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A&P 2 > Exam 1 Lecture 7 > Flashcards

Exam 1 Lecture 7 Flashcards

1
Q

What is SNS reserve directly correlated to

A

Cardiac reserve

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2
Q

What percentage increase can we increase CO In an average human

A

We can increase it about 400% or 4-fold

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3
Q

What is it called when the heart grows from frequent and healthy exercise

A

Physiological hypertrophy
this is usually a good thing

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4
Q

What is happening at point A

A

Point A- right after MI hasn’t really compensated yet in real-world compensation happens immediately but not for my class
CO around 2.5-3.0
RAP 2- increased from 0; heart being a poor pump and heart struggles to pump appropriately

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5
Q

What is happening at point B

A

Point B
Body will compensate by increasing venous return by constricting heart or SNS tighten up
CO 3.0+
RAP- 5 mmHg
this is still decent not super swell

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6
Q

What is happening at point C,D

A

point C, D,
a little improvement
from more volume, from kidneys conserving fluids mostly
increased venous return overall

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7
Q

What is happening at point E

A

Point E,
body still retaining fluids
at this point we are stretching heart out too much

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8
Q

What is happening at point F

A

Point F
not recoverable
the heart is to stretched out
it is time to cut you losses “DCJC”

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9
Q

What happens to the LAP if we increase the pressure a shit ton

A

high LAP will cause pulmonary edema
pulmonary capillaries pressure is definitely lower than systemic; if we have pressure building in LA and excessive pressure, if we add 16mmhg to the 5 currently in there, this prevents all of the fluid reabsorption on venular side of pulmonary capillaries, causing fluid to leak into the lungs
(And yes Shit ton is a real measurement for my class)

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10
Q

For my class what is the normal pulmonary capillary pressure

A

Around 5mmHg

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11
Q

For my class at what value of CO in L/min do we start to see inadequate organ perfusion

A

Anything less than 5.0 L/min
(So 4.999999999 L/min or less)

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12
Q

Explain what is happening at Point C and D

A

Blue line is bad MI
Point C- compensation from system, SNS probably tighten up
Point D- CO 5l/min, venous return increased, moving from point C to D probably from heart recovering some tissues or drugs have helped

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13
Q

What two vasopressors probably won’t work for this chart

A

Norepi and EPI won’t help here the body still has plenty floating around

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14
Q

What does Digoxin do to our filling pressures over time

A

Decrease overtime with Dig body can ease up on the filling pressure since the drug is making the heart a better pump overall; this allows us to operate at a lower filling pressure

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15
Q

What is probably the worst tool by itself for monitoring Shock?

A

Arterial pressure reading is not indicative of level of shock because the system autoregulates it; it is crucial for perfusing tissue, but it is not indicative of CO perfusion

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16
Q

What is the gold standard of CO measurement

A

Swan Ganz catheter

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17
Q

For my shits and giggles, what is the fundamental difference between the red line and black lines in this experiment

A

Black line were able to survive the experiment
Red lines died

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18
Q

What does SVO2 stand for

A

SVO2- saturation venous Hgb with oxygen

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19
Q

Why is lactate levels important for monitoring shock

A

Lactate is a byproduct of anaerobic (no oxygen) metabolism. The higher the lactate the lower the perfusion to the tissues

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20
Q

How does shock impact coagulations levels

A

coagulation levels- shock has a lot of sludge shitty blood flow and creates clots in blood vessels, coag test not the best test overall

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21
Q

For my class in regards to the Swan, what does it mean if the saline dilutes out quickly

A

Normal people call this shooting numbers- injection of cold saline, the faster this saline dilutes out or warms up the higher the CO
die or saline goes through pulmonary artery

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22
Q

What does the fick equation look at

A

Looks at gas quantity’s at 2 different side of circulation

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23
Q

What does VO2 mean?

A

amount of gas absorbed by lungs per minute, (will have VO2 with a little dot on top of the V means it a unit of time)

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24
Q

What is the O2 content or arterial and venous blood for a perfectly healthy 30-year-old male

A

arterial blood- 20ml O2/ dl of arterial blood
vein blood- 15mlO2/dl of venous blood

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25
Q

In normal systemic tissues how much O2 is exchanged out if your arterial O2 is 20ml)2/dl
and your venous O2 is 15mlO2/dl

A

5mlO2/dl

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26
Q

For my class what is a normal VO2 level

A

250mlO2/min

27
Q

Time to bust out the crayons and calculators
Using the fick equation- calculate the CO in L/min if our VO2 is 750mlO2/min and our Delta change between arterial and venous circulation remains normal of 5mlO2/dl

A

150dl/min or 15L/min
(750mlO2/min) / (5mlO2/dl)

