CVP

Question 1

___ is the number one cause of death, what is number two?

Answer 1

cardiovascular disease, cancer

Question 2

CVD - major underlying cause is ___ due to (4).

Answer 2

ischemia, 1. atherosclerosis (plaquing), 2. White thrombus (platelets), 3. Red thrombus (RBC/fibrin net), 4. artery spasm

Question 3

% occlusion before diminished blood flow?

Answer 3

70%

Question 4

what is linked to atherogenesis?

Answer 4

high blood cholesterol

Question 5

inflammatory mechanisms couple ___ to ___

Answer 5

dyslipidemia to artheroma formation (plaque)

Question 6

what characterize early atherogenesis?

Answer 6

leukocyte recruitment and expression of pro-inflammatory cytokines

Question 7

inflammatory pathways promote ___, which is responsible for (2)

Answer 7

thrombosis, MI and most strokes

Question 8

___ can modulate ___

Answer 8

nervous system can modulate inflammation

Question 9

Define hemostasis

Answer 9

prevention of blood loss

Question 10

What are the four mechanisms of hemostasis?

Answer 10

1. vascular spasm
2. formation of a platelet plug
3. blood coagulation
4. fibrous tissue growth to seal

Question 11

Hemostasis - Vascular Constriction (associated with trauma) - list the three types

Answer 11

1. Neural reflexes
2. local myogenic spasm
3. local humoral factors

Question 12

Neural reflexes - ___ induced constriction from ___

Answer 12

SNS, pain

Question 13

Local myogenic spasm is responsible for?

Answer 13

most of the constriction

Question 14

Local humoral factors include ___ from ___, esp. important in?

Answer 14

thromboxane A2, platelets, smaller vessels

Question 15

___ is proportional to ___

Answer 15

degree of spasm, severity of the trauma

Question 16

Platelets function as ___ but cannot ___

Answer 16

a whole, divide

Question 17

Platelets contain (7)

Answer 17

1. contractile proteins (actin, myosin)
2. enzymes,
3. calcium
4. ADP and ATP
5. Thromboxane A2
6. serotonin
7. growth factors

Question 18

Platelet cell membrane contain ___ that avoid normal ___ but adhere to? They also contain ___ containing ___(aka___)

Answer 18

glycoproteins, endothelium, damaged area, phospholipids, platelet factor 3, thromboplastin (initiates clotting)

Question 19

Platelet activation - When platelets contact damaged area they do what four things?

Answer 19

1. swell
2. irregular form w/ irradiating processes protruding from surface
3. contractile proteins contract causing granule release
4. secrete ADP, Thromboxane A2, and serotonin

Question 20

Thromboxane A2 is a ___, meaning?

Answer 20

vasoconstrictor, constriction of smooth muscle

Question 21

Thromboxane A2 potentiates the release of ___. Is this essential for release to occur?

Answer 21

granule contents, not essential but does accelerate process

Question 22

Could a platelet activate with blockage of Thromboxane A2?

Answer 22

Yes, it would accelerate

Question 23

What produces platelets?

Answer 23

bone marrow

Question 24

Platelets are important in ___ because?

Answer 24

minute ruptures, lack of platelets associated with small hemorrhagic areas under skin and throughout internal tissues

Question 25

Platelets have a half life of? Eliminated primarily by___ in the ___. What is a normal range?

Answer 25

8-12 days, macrophage action, spleen, 150,000 to 300,000

Question 26

What is the role of endothelium?

Answer 26

prevents platelet aggregation (dialates)

Question 27

What is endothelium?

Answer 27

inner lining of blood vessels

Question 28

___ and ___ are opposites

Answer 28

Thromboxane A2 and prolactin

Question 29

What produces PG12 (prostacyelin), which does what 3 things?

Answer 29

endothelium, 1. vasodilator, 2. stimulates platelet adenyl cyclase which suppresses release of granules, 3. limits platelet extension

Question 30

Endothelium also produces ___, which does what?

