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BIO 142 > Exam 1: The Heart and Vessels > Flashcards

Exam 1: The Heart and Vessels Flashcards

1
Q

What is the cavity between the lungs that contains the heart?

A

Mediastinum

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2
Q

What are the subdivisions of the pericardium?

A

Parietal pericardium
Visceral pericardium

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3
Q

What is the sac that surrounds the heart (externally)?

A

Parietal pericardium

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4
Q

What is adhered to the heart muscle?

A

Visceral pericardium

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5
Q

What is another name for the epicardium?

A

Visceral pericardium

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6
Q

What are the layers of the parietal pericardium?

A

Serous layer
Fibrous layer

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7
Q

What is the inner layer of the parietal pericardium that produces fluid?

A

Serous layer

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8
Q

What is the outer layer of the parietal pericardium that is made of connective tissues?

A

Fibrous layer

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9
Q

What is the outermost layer of the heart?

A

Epicardium

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10
Q

How thick is the epicardium?

A

Very thin

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11
Q

What is the middle layer of the heart?

A

Myocardium

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12
Q

What is the innermost lining of the heart?

A

Endocardium

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13
Q

How thick is the endocardium?

A

Very thin

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14
Q

What layer of the heart is known as the heart muscle?

A

Myocardium

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15
Q

What type of cells is the endocardium made of?

A

Simple squamous epithelium

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16
Q

List the layers of the heart from most external to most internal:

A

Fibrous parietal pericardium
Serous parietal pericardium
[Pericardial cavity]
Visceral pericardium
Myocardium
Endocardium

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17
Q

What chamber of the heart receives blood flow returning from the entire body (excluding lungs)?

A

Right atrium

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18
Q

What structure returns blood to the heart from structures above the heart?

A

Superior vena cava

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19
Q

What structure returns blood to the heart from structures below the heart?

A

Inferior vena cava

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20
Q

What appendage-like chamber adds volume to the right atrium?

A

Right auricle

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21
Q

What does the fossa ovalis mark?

A

The location of the fetal pulmonary bypass

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22
Q

What is the fetal pulmonary bypass?

A

Foramen ovale

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23
Q

Where is the fossa ovalis/foramen ovale located?

A

In the interatrial septum

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24
Q

What are bundles of muscles only seen in the right atrium? (exist in left, can’t see them)

A

Pectinate muscles

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25
Q

What is the wall between the two atria?

A

Interatrial septum

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26
Q

Where does blood return from the heart itself?

A

The opening of the coronary sinus

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27
Q

What is the valve between the right atrium and ventricle?

A

Tricuspid valve

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28
Q

What are the string-like cords that connect the cusps of the atrioventricular valves to specific muscles of the heart?

A

Chordae tendineae

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29
Q

What is the purpose of chordae tendineae?

A

They prevent the valve from pushing up into the atrium

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30
Q

What is another term for an anatomical part that is displaced?

A

Prolapse

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31
Q

What is the pathology when:
The chordae tendineae break?

A

Ruptured chordae

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32
Q

What is the pathology when:
A valve is forced up into the atrium during ventricular contraction, thus causing blood to go in the wrong direction?

A

Mitral/bicuspid valve prolapse or tricuspid valve prolapse

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33
Q

What is the pathology when:
Some blood goes back up into the atrium (the wrong way)

A

Atrioventricular regurgitation

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34
Q

Where should blood go out through in the heart?

A

The semilunar valves

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35
Q

What do ruptured chordae cause?

A

Mitral/bicuspid valve prolapse or tricuspid valve prolapse

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36
Q

Which chamber of the heart pumps blood to the lungs?

A

Right ventricle

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37
Q

What are specialized muscles of the heart that hold tension on the chordae tendineae?

A

Papillary muscles

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38
Q

What muscles keep tension on the chordae tendineae to keep the atrioventricular valves closed during ventricular contraction?

A

Papillary muscles

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39
Q

What are the internal heart muscles that create “nooks and crannies” in the ventricles?

A

Trabeculae carneae

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40
Q

Which heart muscles are like “struts”?

A

Trabeculae carneae

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41
Q

What is the valve between the right ventricle and the pulmonary trunk?

A

Pulmonary semilunar valve

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42
Q

What is the pulmonary semilunar valve also known as?

A

The pulmonary valve

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43
Q

What is the large artery that leads from the right ventricle to the pulmonary arteries?

A

Pulmonary trunk

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44
Q

What takes deoxygenated blood to the lungs where the blood can become oxygenated?

A

[Right and left] pulmonary arteries

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45
Q

What, in birthed humans, used to be a fetal pulmonary bypass between the pulmonary artery and aortic arch?

A

Ligamentum arteriosum

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46
Q

What, in fetal humans, is a pulmonary bypass between the pulmonary artery and aortic arch?

A

Ductus arteriosus

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47
Q

Where do the pulmonary veins obtain oxygenated blood from?

A

The lungs

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48
Q

Where do pulmonary veins take oxygenated blood from the lungs to?

A

The left atrium

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49
Q

What adds volume to the left atrium?

A

Left auricle

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50
Q

What is an atrioventricular valve between the left atrium and left ventricle?

A

Mitral or bicuspid valve

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51
Q

Are there chordae tendineae supporting both atrioventricular valves?

A

Yes, they are on both valves

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52
Q

What is the chamber that pumps blood to the entire body [except for the lungs]?

A

Left ventricle

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53
Q

Are there papillary muscles and trabeculae carneae in both ventricles?

A

Yes

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54
Q

What is the valve between the left ventricle and ascending aorta?

A

The aortic semilunar valve

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55
Q

What is another name for the aortic semilunar valve?

A

Aortic valve

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56
Q

What is the first part of the aorta that leaves the heart?

A

Ascending aorta

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57
Q

What is the part of the aorta that gives off the first 3 major arteries?

A

Aortic arch

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58
Q

What part of the aorta has blood flowing inferiorly?

A

Descending aorta

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59
Q

What region of the descending aorta is above the diaphragm?

A

Descending thoracic aorta

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60
Q

What region of the descending aorta is below the diaphragm?

A

Descending abdominal aorta

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61
Q

What is the wall between the two ventricles?

A

Interventricular septum

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62
Q

What is the wall between the two atria?

A

Interatrial septum

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63
Q

Is cardiac muscle striated or smooth?

A

Striated

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64
Q

Is cardiac muscle voluntary or involuntary?

A

Involuntary

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65
Q

Are there branches in cardiac muscle?

A

Yes

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66
Q

Is cardiac muscle mono or multinucleated?

A

Mononucleated

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67
Q

What mineral does cardiac muscle require extracellularly?

A

Cardiac muscle requires extracellular calcium

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68
Q

Why can calcium channel blockers be used to treat certain pathologies?

A

Cardiac muscle relies upon extracellular calcium to function normally. For example, if calcium is limited to the heart by CCBs, this may lower blood pressure (treating hypertension)

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69
Q

What are intercalated discs?

A

Structures in the heart that connect cardiac muscle cells together and allow communication

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70
Q

What are gap junctions?

