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HPP 2 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

Cardiology

A

scientific study of the heart and the treatment of its disorders

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2
Q

cardiovascular system

A

heart and blood vessels

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3
Q

Circulatory system

A

heart, blood vessels, and the blood

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4
Q

Two major circuits of the circulatory system

A

systemic circuit
pulmonary circuit

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5
Q

Systemic circuit

A

left side of the heart
takes blood from heart to the body
fully oxygenated blood arrives from lungs via pulmonary veins
blood is sent to all organs of the body via aorta

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6
Q

pulmonary circuit

A

right side of the heart
takes blood from the heart to the lungs for gas exchange and back to heart
lesser oxygenated blood arrives from inferior and superior vena cava
blood is sent to lungs via pulmonary trunk

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7
Q

vena cava

A

largest vein in the body

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8
Q

pulmonary trunk

A

main pulmonary artery
diverged to left and right pulmonary arteries

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9
Q

Position of the heart

A

mediastinum, between lungs

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10
Q

base of the heart

A

wide, superior portion, where the blood vessels attached

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11
Q

apex of the heart

A

inferior end, tilts to the left, tapers to point

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12
Q

size of the heart

A

3.5 in wide at base
5 in from base to apex
2.5 in anterior to posterior

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13
Q

weight of heart

A

10 oz

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14
Q

Pericardium

A

double-walled sac that encloses the heart
allows heart to beat w/o friction, provides room to expand but not excessive
anchored to diaphragm inferiority and sternum anteriorly

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15
Q

Pericardial cavity

A

space inside the pericardial sac filled with 5-30 mL of pericardial fluid

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16
Q

pericarditis

A

inflammation of the membranes
painful friction rub with each heart beat

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17
Q

What makes up the heart wall?

A

Epicardium, endocardium, and myocardium

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18
Q

Epicardium

A

serous membrane covering heart
adipose in thick layer in some places
coronary blood vessels travel through this layer

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19
Q

Endocardium

A

smooth inner lining of heart and blood vessels
coverts the valve surfaces and continuous with endothelium of blood vessels

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20
Q

myocardium

A

layer of cardiac muscle proportional to work load
fibrous skeleton of the heart

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21
Q

In the myocardium there is a layer of cardiac muscle that spirals around the heart and produces what kind of motion?

A

A wringing motion

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22
Q

In the myocardium there is a fibrous skeleton, what does it do?

A

framework of collagenous and elastic fibers
provides structural support and attachment for cardiac muscle and anchor for valve tissue
electrical insulation between atria and ventricles important in timing and coordination of contractile activity

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23
Q

What are the 4 chambers of the heart?

A

Right atrium
left atrium
right ventricle
left ventricle

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24
Q

Which are the two superior chambers that receive blood returning to heart?

A

Right and left atrium

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25
Q

What do the left and right atriums have that slightly increase its volume

A

auricle

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26
Q

What are the 2 inferior chambers that pump blood into arteries?

A

right and left ventricle

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27
Q

Interatrial septum

A

wall that separates the atria

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28
Q

Interventricular septum

A

muscular wall that separates ventricles

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29
Q

Atrioventricular (AV) valves

A

controls blood flow between atria and ventricles
right and left

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30
Q

Semilunar valves

A

control flow into great arteries
open and closed because of blood flow and pressure

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31
Q

Right AV valve

A

3 cusps (tricuspid valve)

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32
Q

Left AV valve

A

2 cusps (mitral/bicuspid valve)
has chordate tendinae
prevent av valves from flipping inside out/bulging into the atria when the ventricles contract

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33
Q

Chordae tendinae

A

cords in the left AV valve that connects the AV valves to papillary muscles on floor of ventricles

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34
Q

pulmonary semilunar valve

A

in opening between right ventricle and pulmonary trunk

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35
Q

aortic semilunar valve

A

opening between left ventricle and aorta

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36
Q

When ventricles relax what happens?

A

pressure drops inside the ventricles
semilunar valves close as blood attempts to back up into the ventricles from the vessels
AV valves open
blood flows from atria to ventricles

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37
Q

When ventricles contract what happens?

A

AV valves close as blood attempts to back up into the atria
pressure rises inside the ventricles
semilunar valves open and blood flows into great vessels

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38
Q

Blood flow through the heart

A
  1. blood enters right atrium from superior and inferior venae cavae
  2. blood in right atrium flows through right AV valve into right ventricle
  3. contraction of right ventricle forces pulmonary valve open
  4. blood flows through pulmonary valve into pulmonary trunk
  5. blood is distributed by right and left pulmonary arteries to the lungs, where it unloads CO2 and loads O2
  6. blood returns from lungs via pulmonary veins to left atrium
  7. blood in left atrium flows through left AV valve into left ventricle
  8. contraction of left ventricle forces aortic valve open
  9. blood flows through aortic valve into ascending aorta
  10. blood in aorta is distributed to every organ in the body where it unloads O2 and loads CO2
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39
Q

Systemic Circulation

A

blood circulation from heart to the body and back again

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40
Q

Pulmonary Circulation

A

blood circulation from the heart to the lungs and back again

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41
Q

What percentage of blood pumped by the heart is pumped to itself?

A

5%

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42
Q

How much blood is pumped by the heart to itself per minute?

A

250 mL

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43
Q

Why is blood flow to the heart slowed during ventricular contraction?

A
  1. contraction of the myocardium compresses the coronary arteries and obstructs blood flow
  2. opening of aortic valve flap during ventricular systole covers the openings to the coronary arteries blocking blood flow into them
  3. during ventricular diastole, blood in the aorta surges back to the heart and into the openings of the coronary arteries
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44
Q

Blood flow to the myocardium during ventricular relaxation x?

A

increases

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45
Q

Aortae

A

largest artery

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46
Q

Venules

A

smallest veins

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47
Q

Venae Cavae

A

the largest veins

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48
Q

myocardial infarction

A

heart attack; complete blockage of blood supply
interruption of blood supply to the heart from a blood clot/fatty deposit can cause death of cardiac cells within minutes
results in long-term obstruction of coronary circulations
responsible for about half of all deaths in the united states

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49
Q

How is some protection from myocardial infarction given?

A

arterial anastomoses which provide an alternative route of blood flow known as collateral circulation

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50
Q

Atheroma

A

blood clot/fatty deposit that obstructs coronary arteries

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51
Q

In myocardial infarction cardiac muscle down stream of the blockage

A

dies

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52
Q

What is a symptom of myocardial infarction?

A

heavy pressure/squeezing pain radiating to the left arm

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53
Q

Some painless heart attacks may disrupt x, lead to fibrillation and cardiac arrest

A

electrical conduction pathways

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54
Q

Which population experiences silent heart attacks?

