CVS Flashcards
ORGANISATION OF THE CARDIOVASCULAR SYSTEM
•The cardiovascular system is a (open or closed?) system of a pump and conduits in the body through which blood circulates.
Closed
CVS
•It consists of:
a. the HEART -which is the ____
b. the BLOOD VESSELS – the ______
pump
conduit channels.
The heart has four chambers – left and right atria and left and right ventricles.
Though it is actually two pumps in (series or parallel?) .
Series
The left ventricle pumps blood through the arteries and arterioles (________) and capillaries (______) vessels, through the venules and veins (______) vessels back into the right atrium.
The right atrium pumps the blood into the right ventricle to complete the ventricular filling.
conductance
exchange
capacitance
The right ventricle pumps blood through the ______ circulation.
Pulmonary
The pulmonary circulation is a (low or high?) pressure circulation while the left ventricle pumps blood through the (low or high?) pressure ______ circulation.
Low
High; systemic
The atria assist the ventricles by forcing extra blood into the ventricles after the period of ‘ _______ ’. This improves the efficiency of the pumps.
passive filling
The generation of a pressure head by the _____ action of the ____ and the sustenance of this pressure by the ____ properties of the _____ ensure the constant flow of blood round the whole body.
pumping; heart
elastic; arteries
THE HEART
- The heart is made up of a different type of muscle, known as the cardiac muscle or _______.
- The cells of the heart muscle are (short or long?) and (straight or branched?) and join to each other at ___ junctions with ____ discs- which allow for communication between the cells.
- This arrangement makes the whole cardiac muscle to function as a continuous unit called _______.
MYOCARDIUM
Long; branched
gap ; intercalated discs
syncytium
intercalated discs
porous or non -porous discs
Porous discs
The superior and inferior vena cava join to form the _____ and open into the _____ near the location of the ________ Node.
The right atrium opens into the right ventricle through the atrio-ventricular valve (_____ valve).
While left atrium opens into the left ventricle through the ______ valve.
The ______ septum separates the left ventricle from the right ventricle.
sinus venosus
right atrium
Sino-Atrial (SA)
TRICUSPID
BICUSPID MITRAL
interventricular
The pulmonary valve (____) guards the opening of the _______ to the pulmonary artery while the aortic valve is at the opening of the _____ into the aorta.
Semilunar
right ventricle
left ventricle
The left atrium receives _____ blood from the ______ veins.
oxygenated
pulmonary
The cusps of the AV valves are supported by the ________ which are specialised tissue anchored to the _______
chordae tendinae
ventricular walls.
A cut section through the wall will reveal the various layers of cardiac tissue epicardium on the outside, myocardium in-between and the endocardium covering the chamber wall. There is a Parietal pericardial membrane surrounding the heart and with the visceral pericardium create a space surrounding the heart.
Ah
BLOOD VESSELS
•The aorta and arteries act as a (high or low?) -pressure storage reservoir.
- The flow of blood into the arteries during systole ____ the outflow at the arteriolar end and thus leads to ___ease in arterial volume and pressure.
- During diastole, _____ of the arterial walls provides a _____ to propel blood out of the arteries and thus maintain flow.
High
exceeds
Incr
elastic recoil
driving force
The (thin or thick?) aorta contains mainly ____ tissue
arteries contain ____ tissue and ______
the arterioles contain mainly contractile _____.
Capillaries which are exchange vessels contain mainly _______.
Thick; elastic
elastic; smooth muscle
smooth muscle
epithelial cells
Capillaries feed into (thin or thick?) -walled venules that coalesce to veins that contain valves which are ____ vessels and vena cava that return blood to the right atrium.
Thin
capacitance
The electrical excitation of the heart starts from the _____ node which is at the head of a specialised cardiac conduction system.
•___ node —________ ______________ -________ – other muscle fibres of ventricles.
sino-atrial
SA
internodal pathways
Atrioventricular node
Bundle of His
Purkinje fibres
The electrical excitation of the heart starts from the Sinoatrial node (SA node), the ______ which is at the head of a specialised cardiac conduction system.
pacemaker
Anterior Internodal pathway of ___
Middle “ “ “ _______
Post. “ “ “ of ____
Bachman
Wenckebach
Thorel
Conduction velocities of parts of the heart •SA node \_\_\_ m/s •Internodal pathways \_\_\_ m/s •AV node \_\_\_\_\_ m/s •Bundle of His \_\_m/s •Purkinje Fibres \_\_\_ m/s •Other muscle fibres vt. \_\_ m/s
0.05
1
0.05
1
4
1
Other parts of the heart are capable of also initiating electrical activity on their own. However the S.A. discharges _____ (due to its ______).