A

Channels that connect the cytoplasms of neighboring cells, allowing the passage of ions and the spread of cardiac APs

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71
Q

What is the main function of intercalated discs and gap junctions?

A

Allow AP to pass from cell to cell throughout the heart with little resistance

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72
Q

What does it mean for the heart to be a functional or physiological syncytium?

A

While the heart muscle cells are mononucleated, they still behave as if they were all one giant multinucleated cell (or one unit)

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73
Q

What allows for the heart to behave as a functional or physiological syncitium?

A

Gap junctions in the intercalated discs

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74
Q

Where is a true anatomical syncytium seen?

A

Multinucleated cells in skeletal muscle

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75
Q

What fibers conduct AP throughout the heart?

A

Conductive fibers

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76
Q

Where does the AP begin in the heart?

A

The primary pacemaker, the sinoatrial node

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77
Q

Are nodes nerves?

A

NO! They are modified muscle cells

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78
Q

Where is the SA node located?

A

The roof of the right atrium between the superior vena cava and right auricle

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79
Q

What pace does the primary pacemaker set in bpm?

A

100 bpm

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80
Q

What slows the hearts rhythm from the SA’s pace (100bpm)?

A

The vagus nerve

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81
Q

What does the vagus nerve slow the heart down to?

A

75bpm

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82
Q

What nervous system controls the vagus nerve and makes the heart slow?

A

Parasympathetic

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83
Q

What is normal sinus rhythm in bpm?

A

75bpm

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84
Q

Can the SA node create an AP by itself?

A

Yes, as seen in hearts still beating after being taken out of a body… Just not for terribly long

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85
Q

What is the “normal” rate of the heart called?

A

Sinus rhythm

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86
Q

What is normal sinus rhythm in adults?

A

75bpm

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87
Q

What is normal sinus rhythm in neonates?

A

120-160bpm

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88
Q

What can overstimulation of the vagus nerve cause?

A

A vasovagal episode

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89
Q

What are symptoms of a vasovagal episode?

A

Dizziness and concomitant syncope (fainting)

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90
Q

Why do you faint in a vasovagal episode?

A

Increased vasodilation and reduction of blood pressure

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91
Q

What does concomitant mean?

A

Along with

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92
Q

What is the secondary pacemaker of the heart?

A

Atrioventricular node

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93
Q

What takes over if the SA node stops?

A

AV Node

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94
Q

Where is the Atrioventricular node located?

A

Interatrial septum

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95
Q

Which node is located just behind the opening for the coronary sinus?

A

AV node

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96
Q

What is the purpose of the AV node delay? Is it a pathology?

A

AV node delay is seen in healthy normal hearts. The AP speed is slowed down by the AV node to allow for optimal filling of the ventricles

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97
Q

Which node is faster? AV or SA?

A

SA node is faster. If the AV node has to take over, it will be much slower

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98
Q

What does nodal or junctional rhythm indicate?

A

Pathology! It suggests the SA node is not working and the AV node took over

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99
Q

What is the bpm of nodal or junctional rhythm?

A

40-50bpm

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100
Q

What is another name for the atrioventricular bundle?

A

Bundle of His

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101
Q

Where does the AV bundle leave the AV node?

A

Interventricular septum

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102
Q

How long is the bundle of His before it splits in two?

A

About 1cm long

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103
Q

What are the two divisions of the AV bundle called?

A

Right and left bundle branches

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104
Q

Where do the right and left bundle branches go down?

A

The thick portion of the interventricular septum to the heart’s apex

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105
Q

What conductive fibers begin at the heart’s apex and move up the sides of the heart into the papillary muscles?

A

Purkinje fibers

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106
Q

What takes over if both the SA and AV nodes stop working?

A

Purkinje fibers

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107
Q

How fast are Purkinje fibers?

A

Very slow- 30bpm

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108
Q

Are Purkinje fibers an acceptable pacemaker?

A

No, the bpm of 30 is so slow it may result in brain damage. If the SA and AV nodes are both broken you will need an artificial pacemaker

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109
Q

What is electrical potential?

A

The difference in charges on the inside and outside of the cell

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110
Q

What is the natural resting electrical potential of a cell?

A

Negative inside, positive outside

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111
Q

What is chemical potential?

A

Difference in chemical ions inside and outside the cell

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112
Q

What is the natural resting chemical potential of a cell?

A

K+ inside
Cl-, Na+, Ca+ outside

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113
Q

What is an influx or efflux of ions called?

A

Current

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114
Q

Where does action potential travel from? (from neuron to neuron)

A

Axon hillock to the terminal of a typical neuron

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115
Q

What is threshold?

A

The point of no return where AP will be generated

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116
Q

What enters the cell to bring it to threshold?

A

Positive Na+ ions

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117
Q

When does a cell reach threshold? What kind of potential?

A

A local potential/stimulus is strong enough to bring lots of Na+ ions into the cell

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118
Q

Is a resting cell polar or nonpolar?

A

Polar (neg inside)

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119
Q

What is the cell’s state when Na+ enters?

A

Cell becomes depolarized

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120
Q

What effluxes outside the cell for it to become repolarized?

A

Potassium

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121
Q

What is the impact of K+ efflux?

A

Cell becomes negative (polar) again, but now the chemical gradient is messed up. This leads to hyperpolarization (too negative)

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122
Q

What fixes hyperpolarization?

A

Sodium potassium pump

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123
Q

What is the Na-K pump ratio?

A

3 Na+ OUT
2 K+ IN

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124
Q

What does the Na-K pump regulate?

A

Cell volume and secondary active transport

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125
Q

What is the plateau in heart cell AP?

A

Influx of Ca++ stops the cell from becoming too negative and creates a plateau

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126
Q

What is the benefit of the heart cell’s Ca++ plateau?

A

This optimizes ejection/emptying of ventricles

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127
Q

How does repolarization complete in the heart?

A

Ca++ influx stops and K+ efflux continues

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128
Q

Does the Na-K pump function differently in the heart?

A

It still pumps 3 Na+ OUT and 2 K+ IN to restore the gradient.

The only difference is the Ca++ plateau due to Ca++ influx

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129
Q

What does the Ca++ plateau represent?

A

A prolonged contraction to maximize emptying of the heart’s chambers (pumping blood OUT)

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130
Q

What slows the heart by using the mechanism described by the Na-K pump?

A

Calcium channel blockers. These prevent the influx of Ca++, which in turn prevents the optimization of the heart’s contractions

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131
Q

What stage of the AP cycle is different in the heart than the neuron?

A

There is no hyperpolarization in the heart’s cycle, there’s a Ca++ plateau

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132
Q

Which has a longer refractory period: nerves or the heart?

A

The heart

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133
Q

Why does the heart have a longer refractory period?

A

To prevent the myocardium from entering tetanus or fatigue

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134
Q

Does the heart’s Ca++ plateau occur at the peak?

A

No, there is a decline/slight repolarization first

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135
Q

How does digitalis poison the Na-K pump?

A

Digitalis prevents Na+ from exiting the cell. This means there is less of a Na+ gradient and Ca++ accumulates inside the heart cell

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136
Q

What does > Ca++ inside the heart muscle do for the strength of contraction?

