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Physio Final > Heart > Flashcards

Heart Flashcards

1
Q

How much of blood is dropped through the AV valves?

A

70%

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2
Q

Where are valves?

A

Veins & lymphatic system

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3
Q

Which side of heart must contract against higher pressure?

A

Venous side

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4
Q

What keeps the AV valves from blowing back open into the atria?

A

Papillary muscles & chordae tendineae

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5
Q

Why do AV valves open?

A

Pressure in atria larger than pressure in ventricle

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6
Q

pH of above 7.45 is considered?

A

Alkalosis

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7
Q

pH below 7.35 is considered

A

acidosis

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8
Q

Cardiac muscle

A

Branched myofiber
Uninucleated
Intercalated disc w/ gap junctions
Functional syncytia

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9
Q

Primary pace maker of heart?

A

Sinoatrial node

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10
Q

Secondary pace maker

A

Atrioventricular node

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11
Q

Where do nerve impulses travel after atrioventricular node

A

Bundle of Hiss –>Purkinje fibers

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12
Q

Where does contraction of the heart start?

A

Apex

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13
Q

What causes automaticity of the sinoatrial node?

A

Unstable resting potential

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14
Q

What causes opening of Na+ channels?

A

Rapid repolarization of potassium channels

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15
Q

HCN channels

A

cause unstable resting potential

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16
Q

What are HCN channels sensitive to?

A 
Cyclic nucleotides (cAMP ) causes by epi/norepi
Increases chronotropic effect)
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17
Q

What causes rapid depolarization of membrane?

A

Fast Ca2+ channels opening

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18
Q

What is a normal heart rate?

A

72 bpm

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19
Q

Where does pacemaker potential start (mV)?

A

-50 mV

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20
Q

What is the effect of sympathetic innervation of the heart?

A

Greater opening of HCN channels

Increase heart rate

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21
Q

What is the effect of parasympathetic innervation on heart?

A

ACh promotes opening of K+ channels

Causes resting membrane slope to be flatter & decrease heart rate

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22
Q

What does endurance training do to heart rate?

A

Increase parasympathetic innervation

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23
Q

Where is the cardiac control center

A

Medulla

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24
Q

Cardiac muscle action potential

A

Stable around -80 mV

Up to +20 mV

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25
Q

What causes myocardial action potential to stay refractory?

A

Calcium plateau

Keeps potential up in positive range, no repolarization

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26
Q

How long is the cardiac action potential?

A

250 milliseconds

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27
Q

Contraction time of myocardial cells

A

300 ms

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28
Q

Action potential & contraction of skeletal muscle

A

1-2 msecs

10-50 msecs

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29
Q

Extraparaventricular contraction

A

Contract quickly, but then long compensatory pause before 2nd contraction
Needed to decrease blood pressure & need another heart beat

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30
Q

Depolarization of atria

A

P wave

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31
Q

QRS wave

A

repolarization of atria & depolarization of ventricle

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32
Q

T wave

A

Repolarization of ventricle

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33
Q

U wave

A

Repolarization of bundle of Hiss

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34
Q

What does a depressed ST segment indicate?

A

Lack of blood flow to ventricular muscle (lack of O2 delivery)

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35
Q

Ventricular fibrillation

A

Random action potentials, could be result of ectopic foci- lose coordination

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36
Q

What kind of action potential does the EKG show?

A

Compound action potential

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37
Q

What are the waves of the atria called?

A

a, c, v

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38
Q

What causes the first heart sound?

A

AV valves

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39
Q

What is the time period in between mitral valve closure & semilunar valve opening?

A

Isovolumic contraction

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40
Q

What causes the dichrotic notch?

A

Semilunar valves closes & aortic volume can’t flow back into the heart & pressure builds to flow back to systemic circulation

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41
Q

How long does the isovolumic relaxation last?

A

Until pressure in the ventricle falls below that in the atia

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42
Q

What is cardiac output

A

Cardiac rate x Stroke volume

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43
Q

Total average blood voume

A

5.5 L

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44
Q

Cause of v wave (in atria)

A

venous return to the atria

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45
Q

Where does ventricular pressure end at?

A

0 mmHg

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46
Q

Where would you measure pressure of 120/80?

A

Aorta?

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47
Q

What do pressure curves look like on the right side of the heart?

A

Much less pressure, but exactly the same

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48
Q

When does the heart receive blood from the coronary arteries?

A

During diastole

49
Q

What shortens during a high heart rate?

A

Diastole time period

Less blood getting back to heart

50
Q

What would the right side of the heart pressure look like?

A

25/8 mmHg

51
Q

What kind of effect on the heart is sympathetic innvervation?

A

Chronotropic & Inotropic bc of synapses en passant

52
Q

What effect does temperature have on heart rate?

A

Increased with increased temperature

53
Q

Hyperkalemia causes what in the heart?

A

Decreased force & rate

54
Q

Hypokalemia causes what in the heat?

A

Cardiac arrhythmias

55
Q

Increased calcium effect on heart?

A

Increase mechanical action, but slow down bc of divalent cation

56
Q

What do cardiac glycoside sugar steroids do to the heart?

A

Increase strength

57
Q

Cardiac output

A

Volume of blood pumped per minute by each contraction

CO =SV + CR

58
Q

Strove volume

A

amount of blood pumped out in a contraction

59
Q

How much blood is in resting stroke volume?

A

70 mL

60
Q

What is resting cardiac output?

A

5 L/min

70 mL x 72 bpm

61
Q

What drives cardiac output?

A

Mean Arterial pressure= 100 mmHg

62
Q

How long does it take each ventricle to pump the total amount of blood?