This pre-empts the others thus setting the pace for the heart beat. This is why the S.A. node is called the Cardiac _______.
faster
unstable membrane potential
Pacemaker
The specialised conductive tissue of the heart contains more ______ and _____. The boundaries of its fibres are (precise or diffuse?) .
glycogen & sarcoplasm
Diffuse
The resting membrane potential in most tissues of the body is about -___mV and is relatively (stable or unstable?) until depolarised.
80
Stable
Depolarisation occurs due to an increase in permeability of the membrane to ___ (conductance) allowing a massive influx of ____ ions.
A plateau phase (slow) usually follows due to increase in _____ ion conductance.
•The repolarisation phase which follows is due to the delayed increase in ___ permeability allowing _____ to _____ while ____ is being pumped ___ of the cell.
Na+
sodium
calcium
K+
potassium
Re enter
sodium; out
in the heart and especially in the sino-atrial node and the atrioventricular node, the membrane potential is (stable or unstable?).
unstable
In SA node
Unlike the other tissues there is a steady ___ease in K+ permeability, ___ease in Ca2+ movement, this leads to a _____ or _______ which continues to rise.
When the potential reaches about -__mV which is the firing level, an action potential is fired.
Decr
Incr
pre-potential or pacemaker potential
40
Ventricular and atrial muscle have prepotentials
T/F
F
Ventricular and atrial muscle have no prepotentials
The pacemaker potential is thought to be due to a group of channels, referred to as ___ channels .
These channels open at very _____ voltages (i.e. immediately after phase ____ of the previous action potential) and allow the passage of ________ into the cell.
• Due to their unusual property of being activated by very negative membrane potentials, the movement of ions through the HCN channels is referred to as the ______
HCN
negative
3
both K+and Na+
funny current
Full meaning of HCN channels
_________________________________ channels
Hyperpolarisation-activated cyclic nucleotide-gated
Another theory regarding the pacemaker potential is the ‘_____ _____’.
Here, calcium is released from the ______, within the cell.
This calcium then increases activation of the _____ exchanger resulting in the ___ease in membrane potential (as a __ charge is being brought into the cell (by the ____) but only a __ charge is leaving the cell (by the ___) therefore there is a net charge of __ entering the cell).
calcium clock
sarcoplasmic reticulum
sodium-calcium
Incr
+3; 3Na+
+2; Ca2+
+1
Ach or pE stimulation (reduces or increases ?) Prepotl by ___polarisation (______ receptors) due to I ___ permeability (through ___ channels) I ____ HR
reduces
hyper
muscarinic
K+; K+
firing
Vagus nerve is _____patheticE
paraSym
The “waves” of depolarization and subsequent repolarization that sweep through the myocardium during electrical systole produce minute differences in electrical potential (i.e., voltage) on the surface of the body. These potential differences can be amplified to produce the __________.
electrocardiogram
Ohm’s law states that the ______ of a ___ (I) flowing in a ____ equals the ___ in ____(E) across the circuit _____ by the _____ (R) of the circuit: I = E/R
These fundamental concepts of electricity underlie the ECG.
T/F
magnitude of a current
circuit
difference
potential
divided
resistance
T
The P wave is produced by ____polarization of the ____.
- The QRS complex is produced by __polarization of the ___
- The T wave is produced by ___polarization of the _____.
de; atria
de; ventricles
re; ventricles
P wave duration:____ sec.
P-R interval: ___-____ sec.
- QRS duration:___-___ sec.
- Q-T interval (corrected for HR):
male =___ sec.
female= ____ sec.
