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A&P II > Exam I > Flashcards

Exam I Flashcards

1
Q

How do you calculate MAP and MPAP?

A

Diastolic + 1/3 (systolic- diastolic)

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2
Q

What is normal CVP/ RA presure?

A

0 mmHg

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3
Q

What is pulmonary circuit pressure right outside of the LA?

A

2 mmHg

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4
Q

Aortic Pressure during ejection, during diastole?

A
  • 120 mmHg
  • 80 mmHg
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5
Q

Does MAP change with a rigid vessel? Why?

A
  • No.
  • SBP increases but DBP decreases
  • Pulse pressure widens
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6
Q

Pulmonary vascular resistance (PVR) is

A

1/7 of systemic vascular resistance (SVR)

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7
Q

What are the different pressures of the capillaries?

A
  • Capillary pressure 30 mmHg (art)/ 10 mmHg (vein)
  • Interstitial Fluid Pressure -3 mmHg
  • Plasma Colloid Osmotic Pressure 28 mmHg
  • Interstitial Fluid Colloid Osmotic Pressure 8 mmHg
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8
Q

Net filtration pressure formula

A

Pc-Pif-πp+πif

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9
Q

Serum proteins that make up colloid pressure

A

in g/dl
* Albumin 4.5
* Globulin 2.5
* Fibrinogen 0.3
* Total= 7.3

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10
Q

For each ____ under the heart will give us an increased pressure of ____ mmHg

A

1.36 cm; 1

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11
Q

Vascular Compliance Formula

A

= ΔVolume/ΔPressure

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12
Q

Vascular Distensibility Formula

A

= ΔVolume/ΔPressurex original volume

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13
Q

Normal Pulmonary Arterial Pressures

A

25/8 mmHg; MAP 16 mmHg
PAWP- 10 mmHg

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14
Q

Percentage of blood volume in the systmeic Circulation

A
  • Arteries 13%
  • Arterioles and Capillaries 7%
  • Vein and venules 64%
  • Total= 84% of 5 L
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15
Q

Percentage of blood in pulmonary circulation and in the heart

A
  • 9%
  • 7%
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16
Q

Normal LV-ESV, LV-EDV, and stroke volume?

A
  • 50 mL
  • 120 mL
  • 70 mL
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17
Q

What is the normal Mean Systemic Filling Pressure (PSF)

A

7 mmHg

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18
Q

Which part of the ANS is the primary controller?

A

Parasympathetic Nervous System

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19
Q

What does 1 represent?

A

Maximum Sympathetic stimulation C.O. curve; Hypereffective

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20
Q

What does 2 represent?

A

Normal sympathetic Stimulation C.O. curve; Normal

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21
Q

What does 3 represent?

A

Zero Sympathetic Stimulation C.O. Curve; Hypoeffective

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22
Q

What does 4 represent?

A

Parasympathetic Stimulation C.O. Curve

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23
Q

What does this graph represent?

A
  • Venular-specific vasodilator- NO donor
  • C.O., CVP, and PSF decrease
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24
Q

What does this graph represent?

