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Hemodynamics Flashcards

1
Q

This refers to the mechanisms which we deliver the right amount of blood to the right location at the right time

A

Hemodynamics

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2
Q

What is the driving factor of blood flow?

A

Pressure gradients

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3
Q

What two factors does blood flow rely on?

A
  1. Cardiac output
  2. Blood flow resistance
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4
Q

This describes how much blood the heart is pumping out

A

Cardiac output

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5
Q

This refers to the tendency for vascular to push blood back to the heart

A

Bloodflow resistance

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6
Q

What is the equation to find cardiac output?

A

Cardiac output = stroke volume (SV) x heart rate (HR)

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7
Q

How do you calculate stroke volume?

A

SV = EDV - ESV

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8
Q

What does EDV stand for

A

End diastolic volume

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9
Q

What does ESV stand for

A

End systolic volume

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10
Q

How to calculate ejection fraction

A

Ejection fraction = SV / EDV

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11
Q

What are the two variables to change that can influence cardiac output

A
  1. Heart rate
  2. Stroke volume
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12
Q

What organ determines the sympathetic and parasympathetic stimulation needed to adjust heart rate (+ maintain bp)

A

Medulla oblongata

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13
Q

How does a positive chronotrope affect heart rate?

A

Increases heart rate

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14
Q

How does a negative chronotrope affect the heart?

A

Decreases heart rate

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15
Q

What three factors does stroke volume depend on?

A
  1. Venous return
  2. Resistance
  3. Contractility
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16
Q

Greater venous return does what?

A

Increases end diastolic volume (EDV)

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17
Q

How does greater resistance affect the heart?

A

Decreases stroke volume

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18
Q

What are the two types of contractility factors?

A
  1. Intrinsic
  2. Extrinsic
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18
Q

What are the two types of contractility factors?

A
  1. Intrinsic
  2. Extrinsic
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19
Q

What are two intrinsic contractility factors?

A
  1. Frank-starling Law of the Heart
  2. Rate-induced regulation (treppe)
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20
Q

What are the extrinsic factors that affect contractility?

A

Epinephrine and norepinephrine

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21
Q

How do epi and norepinephrine increase contractility?

A

Increase Ca²+ availability

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22
Q

Changes in what affect the force of contraction?

A

Peak Ca²+ concentrations; sarcomere length

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23
Q

According to the Frank-Starling Law, larger heart volume results in what?

