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202 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Describe the intrinsic conduction system of the heart

A

a. The SA node in the right atrium and is the primary pacemaker for the heart and delays AV to allow atria to finish before contracting ventricles
b. The AV bundle conducts impulses into the ventricles.
d. The right and left bundle branches conduct impulses down the interventricular septum to the apex.
e. The subendocardial conducting network penetrates throughout the ventricular walls, distributing impulses

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2
Q

Describe the waves and corresponding atrial and ventricular contractions/depolarizations on ECG

A

The P wave shows atria depolarization
P and Q show atria systole
The QRS complex is showing ventricular depolarization
ST shows ventricle systole
The T wave shows ventricular repolarization, a resting state

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3
Q

Describe the events of a normal ECG

A

P-Q: SA node fires an action potential which is through the atria and delayed in the AV node
R-S: depolarization
S-T: depolarization enters the plateau phase
T: repolarization complete, SA node begin slow depolarization

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4
Q

What are the heart sounds and the events they represent?

A

1st is LUB the closure of the AV valves and occurs during ventricular systole. 2nd is DUB closure of the aortic and pulmonary valve and occurs during ventricular diastole

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5
Q

Define these heart structures: valves, chambers, great vessels entering and leaving

A
  1. Superior/Inferior Vena Cava- the vessels that flow oxygen-depleted blood into the right atrium.
  2. Tricuspid Valve- between the right atrium and right ventricle…opens to allow blood to flow into the right ventricle.
  3. Pulmonary Valve- between the right ventricle and pulmonary artery…opens to allow blood to flow into the pulmonary artery.
  4. Pulmonary Artery- sends blood back to the lungs.
  5. Pulmonary Veins- the vessels that flow oxygen-rich blood into the left atrium.
  6. Bicuspid Valve- between the left atrium and left ventricle…opens to allow blood to flow into the left ventricle.
  7. Aortic Valve- between the left ventricle and aorta…opens to allow blood to flow into the aorta.
  8. Aorta- sends blood to the rest of the body
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6
Q

Describe the protective membranes

A

Pericardium: superficial-fibrous pericardium that protects heart and anchors it to surroundings and prevents overfilling, serous- consisting of parietal layer that lines inside of pericardium and visceral- covers surface of heart (epicardium)

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7
Q

Describe the blood flow through heart and out of/into pulmonary and systemic circuits

A

Oxygen deprived blood leaves through the pulmonary artery and goes to the lungs. The blood gets oxygen from the lungs and then goes back to the heart through the pulmonary veins. Oxygenated blood leaves the heart through systemic arteries to give oxygen to our tissues then uses the systemic veins to get back to the heart.

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8
Q

What are the similarities and differences between cardiac muscle and skeletal muscle

A

Both are striated
Both use actin and myosin
Cardiac is involuntary
skeletal is voluntary
Cardiac has intercalated disks
cardiac only has one nucleus skeletal is multi nucleated

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9
Q

Describe cardiac output and reserve, what it means for a fit or a de-conditioned person

A

Cardiac output is the amount of blood pumped out of the heart per minute. Cardiac output for a fit individual is higher than a deconditioned individuals. Cardiac reserve is the difference between the amount of blood that is pumped out of the heart while resting and maximum cardiac output while exercising. When cardiac output increases, blood pressure increases. Blood pressure decreases with cardiac reserve.

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10
Q

How is cardiac output related to blood pressure?

A

BP = CO x R
When cardiac output increases, blood pressure increases as well. Increasing the stroke volume is the most common way to enhancing cardiac output.

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11
Q

How does the autonomic nervous system control cardiac output?

A

Parasympathetic decreases firing rate
Sympathetic increases due to adrenaline/cortisol/TH hormones

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12
Q

What are other influences over cardiac output?

A

Water, sodium, alcohol

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13
Q

Describe the types of vessels and their relation to blood flow, blood pressure, peripheral resistance.

A

Aorta: high BP, easy blood flow due to vasomotion
Elastic Arteries: high BP, close to heart
Muscular Artieries: BP starts to decrease, sending to specific organs, regulating BP
Arterioles: BP declines sharply, vasoconstriction
Capillaries/Venules: BP low, barely has a BP in order to send it back up to the veins
Veins: little to no BP , less muscle

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14
Q

What are the structural and functional differences in veins and arteries?

