Cardiovascular Review Flashcards

1
Q

What does the Systolic Blood Pressure Estimate?

A
  • Work of Heart
  • Force Blood exerts against arterial walls during systole
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2
Q

What does Diastolic Blood Pressure indicated?

A
  • Peripheral resistance
  • Ease blood flows from arterioles in capillaries
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3
Q

When does Diastolic Blood Pressure occur?

A
  • Relaxation phase of cardiac cycle
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4
Q

What is the mean arterial pressure?

A
  • average force exerted by blood against wall during cardiac cycle
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5
Q

Describe structure of veins

A
  • Smooth Muscle Layer
  • One-way valves prevent back-flow of blood
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6
Q

Describe structure of arteries

A
  • Walls contain elastic fibers/muscle fibers
  • Smooth muscle layer
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7
Q

In Arteries, what controls blood flow to capillary beds?

A
  • Smooth muscle fibers
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8
Q

Describe function of capillaries

A
  • Blood pressure forces fluid from capillary
  • Osmotic pressure within capillaries draws fluid back in
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9
Q

How is resistance proportional to the radius of a vessel?

A
  • Inversely proportional to fourth power
  • R = flow resistence
  • R = r (radius)
  • 16R = 1/2 r
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10
Q

What controls the diameter of a capillary?

A
  • Precapillary sphincter
  • ring smooth muscle
  • encircles the capillary at origin
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11
Q

What provides a means for blood flow regulation within a specific tissue?

A
  • Sphincter constriction
  • Sphincter relaxation
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12
Q

What two factors trigger precapillary sphincter relaxation to open more capillaries?

A
  • Driving force of increased local BP plus intrinsic neural control
  • Local metabolites produced in exercise
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13
Q

What do capillaries feed into small veins or venules?

A
  • Deoxygenated blood
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14
Q

What do veins in the lower body eventually empty into?

A
  • Inferior Vena Cava
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15
Q

What is the body’s largest vein?

A
  • Inferior Vena Cava
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16
Q

Where does the Vena Cave return blood to?

A
  • Right atrium
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17
Q

Where does the Inferior Vena Cave return blood from?

A
  • Abdomen
  • Pelvis
  • Lower Extremities
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18
Q

Where does blood from vessels in the head, neck, shoulders, thorax and abdominal wall flow into?

A
  • Superior Vena Cava
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19
Q

Where do the superior and inferior vena cava’s join?

A
  • The Heart
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20
Q

What enters the Right Atrium?

A
  • Mixed-venous blood
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21
Q

What prevents blood from flowing in 2 directs in veins?

A
  • One-way Valves
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22
Q

How does blood travel in veins against gravity?

A
  • One-way valve
  • Small muscular contractions
  • pressure changes in thoracic cavity with breathing
  • Milking propels blood back to heart
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23
Q

What would happen if their were no valves in veins?

A
  • Blood would stagnate in extremities
  • People would faint when standing
  • Reduced venous return
  • Diminished cerbral blood flow
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24
Q

How is blood pressure within different portions of the arterial system determined?

A
  • Relates to total area in the section
  • Resistance
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25
Q

What reduces total peripheral resistance during rhythmic muscle activity? Why?

A

What
- Vasodilation in active muscles
Why
- Enhance blood flow through peripheral vasculature

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26
Q

What propels blood through the vascular circuit back to the heart?

A
  • Alternate muscle contraction/relaxation
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27
Q

What does increasing blood flow during steady-rate exercise rapidly do? when does it happen?

A
  • Increases systolic blood pressure
  • First few minutes
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28
Q

What happens to Systolic Blood Pressure as steady-rate exercise continues? Why?

A

What
- Declines
Why
- Arterioles in active muscles continue to dilate reducing peripheral resistance

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29
Q

What happens to diastolic bllod pressure during steady-rate exercise?

A
  • Remains relatively unchanged
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30
Q

How does systolic blood pressure change with increasing exercise intensity?

A

After initial rapid rise from resting
- Increases linearly wiht intensity

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31
Q

What happens to diastolic blood pressure with increasing exercise intensity?

A
  • Remains stable
  • or Decreases slightly at higher levels
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32
Q

How high might systolic blood pressure increase in healthy individuals during maximum exercise? why?

A

How high:
- 200mm Hg
Why:
- Likely due to large cardiac output

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33
Q

What type of exercise produces higher SBP and DBP at a given VO2max, leg or arm exercise? Why?

