cycle include:

A
  1. Atrial systole
  2. Ventricular systole/atrial diastole
  3. Ventricular diastole
238
Q

What must occur before systole can happen?

What muscle occur before diastole can happen?

A

Heart muscle must depolarize before systole can happen & repolarize before diastole can happen

239
Q

What is the order of depolarization in the heart/conduction system:

A
  1. SA Node
  2. Internodal pathways
  3. AV node
  4. Bundle of HIS
  5. DOWN bundle branches
  6. UP Purkinje fibers
240
Q

The SA node will generate AP which travel via gap junctions along ______ to the _____

A

Internodal pathways; AV node

241
Q

The AP is held up for 0.1 seconds in the _____ node. This is known as the _____

A

AV node
AV delay

242
Q

What is the teleological explanation for the AV delay?

A

The atria needs to contract before the ventricles fill with blood

243
Q

What is the mechanistic explanation for the AV delay?

A

The conduction velocity through the AV node is slower than elsewhere along the conduction system

244
Q

The action potential travels from the AV node ____ the bundle of HIS, _____ bundle branches, _____ Purkinje fibers

A

Down, Down, Up

245
Q

The Purkinje fibers also supply the _____

A

Papillary muscles

246
Q

Contracts during ventricular contraction to tighten chordae tendinae and prevent AV valves from prolapsing into the atria

A

Papillary muscles

247
Q

When do the papillary muscles contract?

A

Ventricular contraction

248
Q

The pacemaker cells with the ____ drive the heart

A

Fastest rate of discharge

249
Q

In general pacemaker cells have high ______

What is an exception to this?

A

Action potential conduction velocities

AV node (due to AV delay)

250
Q

The reason that the AP is held up for a fraction of a second at the AV node is because it has ________ which causes the AP to take longer to move through this area

A

Very slow conduction velocity

251
Q

The speed at which the action potential moves:

A

Conduction velocity

252
Q

The number of action potentials the pacemaker cells can generate in a given amount of time:

A

Rate of discharge

253
Q

Why does the SA node drive the heart?

A

Because it contains the pacemaker cells with the fastest rate of discharge

254
Q

Describe an ectopic focus:

A

Abnormal pacemaker cells (hijackers)

255
Q

If contractile cells convert into AR cells (like after a long viral infection) these cells will be considered an:

A

Ectopic focus

256
Q

Describe the events that occur when the AP takes the internodal pathways:

A
  1. Depolarization of atria
  2. AV delay
  3. Atrial contraction
257
Q

Describe the events that occur when the AP is sent DOWN the bundle branches and UP Purkinje fibers:

A
  1. Depolarization of ventricles
  2. Contraction of ventricles
258
Q

Atrial repolarization occurs at the exact same time as ____.

Describe the wave of atrial repolarization on an ECG:

A

Ventricular depolarization

Because it is the same time as ventricular depolarization it is dominated (bc the ventricles are bigger) and therefor is absent on an ECG

259
Q

Name the wave that is characterized by the following actions:

  1. Atrial depolarization
  2. Ventricular depolarization/atrial repolarization
  3. Ventricular repolarization
A
  1. P wave
  2. QRS complex
  3. T wave
260
Q

The P wave itself does NOT represent atrial ______ but it instead represents atrial _____

A

Contraction
Depolarization

261
Q

Does the QRS complex represent atrial repolarization? Why?

A

No- it represents ventricular depolarization although atrial repolarization does occur at this time (just not represented on ECG)

262
Q

The AV delay occurs during the PR interval.
If AV delay is longer than normal= ________
If AV delays is shorter than normal= _____

A

Longer PR interval
Shorter PR interval

263
Q

When would the Q wave show up on an ECG:

A

Not normally, only on patient with previous cardiac event

264
Q

AR cells do not have a:

A

Steady resting membrane potential

265
Q

Describe the resting membrane potential of AR cells:

A

Unsteady

266
Q

Depolarization to threshold in AR cells

A

Pacemaker potential

267
Q

What are the two channels of pacemaker potential?

