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Physiology > CP/SL Exam > Flashcards

CP/SL Exam Flashcards

1
Q

Equation for O2 consumption (VO2)

A

VO2 = COx(arterial O2 - venous O2)

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2
Q

Cardiac Output/Flow

A

CO = HRSV or change in P (MAP - CVP)/TPR or vA or (change in P * pi * r^4)/(8Lviscosity)

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3
Q

Normal range of CO

A

5-6L/min

25L/min with exercise

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4
Q

Sides that pump to systemic vs pulmonary

A 
Left = systemic
Right = pulmonary
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5
Q

Normal Blood Volume

A

5L

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6
Q

Which circulation system is in parallel vs series?

A 
Systemic = parallel (except liver has both)
Pulmonary = series
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7
Q

Liver blood sources

A

Hepatic artery & portal vein from GI system

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8
Q

MAP

A

about 95mmHg
mean arterial pressure = mean aortic pressure
MAP = DBP + PP/3

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9
Q

CVP

A

about 2mmHg

central venous pressure = vena cava pressure

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10
Q

Normal systemic BP & pulmonary BP

A

Systemic 130/80

Pulmonary 25/10

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11
Q

Mechanisms to help pressure drop

A
  1. Reduce outflow - increase resistance in organs that do no have high demand for nutrients
  2. Increase inflow (CO) - increase HR or contractility (SV)
  3. Increase Volume - short term, veins; long term, kidneys
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12
Q

How much blood does the venous system hold?

A

about 70%

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13
Q

P of right atrium

A

2mmHg

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14
Q

P of left atrium

A

8mmHg

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15
Q

P of right ventricle

A

25/5mmHg

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16
Q

P of left ventricle

A

130/10mmHg

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17
Q

P of pulmonary artery

A

25/10mmHg

Mean = 15mmHg

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18
Q

P of aorta

A

130/80mmHg

Mean = 95mmHg

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19
Q

P of pulmonary capillaries

A

8mmHg

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20
Q

P of systemic capillaries

A

25mmHg

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21
Q

Route of electrical impulse through heart

A

SA -> AM -> AV -> His/P -> VM

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22
Q

What has fast APs? slow APs?

A

Fast - His/P, AM, VM

Slow - SA, AV

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23
Q

Fast AP

A

Phase 0: rapid depolarization, inward Na current
Phase 1: repolarization from inactivation of Na channel, activation of outward K+
Phase 2: plateau - slowly activating inward Ca2+ currents
Phase 3: repolarization from inactivation of Ca2+ currents and activation of IKr & IKs (K channels)
Phase 4: resting potential from inward-rectifying K channels (IK1)

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24
Q

Slow AP

A

Phase 0: slow depolarization from slow activating Ca2+ channels (NOT NA)
Phase 3: repolarization from Ca2+ inactivation and activation of K channels
Phase 4: slow depolarization

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25
Q

effective refractory period

A

only single AP can be elicited, not propagated AP

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26
Q

IK,Ach or IGIRK

If

A

IK,Ach or IGIRK - outward current, hyperpolarizes cell/SA node - PNS
If - inward current, nonselective ion channel (HCN), depolarizes - SNS

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27
Q

Pace of SA node, AV node and His/Purkinje fibers

A

SA node - 100bpm
AV node - 40-60bpm
His/Purkinje - 30-40bpm

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28
Q

Dromotropic effects

A

Conduction velocity
Positive - increases (SNS)
Negative - decreases (PNS)

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29
Q

P-wave

A

atrial depolarization

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30
Q

PR segment

A

conduction through AV node

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31
Q

QRS complex

A

ventrical depolarization

Q wave often too small to detect

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32
Q

bundle branch block

A

QRS widens

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33
Q

ST segment

A

all ventricular tissue depolarized, plateau phase, beginning of repolarization

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34
Q

T wave

A

repolarization of ventricles

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35
Q

Lead I

A

Right arm to left arm

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36
Q

Lead II

A

right arm to left leg

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37
Q

Lead III

A

left arm to groin

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38
Q

AVL, AVF, AVR

A 
A = abdomen
L = left arm
F = femoral artery
R = right arm
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39
Q

shifts in MEA with hypertrophy

A

RVH - clockwise

LVH - counterclockwise

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40
Q

First degree, second degree, third degree AV block

A

First - PR interval increases
Second - P wave not always followed by QRS
Third - pacemaker is His/P

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41
Q

What happens to ST interval with MI or ischemia?

A

ischemia, early stages of MI - ST depression

late stages MI - ST elevation

42
Q

S4

A

atrial gallop - stiffened ventricle

43
Q

S3

A

ventricular gallop - more flexible ventricle
normal in children/young adults
dilated cardiomyopathy in adults

44
Q

S2

A

aortic valve closes

45
Q

S1

A

mitral valve closes

46
Q

Normal SV

A

about 60-100mL

47
Q

Normal EF

A

55-70%

48
Q

Increased preload

A

Increases EDV, EF, SV, CO

49
Q

Increased afterload

A

Increases ESV

Decreases EF, SV, CO

50
Q

Increased inotropy

A

Decreases ESV

Increases EF, SV, CO

51
Q

Largest SA

A

capillaries

52
Q

Largest pressure drop

A

arterioles

due to increase in TPR

53
Q

Poiseulle’s law

A

Q or CO = (change in P * pi * r^4)/(8Lviscosity)

54
Q

factors increasing viscosity

A

increased hematocrit
loss of plasma
sickle cell anemia

55
Q

PP

A

SBP - DBP

56
Q

Which type of shock do you not want to give a vasodilator?

