Heart/Blood Flashcards
Generated from Lectures 18-23
The organ of propulsion in the circulatory system is the _______.
heart
The blood vessels responsible for the distribution of blood are the _______.
arteries
_______ serve as a pressure reservoir in the circulatory system.
Arteries
The transfer of materials between blood and tissues/cells occurs in the _______.
capillaries
_______ are responsible for returning blood to the heart.
Veins
Besides returning blood to the heart, the _______ also serve as a volume reservoir.
veins
The _______ side of the heart is associated with the respiratory system.
right
The _______ side of the heart is associated with the systemic circulation.
left
The _______ fluid adheres to the heart and reduces friction
pericardial
The smooth _______ minimizes surface friction in the heart.
endothelium
_______ prevents overstretching of the heart.
Fibrous pericardium
Inflammation of the pericardium is called _______.
pericarditis
The _______ valve is located between the left atrium and left ventricle.
mitral
The _______ valve is also known as the bicuspid valve.
mitral
Prolapse of the _______ valve can occur if there is too much blood volume.
mitral
The _______ valves open and close due to differential hydrostatic pressures
heart
The _______ ventricle has a thicker myocardial wall than the other ventricle.
left
The _______ valve is located between the right atrium and the right ventricle.
tricuspid
Cardiac muscle is also known as _______.
myocardium
The _______ node and atrioventricular node contain smaller myocardial fibers that are weakly contractile.
sinus
The liquid portion of blood is called _____.
plasma
Red blood cells contain the protein _____, which carries oxygen.
hemoglobin
The hormone _____ stimulates red blood cell production.
erythropoietin
Platelets release _____, which promotes blood vessel constriction.
thromboxane A2 (TXA2)
The protein _____ forms the meshwork of a blood clot.
fibrin
The _____ pathway of blood clotting is initiated by damage to the blood vessel wall.
extrinsic
Hemophilia is usually caused by a deficiency in clotting factor _____.
VIII
_____ is a medical condition characterized by a low red blood cell count.
Anemia
The _____ valve closing produces the “lub” sound of the heartbeat.
AV
The volume of blood in the ventricle at the end of diastole is called the _____.
end-diastolic volume (EDV)
The _____ is the volume of blood ejected from the left ventricle with each heartbeat.
stroke volume
How do you calculate stroke volume?
SV = EDV - ESV
_____ is the amount of blood pumped by the heart per minute.
Cardiac output
How is cardiac output calculated?
CO = HR x SV; cardiac volume = heart rate x stroke volume
An increase in _____ refers to an increase in the force of contraction of the heart muscle.
contractility
An increase in contractility in the heart leads to a _______ stroke volume for a given preload.
greater
__________ 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.
Ventricular preload
__________ refers to the systemic arterial pressure that the ventricle must overcome to open the aortic valve and eject blood.
Ventricular afterload
An increase in preload leads to an increase in _____.
stroke volume
An increase in afterload leads to a _____ in stroke volume.
decrease
The _____ wave of the ECG represents atrial depolarization.
P
The _____ complex corresponds to ventricular depolarization.
QRS
The _____ interval reflects the time it takes for the electrical impulse to travel from the atria to the ventricles.
PR
The _____ wave represents ventricular repolarization.
T
The _____ segment on the ECG should be flat and represents the period when the ventricles are contracting and the heart is ejecting blood.
ST
The _____ is the muscular layer of the heart responsible for its pumping action.
myocardium
The _____ valve is located between the left atrium and left ventricle, preventing backflow of blood.
mitral
The heart is enveloped by a protective sac called the _____, which reduces friction during heartbeats.
pericardium
The equation _____ describes the relationship between flow, pressure, and resistance in blood vessels, illustrating a fundamental concept in hemodynamics.
F = ΔP/R; Blood flow (F) is directly proportional to the pressure difference (ΔP) and inversely proportional to vascular resistance (R)
_____ are the blood vessels with the largest total cross-sectional area and the lowest flow velocity.
Capillaries
According to Poiseuille’s Law, blood vessel resistance is inversely proportional to _____ to the fourth power.
inner radius
An increase in _____ refers to an increase in the volume of blood returned to the heart via the venous system.
venous return
The _____ pressure is typically very low, close to 0 mm Hg.
venous
The _____ are the blood vessels primarily responsible for regulating resistance to blood flow.
arterioles
_____ 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.
Compliance
The equation to calculate compliance is ________.
