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*CLINICAL EXERCISE PHYSIOLOGY > EXAM2- Review of CV Anatomy & Physiology > Flashcards

EXAM2- Review of CV Anatomy & Physiology Flashcards

1
Q

the circulatory system works with what system

A

pulmonary system

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2
Q

names for circulatory + pulmonary system when working together

A

-cardiopulmonary system
-cardiorespiratory system

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3
Q

3 purposes of the cardiorespiratory system

A

-transport O2 + nutrients to tissues
-removal of CO2 wastes from tissues
-regulation of body temperature

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4
Q

when we exercise, our vessels dilate/constrict

A

dilate
-because body temp goes up

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5
Q

in a cold setting, our vessels dilate/constrict

A

constrict
-our body initiates shivering, rapid muscle contraction to give off heat)
-constrict to keep heat within the body

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6
Q

heart

A

creates pressure to pump blood

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7
Q

arteries + arterioles

A

carry blood away from the heart

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8
Q

veins + venules

A

carry blood toward the heart

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9
Q

capillaries

A

responsible for all exchange of O2, CO2, + nutrients with tissues

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10
Q

blue part of the heart represents

A

deoxygenated blood

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11
Q

**be able to label R atrium, L atrium, R ventricle, L ventricle, + interventricular septum on slide 4

A
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12
Q

left ventricle

A

pushes blood to the rest of the body

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13
Q

top segments of heart

A

R atrium + L atrium

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14
Q

bottom segments of heart

A

R ventricle + L ventricle

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15
Q

3 parts of the heart wall

A

-epicardium
-myocardium
-endocardium

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16
Q

myocardium

A

“muscle” responsible for heart contraction
-essentially, the muscle of the heart

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17
Q

myocardium receives blood supply via ____

A

coronary arteries

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18
Q

coronary arteries are responsible for

A

meeting high demands of oxygen + nutrients

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19
Q

myocardial infarction (MI)

A

aka a heart attack
-blockage in coronary blood flow results in cell damage
-cardiac tissue dies; once cardiac tissue is dead, we cannot do anything to regenerate it, which can have extreme effects on a person’s ability to function after a MI

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20
Q

what protects against heart damage during a MI

A

exercise training
-individuals that exercise + have an MI are much more likely to survive + function after

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21
Q

epicardium is also called

A

visceral pericardium

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22
Q

epicardium characteristics

A

serous membrane including blood capillaries, lymph capillaries, + nerve fibers

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23
Q

epicardium function

A

serves as lubricative outer covering

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24
Q

myocardium characteristics

A

cardiac muscle tissue separated by connective tissues and includes blood capillaries, lymph capillaries + nerve fibers

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25
Q

myocardium function

A

provides muscular contractions that eject blood from the heart chambers

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26
Q

endocardium characteristics

A

endothelial tissue + a thick subendothelial layer of elastic + collagenous fibers

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27
Q

endocardium function

A

serves as protective inner lining of the chambers + valves

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28
Q

blood is made up of what 2 things

A

-plasma
-cells

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29
Q

plasma

A

liquid portion of blood
-contains ions, proteins, hormones

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30
Q

3 types of blood cells

A

-RBC
-WBC
-platelets

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31
Q

red blood cells (RBC)

A

contain hemoglobin to carry oxygen

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32
Q

the largest % of cells in the blood are what

A

red blood cells

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33
Q

white blood cells

A

important in preventing infection

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34
Q

platelets

A

important in blood clotting
-if you get a scrape, helps scab

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35
Q

hematocrit

A

% of blood composed of RBC

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36
Q

centrifuge

A

machine that breaks blood into its 2 components (plasma + blood cells)

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37
Q

if someone has an infection, what levels do we expect to go up

A

WBC

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38
Q

typical hemaocrit of blood

A

42%

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39
Q

systole

A

-contraction phase
-ejection of blood

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40
Q

how much blood is ejected from ventricles per beat

A

2/3 blood

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41
Q

why is 1/3 blood left in ventricle after contraction

A

because you must have a little blood leftover to maintain the structural integrity of the ventricle
-if we took all the blood out, the ventricle would collapse

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42
Q

diastole

A

-relaxation phase
-filling with blood

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43
Q

at rest, diastole or systole is longer

A

diastole
-makes sense because our heart wants to do least work required

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44
Q

**during exercise, what happens to systole + diastole

A

both become shorter
-the higher the intensity of the exercise, the more the phases will shorten

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45
Q

pressure in diastole

A

pressure in ventricles is LOW
-things want to travel from high to low pressure, so having low pressure in ventricle during diastole facilitates it filling up with blood