- 12
- 12 - 0.20
- 06 - 0.10
- 45
- 47
blood pressure
- Physical Definition: _______
- Force units: ____
- Area: ____
- Pressure = ______
Force per unit area
dynes
cm2
dyne/cm2
Tire pressures are measured in _____ (force) per _____ (___)
pounds
square inch
psi
Force/area =
lbs/____
or
dyne/___
in2
cm2
Relating pressure to energy
Pressure = Energy/volume
Work = pressure x _____
change in volume
blood pressure
- is the result of ___ that the ____ has ____;
- it is stored energy, or ____ of blood
- this energy is used - “dissipated” in overcoming the ____ within blood to ______ around the circulation.
work
heart; performed
energy/ml
viscous forces
move blood
The heart also expends energy to accelerate the blood from ___ velocity when inside the ____ during ____ to ____ velocity during ____; this is _____ energy
Zero
ventricles
diastole
peak
ejection
Kinetic
The ______ circulation must deliver adequate flow of _____ blood to meet the on-going energy demands of the myocardium!!
oxygenated
coronary
mm Hg stands for “_______________ ”
millimeters of mercury
The man (the ____) is performing work.
•The pump represents the ______, the source of the blood that the heart pumps.
The blood in the bucket represents a ______, the amount of blood pumped each beat
heart
venous circulation
stroke volume
Pressure was first measured in a weird way by the __________ in _____
Rev. Stephen Hales
1733
The Rev. Stephen Hales first measure-ment of arterial blood pressure :
•Blood rose in a ___ connected to the _____ of a ____ to __ ft __ inches =——- mm blood
tube; carotid artery; horse
9; 6; 2900
Mercury is ____ times more dense than blood (or water).
13.6
Rev hales Stephen experiment
The average pressure in mm Hg was therefore
____/____= ____ mm Hg
2900
13.6
213
In a patient in congestive heart failure a physician will note the ____ to which his/her ___ are engorged within the neck - a fluid column!
height
veins
When are pressures measured in cm H20 rather than mm Hg?
when the pressure is relatively low, such as in a vein rather than an artery
How does the height of a fluid column change as one moves away from the pressure source?
The height of the fluid column decreases at locations progressively farther from the source.
Blood pressure decreases from its highest value in the _______ to its lowest value in the _____
ascending aorta
right atrium.
Blood pressure in the aorta and right atrium:
- Pressure in the aorta oscillates during each heart beat - peak (____) pressure occurs during ______; the nadir (____) occurs at the end of the ______ phase (diastole).
- Right atrial pressure is very (High or low?) -
- This gives the “typical” pressure of ___/___mm Hg.
systolic; ejection
diastolic
filling
Low
120/80
Right atrial pressure is 0mmHg
T/F
F
almost, but not quite, zero mm Hg; just enough energy remains in the blood entering the heart to fill the ventricle(s) in preparation for the next beat.
Transmural pressure
Trans ( ______ ) mural (___)
•The difference in pressure between the ___ and ____ of the _____ determines their volume, or _____
across; wall
inside and outside
ventricles
preload
Why were your veins full of blood when your hand was below your heart?
a. venous pressure > interstitial pressure
b. venous pressure - interstitial pressure > 0
c. pressure difference “across” the wall of the vein > 0
d. pressure acting to distend the vessel wall > pressure compressing the wall
e. All the above are correct
E
Bitch!!!!
Preload:
•The volume of blood inside the ventricle(s) immediately prior to the _____ of ____; a major determinant of _____.
•This volume is determined by the pressure ______ minus the pressure ______ (which, by the way, changes with respiration).
beginning; systole
stroke volume
inside the ventricle
outside the ventricle
Afterload:
•Roughly speaking, is the ________ pressure
arterial blood
Afterload is a major determinant of the ______ the heart must perform (I.e _______ consumption)
amount of work
Energy
energy consumption = _____,
the rate of ____ consumption by the _____ which is a critical consideration in people with ________ disease
MVO2
oxygen
myocardium (M)
coronary artery
The total hydraulic resistance offered to the flow of blood around the circulation can, however, be calculated using an equation analogous to ___ law
Ohm’s
It is possible to insert a catheter or probe into a patient and directly measure the resistance to the flow of blood.
T/F
F
It’s not
Computation of total peripheral resistance, TPR
- PAo =_______ (_____)
- PRA =________ (almost ___ mm Hg, and often ________ in this computation)
- CO =_______ (____)
mean aortic pressure; mm Hg
right atrial pressure
0; neglected
cardiac output; L/min
How do resistors connected in series behave?