A

Diabetics
Elderly

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55
Q

Angina Pectoris

A

chest pain from partial obstruction of coronary blood flow
pain caused by ischemia of cardiac muscle
obstruction partially blocks blood flow
myocardium shifts to anaerobic fermentation producing lactic acid stimulating pain

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56
Q

Anastomosis

A

connection that is created between tubular structures, such as blood vessels or loops of intestine

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57
Q

cardiocyte structure

A

striated, short, thick, branched cells, one central nucleus surrounded by light staining mass of glycogen

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58
Q

intercalated discs

A

join cardiocytes end to end

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59
Q

interdigitating folds

A

folds interlock with each other, and increase surface area of contact

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60
Q

mechanical junctions

A

tightly join cardiocytes

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61
Q

fascia adherens

A

broad band in which the actin of the thin myofilaments is anchored to the plasma membrane
each cell is linked to the next via transmembrane proteins

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62
Q

desmosomes

A

weldlike mechanical junctions between cells
prevents cardiocytes from being pulled apart

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63
Q

electrical junction- gap junctions

A

allows ions to flow between cells- can stimulate neighbors
entire myocardium of either 2 atria or 2 ventricles acts like single unified cell

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64
Q

How is damaged cardiac muscle repaired?

A

fibrosis

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65
Q

What does cardiac muscle depend on to make ATP?

A

aerobic respiration

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66
Q

The cardiac muscle is rich in x and y and has huge z.

A

myoglobin and glycogen
mitochondria that fill 25% of the cell

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67
Q

What organic fuels does the heart use?

A

60% fatty acids
35% glucose
5% ketones, lactic acid, and amino acids

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68
Q

Cardiac muscle is fatigue resistant because it makes little use of ?

A

anaerobic fermentation or oxygen debt mechanisms

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69
Q

ischemia

A

deficient supply of blood to a body part that is due to obstruction of the inflow of arterial blood

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70
Q

The cardiac conduction system coordinates the heartbeat. How does it do this?

A

internal pacemaker and nerve-like conduction pathways through myocardium
generates and conducts rhythmic electrical signals

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71
Q

sinoartrial node

A

modified cardiocytes
initiates each heartbeat and determines heart rate
signals spread throughout atria
pacemaker in right atrium near base of superior vena cava

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72
Q

atrioventricular node

A

located near the right AV valve at lower end of interatrial septum
electrical gateway to the ventricles
fibrous skeleton acts as an insulator to prevent currents from getting to the ventricles from any other route

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73
Q

atrioventricular bundle

A

bundle forks into right and left bundle branches
branches pass through inter ventricular septum toward apex

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74
Q

purkinje fibers

A

nerve like processes spread throughout ventricular myocardium

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75
Q

How do signals pass from cell to cell in the cardiac conduction system?

A

gap junctions

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76
Q

Cardiac Conduction system general process

A
  1. SA node fires
  2. excitation spreads through atrial myocardium
  3. AV node fires
  4. Excitation spreads down AV bundle
  5. subendocardial conducting network distributes excitation through ventricular myocardium
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77
Q

Sympathetic nerves in the heart

A

raise heart rate and contraction strength
dilates coronary arteries to increase myocardial blood flow
is in the lower cervical to upper thoracic segments of the spine
continues to adjacent sympathetic chain ganglia
some pass through cardiac plexus in mediastinum
continue as cardiac nerves to the heart
fibers terminate in SA and AV nodes, in atrial and ventricular myocardium, as well as the aorta, pulmonary trunk, and coronary arteries

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78
Q

Parasympathetic nerves in the heart

A

slow heart rate
pathway starts with nuclei of vagus nerves in medulla oblongata
extend to cardiac plexus and continue to the heart by way of cardiac nerves
fibers of right vagus -> SA node
fibers of left vagus -> AV node
little/no vagal stimulation of myocardium

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79
Q

systole

A

atrial/ventricular contraction
pushes blood out of the heart into the large vessels of the circulatory system, blood pressure increases

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80
Q

diastole

A

atrial/ventricular relaxation
chambers of the blood fill with blood, blood pressure decreases

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81
Q

sinus rhythm

A

normal heartbeat triggered by the SA node
set by the SA node at 60-100 bpm
adults at rest is 70-80 bpm (vagal tone)

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82
Q

ectopic focus

A

another part of heart fires before SA node
spontaneous
caused by hypoxia, electrolyte imbalance, caffeine, nicotine, or other drugs

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83
Q

nodal rhythm

A

if SA node is damaged, heart rate is set by AV node, 40-50bpm

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84
Q

intrinsic ventricular rhythm

A

if both SA and AV nodes are not function, rate set at 20-40 bpm
requires a pacemaker to sustain life

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85
Q

arrhythmia

A

any abnormal cardiac rhythm
failure of conduction system to transmit signals (heart block)
bundle branch block
total heart block (damage to AV node)

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86
Q

atrial flutter

A

ectopic foci in atria
atrial fibrillation
atria beat 200-400 times per minute -> type of tachycardia

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87
Q

premature ventricular contractions

A

extra heartbeats that start in ventricles
caused by stimulants, stress, or lack of sleep

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88
Q

ventricular fibrillation

A

serious arrhythmia caused by electrical signals reaching different regions at widely different times; heart can’t pump blood and no coronary perfusion
kills quickly if not stoped

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89
Q

defibrillation

A

strong electrical shock whose intent is to depolarize the entire myocardium, stop the fibrillation, and reset SA nodes to sinus rhythm

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90
Q

ectopic foci

A

region of spontaneous firing from some part of the heart that is not the SA node

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91
Q

Does the SA node have a stable resting membrane potential?

A

no

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92
Q

What is the starting potential of the SA node?

A

-60 mV, drifts upward with an inflow of sodium

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93
Q

Gradual depolarization of the SA node is called

A

pacemaker potential

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94
Q

pacemaker potential

A

slow inflow of sodium ions without a compensating outflow of potassium

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95
Q

In SA node potentials, when -40mV is reached what opens?

A

voltage gated calcium and sodium channels open

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96
Q

Faster depolarization occurs at which voltage?

A

0 mV

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97
Q

Repolarization of the SA node opens what kind of channels?

A

Potassium

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98
Q

When does pacemaker potential start over?

A

When potassium channels close

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99
Q

Each depolarization of the SA node sets off how many heart beats?

A

1

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100
Q

How often does the SA node fire at rest?

A

every 0.8 seconds/75bpm

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101
Q

The SA node is the cardiovascular system’s?

A

pacemaker

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102
Q

Signal from the SA node stimulates 2 what to contract almost simulataneously?

A

atria

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103
Q

After contraction of the atria by the SA node, how long does it take the signal to reach the AV node?

