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Physiology/Pathophysiology I > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Basal metabolism of the heart consumes what percent of oxygen used by the heart?

A

25%

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2
Q

What does basal metabolic activity refer to?

A

Maintain active transport mechanisms at rest

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3
Q

Muscle contraction consumes what percent of the oxygen used by the heart?

A

75%

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4
Q

Pressure Work

A

99% of total work

External work; works ot move blood from low pressure to high pressure

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5
Q

Stroke Work

A

1% of total work of heart (up to 50% heart failure)

Work needed to accelerate blood to ejection velocity

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6
Q

Workload of R side of heart vs L side

A

R side has 1/6th work load of L side

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7
Q

External Work of the heart

A

Pressure Volume Work

Transferring blood to the arterial system against a resistance

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8
Q

Velocity Equation

A

Velocity = Flow/ Cross Sec. A

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9
Q

Minute Work Output

A

Total energy converted to work per minute

Stroke Work x HR

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10
Q

Potential Energy of the heart

A

additional work heart could do if it were able to contract and empty the ventricle

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11
Q

Stroke Work Output

A

Amount of energy converted to work by heart during each beat

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12
Q

Total Energy of the heart

A

Potential energy + Stroke Work Output

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13
Q

Equation for Efficiency of Work

A

Work Output/Total E used = Efficiency

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14
Q

What is the normal efficiency of cardiac contraction?

A

20 to 25%

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15
Q

Efficiency of cardiac contraction can go as low as _____to_____% with heart failure.

A

5 to 10 %

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16
Q

Max systolic pressure that a normal left ventricle can generate

A

250 to 300 mmHg

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17
Q

Max systolic pressure the right ventricle can generate

A

60 to 80 mmHg

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18
Q

Optimal filling volume for the right/left ventricle

A

120 to 170 mls

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19
Q

Normal end-systolic volume

A

50 mL

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20
Q

Normal end-systolic pressure

A

2-3 mmHg

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21
Q

Normal end-diastolic volume

A

120 mLs

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22
Q

Normal end-diastolic pressure

A

5 to 7 mmHg

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23
Q

Normal Stroke Volume

A

70mL

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24
Q

Equation for Cardiac Output

A

CO = HR x SV

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25
Q

What factors change SV?

A

Preload (Intrinsic contractility)
Afterload
Extrinsic Contractility

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26
Q

Changing 1 mmHg preload pressure results in how many mls change?

A

25 mls

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27
Q

Changing 1 mmHg afterload pressure results in how many mls change?

A

0.5 mL

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28
Q

Why does SV increase when contractility is increased (no change in afterload or preload)?

A

Each muscle fiber able to generate more tension at any given resting length

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29
Q

Why does end-systolic pressure decrease when contractility is increased?

A

Stroke volume increased, able to expel more blood

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30
Q

How to calculate changes in contractility on the graph?

A

Slope of the line = Change P/Change V

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31
Q

Substrate utilization for normal energy production by the normal adult heart

A

70-90% oxidative metabolism of fatty acids

10-30% lactate and glucose

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32
Q

Substrate utilization for normal energy production of the normal fetal heart

A

Derive most ATP from lactate and glucose

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33
Q

Substrate utilization for energy production by the adult heart suffering from heart failure

A

Most ATP derived from lactate and glucose

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34
Q

Calculating Stroke Work

A

Volume x Pressure

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35
Q

What does ATP used for muscle contraction encompass?

A

ATP associate with cross-bridge action

Sequestration of calcium; active mechanisms

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36
Q

What is the name of the protein that can bind with oxygen?

A

Myoglobin

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37
Q

Heart removes most of the oxygen from the blood- leaving venous sat to….

A

25%

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38
Q

What is the only way to increase oxygen supply to the herat?

A

Increase coronary blood flow

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39
Q

What percent oxygen does isovolumic contraction use?

A

50% off overall O2 use

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40
Q

Why is cardiac afterload a major determinant of overall oxygen use?

A

Related to tension development (more than pressure generation)

Law of LaPlace: Tension= P x R

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41
Q

Three Basic Principles of Circulatory Function

A
  1. Rate of BF to each tissue is precisely controlled by tissue need (arterioles, CNS, hormones)
  2. CO controlled by sum of local tissue flow (CNS)
  3. Arterial Pressure independent of local BF or CO (kidneys)
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42
Q

Shear Stress Equation

A

SS = 4nQ/ pi*r^3

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43
Q

Reynolds’ number values at which turbulence will begin to appear at a side branch

A

200 to 400

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44
Q

Reynold’s number at which turbulence will being to appear in a straight tube

A

2000

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45
Q

Blood is ___x more viscous than water.

