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Block 2 Week 3 > Integrated Control of the Cardiovascular System > Flashcards

Integrated Control of the Cardiovascular System Flashcards

1
Q

What is the ultimate function of the circulatory system?

A

To maintain blood flow

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2
Q

The ultimate goal of the integrated control
of the circulation is to maintain (blank)
to the tissues to the optimum extent.

A

blood flow

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3
Q

The cardiovascular system is

regulated by so many (blank), its responses are rarely simple.

A

feedback control

loops

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4
Q

(blank) is the venous pressure that results in filling of the heart in diastole (largely depends on venous return)

A

preload

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5
Q

(blank) is the pressure (force) against which the heart must work to eject blood (largely depends on aortic pressure)

A

afterload

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6
Q

What is the equation for cardiac output? What is cardiac output?

A

the volume of blood ejected from the heart per unit time

CO = HR x SV

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7
Q

What is stroke volume and what is the equation?

A

the volume of blood ejected from the heart with each beat

SV = EDV - ESV

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8
Q

What is total peripheral resistance?

A

The total resistance to the flow of blood from the aorta back to the right atrium. Arterioles are the major regulator of peripheral resistance.

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9
Q

What four concepts effect cardiac output?

A

heart rate, myocardial contractility, preload (central venous pressure), afteroload (peripheral resistance)

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10
Q

What are the cardiac factors of cardiac output?

A

heart rate and myocardial contractility

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11
Q

What are the coupling factors of cardiac output?

A

afterload (peripheral resistance) and preload (central venous pressure)

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12
Q

What is the central venous pool?

A

greate veins in thorax and right atrium

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13
Q

(blank) depends on arterial pressure and local vascular resistance

A

tissue perfusion (q)

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14
Q

What is the equation for tissue perfusion?

A

Q (Flow) = MAP / R

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15
Q

(blank) depends on cardiac output and total peripheral resistance

A

arterial pressure

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16
Q

What is the equation for arterial pressure?

A

MAP = CO x TPR

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17
Q

What is determined by stroke volume, aortic distensibility and ejecting velocity

A

Systolic pressure

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18
Q

What is determined by systolic pressure, aortic distensibility, heart rate and peripheral resistance

A

diastolic pressure

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19
Q

(blank) and (blank) play key roles in regulating blood pressure, particularly within short time frames.

A

The autonomic nervous system and the baroreceptors

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20
Q

However, from long-range point of view, 1) the control of fluid balance by the (blank) , 2) (blank), and 3) (blank), with 4)(blank) , is of greatest importance.

A

kidney
adrenal cortex
central nervous system
maintenance of a constant blood volume

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21
Q

explain what will happen when you have an increase in blood pressure?

A

you will get stretch of carotid artery-> depolarization of baroreceptor-> increase firing of afferent nerve-> response from medulla-> decrease sympathetic output-> decrease vascular smooth muscle tone

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22
Q

What three things can effect EDV?

A

filling pressure, filling time, ventricular compliance

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23
Q

What four things effect ESV?

A

heart rate, preload, afterload, contractility

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24
Q

What three things effect intrinsic regulation?

A

threshold potential, maximum diastolic pontential, slope of diastolic depolarization

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25
Q

What 2 things effect extrinsic?

A

ANS, humoral factors

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26
Q

What affect cardiac output?

A

stroke volume, and heart rate

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27
Q

What regulates precapillary sphinctors?

A

oxygen need and local metabolic factors

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28
Q

What two thins do the ANS control?

A

extrinisic regulation and systemic vasomotor control

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29
Q

What makes up the total peripheral resistance?

A

the local vasomotor control and the systemic vasomotor control

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30
Q

Cardiovascular system controls and interacts with (blank)

A

other non circulatory systems

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31
Q

In any well-regulated system, one way to study the extent and sensitivity of its regulatory mechanisms is to (blank) the system and observe how it restores the preexisting steady state.

A

disturb

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32
Q

(blank X 3) these conditions cause primary changes in either cardiac output or total peripheral resistance that must be matched by compensatory changes elsewhere.

A

gravity, hemorrahage, exercise

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33
Q

Cardiac output is primarily determined by the (blank) , whereas total peripheral resistance is determined primarily by the status of the (blank).

A

status of the heart

resistance vessels

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34
Q

What will gastrointestinal asborption and renal excretion of salt and water effect?

A

total blood volume-> end-diastolic volume-> stroke volume

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35
Q

What will mean arterial pressure effect?

A

Pathway 1: capillary filtration/absoprtion-> total blood volume-> stroke volume
Pathway 2: myogenic activity->autoregulation->arteriolar radius->total peripheral resistance

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36
Q

What will respiration or Skeletal muscle contraction effect?

A

venomotor pump-> venous return-> end disatolic volume-> stroke volume

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37
Q

What will venomotor tone effect?

A

venous return-> End diastolic volume

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38
Q

What will sympathetic nerve activity or circulatin epinepherine effect?