A

50 milliseconds

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104
Q

Once the signal from the SA node reaches the AV node it slows down. Why?

A

thin cardiocytes have fewer gap junction
delays signal 100 milliseconds which allows the ventricles to fill with blood prior to the contraction

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105
Q

The signal from the SA node reaches the AV bundle and Purkinje fibers which causes the entire ventricular myocardium to ?

A

depolarize and contract in near unison

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106
Q

What is the stable resting potential of cardiocytes?

A

-90 mV

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107
Q

Electrical behavior of myocardium process

A
  1. Voltage gated sodium channels open
  2. sodium inflow depolarizes membrane, positive feedback cycle opens more sodium channels and incr membrane voltage
  3. sodium channels close when cell depolarizes, voltage peaks at 30mV
  4. calcium from calcium channels prolongs depolarization and creates a plateau that falls slightly because of potassium leakage
  5. calcium channels close, potassium channels open, return to resting membrane potential
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108
Q

Depolarization phase

A

stimulus opens voltage regulated sodium gates, membrane depolarizes rapidly
action potential peaks at 30 mV
sodium gates close quickly

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109
Q

Plateau phase

A

lasts 200-250 milliseconds
sustains contraction for expulsion of blood from heart
Calcium channels are slow to close and sarcoplasmic reticulum is slow to remove calcium from the cytosol

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110
Q

repolarization phase

A

calcium channels close
potassium channels open
rapid diffusion of potassium out of the cell
return to resting potential

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111
Q

What is the refractory period of the myocardium?

A

250 milliseconds

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112
Q

What is the refractory period in skeletal muscle?

A

1-2 milliseconds

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113
Q

Why is there a refractory period in the myocardium?

A

to prevent wave summation and tetanus which would stop the pumping action of the heart

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114
Q

Ventricular systole progresses up from the apex of the heart. It is made of spiral arrangements of cardiocytes that

A

slightly twists ventricles

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115
Q

Tetanus effects on myocardium behavior

A

stimulus frequency is high
relaxation phase disappears
contractions become continuous

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116
Q

Action potential of a cardiocyte

A
  1. Sodium gates open
  2. rapid depolarization
  3. sodium gates close
  4. slow calcium channels open
  5. calcium channels close, potassium channels open
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117
Q

Electrocardiogram

A

composite of all action potentials of nodal and myocardial cells detected, amplified and recorded by electrodes on arms, legs, and chest

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118
Q

P wave

A

SA node fires, atria depolarize and contract
atrial systol begins 100 milliseconds after SA signal

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119
Q

QRS complex

A

ventricular depolarization
complex shape of spike due to different thickness and shape of the two ventricles

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120
Q

ST segment

A

ventricular systole
plateau in myocardial action potential

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121
Q

T wave

A

ventricular repolarization and relaxation

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122
Q

Electrical Activity of Myocardium

A
  1. atrial depolarization begins
  2. atrial depolarization complete- atria contracted
  3. ventricles begin to depolarize at apex; atria repolarize- atria relaxed
  4. ventricular depolarization complete- ventricles contracted
  5. ventricles begin to repolarize at apex
  6. ventricular repolarization complete- ventricles relaxed
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123
Q

PQ segment

A

signal conduction from SA node to AV node; atrial systole begins

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124
Q

Diagnostic Values of ECG

A

abnormalities in conduction pathways
myocardial infarction
nodal damage
heart enlargement
electrolyte and hormone imbalances

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125
Q

Atrial fibrillation EKG

A

no P wave
has QRS complex
irregular depolarization

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126
Q

Heart Block EKG

A

fails to generate QRS complexes

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127
Q

Premature Ventricular Contraction EKG

A

no P wave
inverted QRS complex

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128
Q

Ventricular Fibrillation EKG

A

no P wave
no QRS complex
irregular depolarization, MI

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129
Q

Oxygen poor blood circulates from

A

body tissues to vena cava to right atrium to right ventricle to pulmonary arteries to lungs

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130
Q

Oxygen rich blood circulates from

A

lungs to pulmonary veins to left atrium to left ventricle to aorta to body tissues

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131
Q

coronary circulation

A

blood circulation to supply the blood to the heart

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132
Q

What variables govern fluid movement?

A

pressure and resistance

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133
Q

Pressure

A

causes fluid to flow
gradient can represent a difference between 2 points
measured in mmHg with a manometer/sphygmomanometer

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134
Q

Resistance

A

opposes fluid flow
great vessels have positive blood pressures
ventricular pressure must rise above this for blood to flow into great vessels

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135
Q

Fluid flows only if there’s a?

A

pressure gradient
high->low

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136
Q

when a ventricle relaxes/expands its internal pressure?

A

falls

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137
Q

if bicuspid valve is open blood flows into?

A

the left ventricle

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138
Q

When a ventricle contracts, internal pressure?

A

rises

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139
Q

When AV valves close and the aortic valve is pushed open, blood flows into aorta from?

A

the left ventricle

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140
Q

Opening and closing of valves are governed by ?

A

AV valves going limp when ventricles are relaxed
semilulnar valves under pressure from blood vessels when ventricles are relaxed

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141
Q

valvular insufficiency

A

any failure of a valve to prevent reflux, the backward flow of blood

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142
Q

valvular stenosis

A

cusps are stiffened and opening is constricted by scar tissue
result of rheumatic fever autoimmune attack on the mitral and aortic valves, heart overworks and may become enlarged

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143
Q

heart murmur

A

abnormal heart sound produced by regurgitation of blood through incompetent valves

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144
Q

mitral valve prolapse

A

insufficiency in which one or both mitral valve cusps bulge into atria during ventricular contraction
hereditary: 1/40 people
may cause chest pain and shortness of breath

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145
Q

auscultation

A

listening to sounds made by body

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146
Q

first heart sound (S1)

A

lounger and longer lubb occurs with closure of AV valves, turbulence in the bloodstream, and movements of the heart wall

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147
Q

second heart sound (S2)

A

softer and sharper dump occurs with closure of semi lunar valves, turbulence in the bloodstream, and movements of the heart wall

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148
Q

S3

A

rarely heard in people over 30
exact cause of each sound is not known with certainty

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149
Q

Phases of Cardiac Cycle

A

ventricular filling
isovolumetric contraction
ventricular ejection
isovolumetric relaxation

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150
Q

Ventricular filling

A

during diastole ventricles expand
pressure drops below that of the atria
AV valves open and blood flows into the ventricles

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151
Q

Phases of ventricular filling

A
  1. rapid ventricular filling; blood enters very quickly
  2. diastasis; marked by slower filling, P wave occurs at the end of diastasis
  3. atrial systole; atria contract
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152
Q

End-diastolic volume

A

amount of blood contained in each ventricle at the end of ventricular filling
130 mL of blood

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153
Q

Isovolumetric Contraction

A

atria repolarize and relax; remain in diastole for the rest of the cardiac cycle
ventricles depolarize, make the QRS complex, and begin to contract
AV valves close as ventricular blood surges back against the cusps
heart sound S1
no blood ejected because pressure in aorta and pulmonary trunk is greater than the ventricles

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154
Q

Ventricular Ejection

A

ventricular pressure exceeds arterial pressure and forces semilunar valve opens
pressure peaks in left ventricle at 120 mmHG and 25mmHg in the right
first rapid ejection, then reduced injection
lasts about 200-250 milliseconds
T wave occurs late in this phase

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155
Q

Stroke volume ejected

A

70mL
ejection fraction about 54%

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156
Q

In vigorous exercise what percentage of blood is ejected from the ventricle?