A

3x

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46
Q

What are the functional parts of the circulation?

A

Systemic

Pulmonary

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47
Q

Which functional circulation has a constant internal environment?

A

Systemic Circulation

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48
Q

How much lymphatic flow circulates each day?

A

2.5 L/day

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49
Q

Peripheral veins

A

all veins outside the thorax; not affected by thoracic P

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50
Q

Central Veins

A

major veins within the thorax; affected by thoracic pressure; lowest pressure in vascular system. Determine ventricular filling (if no pulmonary problems)

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51
Q

Cross Sectional A of Aorta

A

4.5 cm^2

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52
Q

Cross Sectional A of Arteries

A

20 cm^2

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53
Q

Cross Sectional A of Arterioles

A

400 cm^2

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54
Q

Cross Sectional A of Capillaries

A

4500 cm^2

55
Q

Cross Sectional A of Venules

A

4000 cm^2

56
Q

Cross Sectional A of Veins

A

40 cm^2

57
Q

Cross Sectional A of Vena Cava

A

18 cm^2

58
Q

Blood volume in veins, venules, and venous sinuses

A

64%

59
Q

Blood volume in arteries

A

13%

60
Q

Blood volume in arterioles and capillaries

A

7%

61
Q

Blood volume in heart

A

7%

62
Q

Blood volume in lungs

A

9%

63
Q

Blood volume in systemic circulation

A

84%

64
Q

Flow velocity in arteries

A

500 mm/s

65
Q

Flow velocity in capillaries

A

0.5 mm/s

66
Q

Flow velocity in arterioles

A

decreasing

67
Q

Flow velocity in venules and veins

A

increasing

68
Q

Mean pressure in arteries

A

100 mmHg

69
Q

Mean pressure in capillaries

A

25 mmHg

70
Q

What factors affect MAP?

A

MAP = CO x TPR

71
Q

Why do arterial systolic, mean, and diastolic pressure change as the patient ages?

A

Decreasing arterial distensibility and increased SVR; changes in pressure control mechanisms by decreasing arterial distensibility and increased SVR

72
Q

What is MAP?

A

Pressure drop across the systemic system; assuming the CVP is 0 mmHg

73
Q

As ________ goes up, MAP will be closer to systolic.

A

Heart rate

74
Q

Why is MAP closer to diastolic pressure under normal circumstances?

A

Spend more time in diastole

75
Q

Equation for distensibility

A

Distensibility =Change vol/ (change P x original volume)

76
Q

Relative distensibilities of arteries and veins.

A

Veins are 8x more distensible than arteries

77
Q

Relative distensibilities of the pulmonary and systemic arteries.

A

PA 6x more distensible than systemic

78
Q

Relative distensibilities of the pulmonary and systemic veins.

A

PV and SV distensibilities are the same.

79
Q

Two equations for compliance

A 
Compliance= Change V/Change P
Compliance= Distensibility x Initial Volume
80
Q

Normal Compliance for systemic arteries

A

2 ml/ mmHg

81
Q

Normal Compliance for systemic veins

A

100ml/ mmHg

82
Q

Normal pressure pulse transmission velocity in the aorta

A

3 to 5 m/s

83
Q

Normal pressure pulse transmission velocity in large arteries

A

7 to 10 m/s

84
Q

Normal pressure pulse transmission velocity in small arteries

A

15-35 m/s

85
Q

Pulse pressure equation

A

PP = SV/ arterial compliance

86
Q

Systolic pressure equation

A

Ps= SV x HR x SVR x (2/3)(SV/Ca)

87
Q

Diastolic pressure equation

A

Pd= SV x HR x SSR x (1/3)(SV/Ca)

88
Q

Normal pressure difference between the peripheral veins and the central veins

A

4 to 6 mmHg

89
Q

How much does intra-abdominal pressure rise during pregnancy, tumors, obesity….

A

15-30 mmHg

90
Q

Standing absolutely still has what venous pressure in the feet

A

90mmHg

91
Q

When standing still, how much circulating blood volume can be lost

A

10 to 20% in 15-30 minutes (pressure in capillaries increases)

92
Q

Normal venous pressure in the feet of a standing person

A

20 mmHg

93
Q

How much does the spleen hold?

A

100 mls

94
Q

How much does the liver hold?

A

Several hundred mls

95
Q

How much do abdominal veins hold?

A

300 mls

96
Q

How much does the venous plexus hold?

