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cardiology > cvs physiology > Flashcards

cvs physiology Flashcards

1
Q

the cardiovascular system is a bulk flow system supplying what?

A
  • O2 and CO2
  • nutrients
  • metabolites
  • hormones
  • and heat
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2
Q

are pumps in series or parallel

A

pumps are in series meaning output must be equal

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3
Q

are vascular beds in series or parallel

A

most vascular beds are in parallel meaning all tissues get oxygenated blood which allows regional redirection of blood

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4
Q

sequence of events during excitation-contraction coupling in cardiac muscle

A
  • cardiac muscle forms a functional syncytiu
  • cardiac muscle has a long action potential
  • long action potential = long refractory period
  • some cells have unstable resting membrane potential and act as pacemaker
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5
Q

resting membrane potential in non-pacemaker tissue

A

-90mV

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6
Q

resting membrane potential in pacemaker tissue

A

no resting potential

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7
Q

describe initiation and spread of electrical activity throughout the heart

A
  1. pacemaker cells in sinoatrial node spontaneously depolarise to threshold
  2. threshold then spreads gradually through the atria causing it to contract, pushing blood into the ventricles
  3. depolarisation spreads to atrioventrucular node, slowly as it gives time for depolarisation
  4. depolarisation spreads rapidly through bundle of His and Perkunje fibres causing ventricular contraction
  5. the ventricles then relax
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8
Q

what does the p wave correspond to

A

atrial depolarisation

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9
Q

what does the QRS complex correspond to

A

ventricular depolarisation

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10
Q

what does the T wave correspond to

A

ventricular repolarisation

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11
Q

what is the RR interval

A

QRS to QRS

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12
Q

what is the PR interval

A

time from atrial depolarisation to ventricular depolarisation, due to transmission through the AV node

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13
Q

what is the normal time for PR interval

A

0.12-0.2s

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14
Q

what is the normal QRS time

A

0.08s

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15
Q

what is the QT interval

A

time taken for ventricles to depolarise and repolarise

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16
Q

what is the normal time for QT interval

A

0.42s at 60bpm (varies with heart rate)

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17
Q

how do you measure the heart rate from an ECG

A

measure the amount of R waves in 30 large squares (6s) and multiply by 10 to get bpm

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18
Q

what is bradycardia

A

slow heart rate below 60bpm

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19
Q

what is tachycardia

A

high heart rate above 100pbm

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20
Q

what is normal heart rate

A

60-100bpm

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21
Q

characteristics of normal sinus rhythm ECG

A

regular rhythm rate
each QRS complex is followed by a normal P wave
PR interval is constant

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22
Q

characteristics of sinus tachycardia ECG

A

heart rate over 100bpm
P waves are hidden within each preceding T wave

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23
Q

characteristics of sinus bradycardia ECG

A

heart rate under 60bpm
prominent U waves in precordial leads is a common finding

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24
Q

what is a STEMI

A

ST-segment elevation - myocardial infarction

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25
Q

what is a non-stemi

A

non-ST segment elevation myocardial infarction

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26
Q

describe late diastole in the cardiac cycle

A

both sets of chambers are relaxed and ventricles fill passively

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27
Q

describe atrial systole in the cardiac cycle

A

atrial contraction forces a small amount of additional blood into ventricles

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28
Q

describe isovolumic ventricular contraction in cardiac cycle

A

first phase of ventricular contraction pushes AV valves closed but does not create enough pressure to open semilunar valves.

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29
Q

describe ventricular ejection in the cardiac cycle

A

as ventricular pressure rises and exceeds pressure in the arteries, the semilunar valves open and blood is ejected

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30
Q

describe isovolumic ventricular relaxation

A

as ventricles relax, pressure in ventricles falls, blood flows back into cusps of semilunar valves and snaps them closed

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31
Q

what is the 1st heart sound

A

closure of the AV (mitral and tricuspid) valves

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32
Q

what is the 2nd heart sound

A

closure of the semilunar (aortic and pulmonary) valves

33
Q

what is the 3rd heart sound

A

rapid passive filling phase

34
Q

what is the 4th heart sound

A

active filling phase

35
Q

what is a systolic murmur

A

stenosis of aortic/pulomary valves or regurgitation of mitral/tricuspid valves

36
Q

what is a diastolic murmur

A

stenosis of mitral/tricuspid valves or regurgitation through aortic/pulmonary valves

37
Q

what would a continuous murmur be a sign of

A

ductus arteriosus

38
Q

effects of the sympathetic nervous system on heart rate

A
  • sympathetic nerves release noradrenaline
  • plus circulating adrenaline from adrenal medulla
  • both act of B1 receptors on the sinoatrial node
  • slope of the pacemaker potential is increased
  • heart rate is increase (tachycardia)
39
Q

effect of parasympathetic nervous system on heart rate

A
  • vagus nerve releases acetylcholine
  • this acts of muscarinic receptors on the sinoatrial node
  • this hyperolarises cells and decreases slope of pacemaker potential
  • heart rate is decreased (bradycardia)
40
Q

effect of sympathetic nervous system on stroke volume

A
  • sympathetic nerves release noradrenaline
  • plus circulating adrenaline from adrenal medulla
  • both act on B1 receptors on the myocytes
  • this increases contractility (an inotropic effect)
  • which gives stronger but shorter contraction
  • stroke volume is increase
41
Q

