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Physiology I > Exam #3 > Flashcards

Exam #3 Flashcards

1
Q

If there is an increase in contractility, how are EF and ESV affected?

A

Increased contractility =

  • Increased EF
  • Decreased ESV
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2
Q

If there is an decrease in contractility, how are EF and ESV affected?

A

Decreased contractility =

  • Decreased EF
  • Increased ESV
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3
Q

If preload is increased, how is SV/CO affected?

A

Directly

- Increased preload/EDV = Increased SV/CO

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4
Q

If preload is decreased, how is SV/CO affected?

A

Directly

- Decreased preload/EDV = Decreased SV/CO

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5
Q

If afterload is increased, how is SV/CO affected?

A

Inversely

- Increased afterload = Decreased SV/CO

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6
Q

If afterload is decreased, how is SV/CO affected?

A

Inversely

- Decreased afterload = Increased SV/CO

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7
Q

If afterload is increased, how is MAP affected?

A

Directly

- Increased afterload = Increased MAP

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8
Q

If afterload is decreased, how is MAP affected?

A

Directly

- Decreased afterload = Decreased MAP

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9
Q

What five factors affect preload?

A
  • Ventricular filling time
  • Ventricular compliance
  • Ventricular filling pressure
  • Atrial systole contribution to ventricular filling
  • Pericardial constraint
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10
Q

How does ventricular filling time affect preload?

A

Depends on HR:

- Increased HR = Decreased filling time = Decreased EDV and SV

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11
Q

How does ventricular compliance affect preload?

How does this appear graphically?

A

Less compliance = more stiffness which decreases filling time = Decreased EDV and SV

Increased slope = bad

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12
Q

How does ventricular filling pressure affect preload?

A

Negative intrathoracic pressure = increased venous return to R heart
- Increased RA pressure = increased EDV and SV

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13
Q

How is afterload estimated?

A

MAP

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14
Q

Do arteries or veins have greater volume?

A

Veins have greater volume

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15
Q

Do arteries or veins have greater compliance?

A

Veins have greater compliance

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16
Q

Do arteries or veins have greater pressure?

A

Arteries have greater pressure

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17
Q

How does aortic compliance affect pulse pressure (PP) and systolic pressure (SP)?

A

Inversely

- Decreased aortic compliance = Increased PP/SP

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18
Q

How does SV affect pulse pressure (PP) and systolic pressure (SP)?

A

Directly

- Increased SV = Increased PP/SP

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19
Q

How does HR affect diastolic pressure (DP) and pulse pressure (PP)?

A

Directly
- Increased HR = Increased DP/PP due to increased time for runoff and greater arterial volume remaining at end of diastole

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20
Q

How does TPR affect diastolic pressure (DP) and pulse pressure (PP)?

A

Directly
- Increased TPR = Increased DP/PP due to increased time for runoff and greater arterial volume remaining at end of diastole

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21
Q

How does central venous pressure (CVP) affect venous return?

A

Directly

- Increased CVP = Increased venous return

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22
Q

If SV and SP/PP are increased, how does this affect MAP?

A

Directly

- Increased SV = Increased PP/SP = Increased MAP

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23
Q

If HR and DP/PP are increased, how does this affect MAP?

A

Directly

- Increased HR = Increased DP/PP = Increased MAP

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24
Q

If SV is increased and HR is decreased, how does this affect MAP?

A

CANCEL OUT

  • Increased SV = Increased PP/SP = Increased MAP
    BUT
  • Decreased HR = Decreased DP = Decreased MAP
    SO CANCEL
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25
Q

If TPR is increased, how does this affect CO and VR on the Cardiac Function Curve + Vascular Function Curve? WHAT IS THE SHIFT?

A

Increased TPR = vasoconstriction
- Increased arterial volume, decreased CO/VR

Shifts DOWN

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26
Q

If TPR is decreased, how does this affect CO and VR on the Cardiac Function Curve + Vascular Function Curve? WHAT IS THE SHIFT?

A

Decreased TPR = vasodilation
- Decreased arterial volume, increased CO/VR

Shifts UP

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27
Q

How does increased HR affect runoff? What does this mean?

A

Indirectly

  • Increased HR = Decreased time for runoff
  • Less blood goes to veins (stays in arteries)
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28
Q

How does decreased HR affect runoff? What does this mean?

A

Indirectly

  • Decreased HR = Increased time for runoff
  • More blood goes to veins and pools there
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29
Q

The venous system is ____ resistance, ____ pressure and ____ compliance

A

Venous system =

  • LOW resistance
  • LOW pressure
  • HIGH compliance
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30
Q

What three things are DIRECTLY proportional to RAP?