Compliance = ΔV / ΔP
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.
True
___________ act as muscular valves, controlling blood flow into individual capillaries.
Precapillary sphincters
The _____ represents the average pressure exerted by blood against the walls of arteries during one cardiac cycle.
Mean Arterial Pressure (MAP)
The equation for calculating MAP is _________
MAP: MAP = DP + 1/3 (SP-DP); [DP = diastolic pressure, SP = systolic pressure}
The difference between systolic and diastolic blood pressure is known as the _____.
pulse pressure
The equation ___________, known as Poiseuille’s Law, mathematically describes the factors influencing resistance to blood flow in a blood vessel.
R = 8Lh / pr^4; Resistance = 8 (length)x(fluid viscosity) / (constant)x(inner radius)^4
The force that drives fluid movement across capillary walls is called _____.
net filtration pressure (NFP)
_____ are specialized structures in veins that prevent backflow of blood, ensuring unidirectional flow towards the heart.
Valves
An increase in _____ activity leads to vasodilation, increasing blood flow to tissues.
sympathetic
_____ is a measure of the total resistance encountered by blood flow in the systemic circulation.
Total peripheral resistance (TPR)
According to the _____ law, an increase in the volume of blood returning to the heart (venous return) leads to an increase in stroke volume.
Frank-Starling
_____ are sensory receptors located in the walls of arteries that monitor blood pressure.
Baroreceptors
_____ is the term for an abnormally elevated heart rate.
Tachycardia
_____ is the process of increasing the diameter of blood vessels, leading to decreased resistance and increased blood flow.
Vasodilation
_____ is the process of decreasing the diameter of blood vessels, leading to increased resistance and decreased blood flow.
Vasoconstriction
The _____ nervous system is responsible for increasing heart rate and contractility, preparing the body for “fight or flight” responses.
sympathetic
The _____ nervous system is responsible for decreasing heart rate, promoting rest and digestion.
parasympathetic
The percentage of red blood cells in a given volume of blood is known as the _____.
hematocrit
_____ are cell fragments in the blood that play a critical role in hemostasis by forming a plug at the site of vascular injury.
Platelets
The _____ nervous system acts to increase heart rate by increasing the inward sodium current (If) and increasing the inward calcium current (Ica).
sympathetic
A(n) _____ agent increases the strength of heart contractions at any given preload.
positive inotropic
Long-term regulation of blood pressure primarily involves adjustments in _____.
blood volume
_____ 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.
Hypovolemic
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.
dicrotic notch
The second heart sound, often described as a “dub” sound, is associated with the closure of the _____ valves.
aortic and pulmonary
______ refers to the increase in ventricular volume during diastole due to the continued inflow of blood from the atria.
Ventricular filling
_______ channels play a critical role in the plateau phase of a ventricular action potential, contributing to the prolonged refractory period observed in cardiac muscle.
L-type calcium (Ca2+)
The _______ node is the primary pacemaker of the heart, initiating the electrical impulses that regulate the heartbeat.
SA
The heart controls both the __________ circulation and the __________ circulation.
systemic, pulmonary
True or False: There are different average pressures in the pulmonary and systemic circulations.
True
The distribution of blood volume is _____% in the heart, _____% in the pulmonary circulation, and ______% in the systemic circulation.
15% heart, 12% pulmonary, 73% systemic
The distribution of blood volume in the systemic circulation is _____% in the arteries, ______% in the veins, and ______% in the capillaries.
16-18% arteries, 50% veins, 5-7% capillaries
The fibrous division between the left and right ventricle is called the __________.
interventricular septum
Values open and close in the heart due to differential ________ pressure.
hydrostatic
Your heart beats about _________ times in one day and about _________ times in a year.