A

F-type channels
T-type channels

268
Q

F-type channel=

A

Voltage-gated sodium channel (funny channel)

269
Q

T-type channel=

A

Transient voltage-gated calcium channel

270
Q

What are the two channels of AP:

A

L channel
K+ channel

271
Q

L channel=

A

Long lasting voltage gated calcium channel

272
Q

Once the membrane potential hits the resting potential that will be the stimulus for:

A

Opening of F-type channel

273
Q

What occurs when the F-type channel opens?

A

Sodium influx into the cell leading to depolarization to 3/4 the threshold

274
Q

At resting potential sodium permeability is ____. But as soon as the F-type channel opens, _____.

A

Low
Sodium permeability increases

275
Q

At 3/4 the way up to threshold what occurs?

A

Transient voltage-gated calcium channels open

276
Q

Why do we call them “transient” voltage-gated calcium channels?

A

Because they only open briefly

277
Q

The calcium flowing in due to the transient voltage-gated calcium channels allows for:

A

Depolarization to threshold (the final 1/4)

278
Q

What work together to get the cells to threshold?

A

F-type channel + Transient voltage-gated calcium channel

279
Q

Once we reach threshold what occurs?

A

L-type calcium channel opens, calcium flows in = spike of depolarization

280
Q

Describe the opening of the L-type calcium channel:

A

Long lasting opening at threshold

281
Q

At peak of depolarization the L-type calcium channel _____ and the permeability of calcium _______

A

Closes
Goes down

282
Q

When the L-type calcium close, _____ opens

A

Voltage gated potassium channels

283
Q

The increased permeability to potassium (opening of K+ channels leads to:

A

Repolarization to rest

284
Q

As soon as repolarization to rest occurs what happens?

A

The process starts over with F-channels opening

285
Q

In skeletal muscle & neurons the depolarization is due to ____ while in cardiac muscle the depolarization is due to _____

A

Sodium moving into cell
Calcium moving into cell

286
Q

Describe what neurotransmitters are involved in sympathetic control of AR cells:

A

Epinephrine & Norepinephrine

287
Q

Describe what neurotransmitters are involved in parasympathetic control of AR cells:

A

Acetylcholine

288
Q

What receptor do norepinephrine & epinephrine bind to?

A

Beta-1 adrenergic

289
Q

What receptors do acetylcholine bind to?

A

Muscarinic

290
Q

Desribe the effects of norepinephrine & epinephrine binding to Beta-1 adrenergic receptors to control AR cells

A
  • Increase in probability of opening of F-type channels & Transient calcium channels
  • Decrease in time to threshold
  • Increase in HR
291
Q

The aspects sympathetic control on AR cells are considered:

A

+ Chronotropic agents

292
Q

Describe the effects of ACH binding to muscarinic receptors to control AR cells:

A
  • Decrease in probability of opening of F-type channels
  • Increase in probability of opening of K+ channels
  • Hyperpolarization of membrane
  • Increase in time to threshold
  • Decrease in HR
293
Q

The aspects of parasympathetic control on AR cells are considered:

A
  • Chronotropic agents
294
Q

Agents that function to increase heart rate

Agents that function to decrease heart rate

A

+ Chronotropic agents

  • Chronotropic agents
295
Q

Facilitated diffusion rate of ion =

(equation)

A

(Change in concentration)(Temperature)(#channels)
______________________________________________________
Probability the channels are open

296
Q

_______ we need to be able to change the heart rate based on the needs of the body

A

Teleologically

297
Q

SA node spontaneous rate =
Normal resting heart rate =

Meaning the heart is under _______ NS control

A

100 bpm
80 bpm

parasympathetic

298
Q

Contractile Cell Depolarization Events:

Phase 4=

Caused by:

A

Resting membrane potential

Sodium channels reset gate & are ready for next AP

299
Q

Contractile Cell Depolarization Events:

Phase 0=

Caused by:

A

Spike of depolarization

Due to sodium entry through the fast voltage-gated sodium channel
- Activation/inactivation gates are open here

300
Q

Contractile Cell Depolarization Events:

Phase 1=

Caused by:

A

Partial repolarization

Fast gated sodium channels close

301
Q

Contractile Cell Depolarization Events:

Phase 2=

Caused by:

A

Plateau

Transient potassium channels close
L-type calcium channels open

302
Q

Contractile Cell Depolarization Events:

Phase 3=

Caused by:

A

Repolarization

L-type calcium channels close
Slow potassium channels open

303
Q

Unlike AR cells, contractile cells have:

A

Resting membrane potential

304
Q

Plateau phase is unique to:

A

Contractile cells (does NOT occur in NS or skeletal muscle)

305
Q

During this phase of contractile cell AP, the number positive charges entering the cell is equal to the number of positive charges exiting the cell:

A

Plateau phase

306
Q

Atrial cell contraction corresponds to what wave on an ECG?

