Heart/Blood Flashcards

Generated from Lectures 18-23

1
Q

The organ of propulsion in the circulatory system is the _______.

A

heart

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2
Q

The blood vessels responsible for the distribution of blood are the _______.

A

arteries

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3
Q

_______ serve as a pressure reservoir in the circulatory system.

A

Arteries

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4
Q

The transfer of materials between blood and tissues/cells occurs in the _______.

A

capillaries

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5
Q

_______ are responsible for returning blood to the heart.

A

Veins

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6
Q

Besides returning blood to the heart, the _______ also serve as a volume reservoir.

A

veins

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7
Q

The _______ side of the heart is associated with the respiratory system.

A

right

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8
Q

The _______ side of the heart is associated with the systemic circulation.

A

left

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9
Q

The _______ fluid adheres to the heart and reduces friction

A

pericardial

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10
Q

The smooth _______ minimizes surface friction in the heart.

A

endothelium

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11
Q

_______ prevents overstretching of the heart.

A

Fibrous pericardium

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12
Q

Inflammation of the pericardium is called _______.

A

pericarditis

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13
Q

The _______ valve is located between the left atrium and left ventricle.

A

mitral

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14
Q

The _______ valve is also known as the bicuspid valve.

A

mitral

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15
Q

Prolapse of the _______ valve can occur if there is too much blood volume.

A

mitral

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16
Q

The _______ valves open and close due to differential hydrostatic pressures

A

heart

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17
Q

The _______ ventricle has a thicker myocardial wall than the other ventricle.

A

left

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18
Q

The _______ valve is located between the right atrium and the right ventricle.

A

tricuspid

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19
Q

Cardiac muscle is also known as _______.

A

myocardium

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20
Q

The _______ node and atrioventricular node contain smaller myocardial fibers that are weakly contractile.

A

sinus

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21
Q

The liquid portion of blood is called _____.

A

plasma

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22
Q

Red blood cells contain the protein _____, which carries oxygen.

A

hemoglobin

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23
Q

The hormone _____ stimulates red blood cell production.

A

erythropoietin

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24
Q

Platelets release _____, which promotes blood vessel constriction.

A

thromboxane A2 (TXA2)

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25
Q

The protein _____ forms the meshwork of a blood clot.

A

fibrin

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26
Q

The _____ pathway of blood clotting is initiated by damage to the blood vessel wall.

A

extrinsic

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27
Q

Hemophilia is usually caused by a deficiency in clotting factor _____.

A

VIII

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28
Q

_____ is a medical condition characterized by a low red blood cell count.

A

Anemia

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29
Q

The _____ valve closing produces the “lub” sound of the heartbeat.

A

AV

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30
Q

The volume of blood in the ventricle at the end of diastole is called the _____.

A

end-diastolic volume (EDV)

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31
Q

The _____ is the volume of blood ejected from the left ventricle with each heartbeat.

A

stroke volume

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32
Q

How do you calculate stroke volume?

A

SV = EDV - ESV

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33
Q

_____ is the amount of blood pumped by the heart per minute.

A

Cardiac output

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34
Q

How is cardiac output calculated?

A

CO = HR x SV; cardiac volume = heart rate x stroke volume

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35
Q

An increase in _____ refers to an increase in the force of contraction of the heart muscle.

A

contractility

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36
Q

An increase in contractility in the heart leads to a _______ stroke volume for a given preload.

A

greater

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37
Q

__________ is the end-diastolic ventricular pressure, which is related to the filling and stretching of the ventricle, ultimately influencing the resting length of the cardiac muscle.

A

Ventricular preload

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38
Q

__________ refers to the systemic arterial pressure that the ventricle must overcome to open the aortic valve and eject blood.

A

Ventricular afterload

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39
Q

An increase in preload leads to an increase in _____.

A

stroke volume

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40
Q

An increase in afterload leads to a _____ in stroke volume.

A

decrease

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41
Q

The _____ wave of the ECG represents atrial depolarization.

A

P

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42
Q

The _____ complex corresponds to ventricular depolarization.

A

QRS

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43
Q

The _____ interval reflects the time it takes for the electrical impulse to travel from the atria to the ventricles.

A

PR

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44
Q

The _____ wave represents ventricular repolarization.

A

T

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45
Q

The _____ segment on the ECG should be flat and represents the period when the ventricles are contracting and the heart is ejecting blood.

