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Physiology Week 4 > Integration of Cardiac Function > Flashcards

Integration of Cardiac Function Flashcards

1
Q

intrinsic mechanisms

A
  • local to the heart
  • mechanical/muscular
  • starlings
  • contractility
  • electrical/ionic, ionic concentrations`
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2
Q

extrinsic mechanisms

A
  • SNS- NE, B1 receptor, increases cAMP, tachy and increased contractility
  • PNS-Ach, M2 receptors, decrease cAMP, brady, decreased contractility
  • neuronal and hormonal signaling pathwats
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3
Q

CO

A

-proportional to oxygen consumption

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4
Q

increase CO

A
  • exercise
  • fever
  • anxiety
  • body weigh
  • pregnancy
  • hyperthyroidism
  • compensatory increases-chronic anemia, histotoxic hypoxia, pulmonary disease with hypoxemia
  • mild inspiratory hypoxia
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5
Q

decrease CO

A
  • sleep
  • aging
  • severe anoxia
  • acute hemorrhage
  • heart disease-acute MI, rheumatic fever, CHF
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6
Q

steady states

A
  • try and keep CO around 5
  • increase volume shifts venous function curve to the right
  • increase SNS shifts cardiac function curve to up, inc HR or SV
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7
Q

response to exercise

A

-mechanical and chemical

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8
Q

mechanical response to exercise

A
  • muscle pump increases venous return
  • increase in RAP
  • increase in end diastolic pressure
  • increase in SV
  • inc in CO
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9
Q

chemical response to exercise

A
  • increase CO2, dec O2, decrease pH
  • local vasodilation of active muscle increases venous return (which increases RAP)
  • also decreases arterial pressure
  • activates arterial baroreceptors (decrease AP- less PNS, more SNS)
  • increase in HR and SV, increase CO
  • vasoconstriction of inactive muscle, splanchnic, cutaneous, renal
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10
Q

SNS

A
  • heart stronger pump

- increases MSFP due to venoconstriction- same volume in smaller vessel

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11
Q

SNS

A
  • heart weaker pump

- decreases MSFP

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12
Q

phases of the cardiac cycle

A
  1. filling
  2. isovolumetric contraction phase
  3. ejection phase
  4. isovolumetric relaxation phase
    - mechanical and electrical events that occur during a heart beat
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13
Q

P

A

-atrial depolarization

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14
Q

QRS

A
  • ventricular depol
  • phase 0 upstroke
  • R onset of ventricular contraction
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15
Q

T wave

A
  • ventricular repolarization

- phase 3

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16
Q

ST segment

A

-plateau in AP

17
Q

TP

A

-ventricular diastole

18
Q

point 1 on cardiac cycle

A

during ejection the volume in the left ventricle falls from 120 mL to 50
-SV is 70
fraction is 70/120 58%

19
Q

point 2

A
  • ventricular filling occurs during early diastole when mitral and tricuspid valves open
  • atrial contraction occurs at the end of diastole and produces only a small rise in the pressure for both the right and left hearts, small increase in vent volume
  • atrial diastole during ventricular systole, atrial pressure rises, falls when mitral valves open
20
Q

point 3

A
  • diastole begins at the dichrotic notch when the aortic valve closes
  • left vent pressure falls when volume is increasing
  • forward momentum of blood entering ventricles distends the ventricles and drops pressure even though volume is increasing
21
Q

point 4

A
  • during systole, left ventricle pressure starts bigger to drive blood but then aortic pressure is higher
  • blood flows because forward momentum but flow is decreased
22
Q

filling phase

A
  • ventricles at relatively low pressure
  • AV valves open (tricuspid and mitral
  • ventricles fill with blood (50-120 ml)
  • P wave of EKG precedes atrial contraction
23
Q

jugular pressure

A
  • follows R atrial pressure
  • A -atrial contraction
  • C- closure of tricuspid valve
  • V- atrial filling and emptying
24
Q

isovolumetric contraction phase

A
  • QRS complex occurs
  • ventricular depolarization
  • ventricular muscles contract, no immediate volume change
  • ventricular pressure rapidly increase until reach aortic pressure AV valves rapidly close
  • pulmonary and aortic valves open
25
Q

ejection phase

A
  • once ventricular pressure exceeds that of the aorta and pulmonary artery
  • blood ejected from ventricles
  • dominant event of systole
  • T wave of EKG at half of outflow phase
  • at end of outflow phase, ventricular pressure decreases leading to isovolumetric relaxation
26
Q

isovolumetric relaxation

A
  • pressure rapidly drops in both ventricles
  • pulmonary and aortic valves close at the beginning of diastole
  • when ventricular pressure drops below that of the atria
  • mitral and tricuspid valves open
  • a new inflow phase begins
27
Q

SV

A
  • affected by changes in EDV and ESV
  • atrial filling pressure-increase impedes venous return decreases EDV and SV
  • ventricular filling time- increase increases EDV
  • ventricular compliance increase increases EDV
  • HR- increase-decreases diastole time, dec EDV
  • increase preload, increase EDV, increases SV (starling-more stretch increases sensitivity)
  • after load increase decreases ejection and increases ESV, less Sv
28
Q

rhythmicity

A

provided by intrinsic mechanisms of SA node

29
Q

atria

A

-contraction is a relatively minor component,

right before left

30
Q

ventricles

A
  • left before right
  • left like squeezing toothpaste
  • right contraction like bellows, approx same volume from both
31
Q

valves

A
  • mitral closes slightly before tricuspid because left ventricle contracts first
  • pulmonary pressure less than aortic so that opens first
  • aortic valve closes first too
  • tricuspid opens first
  • right sided valves open first
  • left sided valves close first
32
Q

S1

A

Lub

33
Q

S2

A

Dub

34
Q

s3

A

diastolic filling gallop

-recoil of ventricles with low compliance

35
Q

s4

A

atrial contraction gallop

-usually pathologic

Physiology Week 4 (6 decks)

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