28
Q

How many ml are in 1 deciliter

A

100ml=1deciliter

29
Q

What percent of the oxygen that the coronaries come in contact with do they extract

A

They extract about 75% of the oxygen that they receive

30
Q

A can of soda how many ml’s of CO2

A

Can of soda is 355ml- has 200-250 cc of CO2 in it

31
Q

Why do we have some retrograde flow at the end of systole on this flowmeter chart

A

from retrograde blood to Aortic valve as it is closing, also from the cusps on the aortic valve that acts as a bowl

32
Q

This graph depicts flow rates through the aorta using a flow meter. Why do we have turbulence flow in the aorta, and what is the peak flow in L/min during systole

A

See a huge spike to 20l/min during systole; this is why we have turbulence right here because high velocity and short time will stagnate blood during diastole

33
Q

How do we calculate pulse pressure variation

A

We look at PP max and smallest PP (black arrows) and find the difference between them

34
Q

If we do a passive leg raise and it reduces pulse pressure variation a lot what does the patient need?

A

They need volume
“he needs some milk…”

35
Q

During inspiration what happens to left heart filling pressure and left heart preload

A

Inspiration reduces left heart filling pressure or left heart preload and will drop systolic BP

36
Q

If our systolic drops more than_______ we need some volume

A

10mmHg

37
Q

What is the term defined as pulse pressure variation greater than 10 mmHg increase during normal breathing.

A

pulsus paradoxus

38
Q

If we have a low preload, what happens to our pulse pressure variation

A

Low preload= a lot of variation

39
Q

Increases in volume does what to our pulse pressure variation

A

decrease variation

40
Q

I dont know why we had to talk about this in class but capillary endothelial cells are like real cells because they are real……. but anyway they have nuclei like everyone else

A
41
Q

What does toxins and endotoxin release do to our blood vessels

A

Dilates them out

42
Q

If the heart sees an increase on volume what will it release in response

A

Heart will release ANP or ANF when venous volumes are high from blood pooling; it tells kidneys to not hold onto fluids and electrolytes

43
Q

What functions as the cell’s digestive system, serving both to degrade material taken up from outside the cell and to digest obsolete components of the cell itself.

A

Lysosomes

44
Q

What does decreased blood flow to the capillaries due to them?

A

Capillaries with decreased blood flow- cells will destroy and lysosomes will come in and attack the cells and dissolve parts of the cells, will create holes in the capillary endothelial cells and thus create holes in BV and allow colloids to leak out and increase permeability of vessels
( I am looking to reword this question any help is appreciated)

45
Q

What is one of the requirements for osmosis that Dr. S talked about

A

for osmosis you must have a semipermeable membrane

46
Q

What is the best treatment option for capillary dysfunction
related to shock

A

best way to stabilize this from getting worse is to give steroids
If you said fix whatever is causing them to be in a shock state you also receive full credit

47
Q

What does apoptosis mean

A

Self destruct

48
Q

What part of the body allows us to have a negative interestital pressure overall

A

SKIN

49
Q

What is the normal value of PCap

A

PCap: 30-10 mmHg

50
Q

What is the normal value of PIsf

A

PIsf: -3 mmHg

51
Q

What is the normal value of PieCap

A

PieCap: 28 mmHg

52
Q

What is the nornal value of Pieisf

A

PieIsf=8mmHg

53
Q

What is the name for a synthetic colloid we can give in shock

A

Dextran

54
Q

Passive leg raise does what exactly

A

Improves venous return to the heart

55
Q

What is the other term for lower brainstem

A

Medulla

56
Q

In terms of SNS reflexs what does the adrenals dump out

A

Epi/norepi

57
Q

What 2 hormones that we discussed in lecture helps our vessels constrict and stay stiff in a short term SNS response besides norepi

A

Vasopressin and ANG2

58
Q

Do the kidneys need imput from any other organ system to hold onto fluids

A

The kidneys dont take no shit from nobody
Kidneys will hold onto fluid from RAAS or it can do it by itself with no other involvement

59
Q

If you lose ______ organ you will be less responsive to shock

A

Spleen because it is a good source of hgb and RBC so if this is gone you are toast
(Heart would also be an answer here…..jk)

60
Q

The lungs hold onto ______ X as much blood as it normally needs, and in a pinch can be a decent blood reservoir

A

2X

61
Q

What is the strongest CV reflex

A

CNS ischemic response- strongest CV reflex- it tells all BV to constrict as much as they can to maintain perfusion to brain

62
Q

What are the 3 important nerves to remember in the SNS reflexes

A

3 important nerves here- glossopharyngeal, herrings, vagus

63
Q

EXTRA CREDIT
LT. Dan’s blood pressure would increase how much in mmHg with passive leg raise

A

Heck i have no idea
Happy studying

A&P 2 (7 decks)

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