effect of parasympathetic nervous system on stroke volume

A
  • little effect
  • probably due to vagus nerve not innervating ventricular muscle
42
Q

effects of preload on stroke volume

A
  • increased venous return causes increased EDV and therefore increased stroke volume
  • decreased venous return causes decreased EDV and therefore decreased stroke volume
43
Q

effects of afterload on stroke volume

A
  • he ventricle will have to work harder to push open the aortic valve and it will have less energy left to eject blood
  • stroke volume will decrease
44
Q

what is systolic pressure

A

the pressure when your heart pushes blood out

45
Q

what is diastolic pressure

A

the pressure when your heart rests between beats

46
Q

what is pulse pressure

A

the difference between systolic and diastolic blood pressures

47
Q

what are korotkoff sounds

A

resonant motion of the arterial wall, which begins after the artery transitions from a buckled state to an expanding state

48
Q

what are korotkoff sounds used for

A

usedto define systolic and diastolic pressures inside the arterial system

49
Q

what happens to the aortic pressure wave as it passes through the vascular tree

A

pressure falls throughout the vascular tree

50
Q

effect of Gravity on pressure and flow in veins

A

decreased EDV, preload, SV, CO, and MAP

51
Q

effect of skeletal muscle pump on pressure and flow in veins

A

rhythmic contraction increases venous return and EDV

52
Q

what is EDV

A

end-diastolic volume

53
Q

effect of respiratory pump on pressure and flow in veins

A

increased respiratory rate and depth increase venous return and EDV

54
Q

effect of venomotor tone on pressure and flow in veins

A

mobilisis capacitance and increases EDV

55
Q

clotting process

A
  • formation of a platelet plug
  • formation of a fibrin clot
56
Q

anti-clotting mechanisms

A
  • stops blood contacting collagen
  • produces prostacyclin and NO
  • produces tissue factor pathway inhibitor TFPI -
  • expresses thrombodulin
  • expresses heparin
  • secretes tissue plasminogen activator t-PA
57
Q

types of capillary structure

A

continuous = no clefts or pores
fenestrated = clefts and pores
discontinuous = clefts and massive pores

58
Q

significance of the blood-brain barrier

A

it shields the brain from toxic substances in the blood, supplies brain tissues with nutrients, and filters harmful compounds from the brain back to the bloodstream

59
Q

what is oedema

A

the accumulation of excess fluid

60
Q

what causes oedema

A
  • raised CVP
  • lymphatic obstruction
  • hypoproteinaemia
  • increased capillary permeability
61
Q

what is active hyperaemia

A

an adaption to match blood supply to the metabolic needs of that tissue

62
Q

what triggers active hyperaemia

A

triggered by an increase in local metabolism

63
Q

what results from active hyperaemia

A
  • increased concentration of metabolites
  • triggers release of paracrine signal (EDRF/NO)
  • causes arteriolar dilation
  • increases flow to wash out metabolites
64
Q

what is pressure autoregulation

A

an adaptation to ensure that tissue maintains its blood supply despite changes in MAP

65
Q

what triggers pressure autoregulation

A

a decrease in perfusion pressure

66
Q

what results from pressure autoregulation

A
  • increased metabolic activity causes a decrease in flow
  • metabolites accumulate
  • triggers release of paracrine signal (EDRF/NO)
  • causes arteriolar dilation causing flow to be restored to normal
67
Q

what is reactive hyperaemia

A

an extreme version of pressure autoregulation

68
Q

what triggers reactive hyperaemia

A

occlusion of blood supply

69
Q

what results from reactive hyperaemia

A

a subsequent increase in blood flow

70
Q

sympathetic nerves effect on arteriolar tone

A
  • release noradrenaline
  • binds to a1 receptors
  • causes arteriolar constriction
  • therefore there is decreased blood flow through that tissue and tends to increase TPR and MAP
71
Q

parasympathetic nerves effect on arteriolar tone

A
  • usually no effect
  • genitalia and salivary glands are exception, increasing flow
72
Q

adrenaline effect on arteriolar tone

A
  • released from adrenal medulla
  • binds to a1 receptors
  • causes arteriolar constriction
  • decreased flow through that tissue and tends to increase TPR and MAP
73
Q

what is MAP

A
  • mean arterial pressure
  • the driving force pushing blood through the circulation
74
Q

what happens with too low a MAP

A

fainting (syncope)

75
Q

what happens with too high MAP

A

hypertension

76
Q

components of the arterial baroreceptor reflex

A
  • vagus nerve
  • glossopharyngeal nerve
  • medullary cardiovascular centres
  • parasympathetic vagus nerve
  • sympathetic nerve
  • adrenal medulla
  • internal carotid arteries
  • common carotid arteries
  • carotid sinus baroreceptors
  • aortic arch baroreceptors
77
Q

function of the arterial baroreceptor reflex

A

to inform the autonomic nervous system of beat-to-beat changes in blood pressure within the arterial system

78
Q

what effect does the upright position have on the cardiovascular system

A

induces cardiovascular stressors on the body due to the shifting of fluid
upright position causes the greatest translocation of blood from the thoracic region to the lower limbs

79
Q

receptors involved in sensing plasma volume

A

osmo-sodium receptors

cardiology (3 decks)

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