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HSC1007 A&P - E > CVS Physiology > Flashcards

CVS Physiology Flashcards

1
Q

what is a cardiac myocyte

A

cardiac muscle cells

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2
Q

how does a cardiac myocyte get its nutrients, o2, and eliminate waste?

A

intracellular fluids and extracellular fluid help with removing waste within the body and help with life-sustaining exchanges

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3
Q

revision : what is homeostasis

A

active and passive transport process to help maintain a relatively stable internal environment

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4
Q

maintaining homeostasis

A
  1. detect deviations from normal ranges
  2. integrate information with other information
  3. make adjustments accordingly to restore it back to normal

Negative feedback example: Body temp high, integrate information, adjust to lower body temp

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5
Q

function of the heart

A

provides metabolic need for tissues by providing o2 and nutrients

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6
Q

factors affecting nutrient exchange with tissues

A

adequate exchange of fluids at the capillaries
- sufficient pressure and output from the heart
- integrity of vessels

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7
Q

what is contractile cells and its other variation

A

cardiac muscle cells that provide the mechanical work of pumping blood

autorhythmic cells/pacemaker cells

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8
Q

what do pacemaker cells do

A

initiate and conduct action potentials responsible for contraction of working cells

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9
Q

what is the route for the action potential of the heart

A

Sinoatrial node > atrioventricular node > bundle of his > purkinje fibers

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10
Q

What is the SA Node located, and what is it’s purpose

A

Main pacemaker of the heart

Right atrium wall, near opening of the superior vena cava

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11
Q

Location and purpose of AV Node?

A

Acts as a junction between atria and ventricles

near opening of coronary sinus

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12
Q

Bundle of his location and purpose

A

specialized tract originating from the AV Node and travels down the interventricular septum (separates left and right ventricle)

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13
Q

Location and purpose of purkinje fibers

A

terminal fibers spreading through the myocardium like tree branches

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14
Q

location and purpose of internodal pathway

A

connects the SA node and AV node to allow transmission of the signal from the SA node

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15
Q

impulse conduction through the heart

A

SA node activates and atrial activation begins

Stimulus spread through the atrial surfaces and reaches AV node

100ms delay at AV node, atrial contraction begins

Impulse travels along interventricular septum through the bundle of his to the purkinje fibers and by the moderator band, to the papillary muscle of the right ventricle

Impulse distributed by purkinje fibers, relayed to the ventricular myocardium, atrial contraction is completed and ventricular contractor begins

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16
Q

What is an action potential

A

electrical signal

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17
Q

rate of action potential of all 4 pacemakers

A

SA node = 70-80 AP/min
AV node = 40-60 AP/min
BH and PF = 20-40 AP/min

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18
Q

what happens if the SA node fails/not functioning properly?

A

AV node takes over as the main pacemaker of the heart

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19
Q

how is efficient cardiac function achieved?

A

atrial contraction and excitation is completed before ventricles contraction

tldr: atrials are coordinated, ventricles are coordinated, simultaneously contract/relax

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20
Q

what controls the HR?

A

autonomic nervous system
- parasympathetic
- sympathetic

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21
Q

some things that affect the HR

A

Resting - P predominates
Epinephrine/temperature - acts on the SA node directly, independent of the ANS

Pain, chemoreceptors, respiratory center, baroreceptor - acts on the cardiovascular control center

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22
Q

how does the 2 autonomous nervous system affects HR (Increase or decrease)

A

Sympathetic - increase HR
parasympathetic - decrease hr

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23
Q

what does an ECG measure, and from where?

A

electrical events in the heart FROM the surface of the body (does not measure the heart directly)

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24
Q

what does an ECG tell you?

A

overall spread of electrical activity throughout the heart during depolarization and repolarization

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25
Q

how many ECG leads and where are they located?

A

12 leads

6 on the heart

right arm to left arm
right arm to left leg
left arm to left leg
left leg (goes up straight from left leg) (aVF)
left arm (across body) (aVL)
right arm (across body) (aVR)
AV = augmented voltage

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26
Q

what is the purpose of having these leads in an ECG

A

viewing electrical events in the heart from a unique vantage point to identify if there is any anomaly

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27
Q

explain what causes the P, QRS, and T wave within a LEAD II ECG

A

P - atrial depolarisation
QRS - ventricular depolarisation (atrial repolarisation is here too but it is overshadowed by VD)
T - ventricular repolarisation

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28
Q

why are the P wave smaller than the QRS complex

A

atria got smaller muscle mass than ventricles

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29
Q

what 3 occasions within a LEAD II ECG is there no electrical activity

A

P-R = AV node delay
S-T = ventricular completely depolarises, cardiac cells undergoing plateau phase
Passive filling of the ventricles