The total resistance for resistors connected end-to-end is simply _______,
but there are relatively (few or plenty ?) vascular beds in series (____ circulations).
their algebraic sum
Few
portal
most circulations in the body are connected in (series or parallel?)
Parallel
Consequences of parallel arrangement of hydraulic resistances in the circulation
• Arterial pressure can’t be controlled by altering the hydraulic resistance of individual vascular beds
T/F
F
It can
Consequences of parallel arrangement of hydraulic resistances in the circulation
•flow through individual vascular beds can be markedly increased or decreased without _____ in ________ and, thereby, mean arterial pressure.
producing major changes in TPR
The cost of hypertension
- _______ BP forces the heart to work harder -
- even though stroke volume is ______eased!
- Hypertension will eventually lead to myocardial ____trophy and, finally, heart ____.
Elevated
not incr
hyper
failure
Effect of exercise on
Heart rate
Stroke volume
Blood pressure
Increased
Increased
Increased
Effect of high BP on
Heart rate
Stroke volume
Blood pressure
Reduced
Unchanged
Increased
Blood is the medium of transportation for the circulatory system
•Two type of blood
•______ blood
•______ blood
- Two type of circulation in series
- ______ circulation
- _______ circulation
Oxygenated
Deoxygenated
Systemic
Pulmonary
The Heart
Shaped like an _______ _____ _____
– Base is the (smaller or larger?) , (flat or round?) part
– Apex is the (superior or inferior?) end which tapers to a (sharp or blunt?) , (flattened or rounded?) point
inverted blunt cone
Larger; flat
Inferior
Blunt
Rounded
•Myocardial cells
– Contract to ___ blood out of heart’s ____
• Electrical conduction system cells
– Initiate and carry ____ throughout heart
propel; chambers
impulses
Cardiac muscle is
_____ shaped and ____ing at their ends
–______ and ___ junctions allow rapid movement of electrical impulses from one cell to another
–________ hold cells together when heart muscle contracts.
Cylindrical; branch
Intercalated disks; gap
Desmosomes
Myocytes – Enclosed in \_\_\_\_\_ – Composed of two protein filaments •\_\_\_\_ • \_\_\_\_\_
sarcolemma
Actin
Myosin
Actin
Myosin
Which is thin, which is thick
Actin is thin
Myosin is thick
Physiological Properties of Myocardial Cells
•Automaticity / Rhythmicity
– Can _______ without _____
• Excitability
– Ability to respond to _____
• Conductivity
– Ability to _____ an electrical stimulus from cell to cell throughout myocardium
• Contractility
– Ability of myocardial cell to _____ when stimulated by an electrical impulse
produce electrical activity; outside nerve stimulation
an electrical stimulus
transmit
contract
Polarized State
•Inside of myocardial cells more ___ly charged in relationship to outside where it is more _____ly charged
negative
positive
Depolarization
•Occurs when ____ly charged
ions move inside cells causing
interior to become ___ly charged
•electrical charge over time referred to as cell’s _____
positive
positive
action potential
Repolarization
Follows ______ and
occurs when:
– Potassium ____ cell causing positive charge to (lower or increase?)
–_____ and _____ are removed by special
transport systems
depolarization
leaves
Lower
Sodium and calcium
In summary
Refractory Periods
Absolute refractory period
–_____________________
• Refractory period
– A ________________
No stimulus no matter how strong will depolarize cell
sufficiently strong stimulus will depolarize myocardium
Cardiac Cycle = ____ sec
•Systole (___sec)
– ____tion of atria and ventricles
- Diastole (___ sec)
- _____tion of atria and ventricles
- 8
- 3; Contrac
- 5; Relaxa
List the steps in cardiac cycle
Hint: 8 steps
- Atrial systole
- Isometric Contraction
- Maximum Ejection
- Reduced Ejection
- Protodiastolic
- Isometric relaxation
- Maximum filling
- Reduced filling
Atrial systole –\_\_\_ sec •Isometric Contraction –\_\_\_ sec •Maximum Ejection –\_\_\_ sec •Reduced Ejection –\_\_ sec •Protodiastolic – \_\_sec •Isometric relaxation –\_\_\_ sec •Maximum filling –\_\_ sec •Reduced filling –\_\_ sec
- 1
- 05
- 15
- 1
- 04
- 06
- 1
- 2
Heart sounds and murmurs
•Out of the __ heart sounds only __ are audible
4
2
1st heart sound – heard as ___.