A
  • Preload
  • SV
  • CO
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31
Q

What two things are INVERSELY proportional to RAP?

A
  • Atrial filling

- VR (venous return)

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32
Q

Are small arterioles or terminal arterioles more highly innervated by SNS?

A

Small arterioles are HIGHLY innervated by SNS

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33
Q

During non-nutritive flow, what does blood flow through? Are the precapillary sphincters constricted or dilated?

A

Blood flows through metarterioles

- Precapillary sphincters constricted

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34
Q

During nutritive flow, what does blood flow through? Are the precapillary sphincters constricted or dilated?

A

Blood flows through capillaries

- Precapillary sphincters dilated

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35
Q

What determines the overall flow of blood to specific capillary beds?

What determines which capillaries are perfused?

A
  • Arteriole radius determines overall blood flow to specific capillary beds
  • Precapillary sphincters determine which capillaries are perfused
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36
Q

What are the most common type of capillary? What type of molecules can pass through?

A

Continuous

- Hydrophilic molecules pass through clefts/small pores; tight junction

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37
Q

What two types of molecule can pass through fenestrated capillaries?

A

Water and small hydrophilic molecules pass through fenestrae (perforations), think leaky

38
Q

What two types of molecule can pass through discontinuous capillaries?

A

Large molecules (proteins) and water pass through wide gaps

39
Q

Where are continuous capillaries found (4)?

A
  • Muscle
  • Skin
  • Lung
  • Neural tissue
40
Q

Where are fenestrated capillaries found?

A

Kidneys

41
Q

Where are discontinuous capillaries found?

A

Liver

42
Q

What is the plasma and interstitium location in relation to capillaries (in or out)?

A
  • Plasma (INSIDE)

- Interstitium (OUTSIDE

43
Q

What is the movement of fluid with filtration?

A

FILTRATION = fluid movement OUT of capillary

44
Q

What is the movement of fluid with absorption?

A

ABSORPTION = fluid movement INTO capillary

45
Q

What type of pressure favors filtration?

A

Capillary Hydrostatic Pressure (Pc) favors FILTRATION

46
Q

What type of pressure favors absorption?

A

Plasma Oncotic Pressure (PIc) favors ABSORPTION

47
Q

Of arterial pressure, arteriole resistance, venous resistance, and venous pressure, which is inversely proportional to Capillary Hydrostatic Pressure (Pc)?

A

Arteriole resistance is inversely proportional to Capillary Hydrostatic Pressure (Pc)

48
Q

Which of the two pressures (Pc and PIc) have the highest pressure?

A

Pc > PIc > Pi > Pii

49
Q

What causes ACTIVE vasoconstriction?

A

+ SNS

50
Q

What causes ACTIVE vasodilation?

A

+ Vasodilator (Adenosine)

51
Q

What causes PASSIVE vasoconstriction?

A

Remove Vasodilator (Adenosine)

52
Q

What causes PASSIVE vasodilation?

A

Remove SNS

53
Q

What is one of the most potent vasodilators we discussed? What are five others we discussed?

A

Adenosine

  • Bradykinin
  • Prostacyclins
  • Prostaglandins
  • ANP
  • NO
54
Q

What are the four primary vasoconstrictors?

A
  • Angiotensin II
  • TXA
  • Vasopressin (ADP, ADH)
  • Endothelin
55
Q

What are the three intrinsic mechanisms?

A
  • Autoregulation
  • Active hyperemia
  • Reactive hyperemia
56
Q

What is active hyperemia?

A

Blood flow to an organ is proportional to its metabolic activity

57
Q

What is reactive hyperemia?

A

Involves ischemia

- Ischemia causes local buildup of vasodilators → increased blood flow to organ

58
Q

What are the two theories of autoregulation, and what does each involve?

A
  • Metabolic theory: involves vasodilators

- Myogenic theory: involves vascular smooth muscle

59
Q

Describe how an increase in pressure would affect autoregulation via the METABOLIC theory.

A

Increase in pressure → Increased flow → More vasodilators washed out = vasoconstriction WHICH THEN DECREASES FLOW (compensation)

60
Q

Describe how an increase in pressure would affect autoregulation via the MYOGENIC theory.

A

Increased pressure → Increased flow but also increases wall tension → vascular smooth muscle contracts = vasoconstriction WHICH THEN DECREASES FLOW (compensation)

61
Q

Which type of Epi adrenergic receptors cause relaxation/vasodilation?

