CV Function and ECGs Flashcards

1
Q

Describe the relationship between resistance and radius of a blood vessel.

A

As radius increases by a certain amount, conductance (or blood flow) increases by the POWER of 4 of that radius change. Resistance increases to the inverse 4th power of that change. [R = 1/ r^4]
Ex:) Arterioles that decrease their diameter by 2x (vasoconstrict), will decrease their flow by 16x while their resistance is increases 16x that amount.

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2
Q

Describe the Equation relating TPR to Blood Flow. What does the relationship show?

A

TPR = (Pa - Pv)/ Qt Or. R = P/Q
This relationship explains that a change in resistance through vasoconstriction causes an increase in BP and vice versa in order for CO to remain constant.

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3
Q

What are the main metabolites that bind receptors to increase Vasodilation?

A

CO2, H+ and lactic acid

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4
Q

How does the body compensate to restore RAP back to normal after a rise from venodilation?

A
  1. Venoconstrict - adjust tone to restore it back to set-point
  2. Positive Inotropy - generate a new set point that’s closer to original RAP (by lowering RAP)
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5
Q

When localizing an MI, what leads will show myocardial injury to the INFERIOR side of the heart and what coronary vessel might be occluded?

A
  1. Leads II, III and aVF show abnormal complexes (ST elevation, T inversion, new Q waves)
  2. Right Coronary Artery might be occluded
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6
Q

Name the artery that may be occluded and the leads that may indicate abnormal complexes where anterior (septal and apical) region of the heart is injured.

A
  1. Left Anterior Descending Artery may be occluded leading to injured anteroseptal/apical regions of the heart.
  2. Leads V1 - V4 may show these abnormal complexes of an MI.
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7
Q

What leads are affected if the LATERAL side of the heart is affected and what coronary artery occlusion might have led to this myocardial injury?

A
  1. Leads V5, V6, I, and aVL may indicate damage to the anterolateral part of the heart.
  2. The Left Circumflex Artery may be occluded.
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8
Q

Name the leads that are affected if the POSTERIOR side of the heart features a tall R-wave and T-inversion on the ECG. What coronary vessel might be occluded to lead to these findings?

A
  1. Leads V1 and V2 may indicate a tall R-wave.

2. The Right Coronary Artery may be occluded.

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9
Q

Rank the order of Adrenergic receptor affinity for NE at…

  1. Low dose
  2. high dose
A
  1. A1 > B1&raquo_space; B2

2. A1 and B1

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10
Q

Rank the order for affinity to Adrenergic receptors for Epinephrine at the following dosages.

  1. High Dosage
  2. Low Dosage
A
  1. A1 and B1

2. B1 and B2

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11
Q

What adrenergic drug would a physician avoid to treat an asthmatic patient with low cardiac output?

A

Avoid Propanolol. This is a NON-SPECIFIC beta blocker that may elicit the adverse effect of bronchoconstriction, compromising breathing.

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12
Q

What happens to preload in the heart under the following scenarios:

  1. Patient is administered NorEpi at LOW DOSE.
  2. A patient, after vigorous exercise is given Albuterol
A
  1. Preload INCREASES due to vaso-and-veno-constriction that increases BP.
  2. Preload DECREASES due to Vasodilation in skeletal muscles, therefore reducing BP (B2 Agonist)
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13
Q

What is the function of the Golgi Tendon Organ, how does it signal the CNS, and what would occur under high stress?

A
  1. GTO (in tendon) detects stress (stretch/tension)
  2. It reports via 1B Afferent Fibers
  3. Under high stress, CNS signals A-motor efferent to inhibit agonist and stimulate antagonist muscles (both IPSILATERAL).
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14
Q

What is the function of the Muscle Spindle, how does it signal the CNS, and how does the CNS send feedback?

A
  1. Spindles sense “Change in length” and “Rate of Length Change”
  2. It signals the CNS via
    - 1A afferents (send change in length)
    - 2A afferents (relay static length)
  3. CNS sends back signals via Gamma Motor efferent fibers.
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15
Q

Within the muscle spindle, what do the following detect:

  1. Chain Fibers
  2. Bag Fibers
A
  1. Chain - Detects Static Length

2. Bag - Detects Change in Length

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16
Q

What 3 Scenarios trigger increased O2 Demand for the heart?

A
  1. Increased Wall Stress (inc. preload from blood)
  2. Heart Rate (works faster)
  3. Contractility (squeeze harder)
17
Q

Describe at least 3 aspects that might differentiate Angina from a Myocardial Infarction.

A
  1. Angina is episodic upon exertion (goes away after exercise)
  2. Infarction can occur from cardiac cell necrosis
  3. MI can result from a completely occluded vessel
  4. Increased Troponin I and T levels signal MI
  5. Angina can be treated with nitroglycerin (vasodilator), Beta blockers and Ca channel blockers (Amlodipine) to decrease HR and O2 demand, respectively.
18
Q

Name 3 signs/symptoms to look for in diagnosing for MI?

A
  1. High Troponin Levels
  2. Radiating pain in the sternum, neck, left shoulder and arm.
  3. SOB (dyspnea)
  4. Syncope (sudden drop in BP)
  5. Nausea, palpitations, diaphoresis
19
Q

What are the normal time ranges for each of the following ECG intervals?

  1. PR interval
  2. QRS Complex
  3. QT interval
A
  1. Start of P to 1st deflection of QRS:120-200 ms or 3-5 small boxes
  2. Start of QRS to end of T-wave: <120 ms or <3 small boxes
  3. Encompasses the whole QRS-complex: 350-420 ms