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Pathophysiology Semester 1 > Chapter 31 > Flashcards

Chapter 31 Flashcards

1
Q

What does Toponin I do?

A

binds to actin in thin myofilaments to hold the troponin-tropomyosin complex in place

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2
Q

What does Troponin T do?

A

Binds to tropomyosin to the thin filaments

binds to tropomyosin, interlocking them to form a troponin-tropomyosin complex

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3
Q

What does Troponin C do?

A

Binds to Ca2+ to thin filament for muscle contraction.

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4
Q

Depolarization of myocardial cell stimulates opening of VG Ca2+ channels in ______????

A

sarcolema

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5
Q

______ is released, causing the power stroke to occur.
Power stroke pulls actin toward the center of the ___ band

A

Pi (an inorganic phosphate group)

A band

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6
Q

If there is an increase in need of oxygen by the coronary blood vessels, what substance dilates the cornary blood vessels?

A

Adenosine

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7
Q

What are the site of inpulse fromation in the SA node?

A

P cells

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8
Q

Does the SA node or the AV node have thicker fibers?

A

AV node

(also more resistance to conductane)

The slower AV node allows for additional ventricular filling time

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9
Q

What are the layers of heart muscle

A
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10
Q

Does it start in Endocardium or Epicardium

Activation?

Deactivation?

A

Activation

Endocardium to epicardium.

Deactivation

Epicardium to endocardium

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11
Q

In phase 4 what is the voltage threshold

A

-40mV

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12
Q

What phase of cardiac pacemaker action potential does repolarization take place?

A

Phase 3

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13
Q

Discribe the phases of cardiac muscle action potential

A

Phase 0: depolarization:
VG Na+ channels open.
Inward diffusion of Na+.

Phase 1: early repolarization:
VG Na+ channels rapidly close.
VG Ca2+ channels open

.
Phase 2: plateau phase:
Rapid reversal in membrane polarity to –15 mV.
Slow inward flow of Ca2+ balances outflow of K+.

Phase 3: rapid repolarization:
VG K+ channels open.

Phase 4: resting membrane potential:
-80 to –90 mV.

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14
Q

Explain what is occurring during each phase of the cardiac cycle

A

Rapid filling of ventricles:

AV valves open.

Atrial systole:

P wave occurs.

Atrial contraction.

Isovolumetric contraction:

QRS just occurred.

AV valves close.

Semilunar valves are closed.

Ejection:

Semilunar valves open.

AV valves are closed.

Isovolumetric relaxation:

T wave occurs.

Semilunar valves close.

AV valves are still closed.

Ventricular pressure drops below atrial pressure.

AV valves open.

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15
Q

First heart sound:

Second heart sound:

Third heart sound:(not normally heard)

Fourth heart sound:(only heard if pathologic)

A

First heart sound:

Produced immediately after QRS wave.

Rise of intraventricular pressure causes AV valves to close.

Second heart sound:

Produced after T wave begins.

Fall in intraventricular pressure causes semilunar valves to close.

Third heart sound:

Tensing of the chordae tendineae during rapid filling and expansion of the ventricle.

The third heart sound is normal in children, young adults, and some trained athletes.

Fourth heart sound:

It is a sign of a pathologic state.

Sound of blood being forced into a stiff/hypertrophic ventricle.

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16
Q

What does the intracardiac pressure venous C Wave represent?

A

Represents the bulging of the mitral valve into the left atrium during early systole.

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17
Q

What has the following influences?

Rate of impulse generation, depolarization, and repolarization of myocardium.
Strength of atrial and ventricular contraction.

A

Autonomic nervous system influences

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18
Q

What has the following influences?

§nnervates all parts of the atria and ventricles.
Shortens conduction time through the AV node.
Increases rhythmicity.
Enhances myocardial performance.

A

Sympathetic nervous system influences

19
Q

Alpha 1 = Does what

Alpha 2= Does what

Beta 1 = Does what

Beta 2 = Does what

A

Alpha 1 = Constricts coronary arteries (NE)

Alpha 2= Vasodilation (by restricting NE release)

Beta 1 = Increases HR and force of contraction (NE)

Beta 2 = Causes coronary arterioles to dilate (Epi)

20
Q

study this

A

Study pic

21
Q

What does this defination describe?

states that the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end diastolic volume) when all other factors remain constant.

A

Frank–Starling law

22
Q

How is Stroke Volume related to TPR?

A

SV inversely proportional to TPR.
Greater the TPR, the lower the SV

23
Q

Laplace’s Law deals with what general topic

A

Wall tension

24
Q

What is the formula for Cardiac Output?

A

CO = SV X HR

25
Q

What are the 3 variables of stroke volume?

A

EDV:
Volume of blood in the ventricles at the end of diastole.

TPR:
Frictional resistance to blood flow in the arteries.

Contractility:
Strength of ventricular contraction.

26
Q

Where is the major cardiovascular control center located?

A

Medulla

27
Q

What causes HR to increase after IV infusions of blood or other fluid?
Reflex mediated by volume receptors in atria.

A

Bainbridge reflex:

28
Q

What are the two main factors that determine the force of contraction?

A

Preload

Aleterations in sympathetic activation

29
Q

What is a normal ejection fraction?

A

Normal is 60-75%

30
Q

How do inotropic agents affect contractility?

A

+ inotropic agents increase the velocity of myocardial contraction and SV.

  • inotropic agents decrease the velocity of myocardial contraction and SV.
31
Q

What are the factors that affect blood flow

A

1)The pressure diffrence (aorta vs Rt atrium)

2)Resistance
R = ln/r(4)
l = length of the vessel
n = viscosity of blood
r = radius of the vessel

32
Q

What is the mean arteral pressure

A

Average arterial pressure during the cardiac cycle

MAP = (cardiac ouput X TPR) Central venous pressure(very small and inconsequential)

or estimate like this =

diastolic pressure + 1/3 (Systolic - diastolic)

33
Q

Where is the greatest pressure drop in vascular system?

A

In Arterioles

34
Q

If you are measureing total resistance in a series what do u do?

If you are measuring total resistance in parallel what do u do?

A

Series:

Total resistance = sum obtained by adding all the individual resistances using Poiseuille’s Law.

Parallel:

Total resistance = sum of reciprocals of individual resistances.

If cross-sectional area is made up of a very large # of parallel vessels, resistance will be greater

35
Q

The following factors are reasons that___?__would be released

Drop in BP in renal artery.
Decrease Na+ and Cl- delivered to kidney.
Stimulation of b-adrenergic receptors.
Angiotensin II.
Low [K+].

A

Factors control renin release

36
Q

Which angiotensin receptors have proinflammatopry effect:
Cause Myocyte hypertrophy and vasoconstriction

A

AT1

37
Q

Which angiotensin receptors have counterregulatory mechanism:
Which mediates vasodilator/natriuretic cascade.

A

AT2 receptors

38
Q

What does the following describe?

Stretch of atria stimulates production of ANP and BNP.
Increase Na+ and H20 excretion.
Antagonistic to aldosterone and angiotensin II.

A

Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)

39
Q

Where is urodilatin produced and what is it?

A

Kidney

Diuretic

40
Q

What is adrenomedullin ADM?

A

Local/paracrine factor, synthesized and secreted from vascular endothelial and smooth muscle cells.
Vasodilator

41
Q

Bradykinin, prostacyclin, and endothelin-1 are all what?

A

Vasodilators

42
Q

What is the major paracrine produced in the endothelium

A

NO

43
Q

When does most coronary blood flow occur?

A

during diastole

Pathophysiology Semester 1 (7 decks)

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