Answer 30

factor VIII (clotting), opposes release of granule contents

Question 31

Platelets are related to ___ synthetase

Answer 31

thromboxane, thromboxane A2

Question 32

Endothelium is related to ___ synthetase

Answer 32

prostacyclin

Question 33

Two roles of thromboxane A2

Answer 33

1. vasoconstrictor

2. potentiates platelet degranulation

Question 34

Two roles of prostacyclin

Answer 34

1. vasodilator

2. inhibits platelet degranulation

Question 35

(2) block (2) production by ___ which converts __ to (2)

Answer 35

Aspirin and ibuprofen block thromboxane A2 and Prostacyclin production by blocking FA cyclooxygenase, , arachidonic acid to PGG2 and PGH2

Question 36

What does anticoagulants do? List the three ways it does this.

Answer 36

prevents clots from forming

1. Chelators - tie up calcium (citrate and oxylate)
2. heparin - complexes with antithrobin III
3. dicumarol - inhibition of Vit K dependent factors II, VII, IX, X synthesized by hepatocytes (aka cumadin and warfarin)

Question 37

What does lysis of clots do/mean? how?

Answer 37

dissolves clots that have already formed, plasmin from plasminogen

Question 38

What is the inactive form of plasmin which circulates in the blood?

Answer 38

Plasminogen

Question 39

Activators of plasminogen -

1. Endogenous activators are found in (3)
2. Exogenous activators include (2)
3. which has a three hour window for ?

Answer 39

1. tissues, plasma, and urine
2. Streptokinase and tPA (tissue plasminogen activator)
3. MI and stroke

Question 40

1. Most of the frank tissue damage associated with infarction occurs upon ___
2. associated with the formation of ___ with ___
3. What pressure of tissues relieved and again perfused with blood ___ are generaged

Answer 40

1. reperfusion
2. highly ROS with unpaired electrons “free radicals”
3. Free radicals

Question 41

1. Define collateralization
2. what two things does it do?
3. What is the role of the SNS?

Answer 41

1. The ability to open up alternate routes of blood flow to compensate for a blocked vessel
2. Angiogenesis (formation of new blood vessels) and vasodilation
3. May impede via vasoconstriction or augment via release of NPY

Question 42

1. Blood Coagulation is known as ___
2. Explain extrinsic mechanism
3. Explain intrinsic mechanism

Answer 42

1. Thrombosis
2. Initiated by chemical factors released by damaged tissues
3. Requires only components in blood and trauma to blood or exposure to collagen (or foreign surface)

Question 43

How many clotting factors are there?

Answer 43

13

Question 44

___ synthesizes # clotting factors, list them

Answer 44

liver, 5, I, II, VII, IX, and X

Question 45

___ depresses liver formation of (4) by blocking action of ___

Answer 45

Coumarin (warfarin or cumadin), II, VII, IX, and X, Vit K

Question 46

Hemophilia -

1. sex linked on __ chromosome, which means?
2. % of cases - defect in factor ___
3. % of cases - defect in factor ___
4. severity?

Answer 46

1. X, exclusively males (comes from mom)
2. 85, VIII
3. 15, IX
4. varying, mild to severe

Question 47

Key step in clotting is the ___ which requires ___

Answer 47

conversion of fibrinogen to fibrin, thrombin

Question 48

1. What is antiphospholipid antibody syndrome?

2. What does it cause?

Answer 48

1. Autoimmune disorder where body makes antibodies against phospholipids in cell membranes
2. Abnormal clots to form

Question 49

Risk Factors in Heart Disease -

1. List ten

Answer 49

1. increasing age
2. mal gender
3. heredity (including race)
4. tobacco smoke
5. high blood cholesterol
6. high blood pressure
7. physical inactivity
8. obesity/overweight
9. diabetes mellitus
10. high blood homocysteine

Question 50

Homocysteine -

1. What is it?
2. can also cause cholesterol to change into ___
3. Can make blood more likely to ___
4. high levels in blood (>12) can be reduced by ?

Answer 50

1. AA in the blood that may irritate blood vessels promoting atherosclerosis
2. oxidized LDL
3. clot
4. increasing intake of folic acid, B6 and B12

Question 51

Antigens in RBCs -

1. at least # commonly occurring antigens and hundreds of rare antigens have been found on the surface of ___
2. most of these antigens are weak and are not likely to cause ___
3. What are the two particular antigen sets that are likely to cause blood transfusion reactions if mismatched?