100,000 times, 35 million times
Blood enters the heart from the systemic circulation through the ________.
right atrium
Blood enters the heart from the pulmonary circulation through the _________.
left atrium
The left and right _______ arteries deliver blood to the heart; the _________ veins drain blood from the heart into the __________.
coronary, coronary, coronary sinus
Cardiac muscle fibers connect to neighboring fibers by __________.
intercalated discs
In the heart, ________ and gap junctions are used to allow exchange between cells.
desmosomes
Describe the order of conduction in the heart starting with the Sinoatrial node (SA).
SA node – Atrioventricular node (AV) – Bundle of His – Right and Left Bundle Branches – Purkinje Fibers
True or False: Purkinje fibers are located at the apex of the heart.
True
In order, the heart undergoes ________ excitation, followed by ________ excitation.
atrial, ventricular
The SA node has two types of cells: _______ and ________.
round (pacemaker) cells, elongated (conductive, no contraction) cells
In a graph of the action potential for the heart, the pacemaker potential is what part of the graph?
The rise from resting membrane potential to threshold
The resting membrane potential in the ventricular contractile fibers in the heart is around ______ mV.
-90 mV
The purposes of the three types of myocardial fibers are ____________, _____________, and___________.
pacemaker (SA/AV), spreading excitation (ventricular wall), doing the contraction work (rest of them)
True or False: pacemaker action potentials and ventricular muscle cell action potentials look the same.
False, pacemaker look similar to neuronal while ventricular have a plateau phase (calcium enters and potassium leaves)
The two types of calcium channels in the heart are ____-type and ___-type.
T (transient opening) and L (long-lasting)
In the heart, L-type calcium channels (DHPRs) and _______ are not physically coupled.
ryanodine receptors
Primary ryanodine receptor isoform found in the heart is ______.
RyR2
In the heart, ryanodine receptors are _________-sensitive.
calcium
Metabolism in cardiac fibers is almost exclusively through ______________.
aerobic cellular respiration
Cardiac cells also can metabolize lactic acid into _____.
ATP
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.
calstabin
An important contributor to impaired calcium handling in heart failure is PKA hyperphosphorylation of _____; the long-term effect is depletion of SR calcium stores.
RyR2
In pacemaker cells, sympathetic stimulation via norepinephrine release _______ (increases/decreases) the rate of action potentials.
increases
In pacemaker cells, parasympathetic stimulation via acetylcholine release _______ (increases/decreases) the rate of action potentials.
decreases
Rate of the ___________ (hyperpolarization/depolarization) determines the pacemaker rate.
depolarization
______ (Fast/Slow) depolarization is called the pacemaker potential
Slow
True or False: Only the contractile muscle
depolarization is seen on the EKG.
True (atrial repolarization cannot be seen)
The P-R interval in an ECG is _____________, which is 0.12 - 0.2 seconds in a healthy heart.
the speed of A-V conduction
Blood pressure is determined by ______ over _________; for instance, 120/80
systolic pressure, diastolic pressure
The Q-T interval is __________, whose speed varies with heart rate.
electrical systole
Diastole occurs after which segment of an ECG?
T wave
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.
True
In a partial AV block, the ECG has ___________.
Occasional P wave without a coupled QRS
In a complete AV block, the ECG has ___________.
P waves not coupled to QRS
(random)
A first-degree AV block has a long _______ interval.
P-Q
An ECG of atrial fibrillation has ___________.
Irregular R-R intervals, and no detectable P waves
If Pressure in ventricle > Pressure in atrium, then the ______ valve closes.
bicuspid/tricuspid
If Pressure in ventricle > Pressure in aorta, then the _______ valve opens.
aortic
If Pressure in aorta > Pressure in ventricle, then the ______ valve closes.
aortic
If Pressure in atrium > Pressure in ventricle, then the _______ valve opens.
bicuspid/tricuspid
There are _____ auscultation sites in the heart.
four
What are the four phases of the cardiac cycle?
Ventricular filling, Isovolumetric contraction, Ventricular ejection, Isovolumetric relaxation
During isovolumetric contraction and relaxation, both sets of values are ______ (opened/closed)
closed
Pulmonary artery pressure peaks at _____ and has a low of ______.