• (high or Low?) intensity, (short or long?) duration.
•Occurs at the ___ of _____
lub; low ; long
beginning of systole
2nd heart sound – Heard as ___.
• (high or Low?) intensity, (short or long?) duration.
•occurs at the ____ of _____
dub
High; short
beginning of diastole
The duration between 1st and 2nd heart sound is the ____ period and between the 2nd and the 1st is the ____ period
systolic
diastolic
Heart murmurs – Abnormal heart sounds
•Systolic murmurs
•Diastolic murmurs
- Causes
- Valvular ______ or ____
- _______ of the vessels
incompetence or insufficiency
stenosis
Cardiac Output
____ of blood pumped from the heart in _____
Expressed in ____
Amount
one minute
LPM
Heart Rate (HR) – number of ____ per _____ = ___
heart beats; minutes
72
Stroke volume (SV) – ____ of blood pumped out of each ventricle per ___ =___
amount; beat
70ml
SV =_______ - ______
End Diastolic Volume (EDV) – End Systolic Volume (ESV)
EDV is the amount of blood in the ventricle at the __________. It is determined by _______
end of diastole
Venous return (VR).
VR is the amount of blood _______ per ____. VR is controlled by several other factors.
returning to the right heart
minute
ESV is the amount of blood __________ at the ______.
It is determined by the ___ of contraction of the ______.
remaining in the ventricle
peak of systole
force
Cardiac muscle fibers
Relationship between C.O and body size =
Cardiac Index (C.I) about ___m2/min
3.2
Effect on the following on CO
Exercise Anxiety deep thinking Heart diseases Eating during pregnancy sitting or standing up from lying position sympathetic stimulation Sleep
Increase
Increase
Unchanged
Decrease
Increase
Increase
Decrease
Increases
Unchanged
FICK’s LAW
-amount of substance ______ by ______ is equal to the ___ of ______ and _____ of that substance
For oxygen (CO=___/_____)
taken or release
peripheral tissues
product
cardiac output and arterial-venous difference
VO2
Ca-Cv
Indicator dilution methods
Cardiac output measurement by indicator dilution method is an ____ technique that measures the amount of blood ____ by the ____ every ____ for ______ in the whole body.
The method involves injecting an ____, which may be a ___,_____, or _____ into the ___ blood, and its concentration is measured continuously in the ____ blood as it passes through the circulatory system.
invasive
ejected
heart; minute
peripheral circulation
indicator; dye ; thermal ; saline solution; venous
arterial
To control C.O, the 2 determinants i.e._____ and ____ should be controlled.
- 2 mechanisms are involved in controlling these 2 determinants
- ____
- ______
H.R and S.V
Extrinsic
Intrinsic
Control of CO
HR- only by _____ methods: _____ and ______
SV- extrinsic by ______; intrinsic by ______
extrinsic; sympathetic and parasympathetic
sympathetic; frank sterling’s law
frank sterling’s law
which states that under ___ conditions, the ____ of the _____ is ___ proportional to the _____
normal
length
cardiac muscle
directly
force of contraction
Control of CO
Venous return
- ___ease pressure gradient increases VR
- ___ease blood volume increased VR
- (high or low?) intrathoracic pressure increases VR
- _________________ in the veins to ensure blood returns to heart
Incr
Incr
Low
unidirectional valves
Basically , (high or Low?) pressure gradient leads to increase in venous return that leads to ___eased ventricular filling ((high or low ?) EDV) which would increase the ___ of the cardiac muscles thereby increasing the ______ leading to more blood being pumped out ((high or low?) ESV), leading to (high or low?) stroke volume equaling (high or low?) cardiac output
High
Incr
High
length
force of contraction
Low
High
High
Control of CO
Preload :
-___ease this, force increases,SV and CO increases
After Load – the pressure the heart will ____ to ____ into the ____ circulation
Incr
overcome; pump; systemic
Blood pressure
-BP= ____ x _____
CO x TPR
Blood flow =______/_____
pressure/resistance
black people have (higher or lower?) BP than white
-urban people have (higher or lower?) BP than rural
Higher
Higher
men have (more or less?) BP than women till women reach _____, then its ____ or _______
More
menopause
equal
they might even have more
Blood Flow is determined by ______ and _____
Resistance and viscosity
An increase in resistance without change in pressure could lead to ____ flow.
zero
Relationship between resistance and radius
R = 1/r4
S.P = ____mmHg
D.P = ___mmHg
120
80
Pulse pressure =______?