Answer 51

1. 30, RBCs
2. a immune response when transferred from one individual to another
3. O-A-B and Rh

Question 52

O-A-B blood types -

1. A and B antigens on RBSs are known as ___ because they can ___
2. __ is essentially functionless
3. genetic locus has what three alleles?
4. due to inheritance, people have ___ of these surface antigens on their RBCs

Answer 52

1. agglutinogens, trigger agglutination that cause most blood transfusionreactions
2. O
3. IA, IB, and IO (6 possible combinations of alleles
4. none, one or both

Question 53

Agglutinins -

1. produced ___ arising ___
2. No agglutinins formed against ___
3. antibody titers peak at about # yo and then do what?
4. Anti __ titers are 2X Anti __ in respective blood type

Answer 53

1. after birth (2-8 months), spontaneously
2. agglutinogens that are present on RBCs
3. 10, decline throughout life
4. A, B

Question 54

Hemolysis in mismatched transfusions -

1. Is an immediate or delayed response MC?
2. Antibodies (primarily __) cause lysis of RBCs by ?
3. hemolysis occurs to the __ RBCs, not the ___ in case of mismatch
4. __ is universal donor
5. is universal recipient
6. ___ is the most lethal effect of a transfusion reaction

Answer 54

1. immediate is less common, delayed is MC
2. IgM, activating the compliment system which releases proteolytic enzymes rupturing cell membrane
3. donor’s, recipients
4. O neg
5. AB pos
6. kidney failure

Question 55

Kidney Failure -

1. toxic substances released from ___
2. ___ shock
3. ___ from lysed RBCs precipitates and ___

Answer 55

1. hemolysed RBCs
2. circulatory
3. hemoglobin, blocks renal tubules

Question 56

Rh blood types -

1. ___ never arise (unlike O-A-B system)
2. # common Rh antigens (called ___)
3. List them
4. A person with the __ antigen does not have __ antigen and visa versa
5. ___ antigen is MC and most ___
6. Lacking the D antigen means?

Answer 56

1. spontaneous agglutinins
2. 6, Rh factor
3. C D E c d e
4. C, c
5. D, antigenic (Rh +)
6. Rh -

Question 57

Rh Blood Types -

1. What happens when Rh+ RBCs are infused into a person who is Rh-?
2. it is upon multiple subsequent exposure that a strong ___ typically occurs

Answer 57

1. it will stimulate the production of anti- Rh antibodies which develop slowly and reach maximum concentrations 2-4 months later
2. hemolysis reaction

Question 58

Erythroblastosis Fetalis -

1. AKA ___
2. characterized by?
3. . causes what to happen?
4. most cases, mother is Rh_ and father is Rh_ and the fetus is Rh_ (inherited from father)
5. the mother develops anti Rh agglutinins from?
6. When do symptoms start to occur?

Answer 58

1. hemolytic disease of the newborn
2. agglutination and hemolysis of the fetus’ RBCs by the mother’s anti Rh agglutinins
3. agglutination of fetal blood, release Hgb which is converted by macrophages into bilirubin leading to jaundice
4. -, +, +
5. exposure to the fetus’ Rh+ antigen
6. usually don’t occur with initial pregnancy and occur with 2nd (3%) or 3rd (10%) pregnancy where fetus is Rh+

Question 59

Erythroblastosis Fetalis -

1. after birth anti Rh agglutinins from mother circulate for another ___ destroying more neonate RBCs leading to ___
2. causes enlargement of ?
3. Many RBCs are ___
4. ___ may precipitate in neurons of the brain causing___

Answer 59

1. 1-2 months, anemia
2. neonate liver and spleen
3. nucleated (and blastic)
4. bilirubin, mental impairment (kernicterus)

Question 60

Prevention and Treatment of erythroblastosis Fetalis -

1. Treatment?
2. Prevention?
3. What does this shot do?

Answer 60

1. replace neonate’s blood with Rh - blood
2. Rh immunoglobulin globulin, which is an anti-D antibody, administered to mother at 28-30 weeks of gestation
3. interferes with the immune response to the D antigen in fetal RBCs that may cross the placenta and enter mother’s circulation