A

ST

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46
Q

The _____ is the muscular layer of the heart responsible for its pumping action.

A

myocardium

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47
Q

The _____ valve is located between the left atrium and left ventricle, preventing backflow of blood.

A

mitral

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48
Q

The heart is enveloped by a protective sac called the _____, which reduces friction during heartbeats.

A

pericardium

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49
Q

The equation _____ describes the relationship between flow, pressure, and resistance in blood vessels, illustrating a fundamental concept in hemodynamics.

A

F = ΔP/R; Blood flow (F) is directly proportional to the pressure difference (ΔP) and inversely proportional to vascular resistance (R)

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50
Q

_____ are the blood vessels with the largest total cross-sectional area and the lowest flow velocity.

A

Capillaries

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51
Q

According to Poiseuille’s Law, blood vessel resistance is inversely proportional to _____ to the fourth power.

A

inner radius

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52
Q

An increase in _____ refers to an increase in the volume of blood returned to the heart via the venous system.

A

venous return

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53
Q

The _____ pressure is typically very low, close to 0 mm Hg.

A

venous

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54
Q

The _____ are the blood vessels primarily responsible for regulating resistance to blood flow.

A

arterioles

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55
Q

_____ is the relationship between the change in volume and the change in pressure within a blood vessel, reflecting the vessel’s ability to stretch and accommodate changes in blood volume.

A

Compliance

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56
Q

The equation to calculate compliance is ________.

A

Compliance = ΔV / ΔP

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57
Q

True or False: Arteries, with their thicker, more elastic walls, have lower compliance, while veins are more compliant due to their thinner walls and larger lumen.

A

True

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58
Q

___________ act as muscular valves, controlling blood flow into individual capillaries.

A

Precapillary sphincters

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59
Q

The _____ represents the average pressure exerted by blood against the walls of arteries during one cardiac cycle.

A

Mean Arterial Pressure (MAP)

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60
Q

The equation for calculating MAP is _________

A

MAP: MAP = DP + 1/3 (SP-DP); [DP = diastolic pressure, SP = systolic pressure}

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61
Q

The difference between systolic and diastolic blood pressure is known as the _____.

A

pulse pressure

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62
Q

The equation ___________, known as Poiseuille’s Law, mathematically describes the factors influencing resistance to blood flow in a blood vessel.

A

R = 8Lh / pr^4; Resistance = 8 (length)x(fluid viscosity) / (constant)x(inner radius)^4

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63
Q

The force that drives fluid movement across capillary walls is called _____.

A

net filtration pressure (NFP)

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64
Q

_____ are specialized structures in veins that prevent backflow of blood, ensuring unidirectional flow towards the heart.

A

Valves

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65
Q

An increase in _____ activity leads to vasodilation, increasing blood flow to tissues.

A

sympathetic

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66
Q

_____ is a measure of the total resistance encountered by blood flow in the systemic circulation.

A

Total peripheral resistance (TPR)

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67
Q

According to the _____ law, an increase in the volume of blood returning to the heart (venous return) leads to an increase in stroke volume.

A

Frank-Starling

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68
Q

_____ are sensory receptors located in the walls of arteries that monitor blood pressure.

A

Baroreceptors

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69
Q

_____ is the term for an abnormally elevated heart rate.

A

Tachycardia

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70
Q

_____ is the process of increasing the diameter of blood vessels, leading to decreased resistance and increased blood flow.

A

Vasodilation

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71
Q

_____ is the process of decreasing the diameter of blood vessels, leading to increased resistance and decreased blood flow.

A

Vasoconstriction

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72
Q

The _____ nervous system is responsible for increasing heart rate and contractility, preparing the body for “fight or flight” responses.

A

sympathetic

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73
Q

The _____ nervous system is responsible for decreasing heart rate, promoting rest and digestion.

A

parasympathetic

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74
Q

The percentage of red blood cells in a given volume of blood is known as the _____.

A

hematocrit

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75
Q

_____ are cell fragments in the blood that play a critical role in hemostasis by forming a plug at the site of vascular injury.

A

Platelets

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76
Q

The _____ nervous system acts to increase heart rate by increasing the inward sodium current (If) and increasing the inward calcium current (Ica).

A

sympathetic

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77
Q

A(n) _____ agent increases the strength of heart contractions at any given preload.