A

Increases strength of contraction

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137
Q

What kicks Ca out of the heart normally? (I.e., when digitalis is not interfering)

A

The sodium/calcium counter transport

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138
Q

What does an ECG/EKG represent?

A

All of the electrical events in the heart muscles combined

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139
Q

What wave occurs just prior to contraction?

A

P wave

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140
Q

What wave represents atrial depolarization?

A

P wave

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141
Q

What wave represents atrial repolarization?

A

It is hidden by the QRS complex

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142
Q

What wave represents ventricular depolarization?

A

QRS complex

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143
Q

What wave represents ventricular repolarization?

A

T wave

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144
Q

Which wave is of an unknown origin and is not always seen on EKGs?

A

U wave

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145
Q

What can enhance the U wave?

A

Hypokalemia (low potassium)

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146
Q

Where is the AV node delay on an EKG?

A

Right after the p wave, there is a flat line prior to the Q dip. This is the delay.

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147
Q

What does this EKG pathology mean?
Enlarged P wave

A

Atrial hypertrophy (enlargement)

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148
Q

What does this EKG pathology mean?
Missing p wave

A

SA node damage

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149
Q

How do you know that the AV node has taken over as pacemaker?

A

There’s a missing P wave, and the bpm has slowed to 40-50

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150
Q

What does this EKG pathology mean?
Extra QRS complex, sometimes inverted

A

Premature ventricular contractions (PVC), where the ventricles beat twice for the beat of one atria

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151
Q

What is another name for Premature ventricular contractions (PVC)?

A

Extra systole

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152
Q

What does this EKG pathology mean?
Enlarged Q, S-T elevation, and/or inverted T

A

Myocardial infarction (MI)

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153
Q

What is a myocardial infarction (MI)?

A

Ischemic necrosis of the myocardium

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154
Q

What does this EKG pathology mean?
Enlarged R

A

Ventricular hypertrophy (enlargement)

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155
Q

What does this EKG pathology mean?
Flattened T

A

Cardiac ischemia or hypoxia

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156
Q

What does this EKG pathology mean?
Prolonged P-Q

A

Damage in the atria blocking APs

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157
Q

What does this EKG pathology mean?
Bifid R wave (2 peaks)

A

An R wave with 2 peaks indicates left bundle branch block

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158
Q

What is an ectopic focus?

A

An AP that originates anywhere except the SA node

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159
Q

What is a premature contraction of the heart that results in an early beat? (You get two beats together followed by an asystolic period)?

A

Extra systole

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160
Q

What is an asystolic period?

A

Period without systole or contraction

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161
Q

Is the recovery beat after an extra systole strong or weak?

A

Recovery beat is very strong and is felt as a thud or flutter

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162
Q

Where is the cardioacceleratory center?

A

In the medulla oblongata

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163
Q

What NS increases heart rate and SOC from the cardioacceleratory center?

A

Sympathetic NS

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164
Q

What sympathetic NS receptors can impact the heart?

A

Adrenergic receptors

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165
Q

What are the neurotransmitters that bind to adrenergic receptors?

A

Norepinephrine and epinephrine

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166
Q

What’s another name for the NTs that bind to adrenergic receptors?

A

Receptor ligands

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167
Q

What does the adrenergic receptor Alpha 1 do to the heart?

A

Causes vasoconstriction increasing BP

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168
Q

What does the adrenergic receptor Beta 1 do to the heart?

A

Increases HR, SOC, BP when bound to norepi

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169
Q

What does the adrenergic receptor Beta 2 do to the heart?

A

Causes relaxation of smooth muscle around blood vessels (vasodilation) which reduces BP around bronchi and bronchioles (bronchodilation)

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170
Q

Which adrenergic receptor is associated with bronchodilation?

A

Beta 2

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171
Q

What does “chronotropic factors” mean? Positive vs negative?

A

Things that effect heart rate
Positive increases HR, negative decreases HR

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172
Q

Does this increase or decrease HR?
Beta 1 receptors

A

Increase HR

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173
Q

Does this increase or decrease HR?
Cardioacceleratory center

A

Increase HR

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174
Q

Does this increase or decrease HR?
Sympathetic NS

A

Increase HR

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175
Q

Does this increase or decrease HR?
Epinephrine/adrenalin

A

Increase HR

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176
Q

Does this increase or decrease HR?
Caffeine and nicotine

A

Increase HR

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177
Q

When is epinephrine released? What does this do to HR and BP?

A

Epi is released due to anxiety and increases HR and BP… This makes anxiety even worse.

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178
Q

What does long-term epi from anxiety do to the body?

A

Cortisol is released from the adrenal glands

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179
Q

Does this increase or decrease HR?
Parasympathetic NS

A

Decrease HR

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180
Q

Does this increase or decrease HR?
Vagus nerve

A

Decrease HR

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181
Q

What is the NT for the vagus nerve?

A

Achtylcholine

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182
Q

What does inotropic factors mean?

A

Things that effect the heart’s SOC

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183
Q

Does this increase or decrease SOC?
Parasympathetic NS

A

Decrease SOC

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184
Q

Does this increase or decrease SOC?
Vagus nerve-Ach

A

Decrease SOC

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185
Q

Where is the cardioinhibitory center located?

A

Also the medulla oblongata

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186
Q

What is in the cardioinhibitory center?

A

Parasympathetic nerves from the vagus nerve

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187
Q

What are proteins/receptors involved in the Parasympathetic NS?

A

Muscarinic receptors

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188
Q

What is another name for muscarinic receptors?

A

Cholinergic receptors

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189
Q

What cranial nerve # is the vagus nerve?

A

10

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190
Q

Is the vagus nerve large or small?

A

Large

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191
Q

What does the vagal NT Ach do to K+ channels?

A

Acetylcholine opens K+ channels, allowing K+ to flood OUT. This hyperpolarizes muscle cells

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192
Q

What is continuous vagal stimulation that keeps the HR down?

A

Vagal tone

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193
Q

What happens to the HR if you cut the vagus nerves?

A

HR increases to 100bpm (the actual pacing of the SA node naturally)

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194
Q

What makes the first sound of the heart?

A

Closure of the atrioventricular valves (especially the mitral valve)

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195
Q

What makes the second sound of the heart?

A

Closure of the semilunar valves, especially the aortic valve

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196
Q

What makes the third sound of the heart?

A

Too much volume in the atrium causes a gallop that sounds like “Kentucky”

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197
Q

Is a third heart sound normal?

A

In children and young adults, it is normal. For those over 40 it can indicate heart failure

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198
Q

How many heart sounds might you hear if you have mitral valve regurgitation?

A

3

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199
Q

When does the third heart sound happen?

A

Immediately following S2 in early diastole

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200
Q

What makes the fourth sound of the heart?

A

Stiff walls (noncompliant or non-elastic) vibrate when blood hits them and it makes a gallop sound like “Tennessee”

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201
Q

What does 4 heart sounds indicate?

A

Myocardial damage

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202
Q

When does the fourth heart sound take place?

A

Occurs immediately before S1

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203
Q

What is diastole?

A

The heart relaxing and filling with blood

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204
Q

What is systole?