A

What
- Arm
Why
-smaller arm muscle mass/vasculature offer greater resistance to blood flow

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34
Q

What happens following a single bout of submaximal exercise for normotensive and hypertensive individuals?

A
  • BP temporarily falls below pre-exercise levels
  • Likely due to unexplained peripheral vasodilation
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35
Q

How long can the hypotensive response to exercise last?

A
  • 12 Hrs
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36
Q

How much O2 does the myocardium extract in the coronary vessels?

A
  • 70-80%
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37
Q

What is the sole mechanism for increasing myocardial O2 supply during exercise?

A
  • Increase coronary blood flow
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38
Q

What two factors increase myocardial blood flow?

A
  • Elevated myocardial metabolism dilates coronary vessels
  • Increased aortic pressure during exercise forces a proportionately greater volume of blood into coronary circulation
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39
Q

What does RPP stand for?

A
  • Rate-Pressure Product
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40
Q

What is Rate-Pressure Product?

A
  • Estimate of myocardial workload and VO2
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41
Q

How is the RPP computed?

A
  • from product of peak SBP measured at brachial artery and HR
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42
Q

What is the Equation for RPP?

A

RPP = SBP x HR

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43
Q

What is the Rate-Pressure Product an index of? explain it

A

What
- Relative Cardiac Work
Explain
- Relates closely to directly measured myocardial VO2 and coronary blood flow in healthy subjects over a wide range of exercise intensities

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44
Q

What does RPP range from? what does it depend on?

A
  • 6000 at rest
  • > 40000 during exercise
  • Depends on intensity/mode
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45
Q

What does cardiac muscle do that other tissue does not?

A
  • Has its own rhythm
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46
Q

At what rate would the heart beat at if left to its own inherent rhythmicity?

A

100b/min

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47
Q

What is the sinoatrial (SA) node’s purpose?

A

Heart’s Pacemaker
- provides Innate stimulus of heat action

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48
Q

What accelerates the heart in anticipation before exercise?

A
  • Nerves that directly supply myocardium
  • chemical “messangers” that circulate in blood
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49
Q

What adjusts to the intensity of physical effort for heart rate?

A
  • Nerves that directly supply myocardium
  • Chemical “messengers” in blood
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50
Q

Where is the cardiovascular control center?

A
  • Ventrolateral medulla
51
Q

What regulates the heart’s output of blood and blood’s preferential distribution to all body’s tissues?

A
  • Input from the brain and peripheral nervous system bombard cardiovascular control center in ventrolateral medulla
52
Q

What are the neural mechanisms for cardiovascular regulation before and during activity?

A
  • Higher brain areas (central command) input to ventrolateral medulla
53
Q

What are the receptors to ventrolateral medulla?

A
  • Aortic and Carotid Arterial Mechano-receptors
  • Cardiac Mechano-receptors
  • Skeletal Muscle Ergoreceptors
54
Q

What do aortic and carotid arterial mechano-receptors read?

A
  • arterial baroreflexes
55
Q

What do cardiac mechanoreceptors read?

A
  • Cardiopulmonary reflexes
56
Q

What do skeletal muscle ergoreceptors read?

A
  • Exercise pressor reflex
57
Q

What are the functions of ventrolateral medulla?

A

Cardiovascular Center
- Heart chronotropic, inotropic function
- Active Skeletal Muscle: Modulation of vasomotor tune
- Inactive Skeletal Muscle: Muscle Vasoconstriction
- Kidney and Splenic Bed Vasoconstriction

58
Q

What does muscle vasoconstriction of inactive skeletal muscle by the ventrolateral medulla do?

A
  • Maintain central blood volume/pressure
59
Q

What does neural influence do to myocardium’s inherent rhythm?

A
  • Overrides it
60
Q

Where does neural input originate from and what does it flow through?

A

From
- Cardiovascular Center
Through
- Sympathetic/Parasympathetic components of autonomic nervous system

61
Q

What innervates the atria from the cardiovascular center?

A
  • Sympathetic and Parasympathetic neurons
62
Q

What innervates the ventricles from the cardiovascular center?

A
  • Almost exclusively sympathetic fibers
63
Q

Where do Parasympathetic nerve endings concentrate in the heart?

A
  • Atria, including SA and Av nodes
64
Q

Where do sympathetic nerve endings concentrate in the heart?