A

90%

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157
Q

end systolic volume

A

60 mL of blood left behind

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158
Q

Isovolumetric Relaxation

A

early ventricular diastole
ventricles expand after T wave ends
elastic recoil and expansion would cause pressure to drop rapidly and suck blood into ventricles
blood flows backwards form aorta and pulmonary into the semilunar valves and closes the cusps
S2 heart sound
AV valves have not opened
both ventricles must eject the same amount of blood

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159
Q

QT interval

A

duration potential of ventricular action

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160
Q

Unbalanced Ventricular Output

A
  1. Right ventricular output exceeds left ventricular output
  2. Pressure backs up
  3. Fluid accumulates in the lung and systemic tissue
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161
Q

Congestive Heart Failure

A

results from the failures of either ventricle to eject blood effectively
usually due to a heart weekend by myocardial infarction, chronic hypertension, valvular insufficiency, or congenital defects in heart structure
eventually leads to total heart failure

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162
Q

Left ventricular failure

A

blood backs up into the lungs causing pulmonary edema
shortness of breath or sense of suffocation

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163
Q

Right ventricular failure

A

blood backs up in the vena cava causing systemic or generalized edema
enlargement of the liver, as cites, distension of jugular veins, swelling of the fingers, ankles and feet

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164
Q

Stroke volume

A

volume of blood pumped out of the left ventricle of the heart during each systolic contraction

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165
Q

cardiac output

A

amount of blood ejected by a ventricle in 1 minute
heart rate x stroke volume
4-6 L/min at rest

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166
Q

A RBC leaving the left ventricle will arrive back at the left ventricle in about?

A

1 minute

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167
Q

vigorous exercise increases cardiac output to ?

A

21 L/min for a fit person
35 L/min for world class athlete

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168
Q

cardiac reserve

A

difference between a person’s maximum and resting cardiac output

increase in cardiac function from rest to peak exercise

increases with fitness, decreases with disease

15 L/min

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169
Q

To keep cardiac output constant as we increase in age, the heart rate increases as

A

the stroke volume decreases

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170
Q

pulse

A

surge of pressure produced by each heart beat that can be felt by palpating a superficial artery with the fingertips

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171
Q

heart rate of infants

A

120 bpm/ +

172
Q

young adult female heart rate

A

72-80 bpm

173
Q

young adult male heart rate

A

64-72 bpm

174
Q

Heart rate rises in which age group?

A

elderly

175
Q

tachycardia

A

resting adult heart rate above 100 bpm

stress, anxiety, drugs, heart disease, or fever
loss of blood/damage to myocardium

176
Q

bradycardia

A

resting adult heart rate less than 60 bpm
in sleep, low body temp, endurance trained athletes

177
Q

Positive chronotropic agents

A

factors that raise the heart rate
potassium deficiency, excess calcium, endogenous catecholamines, nicotine, thyroid hormone, caffeine

178
Q

Negative chronotropic agents

A

factors that lower the heart rate
excess potassium, deficiency of calcium, ACh

179
Q

What does the ANS do to the heartbeat?

A

modulates rate and force

180
Q

Cardiac centers in the reticular formation of the medulla oblongata initiate what?

A

autonomic output to the heart
deciding whether to speed or slow the heart

181
Q

cardiostimulatory effect

A

some neurons of the cardiac center transmit signals to the heart by way of sympathetic pathways

182
Q

cardioinhibitory effect

A

others transmit parasympathetic signals by way of the vagus nerve

183
Q

Chronotropic effects of the ANS- sympathetic

A

post ganglionic fibers are adrenergic, bind to beta 1 fibers

release norepinephrine

activates cAMP -> opening of Ca^2+ in plasma membrane

depolarization of SA node

Ca^2+ taken up by sarcoplasmic reticulum -> cardiocytes relax

heart rate could increase up to 230 bpm

inadequate filling of diastole

stroke volume and cardiac output are reduced

184
Q

Blood pressure= ?

A

Systematic vascular resistance x cardiac output

185
Q

Cardiac output =

A

stoke volume x heart rate

186
Q

What are some determining factors of cardiac outputs?

A

heart rate
contractibility
preload
afterload

187
Q

heart rate

A

number of beats per minute

188
Q

What is the cardio output at rest?

A

4-6 L/min

189
Q

What is the cardio output after vigorous exercise?

A

21 L/min

190
Q

What pathological conditions decrease cardiac output?

A

hypertension
myocardial infarction
arrhythmias

191
Q

cardiac diastole

A

all chambers relax, blood flows into the heart

192
Q

artial systole, ventricular diastole

A

atria contract, pushing blood into the ventricles

193
Q

Atrial diastole, ventricular systole

A

after atria relax, ventricles contract and push blood out of the heart

194
Q

What variables govern stroke volume?

A

preload
contractility
afterload

195
Q

What impact does increased preload or contractility have on stroke volume?

A

increases it

196
Q

What impact does increased afterload have on stroke volume?

A

It decreases it

197
Q

Contractility

A

force of contraction of the heart muscle which contributes to stroke volume and end-systolic volume

198
Q

If contractability of the heart muscle increases, cardiac output ?

A

increases

199
Q

If contractility is impaired, cardiac output will?

A

decrease

200
Q

If there is too much contractility of the heart what happens?

A

heart stops or collapses
increase in mortality

201
Q

Inotropic agents

A

medicines that change the force of your heart’s contractions

202
Q

positive ionotropic agents

A

increase contractility
catecholamines increase calcium levels
glucagon stimulates cAMP production
digoxin raises intracellular calcium levels and contraction strength

203
Q

negative ionotropic agents

A

decreases contractility
hyperkalemia reduces strength of myocardial action potentials and the release of calcium into the sarcoplasm
vagus nerves have effect on atria but too few nerves to ventricles for a significant effect

204
Q

Preload

A

degree of myocardial distension prior to contraction
largely dependent on amount of ventricular filling

filling pressure of the heart at the end of diastole

205
Q

Afterload

A

amount of pressure (mmHg) that the heart has to exert to eject the blood during ventricular contraction
dependent on arterial blood pressure and vascular tone
blood pressure in aorta and pulmonary trunk immediately distal to the semilunar valves
opposes opening of valves, limits stroke volume

206
Q

Ejection fraction = ?