A

The heart contracting and ejecting blood

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205
Q

What is the normal pressure for diastole?

A

Low pressure or 75mmHg for periphery

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206
Q

What is normal pressure for systole?

A

High pressure or 120mmHg for periphery

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207
Q

How do you calculate pulse pressure?

A

Diastole - Systole

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208
Q

What is the pulse pressure for the average healthy person?

A

Diastole - Systole
75mmHg - 120mmHg = 45mmHg

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209
Q

What is the first step in the cardiac cycle?

A

Ventricular filling

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210
Q

What brings blood into the heart, and where?

A

Veins return deoxygenated blood to the heart through the atria

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211
Q

Does pressure increase or decrease in ventricular filling?

A

Atrial pressure increases as blood begins to fill
Ventricular pressure decreases, as systole (ejection) just finished

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212
Q

What happens when the pressure in the atrium is greater than the pressure in the ventricle?

A

The AV valve pops open

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213
Q

What happens when the AV valve opens?

A

Blood floods the ventricles

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214
Q

What percent of ventricular filling is powered by low pressure venous return?

A

80%

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215
Q

What powers 20% of ventricular filling?

A

Atrial contraction

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216
Q

What is the end diastolic volume (EDV)?

A

Volume in the chamber at the end of diastole, or its max volume

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217
Q

What is the max volume, or EDV in ml?

A

120ml

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218
Q

What happens after ventricular filling?

A

Isovolumetric (isovolumic) contraction (IVC)

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219
Q

What happens to the AV valves when ventricles contract?

A

The valves snap shut (all 4 of them)

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220
Q

What does the word isovolumic mean and how does it relate to the cardiac cycle?

A

Same volume, meaning the volume remains the same despite pressure rising sharply

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221
Q

When does the aortic and pulmonary semilunar valves open?

A

When pressure in the ventricles get higher than the pressure in the aorta or pulmonary artery

222
Q

What phase follows IVC?

A

Ventricular ejection

223
Q

Where does blood get ejected out of in the heart?

A

The two semilunar valves

224
Q

What is the BP in the right ventricle?

A

12-25/0 mmHg

225
Q

What is the BP in the left ventricle?

A

120/0 mmHg

226
Q

What is the end systolic volume (ESV)?

A

Blood left in the ventricle at the end of systole/ejection

227
Q

What is the minimum ESV?

228
Q

What is the stroke volume?

A

Actual amount of blood pumped out with each beat

229
Q

How do you calculate stroke volume?

230
Q

What is the typical stroke volume?

A

EDV - ESV
120 ml - 50 ml = 70 ml

231
Q

What is the total blood volume of a woman?

A

4000-5000ml

232
Q

What is the total blood volume of a man?

A

5000-6000ml

233
Q

What is the normal heart rate or sinus rhythm for an adult?

234
Q

What is normal sinus rhythm for neonatal?

A

120-160bpm

235
Q

What is the cardiac output?

A

Amount of blood pumped out each minute

236
Q

How do you calculate cardiac output?

A

Stroke volume (SV) x Sinus rhythm

237
Q

What is normal cardiac output?

A

SV x rate
70 ml x 75 bpm = 5250 ml

238
Q

How often do you pump your entire blood volume?

A

Every minute of your life

239
Q

What does the ejection fraction mean?

A

Percent of blood (EDV) pumped out each beat

240
Q

How do you calculate ejection fraction?

A

(Stroke volume/EDV) x 100

241
Q

What is a normal ejection fraction?

A

(SV/EDV) x 100
(70 ml / 120 ml) x 100 = 58.33%

242
Q

How high can ejection fraction get during exercise?

243
Q

What lowers ejection fraction?

A

Heart disease

244
Q

How does increasing HR impact the ejection fraction?

A

There is reduced time for diastole, not systole, so there is less filling time

245
Q

What does an ejection fraction below 40% indicate?

A

Heart damage and possible heart failure

246
Q

At what point (in bpm) is there not enough filling time so there’s a reduction in the ejection fraction/loss of heart efficiency?

247
Q

What is the maximum HR?

248
Q

What happens in isovolumetric (isovolumic) Relaxation (IVR)?

A

The heart begins to relax, but all four valves are still closed. This means there is the same volume, but pressure decreases steeply

249
Q

How does preload affect stroke volume?

A

The tension/stretch/volume on the heart’s chamber before contraction impacts the amount of venous return. More stretch = more contraction = more stroke volume

250
Q

What is Frank-Starling’s Law?

A

The heart pumps more efficiently with increasing volumes (preload stretch).
Increased venous return causes increased SV and increased ejection fraction

251
Q

How does contractility affect SV?

A

As SOC increases, stroke volume increases

252
Q

What is afterload

A

The pressure the heart must exert to pump blood out of the ventricles during contraction

253
Q

What is peripheral resistance?

A

The resistance or pressure the heart must pump against

254
Q

How does afterload relate to SV?

A

As afterload increases, SV decreases

255
Q

How does BP in the arterioles affect afterload?

A

When arterioles constrict, they increase resistance and therefore increase afterload, leading to higher blood pressure

256
Q

Does increased afterload make it easier or harder for the heart?

A

Increased afterload makes the heart work harder

257
Q

Does this increase or decrease afterload?
Atherosclerosis

A

Increase afterload

258
Q

What is atherosclerosis?

A

Clogging/hardening of the arteries

259
Q

Does this increase or decrease afterload?
Loss of arteries due to tissue damage, scarring, amputation

A

Increase afterload

260
Q

Does this increase or decrease afterload?
Hypertension

A

Increase afterload

261
Q

Does this increase or decrease afterload?
Cor Pulmonale

A

Increase afterload

262
Q

Why does Cor Pulmonale cause right heart failure?

A

Pulmonary diseases increase afterload in the right ventricle, making it work harder. This causes an enlargement of the cells (hypertrophy), thickening of the wall, which decreases volume availability, leading to right heart failure

263
Q

What NS receptor can impact afterload?

A

Stimulation of the sympathetic NS’s Alpha 1 Receptor causes vasoconstriction, which increases afterload

264
Q

Pressure of the: right atrium

265
Q

Pressure of the: right ventricle

266
Q

Pressure of the: pulmonary arteries

267
Q

What keeps the diastole of pulmonary artery pressure from 0?

A

The pulmonary valve and sympathetic tone of arterial walls

268
Q

Pressure of the: left atrium

269
Q

What causes the foramen ovale to close at birth [normally]?

A

Left atrial pressure 8/0 being slightly higher than right atrial pressure 5/0 closes the foramen ovale

270
Q

Pressure of the: left ventricle

271
Q

Pressure of the: aortic arch

272
Q

What keeps the aortic arch diastole from 0?

A

Aortic valve and sympathetic tone of arterial walls

273
Q

What is the mean arterial pressure (MAP)?

274
Q

What is an abnormal rate/rhythm of the heart- either too fast or too slow?

A

Arrhythmia

275
Q

What is an abnormal rate/rhythm of the heart- irregular, but within normal range?

A

Dysrhythmia

276
Q

What is the normal rhythm from the SA node and vagus nerve called?