~24mmHg, ~8mmHg
Ventricular filling occurs during ______ (systole/diastole)
diastole
Increased contractility _______ (increases/decreases) stroke volume (SV); increased preload _________ (increases/decreases) SV; increased afterload _________ (increases/decreases) SV.
increases; increases; decreases
What is the equation for calculating ejection fraction (EF)?
EF = SV (stroke volume) / EDV (end diastolic volume)
What is an inotropic drug?
A drug that changes contractility
How do you calculate Pulse Pressure?
PP = SP (systolic pressure) - DP (diastolic pressure)
What is the equation for Flow?
Flow = Change in Pressure / Resistance
What is the equation for Compliance?
Compliance = Change in Volume / Change in Pressure
True or False: Arteries have more elastic layers than veins.
True
True or False: Arteries have a larger lumen than veins.
False
In the pulmonary capillaries, a decrease in oxygen leads to ______ (relaxation/constriction).
constriction
What is the equation for net pressure?
Pnet = Change in hydrostatic pressure - Change in osmotic force
In arterioles, norepinephrine binding to alpha 1 receptors leads to __________, while binding to beta 2 receptors leads to __________.
vasoconstriction, vasodilation
In vasculature, nitric oxide leads to __________.
vasodilation
In vasculature, histamine leads to _______.
vasodilation
In vasculature, endothelin leads to _______.
vasoconstriction
Normal systolic pressure is _______ and normal diastolic pressure is ______.
<120mmHg, <80mmHg
Prehypertension has a systolic pressure of _________ and a diastolic pressure of __________.
120-139mmHg, 80-89mmHg
Stage 1 hypertension has a systolic pressure of __________ and a diastolic pressure of _________.
140-159mmHg, 90-99mmHg
Stage 2 hypertension has a systolic pressure of __________ and a diastolic pressure of ___________.
> 160mmHg, >100mmHg
In the brain, the cardiovascular control center is in the __________.
medulla oblongata
What does GIRK stand for?
G protein-coupled inwardly-rectifying potassium channels
What are the three ways that heart rate can be altered?
Change rate of depolarizing
diastolic potential; Shift maximum diastolic potential; Shift threshold for activation of AP
What is afterload?
The pressure that the ventricle must produce to open a semilunar valve.
What are baroreceptors?
Pressure-sensitive neurons that monitor stretching
Long term regulation is by altering _______ in the system.
volume
Short term regulation is by altering ______ and ______.
CO, TPR
Cardiac shock is __________.
the failure of the cardiovascular system to deliver enough oxygen and nutrients to meet metabolic needs.
In hypovolumetric shock, homeostatic mechanisms can compensate for an acute blood loss of as much as _____% of total blood volume.
10
High hematocrit is called _________.
polycythemia
Plasma proteins make up _______% of plasma.
7
In hematopoiesis throughout life, the order goes __________.
yolk sac, liver, spleen, bone marrow
_________ are metabolic disorders of the heme biosynthesis.
Porphyrias
The rate of iron incorporation in heme is enhanced by the enzyme _________.
ferrochelatase
Ferrochelatase is inhibited by _______.
lead
What are the three steps in hemostasis?
Vascular Spasm – rapid vasoconstriction; Platelet Plug Formation; Blood coagulation (clotting)
Platelet-derived growth factor
(PDGF) leads to the _________ of
endothelial cells, vascular smooth muscle, and fibroblasts.
proliferation
___________’s primary function is binding to other proteins, in particular factor VIII, and it is important in platelet adhesion to wound sites
von Willebrand factor (vWF)
PGI2 & NO _________ (inhibit/promote) platelet aggregation, while TXA2 _______ (inhibits/promotes) platelet aggregation.
inhibit, promotes
The liver plays a role in blood clotting because it synthesizes bile salts and synthesizes _________.
clotting factors
In blood clotting, the GI tract absorbs ______.
vitamin K
What are the two anticlotting systems called?