A

(stroke volume/ end diastolic volume) x 100

207
Q

Factors affecting preload

A

increased preload causes increased force of contraction
exercise increases venous return and stretches myocardium
cardiocytes generate more tension during contraction
increased cardiac output matches increased venous return

208
Q

Frank-Starling Law of Heart

A

stroke volume is proportional to end diastolic volume
ventricles eject as much blood as they receive
the more the heart fills, the stronger the force of contraction
cardiac output of the left ventricle is the same as the right ventricle

209
Q

What does hypertension increase? What does it oppose?

A

increases afterload
opposes ventricular ejection

210
Q

What can increase afterload?

A

Anything that impedes arterial circulation
lung diseases that restrict pulmonary circulation
cor pulmonale- right ventricular failure
emphysema
chronic bronchitis
black lung disease

211
Q

Emphysema

A

damage to walls of alveoli in lungs
fewer alveoli, less oxygen gas in blood stream

212
Q

Black lung disease

A

coal worker’s pneumoconiosis

213
Q

End diastolic volume

A

amount of blood contained in each ventricle at the end of ventricular filling

214
Q

end systolic volume

A

volume of blood in each ventricle at the end of the systole

215
Q

Stroke volume =

A

EDV-ESV

216
Q

As preload increases, the volume of blood in the heart at the end of diastole?

A

increases

217
Q

What are some inputs to the cardiac center?

A

sensory/emotional stimuli
proprioceptors
baroceptors
chemoreceptors

218
Q

Proprioceptors

A

in muscle and joints; sensory receptors
inform cardiac center about changes in activity, heart rate increases before metabolic demands of the muscle arise

219
Q

Baroreceptors

A

pressure sensors in aorta and internal carotid arteries
blood pressure decreases, signal rate drops, cardiac center increases heart rate
if blood pressure increases, signal rate rises cardiac center decreases heart rate (negative feedback loop)

220
Q

Hypercapnia

A

elevation in the arterial carbon dioxide tension

221
Q

chemoreceptors

A

in aortic arch, carotid arteries and medulla oblongata
sensitive to blood pH, CO2 and O2 levels
more important in respiratory control than cardiac control
negative feedback

222
Q

If CO2 accumulates in blood/CSF and reacts with water, what happens to the H^+ levels? Why is this a problem?

A

they increase
not good because it lowers blood pH and may create acidosis

223
Q

Ionotropic influences muscular contractility and chronotropic influences?

A

heart rate

224
Q

hypokalemia

A

deficiency in potassium in cardiocytes, increased excitability

225
Q

hypercalcemia

A

excess of calcium

226
Q

Nicotine stimulates?

A

catecholamine secretion

227
Q

Thyroid hormone increases the number of adrenergic receptors on the heart making it more responsive to?

A

sympathetic stimulation

228
Q

caffeine

A

adenosine receptor agonist
increases neurotransmission

229
Q

when the adenosine receptor is active what decreases?

A

neural activity

230
Q

hyperkalemia

A

excess of potassium
myocardium less excitable, heart rate slows

231
Q

hypocalcemia

A

deficiency of calcium
decreases heart rate and contraction strength

232
Q

ACh is a negative chronotropic agent that does what?

A

binds to muscarinic receptors
opens potassium gates in nodal cells
hyperpolarizes cells as potassium leaves

233
Q

Coronary Artery Disease

A

coronary heart disease/ ischemic heart disease
caused by plaque accumulation of arterial walls and accumulation of lipid deposits

234
Q

Atherosclerosis

A

accumulation of lipid deposit is that degrade the arterial wall and obstructed in the lumen

235
Q

Symptoms of Coronary Artery Disease

A

chest pain
weakness, light-headedness, nausea
pain/discomfort in arms/shoulder
shortness of breath

236
Q

How can coronary artery disease be treated?

A

coronary bypass surgery- take arteries/veins from other parts of body

balloon angioplasty followed by a coronary artery stent

laser angioplasty followed by placement of a coronary artery stent

237
Q

Arteries

A

carry blood away from the heart, oxygenated

sometimes called resistance vessels

thicker tunica media in proportion to lumen, little tunica externa

high blood pressure

no valves

biggest: aorta ; smallest: arteriole

238
Q

Veins

A

carry blood back to the heart, deoxygenated

greater capacity for blood containment than arteries

thinner walls, larger lumen
tunic media has less smooth muscle and tunica externa has thick, collagen and elastic fibers

subjected to relatively low blood pressure (10mmHg)

biggest: vena cava ; smallest: venule

239
Q

Capillaries

A

connect arteries and veins, smallest blood vessels

contacts tissues and supplies oxygen, CO2, waste, nutrients, and hormones

gas exchange

only tunica intima, very small lumen thickness

distribution varies with metabolic activity of body tissues

low pressure, no valves

240
Q

What are the layers of the blood vessel?

A

Tunica extrema/adventitia: outer layer
Tunica media: middle, thickest layer
Tunica intima/interna: innermost layer

241
Q

What is the tunica intima made of?

A

squamous epithelium
surrounded by a connective tissue basement membrane and elastic fibers

242
Q

What is the tunica media made of? What is it regulated by? What does it regulate?

A

smooth muscle, elastic fiber
regulated by ANS
regulates blood flow and pressure

243
Q

What is the tunica extrema do and what is it made of?