A

Sinus rhythm

277
Q

What happens when the heart beats at <60bpm? Is this ever normal?

A

Bradycardia…Normal in some top athletes

278
Q

What happens when the heart beats between 100-150bpm?

A

Tachycardia

279
Q

What happens when the APs fire at 250-300 AP/min?

A

Flutter (Ventricular/Atrial)
Very inefficient pumping

280
Q

What happens when the APs fire at >300 AP/min?

A

Fibrillation (Ventricular/Atrial)
No pumping, no flow, no beating at all

281
Q

How fast can you lose consciousness (LOC) with fibrillation?

A

3-5 seconds

282
Q

What are the cardiovascular pathology (“trilogy”) from most treatable to irreversible?

A

Coronary Artery Disease
Myocardial Ischemia
Myocardial Infarction

283
Q

What causes coronary artery disease?

A

Arteriosclerosis
Atherosclerosis

284
Q

What is arteriosclerosis?

A

Loss of elasticity or hardening due to clogging/scarring

285
Q

What is atherosclerosis?

A

Clogging of arteries (a type of arteriosclerosis)

286
Q

What causes 50% of all deaths, 1/3 of those between 35-50 years old?

A

Atherosclerosis

287
Q

What causes atherosclerosis?

A

Obesity, sedentary lifestyles, hyperlipidemia, hormones, alcohol, age, hypertension, smoking, diabetes

288
Q

Is coronary artery disease permenant?

A

No, it is reversible

289
Q

What is myocardial ischemia?

A

Reduced blood flow due to vascular occlusion or atherosclerosis

290
Q

Is myocardial ischemia fixable?

A

Yes, it is reversible

291
Q

What is a symptom of myocardial ischemia?

A

Angina pectoris

292
Q

What is angina pectoris?

A

Chest and left neck/arm pain due to build up of lactic acid in the heart

293
Q

What is myocardial infarction caused by?

A

Tissue death (ischemic necrosis)

294
Q

What is a symptom of myocardial infarction?

A

Crushing chest pain, a “heart attack”

295
Q

What does a heart attack look like on an EKG?

A

Prolonged Q wave, elevated ST, inverse T wave

296
Q

Is a myocardial infarction fixable?

A

It is non-reversible

297
Q

What pulmonary diseases can cause right heart failure/cor pulmonale?

A

Emphysema, chronic bronchitis, black lung

298
Q

Why do pulmonary diseases effect the right heart?

A

Destruction of the pulmonary vasculature increases pulmonary afterload. This backup causes pulmonary hypertension

299
Q

What happens to the heart when it works too hard?

A

It hypertrophies and may later atrophy (dilation)

300
Q

What is the difference between hypertrophy and hyperplasia?

A

-trophy = enlargement with same # of cells getting bigger
-plasia = enlargement due to increase in cell #

301
Q

What can right heart failure cause?

A

Peripheral edema (especially in lower extremities) and hepatic congestion

302
Q

What is another name for left heart failure?

A

Congestive heart failure (CHF)

303
Q

What happens in CHF?

A

The left heart is unable to pump blood out due to hypertension (etc.) and this increases afterload. The right heart tries to pick up the slack, and forces a back-up in the lungs.

304
Q

How does CHF impact pulmonary BP?

A

CHF increases pulmonary BP causing a pulmonary edema, which is where the name gets “congestive” from

305
Q

How can enzymes help identify pathologies?

A

When cells die, enzymes are released into the blood. We can test for these enzymes and see what cells died and why

306
Q

What is an example of an enzyme that transfers a phosphate group to another molecule, thereby activating or inhibiting the recipient molecule?

A

Creatine Kinase

307
Q

What does creatine kinase do with creatinine phosphate?

A

Creatine kinase adds a phosphate group from creatinine phosphate to ADP, making ATP

308
Q

What enzyme converts lactic acid to pyruvic acid?

A

Lactic dehydrogenase (LDH)

309
Q

What does Serum Glutamic-Oxaloacetic Transaminase (SGOT) do in the body and where?

A

Helps metabolize amino acids in Kreb’s cycle. Seen in the liver, heart, skeletal muscles, kidneys, pancreas, RBCs

310
Q

Is SGOT specific?

A

No. When you test for SGOT, you learn cells are dying somewhere, but you do not know which specific organ

311
Q

What protein indicates heart damage when found in the blood?

312
Q

What is a pericardial or cardiac tamponade?

A

Fluid accumulation in the pericardial cavity. As pressure builds, it becomes more and more difficult to fill the heart chambers

313
Q

What happens in patent foramen ovale?

A

The foramen ovale fails to close. This causes pulmonary bypass and hypoxia

314
Q

Is patent foramen ovale life threatening?

A

No, many are asymptomatic and require no treatment

315
Q

What is patent ductus arteriosus?

A

A type of fetal pulmonary bypass. When it is closed, it causes hypoxia

316
Q

What is it called when there is a fetal hepatic bypass causing buildup of metabolic toxins?

A

Patent ductus venosus

317
Q

What is coarctation of the aorta?

A

Aortic stenosis (narrowing) and insufficient perfusion of tissues

318
Q

What is an example of a ventricular septal defect?

A

A hole in the interventricular septum

319
Q

What is difficulty breathing called?

320
Q

What is dyspnea when lying down called?

321
Q

What does paroxysmal mean?

A

Sudden extreme attack on your breathing

322
Q

What does paroxysmal nocturnal dyspnea mean?

A

Sudden extreme suffocation at night causing difficulty breathing

323
Q

How does digitalis treat cardiovascular disease? What does it treat?

A

Buildup of Ca++ from the poisoning of Na-K pump and reduction of the Na-Ca counter transport increases the SOC. This treats CHF and arrhythmias

324
Q

Does digitalis increase or decrease HR?

A

Digitalis decreases HR, and can be used to treat hypertension

325
Q

How can nitrates treat cardiovascular disease?

A

They vasodilate allowing more blood flow to the heart, increasing HR

326
Q

What nitrate is used to treat heart problems?

A

Nitroglycerine

327
Q

What cardiovascular treatment causes vasodilation and reduces water retention?

A

ACE Inhibitors

328
Q

Do ACE inhibitors increase or decrease BP?

A

Decrease BP, treats hypertension

329
Q

What do beta blockers do for the heart?

A

Inhibit Beta 1 receptors. This slows HR down, reduces SOC, and reduces BP

330
Q

What do calcium channel blockers do for the heart?

A

If there is less Ca+ in the heart, the HR, SOC, and BP will all DECREASE

331
Q

What reduces blood volume by increasing urine output?

332
Q

How do diuretics impact BP?

333
Q

What does lidocaine do for the heart?

A

Lidocaine resets heart muscles to re-establish sinus rhythm by forcing Na+ channels open

334
Q

What does lidocaine treat?

A

Temporary arrythmias/dysrhythmias

335
Q

What is the innermost layer/inner lining of a blood vessel?

A

Endothelium

336
Q

What is the endothelium made of?

A

Simple squamous epithelium

337
Q

What is the subendothelial layer/space made of?

A

Connective tissue

338
Q

What are the three components of the tunica intima?

