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PEDS 103 > Caridovascular Physiology > Flashcards

Caridovascular Physiology Flashcards

1
Q

Arteries are…

A 
Pressure reservoir that maintain blood flow
Adjustable diameters (alters resistance) to alter blood flow
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2
Q

Where is gas exchange?

A

Capillaries

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3
Q

Systemic Veins are…

A

Expandable reservoir

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4
Q

Each side of the heart functions…

A

independently

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5
Q

Blood Pressure

A

Arterial blood pressure
Pressure exerted on walls of the blood vessels
Reflects driving pressure

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6
Q

Ventricular contraction

A

Pushes blood into arteries which causes stretch
Systole - contraction
1) Ventricles contract
2) Semi-lunar valve opens. Blood flows into valves
3) Aorta and arteries expand and store pressure in elastic walls

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7
Q

Ventricular Relaxation

A

Elastic recoil in arteries maintain pressure during diastole
Diastole - Relaxation
1) isovolumic ventricular relaxation
2) Semilunar valve shuts, preventing flow back
3) Elastic recoil of arteries sends blood forward into rest of the circulatory system

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8
Q

Why does blood flow work?

A

Because of pressure gradients
Heart creates high pressure
From the heart (high pressure) to the arteries (low pressure)

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9
Q

How is blood pressure measured?

A

Estimated by brachial artery through sphymomonometry
Arterial pressure reflects ventricle and aortic pressure
mmHg

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10
Q

Process of measuring BP

A

inflate until arterial blood flow stops (no sound)
Korotkoff sound pulsatile blood flow (systolic pressure)
Blood flow silent (diastolic pressure)

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11
Q

What is systolic blood pressure?

A

Highest pressure

occurs during ventricular systole (contraction)

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12
Q

What is diastolic pressure?

A

Lowest pressure

occurs during ventricular diastole (relaxation)

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13
Q

What is Pulse pressure?

A

Change in systolic and diastolic pressure

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14
Q

What is mean arterial pressure?

A

Average pressure of the heart during cardiac cycle

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15
Q

Formulas

A

Pulse pressure = Systolic - diastolic

MAP = DBP + 1/3 (SBP-DBP)

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16
Q

Blood Pressure Classifications

A

Normal Blood Pressure - 120/80 mmHg (decreased risk of CVD)
Hypotension - when BP is too low
Hypertension - 140/90 mmHg or above (when blood pressure is chronically elevated)

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17
Q

What Determines Blood Pressure?

Arterial Pressure Balance

A

MAP increases when in exceeds out

MAP decreases when out exceeds in

18
Q

What determines BP?

Blood volume distribution

A

Relative amount of blood in arterial vs venous
Arteries = low pressure 11% of blood volume
Veins = high pressure 60% of blood volume
Arterial pressure falls, veins constrict and decreases capacity increases venous return

19
Q

What determines BP?

Total blood volume

A

Blood volume increases blood pressure increases

Blood volume decreases blood pressure decreases

20
Q

MAP is determined by

A

Blood volume (fluid intake)
Effectiveness of heart (HR and SV)
Resistance of the system to blood flow (Diameter of arteries)
Relative distribution of blood between arterial and venous blood (diameter of veins)

21
Q

Blood pressure regulation

A

Blood pressure includes rapid response from CVS and slower response from kidney

22
Q

Fast response BP Regulation

A 
Increase blood volume
Increase blood pressure
compensation by cardiovascular system
- Vasodialtion
- decrease Q
Decreased blood pressure
23
Q

Slower response BP regulation

A 
Increase blood volume
Increase blood pressure
Compensation by the kidney
Excretion of fluid = decreased volume
decreased BP
24
Q

What are baroreceptors

A

Stretch sensitive
Located on walls of aorta and carotid arteries
Detect increase in pressure = increased stretch
Increase stretch= increased afferent firing of carotid sinus nerve

25
Q

Barorecpetors at normal BP

A

aortic and carotid receptors fire continuously (afferent)

Normal firing rate normal sympathetic activity (Efferent)

26
Q

Baroreceptors

Change in BP

A

BP increase = Increase firing rate

BP decrease = Decrease firing rate

27
Q

Baroreceptors
Sympathetic Activity
Change in BP

A

decrease firing rate = increase sympathetic activity

Increase firing rate = decrease sympathetic activity

28
Q

Baroreceptor Reflex

Parasympathetic

A 
Increase BP
Increase firing rate
Increase parasympathetic
Decrease HR
Decrease Q
Decrease BP
29
Q

Baroreceptor Reflex

Sympathetic

A 
Increase BP
Increase firing rate
Decrease sympathetic 
In the Artiolar
Vasodialtion
Decrease TPR
Decrease BP

In the Ventircular myocardium
Decrease force of contraction
decreases Q
decrease BP

In the SA node
decrease HR
Decrease Q
Decrease BP

30
Q

What happens when there is a Hemorrhage?

A 
Arterial Pressure decreases
low firing rate
low para/up sympathetic
up HR        up SV
up Q

Veins constrict/arteries constrict
Up venous pressure up TPR
Up Venous return
Up EDV

Increase TPR + Q = Increase arterial pressure

31
Q

CVD

A 
Disorder of the Heart and blood vessels
2007-  1.3million
2008 - 29% of all deaths
2004 3 million hospitalizations
Costs $2.9 billion/yr
32
Q

What are non-modifiable risk factors?

A 
Age
Gender
Family History
Ethnicity
History of stroke or TIA
33
Q

What are modifiable risk factors?

A 
High BP
Smoking
Inactivity
Overweight
High cholesterol
Diabetes
Excessive alcohol
Stress
34
Q

Blood Pressure and CVD

A

90% of people with hypertension have primary hypertension
Hereditary
Increase TPR
Baro- receptors adapt to higher pressure
Activity decrease no reflex control
Increase atherosclerosis (plaque formation)
Increase BP increase myocardial work
( Increase after load, SV same = high resistance = myocardial hypertrophy)

35
Q

Hypertension Drug Treatment

A

Calcium blockers
Target: Cardiac and smooth muscle
Effects: less calcium entry
Result: HR and contractility decrease and vasodilation

Other
Diuretics: decrease blood volume
Beta-blockers: suppress sympathetic stimulation
ACE inhibitors and angiotensin receptor blockers: decrease vasoconstriction by angitotensin

36
Q

Coronary Artery Disease

A 
Majority of all deaths (54%)
Atherosclerosis 
 - hardening of arteries
 - fat deposits on walls
 - Plaque formation
 - Inflammatory response
37
Q

Development of Atherosclerosis

Fatty Streak

A

1) LDL- cholesterol accumulates between the endothelium and connective tissue and is oxidized
2) Macrophages ingest cholesterol and become foam cells (release cytokines)
3) smooth muscle attracted by macrophage cytokines, begins to divide and take up cholesterol

38
Q

Development of Atherosclerosis

Stable Fibrous plaque

A

4) Lipid accumulates beneath endothelium
5) Fibrous scar tissue to walls off lipid core
6) Smooth muscle divide and contribute to thickening
7) Calcification within the plaque

39
Q

Development of Atherosclerosis

Vulnerable plaque

A

8) macrophages release enzymes that dissolve collagen and make plaque unstable
9) Platelets at exposed to collagen activate and clot

40
Q

What is ejection fraction?

A

SV/EDV

PEDS 103 (8 decks)

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