A
  • SA and AV node
  • Muscle of atria
  • Ventricles
65
Q

What does stimulation of sympathetic cardioaccelerator nerves release?

A
  • Epinephrine
  • Norepinephrine
66
Q

What does the release of epinephrine and norepinephrine from the stimulation of sympathetic cardioaccelerator nerves do?

A
  • Causes chronotropic and inotropic effects on heart
67
Q

What is the chronotropic effect on the heart?

A
  • SA node Depolarization
  • Increase HR
68
Q

What is the Inotropic effect on the heart?

A
  • Increased myocardial contractility
69
Q

Where does sympathetic stimulationg produce vasoconstriction?

A
  • Generalized
  • Except coronary arteries
70
Q

Why does sympathetic stimulation cause generalized vasoconstriction?

A
  • ## Norepinephrin, released by adrenergic fibers, acts as vasoconstrictor
71
Q

What does Adrenergic mean?

A
  • Epinephrin/norepinephrin neurotransmitter
72
Q

Why does dilation of blood vessels under adrenergic influences occur?

A
  • Decreased adrenergic activity
73
Q

What do parasympathetic neurons release?

A
  • Acetylcholine
74
Q

What does the release of acetylcholine from parasympathetic neurons do in the heart?

A
  • Delays rate of sinus discharge
  • Slows HR
75
Q

What is bradycardia?

A
  • slower than normal HR
76
Q

What does Bradycardia result from?

A
  • Stimulation of Vagus Nerve from medulla’s cardioinhibitory center
77
Q

Does Parasympathetic stimulation excite or inhibit tissues?

A
  • Excites some
  • Inhibits others
78
Q

What is the main reason for HR increase at the start and during low/moderate exerise?

A
  • Inhibition of parasympathetic stimulation
79
Q

How does HR increase further during strenous exercise?

A
  • Additional parasympathetic inhibition
  • Direct activation of sympathetic cardioaccelerator nerves
80
Q

What continually modulates medullary activity?

A
  • Impulses originating in brain’s higher somatomotor central command center
81
Q

What provides the greatest control over HR during exercise?

A
  • Central Command
82
Q

What causes the heart rapidly turning on during exercise?

A
  • decreasing parasympathetic inhibitory input
  • Increasing stimulus input from central command
83
Q

What explains how emotional state can effect cardiovascular response? What difficulty does this create?

A

Explains
- Central command of cardiovascular regulation
Difficulty
- Obtaining true resting values of HR and BP

84
Q

What must the cardiovascular center receive?

A
  • Reflex sensory input from peripheral receptors
85
Q

Where are the reflex sensory input from peripheral receptors that send info to the cardiovascular center?

A
  • Blood Vessels
  • Joints
  • Muscles
86
Q

What do chemoreceptors and mechanoreceptors within muscle and vasculature monitor?

A
  • Chemical physical state
87
Q

What do chemoreceptors and mechanoreceptors within muscle and vasculator that monitor chemical physical states do?

A
  • Modify parasympathetic/sympathetic outflow to provide appropriate cardio/respiratory response to various intensitites of physical activity
88
Q

What three mechanisms continually assess the nature and intensity of exercise and muscle mass activation?

A
  • Reflex neural input from mechanical deformation of Type II afferents within active muscles
  • Chemical stimulation of Type IV afferents within muscles
  • Feed-forward outflow from motor areas of central command
89
Q

What govens central nervous system’s regulation of blood flow and BP during dynamic execise?

A
  • Specific Mechanoreceptor Feedback
90
Q

What are the specific mechanoreceptors that govern the central nervous system’s regulation of blood flow and BP during dynamic exercise?

A
  • Pressure-sensitive baroreceptors
  • Cardiopulmonary Receptors
91
Q

Where are the pressure-sensitive baroreceptors that govern the central nervous system’s regulation of blood flow and BP during dynamic exercise?

A
  • Aortic Arch
  • Carotid Sinus
92
Q

What do the cardiopulmonary receptors that govern the central nervous system’s regulation of blood flow and BP during dynamic exercise do?

A
  • Assess mechanical activity in left ventricle, right atrium, and large veins
93
Q

How does peripheral input function as a negative feedback controller to regulate BP?

A
  • Inhibit sympathetic outflow from cardiovascular center
  • Blunt inordinate rise in arterial BP
94
Q

What physical law does blood flowing through a vascular circuit follow?