A

B2

62
Q

Which type of Epi adrenergic receptors cause constriction/vasoconstriction?

A

A1

63
Q

What action do most tissues perform? What does skeletal muscle do, and why?

A

Most tissue vasoconstrict

- Skeletal muscle vasodilates due to its higher concentration of and increased affinity for B2 receptors

64
Q

What type of receptor does Angiotensin II act on? Is this a vasoconstrictor or a vasodilator?

A

Angiotensin II is a VASOCONSTRICTOR that acts on AT1 receptors

65
Q

What type of receptor do Vasopressins act on? Are these vasoconstrictors or vasodilators?

Provide two examples of Vasopressins.

A

Vasopressins are VASOCONSTRICTORS that acts on V1 receptors

  • Ex. ADH, AVP
66
Q

What is the goal of vasodilators? When are they used?

A

Vasodilators used for hypotension (decreased BP)

  • Increase pressure
  • Decrease flow
  • Decrease vessel volume
67
Q

What type of adrenergic receptors increase HR and contractility in the heart?

A

B1

68
Q

What is the purpose of arterial baroreceptors? Where are these located (2)?

A

SHORT-TERM regulation of BP by minimizing changes in pressure and responding to stretch
- Found in aorta and carotid sinuses

69
Q

What receives most of the afferent information and acts as an integrator?

A

Nucleus Tractus Solitarus (NTS)

70
Q

What two nerves are utilized by the afferent pathway? What direction does information travel in afferent?

A

Afferent = baroreceptors to brain

- Uses Vagus and Glossopharyngeal nn.

71
Q

What two nerves are utilized by the efferent pathway? What direction does information travel in efferent?

A

Efferent: away from brain

- Uses Vagus and sympathetic nn.

72
Q

What two centers are utilized by the efferent pathway? To what location does each send information to?

A
  • Vasomotor Center: to peripheral resistance vessels

- Cardiac Center: to heart

73
Q

If BP is increased, how does this affect AP frequency/STRETCH?

A

Increased pressure = increased AP frequency/STRETCH

74
Q

If BP is elevated above normal, which NS is activated and how does this affect MAP? What happens to baroreceptors in this case?

A

Elevated BP = PNS stimulated

  • MAP decreases
  • Baroreceptors are stretched
75
Q

Do baroreceptors or chemoreceptors have a more potent response?

A

Baroreceptors

76
Q

Where are chemoreceptors located in the body (2)?

A

Carotid and aortic bodies

77
Q

If arterioles are vasoconstrictor, how does this affect Pc and MAP? Is absorption or filtration favored?

What concept is this?

A

CAPILLARY FLUID SHIFT
Arteriole vasoconstriction = Decreased Pc
- Increased MAP

  • Favors absorption
78
Q

What three changes to circulation occur when the baby is born (NOT involving shunts)?

A
  • Increased BP
  • Increased HR
  • LV thickens
79
Q

What is the purpose of the Placental Shunt?

Describe the placenta in terms of flow and resistance system.

A

Shunts blood away from lower trunk and abdominal viscera

- Placenta is high flow, low resistance and receives 50% of combined cardiac output (CCO)

80
Q

What is the purpose of the Ductus Venosus?

A

Shunts oxygenated blood from umbilical vein to IVC/heart (bypasses liver)

81
Q

What is the purpose of the - Foramen Ovale?

A

Shunts oxygenated blood from IVC to RA to LA

82
Q

What is the purpose of the - Ductus Arteriosus?

A

Shunts blood from left pulmonary artery to aorta (to body, not lungs)

83
Q

What is the functional issues with Atrial Septal Defect (ASD)?

A

Foramen Ovale does not close leading to a LA to RA shunt

84
Q

What is the functional issues with Ventricular Septal Defect (VSD)?

A

“Hole in heart” leading to LV to RV shunt

85
Q

What is the functional issues with Patent Ductus Arteriosus?

A

Ductus Arteriosus does not close leading to an aortic artery to pulmonary artery shunt

86
Q

What condition often results from Septal Defects?

A

Pulmonary HTN

87
Q

Does the fetal heart work in parallel or series? What does this mean for L and R heart cardiac outputs?

A

Parallel

- L heart and R heart both provide outputs to the body (CO is mixed)

88
Q

What four things increase dramatically with exercise?

A
  • HR
  • CO
  • VR (venous return)
  • Arteriovenous oxygen difference
89
Q

What two things increase slightly with exercise?

A
  • SV

- MAP

90
Q

What one thing decreases dramatically with exercise?

A

TPR

Physiology I (9 decks)

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