A

P wave

307
Q

Ventricular depolarization corresponds to what wave on an ECG?

A

QRS complex

308
Q

Ventricular repolarization corresponds to what wave on an ECG?

A

T wave

309
Q

The _____ cells have the action potential with the pacemaker potential while the ____ cells have the action potential with the plateau

A

AR cells
Contractile cells

310
Q

What are located in the membrane of T-tubules in contractile cells?

A

DHP L-type calcium channels

311
Q

What stimulates the DHP L-type channels to open?

A

Stimulated to open when AP reaches them

312
Q

What are the two ways to reduce cytosolic calcium following contractile cell contraction?

A
  1. Calcium ATPase in SR membrane (primary active uniporter)
  2. Secondary active antiporter in PM (sodium in, calcium out)
313
Q

Excitation Contraction Coupling in Cardiac muscle

Excitation (depolarization) of the PM leads to

A

Opening of plasma membrane L-type calcium channels in T-tubules

314
Q

Excitation Contraction Coupling in Cardiac muscle

Following the opening of plasma membrane L-type calcium channels in T-tubules what occurs?

A

Flow of calcium into the cytosol from the ECF (10%)

315
Q

Excitation Contraction Coupling in Cardiac muscle

After calcium flows into the cell from the cytosol what occurs?

A

Calcium binds to calcium ryanodine receptors on the outter membrane of the SR

316
Q

Excitation Contraction Coupling in Cardiac muscle

After calcium binds to the ryanodine receptors of the SR, what occurs?

A

Flow of calcium out of the SR into the cytosol (90%)

317
Q

When calcium from outside the cell causes calcium from inside to the SR to be released in to the cytosol this is known as:

A

Calcium-induced calcium-release

318
Q

Excitation Contraction Coupling in Cardiac muscle

Once the bulk calcium (90%) flows into the cytosol from the SR with the addition of the other 10% of calcium from the ECF this ultimately causes:

A

Increase in cytosolic calcium concentration, crossbridge cycling & contraction

319
Q

In both skeletal muscle & cardiac muscle contraction _____ is required

A

Calcium

320
Q

In both skeletal muscle & cardiac muscle contraction, _______ begins once calcium binds to troponin

A

Cross-bridge cycling

321
Q

In both skeletal muscle & cardiac muscle contraction a ______ pumps calcium back into the ______

A

Primary active uniporter
SR

322
Q

A difference between cardiac & skeletal muscle contraction is that in addition to the primary active uniporter, cardiac muscle uses a ______ in the membrane to pump calcium into the _____

A

Secondary active antiporter
ECF

323
Q

In skeletal muscle all the calcium form contraction comes from the _______ while in cardiac muscle, some calcium comes from _____ and the rest comes from _____

A

SR
ECF & SR

324
Q

In skeletal muscle, the AP is very quick and is over before the contractile event even begins and can allow for:

A

Summation & tetanus to occur

325
Q

What aspect of the cardiac muscle contractile events causes the AP to be longer?

A

Plateau phase

326
Q

In cardiac muscle contraction, the contractile event occurs simultaneously with the:

A

Electrical activity in the cell

327
Q

In cardiac muscle contraction, by the time the muscle has returned to its resting state, the _____ is already over

Because of this what _____ & ____ cannot occur

A

Contractile event

Summation & tetanus

328
Q

What is the mechanistic explanation of cardiac muscles inability to go into summation & tetanus:

A

Because the duration of the absolute & relative refractory periods is so long that by the time you can actually generate another AP the muscle has relaxed

329
Q

What is the teleological explanation of cardiac muscles inability to go into summation & tetanus:

A

We do not want our heart to go into summation & tetanus, we want our heart to contract & relax between beats so that we can fill our heart with blood & pump it out to the body

330
Q

Where does the electrical signal for skeletal muscle contraction come from?

What stimulate contractile cells to contract?