PP =SP – DP
Mean arterial bloood pressure = ????
MABP = D.P + 1/3 PP
Measurement of ABP – _________ with an inflatable cuff
- ______ method
- _______method
Sphygmomanometer
Palpatory
Auscultatory
NERVOUS CONTROL
-there are ___receptors in the aortic arch and carotid ___
Baro ; sinus
integrated center is the cardiac center located at the __________ made up of 2 parts
-______ area(lateral) and ______ area(medial)
floor of the medulla
pressor
depressor
when the BP is too low, the activity of the baroreceptors gets _____ and the AFFERENTS (____ and ____) sends impulse to the _______ , specifically to the ___ area which is made up of 2 parts,
-the _______center ((ontop or below?)) to increase ____ and _____ area to increase the ___
-after decision has been made, it sends information to the heart through ____ nerves for heart rate increase and ___ nerves to increase vasoconstriction
reduced
vagusX and CN 9
floor of the medulla; pressor
cardiac accelerating ; ontop; heart rate
vasoconstriction; TPR
cardiac; sympathetic
CAPILLARY FLUID SHIFT MECHANISM
-increase in blood pressure leads to (more or less?) fluid being filtered away from the _____ into the ____. Therefore , blood volume ____ and so blood pressure itself ____
More
capillaries
ISF
reduces
reduces
RENAL REGULATION
-there are specialized group of cells in the kidneys called _____
juxtaglumerular apparatus
JG apparatus (located where the ____ part of the nephron comes in contact with the ______ of that nephron) made of ___ cells
tubular
originating glomerular
3
JG apparatus
juxtaglumerular cells
___receptors
are densely located at the _____ of the nephron, sparsely located on the _____
secretes proteolytic ____
Baro
afferent arterioles
efferent arterioles
renin
Macular densa
found at the junction of _______ touch _______
-they are ___receptors(sensitive to changes in _____,specifically _____ conc)
ascending limb of loop of Henle
distal convoluted tubule
osmo; electrolytes; sodium ion
Macular densa
they are in bulk
T/F
T
lacis cells
- ______ cells
- they connect _____ to _____
- they are secretory and produce ______
messenger
jg cells to macula
prostaglandins
when blood pressure ___eases, renin secretion from kidneys is increases
Decr
renin acts on _____ (from ____)to give ______
angiotensinogen; liver
angiotensin 1
angiotensin converting enzyme(ACE) (found in abundance in the ____) acts on ______ to give ______
lungs
angiotensin 1
angiotensin 2
angiotensin 2 does 3 things
(1) it initiates Vaso_____ of the blood vessels to ___ease peripheral resistance and ___ease bloood pressure.
(2) it also constricts ______ of the kidney to reduce its level of filtration (glomerular filtration) so that more water and volume can be retained in the blood to increase blood volume and CO
(3) also by stimulating the kidney cortex to produce _______ which makes the kidneys reabsorb sodium.
(4) also it’s a potent stimulus for the _____ nucleus in the hypothalamus to produce an hormone know as ___ that helps to reabsorb water
(5) stimulates the ______ organ in the hypothalamus which is location for thirsting . You feel thirsty, you take more water. More water you take, more water would be reabsorbed in intestine =increase in blood volume
constriction
incr; incr
afferent arterioles
aldosterone
Supra optic ; ADH
sub fornical
Most potent Vasoconstrictor in the body is ???