A
  • Arterial specific vasodialtor- Hydralazine
  • C.O. increases, PSF stays about the same
  • SVR/ RVR is reduced
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25
What does this graph represent
* Mixed vasodilator * decreased PSF, RVR, C.O.
26
What are the interventions by the body after a nonfatal MI?
* turn up SNS stimulation * increase in venous tone * retention of fluid and electrolytes; blood volume expansion overtime the body retains even more fluid and electolytes and the SNS activity decreases back to normal
27
What does the picture represent?
Mitral Valve Regugitation * retrograde flow whenever **LV pressures > LA pressures; during systole** * starts in Phase II and continues through Phase IV
27
With MV regurgitation, what happens with the heart?
* ↑ Preload, PSF, LAP, LV-EDV, LV-pressure * ↓ SV and if it worsens ↓C.O., MAP (late) * **Systolic murmur during S-T**
27
What does the picture represent?
Mitral Valve Stenosis * elevated resistance with filling * increased risk of fluid build up/ edema in the lungs Cause: * most common: autoimmune reaction, rheumatic fever * Strep/ staph infections
28
With MV stenosis, what happens with the heart?
* ↓Preload, EDV, SV * ↑ blood volume, CVP, PSF, LAP * **diastolic murmur heard during PR and TP intervals**
29
What does the picture represent?
Aortic Valve Insufficiency/ Regurgitation * Retrograde flow: Most during Phase I, some in Phase IV, and least in Phase II * Occurs when aortic pressure > LV pressure * Treat with afterload reducer
30
With Aortic Valve regurgitation, what hapens to preload, afterload, PSF, SV, C.O.?
* ↑Preload and SV, ESV(?) * ↓C.O.
31
What are the three things that affect SV?
Preload, afterload, and contractility
32
What is normal preload pressure of LV?
Oscillates from 2-120 mmHg
33
What does the graph represent and what happens to the SV?
* Increase in Preload * ↑ EDV, SV, C.O decreasing preload would do the opposite
34
What does the graph represent and what happens to the SV?
* Decrease in preload * ↓EDV, SV, C.O.
35
What does the graph represent and what happens to the SV?
Increased afterload * ↑ time of phase II, ESV * ↓SV, C.O. * ↓ velocity of sarcomere shortening, time of ejection, aortic valve closes sooner
36
What does the graph represent and what happens to the SV?
Reduced afterload * ↑ SV, time for ejection, C.O. * ↓ time in phase II, ESV * ↑ time for aortic valve closure
37
What does the graph represent and what happens to the SV?
Increased contractility * ↑ SV and C.O. * ↓ ESV
38
What does the graph represent and what happens to the SV?
Decreased contractility * ↓ SV and C.O. * ↑ ESV
39
What does this graph represent?
Aortic Stenosis
40
With Aortic Valve stenosis, what happens with the heart?
* ↑ LV pressure, HR, afterload, PII time, LV-EDV, preload * ↓ SV, PIII- ejection time * ↓pressures in the aorta, narrowed pulse pressure
41
What does the graph represent?
Heart Failure/ decreased contractility
42
With untreated HF, what happens with the heart? Treated?
Untreated * ↓ SV * ↑ EDV, ESV (compared to normal) Treated with an afterload reducer (ACE-i) * ↑ SV, C.O. compared to the untreated HF * ↓ ESV compared to the untreated HF EDV and contractility do not change (according to the graph)
43
What is Guyton's value for coronary blood flow? Schmidt's?
* 70 mL/min/100 g * 225 mL/ min
44
When do we have coronary perfusion, during diastole or systole?
* Both! * RH perfusion increases during systole * The majority of perfusion occurs in the LH; some increase on the right
45
What two factors influence coronary perfusion?
* ∆P of LV wall and aortic pressure * time bewteen beats
46
Normal O2 content of arterial blood? How much does the heart consume?
* 1 dL= 20 mL/ O2 * 3/4/ 75%= 5 mL/ O2 remaining
47
SNS innervation of the heart
* Ventricular walls * atrial walls * Nodal areas
48
PNS innervation of the heart?
Via the Vagus nerve * right vagus nerve --> RA * Left vagus nerve --> Goes over the top of LA and ends at the SA node * **There is some cross innervation**
49
Removal of PNS stimulation from the heart would increase/ decrease HR?
* Increases from 72 to **110 BPM** * ex. Atropine given
50
Removal of SNS stimulation from the heart would increase/ decrease HR?
* Decrease from 72 to **60 BPM**
51
Identify the anatomy labled