A

Somatic motor neurons

AP from the AR cells

331
Q

In skeletal muscle, contractile response to a single AP is:

A

All or none

332
Q

Graded is opposite of:

A

All or none, may happen differently every time

333
Q

Because skeletal muscle contractile response to a single AP is all or none, the calcium released saturates ______ and contraction strength is _____

A

Troponin
Maximal

334
Q

In cardiac muscle, contractile response to a single AP is:

A

Gradede

335
Q

In “resting” state, AP-induced sarcoplasmic release of calcium in cardiac cells does NOT:

A

Saturate troponin sites

336
Q

The strength of contraction in cardiac muscle is dependent on:

A

Concentration of calcium inside the cell

337
Q

The amount of intracellular calcium is adjusted to:

A

Change or increase the strength of contraction

338
Q

Substances that alter the force of contraction of cardiocytes by changing the cytosolic calcium concentration are termed:

A

Inotopic agents

339
Q

Inotropic agents change the ____ of the heart

A

Contractility

340
Q

+ inotropic agents _____ the force of contraction
- inotropic agents _____ the force of contraction

A

Increase
Decrease

341
Q

Inotropic agents work via:

A

Voltage-gated calciu channels

342
Q

Under sympathetic influence, describe what happens to heart contraction:

A

More forceful and shorter duration

343
Q

When epinephrine & norepinephrine bind to _____ which are GPCRs these activated ______

A

Beta-1 adrenergic receptors
cAMP second messenger system

344
Q

When epinphrine & norepinephrine bind to Beta-1 adrenergic receptros causing activation of camp this results in what two events:

A
  1. Phosphorylation of voltage-gated calcium channels
  2. Phosphorylation of phospholambin
345
Q

When cAMP causes the phosphorylation of voltage-gated calcium channels, this causes the voltage-gated calcium channels to _______ resulting in _____

A

Stay open longer resulting in increased calcium entry from ECF

346
Q

Because phosphorylation of the voltage-gated calcium channels allows them to stay open longer and bring more calcium into the cell from the ECF this leads to what three actions:

A
  1. increased calcium stores in SR
  2. Increased calcium release from SR
  3. more forceful contraction
347
Q

cAMP phosphorylating phospholamban increases the activity of _____ in the SR

A

Calcium-ATPase

348
Q

The increased activity of the calcium-ATPase in the SR (caused by phosphorylation via cAMP on phospholambin leads to:

A
  1. Increased calcium stores in the SR
  2. Faster calcium removal from cytosol
349
Q

The chain events of phosphorylation of phospholambin that ultimately increase the calcium ATPase activity which increases calcium stores in the SR, and causes calcium to be removed from cytosol more quickly leads to:

A
  1. increased calcium release from SR leading to a more forceful contraction
  2. Shortens calcium-troponin binding time leading to a shorter duration of contraction
350
Q

Ultimately under sympathetic influence on contractile cells, you get:

A
  1. More forceful contraction
  2. Quicker duration of contraction
351
Q

Pressure Atria < Pressure veins
Pressure Atria > Pressure Ventricles
Pressure Ventricles < Pressure arteries

A

Between beats

352
Q

Describe the atria & ventricles between beats:

A

Both relaxed in diastole

353
Q

Between beats, the pressure of the Atria is less than the pressure in the veins therefore:

A

Blood will flow into the atria

354
Q

Between beats, the pressure in the atria is greater than the pressure in the ventricles therefore:

A

The AV valves is open so blood is flowing into the ventricles

355
Q

Between beats, the pressure in the ventricles is less than the pressure in the arteries therefore:

A

Semilunar valves are shut

356
Q

Between beats, the blood returning to the right atrium is from the:

Between beats, the blood returning to the left atrium is from the:

A

Systemic circulation

Pulmonary circulation

357
Q

Between beats is the period of ________

Meaning that:

A

Period of passive filling

80% of blood for contraction is loaded into the ventricles at this time

358
Q

Pressure of atria is elevated
Pressure Atria > Pressure Veins
Pressure Atria > Pressure Ventricles
Pressure Ventricles < Pressure Arteries

A

Atrial systole

359
Q

During atrial systole:

