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CV phys > Heller Ch. 10 > Flashcards

Heller Ch. 10 Flashcards

1
Q

What are the three ways of INCREASING stroke volume?

A

Increase preload
Increase contractility
Decrease afterload

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2
Q

What is proportional to preload?

A

Central blood volume

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3
Q

What are six ways of INCREASING central blood volume? (Thus increasing preload, thus increasing SV)

A 
Increase total blood volume
Increase peripheral venous tone
Increase skeletal muscle pump
Increase respiratory pump
Decrease standing
Decrease cardiac output
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4
Q

What increases contractility? (Thus increasing SV)

A

Increased sympathetic activity (NE–>beta receptors)

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5
Q

What increases venous tone? (Thus increasing central blood volume, thus increasing preload, thus increasing SV)

A

Increased sympathetic activity (NE–>alpha receptors)

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6
Q

What is proportional to afterload?

A

TPR (arterial tone)

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7
Q

What are two ways to DECREASE TPR? (Thus decrease preload, thus increase SV)

A

Decrease sympathetic activity (NE–>alpha receptor)

Increase local metabolites (increase local metabolic rate)

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8
Q

How does the “respiratory pump” (deep and rapid breathing) promote venous return? (Thus increase central blood volume, thus increase preload, thus increase SV)

A

Inspiration decreases thoracic pressure

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9
Q

What is one possible concern with a respirator?

A

A respirator increases thoracic pressure…may have CV implications

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10
Q

What happens when lung mechanoreceptors are stretched?

A

Vagal activity is INHIBITED–>increased HR

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11
Q

What response do cardiopulmonary baroreceptors have after inspiration?

A

Increase parasympathetic activity in the heart

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12
Q

What is the net effect of inspiration on blood pressure?

A

Blood pressure is increased (increased SV and HR)

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13
Q

What is the arterial baroreceptor response to the increased blood pressure?

A

Inhibit sympathetic activity

Increase parasympathetic activity

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14
Q

What is the valsalva maneuver? What are some examples?

A

Forced expiration against a closed glottis

Taking a big ol’ dukie
Heavy lifting

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15
Q

What are the consequences of the valsalva maneuver?

A

Increased arterial pressure (particularly on aorta)–> Fall in venous return and BP–>
Compensatory reflex increase in HR and TPR

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16
Q

What happens upon cessation of the valsalva maneuver?

A

Abrupt fall in BP (reduced intrathoracic pressure)
Increased peripheral return–> increased CVP–>
Increased SV, CO, MAP–>
Bradycardia

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17
Q

What combo/series of blood pressures can lead to a stroke?

A

High venous pressure… Followed by

High arterial and pulse pressure

18
Q

What effect does standing have on venous transmural pressure in the lower extremities?

A

Transmural pressure is increased…decreases central venous return

19
Q

What happens as a result of increased transmural pressure in the lower extremities?

A

Distends the compliant peripheral veins

Increases venous volume

20
Q

What happens to transcapillary filtration rate upon standing?

A

Increased filtration rate…due to increased arterial pressure

21
Q

What causes weight loss and hypovolemia upon long-term bed rest?

A

The kidney

22
Q

What is the concern about standing after long-term bed rest?

A

Shifting an already low blood volume from central to periphery–>dizziness

23
Q

What effect does exercise have on skeletal muscle vascular resistance–>TPR?

A

Exercise decreases the resistance

24
Q

What is the effective of decreased TPR?

A

Decreased arterial pressure (MAP=COxTPR)

25
Q

What is the end result of exercise on pressure regulation?

A

Decreased parasympathetic activity

Increased sympathetic activity

26
Q

What causes the decreased parasympathetic/increased sympathetic activity during exercise?

A

Increased set point from the cerebral cortex and increased skeletal muscle chemo/mechano receptor activity
Decreased arterial baroreceptor firing

27
Q

What are CV responses to dynamic exercise?

A

Skeletal muscle pump
Respiratory pump
Increased cardiac reserve

28
Q

What is a major difference between dynamic and static exercise?

A

Dynamic has a significantly larger fall in TPR

29
Q

What are the CV responses to static exercise?

A

Less of an increase in HR and CO

More increase in diastolic/systolic/mean pressures

30
Q

What is the biggest advantage (from a CV perspective) of exercise?

A

Increased blood volume

31
Q

Other than increased blood volume, what are some other CV benefits of exercising?

A

Decreased HR
Increased SV
Decreased resting MAP

32
Q

What is the effect of the placenta on TPR?

A

The placenta decreases TPR by 40%

33
Q

What is the percent increase in blood volume of pregos?

A

50%

34
Q

What adjustment do arterioles go through after birth?

A

From thick-walled and small-diameter to thin-walled and large-diameter

35
Q

What cardiac changes are age-dependent?

A

Decrease in resting and maximum cardiac index
Decrease in maximum HR
Increase in contraction and relaxation time
Increase in myocardial stiffness during diastole
Decrease in number of functioning myocytes
Accumulation of pigment in the myocardial cells

36
Q

What vascular changes are age-dependent?

A

Decrease in capillary density in some tissues
Decrease in arterial and venous compliance
Increase in TPR

37
Q

What is the effect of age-related increase in TPR?

A

Increase in pulse pressure

Increase in MAP–>increased afterload–> decreased cardiac index

38
Q

What does estrogen directly do for the CV?

A

Lowers arterial BP
Greater aortic compliance
Improved ability to induce vasodilatory mechanisms

39
Q

What is the result of the changes estrogen has on the CV?

A

Lower cardiac afterload–>lower LV mass:body mass index

40
Q

What are other cardiac differences are there between men and women?

A

Women:
Have lower HR
Longer QT (greater risk of long-QT syndrome and Torsades)
Twice as likely to have AV nodal re-entry tachycardias

CV phys (11 decks)

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