A

positive inotropic

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78
Q

Long-term regulation of blood pressure primarily involves adjustments in _____.

A

blood volume

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79
Q

_____ shock is a life-threatening condition that occurs due to severe blood loss, leading to a decrease in blood pressure and inadequate oxygen delivery to tissues.

A

Hypovolemic

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80
Q

The _____ is a pressure wave observed in the aortic pressure tracing during early diastole, caused by the rebound of blood against the closed aortic valve.

A

dicrotic notch

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81
Q

The second heart sound, often described as a “dub” sound, is associated with the closure of the _____ valves.

A

aortic and pulmonary

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82
Q

______ refers to the increase in ventricular volume during diastole due to the continued inflow of blood from the atria.

A

Ventricular filling

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83
Q

_______ channels play a critical role in the plateau phase of a ventricular action potential, contributing to the prolonged refractory period observed in cardiac muscle.

A

L-type calcium (Ca2+)

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84
Q

The _______ node is the primary pacemaker of the heart, initiating the electrical impulses that regulate the heartbeat.

A

SA

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85
Q

The heart controls both the __________ circulation and the __________ circulation.

A

systemic, pulmonary

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86
Q

True or False: There are different average pressures in the pulmonary and systemic circulations.

A

True

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87
Q

The distribution of blood volume is _____% in the heart, _____% in the pulmonary circulation, and ______% in the systemic circulation.

A

15% heart, 12% pulmonary, 73% systemic

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88
Q

The distribution of blood volume in the systemic circulation is _____% in the arteries, ______% in the veins, and ______% in the capillaries.

A

16-18% arteries, 50% veins, 5-7% capillaries

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89
Q

The fibrous division between the left and right ventricle is called the __________.

A

interventricular septum

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90
Q

Values open and close in the heart due to differential ________ pressure.

A

hydrostatic

91
Q

Your heart beats about _________ times in one day and about _________ times in a year.

A

100,000 times, 35 million times

92
Q

Blood enters the heart from the systemic circulation through the ________.

A

right atrium

93
Q

Blood enters the heart from the pulmonary circulation through the _________.

A

left atrium

94
Q

The left and right _______ arteries deliver blood to the heart; the _________ veins drain blood from the heart into the __________.

A

coronary, coronary, coronary sinus

95
Q

Cardiac muscle fibers connect to neighboring fibers by __________.

A

intercalated discs

96
Q

In the heart, ________ and gap junctions are used to allow exchange between cells.

A

desmosomes

97
Q

Describe the order of conduction in the heart starting with the Sinoatrial node (SA).

A

SA node – Atrioventricular node (AV) – Bundle of His – Right and Left Bundle Branches – Purkinje Fibers

98
Q

True or False: Purkinje fibers are located at the apex of the heart.

A

True

99
Q

In order, the heart undergoes ________ excitation, followed by ________ excitation.

A

atrial, ventricular

100
Q

The SA node has two types of cells: _______ and ________.

A

round (pacemaker) cells, elongated (conductive, no contraction) cells

101
Q

In a graph of the action potential for the heart, the pacemaker potential is what part of the graph?

A

The rise from resting membrane potential to threshold

102
Q

The resting membrane potential in the ventricular contractile fibers in the heart is around ______ mV.

A

-90 mV

103
Q

The purposes of the three types of myocardial fibers are ____________, _____________, and___________.

A

pacemaker (SA/AV), spreading excitation (ventricular wall), doing the contraction work (rest of them)

104
Q

True or False: pacemaker action potentials and ventricular muscle cell action potentials look the same.

A

False, pacemaker look similar to neuronal while ventricular have a plateau phase (calcium enters and potassium leaves)

105
Q

The two types of calcium channels in the heart are ____-type and ___-type.

A

T (transient opening) and L (long-lasting)

106
Q

In the heart, L-type calcium channels (DHPRs) and _______ are not physically coupled.

A

ryanodine receptors

107
Q

Primary ryanodine receptor isoform found in the heart is ______.

A

RyR2

108
Q

In the heart, ryanodine receptors are _________-sensitive.

A

calcium

109
Q

Metabolism in cardiac fibers is almost exclusively through ______________.

A

aerobic cellular respiration

110
Q

Cardiac cells also can metabolize lactic acid into _____.