Thrombin System, Fibrinolytic System
In the thrombin system, thrombin acts as an anticoagulant by binding to thrombomodulin and activating ________, which inactivates clotting factors VIIIa and Va.
protein C
In the thrombin system, thrombin acts as a procoagulant and cleaves fibrinogen to ________, activates clotting factors XI, VIII, V, and XIII, and stimulates _______ activation.
fibrin, platelet
What are the four blood types (without Rh)?
A, B, AB, O
True or False: There is an O antigen.
False, Type O is the absence A and B antigen
Type ___ blood is the universal donor.
O-
Type _____ blood is the universal acceptor.
AB+
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-).
Rh-, Rh+, Rh+
The heart pumps _____ liters per minute.
5
Intercalated discs contain ______ and ______ junctions.
desmosomes, gap
The SA node is located in the walls of the _________ atrium.
right
Funny (If) current is based on ________ (ion), and the channels are both voltage and ion-gated. It is enhanced with ___________ (parasympathetic/sympathetic) stimulation.
sodium, sympathetic
Calcium leakage in failing hearts may be prevented and treated with ___________.
beta-blockers
On an ECG, atrial depolarization is seen as a ___________.
P wave
On an ECG, ventricular depolarization is seen as a __________.
QRS complex
Capillaries are made up of single, squamous _________ cells.
endothelial
Capillaries are the smallest blood vessels, ______ in diameter.
5-10 micrometers
The tunica interna in veins and arteries is made up of __________.
endothelium
The tunica media in veins and arteries is made up of __________.
smooth muscle
____________ monitor blood chemistry.
Chemoreceptors
___________ is the term for a decreased heart rate.
Bradycardia
In regards to the parasympathetic system affecting heart rate, ACh decreases ________ current, opens _______, and reduces _______.
funny, GIRK, calcium current
Some hormonal vasoconstrictors for arteries include _________.
epinephrine (sometimes, depends on receptor), angiotension II, vasopressin
Some hormonal vasodilators for arteries include _________.
epinephrine (sometimes, depends on receptor), atrial natriuretic peptide (ANP)
Chronic exercise (being trained) can _________ (increase/decrease) cardiac output, _______ (increase/decrease) resting heart rate, and _______ (increase/decrease) stroke volume.
increase, decrease, increase
_______ shock is due to poor heart function.
Cardiogenic
________ shock is due to inappropriate vasodilation.
Vascular
________ shock is due to obstruction of blood flow.
Obstructive
In compensating for blood loss, fixing the volume is done by fluid absorption from the __________.
interstitium
_________ decrease cardiac output by increasing urinary excretion of sodium and water.
Diuretics
________ blockers reduce cardiac output.
Beta-adrenergic receptor
_______ blockers reduce contractility and lower total peripheral resistance.
Calcium-channel
__________ inhibitors cause arteriolar vasodilation to lower total peripheral resistance, and cause a reduction in sodium reabsorption.
Angiotensin-converting enzyme (ACE)
In centrifuged blood, _____% is plasma, _____% is red blood cells, and a tiny bit is the buffy coat (white blood cells and platelets).
55, 45
The proteins in the plasma include __________.
Albumins, globulins, and fibrinogen
________ (type of protein in plasma) help maintain osmotic pressure.
Albumins
_________ (protein in plasma) plays an essential role in clotting.
Fibrinogen
After the pluripotent stem cells in hematopoiesis, the two stem cells that create the branches of blood cells are ________ and _______.
Myeloid stem cell, Lymphoid stem cell
Thrombopoietin stimulates progenitor cells leading to _________ from __________.
platelets, megakaryocytes
What organ(s) release/s erythropoietin?
Kidneys
Heme synthesis begins in the _________.
mitochondria
RBCs circulate for around _____ days before being phagocytized by macrophages.
120 days
In an adult, erythropoiesis occurs in the _________.
red bone marrow
Formation of a platelet plug involves ________ feedback.
positive
Fibrinogen is also known as Factor ___.
I
Fibrin is also known as Factor ____.
Ia
Prothrombin is also known as Factor ____.
II
Thrombin is also known as Factor ____.
IIa
The source of fibrinogen and prothrombin is the ______.
liver
True or False: In the process of a reticulocyte becoming an erythrocyte, it loses its mitochondria and ribosomes.
True