A

Structural
Arteries: Thicker tunica media, vasomotion
Veins: bigger lumen, higher blood volume, valves, less smooth muscle
Functional
Arteries: high BP, away from heart, O2 rich
Veins: low to very low BP, to heart

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15
Q

Describe the functions of blood vessels

A

Blood Vessels are a closed delivery system that carries blood to and from the heart and to the body.

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16
Q

Describe the anatomy of the arteries, veins, and capillaries, as well as how they’re all connected.

A

Arteries/Veins
tunica externa- connective tissue
tunica media- smooth muscle
tunica intima- enhances blood flow
Capillaries
1 layer to capillary walls
Made of endothelial cells
Capillary network connects venules and arterioles and allow fluid to move easily from blood to tissues

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17
Q

Define auto-regulation, vasodilation/vasoconstriction, pulmonary vs systemic circulation

A

Autoregulation: hard working tissues get more blood flow
Vasodilation: widens BV
Vasoconstriction: narrows BV
Pulmonary: movement of blood between heart and lungs
Systemic: movement of blood between heart and body

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18
Q

Define peripheral resistance and its relationship to blood flow

A

Resistance of the arteries to blood flow
1. Diameter: vasomotion, more BV=better BF
2. Blood Viscosity: thickness, slower due to dehydration/polycythemia & faster due to overlyhydration/anemia
3. Length: shorter is better

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19
Q

Define circulatory shock and list its causes

A

Inadequate blood flow throughout the body that could damage body tissues
Causes: - heart problems, low blood volume, changes in blood vessels

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20
Q

Describe the mechanisms of venous return

A

Left ventricle goes through aorta (highest BP) to send blood down elastic arteries that conduct blood vessels to muscular arteries that distribute vessels, then go to arterioles that perform vasomotion and turn into terminal arterioles that connect to post capillary ventless through capillary network, here they filter out what the tissue needs and pick up the waste, low BP here, then the low oxygenated blood is sent against gravity up the veins where there is barely any pressure and to the IVC where there is essentially no pressure.

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21
Q

Describe the structure of capillaries including the vessels feeding them and draining them.

A

Gas exchange site, 1 capillary wall, low BP
TYPES:
Continuous- most common (skin/body), permeable
Fenestrated- has holes, found in endocrine system
Sinusoid- large gaps, found in liver/red bone marrow/spleen

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22
Q

What is the equation for cardiac output? What are the factors influencing HR or SV?

A

CO=HR x SV
HR: parasympathetic causes decrease by slowing firing rate of SA and AV nodes, sympathetic causes increase by adrenaline and cortisol by increasing glucose and TH hormones
SV: preload-amount ventricles are stretched by blood before contraction, contraction force- stronger SV, after load- minimize SV and hypertensive

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23
Q

What are the functions of blood?

A

Transportation - Oxygen from lungs to body tissues as well as CO2 and nutrient transport
Regulation - regulate pH by the bicarbonate buffer and regulation of body temperature
Body protection - prevents blood loss (initiating clot formation when a vessel is broken) and prevents infection (synthesizing and utilizing antibodies).

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24
Q

What are the components of blood and their individual functions

A

Plasma- 90% water and 10% ions, proteins, nutrients, and wastes. Maintains blood pH and Osmotic balance
Red Blood cells/erythrocytes- biconcave cells responsible for carrying oxygen and carbon dioxide
White Blood cells/leukocytes- are a part of the immune system, fight infections, allergic reactions, parasites,etc.
Platelets- fragments of cells responsible for blood clotting

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25
Q

What is hemostasis? What are the steps in order?

A

Hemostasis - the stopping of blood flow
Steps: Vascular spasms (vasoconstriction), Platelet Plug Formation (ADP attracts platelets), Coagulation (blood clots)

26
Q

What are the last 2-3 steps of coagulation (involving fibrin mesh formation)

A
  1. activation of the clotting factor that will help bring proteins to the cite of injury.
  2. Prothrombin creates thrombin through prothrombinase, this allows fibrinogen to turn into fibrin using the thrombin
27
Q

Which stem cell in the red bone marrow initiates all hematopoiesis?

A

hemocytoblast

28
Q

What is the pathway for erythropoiesis?