Question 61

Heart Muscle -

1. Atrial and ventricular are ___ grouped in ___
2. # ___ located nuclei
3. Contains (3) specialized excitatory and conductive muscle fibers
4. Which contract ___ and have ___ fibrils

Answer 61

1. striated enlongated, irregular anatamosing columns
2. 1-2 centrally
3. SA node, AV node, Purkinje fibers
4. weakly, few

Question 62

Syncytial nature of cardiac muscle -

1. syncytium = ___
2. due to ?
3. What are intercalated discs?
4. they are the presence of ___

Answer 62

1. many acting as one
2. presence of intercalated discs
3. low resistance pathways connecting cardiac cells end to end
4. gap junctions

Question 63

Actions Potentials in cardiac muscle -

1. duration of AP is from ___
2. What are three channels?
3. Na+ sharp ___ at onset of ___
4. Ca++ ___ during the ___
5. K+ ___ during the ___

Answer 63

1. .2-.3 sec
2. fast Na+, flow Ca++/Na+, K+
3. increase, depolarization
4. increased, plateau
5. increased, resting polarized state

Question 64

Membrane physiology -

1. in excitable tissue an AP is ___
2. Na+ increases at onset of ___, decreases during ___
3. Ca++ increases at onset of ___, decreases during ___
4. K+ decreases at onset of ___, increases during ___

Answer 64

1. a pulse like change in membrane permeability
2. depolarization, repolarization
3. depolarization, repolarization
4. depolarization, repolarization

Question 65

Slow vs Fast cardiac cell -

1. related to the channels that?
2. typical cardiac muscle have both ___ channels that open during depolarization
3. specialized excitatory cells like the ___ only __ Ca++/Na+ channels are operational during depolarization ___depolarization time
4. ___ blocks ___ channels selectively changing a fast response into a slow response

Answer 65

1. open during depolarization
2. fast Na+ channels and slow Ca++/Na+ channels
3. SA node, slow, increasing
4. tetradotoxin, fast Na+

Question 66

Passive ion movement across cell -

1. What are three considerations we need to think about?
2. in ion channels are open, an ion will seek its ___
3. concentration gradient favoring ion movement in one direction is offset by ___

Answer 66

1. concentration gradient (high to low), electrical gradient (opposite charge attract, like charge repel), and membrane permeability (dependant on ion channels open or closed)
2. Nernst equilibrium potential
3. electrical gradient

Question 67

Resting membrane potential (Er) -

1. during the Er in cardiac muscle, __ and __ are closed while ___ channels are open
2. therefore K+ ions are ___, and when they reach their Nernst equilibrium postential ___ occurs

Answer 67

1. fast Na+ and slow Ca++/Na+, K+

2. free to move, a stable Er is maintained

Question 68

Na+K+ ATPase (pump) -

1. this pump with is ___ dependent operates to pump Na+ ___ and K+ ___ the cardiac cell at a ration of ___
2. as pumping occurs, there is a net loss of ___ from the interior each cycle, helping the interior of the cell remain ___
3. the protein pump utilized energy from ___
4. __ binds to and __ this pump

Answer 68

1. energy, out, into, 3:2
2. one + charge, negative
3. ATP
4. digitalis, inhibits

Question 69

Ca++ exchange protein -

1. in the cardiac cell membrane is a protein that exchanges ___ from the interior in return for ___ that is allowed to enter the cell
2. the function of the exchange protein is tied to the ___
3. if the Na+/K+ pump is inhibited, function of this exchange protein is ?

Answer 69

1. Ca++, Na+
2. Na+/K+ pump
3. reduced and more Ca++ is allowed to accumulate in the cardiac cell increasing contractile strength

Question 70

Refractory Period -

• Absolute*
  1. unable to?
  2. occurs during the ___
• Relative*
  1. requires ___
  2. occurss during ___

1. In a slow response cardiac muscle cell the relative refractory period is __ and the refractory period is about % longer
2. in AV node and bundle this serves to?