A

Vasodilatory/septic

57
Q

Deviations from poiseulle’s law

A
  1. turbulence
  2. viscosity changes with velocity
  3. compliance of blood vessels
58
Q

Reynold’s number

A 
NR = (v*d*density)/viscosity
>2000 = turbulent (aortic stenosis)
59
Q

compliance

A

change in V/change in P

decreases with increasing wall thickness

60
Q

Starlings law of the capillary

A

Q = k*[(Pc + Oi) - (Pi + Oc)]

61
Q

Local control of blood flow through capillaries

A

A. metabolic wastes vasodilate

B. myogenic - smooth muscle contracts/relaxes

62
Q

Central control of blood flow through capillaries

A

A. Humoral
ANP, AngII, Epi, NO, ET-1
B. Neural
norepi

63
Q

Atrial Natriuretic Peptide (ANP)

A

vasodilator
released by atrial myocytes
excretion of Na+ and water

64
Q

Angiotensin II

A

potent vasoconstrictor (increases TPR)
retention of Na (increases BV)
stimulates thirst & ADH release
stimulates aldosterone synthesis

65
Q

Epi

A

vasodilator in liver, heart and skeletal muscle (B2)
vasoconstriction (a1)
increases HR

66
Q

NO

A

EDRF
formed from arginine
vasodilator
produced by endothelium

67
Q

Endothelin (ET-1)

A

potent vasoconstrictor

released by endothelial cells

68
Q

Rate-pressure product (RPP)

A 
RPP = HR * SBP
increase = increased O2 demand
69
Q

Apical skin

A

hand, feet, ears, nose, & some face

has lots of AV anastomoses

70
Q

Cerebral Perfusion Pressure

A

MAP - ICP (intercranial pressure)

71
Q

Glomerular vs Peritubular capillaries

A

Glomerular - high P, filter stuff out

Peritubular - low P, reabsorb

72
Q

Changes in filtration due to changes in AA & EA resistance

A

AA with low R - increases filtration/flow
AA with high R - decreases filtration/flow
EA with low R - increases flow
EA with high R - decreases flow

73
Q

Nicotinic receptors

A

all postganglionic neurons, adrenal medula and skeletal muscle

74
Q

Muscarinic receptors

A

effector tissues for PNS & sweat glands (SNS)

75
Q

PNS vs SNS ganglionic neurons

A 
PNS
pre - long
post - short
SNS
pre - short
post - long
76
Q

Alpha1 adrenergic receptors

A

stimulated by NE and E
radial muscles of eye->dilation
contraction of blood vessels->inc. P

77
Q

Alpha2 adrenergic receptors

A

presynaptic
stimulated by NE and E
autoregulatory - inhibits release of NE

78
Q

Beta1 adrenergic receptors

A

heart
stimulated by NE and E
increases HR and inotropy

79
Q

Beta2 adrenergic receptors

A

stimulated by only E
relaxes bronchi
vasodilates
increases glycogenolysis in liver/skeletal muscle
far vision through dilation of pupil (ciliary muscle relaxes)

80
Q

Bronchioles

A

SNS
B2 - increase airway radius
PNS
M3 - opposite

81
Q

Heart

A

SNS
B1 - increase HR, contractility, and nodal conductance
PNS
M2 - opposite

82
Q

Blood vessels

A

SNS
a1 - vasoconstrict in viscera
B2 - vasodilate in skeletal muscle

83
Q

Liver

A

SNS

B2 - increase glycogenolysis/gluconeogenesis

84
Q

Pupil

A

SNS
a1 - dilate/increase pupil radius
PNS
M3 - opposite (sphincter muscle)

85
Q

Ciliary muscle

A

SNS
B2 - relaxation for far vision
PNS
M3 - contraction for near vision

86
Q

High Pressure (arterial) Baroreceptors

A

exposed nerve endings
Carotid sinus - glossopharyngeal nerve (IX) - cerebral blood flow
Aortic arch - vagus nerve (X) - systemic blood flow

87
Q

Low Pressure (cardiopulmonary) Baroreceptors

A

cardiac atria and pulmonary artery
A receptors - report on HR (sense atrial wall tension during contraction)
B receptors - report on atrial volume (sense atrial stretch during filling)

88
Q

Chemoreceptors

A

CO2 levels

located in carotid fork and aortic arch

89
Q

Where do the baroreceptors signal?

A

nucleus tractus solitarius (NTS) in the CV center (in medulla oblongata)

90
Q

Increase in baroreceptor firing rate

A

negative signal to Vasomotor Center (lowers SNS - controls HR and SV)
positive signal to Cardioinhibitory Center (increases PNS - controls HR only)

91
Q

Vasoactive vs nonvasoactive substances

A

Vasoactive - affect vascular smooth muscle cell contraction and relaxation
Nonvasoactive - affects blood volume

92
Q

serotonin

A

vasoconstrictor

93
Q

histamine

A

vasodilator

94
Q

vasopressin

A

vasoconstrictor at high conc.

increased water reabsorption

95
Q

Increased renin

A

due to decreased BP

cleaves angiotensinogen to AngI

96
Q

ACE

A

angiotensin converting enzyme

AngI -> AngII

97
Q

aldosterone

A

increases retention of Na and water

stimulated by AngII

98
Q

Does a change in TPR change the mean circulatory pressure?

A

no

99
Q

Static exercise

A

Increase HR, TPR, BP, PP

Decrease SV, CO

100
Q

Dynamic exercise

A

Increase HR, SV, CO, BP, PP

Decrease TPR

Physiology (6 decks)

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