  1. The pressure of the atria is greater than the pressure of the veins therefore:
  2. The pressure of the atria is greater than the pressure of the ventricles therefore:
  3. The pressure of ventricles is less than the pressure of the arteries therefore:
A
  1. Potential backflow into the veins may occur
  2. AV valves are open
  3. Semilunar valves are shut
360
Q

As the atria contracts, blood will travel into the:

A

Ventricles

361
Q

Atrial systole is the period of ______

Meaning that:

A

Period of active filling

20% of blood for contraction is loaded into the ventricles at this time

362
Q

Pressure of atrium is decreased
Pressure of ventricles is elevated
Pressure atria < Pressure veins
Pressure atria < Pressure of ventricles
Pressure ventricles < Pressure arteries

A

Atrial diastole/ Early ventricular systole

363
Q

In atrial diastole/ early ventricular systole:

  1. The pressure of the atria is decreased because:
  2. The pressure of the ventricles is increased because:
  3. The pressure of the atria is less than the pressure of veins therefore:
  4. The pressure of the atria is less than the pressure of the ventricles therefore:
  5. The pressure of the ventricles is less than the pressure of the arteries therefore:
A
  1. the atria are relaxed
  2. the ventricles contract
  3. blood will start flowing back into the atria
  4. AV valves will shut
  5. semilunar valves are shut
364
Q

We have filled the bag with blood and have now closed all entrances & exits and we start to squeeze causing a rapid rise in pressure in the ventricles

What stage of the cardiac cycle does this describe?

A

Atrial diastole/ early ventricular systole

365
Q

During atrial diastole/ early ventricular systole is the period of _____

Meaning that:

A

Period of isovolumetric contraction

Pressure in ventricles rises rapidly

366
Q

Pressure atria < Pressure veins
Pressure atria < Pressure ventricles
Pressure ventricles > Pressure arteries

A

Late ventricular systole

367
Q

During late ventricular systole:

  1. The pressure of the atria is less than the pressure of the veins therefore:
  2. The pressure of the atria is less than the pressure of the ventricles, therefore:
  3. The pressure in the ventricles is greater than the pressure in the arteries, therefore:
A
  1. Blood will be flowing into atria
  2. AV valves are shut
  3. Semilunar valves are open & blood is ejected into the arteries
368
Q

During late ventricular systole is the _________

Meaning that:

A

Ejection phase

Equal volume of blood ejected into both circulations

369
Q

During the ejection phase where is blood ejected into:

A

The aorta on the left side or pulmonary trunk on the right side

370
Q

Pressure of ventricles is decreased
Pressure atria < Pressure veins
Pressure atria < Pressure ventricles
Pressure ventricles < Pressure arteries

A

Early ventricular diastole

371
Q

During early ventricular diastole:

  1. Pressure of ventricles is decreased because
  2. Pressure of atria is less than the pressure of the veins therefore:
  3. Pressure of the atria is less than the pressure of the ventricles therefore:
  4. Pressure of the ventricles is less than the pressure of the arteries therefore:
A
  1. ventricles are relaxing
  2. blood will be flowing into atria
  3. AV valves will be shut
  4. Semilunar valves are shut
372
Q

We have emptied this bag of atleast half its volume, closed entrances & exits, and have allowed it to relax.

This describes what stage of the cardiac cycle?

A

Early ventricular diastole

373
Q

During early ventricular diastole is the period of _____

Meaning that:

A

Isovolumetric relaxation

Meaning that the pressure of the ventricles falls rapidly

374
Q

Pressure atria < Pressure veins
Pressure atria > Pressure ventricles
Pressure ventricles < Pressure arteries

A

Late ventricular diastole

375
Q

During late ventricular diastole:

  1. The Pressure of the atria is greater than the pressure of the ventricles therefore:
  2. The pressure in the ventricles is less than the pressure of the arteries therefore:
A
  1. AV valves are open - we start to fill the ventricles again
  2. Semilunar valves are shut
376
Q

During late ventricular diastole, the period of _____ begins

A

Passive filling (again)

377
Q

The volume of blood that is in the ventricle before it contracts (at the end of ventricular diastole)

A

End diastolic volume (EDV)

378
Q

EDV=

A

End diastolic volume

379
Q

The average EDV=

A

135 ml

380
Q

The volume of blood that is in the ventricle at the end of ventricular systole (the minimum amount of blood after contraction)

A

End systolic volume (ESV)

381
Q

ESV=

A

End systolic volume

382
Q

What is the average ESV?