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30
Q

What happens during the P-R interval

A

signal from SA node travels to AV node, then out to the bundle of his
majority of time taken is the AV node delay

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31
Q

How to identify the respiratory rate within a LEAD II ECG

A

time taken between the peak of two R complex within the QRS complex

each square is 0.2seconds or 200ms, one small square is 0.04seconds or 40ms

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32
Q

why is there a plateau phase of the action potential

A

to prevent tetanic contraction, where the heart contracts repeatedly

during the plateau phase, there cannot be another action potential

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33
Q

what is the benefit of having calcium entry from the extracellular fluid (ECF)

A

induces a much larger Ca2+ release, with slow Ca2+ removal to allow for long period of cardiac contraction, this increased contraction ensure enough time for all the blood to be ejected out of the heart

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34
Q

kahoot

the normal pacemaker of the heart is?

A

SA node

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35
Q

Kahoot

blood returning to the heart from the systemic circuit first enters the?

A

right atrium

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36
Q

kahoot

what is range of the Action Potentials/min in the AV node

A

40-60 APs/min

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37
Q

kahoot

what is the parasympathetic system’s influence on the SA node

A

lowers HR

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38
Q

kahoot

the P wave of the ECG is a signal from (in terms of heart, not nodes)

A

atrial depolarisation

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39
Q

kahoot

depolarisation of the ventricle is represented on the ECG by

A

QRS

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40
Q

kahoot

which of the 12 LEAD ECG indicates the apex of the left ventricle?

A

LEAD II

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41
Q

kahoot

what interval helps you calculate the heart rate?

A

RR interval

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42
Q

what is the pacemaker ability?

A

slowly depolarises the membrane potential (mV) from -60 to -40 (threshold potential)

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43
Q

what is required for the pacemaker ability to function?

A

Funny channel allows sodium ions to cross the membrane, sodium is essential for the slow, depolarizing pacemaker potential

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43
Q

what happens once the membrane potential crosses the threshold potential?

A

you get your self-induced action potential

44
Q

what happens to the action potential after it’s self-induced and hit its peak of depolarisation?

A

the action potential is spread throughout the heart

45
Q

mechanical movements of the heart in the cardiac cycle

A

systole and diastole
contraction and relaxation

46
Q

what happens in the first part of the cardiac cycle?

A

all chambers are relaxed
AV valves open
passive feeling completed

Atrial systole begins, forcing small amounts of blood into the relaxed ventricle

47
Q

what happens in the second part of the cardiac cycle

A

Atria begins to relax after contracting (atria diastole)
ventricles start to contract (ventricular systole)
AV valves are close
The semi-lunar valves are also close, as there is not enough pressure to open them
isovolumetric contractions to increase pressure

48
Q

describe ventricular systole second phase within the cardiac cycle

A

semilunar valves open
blood is contracted and goes out of the ventricle

49
Q

describe the ventricular systole within the cardiac cycle

A

ventricles start to relax, back flowing back pushes against the semi-lunar valves and force them shut

all chambers relax, AV valves open and passive feeling occurs

50
Q

overview of cardiac cycle just go see your notes (Part 2 pg11) the damn big graph will all the aortic pressure left ventricular pressure etc etc

A

GO SEE THE DAMN NOTES

51
Q

what gives rise to the first and second heart sounds?

A

1st - closure of the AV valves
2nd - closure of the aortic/pulmonary
valve

52
Q

what is cardiac output and how do you calculate it?

A

Volume of blood pumped out by each ventricle per minute

Cardiac output = heart rate x stroke volume

HR = beats per min
SV = amount of blood pumped from ventricles per beat

53
Q

kahoot

what is the second heart sound associated with?

A

Closure of semi-lunar valves/aortic valve

54
Q

kahoot

ventricular diastole refers to the contraction of the ventricles. True or False?