A

1 minute

63
Q

How much blood is left in the ventricle after systole?

A

65 mL

64
Q

What affects end diastolic volume?

A

Venous filling pressure- increase
Ventricular filling time- increase
Ventricular wall distensibility-increase
Pressure of atrial contraction–Increase

65
Q

What affects systolic volume?

A 
Ventricular contraction- decrease ESV
Lower pulmonary pressure-
Increase
Higher arterial pressure-
Increase (takes more pressure to pump to higher pressure)
66
Q

Increasing cardiac out put increases

A

Blood pressure

67
Q

As end diastolic volume increases, what also increases?

A

Stroke volume

68
Q

As sympathetic innervation increases on heart, what also increases?

A

Stroke volume due increased contractility

Inotrooic effect due to more Ca2+ available

69
Q

What happens to end diastolic volume when you lay down?

A

It goes up, decreased drag down from skeletal muscle pumps

70
Q

What happens to end diastolic volume when you stand up?

A

It goes down

71
Q

Where are the baroreceptors

A

Bifuraction of carotid artery

72
Q

What do baroreceptors detect?

A

Blood pressure

73
Q

Mean arterial pressure

A

Diastolic pressure + 1/3 pulse pressure

74
Q

Pulse pressure

A

Systolic- diastolic

75
Q

Length-tension in myocardial muscle

A

Frank-starling mechaings

76
Q

What causes the increase in stroke volume to increase EDV?

A

Optimal length of sarcomere strucutre as the myocardial cells are stretched out

77
Q

What causes aortic diastole pressure to go up?

A

Atherosclerosis of the arteries

78
Q

What causes aortic systole pressure to increase?

A

Arterio/Atherosclerosis of the arteries

79
Q

Why can’t pulse be taken from veins?

A

Capillaries dampen any feel of ventricle pressure out into the aorta

80
Q

Why can you use Kortocoff sounds?

A

Only hear noise when there is not smooth, laminar flow (caused by increased pressure)

81
Q

Which vessels are the primary resistance vessels?

A

Arterioles

82
Q

What would polycythemia do to blood pressure?

A

Increase viscosity, increase blood pressure

83
Q

What is used to measure antagonistic relations on heart?

A

RR variation

84
Q

How much blood volume is in the veins?

A

2/3 blood volume

85
Q

What kind of vessels are the veins?

A

Capacitance vessles

86
Q

What does breathing affect?

A

Increase pressure on veins so that venous return is increased

87
Q

When standing, the skeletal muscle does what?

A

Increases venous return

88
Q

What affect does sympathetic nerve stimulation have to venoconstrict?

A

Venoconstriction drives blood to more high pressure arteriole side –>increased venous pressure increases EDV

89
Q

What receptors cause sympathetic vasoconstriction of smooth muscle/skin

A

Norepi & Alpha adrenergic

90
Q

What causes sympathetic vasodilation is skeletal muscles?

A

Epinephrine & B adrenergic receptors

91
Q

What causes release of ADH

A

High blood osmolarity

92
Q

What other affect does Angiotensin II have besides aldosterone?

A

Increase vasoconstriction to increase blood pressure

93
Q

What is the pressure on the arterial side of capillary bed?

A

37 mmHg

94
Q

What is the pressure on the venous side of capillary bed?

A

17 mmHg

95
Q

Where does blood pressure drop the most?

A

Arterioles

96
Q

Why does pressure go back up in the veins?

A

Capacitance vessels

97
Q

Where is blood flow the slowest?

A

Capillaries

98
Q

Poisuelle’s Law

A

Q= pi(P)r^4/8nl

99
Q

Why is the valsalva maneuver dangerous?

A

Increases mean arterial pressure while compressing vena cava (no venous return)

100
Q

Arterioles are controlled mainly by what autonomic control?

A

Sympathetic control

101
Q

What happens during low concentration of epinephrine in arterioles?

A

Vasodilation

102
Q

What happen during high concentration of epinephrine in arterioles?

A

Alpha receptors to cause vasoconstriction

103
Q

What happens during increased mechanical stretch on the arteriole?

A

Harder contraction more forcefully

104
Q

What metabolites result in vasodilation?

A

Decreased O2
Increased CO2
Increased H+
Inc in K+

105
Q

What are vasodilators

A

Endothelial Relaxing factor
NO
Histamine

106
Q

How much of blood is in skeletal muscle during exercise?

A

80-85%

107
Q

What happens to blood during exercise?

A

Stealing phenomenon

108
Q

What governs fluid movement?

A

Starling Forces

109
Q

Starling forces equation

A

Pc +(pi)i - Pi + (pi)p

110
Q

Force in capillaries of starling forces?

A 
Pi= hyrdostatic pressure of interstitial forces= 1
(pi)p= colloid osmotic pressure of blood plasma = 25
111
Q

Forces out in capillaries of Starling forces?

A 
P(c)= hydrostatic pressure of capillary (37 or 17)
pi(i)= colloid osmotic pressure of interstitial fluids (0)
112
Q

How much net filtration on arteriole side

A

11 mmHg

113
Q

How much net absorption on venous side

A

-9 mmHg

114
Q

What starling force increases during a sprain?

A

(pi)I =colloid osmotic pressure out

115
Q

Active hyperemia

A

During active contractions during exercise

116
Q

Reactive hyperemia

A

Taking off tourniquet & reaction- reaction to low blood flow

117
Q

Heart rate less than 60 bpm

A

Bradycardia

118
Q

Heart rate greater than 100 bmp

A

Tachycardia

119
Q

Hyperemia

A

Increased tissue blood flow

Physio Final (10 decks)

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