A

65 ml

383
Q

Volume of blood that is ejected per beat:

A

Stroke volume (SV)

384
Q

Stroke volume (sv) =

(equation)

A

EDV-ESV

385
Q

An average stroke volume is around:

A

70 ml per beat

386
Q

Fraction of EDV ejected per beat:

A

Ejection fraction

387
Q

Equation for ejection fraction:

A

SV/EDV

388
Q

The average ejection fraction is _____ at rest

A

52%

389
Q

Heart sounds are due to:

A

Valve closures

390
Q

What causes the first heart sound:

A

Closure of AV valve

391
Q

What causes the second heart sound:

A

Closure of semilunar valve

392
Q

Abnormal heart sounds due to valve dysfunction

A

Heart murmur

393
Q

Heart murmur caused by failure of valves to open completely

A

Stenosis

Lub-Shh-Dub

394
Q

Heart murmur caused by failure of valves to close properly

A

Insufficiency or prolapse

Lub-Dub-Shhh

395
Q

Compare the pressure changes in pulmonary circulation to the pressure changes in systemic circulation:

A

Pressure changes in pulmonary circulation are much smaller

396
Q

The amount of blood pumped out of eat ventricle in one minute:

A

Cardiac output

397
Q

Equation for cardiac output:

A

CO= HR x SV

398
Q

Normal resting CO=

A

70 bpm x 70 ml/beat = 5 L/min

399
Q

During intense exercise CO can:

A

Elevate (to 30-35 L/min)

400
Q

CO is regulated to match:

A

Demands of tissues

401
Q

What factors can increase CO?

A

Physical activity
Metabolic status
Drugs

402
Q

What factors can decrease CO?

A

Blood loss
Heart disease

403
Q

How can we control CO?

A

By changing HR & SV

404
Q

Factors that increase heart rate:

A

Positive chronotropic agents

405
Q

Factors that decrease heart rate:

A

Negative chronotropic agents

406
Q

HR is mainly controlled by:

A

Input from the nervous system

407
Q

_____ increases the HR (AR & Contractile cells)

_____ decreases the HR (AR cells only)

A

SNS

PNS

408
Q

If we want to affect the heart rate we we need to change the function of ____ cells, NOT ____ cells

A

AR cells; contractile cells

409
Q

In order to increase heart rate we need to (2):

A
  1. Increase speed at which APs are generated by the SA node
  2. Increase the speed at which the APs travel through the conduction system
410
Q

Factor that increases the speed at which the AP moves through the myocardium:

What NTs might do this?

A

Positive dromotropic agent

Epinephrine & Norepinephrine

411
Q

Factor that reduces the speed at which the AP moves through the myocardium:

What NTs might do this?

A

Negative dromotropic agent

Acetylcholine

412
Q

To increase the heart rate we need to increase the activity of the ______ & decrease the activity of the ______

A

Sympathetic NS
Parasympathetic NS

413
Q

Equation for stroke volume (SV):

A

SV= EDV-ESV

414
Q

SV is altered by:

A
  1. Change in the preload (EDV)
  2. Change in the afterload (BP)
  3. Change in the contractility (force of contraction)
415
Q

At rest, cardiac muscle sits at a length that is:

A

Less than optimum

416
Q

_____ EDV: ______ stretch of myocardium: moves resting cardiocyte length toward _____: ______ SV

A

Increased; increased; optimum; increased

417
Q

Starling’s law of the heart states:

A

Increased EDV leads to increased SV

418
Q

Anything that increases EDV increases what two other things?

A
  1. Force of contraction
  2. SV
419
Q

Stroke volume is an index of:

A

The force of contraction

420
Q

EDV is an index of:

A

Resting fiber length

421
Q

EDV is _____ to venous return (VR)

A

Directly related to

422
Q

Rate at which blood is returned to the heart from the veins

A

Venous return

423
Q

Flaccid vessels with high compliance & can hold up to 60% of the total blood volume:

A

Veins

424
Q

Can expand to hold more blood without a change in pressure:

A

Veins

425
Q

The change in pressure to return blood to the heart from the capillaries is:

A

Very small

426
Q

______ facilitates blood movement back to the heart (venous return)

A

One-way valves

427
Q

Factors that increase VR that are dependent on one-way valves & veins:

A
  1. increase in skeletal muscle pump
  2. increase in thoracic pump
  3. increase venoconstriction via sympathetic nervous system
428
Q

The increase in venoconstriction via the sympathetic nervous system increasing venous return is due to what receptors?