A

ATP

111
Q

Dissociation of ________ from RyR2 increases channel opening in heart failure; this causes Ca2+ leak from the SR into the cytoplasm and depletes the Ca2+ stores of the cell.

A

calstabin

112
Q

An important contributor to impaired calcium handling in heart failure is PKA hyperphosphorylation of _____; the long-term effect is depletion of SR calcium stores.

A

RyR2

113
Q

In pacemaker cells, sympathetic stimulation via norepinephrine release _______ (increases/decreases) the rate of action potentials.

A

increases

114
Q

In pacemaker cells, parasympathetic stimulation via acetylcholine release _______ (increases/decreases) the rate of action potentials.

A

decreases

115
Q

Rate of the ___________ (hyperpolarization/depolarization) determines the pacemaker rate.

A

depolarization

116
Q

______ (Fast/Slow) depolarization is called the pacemaker potential

A

Slow

117
Q

True or False: Only the contractile muscle
depolarization is seen on the EKG.

A

True (atrial repolarization cannot be seen)

118
Q

The P-R interval in an ECG is _____________, which is 0.12 - 0.2 seconds in a healthy heart.

A

the speed of A-V conduction

119
Q

Blood pressure is determined by ______ over _________; for instance, 120/80

A

systolic pressure, diastolic pressure

120
Q

The Q-T interval is __________, whose speed varies with heart rate.

A

electrical systole

121
Q

Diastole occurs after which segment of an ECG?

A

T wave

122
Q

True or False: In abnormal conduction, many healthy cells
can excite the few healthy cells but few healthy cells can not generate enough current to excite the region of many healthy cells.

A

True

123
Q

In a partial AV block, the ECG has ___________.

A

Occasional P wave without a coupled QRS

124
Q

In a complete AV block, the ECG has ___________.

A

P waves not coupled to QRS
(random)

125
Q

A first-degree AV block has a long _______ interval.

A

P-Q

126
Q

An ECG of atrial fibrillation has ___________.

A

Irregular R-R intervals, and no detectable P waves

127
Q

If Pressure in ventricle > Pressure in atrium, then the ______ valve closes.

A

bicuspid/tricuspid

128
Q

If Pressure in ventricle > Pressure in aorta, then the _______ valve opens.

A

aortic

129
Q

If Pressure in aorta > Pressure in ventricle, then the ______ valve closes.

A

aortic

130
Q

If Pressure in atrium > Pressure in ventricle, then the _______ valve opens.

A

bicuspid/tricuspid

131
Q

There are _____ auscultation sites in the heart.

A

four

132
Q

What are the four phases of the cardiac cycle?

A

Ventricular filling, Isovolumetric contraction, Ventricular ejection, Isovolumetric relaxation

133
Q

During isovolumetric contraction and relaxation, both sets of values are ______ (opened/closed)

A

closed

134
Q

Pulmonary artery pressure peaks at _____ and has a low of ______.

A

~24mmHg, ~8mmHg

135
Q

Ventricular filling occurs during ______ (systole/diastole)

A

diastole

136
Q

Increased contractility _______ (increases/decreases) stroke volume (SV); increased preload _________ (increases/decreases) SV; increased afterload _________ (increases/decreases) SV.

A

increases; increases; decreases

137
Q

What is the equation for calculating ejection fraction (EF)?

A

EF = SV (stroke volume) / EDV (end diastolic volume)

138
Q

What is an inotropic drug?

A

A drug that changes contractility

139
Q

How do you calculate Pulse Pressure?

A

PP = SP (systolic pressure) - DP (diastolic pressure)

140
Q

What is the equation for Flow?

A

Flow = Change in Pressure / Resistance

141
Q

What is the equation for Compliance?

A

Compliance = Change in Volume / Change in Pressure

142
Q

True or False: Arteries have more elastic layers than veins.

A

True

143
Q

True or False: Arteries have a larger lumen than veins.

A

False

144
Q

In the pulmonary capillaries, a decrease in oxygen leads to ______ (relaxation/constriction).

A

constriction

145
Q

What is the equation for net pressure?

A

Pnet = Change in hydrostatic pressure - Change in osmotic force

146
Q

In arterioles, norepinephrine binding to alpha 1 receptors leads to __________, while binding to beta 2 receptors leads to __________.

A

vasoconstriction, vasodilation

147
Q

In vasculature, nitric oxide leads to __________.

