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KCUMB Physiology - Erin > EXAM II Clicker Qs > Flashcards

EXAM II Clicker Qs Flashcards

1
Q

Which of the following conditions may result in tachycardia?

Toxic conditions of the heart

Increased body temperature

Sympathetic nerve stimulation

All the above

B and C only

A

All the above

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2
Q

Circus movements are the basis of heart fibrillation. Which of the following statements is NOT true?

Fibrillation may occur when the refractory period of the muscle is greatly shortened

Fibrillation may occur when the pathway around the circle is too short

Fibrillation may occur when the conduction velocity slows down

Fibrillation may occur when the heart becomes dilated

A

Fibrillation may occur when the pathway around the circle is too short

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3
Q

In the ECG shown below, which of the following heart activites is represented?

Sinus tachycardia

Sinus bradycardia

Complete AV block

Incomplete second degree block with dropped beats

A

Sinus bradycardia

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4
Q

84% of the blood volume is in the systemic circulation. Of this, 64% is in which of the following vessels?

Capillaries

Systemic arterioles

Veins

Arterioles

A

Veins

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5
Q

Blood flow resistance is indirectly proportional to which of the following?

Viscosity

Vessel diameter

Density

Both A and C

A

Vessel diameter

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6
Q

Reynolds number is a measure of which of the following parameters?

Tendency for turbulence

Blood pressure

Conductance

Resistance

A

Tendency for turbulence

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7
Q

Which of the following represents the viscosity of blood with a hematocrit of 38-42?

  1. 5
  2. 0

38

42

A

3.0

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8
Q

The least amount of damping of the pressure pulses would occur in which of the following components of the circulatory system?

Femoral artery

Arterioles

Capillaries

Venules

A

Femoral artery

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9
Q

Which of the following factors affect(s) pulse pressure?

Vascular elastance

Arterial compliance

Stroke Volume

All the above

B and C only

A

B and C only

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10
Q

Which of the following is the most important means for the exchange of substances between the blood and the interstitial fluid?

Blood hydrostatic pressure

Capillary oncotic pressure

Diffusion

Interstitial fluid hydrostatic pressure

Osmosis

A

Diffusion

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11
Q

Define polycythemia

A

High amount of RBCs/Hematocrit level; resulting in high viscosity level (10)

Normal viscosity level = 3

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12
Q

Define autoregulation

A

The ability of tissues to adjust its vascular resistance and maintain normal blood flow through changes in arterial pressure between 70 and 175 mmHg

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13
Q

2 factors that affect pulse pressure

A

Stroke volume

Arterial compliance

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14
Q

Which of the following is the direction of lead III?

0

60

90

120

A

120

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15
Q

Of the 3 bipolar leads, which one is connected to both left and right arms?

Lead I

Lead II

Lead II

All leads are connected to only one arm each

A

Lead I

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16
Q

Name the Arrhythmia

A

Tachycardia

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17
Q
A

Bradycardia

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18
Q
A

Respiratory Type; Spillover Signals

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19
Q
A

SA Nodal Block

Drop in P wave

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20
Q
A

AV Nodal Block

Incomplete

2nd degree

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21
Q
A

AV Nodal Block

Complete AV Block

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22
Q
A

AV Nodal Block

Partial AV Block

P, QRS, or T wave amplitude alterations

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23
Q

Paroxysmal Tachycardia

A

Heart begins rapid rate suddenly and stops suddenly = Paroxysm

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24
Q
A

Ventricular fibrillation

Circus movements

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25
Q
A

Atrial Fibrillation

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26
Q

What happens to elastance and compliance when you have a greater amount of elastic tissue in a blood vessel?

A

High elastance

Low compliance

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27
Q

Define Vascular Compliance

A

Total quantity of blood that can be stored in a given portion of the circulatory system

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28
Q

What is the most important determinant of pulse pressure?

A

Stroke Volume output

Rate increases to same extent as systolic pressure

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29
Q

What are the two major factors that affect pulse pressure?