A

False

55
Q

kahoot

what is the state of the heart valves during isovolumetric ventricular relaxation

A

all closed

56
Q

kahoot

depolarization of the atria is represented on an ECG by which feature

A

P wave

57
Q

Effect of ANS on HR

SA Node*

A

parasympathetic - decrease rate of depolarsation to threshold, decrease HR

sympathetic - increase rate of depolarisation to threshold, increase HR

58
Q

effect of ANS on HR

AV Node

A

parasympathetic - decreases excitability, increase AV node delay

Sympathetic - increases excitability, decreases the AV node delay

59
Q

effect of ANS on HR

Ventricular conduction pathway

A

Sympathetic - increases excitability, hastens conduction through the bundle of his and purkinje fibres

60
Q

Effect of ANS on HR

Atrial muscles

A

parasympathetic - decreases contractibility, weakens contraction

sympathetic - increases contractibility, strengthens contraction

61
Q

Effect of ANS on HR

Ventricular muscle*

A

Sympathetic - increases contractibility, strengthens contraction

62
Q

Effect of ANS on HR

Adrenal medulla

A

Sympathetic - promotes secretion of epinephrine

63
Q

Effect of ANS on HR

Veins*

A

Sympathetic - increases venous return, which increases strength of cardiac contraction via intrinsic pathway

64
Q

2 controls components of stroke volume, and what each component is related to

A

intrinsic control - related to the extent of venous returns

extrinsic control - related to the extent of sympathetic stimulation of the heart

65
Q

can you explain the frank-sterling law of the heart?

A

Intrinsic relationship between end-diastolic volume and stroke volume

higher diastolic volume = higher stroke volume

more blood in ventricles, more blood can be pumped out

66
Q

how does increase diastolic filling result in greater contractions?

A

higher diastolic filling = increased EDV = stretching of the heart = increase length of cardiac muscle fibers before contraction = more force on subsequent cardiac contractions = increase stroke volume

67
Q

what is stroke volume and what is its equation

A

amount of blood pumped from ventricles per beat

EDV - ESV

68
Q

what is ejection fraction and how do you calculate it

what is its normal range

A

fraction of blood ejected from a ventricle with each beat

SV/EDV x 100%

normal range = 55%-75%

69
Q

how does sympathetic and parasympathetic activity influence cardiac output

A

parasympathetic activity increase = lower HR = lower CO

Sympathetic activity increase = higher HR = higher CO

Intrinsic control - sympathetic activity increase = increase venous return = increase EDV = increase stroke volume = increase CO

Extrinsic control - sympathetic activity decrease = decrease stroke volume = decrease CO

70
Q

factors affecting cardiac output

A

preloading (volume of passive and active filling), heart contractibility and rate, afterload (peripheral resistance) (part 3 of cardiac physiology)

71
Q

how does the body compensate for systolic heart failure

A

sympathetic stimulation

kidneys retains salt and water to maintain blood volume as much as possible

72
Q

how does the heart get majority of its blood supply

A

through coronary circulation during diastole, blood flow is adjusted based on the heart’s o2 requirement 70%

systole is the other 30%

opening found on the side of the aortic valve when it is closed, opening closes partially when the aortic valve opens

73
Q

whats the process of the heart’s coronary acquiring more o2

A

increase metabolic activity = increase adenosine = vasodilation of coronary vessels = blood flow to cardiac muscle cells = increase oxygen availability to meet oxygen needs

74
Q

Describe angina pectoris, acute myocardial infarction, and coronary artery disease (CAD)

A

angina pectoris - sensation of chest pains arising from myocardial ischemia

acute myocardial infarction - heart attack

CAD - blockage of the lumen with plague, resulting in reduced blood flow

75
Q

what is a thrombus, embolus, and thromboembolism

A

embolus - abnormal particle floating in the blood vessels
thrombus - abnormal clot in the vessel wall
thromboembolism - thrombus that broke away and obstruct blood vessel elsewhere

76
Q

using endothelium, smooth muscle, collagen fibres, and elastin fibers

state from lowest to highest abundance within large arteries, arterioles, capillaries, and large veins

A

large artery - endothelium, collagen fibers, elastin fibers, smooth muscles

elastin fibers - endothelium/collagen fiber, smooth muscle

capillary - endothelium

large vein - elastin fibers, endothelium, collagen fiber, smooth muscle

77
Q

name 3 examples of blood reconditioning organs and what they do

A
  1. kidney - eliminate waste, adjust water and electrolytes
  2. digestive tract - pick up nutrient supplies
  3. skin - regulation of temperature
78
Q

define flow rate

A

volume of blood passing through per unit of time

proportional to pressure gradient, and inversely proportional to resistance

79
Q

define blood pressure

A

force exerted by blood against a vessel

80
Q

define pressure gradient

A

pressure difference from the start and end of the blood vessel

81
Q

name a type of resistance to affect flow rate

A

friction between blood and vascular wall

82
Q

what is the order that blood flows within the body

A

blood flow is parallel

each major organ has their own artery, its not a lung > heart > organ > organ > organ > back to heart, more like a lung > heart > specific organ > heart again

83
Q

describe more about arteries and them being pressure reservoirs

A

arteries have the ability to distend, which often happens when the heart contracts. Capillaries unable to flow as fast as the heart pumps, so the artery distend. During diastole, when the heart relaxes, blood still flows due to the elastic force that drives the blood along, even though there is no blood flow

84
Q

factors that affect blood pressure

A

volume of blood within the vessel

distensibility of the blood vessel

85
Q

2 types of blood pressure, and their definitions

A

systolic and diastolic

systolic - maximum pressure when blood is ejected into the arteries

diastolic - minimum pressure when blood is draining in the rest of the vessels during diastole

86
Q

what is the formula for pulse pressure

A

systolic pressure - diastolic pressure

87
Q

Define mean arterial pressure, and its purpose. What is the formula?