A

protects and structural enforcement
connective tissue, elastic, and collagenous fibers

244
Q

Conducting arteries

A

biggest arteries, near heart, pumps blood to body

aorta, common carotid, subclavian, pulmonary trunk, and common iliac arteries

layer of elastic tissue, internal elastic lamina, at border between interna and media and external elastic lamina at the border between media and external

expand during systole, recoil during diastole
lessens fluctuations in blood pressure

245
Q

Distributing arteries

A

distributes blood to specific organs, most abundant arteries

brachial, femoral, renal, splenic

smooth muscle layers constitute 3/4ths of wall thickness

246
Q

arterioles

A

smallest arteries
connect to capillaries, low blood pressure, thin wall thickness
control amount of blood to various organs

247
Q

metarterioles

A

short vessels that link arterioles to capillaries

muscle cells form precapillary sphincter about entrance to capillary

constriction reduces/shuts of blood flow

diverts blood to other tissues

248
Q

continuous capillaries

A

tight junctions, lowest permeability
most common, in skin and muscles
allows passage of solutes such as glucose

249
Q

fenestrated capillaries

A

pores, relatively high permeability
kidney’s, small intestine
organs that require rapid absorption/filtration
pore receive nutrients and hormones, allow passage of only small molecules

250
Q

Sinusoids (discontinuous capillaries )

A

large intracellular gaps and gaps in between basement membrane
extremely high permeability
liver, bone marrow, spleen
allows proteins, clotting factors, and new blood cells to enter circulation

251
Q

Capillary beds

A

capillaries organized into networks
supplied by a single metarteriole

252
Q

Thoroughfare channel-metiarteriole

A

continues through capillary bed to venule
vascular shunt mechanism- redirection of blood flow

253
Q

precapillary sphincters

A

control which beds are well perfused

when sphincters open capillaries well perfused 3/4ths of capillaries in body shut down

when sphincters closed, blood flows through vascular shunt

254
Q

What fraction of the bodies capillaries are shut down at a given time?

A

3/4ths

255
Q

Blood flow in capillaries is also known as ?

A

micro circulation

256
Q

Venous valve

A

prevents backflow of blood, so blood can flow against gravity

257
Q

postcapillary venules

A

10-20 um in diameter
smallest veins
receive blood from capillaries

258
Q

muscular venules

A

up to 1mm in diameter
receive blood from postcapillary venules

259
Q

medium veins

A

up to 10 mm in diameter
most veins have individual names
venous valves are a type of this

260
Q

venous sinuses

A

veins with thin walls, large lumens, no smooth muscle, no vasomotion

261
Q

larger veins

A

greater than 10mm in diameter
examples include venae cavae, pulmonary veins, internal jugular veins, and renal veins

262
Q

Blood pressure

A

force blood exerts against a vessel wall

263
Q

How do you measure blood pressure?

A

brachial artery of arm using sphygmomanometer

264
Q

Systolic blood pressure

A

top number
pressure in arteries when the heart is beating and sending blood into arteries
maximal aortic pressure following ejection

265
Q

Diastolic blood pressure

A

bottom number
minimum arterial blood pressure taken during ventricular relaxation between heart beats

266
Q

Hypertension

A

high blood pressure

267
Q

Normal Blood Pressure

A

Systolic: less than 120
AND
Diastolic: less than 80

268
Q

Elevated blood Pressure ranges

A

systolic: 120-129
AND
diastolic: less than 80

269
Q

High Blood Pressure Stage 1 Ranges

A

systolic: 130-139
OR
diastolic: 80-89

270
Q

High Blood Pressure Stage 2 Ranges

A

systolic: 140 or higher
OR
diastolic: 90 or higher

271
Q

Hypertensive crisis ranges

A

systolic: higher than 180
AND/OR
diastolic: higher than 120

272
Q

Hypotension

A

90/60 mmHg or lower

273
Q

Why is the systolic pressure more important?

A

major indicator of cardiovascular disease
increased stiffness of large arteries
buildup of plaque (atherosclerosis)

274
Q

Clinical implications of hypertension

A

aneurysm: bulges in weak blood vessel point
atherosclerosis: build of up lipid deposits
myocardial infarction
stroke
heart failure

275
Q

Clinical implication of hypotension

A

blood loss
dehydration
anemia

276
Q

Why does anemia cause hypotension?

A

low hemobglobin -> decrease oxygen -> blood vessels swell -> blood pressure lowers

277
Q

pulse pressure

A

difference between systolic and diastolic pressure

278
Q

Wide pulse pressure

A

greater than 40 mmHg

heart is working harder/ arteries less flexible

physically inactive at risk

indicator of heart disease, heart rhythm disorders, stroke, and other cardiovascular disease complications

279
Q

Narrow Pulse pressure

A

less than 40 mmHg
your heart does not pump enough blood
heart failure, heart valve disease, or loss of blood

280
Q

Mean Arterial Pressure

A

average arterial pressure throughout one cardiac cycle
= diastolic pressure + (1/3)pulse pressure

281
Q

Average blood pressure that most influences risk level for?

A

edema, fainting, atherosclerosis, kidney failure, and aneurysm

282
Q

Distance from the left ventricle

A

factor affecting blood pressure
increase distance, decrease blood pressure
due to arterial elasticity and effect of friction against vessel wall
no pulse pressure beyond arterioles

283
Q

Cardiac output, blood volume, and peripheral resistance

A

factor affecting blood pressure
resistance hinges on blood viscosity, vessel length, and vessel radius

284
Q

As you get older what does blood pressure do?

A

increases
arteries with less dispensable and absorb less systolic force

285
Q

Peripheral resistance

A

opposition to flow that blood encounters in vessels away from the heart

286
Q

What are the 3 variables of peripheral resistance?

A

blood viscosity
vessel length
vessel radius

287
Q

How does [RBC and albumin] affect viscosity?

A

increases it

288
Q

How do anemia and hypoproteinemia impact viscosity?

A

decrease it

289
Q

How do polycythemia and dehydration impact viscosity?

A

increase it

290
Q

Polycythemia

A

abnormal increase of RBCs

291
Q

The farther liquid travels, the more cumulative friction it encounters. This means pressure and flow xxx with distance?

A

decrease

292
Q

What has the most powerful influence over flow?

A

vessel radius

293
Q

vasomotion

A

spontaneous change in vessel radius
rhythmical contraction-relaxation mechanism (oscillation frequency)
independent of heart beat, innervation or respiration

294
Q

vasoconstriction

A

muscular effort that results in smooth muscle contraction

295
Q

vasodilation

A

relaxation of the smooth muscle

296
Q

laminar flow

A

streamline flow, flows in layers
faster in layers, slower near the wall

297
Q

turbulent flow

A

does not flow linearly, flow is chaotic

298
Q

Vessel radius affects

A

blood velocity

299
Q

Blood flow is proportional to

A

r^4

300
Q

A larger vessel radius leads to what kind of flow

A

greater average

301
Q

Why does blood velocity decrease from the aorta to the capillaries?

A

greater distance; more friction to reduce speed

smaller radii of arterioles and capillaries offers more resistance

farther from heart, number of vessels and their total cross-sectional area becomes greater

302
Q

Why does blood flow increase from the capillaries to the vena cava?

A

decreased resistance going from capillaries to veins

large amount of blood forced into smaller channels

never regains velocity of large arteries

303
Q

What are the most significant points of control over peripheral resistance and flow?

A

arterioles; they are highly capable of vasomotion

304
Q

What produces half of the total peripheral resistance?

A

Arterioles

305
Q

Why is vasomotion important?