A

Stroke Volume

Arterial Compliance

PP = SV/Arterial Compliance

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30
Q

Central venous pressure is another term for…

A

Right Atrial Pressure

Increases with greater venous return

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31
Q

What’s the most important factor that regulates vasomotion?

A

[Oxygen] in tissues

32
Q

What are some common vasodilators?

A

H+

K+

Adenosine

Adenosine Phosphate compounds

CO2

Histamine

33
Q

Define near infinited feedback gain principle

A

Return of arterial pressure back to equilibrium point

Occurs in Kidneys; Pressure Diuresis = increase in urine output

Pressure Natriuresis = increase in Na+ output

34
Q

What are the primary determinants of long term arterial pressure control?

A

Level of water/salt intake

How much the curve shifts in the pressure/shift curve for renal output of salt and water

35
Q

Define chronic hypertension and state the values for normal, hyper, and severe

A

When one’s BP is beyond the upper range values

Normal: 90

Hypertension: 110 (135/90 mmHg)

Severe Hypertension: 150/10 (250/130 mmHg)

36
Q

List the causes of lethal effects of chronic hypertension

A

Cerebral Infart

Heart attack

Coronary Heart Disease

Early heart failure

Uremia = kidney destruction leading to kidney failure

37
Q

Common vasoconstrictors and vasodilators under humoral circulation control

A

Vasoconstrictors: ADH/Vasopressin, Epi, NEpi, Angiotensin II, Catecholamines (hypertension), endothelin (hypertensin)

Vasodilators: Bradykinins, Histamine, Prostaglandins (hypertension)

38
Q

List some factors that result in increased peripheral resistance leading to an increase in BP

A

Angiotensin II

Catecholamines

Thromboxane

Neural factors (Beta-adrenergic)

39
Q

Constitutional risk factors of atherosclerosis

A

Age

Genetics

Metabolic Syndrome; Insulin release (obesity, fasting hyperglycemia, increased lipid TGs, decreased HDL levels, hypertension)

40
Q

Modifiable risk factors for hypertension

A

Hyperlipidemia

Hypertension

Smoking

Diabetes

41
Q

List some causes of the lethal effects of chronic hypertension

A

Early heart failure

Coronary heart disease

Heart attack

Cerebral infarct

Kidney failure

42
Q

Define cardiac index and how do you calculate it

A

Amount of blood pumped through the body per minute (CO) per square meter of body surface area

i.e. 5L/1.7 sq. meters = 3 L/min/m2

43
Q

What is Fick’s Principle of blood flow and how is it determined?

A

Was found to determine Cardiac output of 5L/min or 5000ml/min

CO = O2 consumption / [O2]pul vein - [O2]pul artery

44
Q

List factors that determine CO

A

Body metabolism level

Exercising or not

Age

Body size

45
Q

What is the most important controller of cardiac output?

A

Peripheral factors (TPR)

High TPR = decrease CO

Low TPR = increase CO

46
Q

Factors causing hypoeffective heart

A

Heart diseases, such as:

Increased arterial pressure

Nervous excitation inhibition

Pathological factors that cause abnormal HR

Coronary artery blockage

Valvular heart disease

Congenital heart disease

Cardiac hypoxia

47
Q

Factors that cause hypereffective heart

A

Excercise

Nervous stimulation

Hypertrophy of the heart

48
Q

List the cardiac factors that cause decreased cardiac output

A

MI

Severe valvular disease

Myocarditis

Cardiac tamponade (fluid in pericardium)

Cardiac metabolic arrangements

49
Q

List non cardiac factors that cause a decrease in CO

A

Decreased blood volume

Acute venous dilation

Large vein obstruction

Decreased tissue mass

Decreased metabolic rate of tissues

50
Q

What are the factors that affect venous return to the heart from the systemic circulation?