A

Pathway 1: contractility -> End diastolic volume-> stroke volume
Pathway 2: heart rate
pathway 3: arteriolar radius-> total peripheral resistance

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39
Q

What will metabolic factors effect?

A

autoregulation-> arteriolar radius-> total peripheral resistance

40
Q

What will angiotensin effect?

A

autoregulation->arteriolar radius->total peripheral resistance

41
Q

Sympathetic, norepinephrine, epinephrine and metabolic control ultimately effect what?

A

arteriolar radius->total peripheral resistance-> mean arterial pressure

42
Q

What does blood volume, respiratory pump, and skeletal pump ultimately effect?

A

venous return-> stroke volume-> cardiac output-> mean arterial pressure

43
Q

What does parasympathetic and sympathetic ultimately effect?

A

heart rate-> cardiac output-> mean arterial pressure

44
Q

What makes this happen:

  • to increase the pressure of any blood vessel below the level of the heart, and
  • to decrease the pressure of any blood vessel above the level of the heart.
A

effect of gravity

45
Q

In humans, most of the blood volume is located (blank) the level of the heart in the standing position (unlike quadrupeds in which 70% of blood volume is at or above heart level).

A

below

46
Q

(blank) are critical in maintaining orthostasis

A

Mechanical responses
( muscle pump, venous valves
respiratory pump)

47
Q

The (blank) is critical in maintaining (blank)

A

orthostasis

48
Q

(blank) is composed of skeletal muscles of the legs and venous valves.

A

Muscle pump

49
Q

During leg muscle contractions blood is expelled from the itramusclar veins towards the (blank)

A

heart

50
Q

During inspiration, venous blood is sucked back into the thorax, increasing (blank)

A

venous return and preload.

51
Q

What occurs when an individual moves from supine position to a standing position?

A

1) pooling in blood in lower extremities
2) increased local venous pressure
3) Blood volume and venous return decrease.
4) Stroke volume and cardiac output decrease (Frank-Starling relationship).
5) arterial pressure decreases because of the reduction in cardiac output.
6) The carotid sinus baroreceptors respond to the decrease in arterial pressure by decreasing the firing rate of the carotid sinus nerves.
7) increases sympathetic outflow to the heart and blood vessels and decreases parasympathetic outflow to the heart.-> increased heart rate, arterial constriction and venoconstriction, and ultimately restored venous return, cardiac output and blood pressure.
8) increase in renin and aldosterone
9) Cerebral adjustments consisting in cerebral dilatation due to adjustments in pH, PO2, PCO2 and increased O2 extraction will keep O2 consumption constant.

52
Q

With prolonged standing capillary filtration (blank) venous return

A

reduces

53
Q

Orthostatic pressure causes the body to (blank) compliance in the lower extremities thus increasing the flow of blood to the heart.

A

reduces

54
Q

During a postural change from supine to standing, there is postural displacement of venous blood. Venous valves prevent backward flow, so blood does not flow backward in the inferior vena cava to the lower extremities. Upon standing venous valves close, but the heart keeps pumping blood forward. The additional venous blood blank) the valves and blood is propelled toward the heart.

A

opens

55
Q

What is the response to going from supine to standing?

A

Mechanical responses and ANS

56
Q

What are the mechanical responses when going from supine to standing?

A

muscle pump, venous valves

respiratory pump

57
Q

What are the ANS responses when going from supine to standing?

A 
Decreased efferent vagal nerve activity
  increased heart rate
  Increased efferent sympathetic activity
  increased heart rate, contractility
  peripheral vasoconstriction
  splanchnic venoconstriction
58
Q

the (blank) is critical in maintainin orthostasis/

A

muscle pump

59
Q

What is the muscle pump composed of?

A

skeletal muscle of the legs and venous valves

60
Q

During leg muscle contraction blood is expelled from the (blank) towards the heart.

A

intramuscular veins

61
Q

During (blank), venous blood is sucked back into the thorax, increasing venous return and preload.

A

Inspiration

62
Q

With prolonged standing, capillary filtration (blank) venous return.

A

reduces

63
Q

How do you compensate for loss of blood and therefore decreased cardiac output and arterial pressure?

A

baroreceptors sense this and increase sympathetic nerve activity to increase vasoconstriction, TPR, heart rate, CO, and venous return to increase arterial pressure back to normal

64
Q

When you have hemorrhage what is the hemodynamic respose?

A

reflex compensation, then fluid reabsorption from the interstitial compartment, then decreased renal excretion and increased ingestion of salt and water.

65
Q

What is the summary of compensatory responses to hemorrhage?

A

Increased:

HR, Contractility, TPR, venoconstriction, Renin, angiotensin II, aldosterone, EPI an NOREPI, ADH

66
Q

What is the summary of effects of exercise?

A

Increased:
HR, SV, CO, Arterial pressure, Pulse pressure, AV 02 difference
DECREASED TPR!

67
Q

What is the summary of initial Response to standing?