A

Endothelium
Subendothelial space
Internal elastic lamina

339
Q

Which layer of blood vessels contain smooth muscle?

A

Tunica media

340
Q

Does the tunica media have an elastic lamina?

A

Yes, the external elastic lamina

341
Q

What part of the blood vessel is involved in vasoconstriction/dilation?

A

Smooth muscle in the tunica media

342
Q

Does vasoconstriction make the diameter bigger or smaller?

343
Q

Does vasodilation make the vessel diameter bigger or smaller?

344
Q

What is the outer layer of the blood vessel made of?

A

Connective tissue

345
Q

What are the three layers of the blood vessel?

A

Tunica intima
Tunica media
Tunica externa

346
Q

What is lumen?

A

The inside cavity of the vessel/organ

347
Q

What is the BP of: Aorta, a type of elastic artery

A

120/80 mmHg

348
Q

What is the BP of: Muscular arteries

A

96 (Mean Arterial Pressure)

349
Q

How much of peripheral resistance do arterioles control?

350
Q

What is the total area of the body’s capillaries in m2?

351
Q

What is the BP of: Capillaries

A

14-17 mmHg

352
Q

What % volume of blood are capillaries?

353
Q

Where does gas exchange occur?

A

Capillaries

354
Q

Is there pulse or pulse pressure in capillaries?

355
Q

What % of blood volume is in the venules?

356
Q

What is the BP of: Veins

357
Q

What % blood volume is the veins?

358
Q

What % blood volume is in the heart?

359
Q

Where is most of the blood in the body and how much?

A

Veins (54%)

360
Q

What are the elastic arteries?

A

Major branches near the heart, like the aorta

361
Q

How big are elastic arteries?

A

Very large, near the heart, thick walled

362
Q

Do elastic arteries contribute to vasoconstriction?

A

Very little

363
Q

What are examples of muscular arteries?

A

Inferior phrenic, brachial

364
Q

What type of arteries are most of the named ones?

A

Muscular arteries

365
Q

Which have a thicker tunica media: muscular or elastic arteries?

A

Muscular arteries have thicker tunica media

366
Q

What is the MAP of muscular arteries?

367
Q

What proportionately has the greatest amount of smooth muscle?

A

Arterioles

368
Q

What proportion do arterioles regulate peripheral resistance/afterload/BP?

369
Q

What are the major regulators of blood pressure through vasoconstriction/dilation?

A

Arterioles

370
Q

What is peripheral resistance?

A

Similar to afterload (pressure against which the heart pumps) and correlated with blood pressure

371
Q

How big are capillaries? What do they consist of?

A

Very small, basically only the tunica intima

372
Q

Where do exchanges of gases, hormones, nutrients, wastes occur?

A

Capillaries

373
Q

Are venules thick or thin?

374
Q

Which have valves, veins or arteries?

375
Q

What % of blood is held in venules and veins?

376
Q

Do veins and venules have a large tunica media and smooth muscle?

A

No, relatively little

377
Q

Where is the vasomotor center?

A

Medulla oblongata

378
Q

Where is the sympathetic NS control regulated?

A

Vasomotor center in medulla oblongata

379
Q

How does increasing sympathetic NS effect: Vasoconstriction and BP

A

Increase vasoconstriction, increase BP

380
Q

How does increasing sympathetic NS effect: HR and BP

A

Increase HR, increase BP

381
Q

Does reducing sympathetic NS stimulation decrease BP, SOC, HR?

381
Q

How does increasing sympathetic NS effect: SOC and BP?

A

Increase SOC, increase BP

382
Q

Does the parasympathetic NS act opposite to the sympathetic NS in regards to BP, HR, etc.?

A

Yes. Increase of Parasympathetic NS stimulation decreases HR, SOC, BP

383
Q

Can you exercise arterial muscles?

A

Yes! Continuous stimulation of arteries, called vasomotor tone, improves the vasomotor (BP) system. This is exercised alongside skeletal muscles

384
Q

Local vs systemic BP?

A

Local: POV of a single organ
Systemic: All the arterioles of a body as a whole

385
Q

How does vasoconstriction of a renal artery affect the kidney’s BP?

A

Decrease kidney BP

386
Q

How does vasodilation of renal artery affect kidney BP?

A

Increase kidney BP

387
Q

If you vasoconstrict systemically, how does this impact BP?

388
Q

If you vasodilate systemically, how does this impact BP?

389
Q

Should we assume local or systemic in a question?

390
Q

If you reduce a vessel’s diameter by 1/2, how does this impact blood flow volume?

A

Blood flow volume DROPS to 1/16…That’s a BIG drop

391
Q

How does systemic BP going up impact local BP for a kidney?

A

Systemic increase in BP causes local vasoconstriction of the renal artery to reduce internal kidney BP (or keep it from rising with the rest of the system).

392
Q

Do organs want to stay the same BP?

A

Yes. They will trigger mechanisms to keep their internal pressure the same, even if the systemic pressure changes

393
Q

Does this affect BP/vasomotor control in the short term or long term? Baroreceptors

394
Q

Does this affect BP/vasomotor control in the short term or long term? Chemoreceptors

395
Q

Does this affect BP/vasomotor control in the short term or long term? Higher centers of the brain

396
Q

Does this affect BP/vasomotor control in the short term or long term? Adrenal medulla

397
Q

Does this affect BP/vasomotor control in the short term or long term? Antidiuretic hormone

398
Q

Does this affect BP/vasomotor control in the short term or long term? Atrial natriuretic peptide

399
Q

Does this affect BP/vasomotor control in the short term or long term? Endothelin

400
Q

Does this affect BP/vasomotor control in the short term or long term? Nitric oxide

401
Q

What are baroreceptors?

A

Stretch receptors or mechanoreceptors

402
Q

Where are baroreceptors found?

A

Everywhere in the body, but large concentrations are found in carotid sinus (glossopharyngeal nerve) and aortic arch (vegus nerve)

403
Q

How does an increase in BP affect baroreceptors?

A

Increase in BP, increase in arterial stretch, increased stretch of baroreceptors

404
Q

What happens when baroreceptors are stretched?

A

AP is sent to the vasomotor control center to reduce sympathetic NS stimulation and/or increase parasympathetic NS stimulation to REDUCE BP

405
Q

Where are chemoreceptors found?

A

Everywhere in the body, but large concentrations are found in carotid sinus (glossopharyngeal nerve) and aortic arch (vegus nerve)

406
Q

What triggers chemoreceptors to send AP to increase HR and SOC?

A

Decrease of O2 or increase of CO2 and H+

407
Q

Why do chemoreceptors increase HR and SOC?

A

To increase perfusion and wash away waste products (like CO2 and H+)

408
Q

Where in the body do you see vasodilation due to chemoreceptors?

409
Q

How do chemoreceptors affect the lungs?

A

Increase lung ventilation rate

410
Q

Where in the “higher centers of the brain” causes stimulation of sympathetic NS?

A

Hypothalamus, cerebrum

411
Q

What happens in your body when you are angry/afraid and where?

A

Higher centers of the brain stimulate SNS with norepi and epi. This increases BP

412
Q

What produces most of the body’s norepi/epi/adrenalin?