A

Average pressure driving blood forward.

Formula can either be
= 2/3 diastolic + 1/3 systolic
OR
= diastolic + 1/3 pulse pressure

88
Q

complications if blood pressure is too high or too low

A

too high = blood vessels cannot support the high BP

too low = tissues do not get enough blood

89
Q

describe capillaries

A

site of exchange between blood and tissues

very thin walled, extensive branching, proximity of almost every cell to a capillary

RBC moves in a single file, slow blood velocity which benefits gaseous exchange

high cross-sectional area together with slow velocity of blood flow maintains the constant flow rate

90
Q

what are some important features within the capillaries

A

water-filled pores - allows small water soluble substances to pass through

phospholipid bilayer - allows lipid-soluble substance to pass through

91
Q

As capillaries do not have smooth muscles, what do they utilise to control blood flow? what does it get stimulated by?

A

pre-capillary sphincters

stimulated by increase in metabolic activity = sphincters relax = more open capillaries = increase blood flow to active tissues

92
Q

kahoot

how is mean arterial pressure determined?

A

2/3 diastolic + 1/3 systolic
OR
diastolic + 1/3 pulse pressure

93
Q

kahoot

what is systolic blood pressure?

A

the maximum pressure exerted on the blood vessels during contraction

94
Q

kahoot

which of the following is a reconditioning organ?

A

kidney
skin
digestive tract

95
Q

kahoot

which of the following is an important characteristic of capillaries?

A

high surface area

low blood flow velocity

presence of pre-capillary sphincters

thin-walled so exchange is very quick

96
Q

how is blood flow distribution regulated?

A

local control of arterioles, depending on demands for blood

vasoconstriction and vasodilation of vessels

97
Q

what causes vasoconstriction or vasodilation of the vessel
(intrinsic control)

A

vasoconstriction - high o2, low co2, high endothelin, high sympathetic stimulation vasopressin and angiotensin II

vasodilation - low o2, high co2, high nitric oxide, low sympathetic stimulation histamine

98
Q

what is the result in relation to sympathetic activity changes (extrinsic control)

A

increase sympathetic activity - all arterioles vasoconstrict

decrease sympathetic activity - all arterioles vasodilate

sympathetic fibers supply arterioles smooth muscle everywhere but the brain, as it requires constant supply of blood

99
Q

which takes over control, intrinsic or extrinsic?

list the riding bicycle as an example

A

local control overrides sympathetic vasoconstriction

ride bike = sympathetic activity = everything vasoconstrict = metabolic activity in leg = vasodilate in leg (local so it overrides) = more blood to leg = less blood to other places

100
Q

what is responsible for extrinsic control?

A

cardiovascular control centre - control sympathetic output

adrenal hormones - norepinephrine and epinephrine
norepinephrine - generalised constriction
epinephrine - local vasodilation mechanisms

Potent vasoconstrictors
vasopressin - maintains water balance
angiotensin II - regulates salt balance

101
Q

revision - what two factors affect blood pressure, and 2 components each

A

cardiac output
- HR
- Stroke volume

total peripheral resistance
- arteriole radius
- blood viscosity

102
Q

features of veins

A

low resistance, less elastic recoil, less smooth muscle
slow transit time
blood storage as blood being pumped is faster than blood flow

103
Q

what affects the venous capacity

A

distensibility of the veins
external pressure such as skeletal muscles compressing it

104
Q

sympathetic innervation of the venous return

A

vasoconstriction in veins = lower capacity = higher pressure = faster flow

105
Q

skeletal muscle effect on venous return

A

large veins reside between skeletal muscles in arms and legs
when muscle contracts, veins compress
reduces venous capacity, increase venous pressure, increase venous return

106
Q

effect of gravity on venous returns

A

vessels below heart subjected to gravity
veins are more distensible, resulting in increase capacity
reduces venous returns, reducing cardiac output

107
Q
A

HSC1007 A&P - E (5 decks)

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