A

Alpha-1 adrenergic receptors

429
Q

What is one factor that increases VR that is NOT dependent on one-way valves in veins:

A

Extremely high heart rate (tachycardia) because this causes a drop in EDV which leads to a drop in CO leading to a lower stroke volume

430
Q

Increasing thoracic pressure against a closed glottis used during defecation reflex:

A

Valsalvas maneuver

431
Q

Valsalvas maneuver functions to _____ venous return because it creates a large increase in thoracic pressure which _____ VR, _____ EDV, ____SV, _____CO

A

Decreases (all)

432
Q

How is heart rate related to SV?

A

Indirectly related

433
Q

How is cardiac output related to HR? (at a NORMAL HR)

A

Directly related

434
Q

______ has a greater affect on CO than _____ under normal conditions

A

HR; SV

435
Q

When you increase HR, you increase CO, however past ____ increasing HR will lead to a decrease in CO and this is because:

A

200 BPM; you do not have enough time to fill the ventricles with blood reducing EDV, SV, & CO

436
Q

The pressure that the ventricles must overcome to force open the pulmonary & aortic valves

A

Afterload

437
Q

Anything that increases systemic or pulmonary pressure can _____ the afterload

A

Increase (hypertension)

438
Q

Increase in after load causes a ______ in stroke volume

A

Decrease

439
Q

_______ is not a major factor in healthy subjects

A

Afterload

440
Q

Peak pressure in ventricle:

A

Systolic BP

441
Q

Pressure at which the semilunar valves open; minimum pressure in the aorta

A

Diastolic BP

442
Q

At BP of 130/90 what pressure is needed to open the semilunar valves?

A

90

443
Q

If the heart has to work harder to open the valves (increased BP for example) the will ______ and this will lead to _____

A

Grow; Left ventricular hypertrophy

444
Q

Anything that increases the afterload on the heart will lead to a ______ in SV

A

Reduction

445
Q

The ability of the heart to contract at any given resting fiber length:

A

Contractility

446
Q

The ventricles are never completely empty of blood (ejection fraction) so a more forceful contraction will:

A

Expel more blood with each pump

447
Q

Contractility is varied by controlling the amount of ____ that enters the contractile cell via ______ gated channels

A

Calcium

L type Voltage gated Ca++ channel

448
Q

Because the amount of calcium that enter the cell via the L type voltage gated calcium channels determines the contractility of the muscle this is considered what type of contraction?

A

Graded contraction

449
Q

What affects does a + inotropic agent have on contractility & ejection fraction

A

Increase in contractility
Increase in ejection fraction

450
Q

Give examples of + inotopic agents:

A

Sympathetic stimulation & epinephrine

451
Q

What affects does a - inotropic agent have on contractility & ejection fraction

A

Decrease in contractility
Decrease in ejection fraction

452
Q

Give example of - inotropic agents:

A

Beta-1 Blockers
Ca++ channel blockers

453
Q

Adrenergic effects on cardiac contractility:

A
  1. Increase force
  2. Increase speed
454
Q

Adrenergic effects on cardiac muscle contractility:

The SNS releases epi & norepi which bind to:

A

Beta-1-adrenergic receptors

455
Q

Adrenergic effects on cardiac muscle contractility:

When epi & norepi bind to beta-1-adrenergic receptors in the contractile cell membrane this activates:

A

The inactive cAMP-dependent protein kinase

456
Q

Adrenergic effects on cardiac muscle contractility:

When the cAMP-dependent protein kinase becomes activated, what affects are seen in the contractile cells (3)

A
  1. VG L-type calcium channel gets phosphorylated
  2. Myosin heads get phosphorylated
  3. Calcium-ATPase activity in SR membrane is increased (indirect)
457
Q

Adrenergic effects on cardiac muscle contractility:

Further explain the effects of the VG L-type calcium channel following phosphorylation:

A

-This increases the FDR (rate calcium ions enter cell because the probably that the channel will open is greater)