A

Decrease: Arterial blood pressure, Cardiac output, stroke volume, central venous pressure.

68
Q

What is the summary of compensatory response?

A

Increase: (toward normal)arterial blood pressure, heart rate, (tn)cardiac output, (tn)stroke volume, tpr, (tn)central venous pressure.

69
Q

The renin-angiotensin system is powerful enough to return the arterial pressure at least (blank) back to normal after severe hemorrhage.

A

half way

70
Q

Greater losses of blood can lead to (blank).

A

severe tissue damage, irreversible circulatory collapse, and death

71
Q

Cardiac output is always (blanked) during exercise

A

increased

72
Q

Cardiac (blank) tends to slow the heart rate. Heart rate during exercise is increased by removing cardiac (blank); this will increase HR to ~ 100 bpm. After that, to increase the heart rate above 100 bpm during exercise, cardiac sympathetic tone must be increased.

A

vagal tone

vagal tone

73
Q

During exercise if you have three groups of people:
athletes, mitral stenosis pnts, non-atheletes, whose HR will have the lowest max? Who will be able to do the most exercise at lower heart rates?

A

all will have similiar but athelets will be able to do more excercise

74
Q

Stroke volume and cardiac output are (blank) proportional

A

directly

75
Q

In response to excercise (blank) is increased due to the work of the muscle pump and respiratory pump (this results in increased ventricular filling), and sympathetic venoconstriction in the splanchnic circulation shifting more blood to the heart.

A

EDV

76
Q

In response to exercise, (blank) is decreased due to activation of cardiac sympathetic activity which increases contractility.

A

ESV

77
Q

DURING exercise Increased (blank) will increase (EDV) via muscle pump, respiratory pump (mechanical) splanchnic venoconstriction (SNS)

A

Preload

78
Q

During excercise increased (blank) of heart will decrease ESV.

A

contractility (SNS)

79
Q

Where is CO the highest during exercise?

A

lungs, working muscle, skin

80
Q

During exercise when cardiac stimulation occurs, the sympathetic nervous system also changes vascular (blank) in the periphery.

A

resistance

81
Q

In (blank) sympathetic-mediated vasoconstriction increases vascular resistance, and thereby diverts blood away from these areas.

A

In skin, kidney, splanchnic regions, and inactive muscle,

82
Q

As cardiac output and blood flow to active muscles increase with progressive increases in the intensity of exercise, (blank) decreases.

A

visceral blood flow (i.e., to the splanchnic and renal vasculatures)

83
Q

During exercise, Blood flow to the myocardium increases, whereas flow to the brain is (blank). Skin blood flow initially (blank) during exercise and then increases as body temperature rises with increments in the duration and intensity of exercise. Skin blood flow finally decreases when the skin vessels constrict as total body O2 consumption nears the (blank).

A

unchanged
decreases
maximal value

84
Q

Muscle blood flow can increase 20-100 fold to exercising muscle. How?

A

By local metabolic vasodilation in exercising muscle

85
Q

(blank) are the most important for maintaining

high blood flow in the active muscles during exercise

A

Local mechanisms

86
Q

What are the local mechanism that are most important for maintaining high blood flow in active muscle during exercise?

A

Fall in 02, fall in PH, Increase CO2, Increase in potassium, lactate and adenosine

87
Q

What do these make possible in skeletal muscle during exercise?
Fall in 02, fall in PH, Increase CO2, Increase in potassium, lactate and adenosine

A

increased oxygen consumption over 100 fold

88
Q

(blank) increases muscle blood flow and leads to capillary recruitment, which decreases diffusion distances of nutrients.

A

Metabolic vasodilatation

89
Q

(blank) is always decreased during exercise

A

Total peripheral resistance

90
Q

Why is TPR always reduced during exercise?

A

1) mean arterial pressure will not rise too high in spite of the increase in cardiac output, and
2) an adequate portion of the increase in cardiac output will reach exercising muscle.

91
Q

In exercising muscle will diastolic change as much as systolic?

A

no due to the massive vasodilation the systolic will change more

92
Q

With all this metabolic vasodilatation in skeletal muscle during exercse, how is blood pressure maintained?

A

Through a balance of vasodilation and vasoconstriction resulting in regulation of blood flow and CO

93
Q

What does this:

  • Directs cardiac output to tissues with increased demand (heart, exercising muscle, skin)
  • Offsets vasodilatation, therefore stabilizes blood pressure
A

Vasoconstriction in non-exercising tissues

94
Q

Are the circulatory adjustments the same during dynamic and static exercise?

A

NO! In static you will have less vasodilation in working muscle due to compression of blood vessels with contraction of smooth mucle

95
Q

With more increasing intensity of excercise what happens to your TPR, your CO, HR, skeletal muscle blood flow and MAP?

A 
TPR will decrease more
CO increase more
HR increase more
MAP increase slightly
Skeletal muscle blood flow INCREASE dramatically!!

Block 2 Week 3 (9 decks)

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