A

Aids blood flow through tissues by reducing resistance

regulates oxygen, fluid, and nutrient exchange between the vascular system and peripheral tissues

for arterioles and capillaries

306
Q

Unregulated Vasomotion can lead to conditions such as?

A

hypoperfuison and hypoxia

307
Q

What are the three general controls of vasomotion?

A

local control
neural control
hormonal control

308
Q

Autoregulation

A

ability of tissues to regulate their own blood supply

bloodstream delivers oxygen, incr blood flow, removes metabolites, and the constricts vessels

type of local control

309
Q

Metabolic theory of autoregulation

A

if a tissue is inadequately perfused, waste accumulates

310
Q

vasoactive chemicals

A

substances secreted by platelets, endothelial cells, and perivascular tissue stimulate vasomotion

311
Q

Histamine, bradykinin, and prostaglandins stimulate?

A

vasodilation

312
Q

What do endothelial cells secrete?

A

prostacyclin
nitric oxide
endothelin

313
Q

Reactive hyperemia

A

transient increase in blood flow following brief ischemia

if blood supply is cut off then restored, flow increases above normal

314
Q

Angiogenesis

A

growth of new blood vessels

315
Q

Where does angiogenesis occur?

A

in regrowth of uterine lining, around coronary artery obstructions, exercised muscle, and malignant tumors

316
Q

In neural control, vessels are controlled by?

A

the CNS and ANS

317
Q

Vasomotor Center of medulla oblongata

A

exerts sympathetic control over blood vessels

stimulates most vessels to constrict
dilates vessels in skeletal and cardiac muscle

318
Q

What 3 autonomic reflexes is the vasomotor center the integrating center for?

A

baroreflexes
chemoreflexes
medullary ischemic reflex

319
Q

Carotid vessels

A

supply blood to brain, face and neck

320
Q

Carotid sinus

A

structure appearing as a dilation at the proximal end of the internal carotid artery and above the branches of the common carotid artery into the internal/external carotid artery

321
Q

Baroreflex

A

automatic, negative feedback response

incr BP detected by carotid sinuses

inhibit sympathetic cardiac and vasomotor neurons; reduces sympathetic town, decreases blood pressure

important in short term regulation of blood pressure

322
Q

Chemoreceptors

A

in aortic arch, carotid arteries and medulla oblongata

sensitive to blood pH, CO2, and O2 levels

important in respiratory control

negative feedback loop

323
Q

Hypercapnia and acidosis stimulate the cardiac center to increase?

A

heart rate

324
Q

Medullary Ischemic Reflex

A

automatic response to a drop in perfusion of the brain

increase heart rate, contraction force, and blood pressure

causes widespread vasoconstriction

325
Q

Stress, anger, and arousal can increase?

A

blood pressure

326
Q

How do hormones influence blood pressure?

A

through vasoactive effects and regulating water balance

327
Q

Aldosterone

A

promotes sodium and water retention by kidneys

increase blood volume and pressure

328
Q

Atrial natriuretic peptide

A

increases urinary sodium excretion

reduces blood volume and promotes vasodilation

lowers blood pressure

329
Q

Antidiuretic hormone

A

promotes water retention and raises blood pressure

can be a vasoconstrictor at pathologically high concentrations

330
Q

Epinephrine and norepinephrine can be used in?

A

hormonal control

331
Q

What happens during vigorous exercise?

A

Dilation of arteries in lungs, heart, and muscles
vasoconstriction in kidneys and digestive tract

332
Q

What is the most important blood in the body?

A

Capillaries

333
Q

Capillary Exchange

A

2 way mvmt of fluid across capillary walls

334
Q

3 Routes of capillary exchange

A

through endothelial cell cytoplasm
intercellular clefts between endothelial cells
filtration pores of fenestrated capillaries

335
Q

What 4 mechanisms are involved in capillary exchange?

A

diffusion
transcytosis
filtration
reabsorption

336
Q

Capillary diffusion can only occur if

A

solute can permeate plasma membrane and find passages large enough to pass through

337
Q

Capillary Transcytosis

A

vesicular transport of macromolecules from one side of a cell to the other
important for fatty acids, albumin, and hormones

338
Q

Blood hydrostatic pressure

A

drives fluid out of capillary

339
Q

Colloid osmotic pressure

A

draws fluid into capillary

340
Q

What percentage of fluid do the capillaries reabsorb?

A

85%

341
Q

What percentage of fluid is reabosorbed by the lymphatic system and returned to blood?

A

15%

342
Q

Where does capillary filtration occur?

A

arterial end

343
Q

Where does capillary reabsorption occur?

A

at the venous end

344
Q

Kidney capillaries

A

in glomeruli do not reabsorb, devoted to filtration

345
Q

alveolar capillaries

A

in lung absorb completely to keep fluid out of air spaces, devoted to absorption

346
Q

In resting tissue, capillary activity focuses on ?

A

reabsorption

347
Q

In active tissue, capillary activity ?

A

increases in flow

348
Q

edema

A

accumulation of excess fluid in a tissue

could be caused by increased capillary filtration, reduced capillary absorption, or obstructed lymphatic drainage

349
Q

Venous return

A

flow of blood from the veins back to the right atrium of the heart
blood pressure is the most important part

350
Q

Gravity drains blood from the head and neck to?

A

the heart

351
Q

Where is the skeletal muscle pump and what is it?

A

in the limbs
contracting muscle squeezed out of the compressed part of the vein

352
Q

During inhalation what does the thoracic cavity do?

A

it expands and the diaphragm contracts

blood is forced upward

353
Q

During exhalation what does the thoracic cavity do?

A

contracts, pressure increases

354
Q

circulatory shock

A

any state in which cardiac output is insufficient to meet the body’s metabolic needs

355
Q

low venous return

A

cardiac output is low because too little blood is returning to the heart

356
Q

hypovolemic shock

A

most common low venous return
loss of blood

357
Q

obstructed venous return shock

A

tumor/aneurysm compresses a vein
type of low venous return

358
Q

venous pooling shock

A

long periods of standing, sitting or widespread vasodilation

359
Q

septic shock

A

bacterial toxins trigger vasodilation and increased capillary permeability
life-threatening condition, BP drops to a dangerously low level after an infection

360
Q

anaphylactic shock

A

severe immune reaction to antigen, histamine release, generalized vasodilation, increased capillary permeability

361
Q

How does exercise increases venous return?

A

heart beats faster, harder increasing CO and BP
vessels of skeletal muscles, lungs, and heart dilate and increase flow
increased respiratory rate, increased action of thoracic pump
increases skeletal muscle pump

362
Q

What are the 6 principle organs of the urinary system?

A

2 kidneys
2 ureters
the urinary bladder
the urethra

363
Q

What does the kidney regulate?

