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KIN 335 > Cardiovascular Review > Flashcards

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 indicate?

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 Arterioles, what controls blood flow to capillary beds?

A
  • Smooth muscle fibers
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8
Q

What makes fluid flow in and out 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 = (radius)
    R proportional to 1/(deltar^4)
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10
Q

What controls the diameter of a capillary?

A
  • Precapillary sphincter

The precapillary sphincter consists of a ring
of smooth muscle that encircles the capillary
at its origin and controls its diameter

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11
Q

What provides a means for capillary 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 do the superior and inferior vena cava dump into the Right Atrium?

A
  • Mixed-venous blood
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21
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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22
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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23
Q

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

A
  • Relates to total area in the section
  • less area = more resistance = higher BP
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24
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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25
Q

How do alternating muscle contraction/relaxation affect the blood?

A

propels blood through the vascular circuit back to the heart

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26
Q

What happens to blood flow and systolic bp during first few minutes of steady-rate exercise?

A

rapid increase

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27
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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28
Q

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

A
  • Remains relatively unchanged
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29
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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30
Q

What happens to diastolic blood pressure with increasing exercise intensity?

A
  • Remains stable
  • or Decreases slightly at higher levels
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31
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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32
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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33
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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34
Q

How long can the hypotensive response to exercise last?

A
  • 12 Hrs
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35
Q

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

A
  • 70-80%
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36
Q

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

A
  • Increase coronary blood flow
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37
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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38
Q

What does RPP stand for?

A
  • Rate-Pressure Product
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39
Q

What is Rate-Pressure Product?

A
  • Estimate of myocardial workload and VO2
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40
Q

How is the RPP computed?

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

SBP x HR

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41
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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42
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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43
Q

What does cardiac muscle do that other tissue does not?

A
  • Has its own rhythm
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44
Q

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

A

100b/min

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45
Q

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

A

Heart’s Pacemaker
- provides Innate stimulus of heat action

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46
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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47
Q

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

A
  • Nerves that directly supply myocardium
  • Chemical “messengers” in blood
48
Q

Where is the cardiovascular control center?

A
  • Ventrolateral medulla
49
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
50
Q

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

A
  • Higher brain areas (central command) input to ventrolateral medulla
51
Q

What are the receptors to ventrolateral medulla?

A
  • Aortic and Carotid Arterial Mechano-receptors
  • Cardiac Mechano-receptors
  • Skeletal Muscle Ergoreceptors
52
Q

What do aortic and carotid arterial mechano-receptors trigger?

A
  • arterial baroreflexes
53
Q

What do cardiac mechanoreceptors trigger?

A
  • Cardiopulmonary reflexes
54
Q

What do skeletal muscle ergoreceptors trigger?

A
  • Exercise pressor reflex
55
Q

What does the ventrolateral medulla regulate?

A

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

56
Q

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

A
  • Maintain central blood volume/pressure
57
Q

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

A
  • Overrides it
58
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

59
Q

What innervates the atria from the cardiovascular center?

A
  • Sympathetic and Parasympathetic neurons
60
Q

What innervates the ventricles from the cardiovascular center?

A
  • Almost exclusively sympathetic fibers
61
Q

Where do Parasympathetic nerve endings concentrate in the heart?

A
  • Atria, including SA and Av nodes
62
Q

Where do sympathetic nerve endings concentrate in the heart?

A
  • SA and AV node
  • Muscle of atria
  • Ventricles
63
Q

What does stimulation of sympathetic cardioaccelerator nerves release?

A
  • Epinephrine
  • Norepinephrine
64
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
65
Q

What is the chronotropic effect on the heart?

A
  • SA node Depolarization
  • Increase HR
66
Q

What is the Inotropic effect on the heart?

A
  • Increased myocardial contractility
67
Q

Where does sympathetic stimulationg produce vasoconstriction?

A
  • Generalized
  • Except coronary arteries
68
Q

Why does sympathetic stimulation cause generalized vasoconstriction?

A
  • ## Norepinephrin, released by adrenergic fibers, acts as vasoconstrictor
69
Q

What does Adrenergic mean?

A
  • Epinephrin/norepinephrin neurotransmitter
70
Q

When does dilation of blood vessels under adrenergic influences occur?