Angiotensin 2
People who have tetany have locked jaws
T/F
T
Fibrillation/defibrillator
Delivers ___ to the heart to ____ it or give it the right rhythm
electricity
restart
TPR,CO,Pao
Relate it
TPR=Pao/CO
Measuring arterial BP by cuff and stethoscope
PALPATORY METHOD
- put the cuff
- keep ____easing the pressure by squeezing the ball till you can’t feel the ____ pluse again
- then add extra __mmHg
- then start reducing the pressure back
- the point you feel the radial pulse again
- that’s the _____ pressure
Incr
radial
20
systolic
Palpatory method can be used to measure systolic and diastolic pressure
T/F
F
Only systolic
AUSCULTORY PRESSURE
- repeat the palpatory method but use the stethoscope to listen for when the pulse is back from the ____
- but it comes in sounds, like 5
- when you can’t hear any sound again, that’s the ______ pressure
cubital fossa
diastolic
mean arterial pressure is ____ of ___ pressure+ _______
1/3
pulse
diastole
korotkoff sounds are heart sounds when the cuff changes the flow of blood In the artery;heard by the ____
stethoscope
List the 4 korotkoff sounds
______
____
_______
———
Tap
Mumur
Gong
Muffled
lub sound
___ heart sound
_______ phase
sound from ______ of ______
dub sound
_____ heart sound
_______ phase
sound from _____ of _____
first
isometric contraction
closure of atrioventricular valves
second
prodiastole
closure of aortic and pulmonary valves
wiggers diagram shows pressure and volume ______
pressure-volume loop shows them ______
separately
together
COMPLIANCE
-. CHANGE IN ______
CHANGE IN _______
VOLUME
PRESSURE
DIASTOLIC DYSFUNCTION
- if the myocardium becomes more stiff ((more or less?) compliant) , filling becomes compromised ;small pressure starts corresponding to (small or large?) volume
- the heart becomes less compliant due to myocardial ____trophy
- _____
- deposition of ______ elements
Less
Large
hyper
ageing
less elastic
pulmonary arterial pressure is _____ mmHg
22/11
Systemic vascular resistance exceeds pulmonary’s own
T/F
T
less energy is required to move an equal vol of blood through the systemic as compared to pulmonary circulations!
T/F
F
Venous pressure
- Pressure in __________ is central venous pressure
- pressure in ______ are pheripheral venous pressure
vena cavae and right atrium
peripheral veins
venous pressure is (more or less?) in parts of the body above the heart
Less
pressure is (greater or lesser?) in peripheral veins than central vein
Greater
Physiological Factors that affect venous pressure
____eases when you tilt the body
____eases when you go from standing to supine
____eases during forced expiration (valsalva manuever)
___eases during excitement
____eases due to gravity from standing for a long time
Incr
Incr
Incr
Incr
Incr
Effect of these on VR
High cardiac output venous obstruction congestive heart failure failure of valves in veins renal failure severe haemorrhage Surgical shock -paralysis of muscle
Decreases Increases Increases Increases Increases Decreases Decreases Increases
volume of venous blood is ____ proportional to venous return
peripheral resistance is ____ proportional to venous return
directly
inversely
EFFECTS OF RESPIRATION ON VENOUS PRESSURE
(1) Vasalvar maneuver: forced \_\_\_\_\_ \_\_tive intrathoracic pressure \_\_\_\_ of \_\_\_\_ vein of \_\_\_\_ \_\_\_eased central pressure \_\_\_eased peripheral pressure \_\_\_eased venous return to right atrium
expiration
posi
compression of central ; thorax
Decr
Incr
Decr
EFFECTS OF RESPIRATION ON VENOUS PRESSURE
Mueller maneuver: forced \_\_\_\_\_\_ \_\_\_tive intrathoracic pressure \_\_\_eases central pressure \_\_\_eased peripheral pressure \_\_\_\_eased venous return to right atrium
inspiration
nega
Incr
Decr
Incr
Fibrillation can occur if heart is ____ during ___ refractory period
contracted
relative
FIBRILLATION
_______ heart beats
Irregular
Atrial fibrillation: can be caused by (high or low?) BP,heart attack, e.t.c. It can lead to stroke, heart failure, etc. can be corrected by getting your heart resetted to its regular rythm
-ventricular fibrillation: ventricles of the heart ___ instead of ___ due to disorganized electrical activity .
________________ still remains the best way to fix it
High
quiver
pump
External electrical defiribillation
Arterial pressure
Physiological variation
- ___eases as you age
- (more or less?) in obese person
- (more or less ?) in the afternoon than morning and evening
- (increased or reduced?) during sleep
- (up or down?) after meals
- (up or down?) during excitement and anxiety
Incr
More
More
Reduced
Up
Up
SBP is _____ proportional to exercise
DBP is ______ proportional to exercise
directly
inversely