A

Erythropoiesis: process that produces red blood cells
A decrease in O2 is detected in kidneys that allow the kidneys to release erythropoietin which increases the production of RBC in the red bone marrow which then increases carrying capacity and relieves the stimulus that triggered kidneys

29
Q

define the relevant respiratory volumes and capacities: total lung capacity, residual volume, ERV, IRV, tidal volume and define atelectasis

A

Total lung capacity: sum of all lung volumes
Residual volume: 1L, never leaves
ERV: max exhale
IRV: max inhale
Tidal volume: about 500 mL, background breathing
Atelectasis: when your lung collapses because of too much outside pressure

30
Q

Boyle’s law

A

Volume goes up, pressure goes down and vice versa

31
Q

Dalton’s law

A

O2 N2 CO2 adds up to total air pressure

32
Q

Henrys law

A

Air liquid interface
In blood:
- N2 not soluble
- O2 somewhat
- CO2 mostly

33
Q

Describe ventilation-perfusion coupling?

A

How well the air gets to alveoli and how the blood gets there, they capillaries constrict when there is not much there and when there is a hard working tissue then the capillaries go and vasodialate and pick up most
More ventilation more perfusion!
When you trick or treat you go to the house that has the stuff for you not the house with nothing there

34
Q

Describe the effects of pH (acidity), temperature, and CO2 on oxygen unloading from hemoglobin

A

CO2 takes place of oxygen after they unload
High temp/ high acidity
- needs a hard working tissue

35
Q

What are the relative partial pressures of oxygen and carbon dioxide in systemic and pulmonary circulation, as well as at the alveolar and tissue level.

A

Higher CO2 in blood than in lungs
Partial pressure pushes it out for us to exhale
Higher O2 in lungs so it gets taken by lungs until the pressures equal

Cells that need O2 take it from the blood and in return push CO2 out because they need it to be put into the heart (internal respiration)

36
Q

Describe the three ways carbon dioxide is transported in the blood.

A

By itself: Dissolved gas
In disguise: Bicarbonate
With a friend: binds to hemoglobin

37
Q

What are the neural controls of respiration?

A

Medulla: -ventral resp group: inspiratory neuron set basic rhythm of inhales & expiratory neurons: forced expiration
-dorsal resp group: changes rate and depth
Pons: multitasker of activities, schedules

38
Q

Define hyperventilation, hypoventilation, and surfactant

A

Hyperventilation- Deep and rapid breathing, usually to help eliminate or “blow off” CO2
Hypoventiliation- Breathing at an abnormally slow rate. This results in an increased amount of carbon dioxide in the blood
Surfactant- A substance which tends to reduce the surface tension of a liquid in which it is dissolved. Produced by the type II cells of the alveoli to break up water molecules (rain-ex)

39
Q

List the structures of the conducting zone vs. those of the respiratory zone.

A

Conducting zone: nose, pharynx, larynx, trachea, and bronchi.
Respiratory Zone: bronchioles, alveolar ducts, and alveoli.

40
Q

Describe the pleural cavity

A

A potential space between the two layers of pleura, contains thin film of serous fluid

41
Q

Compare type I and type II alveoli as to structure, function and numbers. Define “dust” cells.

A

Type I: form the major part of the alveoli walls
Type II: secrete surfactant
Dust cells (macrophages): most numerous, wander and keep alveoli free from debris by “eating” dust particles

42
Q

Describe hypocapnia and hypercapnia. How does each condition affect blood pH?

A

-hypo: decrease in aveolar and blood CO2, blood pH is too high
-hyper: increase in arrival CO2 too acidic

43
Q

Describe hemoglobin, its parts, and its jobs

A

complex molecule of our red blood cells made of four iron containing “heme” groups and protein polypeptide chains or “globin”. It functions to facilitate the gas exchange between the lungs and body tissues. Oxygen is taken in from the lungs where it diffuses into the cell and binds with the iron heme groups changing it to a bright red color and then travels through the circulatory system to the capillaries of other body tissues where the oxygen is released as needed and carbon dioxide is absorbed. This deoxygenation changes the color to a deeper darker red. They then travel back towards the lungs where it’s CO2 is released and exhaled in respiration and oxygen is again absorbed

44
Q

What blood can be safely donated to O-?

A

O-

45
Q

What can safely be donated to AB+?

A

Any

46
Q

What blood type is the universal acceptor and what type is the universal donor?

A

Acceptor: AB+
Donor: O-

47
Q

What is trans pulmonary pressure and why is it important?