A
  • Hydrodynamics applied to rigid, cylindrical vessels
95
Q

What are the two factors that relate to the volume of flow?

A

Volume is:
- directly related to pressure gradient between two ends of the vessel
- inversely related to resistance encountered to fluid flow

96
Q

What creates resistance in blood vessels that impedes blood flow?

A
  • Friction between blood and internal vascular wall
97
Q

What three factors influence resistance?

A
  • Blood thickness (viscosity)
  • Length of conducting tube
  • Blood Vessel radius
98
Q

What does Poiseulle’s Law express?

A
  • relationship among pressure differential, resistance, and flow
99
Q

What does Flow equal?

A

Flow = pressure gradient x vessel radius^4 / (vessel length x fluid viscosity)

100
Q

What is true about vessel length in Poiseuille’s Law?

A
  • Remains Constant
101
Q

Explain how blood flow changes

A
  • small variation in blood viscosity
  • Radius change has greatest impact
102
Q

How does blood flow change the most with change in radius?

A
  • Constriction and dilation
103
Q

What type of arteries provide mechanisms to regulate blood flow?

A
  • Small arterial blood vessels
  • constriction and dilation
104
Q

What do any increases in energy expenditure require from blood flow?

A
  • rapid adjustments
105
Q

What happens to local arterioles of active muscles during exrcise? what about vessels of tissues that could compromise blood supply?

A

Active muscles
- Dilate
Unnessary Tissues
- Constrict

106
Q

What two factors reduce blood flow to non-active tissues?

A
  • Increase sympathetic nervouse system outflow
  • Local chemicals that directly stimulate vasoconstriction or enhance effects of other vasoconstrictors
107
Q

How does skeletal muscle blood flow relate to metabolic demands?

A
  • Closely coupled
108
Q

How does skeletal muscle blood flow closely couple metabolic demand?

A
  • nerual vasoconstriction activity
  • locally derived vasoactive substances within endothelium and red blood cells
109
Q

How many muscle capillaries remain open at rest?

A
  • 1 in 30-40
110
Q

What does the opening of dormant capillaries in exercise do?

A
  • Increases total muscle blood flow
  • Delivers large blood volume, only minimal change in blood flow velocity
  • Increases effective surface for gas and nutrient exchange
111
Q

What do local factors related to tissue metabolism act directly on for vasodilation occurs?

A
  • smooth muscle bands of small arterioles
  • precapillary sphincters
112
Q

What are some examples of factors within active muscles that regulate vasodilation?

A
  • decreased tissue oxygen
  • local increase in blood flow
  • temperature
  • carbon dioxide
  • acidity
  • adenosine
  • magnesium
  • potassium
  • nitric oxide produced by endothelial cells lining blood vessels
113
Q

How can the venous system increase local blood flow?

A
  • “assessing” increases in metabolic needs of active muscle
  • Releasing vasodilatory factors
114
Q

What does nitric oxide serve as for blood? what does it do?

A

Signal molecule
- dilates blood vessels
- decreases vascular resistance

115
Q

What provokes Nitric Oxide synthesis in vascular endothelium?

A

Increased blood flow through vessel lumen
- Signal Chemicals
- Sheering stress
- vessel stretch

116
Q

What happens to the vascular endothelium in Congenital Heart Defects?

A
  • No production of Nitric Oxide
117
Q

What does the release of nitric oxide from vasculare endothelial cells do for local blood flow?

A

Initiates Cascade of Events:
- Attenuate sympathetic vasoconstriciton
- induce arterial smooth muscle relaxation
- increase blood flow

118
Q

What do drugs like Viagra and Nitroglycerin do?

A
  • Cause Vasodilation by stimulating NO gas release
119
Q

When does vasodilation occur from NO release?

A
  • When NO penetrates smooth muscle cells
120
Q

What does MAP stand for?

A
  • mean arterial pressure
  • average arterial pressure during a cardiac cycle
121
Q

What is the Equation for MAP?

A

MAP = DBP + [0.33 (SBP - DBP)]

122
Q

What do MAP and Cardiac Output estimate?

A
  • change in total resistance to blood flow in the transition from rest to exercise
  • TPR = MAP/Q
123
Q

What are the net effects of local metabolic-induced vasodilation vs. sympathetically induced vasoconstriction?

A
  • O2 Transport
  • Perfusion Pressure