A

Stronger contraction

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24
According to Frank-Starling Law, a smaller heart volume results in what?
Weaker contraction
25
The sarcomere stretch is determined by what?
End diastolic volume
26
Why does a larger heart volume result in a larger heart contraction?
Heart needs to get to the same end volume (requires more force)
27
What's a potential downside to the frank-starling law
Rise in blood pressure
28
How is contractility augmented by the sympathetic system? (3)
1. Increase in systole duration 2. More depolarizations/min 3. Higher diastolic Ca²+ concentrations
29
What 3 hormones influence the macroscopic blood volume
1. Aldosterone 2. Antidiuretic hormones 3. Atrial natriuretic hormone
30
Where is atrial natriuretic hormone produced? What is the response to it?
Right atrium; increased H2O/Na+ excretion from kidneys
31
What is the response to aldosterone?
Retention of Na+ and H2O
32
How do fluids move at the microscopic level?
Constantly through interstitial, intracellular, and vascular components
33
About how many total liters of fluid are present in the intracellular and extracellular levels?
~50 Liters
34
Whats the arteriolar fluid movement pressure for the capillaries
10 mmHg out
35
What's the venous fluid movement pressure at the capillary level?
7 mmHg in
36
What is driven by selective permeabilty?
Oncotic pressure
37
About what percent of water that leaves the plasma is recaputure?
90%
38
About what percent of water is indirectly returned to the plasma via the lymphatics?
10%
39
What is Poiseuille's Law used for?
Resistance prediction for cylindrical tubes and newtonian fluids
40
Blood flow varies directly with the fourth power of what?
vessel radius
41
vasoconstriction is caused by..?
sympathetic nervous system
42
vasodilation is caused by...?
withdrawal of sympathetic tone
43
Vaso constriction does what to downstream circulation?
restricts
44
vasodilation does what to downstream circulation?
opens
45
The most blood resistance change occurs at what vessels?
arterioles
46
In regards to blood flow, organ systems are ordered in what?
parallel
47
What are 3 advantages of a parallel arrangement of organ systems?
1. constant O2 supply 2. can divert blood flow 3. pressure gradient maintenance
48
What are the 3 cardiovascular responses to exercise (or increased metabolic demand)
1. increased cardiac output 2. decreased total peripheral resistance 3. diversion of blood
49
During exercise, most blood diverts where? about what percentage is this?
skeletal muscles; 80-85%
50
At rest, most blood diverts where?
GI tract, kidneys, brain, skeletal muscles
51
What are two types of extrinsic controls of vasoconstriction/dilation?
1. autonomic innervation 2. paracrine controls
52
In fight or flight responses, what will cholinergic fibers do to vessels?
cause vasodilation
53
in fight or flight responses, adrenergic fibers will do what (regarding blood flow)?
close sphincters (gut and skin) to divert blood flow
54
The parasympathetic nervous system is ALWAYS what?
cholinergic and vasodilatory
55
What are 2 types of intrinsic controls regarding vasoconstriction/dilation?
1. myogenic 2. metabolic
56
This type of intrinsic control maintains constant flow in organs.
myogenic
57
This type of intrinsic control responds to local conditions to trigger vasodilation
metabolic
58
when blood pressure is high, myogenic control will do what to vascular smooth muscle?
constricts to prevent vessel rupture
59
when blood pressure is low, myogenic control will do what to vascular smooth muscle?
dilates to maintain flow
60
What three metabolic conditions will trigger vasodilation?
1. decreased O2 2. increased CO2 3. low pH
61
What can happen (metabolically) when a tourniquet is applied?
increased CO2 and acidity
62
When a tourniquet is released, this can cause what?
hyperemia
63
What are 3 keys to regulating blood pressure?
1. blood volume 2. cardiac output 3. peripheral resistance
64
The homeostasis of blood pressure is primarily regulated by what?
medulla oblongata
65
The medulla oblongata receives input from what (in regards to blood pressure)?
1. baroreceptors 2. chemoreceptors 3. ischemia
66
These receptors in the aorta and carotid are responsible for sending input about pressure to the medulla oblongata
baroreceptors
67
These receptors in the aorta and carotid are responsible for sending input about O2 and CO2 to the medulla oblongata
chemoreceptors
68
these receptors that sense low O2 are found within the medulla oblongata itself
ischemia receptors
69
The AP of baroreceptors increases regarding what conditions?
elevated blood pressure
70
the system in place to stop bleeding response to injury
coagulation system
71
Cells will naturally secrete what 3 things when experiencing no injury?
1. prostaglandin I2 2. nitric oxide 3. CD39
72
What is the purpose of CD39
breaks down ADP into AMP and Pi
73
What prevents clotting (not secretions)?
intact endothelium
74
this describes the stopping of bleeding
hemostasis
75
what two things recruits more platelets?
1. ADP 2. Thromboxane A2
76
Platelets will initially bind to
exposed collagen
77
What factor holds aggregating platelets together?
Von Willebrand Factor
78
Activated plasma clotting factors, leads to the development of what?
fibrin
79
polymerized fibrin fragments do what?
"glue" platelets, WBCs, and RBCs
80
A thickening of the tunica intima due to deposition of lipid, connective tissue, and inflammatory cells
Atheromatous plaques
81
What is the #1 killer in North America?
Artherosclerosis
82
Excess LDLs will likely become responsible for the formation of what?
Atheromatous plaques
83
What is the primary job of LDLs
transport cholesterol to tissues
84
What is the primary job of HDLs?
returns excess cholesterol back to the liver
85
The attempted phagocytosis of LDLs via macrophages produces what?
Foam Cells

Physio (7 decks)

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