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46
Q

during diastole, ventricles are filling with blood from ____

A

atria

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47
Q

pressure in systole

A

pressure in ventricles rises

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48
Q

during systole, blood is ejected in ____

A

pulmonary + systemic circulation

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49
Q

first heart sound

A

systole
-closing of AV valves

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50
Q

second heart sound

A

diastole
-closing of aortic + pulmonary valves

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51
Q

how is arterial BP expressed

A

systolic/diastole

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52
Q

normal BP

A

<120/<80 mmHg

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53
Q

systolic pressure

A

pressure generated during ventricular contraction

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54
Q

diastolic pressure

A

pressure in arteries during cardiac relaxation

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55
Q

pulse pressure

A

difference between systolic + diastolic

ex: 120/80
pulse pressure = 120-80 = 40

56
Q

what would a BP of 120/120 mean

A

no resting period for the heart because pressure is staying consistent the entire time

57
Q

mean arterial pressure (MAP)

A

average pressure in the arteries during cardiac cycle AT REST

58
Q

MAP equation

A

MAP = DBP + (0.33)(SBP-DBP)

59
Q

what does contraction of the heart depend on

A

electrical stimulation of the myocardium

60
Q

describe heart contraction

A

automatic contraction
-need for electrical stimulation

61
Q

describe skeletal muscle contraction

A

voluntary contraction
-brain must send signal to do so

62
Q

sinoatrial node (SA node)

A

-pacemaker
-initiates depolarization

63
Q

atrioventricular node (AV node)

A

-passes depolarization to ventricles
-brief delay (called AV delay) to allow for ventricular filling (blood transfer from atria to ventricle)

64
Q

why does AV delay occur

A

so that atria + ventricles do not contract at same time
-if they were stimulated at the same time, no blood would move

65
Q

bundle branches extend from

A

AV node

66
Q

bundle branches

A

connect atria to L + R ventricle
-splits into 2 so the wave of depolarization can affect L + R side of heart

67
Q

purkinje fibers

A

spread depolarization throughout ventricles

68
Q

4 steps of conduction system of the heart

A
  1. APs originate in the SA node (the pacemaker) + travel across the wall of the atrium from the SA node to the AV node
  2. APs pass through the AV node + along the AV bundle, which extends from the AV node, through the fibrous skeleton, into the interventricular septum
  3. the AV bundle divides into R + L bundle branches, + APs descend to the apex of each ventricle along the bundle branches
  4. APs are carreid by the purkinje fibers from the bundle branches to the ventricular walls
69
Q

regulation of HR

A

a mix/coordination between parasympathetic + sympathetic nervous system

70
Q

parasympathetic nervous system regulates HR via what

A

vagus nerve

71
Q

how does parasympathetic nervous system regulate HR

A

-slows HR by inhibiting SA + AV node
-decrease in parasympathetic tone = increase in HR (typically causes rise in HR up to 100 bpm)

72
Q

sympathetic nervous system regulates HR via what

A

cardiac accelerator nerves

73
Q

how does sympathetic nervous system regulate HR

A

increases HR by stimulating SA + AV node (typically causes rise in HR BEYOND 100 bpm)

74
Q

there is a decrease/increase in HR at onset of exercise

A

increase

75
Q

describe increase in HR at onset of exercise

A

-INITIAL increase (at onset) is due to parasympathetic withdrawal
-LATER increase (a few seconds later) is due to increased sympathetic stimulation

76
Q

**see diagram on slide 16

A
77
Q

what happens when parasympathetic nerve is stimulated

A

-causes release of ACh in little junctions
-ACh then binds to receptors on SA node, which will inhibit HR

-when you need HR to go down, that is when parasympathetic kicks in

78
Q

what happens when sympathetic nerve is stimulated

A

-also goes to SA node
-when cardiac accelerator nerves are stimulated, they release norepinephrine into gap
-stimulatory, will increase HR

79
Q

heart rate variability

A

the time between heart beats

80
Q

HR variability is the standard deviation of what on an EKG

A

R-R interval

81
Q

HR variability is the balance between what

A

between SNS + PNS

82
Q

wide/high variation in HR variation is good/bad

A

higher HR variability = good
-tells us that PNS kicks in when it needs to + same with SNS

83
Q

wide variation in HRV reflects ____

A

autonomic balance
-considered healthy

84
Q

low HRV is a predictor of what

A

cardiovascular morbidity + mortality
-in patients with existing cardiovascular disease

85
Q

what does low HR variability tell us

A

either PNS or SNS is overriding

86
Q

cardiac output

A

the amount of blood pumped by the heart each minute

87
Q

cardiac output is the product of what

A

HR x SV
(heart rate x stroke volume)

88
Q

cardiac output equation

A

Q = HR x SV

89
Q

heart rate

A

number of beats per minute

90
Q

stroke volume

A

amount of blood ejected in each beat

91
Q

what 2 things does cardiac output depend on

A

-training state
-gender

92
Q

males/females have higher cardiac output

A

males
-because bigger build so typically need more

93
Q

one of the key benefits of training

A

greater cardiac output

94
Q

end-diastolic volume (EDV)

A

volume of blood in ventricles at the end of diastole
-basically how good your ventricle is at filling with blood

95
Q

what is another name for EDV

A

preload

96
Q

the more EDV you have…

A

greater contraction
-because more stretch (when ventricle is optimally filled) which facilitates a stronger contraction