1. SNS cervical ganglion 2. Hyoid bone 3. Thyroid Cartilage 4. Thyroid gland 5. Left recurrent laryngeal nerve 6. Left vagus nerve 7. Thoracic SNS ganglion 8. Left phrenic nerve 9. Right phrenic never 10. Right vagus nerve 11. Right recurrent laryngeal nerve
52
What is the forumla for renal plasma flow?
RPF= HCT x RBF
53
How do you calculate net filtration pressure?
NFP= Cap pressure (Pc)- Plasma Colloids (Πp)+ Interst. Colloids (Πisf)- Intst. pressure (Pif)
54
Identify the phase of the cardiac cycle and all the anatomy
Systole 1. Anterior cusp Pulmonic Valve 2. Right cusp Pulmonic Valve 3. Left cusp Pulmonic Valve 4. Left cusp Aortic Valve 5. Right cusp Aortic Valve 6. Posterior cusp Aortic Valve 7. RCA 8. Anterior cusp Tricuspid 9. Septal Cusp Tricuspid 10. Posterior Cusp Triscupid 11. Posterior Cusp Mitral Valve 12. Anterior Cusp Mitral Valve 13. LCA 14. Coronary Sinus
55
What part of the heart is this and name all the anatomy
Right Ventricle 1. Posterior papillary cusp 2. Anterior papillary cusp 3. Septal papillary cusp 4. Septal Papillary 5. Anterior Papillary muscle 6. Posterior Papillary Muscle 7. Chordae Tendinaeae
56
What part of the heart is this and name all the anatomy
Left Ventricle 1. Commissural Cusp 2. Posterior Cusp 3. Anterior Cusp 4. Chordae tendineae 5. Posterior Papillary mucle 6. Anterior Papillary Muscle
57
What area of the heart is this?
Left Ventricle and Aorta
58
What are the 1st and 2nd heart sounds and their durations?
* AV valves closing at the start of systole; 0.14 sec * Closing of the aortic and pulmonic valves; 0.11 secs
59
What and when is the 3rd heart sound?
* rattling of the cartilaginous ring when ventricular walls are not very accomodating * At the beginning of the 2nd third of diastole * Happens in HF or increased volume status in kids
60
What and when is the 4th heart sounds?
* When the atria contract in the beginning of the last third of filling
61
What is diasolic HF and what causes it?
* problem with filling; Concentric LV hypertrophy * Causes: Aortic Valve stenosis and chronic HTN
62
What is systolic heart failure and what cause it?
* thin ventricular walls; Eccentric LVH * Causes: Aortic/ MV regurgitation, Ventricular Septal defect, Systolic dysfunction, congenital issue
63
Effects of increased thyroid hormones?
Increase: * HR, O2 consumption, CO2 production, SBP (kidney reduces DBP), anx, awareness, ocular pressures, glucose metabolism, cholesterol metabolism Decrease: * serum cholesterol, sleep, vitamins
64
Effects of decreased thyroid hormones?
* opposite of the high thyroid symptoms * buildup of connective tissue proteins in the interstitium betweens cells of skin
65
Causes of hypothyroidism
* removal of pituitary gland, iodine deficiency, Hashimoto's, hypothalamus (rare)
66
Causes of hyperthyroidsim and how to treat
* too much iodine, Grave's, trauma/ surgery * Iodine-131, Propylthiouracil (PTU), surgery is last
67
Name and identify the anatomy 13)?
1. Epiglottis 2. Hyoid bone 3. External carotid artery 4. Thyroid cartilage 5. Left subclavian artery 6. Left recurrent laryngeal nerve- goes under the aortic arch 7. Right recurrent laryngeal nerve 8. Brachiocephalic artery 9. Inferior thyroid artery 10. Superior Thyroid artery 11. Adam's Apple 12. Parathyroid nodule 13. Thyroid Veins (he specifically mentioned on the left side)
68
What is the formula of venous return?
VR=(PSF−RAP)/RVR
69
What is Millers formula for SVR/ PVR and the units?
* (MAP-CVP)/ CO x 80 * (MPAWP-PAWP)/ CO x 80 * uses L/ min for C.O. **Centimeters Gram Second (CGS)** * mmHg/(L/min) = (dyne x sec)/〖cm〗^5
70
What is the conversion factor for PRU to CGS?
* CGS= PRU x 1333 * PRU= CGS/ 1333
71
What is Guyton's formula for SVR/ PVR and the units?
* SVR=(MAP−RAP)/(C.O); normal is 1 PRU * PVR=(MPAP−LAP)/(C.O.); normal is 0.14 PRU * uses mL/ sec for C.O.= 83.3 mL/ sec **Peripheral Resistance Unit (PRU)**
72
Normal SVR and PVR in CGS?
* 1200 * 80
73
Mixed venous oxygen saturation
75%
74
What are the reflexes that occur when there is atrial stretching?
* Direct Atrial Stretch Reflex- increases HR 10-15% * Bainbridge reflex- increases HR 50-60% * ANP/ ANF release * Reduction of ANGII, aldosterone, ADH
75
Formula to calculate EF?
SV/ EDV x 100
76
Formula to calculate Flow? RPF?
* F= ∆P/ R * RPF= HCT x RBF
77
Formula for filtration rate?
Filtration rate= Kf x NFP
78
E
79
A.

A&P II (5 decks)

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