The increased FDR results in more calcium release from the SR, which leads to a greater calcium spike, more troponin bound to calcium & ultimately MORE FORCEFUL CONTRACTION

458
Q

Adrenergic effects on cardiac muscle contractility:

Further explain what happens when the myosin heads get phosphorylated by cAMP-dependent protein kinase:

A

Myosin heads get phosphorylated, causing myosin heads to cycle faster

Ultimately will GENERATE TENSION MORE QUICKLY

459
Q

What aspect of the SNS effects on contractile cells is considered the “Contractility effect”

A

Voltage-gated calcium channels getting phosphorylated causes a more forceful contraction

460
Q

Adrenergic effects on cardiac muscle contractility:

Further explain what happens to the activity of the calcium ATPase:

A

This occurs indirectly through phospholambin- when the calcium-ATPase gets phosphorylated, its activity increases therefore the rate of calcium removal from the cytosol is increased so the cell can relax faster

461
Q

Under the effects of the SNS on the contractile cells:

  1. The overall amount of tension will go up
  2. The speed of tension development will be quicker
  3. Muscle will relax more quickly

What are each of these due to?

A
  1. Due to increased amount of calcium released from SR (Contractility effects_
  2. Due to phosphorylation of myosin heads
  3. Due to increased activity of calcium-ATPase
462
Q

Starling’s Law of the heart states that:

A

Anything that increases EDV will increase SV

463
Q

Sympathetic motor neurons & epinephrine through Beta-1-receptors act on ______ to do _____

A

Atria & Ventricles
To increase BOTH HR & SV

464
Q

Parasympathetic nervous system releases acetylcholine that will bind to muscarinic receptors on the _____ that will ONLY effect:

A

Atira
HR

465
Q

Describe parasympathetic NS effects on stroke volume:

A

NO effect

466
Q

At rest the amounts of _____ > ______ meaning that at rest the heart is under ______ influence

A

Acetyolcholine>NE

Parasympathetic

467
Q

Receptors on the atria are for the influence of:

A

HR

468
Q

Receptors on the atria are for the influence of:

Receptors on the ventricles are for the influence of:

A

HR

SV

469
Q

Cardiac output is the function of ____ & _____

A

HR & SV

470
Q

What is the functional unit of cardiac muscle?

What is the functional unit of skeletal muscle?

A

Sarcomeres

471
Q

Because sarcomeres are the functional units of both skeletal & cardiac muscle, they both have a _____ relationship

A

Length/tension

472
Q

What does having a length/tension relationship mean?

A

That there is a resting fiber length where you will optimum tension

473
Q

What happens if you move away from the resting fiber length?

A

You decrease the tension that the muscle can generate

474
Q

The stimulus for cardiac muscle is _____ while the stimulus for skeletal muscle is ______

A

Intrinsic
Extrinsic

475
Q

Describe the calcium release in skeletal muscle:

Describe the calcium release in cardiac muscle:

A

100% SR

90% SR 10% ECF

476
Q

Contractile response to a single AP:

A

Muscle twitch

477
Q

Describe the muscle twitch in cardiac muscle:

A

Graded

478
Q

What is the preferred drug of choice for dysrhythmia?

A

Beta-Blockers

479
Q

Describe the effects of each on CO:

  1. Increasing sympathetic activity
  2. Increasing parasympathetic activity
  3. Increasing movement
  4. Decreasing HR
  5. Increasing resting sarcomere length
  6. Increasing BP
A
  1. Increase CO
  2. Decrease CO
  3. Increase CO
  4. Decrease CO
  5. Increase CO
  6. Decrease CO
480
Q

Explain why increasing movement would increase CO:

A

Due to skeletal muscle pump, which increases venous return, that will increase EDV & therefore increase SV

481
Q

Explain why increasing resting sarcomere length with increase CO.

What would happen if we decreased resting sarcomere length?

A

Cardiac muscle sits at a less than optimum length so by increasing resting sarcomere length we are getting closer to optimum.

Because we are already at a less than optimum length, this would move it further away from optimum

482
Q

Explain why decreasing BP would increase CO:

A

Bc BP is the afterload on the heart. Anything that will decrease the load that the heart has to contract against will increase SV.

Physiology (11 decks)

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