A
  • Decreased adrenergic activity
71
Q

What do parasympathetic neurons release?

A
  • Acetylcholine
72
Q

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

A
  • Delays rate of sinus discharge
  • Slows HR
73
Q

What is bradycardia?

A
  • slower than normal HR
74
Q

which nerve is responsible for bradycardia?

A
  • Stimulation of Vagus Nerve from medulla’s cardioinhibitory center
75
Q

Does Parasympathetic stimulation excite or inhibit tissues?

A
  • Excites some
  • Inhibits others
76
Q

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

A
  • Inhibition of parasympathetic stimulation
77
Q

How does HR increase further during strenous exercise?

A
  • Additional parasympathetic inhibition
  • Direct activation of sympathetic cardioaccelerator nerves
78
Q

What continually modulates medullary activity?

A
  • Impulses originating in brain’s higher somatomotor central command center
79
Q

What provides the greatest control over HR during exercise?

A
  • Central Command
80
Q

What causes the heart rapidly turning on during exercise?

A
  • decreasing parasympathetic inhibitory input
  • Increasing stimulus input from central command
81
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

82
Q

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

A
  • Blood Vessels
  • Joints
  • Muscles
83
Q

What do chemoreceptors and mechanoreceptors within muscle and vasculature monitor?

A
  • Chemical physical state
84
Q

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

A
  • Modify parasympathetic/sympathetic outflow to provide appropriate cardio/respiratory response to various intensitites of physical activity
85
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 III afferents within active muscles
  • Chemical stimulation of Type IV afferents within muscles
  • Feed-forward outflow from motor areas of central command
86
Q

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

A
  • Specific Mechanoreceptor Feedback
87
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 in the aortic arch and carotid sinus
  • Cardiopulmonary Receptors
    -assess mechanical activity in the left ventricle, right atrium, and large veins
88
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
89
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

90
Q

Which three factors influence resistance?

resistance is caused by friction between blood and internal vascular wall

A
  • Blood thickness (viscosity)
  • Length of conducting tube
  • Blood Vessel radius
91
Q

What does Poiseulle’s Law express?

A
  • relationship among pressure differential, resistance, and flow
92
Q

What does Flow equal?
(Poiseuille’s Law)

A

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

93
Q

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

A
  • Remains Constant
94
Q

Which factors of Poiseuille’s law affect blood flow the most

A
  • small variation in blood viscosity
  • The transport vessel length remains constant
  • Radius change has greatest impact
95
Q

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

A
  • Constriction and dilation
96
Q

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

A
  • rapid adjustments
97
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

98
Q

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

A
  • Increase sympathetic nervous system outflow
  • Local chemicals that directly stimulate vasoconstriction or enhance effects of other vasoconstrictors
99
Q

How does skeletal muscle blood flow relate to metabolic demands?

A
  • Closely coupled
100
Q

Which 2 mechanisms allow skeletal muscle blood flow to closely couple metabolic demand?

A
  • neural vasoconstriction activity
  • locally derived vasoactive substances within endothelium and red blood cells
101
Q

How many muscle capillaries remain open at rest?

A
  • 1 in 30-40
102
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
103
Q

Where do local factors related to tissue metabolism act directly for vasodilation to occur?

A
  • smooth muscle bands of small arterioles
  • precapillary sphincters
104
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
105
Q

How can the venous system increase local blood flow?

A
  • “assessing” increases in metabolic needs of active muscle
  • Releasing vasodilatory factors in response
106
Q

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

A

Signal molecule
- dilates blood vessels
- decreases vascular resistance

107
Q

What provokes Nitric Oxide synthesis in vascular endothelium?

A

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

108
Q

What happens to the vascular endothelium in Congenital Heart Defects?

A
  • less production of Nitric Oxide
109
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

110
Q

What do drugs like Viagra and Nitroglycerin do?

A
  • Cause Vasodilation by stimulating NO gas release
111
Q

When does vasodilation occur from NO release?

A
  • When NO penetrates smooth muscle cells
112
Q

What does MAP stand for?

A
  • mean arterial pressure
  • average arterial pressure during a cardiac cycle
113
Q

What is the Equation for MAP?

A

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

114
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

TPR = total peripheral resistance

115
Q

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

A
  • O2 Transport
  • Perfusion Pressure

KIN 335 (14 decks)

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