97
Q

Frank-Starling mechanism

A

greater EDV results in a more forceful contraction
-due to stretch of ventricles

98
Q

what is EDV dependent on

A

venous return

99
Q

venous return

A

how much blood is coming into the heart

100
Q

what 3 things increase venous return

A

-venoconstriction
-skeletal muscle pump
-respiratory pump

101
Q

how does venoconstriction increase venous return

A

increased pressure in veins

102
Q

how does skeletal muscle pump increase venous return

A

-rhythmic skeletal muscle contractions force blood in the veins toward the heart
-one-way valves in veins prevent backflow of blood

103
Q

how does respiratory pump increase venous return

A

changes in thoracic pressure pull blood toward heart

104
Q

stroke volume is dependent on what 3 factors

A

-EDV
-MAP
-strength of ventricular contraction (contractility)

105
Q

how is stroke volume dependent on MAP (average aortic BP)

A

pressure of heart must pump against to eject blood (afterload)
-meal arterial pressure

106
Q

how is stroke volume dependent on strength of ventricular contraction (contractility)

A

enhanced by:
-circulating epinephrine + norepinephrine
-direct sympathetic stimulation of heart

107
Q

oxygen demand by muscles during exercise is ___x greater than at rest

A

15-25x greater

108
Q

what 2 ways is increased O2 delivery accomplished by

A

-increased cardiac output
-redistribution of blood flow (from inactive organs to working skeletal muscle)

109
Q

as soon as we begin to exert ourselves, ___ demands increase

A

oxygen

110
Q

cardiac output increases due to what 2 things

A

-increased HR
-increased SV

both of these increase during exercise

111
Q

describe increase in HR during exercise

A

linear increase until reaches max

112
Q

how to calculate max HR

A

220 - age for adults
-KNOW there is an equation for children, but don’t need to know specific equation

113
Q

describe increase in SV during exercise

A

increase, then plateau at 40-60% VO2 max
-no plateau in HIGHLY trained subjected

114
Q

what does plateau in SV mean

A

after 40-60%, if cardiac output continues to increase it must come from increased HR

115
Q

**see slide 23 graphs

A
116
Q

circulatory responses to exercise

A

changes in HR + BP

117
Q

circulatory responses to exercise (changes in HR + BP) depend on what 4 things

A

-type, intensity, + duration of exercise
-environmental condition
-emotional influence
-training status

118
Q

there is an equal/more/less exaggerated response if you are hitting lower vs upper body

A

LESS exaggerated response for lower body

119
Q

what happens anytime heat/humidity becomes part of the equation…

A

we get a very different response + can disregard typical responses

120
Q

one of the key benefits of being TRAINED (in regards to HR + BP)

A

we see a LOWER change in HR + BP

121
Q

at the same oxygen uptake, arm work results in higher of what 2 things

A

-HR
-BP

122
Q

at the same oxygen uptake, arm work results in higher HR due to what

A

higher sympathetic stimulation

123
Q

at the same oxygen uptake, arm work results in higher BP due to what

A

vasocontriction of large inactive muscle mass

124
Q

when you hit lower body, which muscles constrict

A

upper body muscles
-opposite is true for when you hit upper body

125
Q

steady state

A

physiologically means that body is able to meet demands being placed on it

126
Q

transition from rest to exercise- what occurs at the onset of exercise

A

-rapid increase in HR, SV, cardiac output
-plateau in submaximal (below lactate threshold) exercise

127
Q

transition from exercise to recovery- what occurs during recovery

A

-decrease in HR, SV, + cardiac output toward resting levels
-depends on:
* duration + intensity of exercise
* training state of subject

128
Q

trained vs untrained people in recovery

A

trained people return to recovery much faster than regular individuals

129
Q

**see graph on slide 27

A
130
Q

regular exercise is ____

A

cardioprotective

131
Q

2 reasons why regular exercise is cardioprotective

A

-reduces incidence of heart attacks
-improves survival from heart attack

132
Q

what does exercise reduce during a heart attack

A

reduces amount of myocardial damage from heart attack

133
Q

how does exercise reduce the amount of myocardial damage from heart attack

A

-improvements in heart’s antioxidant capacity (ability to remove free radicals, repair tissue damage, etc.)
-improved function of ATP-sensitive potassium channels

134
Q

when tissues are more sensitive to ATP, what does this mean

A

they require LESS ATP
-beneficial to be better at using ATP in the context of a heart attack
-when cells become necrotic/start to die, heart uses a ton of ATP to counteract the dying cells

135
Q

endurance exercise protects against cardiac injury during heart attack graph- how did untrained compare to trained

A

roughly 1/3 of untrained damage occurred in trained

136
Q

when heart tissue dies can it be regenerated

A

no, nothing can be done to regenerate necrotic tissue

137
Q

**see graph on slide 30

A

*CLINICAL EXERCISE PHYSIOLOGY (15 decks)

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