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Cardio > CV Part 1 > Flashcards

CV Part 1 Flashcards

1
Q

What type of blood and where does the vena cava empty?

A

Mixed venous blood

Right atrium

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2
Q

Sequential blood flow (13)

A

RA → tricuspid valve → RV → pulmonic semilunar valve → pulmonary arteries → lungs → pulmonary veins → LA → mitral valve → LV →aortic semilunar valve →aortic arch → aorta

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3
Q

How does the heart function as 2 pumps?

A

Pulmonary circulation

Systemic circulation

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4
Q

Diastole

A

Ventricular relaxation

Low intraventricular pressure

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5
Q

Systole

A

Ventricular contraction

High intraventricular pressure

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6
Q

What is the myocardium?

A

Cardiac muscle

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7
Q

What is the preferred energy in a healthy heart?

A

Free Fatty Acids

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8
Q

Heart has an extensive vascular network made of

A

Coronary arteries and veins

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9
Q

Majority of cardiac mass is (5)

A 
Endothelium
VSM
Fibroblasts
ECM
Interstitium
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10
Q

What is the myocardium comprised of?

A

Myocytes

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11
Q

How are cardiac muscle cells and fibers joined?

A

Gap junctions

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12
Q

What do gap junctions allow?

A

High degree of electrical conductivity

Free diffusion of very small molecules

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13
Q

What kind of metabolism do cardiac myocytes use to produce ATP?

A

Oxidative phosphorylation

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14
Q

What are cardiac myocytes rich in?

A

Mitochondria (serves as intracellular Ca sinks)

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15
Q

Like skeletal muscle, what do cardiomyocytes contain? (3)

A

CK-MB (cardiac specific creatine kinase)
TnI
TnT

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16
Q

What are possible diagnostic markers for an MI?

A

TnI
TnT
CK-MB

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17
Q

2 ways cardiac muscle is different from skeletal muscle

A

Slight stretch causes release of intracellular Ca

Develop more tension from stretch

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18
Q

What makes up the majority of myocardial mass?

A

Ventricles

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19
Q

What happens during the beginning of diastole?

A

Aortic valve closed
Mitral valve ready to open

LV fibers have no load

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20
Q

What happens during early diastole?

A

Mitral valve opens, filling the LV

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21
Q

Why does the mitral valve open during early diastole?

A

Combination of increasing LA filling pressure and the low LV pressure
(Think gradients)

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22
Q

What happens during the late stage of diastole?

A

Atria contract due to SA nodal firing

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23
Q

Atrial kick

A

Atria contribute 20% to ventricular filling

24
Q

What is preload caused by?

A

Blood induced filling that causes stretch

25
Q

Filling causes

A

Preload on LV muscle fibers

26
Q

Law of Laplace

A

T = P x R

Wall tension = pressure x radius

27
Q

What happens if there’s a greater wall tension?

Think Law of Laplace

A

More filling

Upregulate O2 demand

28
Q

What happens during an isovolumetric contraction?

A

Mitral and aortic valves are closed

LV pressure soars

29
Q

What is afterload in the heart?

A

Aortic pressure

30
Q

What happens when preload > afterload?

A

Aortic semilunar valve opens

LV ejects blood

31
Q

What 2 things happen in phase 1?

A

Diastolic filling

Generation of preload

32
Q

What happens in phase 2?

A

Isovolumetric contraction (systole)

33
Q

What happens in phase 3?

A

Systolic ejection

34
Q

What happens in phase 4?

A

Isovolumetric relaxation

35
Q

What does the end systolic pressure-volume (ESPVR) plot represent?

A

Max. Ventricular pressure developed at a given inotropic state

36
Q

What happens if we increase the EDV in an ESPVR plot? (3)

A

Inc. preload
Inc. systolic intraventricular pressure
Inc. ESV (a little)

37
Q

What happens if we increase afterload in an ESPVR plot? (2)

A

Inc. systolic intraventricular pressure

Inc. ESV

38
Q

What happens to the EsVPR plot given positive inotropy?

A

Inc. max. Systolic pressure

Dec. ESV

39
Q

What are inotropic compounds?

A

Alter the force of cardiac muscle contractility

40
Q

What is the goal of positive inotropic compounds?

A

Increase cardiac pumping efficiency

41
Q

What do positive inotropic compounds increase? (4)

A

Ventricular contractile force
EDV
Contraction velocity
May or may not change time interval btwn excitation episodes

42
Q

What is contraction of cardiac muscle dependent on? (2)

A

APs (induced by Na influx)

Inc. sarcoplasmic [Ca]

43
Q

What does hypocalcemia due to the QT interval?

A

Lengthens

44
Q

What does hypercalcemia due to the QT interval?

A

Shortens

45
Q

What does Digoxin do?

A

Blocks Na/K ATPase → inc. intracellular Na → NCX can’t function → intracellular Ca inc. → contraction enhanced

46
Q

What type of effect does digoxin have on the heart?

A

Positive inotropic effect

47
Q

Digoxin acts as a vagomimetic agent, meaning that it (2)

A

Slows SA and AV nodal conduction

Sensitized baroreceptors

48
Q

You can raise cardiomyocyte [Ca] by

A

Activating B1 and B2 adrenoceptors (norepi-dependent)

49
Q

Lusitropy

A

Increased rate of relaxation due to mobilization of Gi protein-dependent signaling

50
Q

Increased PKA signaling leads to: (3)

A

Activation of type L channels
Phosphorylation of phospholamban
Phosphorylation of Troponin I

51
Q

ACh interrupts ______ which _______

A

Activation of L channels

Slows cardiac muscle contractility

52
Q

Type L channels are dependent on (3)

A

Na induced AP
Catecholamines
ACh

53
Q

Where is the SA node located?

A

Within RA

54
Q

Where is the AV node located?

A

Between right and left atria and the ventricles

55
Q

SA nodal activity controls

A

AV nodal activity

56
Q

AV nodal activity initiates

A

Ventricular depolarization

Cardio (8 decks)

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