A

vasodilation

148
Q

In vasculature, histamine leads to _______.

A

vasodilation

149
Q

In vasculature, endothelin leads to _______.

A

vasoconstriction

150
Q

Normal systolic pressure is _______ and normal diastolic pressure is ______.

A

<120mmHg, <80mmHg

151
Q

Prehypertension has a systolic pressure of _________ and a diastolic pressure of __________.

A

120-139mmHg, 80-89mmHg

152
Q

Stage 1 hypertension has a systolic pressure of __________ and a diastolic pressure of _________.

A

140-159mmHg, 90-99mmHg

153
Q

Stage 2 hypertension has a systolic pressure of __________ and a diastolic pressure of ___________.

A

> 160mmHg, >100mmHg

154
Q

In the brain, the cardiovascular control center is in the __________.

A

medulla oblongata

155
Q

What does GIRK stand for?

A

G protein-coupled inwardly-rectifying potassium channels

156
Q

What are the three ways that heart rate can be altered?

A

Change rate of depolarizing
diastolic potential; Shift maximum diastolic potential; Shift threshold for activation of AP

157
Q

What is afterload?

A

The pressure that the ventricle must produce to open a semilunar valve.

158
Q

What are baroreceptors?

A

Pressure-sensitive neurons that monitor stretching

159
Q

Long term regulation is by altering _______ in the system.

A

volume

160
Q

Short term regulation is by altering ______ and ______.

A

CO, TPR

161
Q

Cardiac shock is __________.

A

the failure of the cardiovascular system to deliver enough oxygen and nutrients to meet metabolic needs.

162
Q

In hypovolumetric shock, homeostatic mechanisms can compensate for an acute blood loss of as much as _____% of total blood volume.

A

10

163
Q

High hematocrit is called _________.

A

polycythemia

164
Q

Plasma proteins make up _______% of plasma.

A

7

165
Q

In hematopoiesis throughout life, the order goes __________.

A

yolk sac, liver, spleen, bone marrow

166
Q

_________ are metabolic disorders of the heme biosynthesis.

A

Porphyrias

167
Q

The rate of iron incorporation in heme is enhanced by the enzyme _________.

A

ferrochelatase

168
Q

Ferrochelatase is inhibited by _______.

A

lead

169
Q

What are the three steps in hemostasis?

A

Vascular Spasm – rapid vasoconstriction; Platelet Plug Formation; Blood coagulation (clotting)

170
Q

Platelet-derived growth factor
(PDGF) leads to the _________ of
endothelial cells, vascular smooth muscle, and fibroblasts.

A

proliferation

171
Q

___________’s primary function is binding to other proteins, in particular factor VIII, and it is important in platelet adhesion to wound sites

A

von Willebrand factor (vWF)

172
Q

PGI2 & NO _________ (inhibit/promote) platelet aggregation, while TXA2 _______ (inhibits/promotes) platelet aggregation.

A

inhibit, promotes

173
Q

The liver plays a role in blood clotting because it synthesizes bile salts and synthesizes _________.

A

clotting factors

174
Q

In blood clotting, the GI tract absorbs ______.

A

vitamin K

175
Q

What are the two anticlotting systems called?

A

Thrombin System, Fibrinolytic System

176
Q

In the thrombin system, thrombin acts as an anticoagulant by binding to thrombomodulin and activating ________, which inactivates clotting factors VIIIa and Va.

A

protein C

177
Q

In the thrombin system, thrombin acts as a procoagulant and cleaves fibrinogen to ________, activates clotting factors XI, VIII, V, and XIII, and stimulates _______ activation.

A

fibrin, platelet

178
Q

What are the four blood types (without Rh)?

A

A, B, AB, O

179
Q

True or False: There is an O antigen.

A

False, Type O is the absence A and B antigen

180
Q

Type ___ blood is the universal donor.

A

O-

181
Q

Type _____ blood is the universal acceptor.

A

AB+

182
Q

Hemolytic disease of the newborn (HDN) can occur when the mother is _____ (Rh+/Rh-) and the baby is ______ (Rh+/Rh-) due to the father. This does not affect the first pregnancy, but does affect subsequent pregnancies if the next baby is _____ (Rh+/Rh-).

A

Rh-, Rh+, Rh+

183
Q

The heart pumps _____ liters per minute.