A

Pressure difference between Ppul and Pip to ensure that the lungs remain inflated

48
Q

Trace blood from the right atrium to the kidney

A

Blood is sent through the IVC into right atrium which is pumped through the ventricle through pulmonary artery which sends to lungs to get O2 rich blood which is then taken back through pulmonary veins which is sent through left atrium and ventricle through the aorta, through descending aorta, through abdominal aorta, through renal arteries to reach kidney

49
Q

Describe the phases of the cardiac cycle and relate them back to the events of EKG

A
  1. Ventricular Filling
    Passive: blood returning to the heart from the veins slowly (happens right before P in the EKG)
    Active: atrial systole (atria contracts and rapidly fills ventricles) (happens between P and Q in the EKG)
  2. Ventricular Systole (happens between S and T in the EKG)
    Contraction: builds pressure with in ventricles and close AV valves
    Blood ejection: blood moves into aorta and pulmonary trunk, SL valves open
  3. Ventricular Relaxation: SL valves close and AV valves open (happens after T in the EKG)
50
Q

Describe the regulation of blood pressure, include neural control, hormonal control and local control

A

Local controls: autoregulation- main part that means hard working tissues get more blood flow to clear waster faster, reactive hyperemia- tourniquet effect when blood is cut off for a period of time blood will rush in once able to make up for loss time, angiogenesis- grow new blood vessels

Neural control includes barorecpetors which are fast, they sense that blood pressure is off, then sends information to the medulla, the medulla determines what to do and it slows or speeds up sympathetic impulses to heart depending on the situation and slows/speeds up vasodilation.

Increasing Hormonal Control: adrenaline- affects the sympathetic system which controls blood pressure, ADH- retains water which increases blood volume, aldosterone- retains sodium which means more water which increases blood volume, angiotensin II- increases vasoconstriction AND aldosterone AND ADH.

Decreasing Hormonal Control: ANP- antagonizes aldosterone, gets rid of sodium which gets rid of water which decreases blood volume, alcohol- ADH antagonist which makes you dehydrated, nitric oxide- vasodialtor and inflammatory chemicals

51
Q

Describe the mechanics of breathing/ventilation, include the muscles involved, the pressures involved and their changes.

A

inspiration:
1. Diaphragm contracts and external intercostals increase the thoracic cavity volume
2. P. Plum < P. Atm
3. Air flows in until pressures equal

Expiration:
1. Inspiration muscles relaxe and thoracic cavity volume decreases
2. P. Plum > P. Atm
3. Air flows out until pressures equal

52
Q

Discuss neural controls of respiration

A

In the Medulla you have the ventral group which allows the inspiratory neuron set basic rhythm of inhales and expiratory neurons allow forced expiration and the dorsal group which changes rate and depth. In the pons it allows for multitasking of activities and schedules automatic things.

53
Q

Trace the route of air from the nares to an alveolus. Differentiate between conducting and respiratory zone structures.

A

Nose > ext nares > nasal cavity > int nare > pharynx > larynx > trachea ( all were apart of conducting zone before this) > (all are apart of respiratory zone starting now) primary bronchi > secondary bronchi > tertiary bronchi > bronchioles > alveolar ducts > alveolar sacs

54
Q

When there’s a imbalance of oxygen in the blood, what happens

A

Negative feedback
Low oxygen makes kidney release erythropoietin to stimulate red bone marrow which increases RBC count which increases oxygen carrying ability in 3-4 days

55
Q

Systole v diastole

A

Systole: Contraction of heart and movement of blood through heart
Diastole: ventricles relax and start to fill with blood

56
Q

Pectinate v papillary

A

Pectinate: atrium
Papillary: ventricle and valves

57
Q

Effects of hemorrhaging on BP and CO

A

Both decrease because it is loss of blood volume

58
Q

Why is the left ventricle thicker than right?

A

Works harder than right because it is sending blood to entire body, right only sends to lungs

59
Q

Functions of respiratory sys

A
  1. Pulmonary ventilation: moving air in/out lung
  2. External respiration: gas exchange between lungs and blood
  3. Transport: O2 and CO2 between lung and tissue
  4. Internal respiration: gas exchange between systemic BV and tissues
60
Q

What is hemolytic disease in a baby

A

When mom has RH- and baby has RH+

202 (2 decks)

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