Answer 70

1. re-stimulate cardiac cell
2. plateau
3. a supra-normal stimulus
4. repolarization
5. prolonged, 25%
6. protect the ventricles form supra-ventricular arrhythmias

Question 71

SA Node -

1. ___ of the heart
2. ___ nature
3. list 6 reasons why

Answer 71

1. normal pacemaker
2. self excitatory
3. less neg Er, leaky membrane to Na+/Ca++, only slow Ca++/Na+ cennels operational, spontaneously depolarizes at fastest rate (overdrive suppression), contracts feebly, and lacks stability and plateau

Question 72

Overdrive Supprestion -

1. if you drive a self excitatoyr cell at a rate faster that its own inherent rate, you will ___
2. mechanism may be due to?
3. cells of the (2) system are under overdrive suppression by the ___

Answer 72

1. suppress the cell’s own automaticity
2. increased activity of Na+/K+ pump creating more negative Er
3. AV node and purkinje, SA node

Question 73

AV node -

1. delays ___
2. this allows the atria to?
3. ___ conduction velocity due to ___
4. in absence of SA node, AV node may act as apcemaker but at a ___ rate

Answer 73

1. the wave of depolarization from entering the ventricle
2. contract slightly ahead of the ventricles (.1 sec delay)
3. slow, smaller diameter fibers
4. slower

Question 74

Effect of HR on systole/diastole -

1. as HR ___ cycle length (CL) ___
2. at a resting heart rate systole __ diastole
3. both the duration of systole and diastole ___, but ___ shortens to a greater extent (at a high HR the ventricle may not fill adequately)
4. HR of 75 BPM = CL ___, S ___, D ___
5. HR of 150 BPM = CL ___, S___, D___
6. during systole perfusion of the myocardium is restricted by?

Answer 74

1. increases, decreases

2.

Question 75

Cardiac Cycle -

• Systole*
  1. ___ beat
  2. contraction or relaxation
  3. inflow or outflow?
• Diastole*
  1. ___ beat
  2. contraction or relaxation
  3. Rapid ___

Answer 75

1. during
2. contraction
3. ejection
4. b/w
5. relaxation
6. inflow (70-75%)

Question 76

Ventricular Volumes - 
Define
1. EDV
2. ESV
3. Stroke Volume
4. Ejection fraction, what is normal?

Answer 76

1. end diastolic volume - volume in ventricles at the end of filling
2. end systolic volume - volume in ventricles at the end of ejection
3. (EDV-ESV) - volume ejected by ventricles
4. % of EDV ejected ( SV/EDV X 100%), 50-60%

Question 77

Terms - define

1. Preload
2. afterload

Answer 77

1. stretch on the wall prior to contraction (proportional to the EDV)
2. the changing resistance 9impedance) that the heart has to pump against as blood is ejected, changing aortic BP during ejection of blood from the left ventricle

Question 78

Atrial Pressure Waves -

1. What are the 3 waves?
2. define A wave
3. C wave
4. V wave

Answer 78

1. A, C, V waves
2. associated with atrial contaction
3. associated with ventricular contraction (bulging of AV valves and tuggin on atrial muscle)
4. associated with atrial filling

Question 79

Function of Valves -

1. Open with a ___
2. example: when ___ pressure > the ___ pressure the ___ is open
3. close with ___
4. example: when ___ pressure > __ pressure the ___valve is closed

Answer 79

1. forward pressure gradient
2. LV, aortic, aortic valve
3. backward pressure gradient
4. aortic, LV, aortic

Question 80

Heart Valves -

1. What are the two types of valves?
2. What are the two AV valves?
3. Explain
4. what are the two semilunar valves?
5. explain

Answer 80

1. AV and semilunar valves
2. mitral and tricuspid
3. thin and filmy, chorda tendineae act as check lines to prevent prolapse, papillary muscles increase tension on chorda tendineae
4. aortic and pulmonic
5. stronger construction

Question 81

Valvular dysfunction -

1. what is it called when a valve does not open fully?
2. what is it called when a valve does not close fully?
3. what is it called when a valve creates vibrational noise?

Answer 81

1. stenotic
2. insufficient/regurgitant/leaky
3. murmurs

Question 82

Heart Murmur Considerations - Timing

1. Systolic: aortic and pulmonary __, mitral and tricuspid ___
2. Diastolic: aortic and pulmonary ___, mitral and tricuspid ___
3. both?