A

5

184
Q

Intercalated discs contain ______ and ______ junctions.

A

desmosomes, gap

185
Q

The SA node is located in the walls of the _________ atrium.

A

right

186
Q

Funny (If) current is based on ________ (ion), and the channels are both voltage and ion-gated. It is enhanced with ___________ (parasympathetic/sympathetic) stimulation.

A

sodium, sympathetic

187
Q

Calcium leakage in failing hearts may be prevented and treated with ___________.

A

beta-blockers

188
Q

On an ECG, atrial depolarization is seen as a ___________.

A

P wave

189
Q

On an ECG, ventricular depolarization is seen as a __________.

A

QRS complex

190
Q

Capillaries are made up of single, squamous _________ cells.

A

endothelial

191
Q

Capillaries are the smallest blood vessels, ______ in diameter.

A

5-10 micrometers

192
Q

The tunica interna in veins and arteries is made up of __________.

A

endothelium

193
Q

The tunica media in veins and arteries is made up of __________.

A

smooth muscle

194
Q

____________ monitor blood chemistry.

A

Chemoreceptors

195
Q

___________ is the term for a decreased heart rate.

A

Bradycardia

196
Q

In regards to the parasympathetic system affecting heart rate, ACh decreases ________ current, opens _______, and reduces _______.

A

funny, GIRK, calcium current

197
Q

Some hormonal vasoconstrictors for arteries include _________.

A

epinephrine (sometimes, depends on receptor), angiotension II, vasopressin

198
Q

Some hormonal vasodilators for arteries include _________.

A

epinephrine (sometimes, depends on receptor), atrial natriuretic peptide (ANP)

199
Q

Chronic exercise (being trained) can _________ (increase/decrease) cardiac output, _______ (increase/decrease) resting heart rate, and _______ (increase/decrease) stroke volume.

A

increase, decrease, increase

200
Q

_______ shock is due to poor heart function.

A

Cardiogenic

201
Q

________ shock is due to inappropriate vasodilation.

A

Vascular

202
Q

________ shock is due to obstruction of blood flow.

A

Obstructive

203
Q

In compensating for blood loss, fixing the volume is done by fluid absorption from the __________.

A

interstitium

204
Q

_________ decrease cardiac output by increasing urinary excretion of sodium and water.

A

Diuretics

205
Q

________ blockers reduce cardiac output.

A

Beta-adrenergic receptor

206
Q

_______ blockers reduce contractility and lower total peripheral resistance.

A

Calcium-channel

207
Q

__________ inhibitors cause arteriolar vasodilation to lower total peripheral resistance, and cause a reduction in sodium reabsorption.

A

Angiotensin-converting enzyme (ACE)

208
Q

In centrifuged blood, _____% is plasma, _____% is red blood cells, and a tiny bit is the buffy coat (white blood cells and platelets).

A

55, 45

209
Q

The proteins in the plasma include __________.

A

Albumins, globulins, and fibrinogen

210
Q

________ (type of protein in plasma) help maintain osmotic pressure.

A

Albumins

211
Q

_________ (protein in plasma) plays an essential role in clotting.

A

Fibrinogen

212
Q

After the pluripotent stem cells in hematopoiesis, the two stem cells that create the branches of blood cells are ________ and _______.

A

Myeloid stem cell, Lymphoid stem cell

213
Q

Thrombopoietin stimulates progenitor cells leading to _________ from __________.

A

platelets, megakaryocytes

214
Q

What organ(s) release/s erythropoietin?

A

Kidneys

215
Q

Heme synthesis begins in the _________.

A

mitochondria

216
Q

RBCs circulate for around _____ days before being phagocytized by macrophages.

A

120 days

217
Q

In an adult, erythropoiesis occurs in the _________.

A

red bone marrow

218
Q

Formation of a platelet plug involves ________ feedback.

A

positive

219
Q

Fibrinogen is also known as Factor ___.

A

I

220
Q

Fibrin is also known as Factor ____.

A

Ia

221
Q

Prothrombin is also known as Factor ____.

A

II

222
Q

Thrombin is also known as Factor ____.

A

IIa

223
Q

The source of fibrinogen and prothrombin is the ______.

A

liver

224
Q

True or False: In the process of a reticulocyte becoming an erythrocyte, it loses its mitochondria and ribosomes.

A

True