A

Several hundred mls

97
Q

How much does the heart hold?

A

50-100 mls

98
Q

How much do the lungs hold?

A

100 to 200 mls

99
Q

ANS activated by centers in

A

Spinal cord
Brain stem
Hypothalamus

100
Q

Efferent fibers originate in spinal cord from ____ to ____

A

T1 to L2

101
Q

Preganglionic transmission options from sympathetic chains

A
  1. Synapse directly with postganglionic fibers
  2. Follow preganglionic pathway to one of two peripheral ganglia where they synapse with postganglionic fibers
  3. Pass through sympathetic chains then through splanchnic nerves to the two adrenal medullae
102
Q

____% of fibers in average skeletal nerve are sympathetic fibers

A

8%

103
Q

Parasympathetic nervous system deals with which nerves

A

3, 7, 9 & 10

104
Q

____% of the parasympathetic nerves are in the vague nerve (cranial nerve 10)

A

75%

105
Q

Transmitter Vesicles store how many molecules of transmitter substance?

A

2,000 to 10,000 molecules

106
Q

How big is the space between presynaptic terminal and postsynaptic membrane?

A

200 to 300 angstroms

107
Q

Two types of ionophore channels

A 
Cation channel (mainly sodium)
Anion channel (mainly chloride)
108
Q

Alpha component can stimulate four different actions

A
  1. Open specific ion channel through postsynaptic membrane- channel can remain open for long period of time
  2. Activation of cAMP or cGMP
  3. Activate enzymes
  4. Gene transcription
109
Q

Cholinergic fibers

A

Fibers that release acetylcholine

110
Q

Adrenergic fibers

A

Fibers that release norepinephrine

111
Q

Parasympathetic transmitter

A

Acetylcholine

112
Q

Sympathetic transmitter

A

Norepinephrine

113
Q

Acetylcholine Production

A

Acetyl-CoA + Choline -> Acetylcholine

Requires: choline acetyltransferase

114
Q

Acetylcholine Removal

A

Catalyzed by acetylcholinesterase into an acetate ion and choline

Choline transported back into terminal nerve ending to be used in production of more acetylcholine

115
Q

Norepinephrine Production

A

Starts in axoplasm of terminal nerve ending

  • Tyrosine –> Dopa via hydroxylation
  • Dopa –> Dopamine via decarboxylation
  • Dopamine into vesicles for final production
  • Dopamine –> Norepinephrine via hydroxylation
116
Q

In the medulla, ___% of the norepinephrine is converted to epinephrine via methylation process

A

80%

117
Q

3 Mechanisms for Norepinephrine Removal

A
  1. 50-80% moved back into terminal nerve ending via active transport process
  2. Most of rest diffuses away from the nerve endings into surrounding tissue
  3. Small amt destroyed by monoamine oxidase (nerve endings) or catechol-O-methyltransferase (all tissues)
118
Q

Norepinephrine and epinephrine released be adrenal medullae into blood remains active for ____ to _____seconds

A

10-30 seconds

119
Q

Level of activity takes __ to ___ minutes to degenerate to nothing

A

1 to 3 minutes

120
Q

Norepinpherine deactivated by __________, mainly in the liver

A

Catechol-O-methyl transferase

121
Q

Two main types of cholinergic receptors

A

Muscarinic & Nicotinic

122
Q

What is muscarinic receptor activated by?

A

Muscarine (Toad-stool poison); acetylcholine

123
Q

What is the nicotinic receptor activated by?

A

Nicotine, acetylcholine

124
Q

Two types of adrenergic receptors

A

Alpha (1 and 2), Beta (1, 2, and 3)

125
Q

Norepinephrine is secreted where?

A

Adrenal Medullae (big effect on afterload)

126
Q

Norepinephrine has main affect on what receptors?

A

Alpha Receptors (smaller affect on beta receptors)

127
Q

Epinephrine is secreted by what?

A

Adrenal Medullae

128
Q

____ frequency of stimulation required for full activation of effector receptors.

A

Low freq.

129
Q

How many impulses per second will maintain normal sympathetic or parasympathetic effect?

A

1

130
Q

How many impulses per second will produce full activation?

A

10 to 20 impulses per second

131
Q

Sympathetic tone in systemic arterioles keep almost all sympathetic arterioles contricted to _____ their normal diameter.

A

1/2

132
Q

Normal release of norepinephrine

A

0.05 ug/kg/min

133
Q

Normal release of epinephrine is

A

0.2 ug/kg/min

Physiology/Pathophysiology I (5 decks)

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