Answer 82

1. stenosis, insufficiency
2. insufficiency, stenosis
3. patent ductus arteriosis and combined valvular defect

Question 83

Law of Laplace -

1. wall tension = ___
2. at a given operating pressure as ventricular radius __, developed wall tension ___
3. increased tension leads to?
4. two ventricles operating at the same __ but with different ___, the larger chamber will have to?
5. How does this law explain how capillaries can withstand high intravascular pressure?

Answer 83

1. (pressure)(radius)/2
2. increases, increasess
3. increased force of ventricular contraction
4. pressure, chamber radii, generate more wall tension, consuming more energy and oxygen
5. small radius = small wall tension

Question 84

Terminology - define

1. Chronotropic
2. Dromotropic
3. inotropic

Answer 84

1. (+ increases HR and - decreases HR), anthing that affects HR
2. anything that affects conduction velocity
3. anything that affects strength of contraction (ex. caffeine would be a + chronotropic agent)

Question 85

Control of Heart Pumping -

1. ___ properties of cardiac muscle cells
2. Explain Frank- Starling Law of the Heart

Answer 85

1. intrinsic
2. within physiologic limits the heart will pump all the blood that returns to it without allowing excessive damming of blood in veins (heterometric and homeometric autoregulation, direct stretch on the SA node)

Question 86

Mechanism of Frank-Starling -

1. increased venous return causes?
2. explain

Answer 86

1. increased stretch of cardiac muscle fibers
2. increase cross bridge formation, increased calcium influx (both increases force of contraction), increased stretch on SA node (increases HR)

Question 87

Heterometric autoregulation -

1. within limits as cardiac fibers are stretched the ___ is increased
2. ___ is removed
3. more Ca++ influx into cell associated with the ___

Answer 87

1. force of contraction
2. more cross bridge formation as actin overlap
3. increased stretch

Question 88

Homeometric autoregulation -

1. it is the ability to?
2. list the 3 parts that induce
3. Explain flow induced
4. explain pressure induced
5. explain rate induced

Answer 88

1. increase strength of contraction independent of a length change
2. flow, pressure, and rate
3. increase stroke volume maintained as EDV decreases
4. increase in aortic BP (afterload) will + force of contraction
5. increased HR will + force
   treppe”

Question 89

Direct stretch on SA node -

1. stretch on SA node will ___

Answer 89

1. increase Ca++ and/or Na+ permeability which will increase HR

Question 90

Extrinsic Influences -

1. Iist four

Answer 90

1. ANS
2. Hormonal influences
3. ionic influences
4. temp influences

Question 91

Control of Heart by ANS -

1. explain Sympathetic innervation
2. explain parasympathetic innervation

Answer 91

1. increases HR, strength of contraction, and conduction velocity
2. decreases HR, strength of contraction, and conduction velocity

Question 92

Interaction of ANS -

1. SNS effects on the heart are blocked using ___ which blocks ___
2. Parasympathetic effects blocked using ___ which blocks ___
3. Explain
4. What can be concluded?

Answer 92

1. propranolol (beta blocker), beta receptors
2. atropine, muscarinic receptors
3. HR will increase, strength of contraction decreases
4. perfectly off setting each other

Question 93

Interation of ANS -
1. From the previous results it can be concluded that under resting conditions: Parasympathetic NS exerts a dominate ___ influence on ___, and sympathetic NS exerts a dominate ___ influence on ___

Answer 93

1. inhib on HR, stim on strength of contraction

Question 94

Direct vs indirect SNS influence -

1. direct innervation of cardiac cells accounts for ___ of the SNS effect
2. indirect effects would be due to ?

Answer 94

1. most ( NE acting on B-1 receptors (85%))
2. circulating catacholamines (epinephrine and NE) released primarily from the adrenal medulla (blood borne) which would find their way to the cardiac B-1 receptors (15%))

Question 95

SNS balance side to side -

1. What happens with stimulation of Left stellate ganglion?
2. What happens with stimulation of right stellate ganglion?

Answer 95

1. decreased ventricular fibrillation threshold, prolongation of QT interval
2. increased ventricular fibrillatin threshold

Question 96

Unilateral denervation -

1. sympathetic denervation is antiarrhythmic, but also antifibrillatory… and effect exquisitely important for?
2. left cardiac sympathtic devervation increases ___ activity

Answer 96

1. any condiction with a high risk for ventricular fibrillation and sudden cardiac death
2. vagal

Question 97

Cardioacclerator reflex -

1. stretch on right atrial wall will?
2. AKA ___
3. helps prevent?