A

Right atrial pressure (7mmHg normal) (a -2 value is due to veins collapse entering the chest)

Degree of filling of systemic circulation

Resistance to blood flow (2/3 determined by venous resistance; altho low and 1/3 via arteriolar & small artery resistance)

51
Q

What is the pressure gradient for venous return

A

The difference b/w the mean systemic filling pressure and the right atrium

The greater the difference, the greater the venous return

52
Q

What is the primary controller of coronary blood flow arteries?

A

Local muscle metabolism; indirect ANS stimulation

Whereas direct ANS stimulation is on blood vessels

53
Q

What are the causes of death after acute coronary occlusion?

A

Decreased CO

Damming of blood in pulmonary blood vessels = pulmonary edema

Fibrillation of the heart

54
Q

What are the sympathetic compensatory mechanisms after an acute cardiac failure?

A

Strengthen muscle contractions (in both healthy & damaged)

Increase vessel tone; causing an increase in systemic filling pressure and increase in venous return

55
Q

What are the ANS compensatory mechanisms after an acute cardiac failure?

A

Baroreceptor reflex

Chemoreceptor reflex

CNS ischemic response

56
Q
A
57
Q

Acute effects and chronic compensatory mechanisms following an acute, moderate heart attack

A

Acute = decreased CO, increased venous pressure (damming of blood in veins)

Chronic = renal fluid retention, less pumping ability of heart

58
Q
A
59
Q

What are the 2 major problems of left heart failure from an acute heart failure

A

Pulmonary vascular congestion

Pulmonary edema

Right atrial pressure becomes 0, capillary pressure decreases and mean aortic pressure decreases

60
Q

What’s happening during “lub”

A

Closure of AV valves at the onset of systole

61
Q

What’s happening during “dub” sound (2nd heart sound)

A

Semilunar valves closing at the end of systole

62
Q

Common valvular defects (7)

A

Aortic/Mitral stenosis

Aortic/Mitral regurgitation

Valvular lesions

Rheumatic valvular lesions

Heart murmurs (backflow)

63
Q

Common congenital defects

A

Patent ductus (left-right shunt) backflow into venous system

Tetralogy of Fallot (right-left shunt) backflow into pulmonary circuit

64
Q

Define Circulatory shock

A

Inadequate blood flow through the body, to where tissues are damaged usually due to too little oxygen or other nutrients delivered to the tissue cells

65
Q

What type of feedback regulation is involved in progressive shock?

A

Positive feedback; further reducing CO

66
Q

Define neurogenic shock

A

Inadequate sympathetic response; can occur without any blood loss

Sudden loss of vasomotor tone

67
Q

Causes of neurogenic shock

A

Deep general anesthesia; vasomotor paralysis

Spinal anesthesia; blocks sympathetic nervous outflow

Brain damage; vasomotor paralysis

68
Q

Vascular distensibility is directly proportional to which of the following?

Increase in volume

Original volume

Increase in pressure

Original pressure

Both A and C

A

Increase in volume

69
Q

Define Conductance

A

The measure of blood flow through a vessel for a given pressure difference

C = 1/R

Conductance is directly proportion to diameter

4 fold increase in resistance = 256x greater flow

70
Q

What is the prime determinant in viscosity levels?

A

hematocrit

Men = 42

Women = 38

Normal viscosity = 3

Viscosity of 10 = polycythemia (60-70 hematocrit level)

71
Q

Define Autoregulation

A

Ability of each tissue to adjust its vascular resistance and maintain normal blood flow thru changes in arterial pressure between (70-175mmHg)

72
Q

What is capacitance inversley proportional to?

A
73
Q

What is capacitance/compliance directly proportional to?

A

Volume

Compliance = increase in volume / increase in Pressure

74
Q

Define central venous pressure

A

Pressure in the right atrium

Regulated by: blood flowing into right atrium and ability of heart to pump OUT of right atrium

75
Q

Define Vasomotion

A

Opening/closing of precapillary sphinctors (end of metarterioles) smooth muscles require O2, therefore if they’re relaxed and gaining more O2

KCUMB Physiology - Erin (11 decks)

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