A

Adrenal medulla

413
Q

What works closely with the higher brain centers and the sympathetic fight/flight?

A

Adrenal medulla

414
Q

What is the name of the antidiuretic hormone (ADH)?

A

Vasopressin

415
Q

Where is vasopressin made and stored?

A

Vasopressin is made in the hypothalamus, then stored and released from the posterior pituitary gland

416
Q

What is ADH responsible for?

A

Primary hormone for tonicity homeostasis and BP control

417
Q

What kind of states trigger ADH release?

A

Hyperosmolar (hypertonic) states trigger ADH release to initiate water retention to bring the body closer to isotonic

418
Q

What common conditions result in elevated osmolarity and subsequent increased ADH secretion?

A

High salt diets and hypertension

419
Q

What hormone promotes water reabsorption in the kidneys?

A

Vasopressin

420
Q

Does ADH vasodilate or constrict?

A

Causes vasoconstriction

421
Q

How does water retention and vasoconstriction impact BP and volume?

A

Increase arterial blood volume and increase BP to maintain tissue perfusion

422
Q

What does ADH turn on when the blood becomes hypertonic/hyperosmotic?

A

Protein synthesis in the kidneys

423
Q

What does ADH activating protein synthesis in the kidneys do?

A

Increase the number of water channels (proteins) in the renal tubules, allowing more water to be returned to the circulatory system

424
Q

How does more water in the circulatory system affect BP?

A

Prevent reduction of BP

425
Q

What is one of the most powerful vasoconstrictors in the body that help increase BP?

A

Antidiuretic hormone (ADH) vasopressin

426
Q

Where does ADH get released from?

A

Posterior pituitary gland, angiotensin 2, pain, nausea, hypoglycemia, nicotine, opiates, certain medications, estrogen

427
Q

What can be released due to increased estrogen at types of the menstrual cycle?

A

ADH! This causes edema (bloating) and BP rise

428
Q

What inhibits ADH?

A

Ethanol
Alpha-adrenergic agonists
Atrial natriuretic peptide

429
Q

How does being intoxicated affect water retention?

A

Increased ethanol due to drinking alcohol, which inhibits ADH, causes diuresis (excessive urination) in drunk people

430
Q

What makes atrial natriuretic peptide (ANP)?

A

Heart’s atria

431
Q

When is ANP released?

A

When BP rises, the atria stretch and released ANP to turn on Na-K pump

432
Q

Where does Na+ go when ANP is released?

A

Pumped out of the blood into urine

433
Q

Does water follow or go away from Na?

A

Water always follows Na

434
Q

Does the body releasing 3 Na+ into the urine due to ANP increase or decrease urination? How is BP affected?

A

More Na+ in urine causes more water in urine, causing more urination. This decreases blood volume and BP

435
Q

Where does 2 K+ go when ANP is released?

A

Into the blood

436
Q

What hormone pumps Na+ and K+ into opposite directions?

A

Aldosterone

437
Q

What releases endothelin?

A

Endothelium in tissues

438
Q

What does endothelin do locally?

A

Local vasoconstriction to decrease local BP

439
Q

What does endothelin do systemically?

A

Increases BP systemically

440
Q

Is endothelin important in systemic or local control?

A

Local control

441
Q

What releases nitric oxide?

A

Endothelium in tissues

442
Q

What does nitric oxide do locally?

A

Local vasodilation to increase local BP

443
Q

What does nitric oxide do systemically?

A

Decrease in BP as a system

444
Q

Is nitric oxide important in systemic or local control?

A

Local control

445
Q

What is the basic filtering unit of the kidneys?

446
Q

How many nephrons are in the kidney’s cortex?

447
Q

Where does urea from unfiltered blood diffuse in a nephron?

A

Urea diffuses OUT into the tubules, along with a lot of water

448
Q

How much water does the body need back (that is diffused out with urea)?

449
Q

How does the body get water back IN that was filtered out with urea?

A

2 hormones: aldosterone and ADH

450
Q

What are the 3 hormones involved in urine filtration?

A

Aldosterone
ADH
ANP

451
Q

Which hormone diffuses substances OUT of the body, through urination?

452
Q

What % of water remains in urine?

453
Q

How does Na+ and urea affect the deep medulla?

A

Makes it hypertonic

454
Q

Where are the 3 filtration hormones found?

A

Late distal convoluted tubules (DCT) and the collecting ducts

455
Q

What is the normal urine isotonic range in the cortex?

A

280-296 mOSM (roughly 300 mOsm)

456
Q

How does a concentration of 1200 mOsm in the deep medulla compare to the renal cortex?

A

Very hypertonic

457
Q

What makes the deep medulla hypertonic?

A

Na+ and urea

458
Q

Does the renin-angiotensin system work for short or long term BP control?

459
Q

Where in the kidneys is renin released from?

A

Juxtaglomerular aparatus

460
Q

What are the tubules in the kidney that indirectly monitor BP through urine flow?

A

Macula densa

461
Q

Where in the juxtaglomerular aparatus is renin released?

A

Granular cells in the afferent arteriole

462
Q

Where does renin turn angiotensinogen into angiotensin 1?

463
Q

What enzyme turns angiotensinogen into angiotensin 1?

464
Q

What turns angiotensin 1 into angiotensin 2?

A

Angiotensin converting enzyme (ACE)

465
Q

Where does ACE convert angiotensin from 1 to 2?

466
Q

What does angiotensin 2 do?

A

Causes intense vasoconstriction, which increases BP
Releases aldosterone

467
Q

Where is aldosterone released from when activated by angiotensin 2?

A

Adrenal cortex

468
Q

What is aldosterone?

A

A steroid hormone

469
Q

Where does aldosterone go when released by the adrenal cortex?

A

To the kidney

470
Q

What turns on the Na-K pump in the kidney?

A

Aldosterone

471
Q

What do ACE inhibitors do to BP?

A

These block ACE, which lowers BP. Used to treat hypertension

472
Q

What is it called when you listen to heart sounds?

A

Auscultation

473
Q

What is a blood pressure cuff called?

A

Sphygmomanometer

474
Q

How do you hear korotkoff’s sounds?

A

Pump blood in the cuff until cut cuts off blood flow in the brachial artery. Slowly release the pressure and listen

475
Q

What are the “puffing” sounds you hear from a blood pressure cuff?

A

The blood flowing into the artery vibrating the walls

476
Q

What kind of pressure is measured during contraction (the first phase of blood pressure cuff)

A

Systole (ex. 120 mmHg)

477
Q

What kind of pressure is noted when the artery is opened enough that there is no more korotkoff sounds?

A

Diastolic pressure (ex. 75 mmHg)

478
Q

Why did they use mercury to measure BP?

A

It is less dense, and if you used water the sphygmomanometer would have to be over 6 feet tall

479
Q

What is perfusion?

A

Blood flow to tissues relative to the tissue’s mass

480
Q

Do organs regulate their own local BP?

A

Yes! It is called autoregulation

481
Q

What is metabolic control?

