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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
Atrial Fibrillation
26
What happens to elastance and compliance when you have a greater amount of elastic tissue in a blood vessel?
High elastance Low compliance
27
Define Vascular Compliance
Total quantity of blood that can be stored in a given portion of the circulatory system
28
What is the most important determinant of pulse pressure?
Stroke Volume output Rate increases to same extent as systolic pressure
29
What are the two major factors that affect pulse pressure?
Stroke Volume Arterial Compliance PP = SV/Arterial Compliance
30
Central venous pressure is another term for...
Right Atrial Pressure Increases with greater venous return
31
What's the most important factor that regulates vasomotion?
[Oxygen] in tissues
32
What are some common vasodilators?
H+ K+ Adenosine Adenosine Phosphate compounds CO2 Histamine
33
Define near infinited feedback gain principle
Return of arterial pressure back to equilibrium point Occurs in Kidneys; Pressure Diuresis = increase in urine output Pressure Natriuresis = increase in Na+ output
34
What are the primary determinants of long term arterial pressure control?
Level of water/salt intake How much the curve shifts in the pressure/shift curve for renal output of salt and water
35
Define chronic hypertension and state the values for normal, hyper, and severe
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
List the causes of lethal effects of chronic hypertension
Cerebral Infart Heart attack Coronary Heart Disease Early heart failure Uremia = kidney destruction leading to kidney failure
37
Common vasoconstrictors and vasodilators under humoral circulation control
Vasoconstrictors: ADH/Vasopressin, Epi, NEpi, Angiotensin II, Catecholamines (hypertension), endothelin (hypertensin) Vasodilators: Bradykinins, Histamine, Prostaglandins (hypertension)
38
List some factors that result in increased peripheral resistance leading to an increase in BP
Angiotensin II Catecholamines Thromboxane Neural factors (Beta-adrenergic)
39
Constitutional risk factors of atherosclerosis
Age Genetics Metabolic Syndrome; Insulin release (obesity, fasting hyperglycemia, increased lipid TGs, decreased HDL levels, hypertension)
40
Modifiable risk factors for hypertension
Hyperlipidemia Hypertension Smoking Diabetes
41
List some causes of the lethal effects of chronic hypertension
Early heart failure Coronary heart disease Heart attack Cerebral infarct Kidney failure
42
Define cardiac index and how do you calculate it
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
What is Fick's Principle of blood flow and how is it determined?
Was found to determine Cardiac output of 5L/min or 5000ml/min CO = O2 consumption / [O2]pul vein - [O2]pul artery
44
List factors that determine CO
Body metabolism level Exercising or not Age Body size
45
What is the most important controller of cardiac output?
Peripheral factors **(TPR)** High TPR = decrease CO Low TPR = increase CO
46
Factors causing hypoeffective heart
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
Factors that cause hypereffective heart
Excercise Nervous stimulation Hypertrophy of the heart
48
List the cardiac factors that cause decreased cardiac output
MI Severe valvular disease Myocarditis Cardiac tamponade (fluid in pericardium) Cardiac metabolic arrangements
49
List non cardiac factors that cause a decrease in CO
Decreased blood volume Acute venous dilation Large vein obstruction Decreased tissue mass Decreased metabolic rate of tissues
50
What are the factors that affect venous return to the heart from the systemic circulation?
**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
What is the pressure gradient for venous return
The difference b/w the mean systemic filling pressure and the right atrium The greater the difference, the greater the venous return
52
What is the primary controller of coronary blood flow arteries?
Local muscle metabolism; indirect ANS stimulation Whereas direct ANS stimulation is on blood vessels
53
What are the causes of death after acute coronary occlusion?
Decreased CO Damming of blood in pulmonary blood vessels = pulmonary edema Fibrillation of the heart
54
What are the sympathetic compensatory mechanisms after an acute cardiac failure?
Strengthen muscle contractions (in both healthy & damaged) Increase vessel tone; causing an increase in systemic filling pressure and increase in venous return
55
What are the ANS compensatory mechanisms after an acute cardiac failure?
Baroreceptor reflex Chemoreceptor reflex CNS ischemic response
56
57
Acute effects and chronic compensatory mechanisms following an acute, moderate heart attack
Acute = decreased CO, increased venous pressure (damming of blood in veins) Chronic = renal fluid retention, less pumping ability of heart
58
59
What are the 2 major problems of left heart failure from an acute heart failure
Pulmonary vascular congestion Pulmonary edema Right atrial pressure becomes 0, capillary pressure decreases and mean aortic pressure decreases
60
What's happening during "lub"
Closure of AV valves at the **onset** of systole
61
What's happening during "dub" sound (2nd heart sound)
Semilunar valves closing at the **end of systole**
62
Common valvular defects (7)
Aortic/Mitral stenosis Aortic/Mitral regurgitation Valvular lesions Rheumatic valvular lesions Heart murmurs (backflow)
63
Common congenital defects
**Patent ductus** (left-right shunt) backflow into venous system **Tetralogy of Fallot** (right-left shunt) backflow into pulmonary circuit
64
Define Circulatory shock
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
What type of feedback regulation is involved in progressive shock?
Positive feedback; further reducing CO
66
Define neurogenic shock
Inadequate sympathetic response; can occur without any blood loss ## Footnote **Sudden loss of vasomotor tone**
67
Causes of neurogenic shock
Deep general anesthesia; vasomotor paralysis Spinal anesthesia; blocks sympathetic nervous outflow Brain damage; vasomotor paralysis
68
Vascular distensibility is directly proportional to which of the following? Increase in volume Original volume Increase in pressure Original pressure Both A and C
Increase in volume
69
Define Conductance
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
What is the prime determinant in viscosity levels?
hematocrit Men = 42 Women = 38 Normal viscosity = 3 Viscosity of 10 = polycythemia (60-70 hematocrit level)
71
Define Autoregulation
Ability of each tissue to adjust its vascular resistance and maintain normal blood flow thru changes in arterial pressure between (70-175mmHg)
72
What is capacitance inversley proportional to?
73
What is capacitance/compliance directly proportional to?
Volume Compliance = increase in volume / increase in Pressure
74
Define central venous pressure
Pressure in the right atrium Regulated by: blood flowing into right atrium and ability of heart to pump OUT of right atrium
75
Define Vasomotion
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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