A

blood volume and pressure
osmolarity
renin
EPO
CO2 and acid-base balance

364
Q

What does the kidney do?

A

filters blood stream
reabsorbs components
removes toxins, waste, and extra fluid

365
Q

renal pyramids

A

structure containing nephrons and tubules

366
Q

renal columns

A

extension of the cortex, in-between renal pyramids

367
Q

lobe of the kidney

A

renal pyramid and a renal cortex

368
Q

renal pelvis

A

funnel-shaped sac, minor calyx, major calyx

369
Q

renal papilla

A

apex of a renal pyramid

370
Q

minor calyx

A

surrounds renal papilla, collects urine from the pyramid

371
Q

ureter

A

tubular continuation of the pelvis and drains the urine down to the urinary bladder

372
Q

unfiltered blood flows into?

A

kidneys through renal artery

373
Q

nephron

A

filtering unit of kidney
1.2 million per kidney
includes glomerulus and tubule

374
Q

kidney filtration amount

A

150 qts/day

375
Q

Most of the water and other substances filtering through glomeri are returned to the body by the ?

A

tubules

376
Q

glomerulus

A

masss of capillaries around the end of kidney tubule
filter blood
small molecules pass into it, larger ones stay out

377
Q

Renal corpuscle

A

glomerulus and a two-layered glomerular

378
Q

Tubule

A

long coiled tube that converts the filtrate into urine

379
Q

Order of fluid flow through tubules

A
  1. proximal convoluted tubule
  2. nephron loop
  3. distal convoluted tubule
  4. collecting duct
380
Q

Renal circulation receives about 21% of ?

A

the cardiac output

381
Q

order of blood flow through the kidney

A
  1. renal artery
  2. afferent arterioles
  3. capillaries
  4. glomerulus
  5. efferent arterioles
  6. peritubular capillaries/vasa recta
382
Q

2 types of microcirculation in kidney

A

glomerular capillary system
peritubular capillary system

383
Q

What can pass through the filter in glomerular filtration?

A

water
electrolytes
glucose
amino acids
fatty acids
vitamins
urea
uric acid
creatinine

384
Q

Urine Composition

A

95% water
2% urea
0.1% Creatinine
0.03% uric acid
electrolytes

385
Q

Indicators of Kidney function

A

creatinine
blood urea nitrogen

386
Q

3 steps of urine formation

A
  1. Glomerular Filtration
  2. Tubular reabsorption and secretion
  3. water conservation
387
Q

Net filtration pressure

A

total pressure that promotes filtration

glomerular blood hydrostatic pressure - colloid osmotic pressure - capsular hydrostatic pressure = this

388
Q

glomerular blood hydrostatic pressure

A

blood pressure in glomerular capillaries
push water and solutes in plasma through glomerular filter

389
Q

Colloid osmotic pressure

A

prevents net movement of water into a solution containing solutes

390
Q

Capsular hydrostatic pressure

A

back-pressure opposing filtration
filtrate is forced into the capsular space

391
Q

glomerular filtration rate

A

amount of filtrated formed per minute by the 2 kidneys combined
indicator of kidney disease
normal range 90-120 mL/min/1.73m^2
measured with a blood test to check creatine levels

392
Q

Indicators to determine renal impairment

A

GFR
degree of albuminuria

393
Q

If GFR is less than 60 it indicates

A

kidney disease

394
Q

If GFR is less than 15 it indicates

A

need of dialysis or kidney transplant

395
Q

Degree of albuminuria

A

level of albumin present in urea
normal range of albumin to creatine ratio is above 30 mg/mmol

396
Q

Renal autoregulation

A

ability of the nephrons to adjust their own blood flow and GFR without external control

regulates glomerular filtraiton

397
Q

Sympathetic controls

A

sympathetic nerve fibers innervate the renal blood vessels
under acute conditions sympathetic stimulation and adrenal epinephrine constrict afferent arterioles

regulates glomerular filtration

398
Q

Renin-Angiotensin-Aldosterone Mechanism

A

activated by a drop in blood pressure
acts to raise blood pressure
secret renin-> converts angiotensinogen into Angiotensin 1 -> ACE converts it into angiotensin 2, the active hormone

399
Q

What is most sodium reabsorbed by?

A

the proximal convoluted tubule

400
Q

What percentage of water is reabsorbed at the proximal tubule?

A

65%

401
Q

What are the two types of capillary systems in the kidney?

A

Glomerular and peritubular

402
Q

Vasa Recta

A

presents in the medullary and is closer to the nephron loop

403
Q

What is the function of the nephron loop?

A

generate an osmotic gradient that enables the collecting duct to concentrate the urine and conserve water

sodium and water reabsorption

404
Q

How do loop diuretics work?

A

reduce NaCl reabsorption in ascending limb of the loop of Henle

increases urine volume-> reduce the fluid volume of the body and blood pressure

405
Q

Where is the major place of secretion in the kidney?

A

Distal convoluted tubule

406
Q

Angiotensin 2

A

potent vasoconstrictor
incr blood pressure
hormone

407
Q

aldosterone

A

salt retaining hormone
increases blood pressure

408
Q

atrial natriuretic peptide

A

made by heart
if high level indicates congestive heart failure
decreases blood pressure

409
Q

antidiuretic hormone

A

promotes water retention and raises blood pressure

410
Q

What makes pee yellow?

A

urochrome

411
Q

Pyuria

A

cloudy, potential indicator of bacterial growth

412
Q

Hematuria

A

blood in urine, potential indicator of UTI or kidney stone

413
Q

Phenylketonuria

A

mousy odor

414
Q

Urinary tract infection odor

A

rotten

415
Q

polyuria in diabetes mellitus

A

> 2L per day or urine

416
Q

Urine volume

A

1-2 L per day

417
Q

Renal clearance

A

volume of blood plasma from which a particular waste is completely removed in 1 minute

Glomerular filtration of waste + amount added by tubular secretion - amount removed by tubular reabsorption

418
Q

Can you determine GFR from urea excretion?

A

no

419
Q

Inulin or creatinine is useful for ?

A

GFR measurement

420
Q

How does the female urethra compare to the male urethra?

A

it’s shorter

421
Q

Why are women more susceptible than men to bladder infections?

A

The relatively short female urethra is less of an obstacle for bacteria traveling from perineum to the urinary bladder

422
Q

What inhibits the release of urine?

A

urethral sphincters

423
Q

Internal urethral sphincter

A

regulates involuntary control of urine flow from the bladder to the urethra

424
Q

External urethral sphincter

A

regulate voluntary control of urine flow from the bladder to the urethra

425
Q

When the bladder is filling the detrusor is xxx and the external urethral sphincter is xxx.

A

relaxed
closed by somatic fibers

HPP 2 (11 decks)

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