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A&P II > Exam 1 - Lecture 4 > Flashcards

Exam 1 - Lecture 4 Flashcards

1
Q

Mixed vasodilators examples

A

sodium nitroprusside, which are nitric oxide donors.

They fall apart when exposed to sunlight

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2
Q

Venous dilators will do what 2 things?

A

Reduce preload (dilate veins) and Reduce metabolic demands of the heart

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3
Q

2 examples of arterial vasodilators and what do they do for the heart? Onset of action?

A

ACE-I and Hydralazine; reduce afterload

20-30 minutes

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4
Q

Phenylephrine is an arterial, venous, or mixed pressor?

A

Mixed, but has a greater effect on constricting veins for increased venous return.

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5
Q

How much right atrial pressure is needed in order to return cardiac output to normal with a failing heart and normal sympathetic activity?

A

8mmHg

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6
Q

With a failing heart, catecholamines will act on both ______

A

heart and circulatory system to help

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7
Q

Talk about the bodies compensation to a failing heart acutely vs chronically

A

Acutely, catecholamines constrict the veins to increase blood return to heart.

Chronically, the catecholamines tell the kidney to retain more fluid, to keep the pressure in the veins elevated and the catecholamines will reduce.

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8
Q

If our sympathetic nervous system is maxed out with an acute failing heart, what is the issue with standing up?

A

Our nervous system prevents us from passing out when we stand up by increasing catecholamine release, and if its already maxxed out, it cant help us.

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9
Q

What is a risk of an overly sympathetic nervous system for the heart?

A

Increased catecholamines in the heart puts extra risk of an arrythmia due to the phosphorylation in the cardiac muscle cells

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10
Q

3 compensations by the body for cardiac failure

A

Increased volume retention, Decreased venous compliance, increased SVR (which will reduce slope of venous return curve)

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11
Q

Definition for Preload

A

Pressures available to fill the heart with blood, measured in mmHg

The pressures determine volume of blood that will fill in the heart.

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12
Q

Afterload definition

A

Pressure right outside the aortic valve

When its high, puts more stress on heart to pump blood out.

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13
Q

Contractility definition

A

A change in stroke volume when preload and afterload are held constant.

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14
Q

If you increase preload, what are the changes on the graph?

A

Increase filling, increase stroke volume, increased EDV

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15
Q

What is the measure of after load?

A

80mmHg, pressure right outside ventricle in aorta before the valve opens

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16
Q

Does afterload change with increased preload?

A

Not really. Maybe a little bit but not on the chart

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17
Q

How is contractility measured on the graph?

A

Where it intersects on the top of the graph. Higher contractility moves to the left; lower to the right

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18
Q

If preload and after load are held constant, and contractility increases, what happens to the ESV?

A

Decreased

19
Q

A higher ESV with no changes to preload and afterload could indicate

A

Lower contractility

20
Q

What happens with decreased preload?

A

Less filling, lower EDV, lower SV

21
Q

What changes with increased afterload?

A

Takes a longer time to open up aortic valve, gives less time for contraction, so lower stroke volume, and higher ESV

22
Q

What phase is increased with afterload? Decreased?

A

Phase 2 increased; phase 1 and 3 decreased

What about phase 4? Idk…

23
Q

What pressure does aortic valve usually CLOSE?

A

100mmHg

24
Q

Why is stroke volume reduced with increased afterload?

A

Less time for contraction since phase 2 is longer, but also extra pressure slams aortic valve shut

25
Q

What changes happen with decreased afterload?

A

Phase 2 and 4 is shorter, and aortic valve shuts later than normal… phase 1 and 3 longer, and decreased ESV since there was more time and less resistance. Increases stroke volume. Preload doesn’t change

26
Q

If contractility increases, what are the changes?

A

Phase 1 and 3 longer, phase 2 and 4 are the SAME, lower ESV, same EDV. Overall larger stroke volume

27
Q

Decreased contractility causes what effects?

A

Shortens every phase except phase 2

Increase ESV, decreased CO.

Decrease BP

28
Q

Does contractility changes change the BP?

A

Yes. More contractility raises BP and vice versa

29
Q

How does cardiac failure change the cardiac curves?

A

Depressed contractility, higher ESV, increased EDV, lower SV, shorter phase 1 and 3

30
Q

What changes with filling pressure with cardiac failure?

A

Higher filling pressure cause heart can’t beat it out and increased volume retention

31
Q

Aortic valve stenosis will occur by the time you are

A

50-60 years old

32
Q

how many leaflets does the aortic valve have

A

3

33
Q

Aortic valve stenosis is what kind of load issue

A

afterload

34
Q

Does aortic stenosis require more or less pressure to eject blood

A

more

35
Q

What are the changes on the chart seen with aortic valve stenosis?

A

Reduced SV, longer phase 2 and 4 (?)

Higher EDV/filling pressure

Heart rate has to elevate with decreased SV

36
Q

How does the aortic valve stenosis affect blood pressure? pulse pressure?

A

High pressure in the ventricle with resistance from the valve means its going to lower the pressure in the aorta, so that means blood pressure will actually be lower with a narrow pulse pressure.

37
Q

Mitral valve stenosis changes on curve graph shit

A

shortened phase 1 because it cant fill in time, so less EDV

Decreased stroke volume

If no other compensations, HR will have to pick up.

38
Q

Compensations for mitral valve stenosis

A

increase Psf, increased atrial pressure, increased blood volume

39
Q

What’s a systemic effect of mitral valve stenosis?

A

The extra Psf and increased blood volume can cause pulmonary edema cause the pressure backflows into the lungs/pulmonary hypertension

40
Q

Aortic regurgitation looks like what on a graph?

A

sideways A, like a fat blob

41
Q

Aortic regurgitation happens with which pressures?

A

High in aorta, low in aorta.

So the ventricle starts filling during phase 4, and continues during phase 2.

42
Q

If we have a chronic leaky aortic valve, the EDV can end up being

A

much much higher from ventricle walls being overstretched (almost 200mL on graph)

43
Q

At the beginning of phase 4 with aortic regurgitation, explain the backwards blood flow?

A

Not much cause the ventricle hasnt relaxed yet, so not much regurgitation. but towards the end of phase 4, it fills alot more as the ventricle relaxes.

44
Q
A

A&P II (4 decks)

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