Answer 97

1. simulate stretch receptors which in turn send signals to MO stimulating SNS outflow to heart
2. bainbrige reflex
3. damning of blood in the heart and central veins

Question 98

Neurocardiogenic syncope -

1. Benzold Jarisch reflex (___), stimulation of sensory ending mainy in the ___ that reflex via the ___ to the CNS
2. reflex effects results in (2)
3. reflex in stimulated by (2)

Answer 98

1. Baroreceptors in ventricles, ventricles, CN X
2. hypotension and bradycardia
3. occlusion of circumflex artery (inferior wall infarct) and increase in LVP and LV volume (aortic stenosis)

Question 99

Major Hormonal Influences -

1. ___ hormones
2. explain

Answer 99

1. thyroid

2. stim both inotropic and chronotropic, also causes and increase in CO by increasing BMR

Question 100

Ionic Influences -

1. What is the effect of elevated K+?
2. Effect of elevated Ca++?

Answer 100

1. dilation and flaccidity of cardiac muscle at concentrations 2-3 times normal
2. spastic contraction

Question 101

Effect of body temperature -

1. Explain elevated body temp
2. explain decreased body temp

Answer 101

1. HR increases about 10 beats for every degree F elevation in body temp, contractile strength will increase temporarily but prolonged fever can decrease contractile strength due to exhaustion of meabolic systems
2. decreased HR and strength

Question 102

Energy substrate for cardiac cells -

1. heart is versatile and can use many different energy substrates, List 6

Answer 102

1. FA 70% preferred
2. Glucose
3. Glycerol
4. Lactate
5. Pyruvate
6. AA

Question 103

Relationship of Evergy to work -

1. 75% of energy the heart utilizes is converted to ___
2. the remaining 25% is utilized as work which is broken down into (2)

Answer 103

1. heat

2. pressurization of blood (99%) and acceleration of blood (1%)

Question 104

Work output of the heart -

1. pressurization of the blood (___): explain
2. acceleration of blood to its ejection velocity (___) : explain

Answer 104

1. potential energy, moving blood from low pressure to high pressure (volume pressure work or external work)
2. kinetic energy, out the aortic and pulmonic valves normally accounts for less that 1% of the work component (can increase to 50% with valvular stenosis)

Question 105

EKG -

1. What does it mearsure?
2. what is lead?
3. what is axis of lead?
4. what is transition line?

Answer 105

1. potential difference across the surface of the myocardium with respect to time
2. pair of electrodes
3. line connecting leads
4. line perpendicular to axis of lead

Question 106

Rate -

1. paper speed?
2. normal rate ranges usually b/w?
3. tachycardia
4. bradycardia

Answer 106

1. 25mm/sec, 1 mm = .04sec
2. 60-80 BPM
3. greater than 100
4. less than 50

Question 107

Intervals -

1. __ interval (includes ___)
2. should be about ___
3. greater than ___ = ___
4. less than __ = ___

Answer 107

1. PR, AV nodal delay
2. .16 sec
3. .2 sec = 1st degree AV block
4. .1 sec = inadequate delay - possible accessory conduction pathway from atria to ventricle

Question 108

Electrocardiography -

1. P wave
2. QRS complex
3. T wave
4. ___ is also part of the QRS complex

Answer 108

1. atrial depolarization
2. ventricular depolarization
3. ventricular repolarization
4. atrial repolarization

Question 109

Leads -

1. what are they?
2. • electrode is ___, - electrode is ___
3. the direction of the deflection (+ or -) is based on?
4. routine EKG consists of # leads

Answer 109

1. a pair of recording electrodes
2. active, reference
3. what the acctive electrode sees relative to the reference electrode
4. 12 (6 frontal plane and 6 chest/horizontal)