A

When perfusion is reduced and there is a reduction of O2, and an increase of wastes/CO2, the tissues vasodilate to increase perfusion again

482
Q

What is myogenic control?

A

Muscle contraction to stabilize BP

483
Q

How would muscles react in myogenic control when BP is raised?

A

When BP is increased and the vessels dilate stretching the walls, the muscle will react with a reflex vasoconstriction to prevent wall damage

484
Q

Do muscles dilate or contract when stretched?

A

Muscles contract when stretched

485
Q

How many capillaries in skeletal muscles are open at rest?

A

25% (75% are closed)

486
Q

Why does the metabolic control system cause vasodilation with exercise?

A

To respond to the increased waste products (ex. CO2)

487
Q

How much can blood flow increase with exercise?

A

Up to a 10 fold increase in blood flow

488
Q

How do arteries in the brain respond to waste products?

A

Vasodilation

489
Q

How does the skin respond to high body temperatures (fever, exercise, etc.)?

A

Arterial dilation

490
Q

Does cold temperature vasodilate or vasoconstrict the skin?

A

Vasoconstrict

491
Q

Are the lung’s autoregulatory mechanisms the same as other regions?

A

No! The lungs always have to be difficult/different/special/opposite

492
Q

What do the lungs do when O2 levels are HIGH?

A

Vessels DILATE to pick up even MORE O2

493
Q

What do the lungs do when O2 levels are low?

A

Vessels CONSTRICT…There’s no point in perfusing the lung if there isn’t any O2 to pick up

494
Q

What happens to the lungs with emphysema?

A

Lung tissue is destroyed, as chronic low O2 levels make the body abandon those tissues

495
Q

When does hypoxic pulmonary vasoconstriction occur?

A

If ventilation is low and there is low O2

496
Q

Where does fluid leak out of the capillary into and when?

A

When blood approaches the capillary, fluid leaks into the extracellular matrix (ECF)

497
Q

What happens to the capillary as blood courses through it and there has been fluid loss?

A

The capillary is concentrated and hypertonic

498
Q

What kind of pressure is built from a capillary that is concentrated and hypertonic?

A

Colloid pressure (PULLING force)

499
Q

What does colloid pressure do as it increases in the capillary?

A

Pulls fluid back in from the ECF thanks to the pulling force

500
Q

How much ECF is drained by the lymphatic vessels?

501
Q

What is continuously washed by fluid?

A

The interstitium

502
Q

What happens if the lymphatics are blocked by tiny worms, tumors, etc.?

A

Massive swelling as seen in elephantiasis

503
Q

What is the pushing pressure?

A

Hydrostatic pressure

504
Q

What is the pulling pressure?

A

Colloid or osmotic pressure

505
Q

Capillary/plasma hydrostatic pressure ____ blood ___ a capillary

A

pushes fluid OUT of

506
Q

Capillary/plasma colloid/osmotic pressure ____ blood ___ a capillary

A

pulls fluid IN

507
Q

Interstitial hydrostatic pressure ____ blood ___ the interstitium

A

pushes fluid OUT

508
Q

Interstitial colloid/osmotic pressure ____ blood ___ the interstitium

A

pulls fluid IN

509
Q

Will low plasma colloid pressure push fluid in or out the capillary?

A

Push fluid out

510
Q

Will high plasma hydrostatic pressure push fluid in or out the capillary?

A

Push fluid out

511
Q

Will high interstitial hydrostatic pressure push fluid in or out the capillary?

A

Push fluid in

512
Q

What is the net result of ECF pushing/pulling within the capillary?

A

Fluid leaves the vessel at the arterial end of the capillary

513
Q

As blood courses through the capillary and fluid is lost, the blood becomes…

A

More concentrated or hypotonic

514
Q

How does prednisone affect Na+ and water retention?

A

Prednisone increases Na+ reabsorption, which increases water retention. This can result in increased fat in face and neck

515
Q

What can kidney/heart/and liver failure cause in the interstitium?

516
Q

What kind of disease/process is plaque formation?

A

Inflammatory

517
Q

What size vessels are inflammatory?

A

vessels > 1 mm

518
Q

What does smoking, hypertension, and hyperlipidemia do to the endothelium?

A

Damages endothelium and causes plaque

519
Q

What is endothelial dysfunction?

A

The barrier is compromised allowing LDL P (small LDL particles) to move in the sub-endothelial space and produce free radicals

520
Q

What is an example of a free radical?

A

Superoxide radical

521
Q

What do free radicals like superoxide radical attract?

522
Q

What do macrophages produce?

A

Macrophages phagocytize and oxidize LDL P, making “foam cells”

523
Q

Where is the fatty streak found and why?

A

The subendothelial space, where macrophages that were full of lipids die (and their contents spill out when they die)

524
Q

What cells are activated to amplify the inflammatory reaction?

525
Q

Where do smooth muscle cells migrate in plaque formation?

A

Into tunica intima from the tunica media

526
Q

What do smooth muscle cells make out of collagen and elastin proteins?

A

Fibrous cap

527
Q

What does the fibrous cap do in the subendothelium?

A

Bulges into the blood vessel narrowing its diameter (atherosclerosis)

528
Q

What can smooth muscle cells release that cause stiffening of the arterial walls?

A

Calcium, they cause calcification

529
Q

What does it mean for an arterial wall to have reduced compliance?

A

Less flexible, can’t stretch

530
Q

How does decreased compliance affect BP?

A

Less stretch increases BP

531
Q

What is an aneurysm?

A

Ballooning artery with an increased chance of fatal rupture

532
Q

What are varicose veins?

A

Overstretched veins with compromised valves, as seen in tissue edema and pregnancy

533
Q

What is orthostatic hypotension?

A

Reduction in BP upon standing

534
Q

What percent of hypertension is primary or essential?

535
Q

What causes primary or essential hypertension?

A

Unknown for sure. Suspected smoking, genetics, stress, obesity, age, race

536
Q

What percentage of hypertension is secondary?

537
Q

What causes secondary hypertension?

A

Atherosclerosis, too much renin

538
Q

What is the BP of malignant hypertension?

A

Diastolic BP > 140 mmHg

539
Q

What can malignant hypertension cause?

A

Encephalopathy, cerebral edema, intracerebral hemorrhage

540
Q

What is shock?

A

Poor tissue perfusion (blood flow) which starves organs

541
Q

What causes cardiogenic shock?

A

Heart failure, usually myocardial infarction

542
Q

Is cardiogenic shock treatable?

A

Poor response to treatment

543
Q

What kind of shock is “bleeding out”?

A

Hypovolemic

544
Q

What type of shock is from an imbalance of PSNS and SNS?

A

Neurogenic

545
Q

What happens in neurogenic shock?

A

Massive vasodilation and peripheral pooling of blood

546
Q

What causes anaphylactic shock?

A

Hypersensitive reaction to allergy

547
Q

What causes septic shock?

A

Bacterial or fungal infection in the blood

548
Q

What does agonist mean?

A

A helper, works WITH

549
Q

What does antagonist mean?

A

Works AGAINST

550
Q

What would a medicine with Acetylcholine do for BP?

A

Lower BP, treat hypertension

BIO 142 (16 decks)

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